To me, moving with ease means making a complex thing look easy; having control in a chaotic environment; being able to access dynamic power; moving without fatigue or risk of injury. What does moving with ease mean to you?

We can get stuck in compensatory patterns from old injuries or postural habits, and our brain forgets how to move efficiently. Or perhaps we've only learnt how to run/lift/squat by copying someone else, forgetting that they have different body shapes to us!

 Poor movement - whether repetitive or just the once - can lead to pain and injury. We've all heard of someone who put their their back out putting on socks. While manual treatment can solve the pain problem at the time of injury, it doesn't always prevent recurrence.

I've been exploring the art of movement coaching with the fabulous Joanne Elphinston since the start of 2020 and it has changed the way I give patients exercises and stretches. It has also allowed me to explore my own movement and troubleshoot my dodgy ankle with good success. I've felt incredibly fortunate to have discovered this resource during the Covid-19 pandemic, because the format of movement coaching really suits Telehealth!

It is almost a separate beast from an osteopathic session, because the focus naturally shifts to the patient gaining an awareness of what is happening in their own body rather than for the practitioner to make the correction. While there are now there are plenty of online cardio or strength-based pilates and gym classes, what I am doing in these sessions are giving specific, individualised movements geared towards neuro-muscular integration i.e. how do we teach your brain to find the easiest and least painful way to perform an action?

Some ideas:
- Do an online course. Laurie Santos has made her Harvard course The Science of Well-Being available for free on Coursera. Or take up a language, there are many free apps for this like Memrise or Duolingo.
- Follow an exercise routine. I started a GMB paid programme last year but never completed it but this might be the time to restart! I loved feeling stronger when I was doing it. The Guardian has a round-up of the best home work out websites - regardless of your level of fitness. PE with Joe on youtube has fun routines to do with the kiddies.
​- Reflect on the irony of human existence - THIS is the moment where staying home and watching TV is the best thing you can do for your country. On my watchlist are Outlander and House of Cards, let me know if you have any recommendations!

- Take the time to say one nice thing a day to each person in your household. It can be easy to be short-tempered with someone, especially when there is so much anxiety around our health, our finances and our future. I follow psychotherapist @sitwithwhit who offers great bite-sized practical advice on setting boundaries and keeping a balanced outlook on life.
- Journaling in all its forms, whether writing a diary, or making art, is very therapeutic.
- Watch the animals at Melbourne Zoo via live cam while you take a break from work. I'm also going to be posting short 1-minute videos for what you can do in your work breaks to keep active, so stay tuned.

The Covid-19 pandemic is unfolding very quickly, and after reviewing all the current information, I will still be taking appointments unless instructed otherwise by health authorities. 

To help everyone and their families young and old stay safe, I will not be treating if I feel unwell, and appreciate that you will do the same. 
 
If you have been overseas in the last 14 days or in contact with anyone who has tested positive for Covid-19 AND feeling unwell, please call the dedicated hotline 1800 675 398. Find out the latest updates from Victoria's Health and Human Services here.

In the meantime, there are plenty of things you can do to help flatten the curve, including
​- Social distancing. Perhaps it's time to pick up a new indoor hobby?
- Washing your hands with fancy soap
- Checking in on others (see below for a card you can print out)
​- Looking after your own health and immunity with lots of sleep, good food and some exercise

Functional movement is the new buzzword in fitness circles, but what is it actually? This is how I have seen it being used so far:

• In a gym setting, with light weights and elastic bands
• Doing body-weight animal style movements like frog hopping and crawling
• Doing exercises specific to helping with everyday movements like sitting in a chair compared to improving the maximum weight you can lift.

I've just done a course that has blown my mind in terms of what functional movement is.
Joanne Elphinston is an Australian-trained physiotherapist who has come up with a different way of how we construct movement by going all the way back to proprioception - simply put, does your brain know where your body is in space?

You may think this is too basic, but I tried this with my dodgy left ankle and realised, when I touch the outside of my foot, I feel it both on the outside and inside of my foot! Freak out moment! So, one reason I keep re-injuring my ankle is because my brain doesn't know which side of my foot is in contact with the floor.

​Joanne showed us lots of cool ways we can re-engage this brain to body connection, as well as postural cues to help muscles, joints and ligaments work more efficiently together. It's dovetails  nicely with a central tenet of osteopathy, that the body functions as one unit. While there still is a role for strengthening and stretching, it is more important to ask, "why is this structure overused and how can we get other structures to share the load?" Are there other ways to move but the brain is avoiding them out of fear or poor body awareness?

I will be practicing these techniques on myself, and am happy to keep everyone updated on my progress, but do get in touch if you are keen to give this a go for your niggles.

Here is one simple exercise you can try:
Go down on all 4s, the starting position for cat and camel. Often, we can hold too much tension in our neck and mid back. Now, imagine you are a kitten (or lion cub), being picked up gently by the scruff of your neck by the mama cat. Feel how you automatically relax through your chest and neck? Meow!

Just leave us your name and email address to win 1 vegan food wrap set from Wrappa. Entries close  midnight 15 Dec 2019. Winners will be picked at random and will be contacted by email on how to pick up their prize.

Wrappa is made in South Australia and use certified organic cotton, either local-filtered beeswax or plant-based wax (VEGAN friendly), damar resin and jojoba oil. I really love their designs! Click here if you like these wraps and want to buy them.

The Guardian has an interesting article about cartilage regeneration in joints. Here is an except:
"Contrary to popular opinion, humans can regrow cartilage in their joints, researchers have found. Experts hope the research could lead to new treatments for a common type of arthritis.Osteoarthritis, in which joints become painful and stiff, is the most common form of arthritis and is thought to cause pain in about 8.5 million people in the UK alone. It is caused by a breakdown in the cartilage that protects the ends of the bones, as well as the growth of new bone around the joint as the body tries to repair the damage.
It has long been thought that adult humans are unable to produce new cartilage, unlike a number of animals, including salamanders, which can not only repair damage to joints but grow whole new limbs."
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What I've found in practice is that x-ray findings don't always correspond to pain. If you went out and x-rayed 100 random people on the street, more people would have evidence of osteoarthritis on film but not report any pain. In this group of assymptomatic people, perhaps their cartilage is able to repair better. 

What can osteopathy do for osteoarthritis? We try to deload the affected joint by improving mobility in the joints above and below, decrease the swelling, improve blood flow to help the body repair the affected joint, and finally, give appropriate exercise and other management strategies to help you continue in the activities you enjoy, eg gardening.

Is fasting just a fad? What if you don't need to lose weight? We look at insulin resistance and break down the jargon - 5:2, fast 800 and TRE!

Fasting is not new, it has been commonly done as a form of purification in a religious setting but recent studies are shedding light on how it actually works.

When you fast, your body saves energy by recycling old or damaged cells and switches to burning fat. When you break your fast, your body responds like the desert after rain. It starts creating new white blood cells and may help reset the immune system.

When the brain is using fat as fuel instead of glucose, it also secretes BDNF (brain-derived neurotrophic factor), which is thought to prevent dementia by strengthening neural connections and increasing the production of new neurons.

Regular fasting helps to improve insulin resistance and lowers blood sugar. Insulin resistance is when your muscles and liver become less sensitive to the release of insulin (see above). When this happens, your pancreas is working harder, you start storing fat around your organs instead of the usual places and yet you still feel hungry all the time.

Dr Michael Mosley says: "It's as if you're constantly pouring money into your bank account, and then finding it incredibly hard to get it out again. High levels of insulin prevent your body from accessing and burning its energy supply."

I've been a fan of Dr Mosley's books and TV shows as the advice seems sensible and backed up by research (both proper trials and testing on himself!) He has popularised several diets based on fasting:

•  Originally the 5:2, which is 5 days of normal eating and 2 days of fasting (500 - 600 calories per day). 
• The blood sugar diet, which is 8 weeks of reduced calorie intake (800 calories a day).
• The fast 800, which is a combination of the blood sugar diet to kick-start weight loss then followed by a modified 5:2 but having 800 calories instead of 500 on the 2 fast days. It also includes time-restricted eating (TRE). I used to think that rapid weight loss was bad for you but it is actually okay as long as you get adequate protein (don't just drink cabbage soup). It also lets you taste success early and gives you motivation to keep going, as well as more energy to then start exercising.
• Time-restricted eating is where you only eat during a 8 to 12 hour window during the day, eg 9am to 9pm, or 8am to 4pm. By itself, it is not enough to lose weight but it gives your digestive system a chance to rest and clear out the old cells and debris. 

If that was confusing, here's the take-home message...
​
 If you are at a healthy weight, some fasting may still benefit you. The easiest way to do it is by time-restricted eating, for example, have an early dinner and not snack after that.

 If you are looking to eat more healthily, low-carb with adequate protein and fat is the most sustainable and tastiest way to go.

 If you are healthy but want to lose some weight, have clear goals and restock your fridge and pantry with alternatives that you can eat safely. You can experiment with the 5:2, fast 800 or any other combination along with increasing your exercise.

 Fast-paced exercise e.g. 3 bursts of 10 minute brisk walking versus 10000 steps a day is easier to do and to stick with long term.

 Getting enough sleep is also key to having fewer food cravings in the day.

 If you have a health condition or are pre-diabetic, please seek medical advice or inform your health professional before starting on any diet.

This is from our winter newsletter.

The effects of trauma can persist long after the provoking incident, both for the sufferer and their families. I've always wondered how the body "stores" memories of trauma as patients have had both emotional responses when part of their body releases.

So, I've been thinking how trauma is a whole-body event, and have started reading The Body Keeps the Score by Bessel Van Der Kolk. I also recently attended a seminar that touched on the issue. I never knew that humans and most large mammals respond to threats in this order:

1) When we are first threatened, we turn to social engagement, for example, calling out for help, talking to a loved one or seeking support from our friends. We signal our distress and get others to come to our aid with our facial expressions or change in tone of voice.
2) If no one comes to help, we go into primitive fight or flight - beat off our attacker or run away. Our sympathetic nervous system takes over, it raises our heartbeat, diverts resources from our digestive system to our muscles.
3) If all fails, we go into freeze or shutdown to conserve energy. When this dorsal vagal system is activated, our metabolism shuts down, our heart rate plunges and we can even stop breathing. We may disassociate from the moment and our bodies, the effects of which last beyond the traumatic event.
Trauma sufferers can be "stuck" in (2) or (3) and unable to go back to a normal functioning of their nervous system. In addition, researchers are discovering that trauma can change the firing in the brain permanently, so some midline and frontal sections don't turn on but the fear centre is always on red alert. This explains why when sufferers experience a flashback or trigger, they lose their sense of the present and feel the trauma happening again as if it was fresh.

There are many methods to help sufferers deal with trauma, one interesting idea is the body needs to complete the stress response in a safe environment. My personal experience with this came while receiving a treatment for lower back pain. I felt my leg tense up, and I immediately recalled being in the surf and bracing against a big wave. My body obviously remembered the strain (even though I forgot it) and needed to finish what it was doing at that time of the injury before my nervous system could reset.
Why do some people suffer from trauma more so than others? While we don't know for sure, our mindset and interpretation of the traumatic event seem to make a difference, as well as our resources. People with a sense of life's purpose, who have better physical capability and social support usually recover better.

If reading this has caused any distress, you can call Lifeline at 13 11 14.
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