I’ve enjoyed the last couple of months reengaging with physiotherapist and teacher Joanne Elphinston in her ART of movement online course. It has really added to my understanding of how to change painful patterns and teach more efficient ones.

One of the cool things I’ve discovered through her work is our body needs a certain amount of tension in fascia and the tissues for us to stay upright. Otherwise, we might as well all be jellyfish. However, if we contract all our muscles, we stiffen up and are unable to move - this is known as the ‘suit of armour’ strategy. Our bodies go from being able to produce finely calibrated movements to only knowing where they are when there is a lot of tension in the muscles.

Our bodies are constantly sensing where we are in space, but injury, stress and hypermobility can interfere with this feedback mechanism. It is as if we become deaf to quiet sounds and can only hear loud noises. What do you do when you can’t hear? Turn the volume up even more! 

​Helping to restore our body’s proprioception is a clever way to improve our balance and get more out of any exercise that we do.​

There are many methods to do this: An easy one that I’ve done in martial arts (without realising its significance) is body slapping or tapping.

First, let's check out your balance on one leg. Now, start with rubbing your palms together quickly, until there is some heat. Then slap or tap both arms, on the outside and on the inside. You want loud, rhythmic noises. Do the same over your chest and belly, over the underwear line in the groin, any part of the back you can reach and finish patting or slapping down the front and back of your legs. At the end, stamp your feet a couple of times. 

​Now for the shakes. Start with your foot, then the knee, and add the hip. Shake it forward and back, and also side to side. Repeat on the other side and follow the same idea for the wrists, elbows and shoulders. Let's look at your balance again. Has anything changed or does anything else feel different in your body? Let me know!

The Department of Health and Human Services (DHHS) has released the updated personal protective equipment (PPE) guidelines for allied health over the weekend, and we now have confirmation of the changes from ‘mandatory’ wearing of face masks in a clinical setting to ‘recommended’. You can read about the changes on the DHHS website here.

In practice, this means both practitioner and patient should wear face masks if:

• you are considered to be in vulnerable health or immuno-compromised
• you work or have been in contact with frontline COVID wards, quarantine systems or international flight crew

All regular santitisation of the clinic will continue between patients.

A couple of people I know had falls in the last month - myself included - so I’ve been thinking about what we can do to prevent falls and injury at any age.

Sometimes being at risk of falling is a result of a health issue, like poor eyesight, incontinence, change of medication or a neurological condition. Be sure to check in with your GP or myself if you feel like your balance has gotten worse recently. Here are a few commonsense tips for around the home:

• Identify and fix up any trip hazards in your living space.
• Get rid of shoes with poor grip, watch your laces.
• Don’t rush chores, take the time to be careful.
• Plan your path and make sure you will have access to any walking aids (if you use them). For example, don’t leave your stick behind at the other end of the house.

​NSW Falls Prevention have a nifty strength and balance video that anyone can do. All you need is a chair and a stretchy exercise band/theraband. I highly recommend it!

Good fall prevention is also about how we recover after we’ve lost balance. This is a simple one that I like to do for balance and coordination. Imagine you are standing in the middle of a clock-face. In front of you is 12 o’clock, to the left is 9 o’clock, to the right is 6 o’clock and behind you is 3 o’clock.

1. Keeping your weight on your back foot in the middle of the clock-face, tap one foot out at 12, 6 and 9 o’clock. To tap at 6 o’clock, take it across your body.
2. Do the same with eyes closed.
3. Can you do this slowly or can you do it fast with tapping 3 times? You can also get someone to call out any number from 1 to 12, and see how accurately you can respond.
4. Step one foot forward to a number but this time transfer all your weight on the moving foot so that you end up with both feet on 12. Do this with eyes open and eyes closed.
5. Now step out slightly wider than what you have been doing, see if you can still keep your balance. How wide can you go before you lose your balance? Can you regain your balance by moving the other foot or your arms?
6. Step forward and balance on the front foot, almost like a hop.
7. For a height or step challenge, stand on a footstool and step down as you go forward, backward, left and right. Make sure the step is secure before doing this!
8. Go back to any of the easier steps, and as you do it, get someone to give you a little tap/push sideways on the shoulder to simulate being bumped. See if you can recover your balance.

Here are some short videos if you need to visualise!

I read an interesting article about pain recently: Can reframing pain make it go away?
​​Quite possibly - is the short answer. 

When we feel pain, it is the result of a complex interplay of emotional and physical factors. A stubbed toe when you are trying to save a falling baby, versus the same mechanical injury after you've had some bad news over the phone, could feel very different. 

The story we tell ourselves about injury and pain can also make a difference in how we recover. As medical science improves, we expect that we can fix everything with the right pill or treatment and can become despondent when it doesn't happen.

Studies have shown that when people are able to reframe and find meaning in a painful experience (this could be a physical like a toothache or an emotional one like heartbreak), their brains activate the body's natural painkillers and the person then becomes more tolerant to pain. 

Often, the fear of being in pain can be worse than the pain itself. Sometimes, stopping that anticipation loop can help you discover micro-movements in which you are pain-free. With all osteopathic treatment plans, we aim to rebuild your confidence with a gradual return to activity and will support you through the whole process of healing.​

Posted by David Attenborough

WHEN I AM AMONG THE TREES
by Mary Oliver
When I am among the trees,
especially the willows and the honey locust,
equally the beech, the oaks and the pines,
they give off such hints of gladness.
I would almost say that they save me, and daily.
I am so distant from the hope of myself,
in which I have goodness, and discernment,
and never hurry through the world
but walk slowly, and bow often.
Around me the trees stir in their leaves
and call out, “Stay awhile.”
The light flows from their branches.
And they call again, “It’s simple,” they say,
“and you too have come
into the world to do this, to go easy, to be filled
with light, and to shine.”

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.