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...
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 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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I attended a seminar last month cheekily called "Run like you stole it", all about running mechanics and how to avoid injury (and less so about pulling off successful bank jobs). While not all of us aspire to be runners, here are 5 tips I took away that will help with any activity. 

Tip 1: Get the diagnosis right
It is hard to know, if you have a spot in your foot that hurts when you do X, what the problem is but that's my job to figure it out, not yours or Dr Google. A good rule of thumb is - if you can't put weight on it and it's swollen up to twice its size, go to the hospital to get some scans. Achilles tendonopathy, heel pain, plantar fasciitis, knee pain, shin splints, patella femoral pain, ITB syndrome are the most common running injuries (not in order). 

Tip 2: The leg is a giant spring
Surprise surprise, even though the lower limb has proportionately more muscle than the upper limb, these muscles work together with tendons to store energy when your foot meets the ground, and release it to help your foot leave the ground. Tendons like the achilles and TFL can get injured when they lose this springlike quality in themselves and also when the surrounding musculature cannot absorb the impact going into the body. One of easiest ways to reduce the jarring is to walk or run softly. Instantly, you are activating your core and being mindful of how you land, instead of stomping.
 
Tip 3: Intrinsic foot strength is not just for dancers
 Flat or high arches - we used to think that we are stuck with them for life but the foot is a lot more adaptable. Don't throw out your orthotics just yet though, we want comfort and stability until the feet are stronger. Here is a simple exercise called foot doming if you want to strengthen your arches. You need to keep 4 points of contact on the ground - on either side of the mid foot and heel as shown - and shorten your foot and lift the highest point of the arch. Start sitting, then progress to standing, and one-legged. 

Tip 4: Skills before volume, volume before intensity
If you are looking to improve in your activity or start a new one, give your body time to adapt to the movement patterns. Break the movement down, strengthen individual muscles, then practice the whole action at a slow to moderate pace, before gearing up to the pace you would like to be at. If your goal is to win a medal at some level of competition, you should have a coach to design your training program to push you out of your comfort zone.
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Read more: Why "easy" days and "hard days" make a difference to your training

Tip 5: Shoes don't make a big difference
There are so many running shoes out there, which one should you pick? The most comfortable, is the answer. Studies have found there is no link between foot type, shoes and risk of injury. Overall, lighter shoes are better and if your feet feel supported in them, then you won't be overworking your leg muscles. Barefoot or minimalist shoes are better for strengthening your intrinsic foot muscles but you need a good 6 months to train your feet to get used to them.

I swear it was New Year's Eve, closed my eyes for a nap and it's more than halfway through February already! This year is going to go in a blur, pretty much like this amusement ride...

I've given the website a bit of a dusting over, hopefully you'll find the information you need, always happy to take on suggestions. 
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I'm going for a runner's workshop next week, and am looking forward to sharing what I've learnt. 

My last day of appointments before Christmas is Saturday morning Dec 22.

I have appointments available all day Sat Dec 29th, Wed Jan 2nd & morning of Sat Jan
5th.

​I will be taking a break in Singapore from Wed Jan 23rd to Sat Feb 9th. I will be back
at work Wed Feb 13th.

 I am away for a course with Dr Jealous next Thursday in Ashland, Oregon. I will be back treating on Saturday Dec 9. 
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Looking further ahead, I will be working until Dec 22, having a week off for Christmas and back in the first week of January 2019. More details to come...

I was in Singapore recently to study visceral osteopathy, something I've been interested in since uni but never had the time to explore. A lot of the traditional knowledge on visceral technique has been accumulated and further refined by French osteopath JP Barral, with some impressive results. You can watch a video of him here.

The course was also well-timed so that I could hang out with family and friends for two weeks after. Most of the great eating took place then... to avoid any embarrassing sounds while in class!

My first available appointment in Thornbury is from Wednesday July 25 and in Seddon from Friday July 20. Email me if you would like to be on the waitlist for an earlier appointment.