Nelson's Log

MATTRESSES
I have been thinking about mattresses recently. Patients are asking about them all the time but the time has come for the Nelson's to invest in a new mattress, and what an investment it is! Apart from a good nights sleep, the effects on the back, neck or shoulders can be dramatic if the mattress is uncomfortable. And to get a reasonable mattress one's got to fork out a considerable chunk of one's hard earned money!
13 or 14 years ago when we bought our present mattress I was attempting to educate Irina quickly about the optimal sleeping surface as we viewed mattresses. Unfortunately there are times(most times) when she does not see me in the exalted osteopathic light that I feel is my due! So despite my exhortations to go medium and supportive her instincts were saying hard, orthopaedic and wooden floor-like. So, as a compromise, we ended up with one of those doubles that you zip together and the end result for me was years of sleeping bliss and for her, well, I think, years of the opposite.
Of course, I hasten to add, I have memories of, in the earlier years of this mattress chivalrously offering to swap sides of the bed only to be declined. This is called living with(or in Irina's case sleeping with) the results of a poor decision. I refer to the mattress here, not myself!

If a good quality mattress feels uncomfortable and you suspect it is somehow damaged and it is still in guarantee some retailers will send an independent assessor from "The Furniture Ombudsman" to see if you are entitled to a new mattress.

POSTURE
There has been a lot written and said about posture in the media recently. Headlines such as "Sitting is the New Smoking" and "The Positive Effects of Power Pose before an Interview".
Apparently sitting for too long can negatively affect your cardiovascular as well as musculo-skeletal health. So standing to read and work is the way to go. Then add to this the positive psychological and neuro-humero-physiological effect of the way you stand. Amy Cuddy, at The Harvard Business School, did research on standing poses and found that certain poses led to a more positive and more confident psychological outlook, as well as an increase in testosterone/adrenalin and decrease in cortisol (the stress hormone).
My reaction to all of this is that if all it takes to somewhat improve our physical and psychological health is standing more at work and standing well what are we all waiting for. Simple.

EXERCISE AND INJURIES
Recently loads of people have said to me "what's the point in this exercise lark if the whole time I am getting injured". I certainly sympathise with this view as if I had not constantly got injuries doing my sports I probably would'nt be an osteopath today. As a child and teenager playing front row rugby did not do a whole lot of good for my upper back and shoulders. Then in my 20s my steady, arduous climb to Judo black belt lead to further injuries of the low back, hips, shoulders and hands. Running all my life has probably not been great for my hips and knees.
On the other hand if I had not done all this how would my mental and physical health be today. There is no answer to that but now I am older and, I hope, wiser. I can now see the benefits of exercising slightly more cautiously. Pacing oneself, varying the exercises and demands on ones body. But one has to keep on going because movement is so important.

MISINFORMATION
Recent articles in the press have seemed to misrepresent the guidelines of NICE(National Institute for Health and Care Excellence). In The Times today the Health Editor, Chris Smyth wrote an article with the entirely misleading title: Pilates not painkillers the best cure for backache. This is so misleading in so many ways. NICE guidelines still include medication, manual therapy, psychological therapies and exercise for non invasive management of low back pain and sciatica. Pilates not mentioned even once.
Of course, for balance, however, the benefits of pilates are wonderful for back pain and sciatica, as are yoga, personal trainers, gym based exercise and stretching.
Another grumble I have is that where NICE use the expression "manual therapy" articles in the press translate this to physiotherapy. Why do they do this? I don't know. Do they think people do not know what manual therapy is or is there still a general bias in favour of physiotherapy?

EXERCISE
To add to my comments on exercise and injury, I do think it is important to stop and think before exercising. Is the intensity too high? Is the quantity too much? Perhaps there has been a 6 month lay-off period for some reason; do you start up exactly where you left off or do you escalate slowly? Likewise, a first time exerciser of whatever age must pick it up slowly. Enjoy it! Exercise is for life; you cannot get fit in one day or one week. Build it up slowly.


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