- have a baseline assessment
- set specific goals
- develop a realistic rehabilitation programme
David Rigg was able to make a substantial difference to this climber's longstanding hand injury which was interfering with his training before the Petzl RocTrip Argentina. Dave emphasises the need to
For a link to some early video clips about the trip go to http://www.youtube.com/watch?v=4MAqC8_hL6E. The full video won't be available until next April/May.
The Royal Family hit the headlines this morning with reports of Kate Middleton being admitted to hospital with severe vomiting in pregnancy.
Morning sickness is a condition that occurs naturally during pregnancy. Studies show that between 50-80% of all women experience some nausea or vomiting while pregnant, which usually subsides with time.
However, between 1-2% suffer a condition known as hyperemesis gravidarum - morning sickness which is so severe and long-lasting that it can cause weight loss, dehydration, and even hospitalisation.
Could acupuncture help?
Research has established that acupuncture is successful in treating sickness from any cause. It has been used for several decades for treating seasickness, nausea and vomiting after operations and in women recovering from breast surgery, including mastectomies. A study from Australia shows that acupuncture can help relieve morning sickness for pregnant women.
"Women now have an additional option to manage their morning sickness" said research co-ordinator, Dr Caroline Smith. "Our results have shown that as little as one acupuncture treatment can significantly change the way these women feel."
The study involved nearly 600 women who were less than 14 weeks pregnant with symptoms of nausea or vomiting.They were given weekly 20-minute sessions of acupuncture for four weeks. Dr Smith, from the Women's and Children's Hospital and Adelaide University said: "We found that acupuncture reduced nausea throughout the trial with dry retching being reduced from the second week."
Hyperemesis - the more severe form of morning sickness - can also be helped
Another study, which was only carried out on a small number of women, also demonstrated benefit for the group of women who are severely affected.
However limited, the authors said the study "confirms the results from other studies on the effectiveness of manual acupuncture, acupressure, electroacupuncture, and transcutaneous electrical nerve stimulation in the acupuncture point PC6 against different types of nausea/vomiting." They concluded that although further testing must be conducted, "the present study · strongly indicates that acupuncture has a clinically useful effect in hyperemesis gravidarium."
Carlsson C, et al. Manual acupuncture reduces hyperemesis gravidarum: a placebo-controlled, randomized, single-blind, crossover study. Journal of Pain and Symptom Management October 2000;20(4):273-279.
A DIY treatment
This is definitely one that you can try at home, and we always suggest this first when women ring up to ask about acupuncture for morning sickness. The wrist bands that you can buy for seasickness and travel sickness at Boots, Sainsburys and the other major chemists stimulate the same acupuncture wrist points that were used for the study above. They have also been used successfully for the treatment of sickness after operations and with chemotherapy.
They will cost less than £10. They come in pairs but you only need one. One large study with patients who had sickness because of chemotherapy showed that the best effect came from;
If that doesn't work, then it is worth trying some acupuncture.
Figures just released by the NHS show that fewer than 20% of people who have a cardiac arrest in the UK will survive, because bystanders don't know what to do. This is an appalling statistic - in Seattle in the US, and Stavanger, Norway, the figure for survivors is 52%, because many citizens and schoolchildren have been trained in CPR, and know how to respond.
The British Heart Foundation has produced a short YouTube video, starring Vinnie Jones, to show you what to do. They know of 28 people who are alive because bystanders were able to carry out CPR after watching this video clip.
Please watch this now - you may save a life!
Lack of sleep makes fat cells sluggish
You know that not enough shut-eye makes you irritable, but did you know that lack of sleep has also been linked to diabetes and weight gain? Researchers had not understood why, although one theory links it to a rise in the stress hormones, cortisol.
Some recent research, recently reported in New Scientist 20 October 2012, from the University of Chicago suggests another answer (Annals of Internal Medicine, DOI:10.7326/0003-4819-157-8-201210160-00005).
Matthew Brady and his team tested fat cells taken from the bellies of seven adults who slept for 4 nights for up to 8 and a half hours and then another 4 nights for only 4 and half hours.The team found that after sleep deprivation fat cells were 30 percent less responsive to insulin (a hormone that makes muscle, liver and fat cells take up glucose after a meal). This leads to higher blood glucose levels which are linked to diabetes. Fat cells also release the appetite regulating hormone leptin, and this mechanism may also be disrupted by lack of sleep.
The researchers were surprised by the strength of the response to lack of sleep. As they pointed out, four nights of sleep curtailment "represents a real world situation, such as sitting for final exams or having a newborn in the house".
A 3 minute phone call will help develop a simple test for diagnosing Parkinson's Disease.
Parkinson's is a devastating disease for those living with the condition and currently there is no cure. Diagnosis can also be slow as there are no blood tests to detect it.
But now mathematician Max Little has come up with a non-invasive, cheap test which he hopes will offer a quick new way to identify the disease.
Watch his presentation at a TED conference in Edinburgh earlier this year, explaining the principle of the test and see how you can help to make it better.
Max is looking for volunteers to contribute to a vast voice bank to help the database to learn even more. He is aiming to record up to 10,000 voices and has set up local numbers in 10 countries around the world. In the UK the number is
Anyone can call and they need to state whether or not they have been diagnosed with the disease.There is also a website where people can find out more about the project. "The more people that call in, the better," he said. "If we get 10,000 recordings we'd be very happy but even a tenth of that would be great,"
Are your headache pills giving you a headache?
More than one million people in Britain may be suffering from constant, crippling headaches because they are taking too many painkillers, experts say.
The pills people take to relieve headaches and migraines may be making things much worse, according to the National Institute for Health and Clinical Excellence (NICE) in guidance to the health service for England and Wales.
So the tablets you take to relieve that awful headache may well be just making matters worse.
The problem begins with taking the odd painkiller for tension headaches or migraines, which usually works. But some people take the pills more and more often, until they are on tablets for more than half the days in a month. Nice says that if this goes on for more than three months the medication ends up causing the problem it is intended to cure.
At risk are those who are taking paracetamol, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, for their headaches, either alone or in combination, for 15 days a month or more. (Bear in mind that long term use of paracetamol and NSAIDs also increases the risk of developing Alzheimer’s disease).
The risk of increasing the number of headaches or migraines is also carried by migraine sufferers taking triptans, opioids, ergots or combination analgesic medications for just 10 days a month or more.
“It may get worse before it gets better”
The solution is far from easy. Manjit Matharu, honorary Consultant Neurologist at the National Hospital for Neurology and Neurosurgery, said people needed to stop taking the painkillers completely.
"For the first two to three weeks, they are likely to have a severe rebound. They will have an awful two to three weeks. Patients understandably worry about how they are going to feel in the middle of a withdrawal," he said.
"What I do is make sure that anybody who is going through a withdrawal and [who] I know will be in a huge amount of pain does not have the usual responsibilities." He will write sick notes to excuse people from work and call relatives to make sure there is support. "We find if we do this, in a supportive manner, it is quite successful, 80% of patients successfully do it when you outline to them that there is an awful phase but you will feel much better after it."
What’s the alternative? Acupuncture is good, says NICE
The NICE guidelines on the management of headache published in September are a little confusing in that having recommended patients stop their medication and analgesics, doctors should then prescribe analgesics, such as NSAIDs, and triptans!
One positive statement though is that patients should be offered a course of acupuncture for tension type headaches. They recommend up to 10 treatments but our clinical experience has been that usually 5 or 6 treatments are enough.
The guidelines only talk of acupuncture for tension type headache, but our clinical experience,again, has been that it is very effective for migraines and hormonal and period related headaches too. There has been a very large study in Germany which showed the benefit of acupuncture for migraine and there was a British study demonstrating that acupuncture was more effective than conventional treatment, which was actually carried out at the National Hospital for Nervous Diseases (as it was then).
Other ways - exercise and osteopathy
Regular gentle exercise - yoga, pilates, swimming and walking, will almost certainly help to reduce tension type headaches. Many headaches are due to problems in the neck and these may well be helped by gentle osteopathy which looks to find the areas of tension and stiffness and then to relieve them by achieving more mobility and flexibility.
NB Any persistent or sudden severe headache should always be checked by your doctor first.
Bigger than the Olympics?
London 2012 looks as though it will be the most successful Olympics of all time for Britain. Jessica Ennis, Bradley Wiggins, Ben Ainslie, Mo Farah, Andy Murray... the medals kept coming. But the Olympics are for youngsters – few will still be competitive beyond the age of 32.
Even the brilliant opening ceremony by Danny Boyle was a celebration of the young. The oldest participants (excluding the Royals) were Paul McCartney and the NHS, and Sir Paul looks in better shape.
Next year though is the World Masters Athletics (WMA) to be held in Brazil – 50,000 athletes are expected to take part. That's a lot more than the London Olympics. Although some will be older elite athletes, including some past Olympians, many of them will be newcomers to sport and exercise.
The WMA was founded to encourage sport in women over the age of 35 and men older than 40, but the message may be“You’re never too old”. Charlie Booth the Australian sprinter won gold at the age of 99 (maybe because he was the only entrant in the 95+ age category). Another Australian, Vic Younger, aged 90, took 8 gold medals and 2 silver in weightlifting and athletics. He only took up exercise at the age of 60 when he retired from work.
Grow old disgracefully – down with ‘normal’ aging!
It’s easy to dismiss these as exceptional examples, as not normal. We may think that there are two separate races of humans; those that can and those that can’t. Perhaps this is nowhere more obvious than in the US where the country that has the highest rates of obesity in the world is top of the Olympic medal table. We seem to believe that getting older has to be accompanied by illness, infirmity, suffering and increasing reliance on medication. This is accepted as ‘normal’ aging.
But the research evidence of hundreds of studies on older adults and physical activity show that regular and moderate exercise can
cut age declines in half and reduce disease risk by 50%. Studies show that people feel better right away (less aches and pains, improved mood, better sleep, alertness, more energy, improved flexibility) and in time do better (get stronger, less breathlessness, lose weight, improve their memory, avoid diseases and reduce the risk of stroke, diabetes, cancer, premature heart
disease and early death). They are getting older but they are staying fitter and enjoying those extra years.
There are several reasons why older people choose not to exercise – fear of injuring themselves, fear of embarrassing themselves and looking foolish, the belief that older people just don’t run or jump or swim or whatever. But in developing countries and more primitive cultures physical exertion does not stop at age 60 or 65. Exercise is a necessary part of life and these societies do not suffer from the Diseases of Western Civilisation (cardiovascular disease, obesity, osteoporosis, diabetes type 2, some dementias).
Sitting still will kill you
Sedentary living (not exercising) leads to the same risks as those experienced by a 20 per day smoker. For thousands of generations humans needed to expend large amounts of energy simply to get their food (either hunting wild animals or scavenging and gathering nuts and berries). We still carry those genes within us. But modern lifestyles mean that we hardly exercise by comparison with our ancestors, and this lack of exercise is what leads to obvious disease.
Well-derly or ill-derly?
Fortunately we now know enough about the effects of exercise in the body to reverse much of the damage that inactivity brings. We
don’t actually need to do a great deal but what we do need to do should be brief, high intensity, and include resistance training (usually weight training). One study encouraged a group of 90 years olds (the oldest was 98!) to follow an 8 week programme of high-intensity resistance training. They registered an astonishing 174% increase in leg muscle strength, with an improvement in walking speed of 48%.
Because exercise has such a huge influence on whether or not we suffer from chronic disease, you can largely choose whether you will be well or ill in old age;" well-derly" or" ill-derly".
“Just do it”
Has more than 30 years experience in practice as a medically qualified osteopath and acupuncturist.