[mctrials23]

As I near the ripe old age of 28 I am starting to think more and more about my long term health and mobility. Since I started climbing again I have been a lot more focussed on non-climbing exercises to build strength outside of my twice a week wall sessions and. Some of this is purely for strength and general antagonistic training and other areas address flexibility and mobility.

Things like deadlifts have shown me deficiencies in my lower body and especially ankles. I have had minor back issues for about 10 years now but they come and go in short amounts of time and I can't pinpoint what triggers or fixes them. I injured my shoulder about 6 months ago.

Basically I feel like I am in need of a general once over from an Osteo / Physio to try and fix some of these issues once and for all. One of the things that seems to become more apparent the more I read is that just because you cannot move A very well doesn't mean that B is not the cause or even F.

Can you get someone to check all parts of the body for range of movement, imbalances, postural issues, scar tissue impingements etc? Have any of you had it done?

[tomtom]

Osteo or a GOOD physio (or good Osteo for that matter) could help? Mine helped sort out my herniated discs - but spent alot of time working on my thorasic spine - which in his words has probably not moved since I was a a teenager... Back problems probably linked to poor posture giving over S shaped spine - as top of back was inflexible etc...

Theres a fair ammount of snake oil going on I suspect , but it seemed to make sense...
TT

[tommy_k]

Are you aware of mobilityWOD and the associated book "Becoming a Supple Leopard" by Kelly Starrett?

It basically covers whole body movement, flexibility, mobility etc. and shows you ways how to address them on your own.
I know there is a bit of controversy regarding a lot of the material out of the Crossfit corner, but if you don't take everything for face value but use your own head too, there is some really good stuff in there which might be able to help you.

I also doubt that there is a "one stop solution" that will fix everything right now and forever. It is probably much more of an ongoing process and just as in climbing you'll have to keep working on to maintain a healthy body.

Just a thought ...

[Paul B]

Are you aware of mobilityWOD and the associated book "Becoming a Supple Leopard" by Kelly Starrett?

It basically covers whole body movement, flexibility, mobility etc. and shows you ways how to address them on your own.
I know there is a bit of controversy regarding a lot of the material out of the Crossfit corner, but if you don't take everything for face value but use your own head too, there is some really good stuff in there which might be able to help you.

Do you mind summarising, as mobilityWOD seems to be a bit of buzzword atm?

[mctrials23]

Are you aware of mobilityWOD and the associated book "Becoming a Supple Leopard" by Kelly Starrett?

I've used a few bits and bobs on that site already. He seems to know what he is doing. The crossfit association I think is just because he does crossfit and as a result helps a lot of them. I can't imagine he is a crossfitter that just dabbles in the mobility stuff. Seems like his day job.

I also doubt that there is a "one stop solution" that will fix everything right now and forever. It is probably much more of an ongoing process and just as in climbing you'll have to keep working on to maintain a healthy body.

Thats kind of why I want to do this now. Lots of people with these issues are talking months / years of work to get to where they should be. I'm pretty heavy for a climber so I fear that the more stress I put on my body from climbing as I get into the harder grades will be quite likely to find any big issues.

[Sloper]

Osteo or a GOOD physio (or good Osteo for that matter) could help? Mine helped sort out my herniated discs - but spent alot of time working on my thorasic spine - which in his words has probably not moved since I was a a teenager... Back problems probably linked to poor posture giving over S shaped spine - as top of back was inflexible etc...

Theres a fair ammount of snake oil going on I suspect , but it seemed to make sense...
TT

Tom, I thik your spine has moved rather a lot and that your osteopath is talking utter drivel.

excessive / reduced cervical or thoracic lordosis is not a triffling injury but I'm yet to be pursuaded of having someone 'crack' your neck / back is a good idea: my extensive tests with spinal manipulation have highly statistically significant results of pretty instant death. (usually in poultry, the odd rabbit and so on).

I'm not sure how an osteo could address a herniated or bulging disc, isn't that what reiki is for? 

[petejh]

Sloper, if the entire population of the planet was divided into 10 equally-sized deciles and ranked in order of 'most likely' to 'least likely' to give useful advice on musculoskeletal issues and manipulation, you'd fall somewhere within the second-to-bottom decile alongside 'the bloke I recently stood next to in the pub' and 'my dad', but just above 'Gordon Brown' and 'Norman Lamont'.

[chris j]

I would suggest seeing a good physio, or possibly more than one depending on areas of concern as they tend to specialize in different areas. Probably a shoulder specialist would be best as this is probably the most complex joint and of greatest concern to a climber.

I'd also recommend the Supple Leopard book. Contains many different ways of bringing on your pain face breaking down knotted up muscles with a massage ball and interesting things to do with rubber bands and a cut up bike inner tube. For Paul my take on the book is that it spends a fair chunk showing good posture for standing and many gym exercises (squats, deadlifts, turkish get-ups etc) and analysis on what mobility issues you have depending on which way you fail to do the exercise correctly. The second half of the book is split into ways to break down and mobilise/stretch the areas of concern the first half of the book told you about to restore range of movement...

[thekettle]

I'd second the motion to find a recommended physio/osteo, what you're essentially after is a functional movement assessment or functional movement screening. If you want more depth than 'Supple Leopard' for DIY work on this subject I can recommend this book as an excellent resource:
https://wordery.com/stability-sport-and-performance-movement-joanne-elphinston-9781905367429?currency=GBP&gtrck=UFpDZkw4dlpWZkdyN1dlckFhWDNZbUFyUlZGRFdraFh1bjJ2MUIrVkFLdnA3Z0xwRk1NcVdhaUNOQmRoQzE0OS9GbW1waGFlSlczUVkwV01pam9jN2c9PQ&gclid=Cj0KEQiA99qnBRDnrYCkt4ClzZABEiQAvqPaLAeI0IDLoCnJKjcFoDOEPjMQsare9ApmpO8Y1MYAZQAaArRe8P8HAQ

[Sloper]

Sloper, if the entire population of the planet was divided into 10 equally-sized deciles and ranked in order of 'most likely' to 'least likely' to give useful advice on musculoskeletal issues and manipulation, you'd fall somewhere within the second-to-bottom decile alongside 'the bloke I recently stood next to in the pub' and 'my dad', but just above 'Gordon Brown' and 'Norman Lamont'.

And you're an orthopaedic surgeon?

I've read thousands of medico legal reports dealing with everything from minor soft tissue injuries through to catastrophic injury and I can never recall a case where the suggested treatment was 'spinal manipulation' (other than the equivalent of TEETH).

Osteopathy is 'alternative medicine'.  What do you call alternative medicine that works? 'medicine'.

Hardly the gold standard, but http://en.wikipedia.org/wiki/Osteopathy I wonder why mainstream 'big pharama' isn't diverting research funding from reiki to show how effective this 'medicine' is 

[Boredboy]

Medico legal reports may not be representative of the average person with back pain, spinal manipulation is part of the NICE guidelines on the conservative treatment of lower back pain and has an important place in the treatment of non specific lower back pain. A spinal surgeon or doctor may offer pain killers, injections or the knife, give me manipulaton or even reiki any day as long as it helps.

[petejh]

To the original poster -

Yes you can get his sort of thing done, I had this sort of functional analysis done post spine surgery last year. I was lucky enough to stumble upon a well-trained and very experienced personal trainer working as part of a team in a local sports injury clinic. Among a long list of quals and experience in various training disciplines she is a NASM Certified Personal Trainer who specialists in Functional Movement / Functional Training and Corrective Exercises.

I recommend hunting down someone along those lines - a Certified Personal Trainer with quals/experience in functional movement analysis and corrective exercises. It's probably worth asking around the universities and sports teams - I've been told that good people with the above qualification are relatively thin on the ground, but don't know how true that is. In my experience of seeing physios/osteos, chiros and others, the person I'm now seeing is by far the most effective at keeping me healthy. When something acute is niggling then the physios/chiros etc. are more relevant.

It's worth complimenting any analysis with getting a good sports massage therapist on board to iron out any identified tightness that you can't self-treat. Again I got lucky through a word of mouth recommendation and found a very knowledgeable sports massage therapist. Not a whale-song practitioner who gives you a soothing rub and some peppermint oil.

Of course none of this comes cheap! I accept the cost as part of wanting to stay in good shape/ingrain good habits to keep me healthy for as long as possible.

All this assumes that you buy into the current popular theory which says imperfect movement patterns, weakness in the kinetic chain and muscle imbalances contribute to injury - it isn't cut and dried and opposing theories claim that there exist people with terrible movement mechanics who never get injured. But I get a lot from it.

[petejh]

Sloper, if the entire population of the planet was divided into 10 equally-sized deciles and ranked in order of 'most likely' to 'least likely' to give useful advice on musculoskeletal issues and manipulation, you'd fall somewhere within the second-to-bottom decile alongside 'the bloke I recently stood next to in the pub' and 'my dad', but just above 'Gordon Brown' and 'Norman Lamont'.

And you're an orthopaedic surgeon?

Your (self)love of the serious professions is laudable but an orthopedic surgeon is someone you go to see when all else has failed. Effectively you've reached the point of admitting the body's self-healing mechanisms are a lost cause and it requires someone applying deliberate trauma to heal you.

[psychomansam]

One reason we don't do all-over health checks is that it would results in endless unnecessary treatment.
If you have endless time and money, your plan sounds like a good one. Assuming the unnecessary treatment isn't harmful.
If you're lucky, ignorance, the placebo effect and the odd benefit will outweigh the harms and you'll move on.
If you're unlucky you'll get conned into becoming dependent on expensive treatments by a well-meaning practitioner of one of the above arts, who will in fact be exacerbating the problem. And getting paid well for the service.

None of the above negativity seemed sufficiently strong.

[TheTwig]

Are you aware of mobilityWOD and the associated book "Becoming a Supple Leopard" by Kelly Starrett?

It basically covers whole body movement, flexibility, mobility etc. and shows you ways how to address them on your own.
I know there is a bit of controversy regarding a lot of the material out of the Crossfit corner, but if you don't take everything for face value but use your own head too, there is some really good stuff in there which might be able to help you.

Do you mind summarising, as mobilityWOD seems to be a bit of buzzword atm?

+1 for Becoming a Supple Leopard, got it on my shelf. Great book and especially good for people into weights

[tommy_k]

Do you mind summarising, as mobilityWOD seems to be a bit of buzzword atm?

Sorry, didn't see that at first.
Hm, I'm not sure what exactly you'd like to hear. I suggest you go to youtube and check out some mobilityWod / mWod episodes from Kelly Starrett and give some of the exercises or mobility drills a try.
If you then have any specific questions, I'm happy to help, I just wouldn't know how to summarize the entire topic better than quickly giving it a try yourself 

[Sloper]

Sloper, if the entire population of the planet was divided into 10 equally-sized deciles and ranked in order of 'most likely' to 'least likely' to give useful advice on musculoskeletal issues and manipulation, you'd fall somewhere within the second-to-bottom decile alongside 'the bloke I recently stood next to in the pub' and 'my dad', but just above 'Gordon Brown' and 'Norman Lamont'.

And you're an orthopaedic surgeon?

Your (self)love of the serious professions is laudable but an orthopedic surgeon is someone you go to see when all else has failed. Effectively you've reached the point of admitting the body's self-healing mechanisms are a lost cause and it requires someone applying deliberate trauma to heal you.

Of course the body heals itself, of that there is no doubt.

The point is that as an intervention osteopathy has little / no evidential base as a means of 'cure'.  There was a RCDBT trial of acupuncture where medics in white coats inserted needles in random places and this was found to be just as effective as acupuncture conducted by a 'master'.

To put it simply osteopathy is based myth and magic rather than science and medicine.

[mctrials23]

One reason we don't do all-over health checks is that it would results in endless unnecessary treatment.
If you have endless time and money, your plan sounds like a good one. Assuming the unnecessary treatment isn't harmful.

None of the above negativity seemed sufficiently strong.

I thought this was the argument for not having a full body scan / health checkup where your blood etc is tested but good posture is not a matter of opinion as far as I know. I thought that we are pretty sure how all the joints, muscles etc should work and the basic range of movement joints should allow.

I'm not looking for someone to diagnose me with an illness, I am looking for someone to say "fix your posture by doing this, try this exercise to restore full ROM to your ankle, use these exercises to fix the imbalance in the front of your shoulder" etc

I didn't think that any of this was hokum...

[Fultonius]

Just throwing this out there, but could it be a good idea to get some climbing coaching, but also explain the the coach your concerns and needs? (S)He will be able to identify any climbing related strength and flexibility deficiencies and, in addition, you'll get some movement skills and tactics thrown in for free!

[petejh]

Sloper - you're arguing the wrong point -  a 'cure' for what? We're talking about the theory that muscle imbalances, a weak kinetic chain and 'poor' posture may contribute to injury and whether it's worth having these things checked out by somebody qualified/experienced in the currently popular theories doing the sports medicine/personal training rounds. I.e. the issue is one of prevention of or rehabilitation from injury. There's a saying about that..
I'm not advocating osteopathy (I've never seen one and doubt I ever will) - I get the impression the original poster wasn't either but was just asking who to see.

You're doing a grand job of proving my characterisation of you - as a fuckwit with little useful advice on this subject - as spot on.

To quote my neurosurgeon - expensive as fuck private harley street - Sloper you'd definitely approve of him:
'''Whatever system you use [of core/kinetic chain strengthening] developing your core muscle strength is perhaps the most important element of rehabilitation and back pain prevention''


mctrials - it's worth reading up on the subject because there are plenty of people who disagree with the muscle imbalance theory. A little knowledge and a questioning attitude helps prevent you believing anything a 'practioner' tells you.  Here are a couple to start with:
http://www.bboyscience.com/outdated-pain-theories-part-3/
https://www.painscience.com/articles/posture.php

[Sloper]

The OP posited the question as to whether he should seek a once over from an osteopath and my advice is no, I regard them as taking money from the deluded with no proper evidential base for their 'treatments'.

A good physio however is well worth the outlay.

[petejh]

The OP said 'osteo / physio', you just chose to focus on the one you consider to be a quack while ignoring the other.

And in reply to your ''evidential base'':

To once more quote the consultant neurosurgeon - your idea of the gold standard guy, this time on evidence based medicine:

Whilst you may well gain benefit from sessions with a professional physiotherapist, or other manipulative therapist (osteopath, chiropractor (his words)) it is essential that you develop your own programme. The aim is to maintain the range of movements in your spine - of the discs and of the multiple joints. ...  Stretching of the hamstrings and the rest of the body will then reduce the amount of movement required of the spine. This is very important and often neglected. Your physiotherapist may have taught you specific movements. However, the simplest programme and one which may be adequete is as follows:
..
[goes on to explain a very simple 'touch your toes and sideways/backwards bends]
..
Is this ''evidence based medicine''? No, and virtually no back pain treatments are, in the sense of the definitions fashionable today. But I was taught these stretches by my predecessor Mr John O'Connell when I was appointed consultant at St. Bartholomews in 1990. He had been the first surgeon to perform discetomy in Britain and I still encounter patients he saw in the 1950s who tell me they ''have been doing the stretches ever since and have been perfect''. This is evidence enough for me. Sadly he is no longer with us but I would have much enjoyed witnessing one of the modern zealots of evidence based medicine suggesting to Mr O'Connell that he didn't have any!


I too would enjoy watching you argue with someone like that for your gold-standard evidence-based medicine Sloper.

If something gives long-term relief of symptoms without causing further harm, that's a successful outcome. Whether it fits into an 'accepted' definition is less important.

[TMR]

I had a good experience seeing an osteopath. She was towards the physio/sports massage end of the osteo spectrum rather than the wellness/baby massage end tho (she had a physio degree as well as studying osteopathy, which i think was key).  I saw her once a week for a month during which she did a lot of deep tissue massage and checking of posture and mobility. After that I saw her once every six weeks until i was confident i could self manage. The main benefit for me was having a professional diagnose what was actually wrong, allowing me to take steps to deal with it.

 I agree with pete here that the talk of "cure" is inaccurate (for me at least), anyone regularly (as in 3 times a week) climbing or training will develop issues that need addressing before they become serious injuries. I now have the attitude that if i want to climb hard, i need to factor in time for body maintenance.

On the back cracking issue, both my osteo and a physio i have seen at a later date have done this, so it's not just the realm of "quacks". Personally i can't get enough of it.

Also, get on mobilityWOD. You won't regret it.

[tomtom]

To put it simply osteopathy is based myth and magic rather than science and medicine.

Please do not put medicine and science in the same sentence implying they are similar!

From my own experience, the (Well qualified) physio I saw got my diagnosis quite wrong. The (well qualified) Osteo I saw got it right and I am now in the latter stages of recovery...

I didnt see a physio or osteo expecting to be 'cured' by their magic hands etc... but to act more as a project manager for my back pain - to find out what was wrong and suggest what exercises/rest/ice/heat I should have do/have done in order for it to get better..They kept a record of my injury - how I was progressing - and adjusted my program of exercises accordingly. For that I paid £40 a week/two weeks.

That the Osteo cracked my back and neck every trip (and I felt better for a couple of hours after that) I saw as an added bonus...

Both had theories as to why I was in pain. Physio thought the intense pain in my left glute was linked to a late teens broken right shoulder.. (!?!?), Osteo said it was the sciatic nerve being pressed due to herniated discs in my lower back - not helped by bad posture and a rigid upper back...

Maybe I saw a shit physio and a good osteo? TBH I didnt see too much difference in how they operated (as professionals) except they came from slightly different viewpoints. One massaged and stretched (including leaving me with quite some bruising on my back) - the other manipulated and stretched...

[chris j]

That the Osteo cracked my back and neck every trip (and I felt better for a couple of hours after that) I saw as an added bonus...

The spinal manipulation is what scares me about osteos and chiropractors but then my sister in law is a nurse who loves to spread stories of doom and gloom about the times it goes horribly wrong. After I fell on my head a few years back I had some back and neck manipulation and having a bloke say 'try and relax' followed by a loud crack and a moment of panic while I check I'm not paralyzed didn't really work for me... It never provided anything more than very short term relief for me so I made my excuses and didn't book a repeat as soon as I could.