Back Pain
We have writtern some articles on back pain and hope you find them useful

A question I often get asked is, ‘can I keep training with this injury?’. Many of my patients are passionate about their fitness pursuits, and the thought of missing a week or more of training is upsetting to them.


I can sympathise with this because I love to train too. I am currently training for an ultramarathon, and during my plan, I have had three niggles that I was convinced would stick with me until the race.


Well, thankfully, the short answer is, ‘yes’, you can train through injury. In my case, I made a few adjustments to my plan, and I was able to keep up with my weekly mileage whilst the injuries recovered. I am now back to running injury-free and I didn’t take any rest.


Before we get into it, I want to make a little caveat to this article; the advice here should be taken carefully. Some injuries should be rested, and I do advise this from time to time. I will try my best to explain how to train through pain, but if you are ever in doubt, seek advice from a professional.


With that said, yes, you can train through (most) injuries. The reason for this is that science is starting to realise that recovery from injury largely happens in the brain. There are cellular changes that need to happen locally in a damaged tissue, which is facilitated by the nervous and immune systems, but the way the brain processes what has happened and how it coordinates the body in response to the injury is perhaps a more important factor in one’s recovery.


When you are training, you are sending information up to the brain that helps it reconfigure your movement patterns, and this also helps coordinate the response from the immune system.


The other important benefit of continuing to exercise is that you are staying strong. Strength (or lack of it) is the number one predictor of one’s risk of injury. It’s important to note that strength is task-specific, so if you are a runner, it is important to stay ‘running strong’, and the best way to do that is to run!


The way I think about problems in the body is that if we are taking two steps forward and only one step back, we’re winning. So the goal when training is to not aggravate the system so much that you’re taking two steps forwards and two steps back.


If you are injured, I have a few rules to follow which should help you win the battle:


  1. Try to find a way to adapt your training to not aggravate the injury. With gym work, this is easy because you can always take out the movement patterns that aggravate the pain. For example, if you have a shoulder injury that doesn’t like overhead press but can cope with bench press and pull-downs, you can keep training your shoulders by avoiding the overhead press movement. Often, strengthening the joint with planes of motion that don’t cause pain will help the plane that is struggling.

    You can play with other variables too. Reducing the load, the speed and the range of motion can activate the muscles and joints in a way that is safer. Over time, you can increase these variables back to their original levels.

    With running, this can be a bit trickier. One of my injuries was a foot problem which caused stabbing pain in the ball of my foot each time it hit the ground. This isn’t ideal as a runner because my feet often need to hit the floor! I found a way to manage it, though, by changing my gait to more of a ‘waddle’, running on trails instead of roads and reducing my speed. Although this was a much slower run, I was getting the miles in, which helped me stay on track for the ultra.


  1. Pay attention to the first few minutes of your session, and things should get easier. If they progressively get worse, that is probably your body’s way of asking you to stop. Most problems get a bit easier when you are warmed up, and this is a sign that you can continue, but listen to the language of your body and stop if you need to.


  1. Get treatment and do the rehab. Getting a good diagnosis, hands-on treatment, and personalised exercises from a professional can help accelerate the recovery process. The body is a healing machine, and anything we can do to enhance the body’s natural power will increase the likelihood that an injury will recover even if you are training on it.


Are there any times that you shouldn’t exercise through injury? Yes, of course! Everything I have spoken about above involves adapting your training in a way where you manage the pain to prevent it from getting worse. This often involves reducing the intensity significantly to find a level of training that works for you.


Sometimes, however, this isn’t possible. This is why I often advise my patients to avoid matches, races and team events where the intensity is out of their control. It’s one thing to train on your own in an intelligent, controlled way, but another to ramp up the intensity and put your body at risk.


If pain and injury are holding you back, we can help in this clinic. We also like to discuss lifestyle factors, not just to get you out of pain but to live a healthy life with well-being as a priority.


Regular readers of mine will not be surprised to hear that I love to stretch. I find myself wriggling around every day, gently testing range of motion in my muscles and joints, exploring my body through movement. I find it helps my body feel energised and my mind calm. As an osteopath, I prescribe stretches on a daily basis, and my patients come back reporting that the stretches help their injuries and improve their movement patterns.

So you can imagine the mild sense of panic I felt this week as I was reading a New Scientist article that questioned whether we even need to be stretching at all!

The opening paragraphs noted that scientific research hasn’t definitively found that stretching prevents injury, and it doesn’t seem to be a factor in helping us live longer either.

So if stretching doesn’t prevent injury, nor does it contribute to longevity, what is the point of it, and why does it feel so good?

Well, for starters, it helps us undo the effects of our modern convenience tool, the chair. Sitting for more than 4 hours a day has been shown to significantly reduce hip flexibility. Sitting at a computer busy on a keyboard also impacts our upper backs and shoulders. Stretching regularly can undo these effects and bring us back to a good baseline level of flexibility.

Maintaining a half-decent baseline of movement is important for day-to-day tasks, but what if you enjoy fitness training or sport? Do you need to stretch more?

Thankfully, you don’t necessarily need to stretch for longer periods of time, but you may need to think about how you stretch.

My favourite line of the New Scientist article was a quote from exercise scientist James Nuzzo. He says, “we need to get it out of our minds this notion that stretching holds a monopoly on the lengthening of tendons and muscles”. Ah, now this is right up my street. There are plenty of ways to get more flexible, and it turns out the traditional way of holding stretches (like trying to touch your toes) is a pretty inefficient way to get there. A much better way, particularly when it comes to sport, is to use movements that mimic the thing you are about to do. Use lots of variations and gradually increase the range of motion. You can even add load to the stretch to enhance it.

So if you are a footballer, you need to use running, agility drills and kicking-type movements. If you are a weightlifter, use squat variations for your hips and hang from a bar for your shoulders.

It turns out stretching has other benefits too. Interestingly, the act of taking our body through full range of motion doesn’t just help our musculoskeletal system; it also helps our arteries. The mechanism isn’t fully understood yet, but it seems that stretching also improves the elasticity of our blood vessels, and this can help prevent heart disease.

I breathed a sigh of relief when I read that stretching does speed up recovery from injury too. While traditional stretching doesn’t necessarily prevent injury, it can speed up recovery when one is injured because it helps turn off the inflammatory response in the tissues. So my patients haven’t been lying to me; it really does help!

Thankfully, to get these benefits of improved flexibility, a healthier cardiovascular system and speedier recovery from injury, you don’t need the Instagramable forward bend where you can rest your head on your shins; you just need a consistent, gentle movement practice that tests your boundaries a little. You don’t need to be top of your yoga class, but it would help everyone to have a practice two or three times a week that keeps them mobile.

And lastly, I don’t need any scientific research to tell me that connecting with my body through movement just feels good! Not only for my body, but also for my mind. I feel calm, grounded, connected. These abstract words that don’t neatly fit into a scientific paper. No matter what the science says, I know I will have a mobility practice for the rest of my life, and I hope you do too.

pigeon pose

Benefits of the pigeon pose

The pigeon pose is one of my favourite stretches!

I call it a ‘keystone stretch’ because the pigeon pose helps to unlock so many things. The stretch primarily targets the glutes and the piriformis, but it will also be helping some of the deep rotators of the hip. Some of these muscles have connective tissue attachments to the lower lumbar ligaments and to something called the ‘thoracolumbar fascia’ which spans from the pelvis to the thorax.

So you can see why I call it a keystone stretch! Loosening the back of the hip and pelvis really can have a huge impact on the rest of the body. (For the anatomy geeks among you, check out the muscles of the hip here.)

How to do the pigeon pose

We call it a ‘pose’, but really I don’t think of it that way. I prefer to think of it as a framework to help explore my body through movement.

Here are some of the little nuances and tricks I use to engage with the tissues a bit more and to find the bits that need the stretch the most.

I often recommend the pigeon pose to help unlock a stiff lower back, tight hips, or if someone is either very active with exercise, or very sedentary with lots of sitting.

The stretch can be fairly intense, so it is not always recommended if you are in acute pain and it is best to check with your osteopath to see if it is right for you. Always follow the principle that a stretch should feel ‘nice’. If it becomes sore, stop until you get to see your health professional.

You can find out more about how we treat back pain here and hip pain here.

If you want to see how the pigeon pose might fit into a complete hip stretching routine, have a look at this video.

lower back pain

The statistics say that 80% of us will experience lower back pain in our lifetime, which is a lot, but I’m sure it must be more!

Maybe I have a skewed perspective of reality because I’m an osteopath – everyone I see has (or had) a problem, the healthy ones don’t end up in the clinic! But either way, many of you readers will have had some experience with back pain, either acutely (which lasts days or weeks), or chronically (which lasts months or more).

Pain is a funny thing and it can play tricks with your mind. Today, I’m going to give you 5 tips to manage acute lower back pain so that when injury strikes, you are able to stay calm and accelerate your recovery.

Tip #1: Don’t Panic! Lower back pain doesn’t last forever

When acute pain strikes, your brain can feel like the scene in Airplane! where they’re told not to panic. Your thoughts go into overdrive wondering how long the pain will last, will it be forever, are you going to be able to enjoy your hobbies again, will it get worse? And on and on.

The thing to remember is that these thoughts are entirely normal and go hand in hand with acute lower back pain. When an injury occurs, your immune system goes through a cycle that lasts a few days and can be incredibly painful, but it doesn’t last forever.

Pay attention to your thoughts, let them go, and move on to taking positive steps like the ones below.

Tip #2: Keep moving! Movement is your lower back’s friend 🙂

Our intuitions tell us that pain is there to let our brain know about tissue damage happening in the body, but this is not strictly true. Pain is there to change your behaviour. So yes, when you are in pain, you will walk differently, you will be slower, you will make different choices with your body so the pain doesn’t strike, but this doesn’t mean the pain is a bad thing.

Pain will catch you out from time to time, often unexpectedly, but it’s not your body’s way of saying that more damage is happening, it’s just reminding you that you are not quite ready for that movement pattern yet. Your body will find a new way to complete the task instead. (I’ve seen some very creative ways of putting one’s shoes on in the clinic!)

Even if things hurt, it’s still very helpful to keep moving. All sorts of amazing things happen, even when you are going for a slow walk. The gentle ambulation massages and nourishes the muscles, joints and connective tissues and it sends helpful neurological information up to the brain.

You know what I always say; movement is medicine and motion is the lotion!

Tip #3: Stretch the hips and shoulders to help your lower back

When you are in pain, it is human nature to focus on the painful area. But you are a complex machine and all your moving parts talk to each other. You have networks of muscle criss-crossing your body. By stretching the hips and shoulders, you will help to release some of the tension that builds up due to the lower back pain.

Stretching other parts of your body is often easier than stretching where it hurts, but it will still have direct and positive results. Many of our hip muscles also attach to the lower back, and so do some of our shoulder muscles. Stretching these can ease the pain without stressing the lower back.

Head over to our YouTube channel for some ideas on where to get started.

Tip #4: Heat or ice? What’s the best treatment for your lower back?

This question confuses everyone, and to be honest, I never give a clear, single answer either! The research keeps flip-flopping, but the current thinking is that icing an injury can be helpful for the first day or so, then use heat. This is because inflammation isn’t the baddie we once thought, but it is an essential part of the healing response. Ice blocks the production of inflammation which may not be helping things, whereas heat improves blood flow which helps your body drain it away once it’s done its thing.

However, I have some patients who love icing their injuries. In those cases, I don’t stop them! There may be other reasons why it helps them, ranging from neurological pain-blocking effects to just the psychological placebo-type effect.

And vice versa, some people love the calming, soothing effect of heat. If that’s you, then go for it.

Either way, ice or heat, the point of them is to help you move more freely and more confidently. Movement is the true medicine.

Tip #5: Seek help! An osteopath can treat your lower back pain

The majority of low back pain episodes get better fairly quickly, but seeing someone like an osteopath does two main things; firstly, it will get you better faster so that you can get back to all the fun things in your life. Secondly, it will help you understand why the problem happened and how to build a plan so it doesn’t happen again. This may involve some lifestyle changes or some exercises to help improve your body’s function.

There are people out there to help you with anything in life, it just so happens this is the sort of thing an osteopath can help with!

Here is a video to get you started with a basic lower back exercise. It should feel ‘nice’, so don’t do it if it causes any pain.

Lower back pain is likely to affect most of us at some point in our life.

If you have any questions about it, you can see more about how our osteopaths can help you here, and please feel free to email [email protected], or call for a chat if you have any other questions 01245 522360.

We also have an online booking system to book an appointment direct.

See our back pain page for more information.

Just over a year ago I wrote an article for this magazine titled ‘The Myths of Back Pain’. In it, I discussed how it is okay to twist and bend despite all the health and safety advice, why you should be lifting heavy weights as part of your general health and exercise model, and why training to get a six-pack could be doing more harm than good.

In the clinic, I still hear people worrying about these things and I wanted to address some other common myths that crop up on an all-too-regular basis.

First, a quick recap…


Myth #1: Lifting heavy weights is bad

People often think heavy lifting is bad for the spine, but the research is quite clear that strength is a key player in the prevention of back pain. In order to get strong, lifting weights can be helpful, but it’s not necessary. If you don’t want to go to a gym, using your own body as a weight might be the answer. Certain movements in yoga and Pilates can be really tough! This sort of strength is good because it teaches you how to control your own body.


Myth #2: You shouldn’t bend and twist

Whenever people say they avoid bending and twisting, I think, ‘but you’re a human’! You should see the amazing anatomy we have interlacing through our body, specifically designed to perform at its best in a bend and twist.

Research has shown that those who limit their movements when reaching in the space around them are more likely to have back pain. Those who have more variability in their system have a lower incidence of pain.


Myth #3: Training your core prevents back pain

This myth specifically relates to movements like the sit-up which try to isolate the abs in an attempt to get the elusive six-pack. The evidence shows that doing too much of this type of training makes it more likely you will have back pain.

Of course, it is helpful to have strong core muscles, but they should be trained in a dynamic and integrated way that includes the hips and shoulder muscles. This helps build strength and control throughout the whole body.


So, onto the new ones.

The next myth is the most common one I encounter and it’s one I really want to nip in the bud:


Myth #4: If you have pain now you will have pain forever

This idea can be quite scary for people. When you have pain, it’s easy to think it will last forever or will get worse over time, but the vast majority of problems get better.

Pain is common after a certain age, but it’s not normal. Phrases in our language like, ‘it’s all downhill from forty’, or ‘it’s my age’ keep the candle of myth burning.

Rather than blame age, I prefer to blame habits. As long as we are alive our body has the ability to change. This is a process known as BIOPLASTICITY. Our body changes in response to a given stimulus, particularly the ones we do the most often.

So what stimulus are you giving your body? If it is a stimulus of a sedentary lifestyle, high carb diet and lack of stretching, your body’s response to that will be to tighten up and have pain.

If, however, the stimuli you give your body include a healthy diet to nourish the cells and regular stretching and exercise to gently and progressively test your body’s limits, it doesn’t matter what your age is, your body will respond positively.


Myth #5: Rest helps the back

When you are in pain, rest can feel the right thing to do. After all, moving hurts! The problem is, rest doesn’t accelerate healing, movement does.

In the clinic we use a couple of silly phrases; ‘movement is medicine‘ and my personal favourite, ‘motion is the lotion‘. Each time we take a step, our body creates a pump to draw in nutrients and squish away waste. This helps our immune system do its thing and create healing.

Sure, you should avoid sharp pain, but do as much as you can to keep mobile when injured.


All of this advice comes with the caveat that if you are worried about an injury you have, you should seek professional advice. Seeing someone like an osteopath would help you create an individualised plan to figure out the problem and get you back on the road to health.

If you would like to ask our team of osteopaths any questions, please get in touch by calling 01245 522360 or take a look around the rest of our website.

Yours in health! 🙂

See our back pain page for more information.

Imagine the panic. You’re taking a well-deserved rest away on holiday. The sun is beating down and that makes your crisp, cold drink taste all the better.

Then, seemingly out the blue, your back goes. No! You’re in a foreign country, not sure how to get the care you need, but most importantly, the pain takes the enjoyment out the holiday.

At this time of year, I hear this story a lot in the clinic. But fear not, trusty reader, I will give you a few tips to prevent the dreaded woes of holiday back pain. By following these tips, you should keep the pain away and make the most of your time off.


Sun loungers

Remember, most sun loungers are designed to stack well, not to look after your back. I have rarely found a well-designed lounger which offers the correct support.

The other major problem with sunbathing is that it is so abnormal for us to lay down for that amount of time during the day! We often think pain is caused by DOING something, but very commonly I see injury caused by NOT DOING.

The extra rest we take on holiday can actually do us harm. Get up, walk and stretch regularly.


Flip flops

Wearing flip-flops can tighten the plantar fascia (the connective tissue under our feet) and lead to tight calves, hamstrings and hips (we call this the ‘posterior chain’).

This lack of flexibility through the posterior chain can leave your back vulnerable to injury. People with tight posterior chains often have their back ‘go’ with seemingly innocuous movements, like bending down to brush their teeth or pick a small object up from the floor.

It confuses them because it seems such a simple movement when actually, their back has been overloaded by the lack of flexibility in the legs and hips.



It’s super important to stay hydrated in hot countries, especially if there are a few extra alcoholic drinks thrown into the mix.

Being dehydrated can reduce tissue health and leave us prone to injury.


Sudden increases in activity

If lounging around the pool isn’t your thing and you prefer to trek up mountains and take in the views, make sure you do some training beforehand.

I’ve said many times that it is ‘contrast’ that is the biggest cause of pain. If you have been busy in the office and haven’t had time to train, then you go ploughing up mountains your body probably won’t thank you.


What to do if you are in pain?

If the worst happens and you do end up injured on holiday, my advice is always the same.

Try to move little and often. We follow the “Goldilocks Rule”. Move too little, you will tighten up. Move too much, it can make the pain worse.

A simple rule of thumb is that if you are injured you should break your day into twenty-minute chunks. After sitting for twenty minutes, get up, move, walk, give your hips a little wiggle and stretch. After twenty minutes of that, put your feet up by the pool again.

The latest research is saying that it is helpful to use an ice pack for 20 minutes at a time every couple of hours, but only in the first day after the injury. After the first 24 hours, use heat and stay mobile.


And of course, when you get back on home turf, get booked in with your local osteopath to get you on the mend and ready to face normality. Or, if you are feeling tight before you go, prevention is always better than cure and a treatment or two can help you make the most of your well-earned rest.

As always, we at Forté Physical Health are here to help and you can get in touch at [email protected] or call 01245 522 360. And if you want ideas for flexibility exercises, click these links to our Facebook page and YouTube channel.


Have a healthy month!

See our back pain page for more information.

Change of Seasons

Every day, as I walk around the plinth treating my patients, I look up through the window and see the tops of the trees.

Listening to my patients’ stories, learning from them and laughing with them, and seeing the gradual change of the seasons outside, it makes me happy.

As I sit here writing this on a Monday morning, the tree closest to me has sprung to life with beautiful white blossom, which wasn’t there when I finished for the week on Saturday.

It’s such a vibrant and fast-changing time of year which gives us all a lift. When the days get longer and the sun starts to shine, we get out in the garden, get back on our bikes, and dust off our running shoes.

This movement is good for our bodies and the fresh air is good for our soul.

Be Careful – We Have Been Hibernating!

However, I want you to have a little Chris sitting on your shoulder saying ‘be careful’! This time of year is when we see a lot of injuries to the back caused by doing too much too soon.

We have been hibernating, snuggling into our wooly jumpers and nursing our hot chocolates (or nice winter ales if you’re anything like me!) for the last few months, and it takes the body a while to kick back into gear.

It doesn’t cross most peoples’ minds to warm up before, say, doing the gardening, but it’s essential, especially for the first few times. Our muscles and joints stiffen when they’ve not been used much, and our nervous system needs to be ‘reminded’ of the movements it once did.

Take It Easy

Spending a few minutes twisting, bending and reaching to loosen up will do you a huge favour. Be mindful and mentally ‘check in’ with how your body feels and for the first few sessions take it easier than you think you need to. If you’re on the bike, take it slow. If you’re in the garden, take more breaks than you feel you need. If you’re doing the spring clean, rope in the family to help with the lifting.

This is always a time of year where my phone becomes very busy in the clinic, so to avoid being one of those callers, take a little bit of time to get your body ready for the task at hand. It doesn’t take much to make a big difference.

Get in Touch

If you feel completely stuck and don’t know where to start when it comes to stretching, we put out lots of videos on our Facebook page giving you some ideas, so check us out at, and as always, we love to chat so if you have any questions, give us a call at 01245 522360 and ask for Chris.

Have a healthy month!