Learn With OHC

Learn with OHC is an initiative where we share our knowledge and expertise in a way that is accessible to everyone. We are here to guide you to understand your body and health a little deeper on top of the Osteopathy and Physiotherapy treatments we provide.

Start with these bite-sized truths to learn more.

  • OHC Truths #01
    Why Is Sleep So Important?

    Our nerve-signaling chemicals called neurotransmitters control whether we are asleep or awake by acting on different groups of nerve cells or neurons in the brain. When trying to fall asleep, we generally will go through the 5 stages of sleep. These sleep stages progress in a cycle from stage 1 to REM (Rapid Eye Movement) sleep and the cycle repeats again with stage 1. 

    During stage 1 (light sleep), we drift in and out of sleep and can be awakened easily. Our eyes move very slowly and muscle activity slows. People awakened from stage 1 sleep often remember fragmented visual images.

    When we enter stage 2 sleep, our eye movements stop and our brain waves become slower, with occasional bursts of rapid waves called sleep spindles.

    In stage 3 and 4 (deep sleep), extremely slow brain waves called delta waves begin to appear, interspersed with smaller and faster waves. There is no eye movement or muscle activity. People awakened during deep sleep do not adjust immediately and often feel disoriented for several minutes after they wake up.

    When we switch into REM sleep, our breathing becomes more rapid, irregular and shallow, our eyes jerk rapidly in various directions, and our limb muscles become temporarily paralyzed during sleep. Our heart rate increases and blood pressure rises. When people awakened during REM sleep, they often describe bizarre and illogical dreams. 

    So how many hours of sleep do we need? The hours of sleep correlates to our age. Infants require about 16 hours a day while teenagers require 9 hours on average. Although 7-8 hours a night appears to be the best amount of sleep for most adults, some may need only 5 hours or as many as 10 hours of sleep each day.

    When we sleep below the recommended hours our body needs, we’ll usually feel tired and out of sorts the next day resulting in an impaired judgment or even slow reaction time. If this sleep deprivation continues, hallucinations and mood swings may even develop.

     

  • OHC Truths #02
    How Does Your Posture Lead To Disc Issues?

    Many people in Singapore currently have jobs that require them to work in front of computers for many hours a day. It is important for these group of people who lead sedentary lifestyles to ensure that they get sufficient exercise to lower their risk of cardiovascular disease, type 2 diabetes, dementia and cancers. Sitting is an inevitable static posture that increases stress on the entire back, shoulders, arms, and legs, and especially the muscles of the spine. Working long hours which leads to prolonged sitting without intermittent breaks has been proven to cause changes in disc height. When people hunch over by curving the spine or pulling the shoulders in, gradual pressure can be placed upon the spine creating disc issues. The poor posture puts unnecessary strain on the joints, inhibits mobility and creates muscle imbalances. Slouching is another form of poor posture that is damaging to the spine because it overstretches spinal ligaments and surrounding structures of the spine and nerves.

    The spine comprises of vertebrae, discs and ligaments and tendons connecting everything together. The discs between the vertebrae act as a cushion which promotes flexibility and range of motion. These discs are primarily made of water and as a body age, the amount of water decreases. The discs can then slip, develop small cracks or bulge depending upon the pressure. When people continue sitting in a poor posture as they age, the load in the back and neck increases. This results in added stress to the disc in the lower back which over time causes it to degenerate and lose its ability to cushion and act as normal shock absorbers. The discs may be pushed out towards the back from their normal position which then causes bulging or herniated discs.

  • OHC Truths #03
    Is Your Arm Pain Actually A Neck Problem

    Long hours at the office have been causing headaches and soreness around my neck region. Lately, I have also been experiencing pain and occasional numbness/tingling into my fingers. I was told that I may have Carpal Tunnel Syndrome. However, the pain worsened and my friends suggested that I see someone else for a second opinion as it could possibly be a neck issue instead.

    It is often said that tingling and numbness sensations in the hand are related to Carpal Tunnel Syndrome. This may not be 100% true.

    The nerves that travel down to your hand actually start from the base of your skull, at the neck area. If this nerve is being irritated or compressed at the neck region, this condition is called Cervical Radiculopathy.

    So what causes Cervical Radiculopathy?

    Cervical Radiculopathy often arises from poor long term posture or degenerative changes that occur in the spine as we age or from an injury that causes a herniated or bulging intervertebral disk.

    The nerves that travel down into your arms exit the spinal cord through spaces between the bones in your neck. The bones have gel cushions between them called discs. As the discs in the spine age, they lose height and begin to bulge. They also lose water content, start to dry out and become stiffer. This problem causes a reduction of the disc spaces and loss of disc space height. A nerve can be compressed if the disc material is pressing on the nerve or if the bones develop spurs from arthritis, making the opening for the nerve much smaller. Sometimes the joints in the spine can become inflamed and cause nerve irritation.

    As the discs lose height, the vertebrae move closer together. The body responds to the collapsed disc by forming more bone — called bone spurs. This is actually a body response to help you and to strengthen the disc. These bone spurs contribute to the stiffening of the spine. They may also narrow the foramen — the small openings on each side of the spinal column where the nerve roots exit. Consequently, the herniation pinches the nerve root causing pain. If the nerve is impinged for a sustained period of time and left untreated, the symptoms may get more severe resulting in tingling and numbness that radiates down into your hands and fingers.

  • OHC Truths #04
    Anemia

    𝐂𝐨𝐦𝐦𝐨𝐧 𝐬𝐢𝐠𝐧𝐬 𝐨𝐟 𝐀𝐧𝐞𝐦𝐢𝐚
    ⁣⁣
    Anemia happens when there is decreased red blood cells in the body, it’s the most common blood disorder and affects over 1 billion people globally. Easily treatable with diet changes and iron supplements.

  • OHC Truths #05
    Adrenal Fatigue

    What Is Adrenal Fatigue?

    Feeling tired despite getting enough sleep and endless craving of salty food might be a sign of adrenal fatigue. Adrenal fatigue is a term applied to a collection of nonspecific symptoms such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. This fatigue is usually associated with intense stress and often follows with chronic infections like bronchitis, flu or even pneumonia.⁣

    When we are under stress, our immune system responds by revving up. Our adrenal glands which are small organs above the kidneys respond to the stress by releasing hormones like cortisol and adrenaline. These hormones are part of our fight or flight response which increases our blood pressure and heart rate. When the adrenal glands that activate during stress get overworked, they are unable to keep pace with the demands of perpetual fight or flight arousal. As a result, these glands cannot produce quite enough of the hormones we need to feel good resulting in adrenal fatigue.

  • OHC Truths #06
    What Are Dermatomes

    Did you know, our human body is divided into multiple skin zones known as dermatomes?⁣

    Each specific dermatome is supplied according to the spinal nerve. The nerves from the neck supply the arms, those from the upper-middle spine supply the chest/abdomen and those from the lower spine supply the legs. The assigned nerve transmit sensory input like pain, touch, temperature or vibration from a particular region of the skin to the brain. The nerves enter the nerve root at the spine then travel toward the periphery of the body. When the nerve root gets irritated or injured, the person can experience pain or neurological symptoms such as tingling or numbness in a specific area of the skin without having suffered a local injury. Dermatomes are especially useful to diagnose the level of spinal injury or dysfunction. ⁣

    Dermatomes actually develop during the embryo stage. As we grow, they “twist” and overlap instead of following a regular pathway.⁣

    In reference to the anatomical image:⁣

    C1 does not have a dermatome.⁣

    C2 dermatome handles sensation for the upper part of the head.⁣

    C3 dermatome covers the side of the face and back of the head.⁣

    C4 dermatome covers parts of the neck, shoulders and upper part of arms.⁣

    C5 dermatome covers the outer part of the upper arm down to about the elbow.⁣

    C6 dermatome covers the thumb side of the hand and forearm.⁣

    C7 dermatome goes down the back of the arm and into the middle finger.⁣

    C8 dermatome covers the pinky side of the hand and forearm.⁣

    Clinical scenario: A patient complains of pain with associated reduced sensation in the little and ring fingers as well as inner part of their hand. They did not injure their hand but slept with their neck in a funny position the previous night and woke up with some neck stiffness. During assessment, there is no hand or forearm lesion detectable. Neck movements are uncomfortable and restricted indicates that one of the nerve roots at the base of their neck (between the cervical vertebra 7 and thoracic vertebra 1) has been irritated causing pain that reduces sensation in the two fingers and hand.

  • OHC Truths #07
    Why Our Body Heats Up During A Fever

    A fever is our body’s response against an infection. When we are attacked by an invader, our body reacts by raising the temperature to try and kill it. ⁣

    Our normal body temperature is generally around 36 degrees Celsius. A fever would usually occur above 37 degrees Celsius.⁣

    So what causes a fever?⁣

    A fever is caused by chemicals known as pyrogens flowing in the bloodstream. Normally, pyrogens help the immune system by fighting infectious agents such as bacteria and viruses which are sensitive to temperature changes. The hypothalamus in the brain is in charge of regulating body temperature and acts as the body’s thermostat. When pyrogens bind to certain receptors in the hypothalamus, our body temperature rises.⁣

    While fever does help the body fight infections, it can also turn fatal. Body temperature above 40 degrees Celsius should be treated as medical emergencies and medical help must be taken right away. This level of heat can threaten the functions of proteins whose regular functioning depends on the body’s normal temperature. Severely high fever can cause seizures, confusion, throbbing headaches, unusual sensitivity towards bright light or sound and even difficulty in breathing.⁣

    Sufficient rest, sunshine (Vitamin D) and reduced stress can enhance recovery and help in fighting an infection. If you have a prolonged temperature, please seek medical attention immediately.

  • OHC Truths #08
    Leaky Gut Syndrome

    What Is A Leaky Gut?
    ⁣⁣⁣
    Your intestinal lining contains the ‘gut flora’ and is composed of hundreds of different ‘friendly’ bacteria. It serves the function of absorbing nutrients from food and protecting us from bacteria and toxins.⁣

    Leaky gut is a condition where the permeability of the lining increases allowance of bacteria and toxins to enter into the bloodstream. This can cause widespread inflammation and an immune system reaction. ⁣

    Leaky gut may play a role or be associated with certain conditions such as Celiac disease, chronic fatigue syndrome, migraines, autoimmune diseases, inflammatory bowel disease and Type 1 Diabetes. ⁣
    ⁣⁣⁣
    There are numerous factors that affect gut permeability such as:⁣⁣⁣
    – Lack of varied diet (whole foods and whole grains)⁣
    – Deficiency in Vitamin A, D and zinc⁣
    – Excessive sugar intake ⁣
    – Lack of prebiotics ⁣
    – Chronic alcohol consumption/stress that increases sensitivity and reduces blood flow⁣
    – Lack of sleep⁣
    – Lack of physical activity⁣
    – Antibiotic use which decreases the levels of good bacteria ⁣
    – Long-term use of Non-Steroidal Anti-Inflammatory Drugs (such as Ibuprofen)⁣
    ⁣⁣⁣
    To improve your gut flora, you can follow the steps below:⁣⁣⁣
    – Consume a diet rich in fibers like fruits, nuts, vegetables, and whole grains as well as sources rich in probiotics (yogurt, kimchi, kefir, tempeh).⁣⁣⁣
    – Reduce your refined carb intake to reduce overall sugar intake.⁣
    – Eat foods rich in polyphenols (high in antioxidants) (blueberries, dark chocolate, green tea).⁣
    ⁣⁣- Take a probiotic supplement.⁣
    – Get in the sun for 20mins a day for the daily intake requirement of Vitamin D.⁣
    – Cutting out caffeine late in the day, sleeping in complete darkness and having a structured sleep routine.⁣⁣⁣
    – Regular exercise, meditation and deep breathing exercises to reduce stress levels.

  • OHC Truths #09
    Why Physical Activity Is Important For Mental Health

    When we talk about physical activity, we immediately think about long gym workout sessions but they are not the same thing. Physical activity is any activity that works your muscles and requires energy. This can include work, household or leisure activities.⁣⁣⁣⁣

    ⁣⁣Various types of daily physical activities such as walking, taking the stairs instead of the lift or even cycling can aid in improving your mood. You do not have to do all your different physical activities at once but the best way is to add small amounts of them throughout your day. A quick 10-15min of physical activity a day can make a bigger long-lasting difference if you stick with it. ⁣⁣⁣⁣
    ⁣⁣⁣⁣
    Physical activity has loads of beneficial health effects on the body such as protection against heart disease, diabetes, arthritis, improving sleep and lowering blood pressure. Emotionally and psychologically, physical activity can support with fighting depression and anxiety. You will gain self-confidence when you meet your exercise goals and get into shape, foster social interaction with others when you are in the gym or exercise class and it can be used as a healthy coping mechanism in dealing with depression and anxiety. The release of feel-good endorphins and other natural brain chemicals enhances your sense of well-being while taking your mind off the negative thoughts that feed depression and anxiety.⁣⁣⁣⁣
    ⁣⁣⁣⁣
    But where to begin?⁣⁣⁣⁣
    – Find an activity that you enjoy doing to fit into your daily routine as you are more likely to stick to it.⁣⁣⁣⁣
    – Talk to your GP or therapist for guidance in including a physical activity routine into your overall treatment plan.⁣⁣⁣⁣
    – Set realistic small goals you can reach and tailor your routine to your own abilities.⁣⁣⁣⁣
    – Look at physical activity positively as one of the tools to help you get better.⁣⁣⁣⁣
    – Analyze the barriers that are stopping you from being physically active and find what works best for you.⁣⁣⁣⁣
    – Give yourself credit for every step in the right direction no matter how small.

  • OHC Truths #10
    The Truth About Blue Light

    Blue light is everywhere around us! It is particularly found in sunlight and LEDs. We tend to get the most exposure to blue light outdoors. Some artificially created indoor sources of blue light also include LED lighting emitted from our televisions. Compared to our ancestors, our lifestyles have evolved in more ways resulting in greater exposure to sun and increasing usage of LED lighting, leading to greater risk of health issues.⁣

    Blue light is an umbrella term referring to different light variations. It is just one part of the spectrum of light emitted. The most harmful is the blue-violet light as it is a contributing factor of age-related macular degeneration and damages the retina. As almost all visible blue light passes through the cornea and lens and reaches the retina, this light may affect vision and could prematurely age the eyes. Too much exposure to blue-violet light could lead to digital eyestrain whereby blue light from screens and digital devices can decrease eye contrast. Fatigue, dry eyes, bad lighting and poor posture in front of the computer can also cause eyestrain.⁣

    However, it is important to note that not all blue light is harmful! Some blue light exposure is essential for good health. One variation is the blue-turquoise light that enhances our cognitive and sleep behaviour. This light boosts alertness, helps memory and cognitive function and elevates mood. It is also very important in regulating our circadian rhythm — the body’s natural wakefulness and sleep cycle. Exposure to blue-turquoise light during daytime hours helps maintain a healthy circadian rhythm but too much late at night can potentially cause sleepless nights and daytime fatigue.⁣

    𝐇𝐨𝐰 𝐭𝐨 𝐩𝐫𝐨𝐭𝐞𝐜𝐭 𝐲𝐨𝐮𝐫𝐬𝐞𝐥𝐟 𝐟𝐫𝐨𝐦 𝐛𝐥𝐮𝐞 𝐥𝐢𝐠𝐡𝐭 𝐚𝐭 𝐧𝐢𝐠𝐡𝐭?⁣
    – Use dim red lights for night lights. Red light has the least power to shift circadian rhythms and suppress melatonin.⁣
    – Avoid looking at screens 2 to 3 hours before bed.⁣
    – Consider wearing blue-blocking glasses or installing an app in your electronic devices that filters the blue/green wavelength at night.

  • OHC Truths #11
    Visceral Referred Pain

    Physical pain that feels diffused with poorly defined area of sensation could be referred pain from our viscera. This occurs when an organ is dysfunctional and consequently the nerves that supply it becomes irritated. When the irritated nerves arrive in the spine, they might converge with other healthy nerves which attach to the same spinal levels. All these nerves then go up in the brain, and when the brain tries to understand where the pain is coming from, it gets confused by the overlapping of irritated and healthy nerves. As a result, the brain makes us perceive pain in the area supplied by healthy nerves. ⁣

    In reference to the image:⁣
    – Liver and gall bladder can refer pain into the right shoulder and right middle back. The gall bladder can also refer pain into the right superior abdominal quadrant. ⁣
    – Stomach and oesophagus can refer pain in the middle of the chest just at bottom of the sternum and on the back in between the shoulder blades. ⁣
    – Prostate can refer pain into the lower back.⁣
    – Lungs and diaphragm can refer pain into both shoulders and neck.⁣
    – Heart can refer pain into the left chest and arm. When the pain perceived is high, it is usually a sign of heart attack therefore the person should go to the hospital immediately. ⁣
    – Bladder can refer to the inguinal and buttock area. Sometimes it might resemble hip pain. ⁣
    – Kidneys can refer in the lower back and abdomen and upper legs area. ⁣

    𝐇𝐨𝐰 𝐢𝐬 𝐯𝐢𝐬𝐜𝐞𝐫𝐚𝐥 𝐫𝐞𝐟𝐞𝐫𝐫𝐞𝐝 𝐩𝐚𝐢𝐧 𝐝𝐢𝐚𝐠𝐧𝐨𝐬𝐞𝐝?⁣
    The pain is described as a vague, constant, poorly defined sensation of discomfort in a broad area. No triggering factor or injury that caused the pain. No relieving factors and no particular movements that trigger the pain. Patient does not feel well and noticed changes in their body such as pallor, profuse sweating, nausea, gastrointestinal disturbances and changes in body temperature, blood pressure and heart rate. On assessment, the pain is not aggravated or reproduced by any movement performed. Specific tests are conducted to the suspected involved organ to check if the pain is reproduced.

  • OHC Truths #12
    Anatomy Of The Muscle

    A muscle is a group of soft tissues which contract together to produce a force. A muscle consists of muscle cells fibers surrounded by protective tissue. Each skeletal muscle fiber is a single cylindrical muscle cell. An individual skeletal muscle may be made up of hundreds or even thousands, of muscle fibers bundled together and wrapped in a connective tissue covering. Each muscle is surrounded by a connective tissue sheath called the epimysium. The fascia, a layer of connective tissue outside the epimysium, surrounds and separates the muscles, allowing each part to slide and function better. Portions of the epimysium project inward to divide the muscle into compartments. Each compartment contains a bundle of muscle fibers. Each bundle of muscle fiber is called a fasciculus and is surrounded by a layer of connective tissue called the perimysium. This layer allows nerves and blood to flow to the individual fibers. Within the fasciculus, each individual muscle cell, the muscle fiber, is surrounded by connective tissue called the endomysium.⁣⁣⁣⁣

    Skeletal muscles have an abundant supply of blood vessels and nerves. This is directly related to the primary function of skeletal muscle, contraction. Before a skeletal muscle fiber can contract, it has to receive an impulse from a nerve cell. Generally, an artery and at least one vein accompany each nerve that penetrates the epimysium of a skeletal muscle. Branches of the nerve and blood vessels follow the connective tissue components of the muscle of a nerve cell and with one or more minute blood vessels called capillaries.⁣⁣⁣⁣
    ⁣⁣⁣⁣
    Reflected in the image is the structure of the voluntary which are those muscles of which we can control the action or movement and that we voluntarily activate when we need to perform an action.⁣⁣⁣
    ⁣⁣⁣⁣
    In comparison, involuntary muscles also known as white muscles or smooth muscles are muscles in the human body whose contraction is controlled by the autonomic nervous system. These muscles are present in the walls of the digestive system, blood vessels, bronchi, uterus and bladder.

  • OHC Truths #13
    Myotomes

    Myotome refers to the muscles served by a spinal nerve root. Therefore, myotomes is a set of muscles innervated by a specific single spinal nerve. When the spinal nerve root or the spinal cord from which the spinal nerve root originate is damaged, the muscles supplied by these nerves (if the lesion is more extended) can become weak if the lesion is partial or paralysed if the lesion is completed. Myotomes are especially useful to determine where damage to the spinal nerve root has occurred. ⁣

    Most muscles in the limbs receive innervation from more than one spinal nerve root and are comprised of multiple myotomes. For example, the biceps muscle flexes the elbow. It is innervated by the musculocutaneous nerve, which originates from the spinal nerve roots of the cervical vertebrae 5, 6 and 7. All three of these spinal nerve roots can be said to be associated with elbow flexion.⁣

    There are 31 spinal nerves. Each vertebrae has a spinal nerve. The nerves are categorized by the vertebra which house them. There are 8 cervical nerves, 12 thoracic nerves, 5 lumbar nerves, 5 sacral nerves and 1 coccygeal nerve.⁣

    The list below details which movement(s) has the strongest association with each myotome:⁣
    C5 – shoulder abduction, C6 – Elbow Flexion Wrist extension, C7 – Elbow extension, C8 – Finger flexion, T1 – Finger abduction, L2 – Hip flexion, L3 – Knee extension, L4 – Ankle Upward Movement, L5 – Great Toe extension, S1 – Ankle Downward Movement ⁣

    Technique application: Problem lifting your foot or “foot drop” can be a sign of concern in the lower part of your spine (L4-S3). To make a diagnosis, a power test will be done to the muscles and to resist some movements. On the base of which muscles are weak and how severe the weakness is then it will possible to evaluate the location and severity of the lesion.

  • OHC Truths #14
    What Is Spinal Stenosis

    Spinal stenosis is the narrowing of the spaces within the spine which then puts pressure on the nerves that travel through the spine called spinal cord or that exits from the spine called spinal nerves. Spinal stenosis is most commonly caused by wear and tear changes in the spine related to ageing. The types of spinal stenosis are classified according to where on the spine the condition occurs. ⁣⁣⁣⁣
    ⁣⁣⁣⁣
    There are two main types of spinal stenosis:⁣⁣⁣⁣
    – Cervical stenosis is when the narrowing occurs in the part of the spine in the neck.⁣⁣⁣⁣
    – Lumbar stenosis (most common) is when the narrowing occurs in the part of the spine in the lower back.⁣⁣⁣⁣
    ⁣⁣⁣⁣
    Some causes of spinal stenosis may include:⁣⁣⁣⁣
    – Overgrowth of bone. Wear and tear damage from osteoarthritis on the spinal bones can prompt the formation of bone spurs which can grow into the spinal canal. Anyone over the age of 50 is at risk.⁣⁣⁣⁣
    – Herniated discs. A herniated disc may allow some of the soft inner material to escape and press on the spinal cord.⁣⁣⁣⁣
    – Thickened ligaments. Ligaments of the spine can become stiff and thickened over time, bulging into the spinal canal.⁣⁣⁣⁣
    ⁣- Tumours. Abnormal growths can form inside the spinal cord compressing it. These are uncommon and identifiable on spine imaging with an MRI or CT scan.⁣⁣⁣
    – Spinal injuries. Car accidents and other trauma can cause dislocations or fractures to one or more vertebrae. Displaced bone from a spinal fracture may damage the spinal cord. Swelling of nearby tissue immediately after back surgery also can put pressure on the spinal cord or nerves.⁣⁣⁣
    ⁣⁣⁣
    Manual therapy can help improve the mobility of the spine and the dynamics of the nerves reduces the pressure on the spinal cord and nerves. It also helps to lessen the muscle tension caused by the condition and the poor spinal mobility. Regular exercise can help build and maintain strength in the muscles of the arms and legs. This will improve balance, ability to walk, bend, move about as well as control pain. A physical therapist can show which exercises are right.

  • OHC Truths #15
    Types Of Muscle Tissues

    Did you know that actually about half of the body’s weight is muscle? In the human muscular system, the muscle tissue is categorized into three distinct types – skeletal, smooth and cardiac.⁣

    There are over 650 skeletal muscles that move bones and other structures. Also known as voluntary muscles, skeletal muscles are attached to bones by tendons and produce all the movements of body parts in relation to each other. These muscles can also be used in involuntary reflex responses when a fast movement is required. For example, they will respond rapidly to instant chemical and electrical impulses from the brain when touching a hot stove by withdrawing the hand from the dangerous situation without conscious thought.⁣

    Smooth muscle is an involuntary muscle found in the walls of hollow organs throughout the body. Smooth muscle contractions are movements triggered by impulses that travel through the autonomic nervous system to the smooth muscle tissue. The arrangement of cells within smooth muscle tissue allows for contraction and relaxation with great elasticity. The smooth muscle in the walls of organs like urinary bladder and uterus allows those organs to expand and relax as needed. The smooth muscle of the alimentary canal (digestive tract) facilitates the peristaltic waves that move swallowed food and nutrients. In the eye, smooth muscle changes the shape of the lens to bring objects into focus. Artery walls include smooth muscle that relaxes and contracts to move blood through the body.⁣

    Cardiac muscle is found only in the heart and is an involuntary muscle, which contracts in response to signals from the cardiac conduction system to make the heart beat. The heart wall is composed of three layers. The middle layer, the myocardium is responsible for the heart’s pumping action. Cardiac muscle is made from cells called cardiocytes which have a striated appearance. Cardiocytes are branched, allowing them to connect with several other cardiocytes, forming a network that facilitates coordinated contraction.

  • Buro Exclusive written by Janice Sim
    Is your desk job silently killing your back?

    Unfortunately, being a millennial doesn’t make you an exemption

    You might think the pains and perils of a failing back is one that’s only prevalent in anyone aged above 60. Here’s where you’re wrong: I’m 25, and here I am, having the worst time trying to tie my shoelaces. In fact, my mum helped me get my sneakers on today, which brings me to a new low.

    I’m never once had a serious injury of any sort; more often than not, I’m just chided for crummy posture. I’d get the occasional back aches when I sit down for far too long but nothing that requires me to make a trip to the doctor’s.

    So when sharp jolts of pain came shooting through my lower back when I got up from my dinner table the exact same day of the interview, it was like the universe rebutting, “Joke’s on you, lady”. The impact went almost from a zero to hundred, rendering me almost immobile, and obviously scared to death. It didn’t take me very long to start wobbling back to Orchard Health Clinic. At that point, it was already immensely painful to cough, sneeze, bend over, let alone walking like a normal person.

    orchard health clinic interior room

    My diagnosis? Prolonged poor posture, deep hip flexor tension, poor hip and mid-back mobility, and weakness of core-stablising musculature. Following an hour-long treatment session, where I was tugged, lifted and rubbed with caution and care — all to reduce the spasm state of my lower back muscles and to ease the tension on my lower back, it was clear that it was impossible to fix me with just one session. I was told the pain would stick around for a week, but that I should start regular at-home stretches and exercises that would help reduce the strain and strengthen my muscles. My biggest takeaway was that sitting down for a prolonged period of time was almost dangerous — just because you feel at ease and comfortable doesn’t mean something calamitous isn’t creeping up your spine.

    Sure enough, I was one of those that suffered the brunt of it, as others who have sat at their desk jobs longer than myself might have never encountered a back or neck problem. But honestly, from going from zero symptoms to a health scare to come knocking like this, prevention ultimately is better than cure. Especially when the cure isn’t one that’s as instantaneous as popping a miracle pill.  (Side note: I’m feeling better, but it’s an ongoing journey with my osteopath.)

    Sufficiently concerned yet? They shared a few tips and tricks to make sure you keep your back and neck strong and healthy within the compounds of your office.

    SIT ON A TOWEL
    Roll up your towel into a third and place it at the back of your chair, before sitting back on it with only the bones of your bum. By doing so, your pelvis is tilted forward, and also distributes the weight of your head and chest onto your spine and not just the back of your neck. It’s a strange habit to have to explain to your co-workers but this relieves a load of tension.

    THE HEIGHT OF YOUR COMPUTER SCREEN MATTERS
    Laptop users might find themselves looking down at their screens a lot, which isn’t a good thing especially when we find our heads going lower and lower as the day goes by. Try to find props in order to prop up your laptop so that it meets your eye level — if needed, invest in an external keyboard. This reduces the weight on your back and forces you to sit upright.

    laptop screen back health

    ACTIVATE YOUR SHOULDERS
    Work your shoulders in circular motions, as this helps to take the tension off the front, which also coincides with your back muscles. Easing any joints and muscles at the front will benefit those at the back — after all, it’s all part of the same body.

    THE SIMPLEST OF STRETCHES GO A LONG WAY
    You might not be able to accomplish a downward dog while hard at work, but stretching your chest back and forth, rolling your hips back, and rotating your body movements allow more blood to get into the joints in order to maintain overall joint health.

  • Esquire Magazine January 2020 Issue: How To Maintain Good Sleep Hygiene
    How To Maintain Good Sleep Hygiene

    Up on the cosy fourth floor of lululemon Duxton, also known as the Luoft, an expert from Orchard Health Clinic whipped open a therapy table and gave complimentary one-on-one consultations and on-the-spot treatment.

    We sat down with an osteopath at Orchard Health Clinic who gave us three tips to maintain good sleep hygiene and improve sleep quality.

    Sleep hygiene is a behavioural and environmental practice developed in the late 1970s as a method to help people with mild to moderate insomnia. It is a variety of different practices and habits that promote good night-time sleep quality and full daytime alertness. Obtaining a healthy sleep amount of seven to eight hours is important for both physical and mental health.

    Here is how to improve your sleep and recharge your energy levels:

    Stay away from your electronics an hour before bedtime

    Blue light from lamps, mobile phone, computer and TV screens can make it difficult to fall asleep as it inhibits melatonin release to the brain. Keeping electronics out of the room will strengthen the mental association between your bedroom and sleep. If you have your phone/computer close by, the temptation of using them will be higher and it will wake up your brain resulting in broken sleep.

    Make sure your room is cool enough

    Your bedroom should be around 20 degree Celsius for optimal sleep experience. A dark environment will also facilitate good sleep. Use heavy curtains, blackout shades or an eye mask to block light to tell your brain to switch off. Mattress and pillows should be comfortable. Lower the volume of outside noise with earplugs or a ‘white noise’ appliance.

    Cultivate an active and healthy lifestyle

    Avoid heavy, fatty or spicy food as they can trigger indigestion and heartburn. Caffeine should be avoided six hours before bedtime as well as sugar as they are stimulants that can keep you awake. Alcohol is well-known to help you fall asleep faster, but too much close to bedtime can disrupt sleep in the second half of the night. It is better to limit alcohol consumption to one to two drinks per day and to avoid drinking within three hours of bedtime. Refrain from using tobacco products too close to bedtime. As little as 10 minutes of aerobic exercise such as walking can drastically improve night-time sleep quality. It will be best to avoid strenuous workouts close to bedtime as it stimulates the body to secrete the stress hormone “cortisol” which helps activate the alert mechanism in the brain. Try to finish exercising at least three hours before bed.

  • Frozen Shoulder
    What is Frozen Shoulder (Adhesive Capsulitis)

    Frozen Shoulder also called Adhesive Capsulitis is a common disorder that causes pain, stiffness and loss of normal range of motion in the shoulder. There are 3 stages to Frozen Shoulder.  

    Stage 1 Freezing: In the “freezing” stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.

    Stage 2 Frozen: Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the “frozen” stage, daily activities may be very difficult.

    Stage 3 Thawing: Shoulder motion slowly improves during the “thawing” stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.

    Physical therapy can help with Frozen Shoulder pain. The overall goal of physical therapy is to restore movement. Once the evaluation process has identified the stage of the condition, a physical therapist will create an individualized exercise program tailored to specific needs. Exercise has been found to be most effective for those who are in stage 2 or higher.

    In stages 1 and 2, exercises and manual therapy techniques will help maintain as much range of motion as possible and reduce pain. Modalities such as heat and ice treatments will also be to help relax the muscles prior to other forms of treatment. A gentle home-exercise program will be designed to help reduce the loss of motion when there is progress and safe healing.

    The focus of treatment during stage 3 is on the return of motion. Treatment may include the introduction of more intense stretching techniques to encourage greater movement and flexibility, manual therapy to a higher level to encourage the muscles and tissues to loosen up and strengthening exercises targeting the shoulder area as well as core muscles.

    In the final stage, the therapist will focus on the return of normal shoulder body mechanics and functional training. Treatment may include manual therapy, stretching techniques focused on the specific directions and positions, strengthening exercises and functional training which address movements and tasks that are required in daily and recreational life.

    If in doubt, seek professional advice.

  • Carpal Tunnel Syndrome
    Do You Have Carpal Tunnel Syndrome?

    Carpal Tunnel Syndrome is a common condition that causes pain, numbness and tingling in the hand and arm. The condition occurs when one of the major nerves to the hand, that is the median nerve is squeezed or compressed as it travels through the wrist. 

    This syndrome occurs when the tunnel becomes narrowed or when tissues surrounding the flexor tendons swell, putting pressure on the median nerve. These tissues are called the synovium. Normally, the synovium lubricates the tendons, making it easier to move the fingers.

    When the synovium swells, it takes up space in the carpal tunnel and over time, crowds the nerve. This abnormal pressure on the nerve can result in pain, numbness, tingling and weakness in the hand. 

    Most cases of Carpal Tunnel Syndrome are caused by a combination of factors. Studies show that women and older people are more likely to develop the condition. Other risk factors for carpal tunnel syndrome include heredity, repetitive hand use, hand and wrist position, pregnancy, diabetes, rheumatoid arthritis and thyroid gland imbalance are conditions that are associated with Carpal Tunnel Syndrome.

    Symptoms may include numbness, tingling, burning, pain, occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers, pain or tingling that may travel up the forearm toward the shoulder, weakness and clumsiness in the hand and dropping things. In most cases, the symptoms of carpal tunnel syndrome begin gradually without a specific injury. Many patients find that their symptoms come and go at first. However, as the condition worsens, symptoms may occur more frequently or may persist for longer periods of time.

    Physical therapy can help with Carpal Tunnel Syndrome. It is recommended as it helps to regain mobility and flexibility as well as help the wrist get stronger. A physical therapist will apply manual therapy techniques that include mobilisation of soft tissue, carpal bone and the median nerve. Other modalities such as therapeutic ultrasound therapy and splinting will also be utilized to assist with treatment. Strengthening exercises, stretches, lifestyle recommendations and ergonomic modifications will then be prescribed when there is progress. If in doubt, seek professional advice.

  • De Quervain's Syndrome
    What Is De Quervain's Syndrome

    De Quervain’s Syndrome or De Quervain’s Tenosynovitis is a painful condition that affects the tendons in your wrist. It occurs when the 2 tendons around the base of your thumb become swollen. The swelling causes the sheaths (casings) covering the tendons to become inflamed. This puts pressure on nearby nerves, causing pain and numbness.

    Chronic overuse of the wrist is commonly associated with De Quervain’s Tenosynovitis. Tendons are rope-like structures that attach muscle to bone. When gripping, grasping, clenching, pinching or wringing anything in the hand, two tendons in the wrist and lower thumb normally glide smoothly through the small tunnel that connects them to the base of the thumb. Repeating a particular motion day after day may irritate the sheath around the two tendons, causing thickening and swelling that restricts their movement. Other causes of De Quervain’s Tenosynovitis include direct injury to the wrist or tendon, scar tissue can restrict the movement of the tendons or inflammatory arthritis such as rheumatoid arthritis.

    Symptoms of De Quervain’s Tenosynovitis include pain near the base of the thumb, swelling near the base of the thumb, difficulty moving the thumb and wrist when doing something that involves grasping or pinching. A “sticking” or “stop-and-go” sensation in the thumb when moving it. If the condition goes too long without treatment, the pain may spread further into the thumb, back into the forearm or both. Pinching, grasping and other movements of the thumb and wrist aggravate the pain.

    Physical therapy can help with De Quervain’s Tenosynovitis. Reducing pain and inflammation will be the first step to treating De Quervain’s Tenosynovitis. The therapist may recommend refraining from activities especially those that involve repetitive hand and wrist motions. Icing can help with reducing inflammation as well. Manual therapy and functional training can help prevent further stress on the tendon. Exercises and stretches will also be prescribed to help relieve any tightness in the forearm. If in doubt, seek professional advice.

  • Triangular Fibrocartilage Complex (TFCC)
    What are Triangular Fibrocartilage Complex (TFCC) Tears

    The Triangular Fibrocartilage Complex (TFCC) is an area between your radius and ulna, the two main bones that make up your forearm. The TFCC is made of several ligaments and tendons, as well as cartilage. It helps the wrist move and stabilizes the forearm bones when grasping something or rotate the forearm. A TFCC tear is a type of injury to this region. 

    There are two types of TFCC Tears.

    Type 1 TFCC tears are caused by injury from falling and landing on an outstretched hand, which can damage the ligament, cartilage and tendons to the region. Also known as FOOSH (Falling on an outstretched hand).

    Type 2 TFCC tears are caused by the slow breakdown of the cartilage in the TFCC, usually due to age or an underlying condition, such as rheumatoid arthritis or gout. The first step in treating TFCC tears is to temporarily stop doing any activities that cause wrist pain while the tear heals. Wearing a splint or cast is recommended to prevent the wrist from moving.

    Treatment options for TFCC tears depend on the type, cause and extent of the damage. It is best to avoid using the affected wrist to prevent further injury and to allow it to heal properly. In general, TFCC tears require about six weeks of physical therapy. This involves doing gentle exercises and activity adjustments for the injured wrist that aims to help rebuild strength in the TFCC, improve flexibility, improve range of motion, reduce pain and swelling. If resting the wrist and physical therapy do not provide any relief, surgery may be needed to repair the tear. If in doubt, seek professional advice.

  • Plantar Fasciitis
    Do You Know What Is Plantar Fasciitis?

    Plantar Fasciitis is one of the most common causes of heel pain. Plantar Fasciitis involves inflammation of the plantar fascia which is a thick, web-like ligament that connects the heel to the front of the foot. The plantar fascia acts as a shock absorber and supports the arch of the foot, helping with movements such as walking. If tension and stress on this fascia become too great, small tears can occur. Repeated stretching and tearing can also irritate or inflame the fascia, causing heel pain and stiffness.⁣

    ⁣Typically, Plantar Fasciitis causes a stabbing pain in the bottom of the foot near the heel. The pain is usually the worst with the first few steps after awakening although it can also be triggered by long periods of standing or getting up after sitting. Do note that the pain is usually worse after exercise and not during it. This pain occurs because the plantar fascia shortens when the foot is at rest. Walking and standing a short while usually elongates the plantar fascia, causing the heel pain to lessen or go away. Other factors such as the age of between 40 and 60, foot mechanics (flat feet or high arch) and obesity can increase the risk of developing plantar fasciitis.⁣

    Physical therapy can help with Plantar Fasciitis. A physical therapist will develop a program to decrease the symptoms. Treatment may include manual therapy and ice therapy to decrease pain and inflammation. Kinesio taping of the foot may also be done to help provide short-term relief. Lifestyle recommendations and stretching exercises will be prescribed to improve the flexibility of the ankle and plantar fascia. Usage of a night splint and selection of supportive footwear and/or shoe inserts that minimize foot pronation and reduce stress to the plantar fascia may also be encouraged if necessary. If in doubt, do seek professional advice.

  • Scoliosis
    What Is Scoliosis

    Scoliosis is a sideways curvature of the spine which visually shows a C- or S-shaped spine. It can affect any part of the spine, but the most common regions are at the level of the chest and the lower back. Scoliosis can appear at any age but it often presents from the age of 10 to 12 years or during the teens. Infants can sometimes have symptoms as well. While scoliosis can be caused by conditions such as cerebral palsy, muscular dystrophy, spina bifida or a birth defect, the cause of most scoliosis is idiopathic. Scoliosis ranges from 10-20 degrees (mild), 20-50 degrees (moderate), and severe (greater than 50 degrees).⁣

    Signs and symptoms of scoliosis may include uneven shoulders⁣, uneven waist⁣, one shoulder blade that appears more prominent and one hip higher than the other⁣. If a scoliosis curve gets worse, the spine will also twist or rotate in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side.⁣

    To treat patients with scoliosis, physical therapy takes a comprehensive orthopaedic approach to treatment. Functional techniques are utilized to assist the patient with joint and soft tissue dysfunctions along with deficient neuromuscular strength and endurance. In addition to providing postural recommendations for sitting, standing and sleeping, self-management strategies that are designed to facilitate the overall rehabilitation process will be provided. Exercises that exhibit safe and appropriate flexibility and strengthening exercises will also be prescribed to improve tolerance for everyday and recreational activities. If in doubt, do seek professional advice.

  • Sciatica
    What Is Sciatica

    Sciatica refers to pain that radiates along the path of the sciatic nerve which is the longest and widest nerve in the human body that branches from the lower back, through the hips and buttocks, down each leg and ending just below the knee. The sciatic nerve controls several muscles in the lower legs and supplies sensation to the skin of the foot and the majority of the lower leg. Typically, sciatica affects only one side of the body. Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.⁣

    Signs and symptoms of sciatica pain include a constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet. The pain may be accompanied by numbness in the back of the leg and sometimes tingling or weakness may also be present. Pain typically affects one leg and often results in a feeling of heaviness in the affected leg. ⁣Posture induced symptoms that worsen while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down or while coughing may also be present. ⁣

    Physical therapy and exercise help strengthen and mobilize tissues in the lower back, pelvis, abdomen, buttocks, and thighs. A physical therapist may utilize a combination of various types of physical, manual, soft tissue mobilization and exercise therapies in treating sciatica. Techniques such as muscle energy technique to reduce pain and restore function as well as myofascial release and soft tissue mobilization to mobilize the tissues and decrease muscle tension will be used in treatment. Strengthening exercises, functional retraining, gait training and lifestyle recommendations will also be incorporated to strengthen muscles and prevent re-injury. 

    It is not always possible to prevent sciatica and the condition may recur. However, it is always imperative to protect the back from the condition with these tips:⁣

    – Exercise regularly to keep the back by focusing more on the core muscles in the abdomen and lower back that are essential for proper posture and alignment. A physical therapist can recommend specific exercises for you. ⁣

    – Maintain proper posture when sitting by choosing a seat with good lower back support, armrests and a swivel base. Consider placing a pillow or rolled towel in the small of the back to maintain its normal curve. Keep the knees and hips level.⁣

    – Use good body mechanics. When lifting something heavy, let the lower extremities do the work by keeping the back straight and bending only at the knees. Avoid lifting and twisting simultaneously. ⁣

    If in doubt, do seek professional advice.

  • Headaches
    Types Of Headaches

    Headaches are one of the most frequent complaints. Many of us are familiar with some form of the throbbing, uncomfortable and distracting pain of a headache. Although headaches can be defined as pain in any region of the head, the cause, duration, and intensity of this pain can vary according to whether they are primary headaches or secondary headaches. The most common headaches are primary headaches. Primary headaches occur when the pain in the head is the condition or is not being triggered by something that the body is dealing with like allergies or illness.

    Tension headaches are extremely common and most people will experience them. They present as a dull and constant pain felt on both sides of the head. Other symptoms can include tenderness of the face, head, neck and shoulders, a feeling of pressure behind the eyes and sensitivity to light and sound. These headaches normally last from 30 minutes to several hours. Severity can vary but these headaches rarely prevent day-to-day activities. The cause of tension headaches is ambiguous but stress, anxiety and depression are usual triggers. Other potential triggers include loud noise, skipped meals, eye strain, lack of exercise, bad posture, sleep disruption or dehydration. 

    Migraine pain is an intense pulsing from deep within the head and can last for days. It is often throbbing and usually one-sided. The headache significantly limits the ability to carry out daily activity. People with migraine headaches are often sensitive to light and sound. Some migraine is preceded by visual disturbances. About one out of five people will experience these symptoms before the headache starts. Known as an aura, it may cause one to see stars, blind spots, flashing lights, shimmering lights or zigzag lines. Auras can also include tingling on one side of the face or in one arm and trouble speaking. Migraine attacks can also be associated with other nervous system conditions or run in the family. Women are three times more likely to develop migraine as well as individuals with post-traumatic stress disorder. Certain environmental factors such as exposure to chemicals, some foods or hormone fluctuations are also common migraine triggers.

    Cervicogenic headache (CGH) is a chronic headache that arises from the atlanto-occipital and upper cervical joints. A cervicogenic headache is a common cause of a chronic headache that is often misdiagnosed as migraines. It is actually rooted in the cervical spine (neck) or base of the skull region. They are caused by problems with the nerves, bones or muscles in the neck. Although pain may be felt in the head, instead, the pain is actually a referred pain from another location in the body.

    Treatment for headaches is customizable depending on the type of headaches. Physical therapy, soft tissue massage and gentle spinal manipulation can help alleviate the pain in the head and neck. These techniques work to reduce nerve irritation, decrease muscular tension, increase circulation in the tissues, correct alignment, and improve the mobility of the cervical spine. Rehabilitation recommendations such as exercises, lifestyle and nutrition can also be provided to address usual triggers and prevent future recurrence. If in doubt, do seek professional advice.

  • Whiplash
    What Is A Whiplash

    Whiplash also called neck sprain or neck strain is a neck injury due to forceful, rapid back-and-forth movement of the neck like the cracking of a whip. Whiplash is characterized by a collection of symptoms that occur following damage to the neck. In whiplash, the intervertebral joints (located between vertebrae), discs, ligaments, cervical muscles and nerve roots may become damaged.

    Symptoms of whiplash may be delayed for 24 hours or more after the initial trauma. However, people who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury. These symptoms include neck pain, neck stiffness, irritability, sleep disturbances, fatigue, difficulty concentrating, memory problems, dizziness, lower back pain, headaches, pain in the arm, hand or shoulder.

    Recovery time depends on how serious the whiplash is. Most cases resolve in a few days but other neck strains may take weeks or longer to heal. Once the acute symptoms of neck strain are gone, physical therapy will be needed to make the neck muscles more limber and stronger to recover and reduce the odds of neck strain in the future. 

    Physical therapy is an effective treatment that can help restore proper function and movement of damaged tissues for whiplash, especially when combined with other treatments such as bracing and medications. Deep tissue massage technique, direct pressure and friction will be used to release the tension in the soft tissues (ligaments, tendons, muscles). Therapeutic ultrasound, hot therapy and cold therapy will also be incorporated to get more blood flow while reducing inflammation and muscle spasm. Exercises that help improve range of motion and strength, as well as lifestyle recommendations will also be prescribed depending on condition and health history. If in doubt, seek professional advice.