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Tewkesbury’s local experts in clinical chiropractic & remedial massage.

Call today on 01684 291 261 to arrange a free chat with Aidan (our chiropractor).
We'll let you know if we can help you, and if we can't, who can.

NB: This is a blog of our personal opinions, and is provided as a brief overview of things we think you might find interesting.

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  • Frozen ShoulderLet’s take a look at frozen shoulder.
    AKA adhesive capsulitis.

    Frozen shoulder is a chronic shoulder condition typically lasting 1.5 - 2 years; but can be triple that. It is characterised by both pain and restricted movement. The cause is often unknown, though it is related to immobility of the shoulder (eg after keeping your arm in a sling), previous injury to the shoulder, and to diabetes. The process is one of inflammation and contraction of the shoulder capsule, often with some scar formation within the joint itself.

    Classically, frozen shoulder goes through three phases
    Frozen Shoulder ArthroscopyFreezing/painful phase: Gradual onset of shoulder pain at rest with sharp pain at extremes of motion, and pain at night with sleep interruption which may last anywhere from 3-9 months.
    Frozen/stiffening phase: Pain starts to subside, progressive loss of glenohumeral motion in capsular pattern. Pain is apparent only at extremes of movement. This phase may occur at around 4-6 months and can last for about 12 months.
    Thawing/resolving phase: Spontaneous, progressive improvement in functional range of motion which can last anywhere from 1 to 4 years.

    Conservative management of frozen shoulder does not really offer a cure, or reduce the duration; but attempts to reduce the severity of the symptoms – both pain and freezing; and is based around mobilisation, massage, stretching and strengthening. NB: because the goal of conservative management is for symptom reduction, not cure – it is impossible to know for sure if it is working or not.Phases of healing for Frozen Shoulder
    Medical management of frozen shoulder is based around steroid injection to reduce inflammation, or manipulation under anaesthetic to break down scar tissue.


    You can find out more here:

    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.

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    Lower Core 17 January 2020 | Comments (0)

    Deep Intrinsic lumbar muscle groupLet’s take a look at core strength and stability for the pelvic girdle and low back.

    First of all – what is meant by your Core Musculature? Well, this largely depends on who you ask. As physical therapists, we mean the deep muscles that stabilise your body, and allow other, larger muscles to create movement from a firm base – the foundations if you like. The 2 most important areas for this core stability are for the shoulder girdle and neck; and for the pelvic girdle and lower back (the subject of this post).

    As humans, we stand upright, using our spine as a pillar, which needs to be supported to stay that way; that support largely comes from the deep intrinsic lumbar muscle group (especially multifidus) which tether each vertebra onto the one below, alongside the transverse abdominus muscle which acts more like a weight-lifter’s belt… Core Endurancethat’s active, in the right place, and with you 100% of the time; these are “backed up” by the diaphragm and pelvic floor musculature.

    Unfortunately, the deep intrinsic muscles are directly inhibited by pain in the lumbar or pelvic areas, and waste away quite quickly; it is also a muscle group for which you have limited to no conscious control. Despite lacking control over these muscles, they will contract alongside the transverse abdominus muscle; which is how you can go about strengthening and stabilising your spine. Once you have that stability your lumbopelvis will move more efficiently, with less chance of injury, and if/when injured, may recover more quickly.Core Strength


    You can find out more here:

    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.

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    Ice or Heat 11 January 2020 | Comments (0)

    Apply ice as soon as possible after injuryLet’s take a look at the therapeutic use of ice and heat.

    As a rule of thumb, you should apply an ice pack as soon as possible after an injury; applying it for 10-15 minutes, and repeating after 60-90 minutes. Make sure that the ice pack is dry, and covered in a layer of material. The closer you can stick to this regime the better.

    After the 3rd or 4th day, then it becomes a little less clear as to which you should use. Generally after this time, muscles will respond better to heat, whilst joints will respond better to ice. If you’re unsure, try alternating between the two. Apply ice for 10 minutes, then 45 minutes later, heat for 10 minutes; repeating this cycle.

    Heat: Directly stimulates sensory nerve fibres, altering your perception of pain, by overloading the sensory pathways. Heat also increases the metabolic rate of the tissue, increasing the efficiency of what they’re doing at the time - namely, trying to heal the injury. Heat can also directly increase flexibility of tissue, resulting in relief from muscle spasm, and increased range of motion.

    Ice for pain reliefHeat may exacerbate bleeding &/ oedema locally. Possible side-effects include burning if too hot.

    Cold: Applied for up to 5 minutes, narrows the blood vessels, which will help to reduce bleeding and oedema in the early stages of healing. If applied for more than 5 minutes (but less than 20 minutes), cold has the opposite effect, improving the local blood flow; but then, by removing the ice, the body's own regulation systems will rapidly warm the area, exciting the cells, who can then use the extra blood supply provided.

    Ice can also have an analgaesic effect through stimulation of some of the sensory nerves (similar to heat), combined with reducing the conductivity of the pain sensory fibres allowing some pain relief.

    If overused then the use of cold therapy will slow down the healing process. Possible side-effects include an ice-burn if used inappropriately (ice-pack not wrapped in dry tea-towel).


    Heat for pain reliefUltimately, both can have a beneficial effect, and "using the wrong one" won't do any damage. Equally, something hot and something cold work better than chemical mimics (such as deep heat or ice spray) though the chemical mimics can often be more convenient.


    You can find out more here:




    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.

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    Sports Bras 03 January 2020 | Comments (0)

    Importance of Bra FittingBoobs – they’re just so important, for so many of us; so let’s get a bit better at looking after them.


    Repetitive trauma or bouncing up and down from jogging, jumping, dancing, or many other forms of activity, can cause permanent damage resulting in breasts dropping. The breasts are composed of mainly fatty tissue with the mammary glands and muscle. The muscle is deep so cannot help much in supporting the breast. There are, however, ligaments interwoven through the breast called Coopers Ligaments, which help hold the breasts up; but they are thin and not very strong. If the breasts are not supported properly with a good sports bra then repetitive bouncing can stretch these ligaments permanently.


    Importance of Bra FittingIt is not just the larger breasted women who suffer breast pain when exercising; smaller breasted women can suffer from jogger’s breast just as much. It is also possible that breasts that are not properly supported can lead to tension and strain in the upper back and neck, particularly in the larger breasted woman. The excess weight at the front can mean the back muscles have to work harder to keep the shoulders in the correct position. Massage and posture can help reduce the tension, and pain this results in; but can’t do anything for the boobs themselves – prevention is better than cure. So wear the correct sports bra. This should give support and prevent vertical movement as well as side to side movement.


    There are many types of sports bra available and the most suitable for one person is not necessarily the best for another person. When choosing a sports bra you should take into account:

    Importance of Bra FittingSupport level - this will depend on your size (larger breasts need more support) and your sport (high impact?)

    Compression or encapsulation - Compression bras basically compress the breasts against the chest and are usually crop-top styles. Encapsulation bras keep the breast separate in defined cups, more similar to a standard bra. Women with larger breasts should pick an encapsulation bra. Smaller breasted women may feel a compression bra is sufficient. A few styles both compress and encapsulate.

    Strap width - Make sure the straps are wider than a standard bra. This will help support the breasts and prevent the straps digging in.

    Material - Make sure the material is breathable and comfortable to wear. Also ensure that there are no seams on the cups which could cause nipple chafing!

    You can find out more here:




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    How much physical activity should you doAs we’re in the New Year’s Resolution time of year; let’s have a look at getting and keeping active.


    PE has a lot to answer for. If it brings to mind freezing changing rooms and slogging through muddy fields then it’s likely you’re not alone in those thoughts. The inspiration that PE was meant to offer a future generation to be active and stay healthy is all too often sadly lacking. It doesn’t have to be this way; exercise can = activity which can = something YOU enjoy


    How active are weWhen jobs were predominantly manual, when kids climbed trees (more often) and cars were a luxury, physical activity was a regular and normal part of life. With modern day progress has come a requirement for us to go out of our way to achieve even slightly raised heartbeats, which is a shame at best and harmful at worst; it is after all, what our bodies are naturally designed to do and many of the health epidemics – obesity, back pain, diabetes, heart disease – sweeping the modern world can be directly linked in part to our modern reduction in physical activity.

    Most people KNOW the facts and don’t need convincing that exercise will do them good. But directly opposing this knowledge are the often negative perceptions attached to exercise and the fact that many of the benefits – feeling better, living longer, being healthier – can seem abstract and indirect and don’t really cut it when faced with a comfy sofa, an unfinished box set or simply less effort expended.

    What counts as moderate physical activityIt’s possible that we’re biologically programmed to not exert ourselves unless there’s an immediate, tangible reason to do so, then there are the biases and beliefs that we’ve acquired over a lifetime and any previous negative experiences of exercise – PE yes I’m talking about you – make skipping out of the door with a huge smile in place something that even the most enthusiastic gym bunnies can struggle to achieve.

    But remember, it may not be as involved as you think. Guidelines recommend: 150 mins/week of moderate aerobic activity or 75 mins/week of vigorous aerobic activity. That’s less than 30mins/day of ‘moderate’ activity. “Moderate” means brisk walking; housework; gentle cycling (10-12mph). Moderate isn’t all that difficult to achieve and may well already be part of your day. And if not, with a little thought it probably could be. Walk or cycle instead of driving? Clean the windows or mow the lawn? ‘Vigorous’ activity requires a little more effort but make that a walk up Cleeve Hill, ride the bike a little quicker or some serious garden action and you’re there.

    What are the health benefits of physical activityIf you enjoy it your brain will remember that enjoyment, and feed it forward into anticipation (just like trying to do something you don’t enjoy). If you don’t enjoy it, bin it; don’t let negative associations getting a grip – you’re unlikely to stick with it anyway – and save your precious time for something else.

    Not sure what you enjoy? Then be a doer; make an effort, have a think and investigate – remember it doesn’t actually have to be something that hard to do or incorporate into your life and it certainly doesn’t have to be hockey / rugby / running / swimming or whichever sport it was that put you off in the first place. Try a dance class, borrow a dog for an hour, take the kids for a bike-ride and picnic (or simply explore the pubs in surrounding villages), volunteer at the nature reserve, maybe pop down to the sailing club and try messing about on the water or join a friend who keeps blathering on about their Zumba, Pilates or Taekwon-Do… the possibilities are endless. We will all enjoy different things – find what works for you and own it; and accept that what you enjoy may not be the first thing you try.Physical activity map


    Start Small = Last Long

    If you haven’t broken into a jog since you were a slim, fit youngster then any past ‘10 miles before breakfast’ are likely to be an unrealistic target currently, leading to pain and injury if you manage even half that. Be realistic about what you think you can achieve injury-free and then reduce it slightly. If you’re not sure what you can manage then simply start very small and gradually bump up – miles, minutes, reps – from there. E.g. follow a ‘CouchTo5K’ plan to get into running, gently and realistically increasing your mileage and letting your body avoid overuse injuries by becoming gradually fitter and stronger.

    You only have to prove it to YOU

    Active travelDo whatever activity floats YOUR boat and makes YOU feel better and happier overall – remember, a brisk walk to the shops / chasing the grandkids / gardening is likely enough. There IS some effort required to get organised, get out the door and partake but choose wisely and the overall effect will be a fitter, healthier and crucially HAPPIER you.

    If you’re really struggling with motivation then consider where your mental health is at and if you think you need a helping hand, see your GP. There is no perfect way to train, no one size fits all; draw your own map and see where it takes you.

    And finally

    Chiropractic &/ Massage can play a huge part in tackling your physical niggles and advising and helping you get healthier, fitter, stronger and consequently happier. We’re here if you need us!Walking Rugby


    #LoveActivity #Chiropractic #Massage #ExerciseWorks #Tewkesbury

    Find out more here:





    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Impingement SyndromeLet’s take a look at subacromial impingement syndrome (SIS).
    AKA subacromial pain syndrome or rotator cuff impingement
    SIS is a symptomatic irritation of the structures passing through the narrow space below the acromion of the shoulder (the hard, flat bone forming the “roof” of the shoulder). Consequently, it is a syndrome made up of many different conditions, involving the irritation of many different structures, such as bursa or tendons; and can have many different causes.
    SIS is characterised by pain at the top and outside of your shoulder; which is typically worse when you lift your arm, or at night, possibly affecting your sleep; and a feeling of weakness in the arm.Impingement Syndrome
    If you do suffer from this, it is important to remember to keep the shoulder itself active and mobile; preferably in a way that does not aggravate the pain (“no pain, no gain” – does NOT work; but nor does ignoring it, or being afraid to use the shoulder; find the “goldilocks zone” between the two for the most efficient healing). There are several stretching and strengthening exercises that you can do to help with this; along with strategies such as ice or heat, massage or mobilisation. Steroid injections are often useful as well; though with so many potential causes underlying this series of conditions, there is no one-size-fits-all approach to care.
    Is it Impingement Syndrome


    You can find out more here:
    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.
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