Osteopathy, chiropractic, Acupuncture, Physiotherapy, Massage, Rolfing, Hellerwork, Yoga & Pilates . . . . . .
The following information is based on my own personal experience and the experiences of my clients. It is not a definitive description of the functions of any discipline mentioned and some would no doubt argue with my observations, but it may go some way to save you time and money and point you in the right direction.
My personal opinion is that, if you have an isolated problem or injury (*1), you should expect at least 90% improvement in 4 to 6 sessions with any therapist and should expect to feel a noticeable difference after each one. If nothing feels different then you should conclude that – as far as your problem is concerned – nothing happened and you have just wasted a lot of time and money and should perhaps look for someone else.
Which one do you need?
A difficult question and one which is not totally solved by knowing who does what. For instance, it’s a misconception that osteopaths have a monopoly on “spinal manipulation” simply because it’s commonly referred to as “osteopathic manipulation” (Hoover are not the only manufacturers of hoovers and did not – as far as I know – actually invent hoovers any more than Mr Osteopath invented spinal manipulation). Also, if your problem is – for example - chiropractic, a good massage therapist will help you much more than a bad chiropractor, though a good chiropractor would typically be even better if you see my point. To my mind, unless you have an acute problem which unarguably points to a specific type of therapy, you are better off using the following guidance to find a good therapist who appears versatile and having a brief chat with them about your problem to see if they can help before turning up and handing over your cash.
Finding a good one
(As suggested in other pages, the letters after a therapists name indicate the level and quality of their training and – presumably - of their learning. These letters do not – in my opinion and experience - guarantee the quality of their work. This means, for example, that one osteopath will be much more effective than another and, as above, a good massage therapist with little training may do better spinal manipulation than a bad osteopath or physiotherapist with years of training and a few letters after their name. So what is the quality of an individuals work assured or indicated by? By their work, and nothing else).
1 – Ask everyone you know who they have been to with any similar problem and try to get a recommendation. If you get a recommendation, go to step three. If not, trudge wearily to step two.
2 – Have a browse on the internet. If you find someone who sounds good and has their own website, proceed to step three. If not, go straight to step five.
3 – Have a look at their website. If all they quote is their governing bodies literature and headlines and/or only have testimonials from other therapists who probably work at the same clinic (I can give you a couple of howling examples if asked privately) move on.
4 – Look for testimonials from people who sound like they had the same problem as you and were helped by this person.
5 - Call or email outlining your problem and asking for confirmation that they can help you and ask for a likely number of treatments that will be needed. Go with your intuition but pay attention to item six and seven.
6 – DO NOT be sold anything purely on the strength of how good someone says their own work is. NO ONE will tell you that they are average!!!
7 – A conscientious therapist will (in my opinion) do their utmost to help you to help yourself and save you from coming back for unnecessary treatment (there are many who ABSOLUTELY do not). They should be interested in identifying what it is you do that may have caused your problem and should also – where appropriate – give you effective movements/work (*2) to do between sessions.
They deal largely with skeletal problems and the ailments consequent from spinal misalignment. From a case history and physical examination they will assess joint dysfunction and manipulate joints back into their correct position. If your back makes a loud cracking noise followed by excruciating pain, they’re the guys for you.
PROS - As a therapist, watching a good one work can be quite awe inspiring. When a specific joint is jammed they will get it very accurately. If your problem is a jammed joint in your spine there is – in my opinion – no-one better.
CONS – Joints will usually either become jammed because of muscle tension (compression) or will cause muscle spasm to support a vulnerable joint. Those osteopaths that purely manipulate (too many in my experience) will only make temporary improvements, which is why people keep saying “I’ve got a brilliant osteopath, I’ve been seeing him for years”. My question: if he’s so good, why have they been seeing him for years! Also be aware that, as previously stated, osteopaths do not have a monopoly on spinal manipulation.
ANY GOOD ONES? – Many. I’ve had treatment from a few who were painlessly ineffective and a couple who were painfully so, but most of my experience has been positive. The best I know is Toby Borradaile who works in W1, SW1, SW4 and Exeter (firstname.lastname@example.org)
HOW SuppleworX FITS – As you’ll see from clients comments on the ‘Articles & Reviews’ page, I have treated many people successfully where osteopathy and others have failed. For those people, my work was far more effective than osteopathy or anything else. However, I have been fortunate to work with some exceptionally gifted osteopaths and, where appropriate, have had no hesitation in recommending that my clients have a session with them where I feel that their problem is more osteopathic than my skills allow and that this course would speed up their recovery.
Chiropractors use slightly different techniques to those used by osteopaths but still rely largely on spinal manipulation to solve your problems. There are numerous ‘splinter-groups’ who will do more or less but, typically, chiropractic looks at your pain first, decides for itself which joint that is the obvious culprit in causing subsequent nerve disruption and manipulates (moves/releases) it.
PROS – If they get it right they are very effective and will often treat you for as little as 15 minutes per session so you get big chunks of your life back.
CONS – If they get it wrong, their 15-minute appointments are barely long enough to say hello and goodbye let alone re-assess and do anything more significant.
ANY GOOD ONES? – I know a couple but none that I generally refer people to. This is largely for geographical reasons and is more because I happen to know and work with good osteopaths rather than because of any preference, though I do have severe reservations about the 15-minute thing.
HOW SuppleworX FITS – As per osteopaths above and as already mentioned.
There are numerous styles and theories which, to my mind, fall into two distinct categories. The oriental style has a map of you body’s energy pathways (meridians) and will put needles at the appropriate points to stimulate and release ‘blockages’ in these pathways at various points depending on your condition or ailment. Western style acupuncture (often used by osteopaths and chiropractors as a additional tool) will sometimes use needles to stimulate nerve function (your nerve pathways follow an uncannily similar path to the less visible energy ‘meridians’). More commonly, they will make needle sized holes in stuck muscles to cause micro-bleeding in the muscle fibre’s which allows them to ‘breathe’ – an approach that my small brain finds much easier to make sense of but one which can be pretty painful.
PROS – 50% of my clients who had tried acupuncture said it was very helpful and effective.
CONS – 50% of my clients who had tried acupuncture said it did nothing.
ANY GOOD ONES? – 50% of my clients who have tried it say they know a good one!
HOW SuppleworX FITS – Because my work is structural and acupuncturists usually aren’t, we can are barking up very different trees. Some clients need or want both, some don’t, but we do not interfere or contradict each others work.
There is a physio in Chertsey Surrey whose ‘hands-on’ work I am not overly enthused by. However, in terms of clinical diagnosis he is god, and I have sent a couple of clients to him when the root of their problem has eluded me and everyone else. I mention him because, other than him, I can only say this of physiotherapy. I have been treated by a few and gained nothing from the experience other than an understanding of how much work they get from insurance companies and what lengths (certainly these ones) will go to to keep it. I had one client who had received good work from a physio who obviously had his head screwed on the right way. Other than that and of the many many of my clients who have received physiotherapy, the following things were reported in ALL cases:
1 – their work was completely ineffective
2 – everyone was told to go the gym and make the offending muscles stronger (this is usually the last thing you should be doing)
3 – the course of treatment went on forever
4 – where insurance companies were paying, treatment (often) went on till the money ran out
5 - no one got fixed, no one asked them to explain why and no one got their money back (would you let a car mechanic get away with that?)
6 – I usually managed to make bigger improvements in one session than they had done in countless sessions (at which point some people were beginning to think maybe they should ask the physio for their money back. Except that for most of them, it was the insurance company’s money so they didn’t think it was the same thing!)
I’m not making any judgements here, just reporting what I’ve experienced and heard. One of my proudest possessions is an email from the head of clinical physiotherapy at a London hospital who wanted to know if I would teach her what I do!
PROS – According to me and my 800+ clients, there are two good physiotherapists
CONS – According to me and my 800+ clients, there are two good physiotherapists.
ANY GOOD ONES? – Hmmm!
HOW SuppleworX FITS – After 4-6 sessions (max), I have fixed ALL the problems that many of my clients had taken to physiotherapy first.
There are many different forms of massage which have very different intentions and very different effects. There is nothing wrong with any and a place for all. The main problems for the potential recipient are that:
1 – the huge choice can resemble a menu that you cannot understand
2 – too many claim to do things beyond their capability and do not do what they say on their own particular box.
Without going into all the various splinter groups (which you can easily read about elsewhere on the internet) there are two distinct types. Both will focus on soft tissue - muscles and sinews. One works at a very superficial level and the intent and/or outcome is one of soothing or relaxing. Nothing wrong with that if that’s what you wanted, but very irritating if you paid for a deep tissue massage and got stroked to death for an hour instead. The other group (which you’ll not be surprised to know that I fit into) works at a deeper level and are typically referred to as Sports Massage or Deep Tissue Massage Therapists. What’s the difference? Nothing. Be clear that “deep tissue” doesn’t have to mean “deep pressure” and a good therapist will know exactly how hard a muscle can be pushed before it fights back and causes you avoidable discomfort. Both work deeper into the muscles to release and balance their tension relative to the other muscles they work with. Very often, if muscles are released from tension, the joints they were holding onto will spontaneously release. Massage therapists who work with this intention often refer to their work as being structural. Others, sadly, will take their title as license to batter your muscles into submission and will achieve little, muscularly or structurally.
PROS (deep) – If your problem is muscular, a good massage therapist is your answer. Because many work at a structural level, there is a big overlap into the work you would typically expect to be the exclusive realm of osteopathy or chiropractic. Also, be being more focussed on muscular work, any joint manipulation needed subsequently will be less aggressive and more effective than when it is done without first addressing muscle tension appropriately. The problem with many structural dysfunctions is that you will not know they are there until someone identifies the problem and eliminates it. If you have what appears to be a muscular problem that just wont go away despite good quality ‘deep’ massage, it’s very likely that you have an underlying structural problem. Until that has gone, the muscular reaction just keeps coming back as a reaction to the more fundamental skeletal problem.
CONS (deep) – A bad one will hurt you and achieve little
ANY GOOD ONES? (deep) – Massage is an important part of what I do but it is only part of what I do and my fees reflect the uniqueness and effectiveness of my work on a structural level. But if you can afford my fees for purely massage work and happen to want – arguably – the best massage therapist in London, you know where I am. My personal experience of ‘deep’ massage as a recipient has usually been of ‘grimacing and whimpering’ variety with the exception of two therapists. One was an extraordinarily gifted young German guy who had not even finished his basic training and who, sadly, I lost contact with. The other is my girlfriend Sue Glasgow. (email@example.com)
PROS (superficial) – It’s a nice way to go to sleep
CONS (superficial) – It’s an expensive way to go to sleep
ANY GOOD ONES (superficial) – I’m sure there are lots, it’s just not my thing.
HOW SuppleworX FITS – Deep, structural and effective. Does what it says on the tin.
Rolfing & Hellerwork
Regarded by many as being very similar to SuppleworX but without the specialization in hip and back problems. Of all the various offshoots from massage/physiotherapy, these are perhaps the best known and most respected which is why they get an honorary mention. They are very similar in a number of ways. Firstly, they take an all-encompassing view of the human structure. This means that they will want to work through your whole musculo-skeletal system, a view I largely share but I personally think that 10 - 11 sessions are a on the ‘over-kill’ side of thorough and that’s what they usually want you to sign up for. Rolfing coined the term “Structural integration” (which is a shame, because I wanted it!) and works largely with fascial tissue (*3) to release and realign all the joints in your body, as does Hellerwork. However, whilst not belittling the excellent work they do, they are not trained in and usually do not carry out joint or spinal manipulation as distinct from the joint mobilization which they definitely do.
PROS – Can be immensely effective
CONS – 10 or 11 sessions is a lot of time and money to commit to. Because they (usually) rely on friction to manipulate and release fascial lesions, it can be horribly painful, possibly the most painful thing I’ve ever had which had an invoice attached to it!
ANY GOOD ONES – I don’t personally know anyone who does Hellerwork. I was fortunate to get treatment from International ballet dancer and choreographer Russel Malephant but I gather he’s a bit tied up with award winning dance work and is no longer practicing. As with everything else, there are good ones and, no doubt, bad ones.
HOW SuppleworX FITS – Many have said that SuppleworX is similar, most have said that it’s quicker and equally effective. SuppleworX is also more focussed on skeletal alignment so addresses directly a number of areas that these disciplines expect to get as part of the process. For most people I do not think that one compliments the other so much as offers a choice.
There are numerous styles. Some have been around for 2000 years, some considerably less. Depending on how you look at it, it’s a movement and exercise class, an opportunity to turn off your mobile and shut up for an hour, or it’s a way of life. Either is fine as long as you get what you want. As with any form of ‘hands-on’ treatment, the versatility of the practitioner or teacher is probably more important than the style of yoga that they teach.
PROS – For some people, their yoga class is their only escape from their working week so thumbs up to that. Again, dependant on the style of class it can be an excellent way to get more connected with your own body (perhaps Hatha would be the best example) or, at the other end (Ashtanga?) it can be a great workout.
CONS – They don’t all deliver what they say on the box. Many of the basic yoga postures are mechanically treacherous and we are no longer built/programmed to do them as we perhaps were 2000 years ago. Anyone who thinks that standing on your head is a good idea has not got much of value inside theirs.
ANY GOOD ONES? – Loads, just don’t ask me to recommend any
HOW SuppleworX FITS – If you’re into yoga but have reached a point where your range of movement on one side cannot match the other, there is a strong possibility of alignment issues that you cannot stretch around so my clinical work can help. Also, if you’re into yoga, the techniques I teach at my stretch workshops will make you much better at yoga. If you’re not into yoga? What I teach at my workshops will save you years of doing yoga
There is a huge fixation with core strength and stability at the moment and it’s not entirely healthy. Firstly there is a big difference between core strength and core stability, the former being largely pointless other than for aesthetic reasons and the latter being questionable in its merits. There is nothing good about a strong core that doesn’t move and not much more benefit in a core that is stable but distorted. If your hips and/or lower back are out of position then your core is distorted. Pilates will stabilize it but will not change it. Once in the correct position and free to move, Pilates – unlike much other core training – is an excellent way of training functional strength (*4) into this area. It’s a popular misconception that sufficient core strength to stabilize (read “lock-up") your lower back is a good idea. Here’s a simple question. If your lower back was not supposed to move, why did god put so many hinges in it?
PROS – Good at what it’s supposed to do
CONS – Only if it’s done when your body is ready for it
ANY GOOD ONES? – I believe so
HOW SuppleworX FITS – When I’ve finished with you, you’ll be ready for Pilates!
(*1) – An isolated problem could be – for example - a specific injury site, a long term lower back problem or neck and shoulder pain. These kind of problems should be dealt with quickly and effectively. ‘Bad’ posture can also often be dealt with very quickly but bear in mind that there will be a lot of homework. A life-long – presumed – genetic deformity or continually aching muscles from being continually beaten to death in a gym is not an isolated problems, treatment will take longer or will often mean continual ‘work in progress’. (these are just a few axamples, not a definitive list).
(*2) – If your problem is muscular, anyone who says “your xxxx muscles are weak, you must go to the gym and make them stronger” should be avoided and their advise ignored at all costs. They usually have the same letters after their name and – in my humble opinion - do absolutely nothing that anyone with a brain would pay for.
(*3) – Fascial tissue is something akin to a cling-film suit that encapsulates and connects the skeletal muscles. The funny thing is that some people (Rolfers and Hellerworkers et-al claim to address myofascia and little else whilst ‘deep’ massage therapists often put their hands up to knowing nothing about it, saying that they only work with deep muscles. The truth is that the pressure needed to release fascial tissue running over deep muscles means that you cannot address fascia without effecting major muscles. Equally, anyone who works deep muscles effectively will – knowingly or otherwise – be releasing fascial tissue. The intent of both is singular but the effect of both is not, so it’ another example of someone from one field who is versatile being able to address a number of areas effectively.
(*4) Functional strength supports a mobile structure and promotes movement. Dysfunctional strength will stabilize a dysfunctional structure and, thereby, further restrict its movement.