S2 E2: S2 Ep2 – Osteopathy & Therapy coaching: Mind and Body care

As you know, an osteopath, a lot of the time we're known for treating people with low back pain.

I'm not quite sure where that came from, but, you know, we are synonymous with low back pain.

Yes, we can treat that, but we can also treat an awful lot of other conditions as well.

One of the key things about osteopathy is that we are taught a number of ologies.

We are taught pathology, physiology, biochemistry, you name it, we're taught it.

And also we have to think over a thousand hours of clinical hands on work during our degree course.

So we are pretty well equipped to treat most conditions.

And one of the things that a lot of people don't realise about osteopathy is that we are one of the few medical healthcare professionals outside of the NHS that's actually allowed to diagnose.

So we need that ability because we never know who's going to walk through the door.

You know, somebody may come in with a case of low back pain, but actually there's something much more serious going on.

If, as a part of our conversation, when I'm explaining to them what therapy coaching is all about and they bring their issue that they've got, whether it be anxiety or self esteem or struggling with emotional regulation, it could be a health anxiety.

I've dealt with, I've dealt with exam anxiety, I've dealt with all sorts of different anxieties, panic attacks, people being afraid to go outside, go outside their front door.

Health anxiety is another one.

So I don't know what I'm going to get.

And in the course of that conversation, that discovery session, if, with my training, I feel that actually there's more going on here, there's something behind all this.

It could be a traumatic experience, it could be something, it could be depression, it could be a potential disorder that's lurking behind.

And I've got a network of psychiatrists, psychotherapists and counsellors and I will recommend that person go and see them because they are the right people that this client should be going to see.

Hello and welcome to the second episode of season two of the Pain Free Living podcast with me, your host, Bob Allen and my co host, Claire Elsby.

And in this episode we're going to talk about the kind of different treatment approaches.

So mine is very physical based and Claire's is very mental health therapy based.

And we're going to, you know, we're just going to talk about the kind of people we have helped over the, over the years as, you know, an osteopath a lot of the time we're known for treating people with low back pain.

I'm not quite sure where that came from, but, you know, we are synonymous with low back pain.

Yes, we can treat that, but we can also treat an awful lot of other conditions as well.

One of the key things about osteopathy is that we are taught a number of ologies, we are taught pathology, physiology, biochemistry, you name it, we're taught it.

And also we have to do over a thousand hours of clinical hands on work during, during our degree course.

So we are pretty well equipped to treat most conditions.

And one of the things that a lot of people don't realise about osteopathy is that we are one of the few medical healthcare professionals outside of the NHS that's actually allowed to diagnose.

So we need that ability because we never know who's going to walk through the door.

Somebody may come in with a case of low back pain, but actually there's something much more serious going on and we need to know, is that something we can treat, is that within our scope of treatment or is that something that we have to refer to?

GP and I have sent not many, but I have sent the occasional person to AE because the signs and symptoms they were showing indicated something that was potentially very serious, called Corda require syndrome, and that is a medical emergency.

I sent them to ae.

Luckily it wasn't that they had a viral infection which was causing a number of problems, but it wasn't that.

But, yeah, that's the kind of situation we have to deal with.

I have had another client who came in, they'd been to see the GP with shoulder pain and they came in to see me because they still had the shoulder pain and the medication that they'd been prescribed wasn't working.

Now, I examined them, I looked at what was going on and there's that little spider sixth sense that says that this isn't what it appears to be.

And unfortunately, in this case it was not just mere shoulder pain, it was actually cancer.

There's a very rare form of cancer which can refer pain up into the shoulder.

It was actually up into the right shoulder.

So although it appeared that it was just shoulder pain, the signs and the symptoms were not that.

So I sent them back to the gp, said we need to get an MRI scan done.

They got the MRI scan done and it turned out to be cancer, unfortunately.

But that is a level of training that we have to have because as I said, we never know who's going to walk through the door.

I have treated so many different conditions, from ankle sprains to knee pain to hip pain, to shoulders, heads, shoulders, knees and toes, all of the above.

So that's the range of skills that we need to have.

I mean, I don't know what specialist training you have as a therapy coach, Claire, but how about yourself?

It's very similar to you in a way that I don't know what someone is going to present with when they log on, because I tend to see most of my clients online and I offer a free discovery session, which is really where I can triage the person.

So if as a part of our conversation, when I'm explaining to them what therapy coaching is all about and they bring their issue that they've got, whether it be anxiety or self esteem or struggling with emotional regulation, it could be a health anxiety.

I've dealt with, I've dealt with exam anxiety, I've dealt with all sorts of different anxieties, panic attacks, people being afraid to go outside, go outside their front door.

Health anxiety is another one.

So I don't know what I'm going to get.

I.

And in the course of that conversation, that discovery session, if, with my training, I feel that actually there's more going on here, there's something behind all this.

It could be a traumatic experience, it could be something.

It could be depression, it could be a potential, a disorder that's lurking behind.

I will then I've got a network of psychiatrists, psychotherapists and counsellors and I will recommend that person go and see them because they are the right people that this client should be going to see.

There have been occasions where the individual has been through the therapy, so they've been through that clinical therapy and they've dealt with whatever it is or understand how to deal with whatever it is that's been going on for them because potentially trauma, I would say, is a common one, but they're now ready to sort of look forward and that's when they can come back to me because that's not necessarily what a therapist would deal with.

So that's really when I tend to see that person again.

Yeah, and I think that's quite a skill.

I think that's something which we hadn't thought about, but actually one of the skills of doing what we do is to know our scope of practice.

It's to know who can we treat and who can we help and when we need to refer.

And I do know that there are situations where people don't do that.

They.

They go beyond Their scope of practice and they, where they haven't really got the skills to do that.

Yes.

You know, so I think that is, that is something that I hadn't thought about to bring out in this episode.

But actually it's a really important point is to know, know what our limitations.

Are and mean it's drummed into me as part of my training what our boundaries are.

And also it's, you know, I'm bound by my professional organization and there's a code of ethics.

So you know, I'm very aware of that and having done counseling as well, I'm very aware of the different kinds of disorders and how these can manifest themselves and also the language people use.

So it's usually in that discovery session where I can very gently suggest that I'm not necessarily the best person for them, but I could recommend X, Y.

And Z. Yeah, and I think that's another key point as well is that is having that support network where they may not be suitable for us to treat, but we have got somebody we can refer them to.

So, you know, it's a bit like it's signposting basically.

So somebody may not be.

Yeah, they may not be suitable for what we do, but we know somebody who can help.

And I know that I had one or two people who have come to see me where as well as hands on treatment for me as an osteopath, I have referred them to therapists, psychotherapists, therapy coaches, because that's all part of the puzzle and it's not an area that I'm qualified to deal with.

But then we get into the whole mind, body concept and they are not separate.

They, there, there are a lot of areas in the medical profession where you have the body.

That is your physiotherapist, that's where your chiropractor, that's where your osteopath deals with.

And then you've got the mind, which is where the therapy deals.

Yes.

And they deal with them separately.

But actually you cannot have good physical health without good mental health.

You cannot have good mental health without good physical health.

So this is where a partnership like ours, this is where, you know, that's where the benefits are.

Yeah, and some people know that, but I think that's, it's, it's not as widely accepted as it should be and we're gonna, we're getting a little bit controversial here.

So moving it back on track.

So Claire.

Love it.

Who's your typical client then?

What do you, who would you normally see?

Oh, well, I would divide it into two separate types.

Types, probably not the right word, but it's someone who's feeling, they're not feeling at the best and they haven't been feeling at the best for a little while.

It's been lingering, so I'm thinking of a client particularly that told me that he felt that he was walking around in his own private bag of fog and that was the only way he could describe it.

And he didn't know what was wrong with him, but he just knew that he needed help.

And in his particular situation, it had been lingering for probably about six months.

He didn't feel that he was depressed, but he certainly had low mood and he certainly felt he'd lost his mojo and he had got to the point where he was overthinking everything.

And even a trip to the shops was a challenge for him.

And he'd always been a really confident, competent individual and he just couldn't understand why this was happening to him.

There was no trigger, it was nothing that happened.

It had just come upon him over time and he couldn't quite shake it off.

So he would probably be a very good example of someone who came to me, we had our discovery session.

I couldn't pinpoint anything in his language that would suggest to me there was anything deeper.

So I thought, right, okay, if you're happy, we'll work together and we'll just see how it goes.

And I'm really pleased to say that he's doing amazingly well.

One of his things was that I said he was worried about going to the shops.

Since then, since we've been working together, he's been on a holiday to Thailand, he's been on another one to Mauritius and he, he feels he's completely got his mojo back and he just doesn't understand how he got himself into that situation in the first place.

But that would be an example of someone that just felt they needed some help and didn't know where to turn.

So if I hadn't been able to help him, if I'd felt it, I would still have been able to support him in pointing him in the right.

Direction, which is all part of the process.

Yeah, yeah.

I mean, for me, one of the areas that I do quite well in is where you've got people have had long standing problems.

They've been to see a physio, they've been to see a consultant, they've been to the gp, they've been everywhere and not had any success.

So I had somebody recently who had a fall and tore his acl, which is a ligament in the knee joint, nine years ago and he had an ACL repair and that worked okay.

Ish.

But a year of physiotherapy and he was still getting some pain and he was still not 100%.

That was nine years ago.

Basically the NHS gave up on him because they couldn't work out what was going on.

They'd done everything they could and they thought, yeah, okay, we're kind of at our limit now, we don't know what else to do.

So he lived with the pain for quite a while because he didn't think there was anybody else that could help him.

I think he'd seen a couple of physios and a couple of other people who couldn't work out what was going on.

Then he just lived with it for a while and then somebody suggested come and see me and he did.

And two treatments later he's back out and no problem at all, I'd say not because I'm brilliant, but.

Oh, you.

Thank you, Claire.

Thank you.

But it was interesting because the pain was in the left knee, but it was also.

But he had a lot of restrictions in the right hip.

Now the question is, did the knee come first or was the hip part of the problem or did the hip develop as part of the knee problem?

But one, it worked out that one was maintaining the other.

So rather than doing work on the knee, which is what a lot of people would do because that's where the pain is.

Just with the examination, I found that actually there was a lot of restriction in the right hip.

So treated the right hip and miraculously the knee got better and then he was back out playing golf and he was talking twice, which is really rubbish for my business.

It doesn't make me any money at all.

But actually that, and this is one of the joys of osteopathy is that we.

It's a whole body approach, it's not just a.

Okay, back.

That's.

That's the problem, that's what we need to fix because it did.

It hadn't, that's what people had tried and it hadn't worked.

So, okay, let's think a little bit broader, let's see what else might be going on and then start to work our way through and say, if that is the problem, let's treat that and let's.

And treat the knee as well and then see where we go from there.

But yeah, that, that was a really, really good result.

Not totally expected, but yeah, but he's happy.

She's Very happy back playing golf.

So for me, one of the things that I found in my many years of practice is that, so when I started I wanted to work with people with disabilities because that is a group that is very poorly served by the nhs.

The NHS is brilliant for emergencies, not so great for chronic problems like long standing low back pain, like this guy with the long standing knee pain.

It's not great for that because it's very focused on where does it hurt?

That's what we're gonna work on as opposed to looking at the whole body.

So one of the things that I wanted to do was work with people with a disability because that was very underrated.

So when I left uni on the last day, I said to the tutors, this is what I wanna do, I wanna work with people with disabilities.

Where can I go to get extra training?

So like, so to enhance the skills that I have.

And they said, well, nowhere.

There's nobody that's really doing it.

So I thought, okay, I'm gonna have to do this myself.

So I found a charity based down in Bedford that one of the other people in the clinic I was working in did some work for and I worked there for two years and that was just working with people, adults with learning disabilities and just finding out what the issues were.

What can I do to help?

How does that work?

Especially with people that are non verbal, you know, But I learned a lot and I've just kind of developed, carried on developing that.

So I've worked with wheelchair basketball teams, I've worked with people with hypermobility, all kinds of stuff, because that, that was an area that I really wanted to work in and that was great.

But also what, what's happened and I'm not quite sure how it happened, but I, I have a lot of older clients.

Again, it's a very poorly served group in the healthcare system generally.

So they tend to give them, they tend to just load them with meds and that's, that seems to be it.

So I've worked with a lot of older adults.

I think the oldest was about 93.

And again, get good results.

Partly because, yeah, I've got some skills and experience which I know can help, but also because I listen to, you know, I, I will sit and I will talk and we'll get stories and get an understanding of.

It's not just your back, it's, there's something else going on as well.

Let's work on all of those areas and you know, it works.

I'm not sure if I should tell this story, but I'm going to tell it anyway.

There was a client of mine, so one of the buildings I work at, the.

They.

They came in and parked in the disabled space because they were in excruciating pain and they came in to see me hobbling on a.

On a walking stick because they're in that much pain.

But by the end of it, they were so much better, they didn't actually need the walking stick anymore.

Wow.

I mean, it was quite.

It was quite a simple thing, you know, what you're looking for.

It's quite a simple thing to work out.

But then they still hobbled out because they parked in the disabled spot and it was a bit naughty.

So.

Yeah.

But, yeah, you know, it's.

Like I said, it's a lot of it is experience and having an understanding of the body and how it works.

So, yeah, those are the kind of two areas I tend to work in a lot, is people with disabilities and older adults.

You kind of have a particular target or do you treat everyone?

Well, the other.

The other area that I'm seen to be attracting, if you like.

I guess that's something.

Yeah, is it's where an adult parents.

Where their child is going through a assessment at school for neurodiversity, which is becoming more and more and more common.

And as a result of that, the.

What generally happens is the parents get really curious about neurodiversity.

What does this mean?

What does this mean for my child?

And do loads and loads and loads of research and then either one or both will.

There'll be like a little penny drop moment quite often where they'll go, oh, that sounds like me.

Yeah.

And then it's a whole other issue and it's like, it's.

It's about an understanding of what that means for them.

So obviously they're not going through the diagnosis process, so they've got questions about what does this mean for me, should I get a diagnosis as well?

And so what I do with those clients is it's more of a psycho education, if you like.

It's explaining what neurodiversity is, but particularly because everyone is so different, what does their neurodiversity look like and what does that mean for them?

And because they're adults, they will already have loads and loads of workarounds.

They'll have spent a whole lifetime doing it.

So what workarounds are they doing at the moment that are helpful?

What's actually getting them to where they want to be, but equally which ones aren't Maybe quite so helpful and maybe there's other ones that I'm aware of through training and working with other neurodivergent adults that I know work for them and they might like to try.

So there's also the aspect of if they do want a diagnosis is supporting someone through that process because it can be quite brutal.

Just because of the language that's being used and the kind of forms they have to fill in and everything, or deciding with them or helping them to decide.

I don't make the decision whether it's useful to them.

Do they actually need it?

If they think they're neurodiverse and everything is pointing towards that, what difference does a diagnosis actually make?

Ah, this is quite an interesting one, you see.

Sorry to interrupt, but back in my osteopathy training days I did some work as a dyslexia support tutor for adults.

So I was working with adults with dyslexia.

Yeah.

And basically what had happened was they had exactly as you said.

They developed coping strategies to get through their young life and to get jobs where they didn't need to do the paperwork.

But because they tended to be really, really good at the jobs, they got promoted.

Yes.

And getting those promotions meant that they then started to get paid for.

They were moving away from the skills that they developed to cope with what they had to do and they were moving more into paperwork based roles that they were not suited for and didn't want to do.

So what happened back then is the, because of Disability Discrimination act, they, in the olden days, pre disability discrimination, they would, the company would either sack them.

Yeah.

But because that act come in, they had to, you know, if, if it was clear they couldn't, they weren't coping with the job.

Had to understand why they weren't coping with the job and then put appropriate measures in place to.

What was it?

Your reasonable adjustment.

Thank you.

Reasonable adjustments.

So that's when the company that I was working for got called in.

So we went in, we gave coping strategies and voice to tech software and all of those sorts of things.

It worked really, really, really well.

Really, really well.

But I mean one guy, he was, he was a network manager.

He'd gone all over the world installing networks and doing really, really well.

And then they promoted him to manager which meant that he then had to do loads of paperwork and that was when it didn't go so well.

So the courses were like six weeks and gave him a load of coping strategies and there's a couple of times where they had no idea they had dyslexia until they'd been tested.

And then in the first session, it kind of went.

I had this great diagram of all the different aspects of dyslexia, dyscalculia, dyspraxia, everything was on.

And we'd go through that and explain that dyslexia is not this.

Dyslexia is all of this.

It's a massive spectrum of different issues and we're going to work through this with you.

And I had a couple of people break down in tears because they didn't realize that it, it wasn't them, there was a condition that they had or there was something that was affecting them that they had no control over.

And because they've gone through all of their lives not having a clue, just being different and being labeled as stupid, that having somebody say, it's not your fault.

This is why, yeah, things happen.

This is why things have happened the way they are.

And this is why you struggle with reading or why you, you know, dyspraxia.

You have clumsy, clumsy child syndrome, as they used to call it back in the day.

Yeah.

So, yeah, it's quite interesting how things have changed.

It's.

Honestly, it's that moment when you actually see a client sitting in front of you and it's like they've just suddenly received an explanation.

Yeah.

That light bulb moment.

It is a genuine light bulb moment.

And that's what I mean by psycho education.

It's being able to explain and then support them in their particular version.

Because everyone I saw was different every case.

Different strategies, different, different approaches to how they could do the things they needed to do.

So.

Yeah.

But I think only once have I have I experienced someone where they're really disappointed, really have really struggled with the thought that they might be adhd.

Everyone else, it's been a question of.

Ah, right.

Explains it.

That explains it.

Right.

It's not an excuse, you know, going forward, but I can find workarounds now.

Yeah.

And it's no longer gonna hold me back, you know, because I'll.

I'll find a way to deal with this.

Yeah.

And it's.

It's like you say, I've.

I'm.

There's a reason why I'm a little bit different.

Yeah.

So, yeah, that's exactly the.

It's those adults of children where they're getting diagnosed and they've suddenly got curious about themselves.

Yeah.

Does that mean it's me?

Yeah, yeah, it's that one.

Okay.

Yeah.

I think that's the end of episode two.

Yeah.

So we've got another episode coming up, which is where we talk about, if you do come and see one of us, what the process is.

Because, again, one of the big mysteries is that when you go and see a therapist, whether it's a physiotherapist, osteopath, psychotherapist, what happens when you walk through that room, when the door closes, what's going to happen next?

So in the next episode, we're going to talk a bit about that.

Hope you enjoyed this one and we'll see you at the next one.