New clinic opening November 2018

We are pleased to announce that in November 2018, we will open a new osteopathic clinic in Finchampstead, Wokingham, Berkshire. The lovely semi-rural setting, allows for easy access and on-site parking. Eleanor and Dustie will be seeing patients here from the second week in November. More news to follow. Please note: Our Chalfont clinic will remain and Antonietta and Rebecca will be seeing patients as normal. Eleanor and Dustie will have reduced hours in CSG from November, but will still make regular visits to see patients.

 

Erb’s Obstetric Palsy

Erb’s Obstetric Palsy is a form of brachial plexus palsy is caused by damage to the C5 & C6 (and sometimes C7) nerves of the brachial plexus (which is located just above the clavicle). It can be caused by trauma to the nerve roots (stretch, rupture or avulsion) during delivery or a a clinical emergency where it is imperative that baby is helped out of the birth canal. Symptoms vary depending on the severity of the injury and the actual location.

Presentation: Some infants present with mild weakness or discomfort in the limbs, where others may have a loss of sensation or severe pain. Many infants will turn their arm inward, with a bent elbow, others hold it straight (with their hand slightly cupped).  Either may have difficulty moving the limb and some may also have reduced grip.

Treatment: In some cases, the problem will disappear on its own, but in severe cases, surgery maybe necessary. Others respond well to manual therapy, such as physiotherapy and osteopathy. Hydrotherapy can also be used to support the affected limb during therapeutic treatment. Recovery takes 1-12 months depending on the individual case and severity, but most average cases recover around month 3-4.

Occupational therapy may also be necessary with slightly older children to ensure that they can undertake day to day activity, such as eating and typing shoelaces.

Home management: Parents may be asked to undertake some activities to help baby’s recovery. These may consist of stretching, motion exercises, sensory stimulation and strengthening activities.

Recovery: In many cases (up to 80%), where an appropriate care team has been consulted, recovery is successful.

Surgical approaches: Where manual therapy alone is inadequate, surgical options may be considered. These often take the form of: Nerve Graft Repair or Nerve Decompression.

References:
El-Sayed AAF. Evidence of the Effectiveness of Primary Brachial Plexus Surgery in Infants With Obstetric Brachial Plexus Palsy–Revisited. Child Neurology Open. 2017;4:2329048X17709395. doi:10.1177/2329048X17709395. 
Al-Qattan MM, El-Sayed AAF. The outcome of primary brachial plexus reconstruction in extended Erb’s obstetric palsy when only one root is available for intraplexus neurotization. European Journal of Plastic Surgery. 2017;40(4):323-328. doi:10.1007/s00238-017-1302-2.
Al-Qattan MM, El-Sayed AAF. The outcome of primary brachial plexus reconstruction in extended Erb’s obstetric palsy when only one root is available for intraplexus neurotization. European Journal of Plastic Surgery. 2017;40(4):323-328. doi:10.1007/s00238-017-1302-2.

Pregnancy for a Second Time

Pregnancy for a Second Time

Written by Rebecca Willoughby

The information below is for first time and subsequent pregnancies alike.

No one but your family can decide on the time between children, however if you have suffered with issues such as Gestational Diabetes, Diastasis Recti or Symphysis Pubis Dysfunction it may be worth considering the time between children more carefully and what measures you put in place to help your body recover between pregnancies.

Painful or Difficult Walking

(Symphysis Pubis Dysfunction & Pelvic Girdle Pain)

This is not dangerous to the baby but can cause severe pain for mum. Symphysis Pubis Dysfunction is pain at the front of the pelvis while Pelvic Girdle Pain causes pain mainly in the back of the pelvis. There is sometimes pain in the pelvic floor area.

It’s estimated that 1 in 5 pregnant women suffer with pelvic pain to some degree.

In the majority of cases it occurs in the second and third trimester. Occasionally it occurs after labour.

It is important to take preventative steps and seek help as soon as symptoms are felt.

Symptoms

  • Pain localized to the front of the pelvis (Pubic Symphysis): Shooting, Stabbing, Burning, Grinding and Clicking
  • Pain radiating to lower abdomen, groin, pelvic floor and front of the thigh
  • Pain on walking, going up and down stairs, getting up from a chair, standing on one leg, bending the hip or taking it out to the side, turning over in bed, moving your legs apart (getting in and out of the car, shower or bath).

If you had Symphysis Pubis issues in your first pregnancy ensure that you follow the advice you were given during your first pregnancy from the very beginning of your subsequent pregnancy. Just as a reminder:

It is important to avoid pain causing activities such as fast walking, climbing stairs, taking legs apart (getting in and out of the car, shower or bath), however it is also important to maintain mild to moderate exercise within painless limits. Take regular rest breaks throughout the day and after exercises. Swimming is a great exercise as you are not weight bearing on the pelvis but maintaining some fitness (N.B. avoid breast stroke). Yoga and Pilates are also good for maintaining suppleness as well as abdominal and pelvic strength, but avoid any positions that lead to taking the legs apart from each other.

Other advice that might help:

  • Get help with household chores
  • Wear flat, supportive shoes
  • Avoid standing on one leg – sit down to get dressed
  • Keep knees together when getting in and out of the shower, bath or car – a plastic bag on the seat can help to swivel
  • Avoid squatting and open legged postures
  • Sleep on your side with something between your knees to keep the top leg level
  • Take the stairs on at a time or go upstairs backwards or in a sitting position
  • Avoid bending and twisting to lift anything
  • Avoid carrying a child or bag on one side
  • Avoid crossing your legs
  • Avoid strenuous work during pregnancy
  • Try to avoid poor posture and excessive weight gain

Most relaxing posture for Pubis Symphysis

  • Lie on your back or in a semi seated position
  • Have your knees and hips flexed
  • Move feet approximately 12-18 inches apart
  • Now bring the knees together
  • Lie on your back or in a semi seated position
  • Have your knees and hips flexed
  • Move feet approximately 12-18 inches apart
  • Now bring the knees together

For osteopathic appointments, please call. 01494 980197

Appointments available 7 days a week.