I can’t begin to count how often patients have asked me the differences between all three therapeutic modalities are. While the differences used to be more defined historically, it's now difficult to differentiate each therapy as there are quite a number of techniques and treatment approaches which we all share. Some of you will be aware of these, having perhaps been to manual therapists from all three. 

Some of you may only be aware of physiotherapy through the NHS, which is often quite different to the treatment protocol offered by private physiotherapists. In fact in my experience from attending continued professional development courses that  there are almost always a mixture of all three types of practitioners present on virtually all of the courses I have attended in the last 10 year period.

Osteopathy
Osteopathy in its most traditional form is a manual therapy which aims to reduce pain and return patients back to full function. It works with the structure and function of the body and is based on the principle that well-being of the individual is based on the neuro-musculo-skeletal system (nerves, muscles, skeleton and connective tissue) all working harmoniously together.

Osteopaths use touch, physical manipulation such as joint articulation and release (manipulation), stretching and a variety of soft tissue massage to increase the mobility of joints, to relieve muscle tension, to enhance the blood and nerve supply to tissues, and to help your body’s own healing mechanisms. They often provide advice on posture and exercise to aid recovery, promote health and prevent symptoms recurring. So osteopaths work to restore your body to a state of balance, where possible without the use of drugs or surgery.

All UK Osteopaths have completed a 4 year degree with rigorous clinical training after-which they have to be registered with the General Osteopathic Council (GosC). 30 hours of continued professional development (CPD) is required from us to enable us to remain on the register.

Physiotherapy
Physiotherapy [like Osteopathy] encompasses a range of interventions, services and advice aimed at restoring, maintaining and improving people's function and movement and thereby maximizing the quality of their lives, as defined by the CSP. Therefore much like osteopaths Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice. They maintain health for people of all ages, helping patients to manage pain and prevent disease.

It is certainly my belief that there are subtle differences between physiotherapy in the NHS (where perhaps the emphasis due to time constraints, funding, resources etc.) are more focused around rehabilitation through education and exercises programmes, thereby empowering their patients to participate in and achieve their own recovery. Physiotherapists in private practice have more time to spend with their patients and therefore can employ a range of other skills in addition to further improve a patient’s movement and function.

Physiotherapy is a degree-based healthcare profession Physiotherapists practising in the UK must be regulated by the Health and Care Professions Council (HCPC) and complete CPD hours annually. All our physios here at the Centre are also registered with the Chartered Society of Physiotherapy (CSP).

Chiropractic
Again, as with Osteopathy, Chiropractic is a healthcare profession concerned with the diagnosis, treatment and prevention of disorders of the neuro-musculo-skeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques including joint adjustment and/or manipulation with a typical focus on subluxations (misalignments of the spine). However they also address posture and lifestyle advice.

Chiropractic’s also study for 4 years, are regulated (by the General Chiropractic Council) and have to complete CPD hours each year.

There is a very short whistle stop tour through the three professions in a very simplistic and historic way. However, many of the manual techniques are now shared across the disciplines, as are the use of other techniques such as acupuncture in its various forms, from the traditional acupuncture perspective through to the very western dry needling type of acupuncture in its various guises.

If you're in need of treatment, it's really all about finding a practitioner and therapy and indeed their right skill set to best suit you. Sometimes that may come down to having a chat with a practitioner, looking online and ensuring that they are part of recognised regulatory body, getting recommendations from friends and family and, otherwise, going for an initial consultation.

I think the main point to take note of here is that each practitioner is an individual and is shaped by their own interests, experiences and the courses that they have undertaken since their undergraduate qualification. So it’s not only you - the patient as an individual, but the practitioner too and much less about the label that practitioner holds!
​

If there's one thing we've lost in our high-tech way of life, it's rhythm. And I don't mean whether you can bust a move (I'm sure you can). I'm talking about cortisol rhythm.

Cortisol is a hormone, and one of the main stress response chemicals produced by the adrenal glands. It is responsible for maintaining the health of and proper communication between every cell in your body. When it is in a healthy rhythm, cortisol is highest in the morning to give us energy and kick start our day, keep inflammation low, and immune response at its peak. It is naturally lowest before bed allowing us to wind down into a rest-and-repair phase. 

Prolonged exposure to digital devices at night that emit high levels of blue light, Lowers Melatonin production an important hormone that controls the sleep-wake cycle and can raise Cortisol levels associated with stress. When this natural cycle is disrupted, we can end up with:

• Sleep problems (insomnia, waking in the night, waking up tired in the morning)
• Hormonal imbalances
• Anxiety and depression
• Blood sugar and metabolic problems (including sugar cravings, metabolic syndrome, PCOS, and diabetes)
• Weight challenges
• Decreased memory, focus, and willpower
• Immune system imbalances leading to more frequent infections, reactivation of old viruses, allergies, inflammation, and even autoimmune disease

In fact, most long-term chronic health problems can be traced to disturbances in the natural Cortisol pattern. For example, obesity, digestive problems, diabetes, and even cancer have been linked to disturbances in Cortisol rhythm. So resetting your Cortisol rhythm is one of the most important steps we can take to lower stress and promote balance in our lives now, and ensure our health for the long term.

Disruption to Our Natural Circadian Rhythm
Before the invention of the light bulb, our Circadian Rhythms were well in sync with the sun, because nighttime light disruption was minimal. 

Your Circadian Rhythm is basically a 24-hour internal clock that is running in the background of your brain and cycles between sleepiness and alertness at regular intervals. It's also known as your sleep/wake cycle.

Today our exposure to blue light naturally emitted from the sun, isn’t controlled by the sun alone and the prolonged use of electronic devices in the hours leading up to bedtime has significantly increased our daily exposure to blue light. 

Exposure to artificial blue light in the evening can really disrupt the Circadian Rhythm. This disruption likely leads to a lower quality and quantity of sleep - which can result in major depression, bipolar disorder, post-traumatic stress disorder, generalized anxiety and other mood disorders.

What You Can Do
When done consistently, limiting the time spent on electronic devices in the evening alone can transform your life by resetting your sleep and lowering your Cortisol levels. While the science behind how blue light affects our health is still being studied, there are easy steps you can take today to protect your health.

• Limit screen time. Perhaps the most important thing you can do to protect your health from the harmful effects of nighttime lighting is to limit screen time after the sun goes down.
• Remember the most significant environmental trigger to your Circadian Rhythm is light. The metabolic processes should follow roughly a 24-hour pattern, so exposure to lighting in longer intervals can be disruptive. Because digital screens emit a significant amount of Blue Light, limiting your exposure to these sources is a great first step. 

Try it tonight! Turn off your digital screens two hours before bed. It's likely that you’ll start sleeping better immediately and you’ll also begin to feel better over time.

• Wear Blue Light Glasses. Blue light glasses are a trending topic, because they offer so many health benefits. They work by blocking a portion of the blue light wavelength from reaching your eyes.
• Remember that blue light is particularly important in regulating your circadian rhythm, because it creates the strongest response from the ipRGC photoreceptors. These receptors play an important role in the circadian rhythm and mood regulation. When we are exposed to these wavelengths at the wrong time of day, it can confuse our bodies.
• Get Outside during the day and reset your circadian rhythm. Exposing yourself to sunlight will send a signal to your body and help regulate your circadian systems.
• Adjust screen brightness. Maybe you work the night shift, respond to after hours emails, or simply want to catch up on your favourite TV drama, sometimes avoiding screens at night is difficult. Blue light glasses will protect you from any source of the wavelength. However, many mobile phones and computers also offer the option to adjust your screen’s brightness. You may find that shifting your brightness down during the evening can help minimize light pollution in your home.
• Change your light bulbs. Many energy saving light bulbs contain LEDs, which tend to produce higher amounts of blue light. By switching your light bulbs to a warmer hue, you can reduce your exposure. 

​

Diabetes is a disease in which your body cannot produce enough insulin, cannot use insulin, or a mix of both. In diabetes, sugar levels in the blood go up. This can cause complications if left uncontrolled. 

The two types of diabetes are – Type 1 diabetes is where people’s body do not produce insulin caused by an auto immune reaction, where the immune system attacks the cells producing insulin in the pancreas and is often diagnosed in younger age, and Type 2 diabetes is where the body often develops a resistance to insulin, i.e the body still produces it, but the body has an inability to react to it. Most of the increase in diabetes in the last 20 years is of Type 2.

Diabetes Symptoms
Early symptoms of diabetes are often undetected because they may not seem that serious. Some of the mildest early diabetes symptoms include:

• frequent urination
• unusual fatigue
• blurred vision
• weight loss, even without dieting
• tingling or numbness in hands and feet

The potential health consequences are often serious. Diabetes raises the risk of cardiovascular disease and can cause problems with your eyes, skin, kidneys, and nervous system (including nerve damage, or neuropathy). Diabetes can also cause erectile dysfunction (ED) and other urological problems such as inability to control urination, and urinary tract infections.

Fortunately, many of these complications are preventable or treatable with awareness and attention to your health.

Risk Factors 
Many factors can increase your risk for experiencing complications from diabetes, including:

• smoking
• being overweight
• avoiding physical activity
• having high blood pressure or high cholesterol
• being older than 40

Quitting or reducing smoking, exercising regularly, and maintaining a healthy weight are all highly effective ways to prevent the onset of diabetes. 

Lifestyle Changes

• Certain lifestyle choices can greatly impact your physical and mental well-being if you have diabetes:
• Balancing your meals with an even mixture of starches, fruits and veggies, fats and proteins can improve your bodily health and delay the onset of diabetes symptoms. 
• Avoid excess sugar, especially in carbonated drinks like soda and sweets. 
• Keep a regular exercise schedule and manage your blood sugar within your exercise regimen. This can allow you to get the full benefits of a workout without feeling shaky, tired, dizzy, or anxious. 

Could a Very Low Calorie Diet Reverse Type 2 Diabetes?

Scientists are busy researching a new weight management treatment, which includes a very low-calorie diet, to help people put their Type 2 diabetes into remission. The study is called DiRECT, short for Diabetes Remission Clinical Trial, and it could completely change the way Type 2 diabetes is treated in the future.

“Our findings suggest that even if you have had Type 2 diabetes for six years, putting the disease into remission is feasible”, says Prof Michael Lean from the University of Glasgow who co-led the study. “In contrast to other approaches, we focus on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimise individual results.”

The first year results are hugely promising. They show that it’s possible for some people to put their Type 2 diabetes into remission using a low-calorie, diet-based, weight management programme, delivered by their GP. Almost half (45.6 per cent) of those who took part in the programme were in remission after a year.

The study found there was a close link between Type 2 diabetes remission and total weight loss. 86 per cent of people who lost more than 15kg on the programme were in remission after a year, as were 57 per cent of people who lost 10–15kg, and 34 per cent who lost 5–10kg.

In the comparison group, where people had the best diabetes care currently available, but didn't try the new weight management approach, only 4 per cent went into remission.

If you would like to read more about this ongoing research, please visit Diabetes UK to get all the facts http://www.diabetes.org.uk/direct

You can also find out your risk of developing Type 2 diabetes by taking the test: https://riskscore.diabetes.org.uk/start

WHAT IS CHOLESTEROL?

Cholesterol is found in every cell of the body and has important natural functions when it comes to digesting food, producing hormones, and generating vitamin D. It is manufactured by the body, but can also be taken in from food. It is waxy and fat-like in appearance.

There are two types of cholesterol - LDL (lowdensity lipoproteins, bad cholesterol) and HDL (high-density lipoproteins, good cholesterol). 

LDL (bad) cholesterol
LDL cholesterol is considered the “bad” cholesterol, because it contributes to fatty buildups in arteries (atherosclerosis). This condition narrows the arteries and increases the risk for heart attack, stroke and peripheral artery disease, or PAD.

HDL (good) cholesterol
HDL cholesterol can be thought of as the “good” cholesterol, because experts believe it acts as a scavenger, carrying some of the LDL (bad) cholesterol away from the arteries and back to the liver, where the LDL is broken down and passed from the body. 

A healthy HDL cholesterol level may protect against heart attack and stroke. Studies show that low levels of HDL cholesterol increase the risk of heart disease.

WHAT CAUSES HIGH CHOLESTEROL?

All of the below can either increase your cholesterol level or affect the ratio of good to bad cholesterol:

• eating a diet high in saturated fat
• smoking – a chemical found in cigarettes called acrolein stops HDL transporting cholesterol from fatty deposits to the liver, leading to narrowing of the arteries (atherosclerosis)
• having diabetes or high blood pressure (hypertension)
• having a family history of stroke or heart disease
• being over weight
• There’s also an inherited condition called familial hypercholesterolaemia, which can cause high cholesterol even in someone who eats healthily.

Sometimes the way we live our life can affect how our genetic makeup is expressed. For example a diet high in saturated fat or being overweight may help “switch on” certain genes which increase cholesterol levels.

By making significant changes to your diet, within a few weeks you should see a reasonable reduction in your cholesterol levels. It is important to maintain these changes and perhaps even build on them in order to keep your cholesterol consistently low.

WHEN SHOULD CHOLESTEROL LEVELS BE TESTED?
Your GP may recommend that you have your blood cholesterol levels tested if you:

• have been diagnosed with coronary heart disease, stroke or mini stroke (TIA), or peripheral arterial disease (PAD)
• have a family history of early cardiovascular disease
• have a close family member who has a cholesterol-related condition
• are overweight
• have high blood pressure, diabetes, or a health condition that can increase cholesterol levels

WHAT SHOULD MY CHOLESTEROL LEVELS BE?
Blood cholesterol is measured in units called millimoles per litre of blood, often shortened to mmol/L.

As a general guide, total cholesterol levels should be:

• 5mmol/L or less for healthy adults
• 4mmol/L or less for those at high risk 

As a general guide, LDL levels (bad) cholesterol should be:

• 3mmol/L or less for healthy adults
• 2mmol/L or less for those at high risk
• An ideal level of HDL is above 1mmol/L.  

A lower level of HDL can increase your risk of heart disease.

Your ratio of total cholesterol to HDL may also be calculated. This is your total cholesterol level divided by your HDL level. Generally, this ratio should be below 4, as a higher ratio increases your risk of heart disease.

However, cholesterol is only 1 risk factor and the level at which specific treatment is required will depend on whether other risk factors, such as smoking and high blood pressure, are also present.

HOW CAN I LOWER MY CHOLESTEROL LEVEL?
The first step in reducing your cholesterol is to maintain a healthy, balanced diet. It’s important to keep your diet low in fatty food.
Try to avoid or cut down on the following foods, which are high in saturated fat:

• fatty cuts of meat and meat products, such as sausages and pies
• butter, ghee and lard • cream, soured cream, crème fraîche and ice cream
• cheese, particularly hard cheese
• cakes and biscuits
• milk chocolate
• coconut oil, coconut cream and palm oil

You can swap food containing saturated fat for fruit, vegetables and wholegrain cereals. This will also help prevent high cholesterol returning.

The government recommends that a maximum of 11% of a person’s food energy should come from saturated fat. This equates to no more than:

• 30g of saturated fat a day for the average man
• 20g of saturated fat a day for the average woman
• Children should have less

Check the labels on the foods you’re eating to find out how much saturated fat you’re consuming. Many experts believe that the fats found in avocados and oily fish, such as mackerel, salmon and tuna, are good for you. These are known as omega-3 fatty acids and high doses can improve (lower) triglyceride levels in some people. However, too much omega-3 fatty acids can contribute to obesity.

Other lifestyle changes, such as taking regular exercise and giving up smoking, can also make a big difference in helping to lower your cholesterol.

If these measures don’t reduce your cholesterol and you continue to have a high risk of developing heart disease, your GP may prescribe a cholesterol-lowering medication, such as statins. Your GP will take into account the risk of any side effects from statins, and the benefit of lowering your cholesterol must outweigh any risks.

TREATMENT
If you’ve been diagnosed with high cholesterol, you’ll be advised to make changes to your diet and increase your level of exercise. If after a few months, your cholesterol level hasn’t improved, you may be advised to take cholesterol-lowering medication.

Changing your diet, cutting down on alcohol, stopping smoking and exercising more will also help to prevent high cholesterol developing.

Cholesterol-lowering medication
There are several different types of cholesterol-lowering medication that work in different ways. Your GP can advise you about the most suitable type of treatment, and may also prescribe medication to lower high blood pressure (hypertension) if it affects you.

The most commonly prescribed medications are:

Statins
Statins block the enzyme (a type of chemical) in your liver that helps to make cholesterol. This leads to a reduction in your blood cholesterol level. Statins are prescribed to people who are at high risk of heart disease, because they need to be taken for life, otherwise cholesterol levels start to rise again once you stop taking them.

You’ll usually be started on a medication called atorvastatin. Other statins include simvastatin and rosuvastatin.

Aspirin
In some cases, a low daily dose of aspirin may be prescribed, depending on your age (usually over 40 years old) and other risk factors.

Low-dose aspirin can help to prevent blood clots forming, particularly for someone who’s had a heart attack, has established vascular disease, or a high risk of developing cardiovascular disease (CVD).

You may also be advised to have periodic blood tests to ensure your liver is functioning well.

Ezetimibe
Ezetimibe is a medication that blocks the absorption of cholesterol from food and bile juices in your intestines into your blood. It’s generally not as effective as statins, but is less likely to cause side effects.

Bile acid sequestrants (resins) or fibrates
If statins or ezetimibe aren’t effective, you may be prescribed a bile acid sequestrant or a fibrate.

Bile acid sequestrants bind to bile acids in the intestine and stop them from being reabsorbed. The body has to use cholesterol to make more bile acid, which reduces cholesterol levels in the blood.

Fibrates help to slow or halt the build-up of cholesterol in the arteries to reduce the risk of heart problems. They are given to people who have high cholesterol levels because they have a raised level of triglycerides in their blood.
If you have concerns about your cholesterol levels then it’s probably best to talk to your GP and get tested, but in the meantime why not take the ONE YOU Heart Age Test, which estimates your heart age compared to your real age. It also explains why it’s important to know your blood pressure and cholesterol numbers and advice on how to reduce your heart age.

Take the test here>>>>

​Back pain is one of the major disabling health conditions among older adults aged 60 years and older. Many causes of lower back pain are age-related with physical and psycho-social changes.

Back pain for the older adult is often associated with ‘wear and tear, or what is medically known as degeneration. For us two-footed creatures it is quite normal, and happens often earlier than you might think but there are steps you can take to offset the degeneration that comes with ageing.

It can often start in late 20’s early 30’s with acute disc problems or ‘slipped disc’ as they are commonly known and very debilitating, but as we get older back pain is often less acute but troublesome on a lower grade level. However, what is seen on MRI and X Ray does not always correlate with the amount of pain versus the degree of wear and tear.

The causes of degenerative back pain are many and varied, often involving multiple factors such as family history, posture, and particularly the movement patterns that we do at work, home and including interest, sports hobbies that we have. In essence, ‘we are what we do.’

Sometimes in older adults as they retire their movement patterns change, with some becoming more sedentary, whilst others take on different repetitive work such as DIY which their body is not accustomed to. Both ends of the spectrum can cause problems.

Similarly, older adults are more likely to develop osteoporosis, leading to fractures of the vertebrae affecting both men and women. Of course, there are other problems such as lumbar spinal stenosis tumours, spinal infection. However, whilst they exist, they are less common.

So how can we help ourselves. Well for the likes of degeneration and osteoporosis the golden rule is always activity, ‘use it or lose it.’ BUT activity as long as it’s not extreme can help.

This doesn’t have to mean extreme activities, it may be just walking regularly every day, with the dog, a friend etc also maybe explore hobbies like cycling - it doesn’t mean you have to run a marathon!

Similarly doing large amounts of DIY over a short period may well cause some problems, so this is where people need to pace themselves and change the activity regularly. Give the body chance to become adjusted to the change of activity and movement pattern.

Another factor to take into consideration for older people is balance and coordination. As mobility in joints can become restricted due to sedentary lifestyles, our ability to cope with sudden movements or upsets to balance deteriorates. This can lead to falls with the inevitable breaks and fractures bringing further limitations to activities and impacts on well-being.
​
Again, staying mobile and even trying new activities will help to offset the degeneration that come with ageing. Doing simple balance exercises such as one-leg balance or taking up yoga or tai-chi can lead to big improvements in movement. Better coordination can reduce tension in the body and the resultant wear and tear on joints and muscles.

Just remember to follow the basic rule: Move well, move often.

If you would like more advice give us a call on 01480 455221 or email info@centreforcomphealth.co.uk. We have plenty of practitioners ready to help you manage your back pain. Follow us of Facebook and Twitter

Before we look at the new treatment, let's look at a few facts about migraines. There are two types of migraine:

1. Classical migraine is when you have a warning sign, known as aura, before the migraine begins. About a third of people with migraine have this. Warning signs may include visual problems (such as flashing lights) and stiffness in the neck, shoulders or limbs, tingling sensation in the limbs, difficulty in co-ordination or speaking. 

2. Common migraine is when there is no aura.

Here are a few migraine facts.

• Migraine is the cause of 20 % of all headaches.
• It affects 15% of adults in the UK.
• They affect women more frequently than men.
• Usually first present before 40 years of age.
• This type of headache occurs when blood vessels of the head and neck constrict, resulting in a decrease in blood flow to the vessels, and then subsequently dilate causing pain.
• Migraine is usually experienced as a severe throbbing pain at the front or on one side of the head. Some people also have associated feelings of sickness and sensitivity to light and sound, sweating, tummy pain, feeling very hot or cold.
• Commonly lasts from a few hours to one or two days in some cases.

​​How is migraine diagnosed?
Your GP or therapist will ask you about history of any previous illnesses, family background, diet and lifestyle. They will ask for information about the headache, its length, duration, location, associated features, quality and causative factors.

Treatments

• Medically there are various treatments available for relieving acute attacks, starting with over-the-counter painkillers such as paracetamol or ibuprofen. These are most effective if taken as early as possible into the attack, preferably in a soluble form.
• Triptan medicines such as sumatriptan (Imigran orZomig). They cause the blood vessels around the brain to contract (narrow), as it is the dilating of blood vessels that causes the pain.
• There are also preventative medications such as Beta-blockers eg propranolol, amitriptyline (antidepressants)but are seen to be useful for migraines
• Identify and avoid trigger factors.

Natural treatments 
These include:-

• Osteopathy – to look at the body structure, in particular the head and neck for areas of tension or restriction of movement to the neck, but often involves the back too. Often there are preventative measures that can be advised upon to help manage migraines

• Physiotherapy – looks at the structure of the neck restriction of movement.
• Acupuncture – looks both to relieve tension and pain felt from a migraine, often there are preventative measures that can be advised upon to help manage migraines.

New Treatment for Migraine
A new preventative drug - Erenumab, could help those suffering from the most hard-to-treat migraines. It is sometimes possible for people to use an “abortive” medication, which, when taken early, can arrest the migraine process. For many patients, a preventive medication can decrease both the frequency and the severity of the migraines. Researchers have been working for decades to develop a “targeted” preventive therapy specifically for migraine, and now we are finally close to having an exciting new treatment.

In a recent study, 246 people who had an episodic migraine were given injections of either 140 milligrams of Erenumab or a placebo once a month for three months. After three months, 30 percent of the people treated with Erenumab had half the number of headaches compared to 14 percent on placebo. Those treated with Erenumab also saw a reduction in the number of days they had headaches. The safety and tolerability of Erenumab was similar to placebo, and none of the participants taking Erenumab stopped treatment due to side effects.

Professor Uwe Reuter added: "Our results show that people who thought their migraines were difficult to prevent may actually have hope of finding pain relief. More research is now needed to understand who is most likely to benefit from this new treatment.”

​Vascular disease is the collective term for diseases of the arteries, veins and lymphatics. Every part of the body to which blood flows can be affected by it. It’s as common as cancer and heart disease and accounts for 40% of deaths in the UK, many of which are preventable.
Vascular disease is not fully understood, but once it occurs it is not possible to  reverse or stop it from occurring. We do however know what the main risk factors are that speed up the process of atherosclerosis (the build-up of fatty material called atheroma within the artery walls causing them to narrow) and make some people more likely to develop this condition. These are:

• Smoking
• Diabetes
• High Blood Pressure
• High Cholesterol
• Diet and weight

Vascular disease can also be a hereditary condition, so if you have a history of the disease in your family, please discuss this with your GP.

If you’re over 40 years old, you are entitled to a free health check, which is carried out by your GP or practice nurse. Based on the results of your health check, your GP or nurse will advise you on what you can do to keep your heart and circulation healthy. Your GP will also consider whether you need to take medicine to protect your heart and circulation.

To get an indication of your potential risk and for pointers on how to minimise them, please try out the vascular risk checker. It only takes a few minutes to complete.Here is the link www.circulationfoundation.org.uk/risk-checker

STOP SMOKING
Smoking is the worst enemy of vascular disease and can increase the likelihood of developing the disease by 400%. It is very rare to find someone with arterial vascular disease who has not smoked at some stage in their life. It increases the risk of heart attacks, strokes and lower limb amputation.

It can be hard to quit, so getting support is important. Your GP can give you advice on how to give up, and information on stop-smoking services, nicotine-replacement products, and medicines to help you stop smoking.

Or you could try one of the following helplines or websites:
Smokefree – Phone: 0800 022 4 332.
Website: http://www.smokefree.nhs.uk

QUIT – Phone: 0800 00 22 00.
Website: www.quit.org.uk.

EAT HEALTHY
Eating a healthy diet can reduce your chances of developing vascular disease. A balanced diet can not only keep your weight, cholesterol and blood pressure under control, but it can also prevent against fatty deposits building up in your arteries. It can also reduce your risk of getting Type 2 diabetes.

Make sure you include plenty of fruit, vegetables and starchy foods, like wholegrain bread, pasta and rice, and reduce the amount of saturated fat, salt and sugar you include in your diet.
 

• Fruits and vegetables – There is good evidence that eating at least five portions of fruit and veg a day can lower the risk of vascular disease. Why not sign up to the Change 4 life Fruit & Veg Boost and receive FREE recipes, useful hints and tips and shopping advice! See the website here.

 

• Fats – We all need some fat in our diet; it is a good source of energy and provides essential fatty acids which our bodies cannot make themselves. However, eating too much saturated fat, can raise the level of cholesterol in your blood and increase your risk of vascular disease. Try cutting back on the total amount of fat you eat and replace saturated fats with monounsaturated and polyunsaturated fats.

 

• Salt – Eating too much salt can raise your blood pressure. By reducing the amount of salt you consume you can lower blood pressure and reduce your risk of vascular disease, heart attack and stroke.

For more information and tips on eating a healthy diet, please visit http://www.nhs.uk/live-well/eat-well
 
EXERCISE
Exercise is key to vascular health too. Exercise keeps us all fit and healthy, and for patients with vascular disease it can be particularly important. Patients with peripheral vascular disease can improve their symptoms and ability to mobilise, by undertaking a specific exercise programme. Patients who require an operation, both major and minor, can improve their recovery rate by being fitter and healthier beforehand. Could this be the right time for you to increase your level of exercise? Start with simple goals, and slowly build up your own exercise regime.

For more information on the benefits of physical activity please visit the Physical activity guidelines for adults
https://www.nhs.uk/live-well/exercise

Chronic Fatigue affects around 250,000 people in the UK and often diagnosed under a range of conditions including Myalgic Encephalopathy (ME) and Chronic Fatigue Syndrome (CFS). But while the exact cause is not known (it can occur in a wide age-range and types of people), three times as many women are affected than men. Many feel their condition was linked to a viral infection such as Glandular Fever. Trauma, stress and mental exhaustion are also considered to be other possible triggers for Chronic Fatigue.

Symptoms can differ from one sufferer to the next, but many experience persistent severe tiredness, muscle and joint pain, poor quality sleep, gastric disturbances, poor memory and concentration. For some the symptoms can be mild and the condition managed by careful scheduling of activities and allowing time to rest. In more severe cases, Chronic Fatigue limits the individual to all but simple tasks and can have a dramatic impact on lifestyle. Severe Chronic Fatigue is quite rare with most sufferers experiencing mild to moderate symptoms.

Diagnosing Chronic Fatigue involves first ruling out any other conditions that may be causing symptoms. If symptoms persist for more than four months in adults and three for children and young adults, then a doctor is likely to diagnose Chronic Fatigue.

Treatment for Chronic Fatigue often involves a multi-discipline approach as people respond in differrent ways

​
SELF-HELP - http://www.centreforcomphealth.co.uk/chronic-fatigue-syndrome-self-help.html

We hear a lot about the benefits of mindfulness for our health and well-being these days, and as every golfer knows – it’s pretty useful on the course as well. But does it require months of study and practice to be able to apply it to your game?
 
The good news is… no. Of course, the more you practice any skill, the better you will get, but it’s possible to become mindful in a second, or as I prefer, the old-fashioned term, to get into the 'here and now' or ‘the moment’. And do you know what? Golfers are usually pretty good at being in the moment... with a little practice.

Here's an example of a simple procedure you can apply for every shot you play, whether driving, chipping or putting. It's about breaking the shot down into individual parts so you don't have to think about a thing that isn't relevant at each particular moment in time.

Let's imagine you're around 80 yards from the green. What needs to happen to get the ball into the hole?

1. So first you need to select the club most appropriate to the shot - you're not playing the shot yet, only playing it through in your head.
2. Next you need to line up the shot, obviously taking into account the conditions of the day - but remember, you're not playing the shot for real yet, you're just assessing up the situation.
3. Then you take your position over the ball, all nicely lined up as you worked out in step 2. Some like to maintain a visual of where they want the ball to land, and as long as this helps you stay in the moment without it being a distraction, then this is fine.
4. Now you're ready to swing the club. You don't have to think about the choice of club because that's already done in Step 1. You don't have to think about the direction you're aiming, as you've already done that and in the right line, a la Step 2.
5. Now just swing :0)

​The key to being in the moment (or mindful if you prefer) is to focus only on the current task in hand. By not getting ahead of yourself, or by not worrying if you've got the right club once you've made the decision, keeps things simple.

From a physical point of view, it also reduces inappropriate muscular activity and therefore minimizes the chances of miss-hitting. If you've got unnecessary thoughts going through your head, you'll have corresponding muscular responses. For instance, if you're worried you're going to fluff the shot, your neck and shoulders will tighten and your shot WILL suffer.
When you're over the ball, you don't need to be distracted by thoughts of what might happen next - this isn't being in the moment and WILL have a negative impact on your shot.

By taking your time and focusing ONLY on what you're doing at that moment, can bring about a stillness, reducing the traffic firing up and down your spinal cord that will only interfere in your thoughts and movement.

Go on, give it a go and see if this simple technique makes a difference for you.

Post by Roy Palmer, our Alexander Technique Teacher and author of Golf Sense.