Archive: September 24, 2015

Unfit or side stitch? Tips on overcoming a stitch

I recently re-starting my running programme and was shocked to find I could only run 5-10 minutes before having to stop due to pain under the ribs. At first thought I presumed this was due to being deconditioned but when this didn’t settle after a few weeks I sought the advice of my good friend and colleague Daniel Kay (Osteopath at

Thankfully, he had the answer! After listening to me describe my symptoms, he told me it sounded like I was experiencing a side stitch. Interestingly, this injury is really common in new runners, and those who are returning to running, and is thought to be the diaphragm going into spasm.

So of course I was very keen to find out how to treat and overcome this injury and thought I would share the tips he gave me. I have applied these to my training and am now gradually increasing my speed and distance.

TIP ONE: Make sure you are not just mouth breathing and are inhaling as much through nose as possible

TIP TWO: Try to regulate your breathing to follow the same rhythm as your gait, i.e. exhale either every left/right foot step or every other or three, depending on your effort

TIP THREE: Try to fully exhale every 20 – 30 or so breaths to try and get the last 25% out of the lungs

TIP FOUR: Keep your head up and fix your gaze at least 100m ahead, try not to look at your feet or immediately in front for prolonged periods

TIP FIVE: Make sure you are hydrated and have not just eaten

The most comfortable seat in the office

Sitting uncomfortably at your desk at work can lead to you developing work related upper limb disorders (WRULD’s) or spinal pain which can be tricky to shift once aggravated. Many patients we see think the chair is often the culprit but it is isn’t always the case. We have found that as long as your chair has all the basic functions recommended by the Health and Safety Executive (HSE) it is actually more about how you set up and use the chair you have that really counts!

Here are our 5 top tips for getting the best from your office chair:

1. Adjust the seat height so your elbows are at the 90 degrees when using your computer – if you feet no longer touch the floor comfortably then invest in a foot stool.
2. Check the height of the back rest suits your stature! The built in lumbar support should sit in the arch of your lower back and the top of the back rest should be level or higher than your shoulder blades.
3. Position yourself right into the back of the chair so you can make full use of the back rest and support.
4. Pull your seat in nice and close to the desk to avoid ‘perching’ on the front of the seat.
5. Fix the back rest in position during typing and clicking activities but change it to free flow movement when you are talking on the phone, to colleagues or thinking of the next big idea!

For more information on what basic functions all office chairs should have and why work station assessments are required then visit the HSE’s website here.

pregnant women and physically demanding tasks

Employers often ask us our advice on what is safe for their pregnant workers to continue to do at work. There are of course a variety of factors that are considered hazardous to any worker, but through pregnancy these exposures can be more harmful to the worker as well as affect the developing fetus.

So what does the law say? Well there are a number of regulations that protect the pregnant worker such as the EU Directive-Pregnant Worker (1992), the Management of Health and Safety at Work Regulations (1999) and the Equality Act (2010). The employer has a duty of care assess any risks and to control them.

During pregnancy, any risks identified by an employer means they must try to alter hours or duties to try and control them or to seek alternative work tasks for them.

What physical tasks could affect the pregnant worker? There are varying levels of evidence to suggest that physical factors may be hazardous. For example, noise, vibration, radiation, extreme temperatures and handling loads (European Agency for Safety at Work 1992).

But what evidence is there around handling heavy loads at work whilst pregnant? There are some low quality studies which suggest that prolonged standing, heavy lifting and repetitive bending may affect pregnancy outcomes. However, most evidence is conflicting which is largely due to difficulties in defining what ‘heavy lifting’ actually is.

Restricting heavy physical work demands is therefore not seen as mandatory as the risks appear to be very small. Furthermore, physical activity during pregnancy has also been proven to have some health benefits (Kramer and McDonald 2006) so it is often encouraged that women continue with normal activity where possible.

Are pregnant women more prone to injury? During pregnancy, the hormonal changes affect the ligament elasticity which can predispose them to musculoskeletal injury. Special consideration should therefore be given when asking them to complete heavier tasks at work (HSE 2012).

Important final thought… Employers should always assess their pregnant workers individually to look at their physical capacity. If any difficulties arise during the pregnancy then a review is urgently required and medical advice sought.

The Health and Safety Executive (HSE) offers plenty of information and risk assessment templates for further support.

Click here to find out more information at the HSE website.