Sprains and strains to muscles and joints happen to all of us and for most, they are a painful but temporary reminder to be a little more careful. Prompt action can help your body to heal faster and may prevent further injury or prolonged pain. 

Strained or ‘pulled’ muscles often happen when we over-exert untrained muscles, train without properly warming up or try to go beyond a joint’s natural flexibility. Sometimes we feel the pain straight away, however, some injuries might not cause pain until later on. What can you do?

Remember RICE (Relative rest, Ice, Compression, and Elevation), using these can help to relieve the pain and start the healing process.

Relative rest: The first thing to do if you feel pain is to reduce the offending activity – pain is usually your body’s way of telling you that there is something wrong that needs your attention. It can be normal to feel a little sore after exercises for a day or two, but if it is more than this, pushing through the pain is rarely beneficial.

However, movement stimulates the healing process so stay as mobile as you comfortably can. Try to keep the joint moving through a comfortable range of motion, without forcing it to the point of pain. This will help to encourage blood flow and keep your joint flexible whilst it heals. This is particularly relevant for back pain as gentle exercise, such as walking, can help. You should slowly build your activity levels up as soon as your symptoms begin to resolve and as soon as you are able.

Ice: Cooling the area using an ice pack can help to reduce swelling and pain. Wrap a thin tea towel around the area so as to avoid direct skin contact and then apply the pack to the injured area for 10 – 15 minutes. You should repeat this several times per day for the first 72 hours. This will help to control inflammation, making it easier for your body to get blood and nutrients to the area and resolve the injured tissues.

Compression: Gently applying a compression dressing may help to temporarily support the injured joint and reduce swelling, though remove this immediately if there are signs that this is reducing the circulation to the area (numbness, pins and needles, the skin turning white or blue etc).

Elevation: If the injury is in the lower limb (knee or ankle), elevating the area a little can make it easier for your body drain fluids that might accumulate around the area, causing swelling. For example, if you’ve hurt your knee, sitting down with the knee raised on a low foot stool may ease your pain.

Seek medical attention. If you have pain that can’t be controlled with over the counter painkillers, can’t put weight on the injured limb, experience paralysis or loss of sensation or the swelling is very bad, seek help from your local A&E department, urgent care centre or telephone 111 for advice.

If the pain or swelling fails to improve within a week, a visit to an osteopath may be beneficial. They will be able to assess the injury, advise you on the correct treatment and can provide some manual therapy which may help it get better faster.

At Calmer Clinics, we have well-experienced osteopaths who have been working with athletes and sports people, the elderly, and also kids and babies.

To book your injury assessment and healing appointment with them ( Laura Maidment, Alexia Lescure, David Propert and Owen Davis) check their profiles or give us a call/email here. 



They call me the wanderer! The Vagus Nerve and Psychobiotics.

In human anatomy, when we talk about the Vagus Nerve, we are not describing what happens somewhere in the Nevada desert. No, the 10th cranial nerve is named after the latin for ‘Wandering’. As are the words vague and vagabond. The reason this particular nerve is described as such is because it is the longest of the cranial nerves and stretches from the paired roots in the brainstem to the lowest part of the viscera, connecting with the heart along the way.vagus-nerve-connectionThe vagus nerve is part of the autonomic nervous system, responsible for functions we normally do not consciously control, although, by means of biofeedback and certain yogic and other mindfulness practices, we can learn to regulate them. The autonomic nervous system is divided into a sympathetic (‘fight/ flight’) division and a parasympathetic (‘rest/ digest’) division. The vagus nerve is part of this latter functional division and so is vitally important when it comes to controlling the vegetative, relaxation and healing/ repair processes of the body.

There is constant activity in the vagus nerve which we term ‘Vagal Tone’. So, for example, when the heart rate needs to slow down our vagal tone increases to enable this. When our gut needs to process a meal, again, vagal tone increases to facilitate digestion. Conversely, when our heart rate needs to speed up or our gut function can idle, the vagal tone decreases. This happens during the acute stress response (‘fight/ flight’) to produce the necessary physiological changes required for dealing with the situation. All perfectly healthy and normal. However, if the stressor persists (or is perceived to still be there) the stress response becomes chronic and inappropriate which is characterised by a sustained low vagal tone. This, in turn, can lead to problems such as heart beat irregularities (‘palpitations’, racing heart rate), gut disorders (IBS, acid reflux, ulcers), and inflammation.

So, one of the best ways of monitoring how stressed we are would be to measure vagal tone. But how do we do this? With the development of wearable technology and applications on devices such as the smartphone, we can now do this accurately and non-invasively. The metric used is something called ‘Heart Rate Variability’, or HRV for short, and there are several apps that can measure this. A high HRV means high vagal tone which is desirable over the long term. Individuals with low HRV (low vagal tone) over time are vulnerable to the dysfunctions associated with chronic stress (dis-stress). For example, a low vagal tone is associated with chronic inflammatory changes, including the release of chemicals called cytokines, which are fundamental to diseases such as the rheumatic conditions and atheroma as well as psychological conditions such as depression and hyper-anxiety. Recent research has shown that stimulating the vagus nerve actually secretes anti-inflammatory factors (‘Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis’ by Koopman et al in PNAS, July 2016) and this has exciting implications for interventions in these disease processes, for example with surgically implanted vagus nerve stimulators (VNS).

Another feature of vagal tone is its role in the so-called ‘Gut-Brain’ relationship. The vagus nerve not only communicates the status of our gut to the nervous system and vice-versa but also integrates information about what is going on in the immune, endocrine, and nervous systems. We know that the ecology of the gut has profound effects on overall body physiology and the mechanisms for this are being elucidated. One of the key developments in our understanding of our relationship with gut flora has been the discovery of communicating factors produced by the commensal microbes (microbiomes) in our gut. The vagus nerve responds to these and, in turn, can transmit information to and from the gut/ brain. Those ‘gut feelings’ really are profound! A new book by Dr. Emeran Mayer, professor of medicine and psychiatry at UCLA, called ‘The Mind Gut Connection’ explores this new science of ‘Psychobiotics’.

Can we influence this without impacting a vagal stimulator or applying a Vulcan nerve pinch?


Yes, we can, and it’s not especially difficult. Vagal nerve stimulation occurs when we take a few deep breaths and breathe out slowly and forcefully to exercise the diaphragm. It also gets stimulated when we hum or speak due to the resonant frequencies (a reason, perhaps, for the efficacy of the ‘OM’ chant or singing and chanting in religious ceremonies). Splashing cold water on the face is another way of triggering a parasympathetic (vagal) response and may be linked to the so-called mammalian dive reflex. Loving-kindness meditation has been shown to induce higher vagal tone (‘How Positive Emotions Build Physical Health: Perceived Positive Social Connections Account for the Upward Spiral Between Positive Emotions and Vagal Tone’, Fredrickson and Kok 2010). Also, given the importance of the reciprocal gut/ brain connection, maintaining a healthy gut ecology is vital for good parasympathetic/ sympathetic balance.

At Calmer Clinics we are proud to have a range of clinical approaches that can address these issues, helping to restore a healthy vagal tone.