A recent client at Unwind came to see me after four months of near-constant pain from tennis elbow. He’d done all the right things — researched exercises, worked with an NHS physiotherapist, and initially made great progress. His day-to-day pain reduced significantly.
Then it flared up again with a vengeance.
That frustrating feeling of “I’ve done everything — and I’m back to square one” is incredibly common with tendonitis (more accurately called tendinopathy). If you’re reading this, you may know that story well.
I do too. I’ve had tennis elbow (lateral epicondylitis) and, more recently, golfer’s elbow (medial epicondylitis) courtesy of some over-enthusiastic indoor bouldering. What I’d like to share is how I stopped my own golfer’s elbow before it fully took hold — and the approach I used with this client.

Renowned physiotherapist Kelly Starrett encourages us not to focus only on the site of pain, but to look at what’s happening “upstream and downstream.” In the case of tennis elbow, that means considering the relaxed position and function of the shoulder, head and neck, wrist, and hand.
Many extremity problems also stem from altered alignment in the spine and pelvis, often the result of old injuries the body has adapted around.
Since completing Kelly Starrett’s movement and mobility course in 2024, I use his assessment methods to identify areas of restricted motion and weakness. I also draw on Grey Cook’s Functional Movement Screen to help uncover the underlying drivers that often cause conditions like tennis elbow to keep returning just when you think they’ve resolved.

The hands-on chiropractic work I provide aims to improve structural alignment, changes that many clients notice from the very first session.
The “homework” I give is based on the research of Dr Keith Barr, Professor of Molecular Exercise Physiology, whose work focuses on how tendons heal and how to build their strength and resilience. If you’re interested in learning more, you can find several interviews with him on YouTube and Instagram where he explains his research in detail. 

This is exactly what my recent client did. He adjusted the exercises he had already been doing — which had stopped producing results — and applied Dr Keith Barr’s principles of tendon healing. After just one chiropractic session, he returned the following week reporting the most progress he’d experienced in months: his daily, near-constant elbow pain had reduced to being mostly pain-free, with discomfort only at specific and predictable times. 

​This was fantastic news and exceeded my expectations for how quickly he might notice improvement. That said, his elbow isn’t completely out of the woods yet. The biggest challenge now will be resisting the temptation to use the arm as normal too soon and risk setting the problem back. 

At the time of writing this blog it's still early days and with his permission I will add an update on his progress.

Could your discomfort be the result of a lifetime of your body compensating for old injuries or poor posture? If so, I can help. In this blog post, I’ll explain how past injuries are often compensated for and hidden from our day-to-day awareness, while quietly building into bigger problems over time. I’ll also share a couple of simple ways you can test the current state of your body.​

Do you wake up with stiff or sore joints? How flexible are your hips, knees, and ankles? Can you comfortably rest in a squat position—like a toddler—with your heels on the ground? How mobile are your neck, back, and shoulders, or have they gradually stiffened over the years?
It’s also worth thinking about what your body has been through in the past plus your physical daily habits. Have you had past injuries such as falls, sprains, road accidents, or sports injuries? Do you eat a lot of sugar? Are you getting enough protein in your diet? (Most adults need around 1.5-2g of protein per kilogram of body weight per day—more if you exercise.) Do you tend to breathe through your mouth? Have you ever broken a bone from a fall?
All of these factors can influence the overall condition of your body. When you decide to improve your health and reduce aches and pains, it can feel overwhelming if there are many things to change at once. Instead, start with small, manageable steps. Choose one area of your health or lifestyle where making a positive change will be relatively easy, and track your progress. 

When temperatures drop and snow compacts into ice, the risk of slipping and taking a heavy fall increases for everyone. Wearing good, grippy shoes, using snow grips, or walking poles can certainly help—but what else can you do to reduce your risk of falling, and limit the damage if you do?
One of the most important steps is improving your body’s overall condition and resilience.

I now include this squat test as part of the initial consultation because it reveals a lot about how your body is functioning. It helps us see where your mobility, balance, and strength are currently at, and it gives a good indication of which stretches or exercises may benefit you—if you choose to work on them once you’re out of pain. It’s also something I’m continuing to work on and improve for myself, so I know firsthand how valuable it can be.

Oh no I caught a cold, I thought I was taking all the right supplements so how did the cold get in? What we know from research is there's such a fine balance of our body in our environment (not just our home, where we live but also our diet, lifestyle and stress levels) that influences how well our immune system functions.

In this list below there are going to be things you'll have more control over than others. It's about doing our best with the resources and knowledge we have at this point in time. See what you have control and influence over and where you can make changes for the benefit of your immune system.

The problem all of us have is, even from birth, our spine and body has had to make compensations for misalignments that the body could not self-correct. Typically this happens seemlessly in the first 20 years of life and for the most part, we will have been unaware of these minute tilts and twists the body has used to keep the whole body balanced over our feet. Speaking generally, this compensation begins to make itself known from our mid-20's onwards with aches, tension and the occasional muscle twinges and spasms as the muscles work hard to hold the skeleton upright against gravity.

One of the most common reasons for a disturbed night's sleep is pain or discomfort from muscles and joints. Depending on what is going on for you the following suggestions may only help to a certain extent and the main focus may need to be on correcting your spine. If you haven't already been in touch with me I encourage you to look into each of the following recommendations to see what difference they make. If you have any questions, feel free to get in touch.

Side sleeping is the optimum position for your back, neck, internal organs and breathing. There are all sorts of reasons why this may not be comfortable for people and if this is you, this is a key factor to address where possible. For my line of work I'm thinking of musculoskeletal reasons why you may not be comfortable in this position. 
Perhaps you get shoulder pain, or pins and needles or hip pain. Whatever those types of symptoms it's likely that you don't have to put up with them if you get your body corrected.
Side sleeping is best for the open ventilation of the airways too. 

Sleeping on your front often contributes to low back discomfort as the curve in the lumbar spine arches more. Turning your head to one side will also create tension in the neck and shoulders and tends to flatten the thoracic kyphosis (mid back curve).

Optimum positioning of your head is helped by getting your pillow height just right...

This is the easiest and cheapest thing to change first.
Lying on your side you're looking to keep your head inline with the rest of your spine. This is done by trial and error using layers of foam for a pillow. Alternatively you can use layers of towels under a thin pillow. To find the correct number of layers you will need to test it out.

As a rule of thumb: If your pillow is too low your shoulders will feel rounded forwards and you'll feel like your body wants to roll forwards - add a layer.
If your pillow is too high you'll feel like your body wants to roll backwards - take a layer away.

Stick with it, you will find the 'sweet spot'!

The position in which you relax in the evenings has the potential to prime your body for discomfort the following morning.
One of the worst things for our spine is to sit slumped and twisted on a soft sofa (at any time of day) despite being comfortable at the time. Sadly it's also quite a good way to undo your Chiropractic adjustments too.
How do you usually sit?
Which way does your spine flex?
Which way do your hips twist?
What's happening in the knee and ankle joints?
Could you sit as comfortably the opposite way round?
This tells you a lot about which discs, ligaments, muscles and joints you're repeatedly stressing and possibly resetting the issues that you wanted to resolve. It's worth being aware of this so that you can make a more informed choice about what you sit on and how you sit on it.

I strongly advise you to invest in a sit/stand desk, they're so good! The one I have is from IKEA - of course there's plenty more companies that make them. There are many models to choose from and I see that there's an option to just buy the frame so that you can make your own desk top that fits your office. Get creative, I'm thinking a light kitchen worktop so you can have this desk/work-top type set up.

The benefits of changing working position throughout the day...

• You'll vary the loading on your spinal discs and joints so that no one area takes the strain all day
• Sitting for long periods of time naturally flares the pelvis and will stretch the supportive ligaments potentially causing you discomfort. If you get to stand for a while and move around during regular breaks it makes sense that you'll avoid this.
• In a sitting position the hip flexor muscles are in a shorten position and hip extensors are lengthened, you can appreciate that over the course of weeks, months and years of being in this position can lead to muscular imbalance issues and that's not great news for low back problems.
• You burn more calories standing because it's a more active position.

The options you have...

1. Buy a brand new hydraulic sit-stand desk and stool (or if possible, modify a desk chair you already have)
2. Get a Varidesk or something similar to place on top of your existing desk.

The surface that you stand on or have your chair on must be level and hard ie not carpet or a spongy/squashy surface. This goes for whatever you wear on your feet. The reason being, if your heels sink down into the floor surface or shoes making them lower than the bones in your mid-foot it sends the message to your brain that you're standing on a very slight slope, the body has to then make compensatory adjustments in the joints of your legs, back and spine and your muscles to keep your centre of gravity balanced. This can lead to a build up of tension and fatigue in certain areas of the body that are specific to your configuration.

My patients commonly talk about 'a weak spot' or an old injury area of their body that tends to play up when they sit for long periods or with certain activities. Do you have that? What positions bring it on? Which of these main points that I'm talking about could you modify that could help reduce this mechanical stress?

If you've visited the Unwind clinic you may have noticed the stool I use complete with it's DIY mods that I've done. It was originally a 'saddle stool' which I did find really comfy but eventually realised it was giving me headaches. I unscrewed the seat part and binned it, replacing it for a square of MDF with a piece of 4mm yoga mat glued on for comfort. This is the best office chair I've ever had. I can set the height and angle (tipped forwards) so that it gives me all the support I need for my back, this is what we want to achieve for you too.

Many office chairs, dining chairs, bar stools etc etc have the surface of the seat tilting backwards which encourages your pelvis (which supports your whole spine) to rock backwards into a slumped shape. Slumped is bad, equally, having to hold yourself upright - fighting against the position the chair is forcing you into - is also bad news for your back and neck.

You can use wedge cushions or the yoga wedge that I have in the clinic to improve the function of your chair.

What repetitive movements are you doing throughout the working day? Which activities are contributing to your problem? Is there a way to change it?
Do you have to repeatedly stretch or bend down to one side to say use the printer, getting things out the drawers or talk to colleagues? 
Do you talk on the phone a lot? Do you trap the phone between your ear and shoulder in order to multitask?

My advice is to explore how to look after your body so well that you remain fit and active and injury-free - physically and mentally. This means getting in tune with our body and recognising the body signals that alert us that things are beginning to 'go-downhill' and take steps to resolve the issue rather than waiting until a problem really takes hold.

There are many yoga and pilates exercises which are great for your body. For those of you receiving care at Unwind I will make specific recommendations to modify some positions to ensure the progress of your treatment.

This is important from a chiropractic view point because whatever twists you had in your spine and whole skeleton before you got pregnant will now be changing as a result of the effects of this hormone circulating in your body during this time and for approximately 5 months after childbirth.

You may know someone who's back pain disappeared when they got pregnant and hasn't returned or equally someone who never had a bother with their back/neck/shoulders etc until they had children. Aside from the physical stresses of pregnancy, child birth and bringing up children, a woman's body isn't the same as it once was and this absolutely includes the alignment of the spine.

• The condition of your spine before you became pregnant,
  
• How the spine twists to compensate for old injuries and postures,
• Relaxin hormone,
• Foetal position and your posture,
• The pelvic floor & baby sling analogy

Finally an exercise you can try at home.

• A simple exercise you can do that may relieve your back ache and pain, and pubic symphysis disorder pain. If you have knee and/or upper extremity (shoulder, elbow, wrist and hand) problems please seek advice from me or your health care provider before trying this exercise as they will also be a priority for treatment too.
• How treatment at Unwind has helped other mum's-to-be.

The pregnancy hormone Relaxin is released during the first trimester until approximately 5 months after the baby is born. It affects the size and elasticity of ligaments, connective tissue and muscle, preparing the mother's body for adapting to carrying her baby and giving birth.

As I mentioned earlier, this relaxing effect on the body tissues will allow for the body to go further into it's twist or altered alignment. From a biomechanical stress point of view this means the regions of stress will change relative to what they were before pregnancy.

To make sense of this we must remember that the human body works as a whole, a single functioning unit where balance is key. Think of your body as a piece of architecture, this is a great analogy.

This explains why some people who have never experienced musculoskeletal pain before suddenly have a problem and equally those who have suffered for years find that their pain issues are resolving. Sadly for the latter, this doesn't mean they're fixed, it means that the region of the body under the highest compensatory stress and strain has now shifted to another region of the body, that for now, can take the strain. (Often these people tell you they have been experiencing a new pain problem that they haven't had before or in many years.)

Whilst the significant associations with insufficient sleep and physical diseases and mental disorders are seriously alarming, we can use this knowledge to our advantage and take small, simple steps feel better now and for the future.

In his book Matthew Walker, Professor of Neuroscience and Psychology at the University of California, Berkeley and Director of the Sleep and Neuroimaging Laboratory, describes how a lack of sleep negatively affects many chronic pain conditions. 
The latest sleep research gives us the knowledge we can use to boost your progress with treatment. In this blog I'll talk about why and how we can make small changes to improve our sleep quality to not only feel better in the coming few days but reduce the risks of lifestyle related dis-ease in the future.

Sleep studies are able to show us the patterns of sleep we go through by monitoring brain wave activity. The question of why we sleep has been a subject of great interest, given that insufficient sleep predicts all-cause mortality including your risk of post-traumatic stress disorder (PTSD) and other mental health conditions, we can confidently say it is one, if not the main foundational pillar of health.

I recently attended a seminar series about the neurobiology of pain conditions and it was the research on Overlapping Chronic Pain Conditions (OCPCs) that the presenter discussed that really peaked my interest. Most, if not all, of my clients at Unwind have this to some degree and when you listen to the interviews and TED talk with Matt Walker you really get an appreciation of you can make proactive, positive steps to turning the condition of your body around for yourself.

This is the great thing, it's free! All you have to do to start is see which ideas below you know you use improve your sleep and therefore have a knock-on affect for your...

• Chronic, reoccurring widespread pain conditions
• Inflammatory conditions
• Diabetes and blood sugar control
• Weight loss
• Sports performance
• Concentration levels
• Overall feeling of wellbeing

Pick just one or all five of these tips to begin transforming the quality and quantity of your sleep...

1. Give yourself enough time to digest your food before bed. Sleep is a time for rest and repair of the body, brain and mind. This cannot happen properly if you have a belly full of undigested food.
2. For good sleep to occur our core body temperature must drop slightly and a cool bedroom will help this happen.
3. For normal melatonin release in the brain we need light levels to be very low. Blue light from screens signals to our brain that it's time to be wide awake. This is courtesy of millions of years of evolution and cannot be cheated.
4. Caffeine has a half-life of approximately 10 hours. It is a psychoactive drug that affects the amount of the various stages of sleep that you get at night. Even if you stay asleep all night after a coffee in the evening, your time in deep sleep is very likely being affected.
5. Exercising (both cardiovascular and resistance) is so important to overall health and sleep. Ideally exercise in the morning. If you only have time for exercise in the evenings you can reduce your core body temperature before bed by having a hot bath or sauna. This brings blood to the surface of the body and aids cooling the core.

For more information about how releasing Nitric Oxide improves your health and wellbeing click here to read more.

If you are in pain or your body is preventing you from exercising for any reason do get in touch with me to see whether I can help you. Getting people active again is one of the most rewarding parts of my job, I love it!