The Tokyo 2020 Olympic Games might be over. But that won’t stop one particular moment from going down in history.

When Simone Biles – the four-time Olympic gold medallist gymnast – withdrew from the team final in a bid to ‘focus on her wellbeing’, followed by the individual all-round, vault, bars and floor finals, it made headline news across the world.

Some accused the American gymnast of using ill mental health as an excuse. While others praised the 24-year-old for putting her total wellbeing first.

Striking the balance between physical and mental health

At the time, Simone told journalists: “I have to focus on my mental health.

“I just think mental health is more prevalent in sports right now… we have to protect our minds and our bodies and not just go out and do what the world wants us to do.”

This is something Osteopath Robin Kiashek agrees with.

Robin, who has 25 years’ experience in helping his patients achieve physical and emotional wellbeing, is a big believer in taking a holistic approach when it comes to your health.

“Simone wasn’t the first athlete to take a step away to protect her mental health and overall wellbeing – and I’m sure she won’t be the last,” Robin says.

But whether you agree with Simone’s decision or not, striking the right balance between your physical and mental health is a necessity.

“This is because you are more prone to physical injury if you aren’t in the right mental state,” Robin adds. “And once you are injured, rehabilitation can be a long road to recovery. “You only have to watch tennis champion Andy Murray’s touching documentary to witness this. In the documentary we see Andy’s struggle with chronic hip pain, which resulted in many attempts to ‘fix’ the problem, including an unsuccessful surgery.”


R is for rehab and rest

We’ve spoken before about how the ‘Next Day Delivery’ culture of expecting results at the click of a button is becoming increasingly prevalent.  And our approach to recovery from injury is no different.

But many patients who have a sports-related injury feel that by ‘keeping calm’ and ‘carrying on’, it can help combat their disruption and control stress.

“When in fact overdoing things can often be a factor in causing the initial injury,” Robin says. “Which is why it’s so important listen to your body.


R is also for rest

However, this can be easier said than done. As carrying on as normal is something we are all guilty of doing – Robin included.

Robin recently tore his medial knee meniscus doing excessive breaststroke, which he acknowledges was his own fault.

He said: “As soon as my local swimming pool reopened after the long lockdown, I quite literally dived straight back in to doing the 60 length sessions I was doing prior to this.

Which is why Robin is encouraging everyone to ease back into exercise safely. And be intuitive of your mind and body.

Perhaps when exercising, the words to keep in mind come from the 32-time Olympic and World Championship medallist, Simone, who said: “Physical health is mental health.” Or as the ancient Greeks once said: “Mens sana in corpore sano”, which means: “Healthy in mind, healthy in body”.


Robin Kiashek is an Osteopath with 25 years’ experience in the industry. If you are struggling with any condition affecting your body and struggling to find a solution, don’t hesitate to reach out.



By the title of this blog, you might be thinking this article has something to do with the overly colourful and sugary array of treats designed to tempt you into filling up a carton (or two) on your trip to the cinema.

But it hasn’t. This blog is in fact talking about a taking a ‘pick ‘n’ mix’ approach to exercise. Stick with us…


Exercise is for everybody

No matter your age, there is a form of exercise for everybody. Whether it’s cycling, boxing, swimming, the once-popular step aerobics or perhaps the more sort after HIIT training. The list goes on.

But with exercise options being limited last year, after the temporary closure of gyms and postponement of in-person exercise classes due to the Covid-19 pandemic, more and more people have turned to running.

“Which is great,” Osteopath Robin Kiashek, says. “It’s certainly much better than sitting on the sofa.”

“I see patients who run 10K, four times a week and have been doing so for years. But I understand that it’s not just about the cardio benefits that it brings. People use exercise time to destress mentally too. Perhaps to mentally switch from work brain to home brain, or vice versa.”

According to the latest stats, an estimated 7 million people across the UK turned to running or jogging in 2020 during the height of the Covid-19 pandemic to boost their mental health.  With one in seven people in the UK saying running had helped them deal with stress.

But with our love affair with running seeing no signs of slowing down, there is of course the risk of injury.

“Such a high impact exercise will affect your joints,” Robin says. If not now, it will happen at some point later.

“I’m not picking on running. We all know how many positives come from it. And you only have to look at the stats to confirm this. But in the case of our 10k runner, that’s a lot of weight through those knees. And that’s assuming you’re not carrying any extra weight to start with.”


So what exactly is the answer?

With restrictions being lifted on July 19th and more and more exercise options opening up, the key is to make sure that your weekly exercise regime is varied.

“Just like pick ‘n’ mix,” Robin adds. “So why not strike a balance with high impact exercises and introduce some low impact cardio workouts into your exercise regime?”.


Examples of low impact cardio workouts

Low impact cardio is brilliant for keeping you moving, while being gentler on your joints. But don’t have any doubt – this form of exercise can still get your heart rate up. It allows you to reap the benefits of cardio, without placing stress on your joints.

Some low impact cardio exercises to try include:

  • Cycling – whether it’s static cycling or road cycling, this is a superb form of cardio but less high impact than running or HIIT. It virtually has not impact on your joints. Just remember: the faster you cycle or the more hills you climb, the higher your heart rate will get.
  • Swimming – this form of low impact cardio can help strengthen muscles in your whole entire body. Although, here’s a word of warning about breaststroke. This form of swimming style can place stress on both your hips and knee by the propulsive kicks of the legs that power you forward. So take it slow – or practice front crawl instead.
  • Strength training – this form of low impact exercise is just as important, especially as we age. Why? Muscle-strengthening activities help maintain the ability to perform everyday tasks. Strength training, like lifting weights, also slows down the natural rate of bone and muscle loss associated with ageing.
  • Yoga – depending on the pace and the style of yoga you choose, you can increase your heart rate. Along with its cardiovascular benefits, yoga also helps you to build flexibility and strength. Two things we all need. Plus, did we mention its de-stressing ability?


Robin Kiaskek is an Osteopath with 25 years’ experience in the field. Robin is a big believer in taking a holistic approach when it comes to your health. If you are struggling with any condition affecting your body and struggling to find a solution, don’t hesitate to get in touch.

Plunging yourself into cold water might not necessarily be on the top of your to-do list (and who can blame you?!).

But with the recent lockdowns forcing the temporary closure of indoor swimming pools, there’s been a rise in the number of people turning to open water swimming.

As shown by  recent stats, 45% of swimmers increased how much they swam outside in 2020. The same stats estimated that outdoor swimming in the UK has increased by between 1.5 and 3 times since 2019. And there’s good reason. According to a small number of studies, celebrities and athletes – cold water therapy has a myriad of health benefits.

What exactly is cold water therapy?

Cold water therapy – which can sometimes be referred to as cold hydrotherapy – is the practice of using water that’s around 15 degrees to treat health conditions or stimulate health benefits.

Despite the recent hype around the practice, cold water therapy is nothing new. It’s actually been around for a couple thousand years. But recent modifications of this practice include short and sharp cold showers, outdoor swims and cold-water immersion therapy sessions.


So, why the buzz?

The exact benefits of cold-water therapy are long disputed in the health industry. But according to certain enthusiasts, taking a cold water dip is the answer to many things.

On a recent episode of Gwyneth Paltrow’s The Goop Lab, the actor and entrepreneur sent a group of her employees to Lake Tahoe in Nevada to experience to popular Wim Hof method.


The Wim Hof method

This method is based on a combination of extreme cold-water therapy and specialised breathing techniques. It was the brainchild of Mr Wim Hof – a former athlete – who swears by this regime and raves about the many benefits it can bring.

In the episode he says: “Cold water is a great way to learn to deal with stress. If you learn how to breathe deep, you can go into the cold water and adapt. You become the alchemist of life itself.”


So, what exactly are the benefits of cold water therapy?

According to Mr Wim Hof, cold water therapy can:

  • Improve your circulation
  • Reduce inflammation in your body
  • Higher energy levels
  • Deepen your sleep


However, it’s important to note that not much research has been done to solidify these claims. But science does suggest that it can:

  • Lessen muscle soreness – a 2011 study found that cyclists who took part in intense training sessions had decreased soreness after they immersed in cold water for 10 minutes. A later 2016 study reported the same thing.
  • Ease symptoms of depression – some studies have suggested that cold open water swimming has helped to ease symptoms of depression and anxiety. In one study, a woman who had experience anxiety and depression from the age of 17 turned to open water swimming aged 24. The study confirmed that over time, her symptoms decreased significantly.
  • Cold water can boost your immune system – A handful of studies have suggested that daily doses of cold water could bolster your immune system over a period of weeks or months.


To take the plunge or not to take the plunge

Keen swimmer and Osteopath Robin Kiashek says: “The jury is still out on whether cold water therapy is the answer to a wide range of health problems.


“But as highlighted above, there are a handful of health benefits that cannot be disputed. I myself have been swimming for as long as I can remember. With indoor swimming pools now reopening, I can’t say I will be practicing my front crawl in my nearest lake – but I might try turning the shower temperature down a few notches.”


Robin Kiashek has more than 25 years’ experience in his field. He believes in taking a holistic approach when it comes to treating his clients. If you are suffering from a series of health issues – whether it’s headaches, aches and pains or long covid – don’t hesitate to get in touch.


NB: Cold water swimming should be done with guidance from a professional and consider that certain medical conditions and ages should be taken into consideration.






‘What is the difference between an Osteopath and a Chiropractor?’

A frequently asked question for many Osteopaths.

There are a handful of similarities between the two professions, but also differences in terms of their philosophy, patient assessment and the way they treat patients. And it’s useful to understand how each operates when you are considering treatment.

 The philosophy of Osteopaths

Osteopaths deal with the whole body.

They take on a more holistic approach, treating musculoskeletal disorders relating to muscles, ligaments, joints, nerves, cartilage, tendons and the general skeletal system.

They also identify underlying, causative factors.  So, Osteopathy can not only help to heal specific conditions but also work towards improving your overall health.

Osteopaths will consider where the root cause of your problem may be originating.  For example, a patient may be suffering with facial pain, but this could be stemming from a problem in their neck.  Which is, in turn, related to the function of the upper back, which is dependent to some extent on the biomechanics of their lower back. And their lower back is linked to the pelvic area – so they could be suffering with possible issues in their knees or feet.

Osteopath Robin Kiashek, who has more than 25 years’ experience said: “To help my patients understand the difference, I encourage them to think about house subsidence. London’s housing stock is built on clay, and during the hot summer months it is not uncommon to find the older properties developing cracks in the upper floors. One option is to fill in the cracks every year. But the problem is to do with ground movement below the house.

“Therefore, to solve the problem once and for all, Osteopaths generally address those underlying factors. In other words, they will, of course, fill in the cracks. But they will also address the movement below the house.”

The philosophy of Chiropractors

Chiropractors primarily focus on the spine.

Generally speaking, Chiropractors believe that spinal misalignment is the root cause of their patient’s back symptoms. The spinal cord is simply an extension of the brain, and according to chiropractic belief, slight misalignment of a vertebra will affect the spinal nerves coming off the spinal cord.

Chiropractors believe that manipulation of the displaced vertebra, will address the spinal nerve compression and hence associated muscle or organ involvement.

Assessment with Osteopaths

At the initial consultation, Osteopaths will take a case history of the patient’s problem. This is followed by a physical examination during which they will ask the patient to undergo various movements in a bid to reproduce their symptoms.

The Osteopath will use a combination of visual analysis and touch (or palpation) to understand the problem at hand. They may also use orthopaedic tests and occasionally refer for further x-ray or MRI investigation to help form a diagnosis.

Once a diagnosis has been reached, an Osteopath will give the patient a full explanation and a treatment plan. A treatment will be included in the initial Osteopathic consultation, assuming it is safe to do so.

The treatment plan will let the patient know what aggravating factors to avoid and will include lifestyle advice to help them do so.

Assessment with a Chiropractor

At a Chiropractor’s initial consultation, they will usually come to diagnosis from the use of x-rays, focussing largely on the spinal integrity. On the second visit, the patient will be informed of the Chiropractor’s diagnosis and on the third visit, treatment will commence.

Treatment: what to expect with an Osteopath

After the initial consultation, treatment will begin, and most Osteopaths will then see patient once a week for half an hour.

Treatments may include gentle soft tissue release through massage, joint mobilisation and gentle conservative spinal manipulation. In addition, Robin Kiashek may use a range of allied therapies including Western Medical Acupuncture and Low Level Laser Therapy.

Treatment: what to expect with a Chiropractor

Chiropractors are more well known for focusing on the spinal adjustments or clicking which may not be as gentle as Osteopathic treatment. The Chiropractor will focus primarily on the lower and upper back and neck.

Chiropractors tend to see their patients ‘little and often’. Treatments themselves normally last around 15 minutes. But they may see their patients two to three times a week.

A final word from Robin

Robin added: “In addition to the difference between Osteopathy and Chiropractic outlined above, it’s important to remember that each Osteopath and Chiropractor will practice in their own unique way.  They may have particular specialisms or areas of interest.  So, don’t’ be afraid to do your research – practitioners will be more than happy to answer your questions.”

If you are in pain or have any questions about how Osteopath, Robin Kiashek, could be of benefit,  then please get in touch. Osteopaths are deemed as essential workers. Therefore, they can continue to treat patients through lockdown and patients are permitted to seek medical help. Robin Kiashek is fully compliant with Government regulations re PPE.

TMJ disorders

According to a survey 68% of us confirmed that our stress levels have continued to increase over the course of 2020.

And it’s no wonder. This year has tested us all.

As a trained Osteopath with more than 20 years experience in the field, I know that stress can manifest itself in the body in many different ways. More recently, I’ve seen a number of clients suffering from a (TMJD).

What is the main cause of TMJ?

TMJD or TMD is not necessarily a well-known term, but it affects around one in 10 people in the UK.

TMJ stands for temporomandibular joint. This joint connects the lower jaw to the skull (or upper jaw) in front of the ear. A TMJ disorder is a condition affecting that joint and the muscles involved in chewing. It can also importantly affect the Trigeminal nerve, which is situated next the TMJ, giving rise to facial symptoms:

It has no definitive cause but can be brought on by over-clenching of the jaw and teeth, wear and tear of the inside jaw, injury or surgery, and stress, all of which has a physiological relationship to the neck and upper back.

According to Bupa, women tend to develop jaw conditions more often than men. It can occur at any age, but most people have them when they’re between 20 and 40.

TMJD symptoms

Symptoms include:

  • Jaw pain
  • Headaches
  • Clicking, popping and grating noises when chewing or opening the mouth
  • Earache
  • Neck/shoulder pain
  • Difficulty chewing
  • Locking of the joint
  • Facial and eye symptoms (see illustration of Trigeminal nerve distribution above)

It goes without saying that these symptoms can have a significant impact on a person’s lifestyle if left untreated. So, it’s worth seeking medical advice if symptoms are severe or long lasting.

It may be possible to alleviate the symptoms of a TMJD by eating soft foods, avoiding chewing gum and nail biting. The same could be said by completing daily Rocabado exercises, taught by Robin Kiashek, which helps to alleviate TMJ stress.

But Osteopathy can also be effective in easing the pain of TMJD by understanding the factors which may be causing the TMJD. Whether they are physical factors in the patient’s upper back, neck and/or emotional factors. Dental factors should be taken into consideration.

TMJ disorder treatment testimonials

But don’t just take my word for it. I have worked with dentist David Cook, BChD, at the London Holistic Dental Centre for more than a decade. David has referred his clients suffering from TMJ to me to help alleviate the pain.

David says: “I have worked with Robin for over 15 years and his skill and dedication have been demonstrated countless times. I treat a lot of facial pain and TMD and I have found his holistic approach is of enormous benefit to my patients, those that see him can expect a smoother, faster recovery and better long-term stability.

“He is an excellent diagnostician and his knowledge and approachability make him a valued member of my clinical team. As a dentist, I am subject to major spinal strain and can also vouch for Robin’s superb support in keeping my body straight, mobile and pain-free.”

If you’re a sufferer of TMJ, or have been suffering from the symptoms associated with this disorder, please don’t hesitate to get in touch or book an appointment.

There’s an increasing amount of anecdotal evidence from people suffering from Long Covid.  This is where symptoms remain for much longer than the suggested two week period and are often accompanied by issues outside the officially recognised cough, fever and loss of taste or smell.  These most commonly include debilitating fatigue, breathlessness, muscle aches and joint pain.  Also, ‘brain fog,’ memory loss, lack of concentration, and depression. Very similar to the symptoms of Chronic Fatigue Syndrome (CFS).

What is Chronic Fatigue Syndrome?

The main symptom of Chronic Fatigue Syndrome (CFS) is feeling extremely tired and generally unwell.  But this tricky condition can also deliver a range of additional nasties.  The severity of which can vary from day to day, or even within a day.  These include:

  • muscle and/or joint pain
  • headaches
  • sleep issues
  • brain fog – problems thinking, remembering or concentrating
  • a sore throat or sore glands that are not swollen.
  • flu-like symptoms.
  • feeling dizzy or sick.
  • fast or irregular heartbeats (heart palpitations)

Over the past few weeks, Osteopath Robin Kiashek has seen an increase in the number of patients presenting with these types of symptom.

Robin said: “Several of the patients I’ve seen with CFS symptoms know they have had COVID.  But, of course, we will never know how many people have already had it but were asymptomatic.”

What can be done to ease the symptoms of CFS?

Robin has been a licensed practitioner in The Perrin Technique™ for CFS/ME and Fibromyalgia for over 10 years.

This is a manual method that aids the diagnosis and possible treatment of Chronic Fatigue Syndrome/ME.  It was developed by Osteopath and neuroscientist Dr Raymond Perrin DO PhD in 1989.

What is the Perrin Technique™?

The Perrin Technique™ is based on Dr Perrin’s theory that different stress factors whether physical, allergies, emotional or infections lead to an overstrain of the sympathetic nervous system.

Further investigation has led to a probable cause of this nervous system overload being a build-up of toxins in the fluid around the brain and the spinal cord.

Some of the poisons caused by infection or inflammation in the head or spine flow through channels from the brain into the lymph ducts of the head face and neck.

The toxins are also meant to drain down the spinal cord and out into the lymph ducts lying along the spine. In a CFS/ME sufferer there is a back flow of these normal drainage points which leads to further toxicity and dysfunction of the central nervous system. This leads to the many symptoms we see in CFS/ME.

Research over past 30 years has validated Dr Perrin’s theories read more about them here.

The Perrin Technique and Long COVID

Dr Perrin and his colleagues from the University of Manchester have written to a number of medical publications to highlight the potential for a post-viral syndrome to manifest following COVID-19 infection.  A similar situation was previously reported following Severe Acute Respiratory Syndrome (SARS) infection, also a coronavirus.

Back in the clinic

Whilst this may sound like yet another blow from the hammer that is proving to be 2020, there is light at the end of the tunnel.

Robin said: “Working with the symptoms of CFS is never straightforward and patients often end up at my door after suffering for months (if not years).

“They have frequently been subjected to a barrage of medical tests and received lots of negative results.  So, they are also feeling understandably anxious about what’s could be ailing them.

“The good news for people struggling with Long COVID symptoms is that they are fairly recent and are therefore likely to respond more quickly to treatment.  But it can still be a long haul.”

Patient X has been seeing Robin intermittently since the end of April, shortly after they started to feel unwell.

Patient X explains: “In April, I was feeling the post-viral effects of likely Covid-19 and felt I had nowhere to turn to for support from a health and well-being perspective. My GP practice still remains phone consultations-only and I was frustrated that my health wasn’t improving. I had crippling fatigue, strange neurological symptoms, insomnia, dizziness and many other symptoms following the acute viral phase.

“Luckily, I did some research and learned that the Perrin Technique might be beneficial.

“I started regular sessions with Robin and was grateful for the holistic advice. He confirmed that I had post viral fatigue which mirrors chronic fatigue syndrome and I started my Perrin Techniquesessions weekly.

“I am not 100% yet back to normal, but I feel it’s been a beneficial journey so far. I also feel empowered that I have a way of helping my recovery beyond resting and healthy eating.”

There are two Robin Kiashek Osteopath Clinics  – in Central London (on Regent Street) and in East Finchley.

If you’re suffering with any of the symptoms listed above, then why not request an appointment or call on 020 8815 0979?

I recently spent a fascinating day at the Royal Society of Medicine for the 9th Annual Spinal Symposium which looked at the spine from a range of perspectives.

The spine is often the part of the body that people most readily associate with Osteopathy (although we can assist with many other issues and help you to reach your goals in mind and body).

I think it’s vital to remain up to date with current thinking and I regularly refresh my learning with CPD events such as this, where I am always interested to hear about new developments, opinions and practices.

Annual Spinal Symposium

We heard from six excellent orthodox medical consultants who covered topics including dizziness and facial pain, degenerative spinal diseases and sport and the spine. But, for me, the most interesting speaker was Rheumatologist, Dr Roger Wolman who talked about the different types and levels of pain that people experience, and then focussed on chronic pain.

This is an issue that fascinates me and Dr Wolman’s assertion that there is often a poor correlation between chronic pain and structural abnormality certainly resonated with my experiences in clinic. Pain is often a measure of distress , both physical and sometimes emotional and not necessarily injury.

Managing chronic pain

He spoke at length about managing chronic pain and the important role that we can play in educating people about it. According to Dr Wolman, even just understanding chronic pain can help to change pain levels. He also stressed the need for patients to understand the relationship between stress, anxiety, depression and pain; to know their pain triggers; and the limited role of medication in these situations.

I have written before about the approach I take at my Clinics and how I believe in treating the person and not just the symptom they present with. This ‘body-mind detective’ role – systematically locating and treating the root cause of often very complex problems – is one I greatly enjoy and I have been able to help a number of patients who have been suffering with chronic pain over long periods of time.


I’ll leave you with the kind words from a patient: “Robin’s treatments have helped reduce my back and neck pain which had plagued me for years. He has taught me how to reduce re-occurrences through exercise and lifestyle change – I was very despondent before I came to see him and he continues to help me hugely; I’m very grateful.”

So, if you’ve been nursing a niggle or putting up with pain for a while then why not book an appointment?

I know my story is your story too.

Five years ago, I turned 50. It felt as though everything changed overnight. 
In my 20s, 30s and 40s, I charged ahead with life, first throwing myself into my career — I worked as a magazine publisher — and then, in my late 30s, meeting my husband, getting married and having children. 
Those busy years almost seemed like one long decade, during which I didn’t feel any different about how I looked or acted. 
I never stopped to think about what impact the way I was living might have down the road.

Then, one day, I woke up and… I was 50. Suddenly, I would catch myself in the mirror and notice my drying skin, crow’s feet, the way my hair looked. I felt aches and pains for the first time. I also began to gain weight. 
It wasn’t a huge amount, but it was steady and showing no signs of slowing down. Weight gain can often be a part of the aging process, especially after women go through menopause. However, I remember reading somewhere that five pounds was an acceptable amount to gain, but anything more was another term for “letting yourself go.”

I knew that if changes weren’t made — and fast — I’d be heading into my 50s at a terrible disadvantage. Wanting to stay healthy, fit, energetic and productive for the rest of my life, I was ready to change — and possibly save — my life.
 I didn’t simply want to think, “I’m 50 now, that’s it, my life is over.” I wanted to be fearless after 50. There’s been a lot written about how women cease to exist once they hit this age. 
Despite our great consumer power, post 50 women are often dismissed as invisible, and seen as neither young nor interesting enough. This is so wrong, and I was depressed thinking that this was my future.

But, there was more…

When I turned 50, I found myself asking the ‘what if’ questions: What if I get sick or have a heart attack? What if I get Alzheimer’s? What if I get cancer? Do I already have cancer without knowing it? 
I looked around and people my age were having strokes, struggling with depression, developing diabetes. 
It’s not that younger people didn’t have some of these health concerns, but that after 50 they seemed all too common. And the closer I looked, the more I realized that many of these health issues were in my control. The more I thought about it, the more questions I had. I began to wonder if there were tests I should be getting and asking what I could do to make sure that I lived a healthy life.

Like many women, I had gone a long time without doing simple things that could positively affect my health. 
Many of us are part of the so-called sandwich generation — caught between looking after our children and caring for elderly parents — and I realized life had kept me busy taking care of others, yet failing to do the right things for myself.

Sleeping enough and exercising daily had come to seem like an indulgence, even as I made sure that my family was well-fed and well-rested. 
So I embarked on a quest to discover how ordinary women could look and feel their best in their 50s and beyond. 
I soon realized that what I wanted was the best information I could find. I began to contact beauty experts and financial experts. 
I talked to the renowned hairdresser Frederic Fekkai, and to fashion designer Diane von Furstenberg. 
I tracked down women’s health specialists and exercise gurus, nutritionists and make-up experts. And, after hearing their advice, I took it.

I started going for slow runs with breaks for walking every day and learned how to do push-ups and other exercises to prevent osteoporosis. 
I went for annual health checks. I changed the way I ate and dropped the bad habits I’d slipped into. 
Where I had once spent my time dieting instead of eating, I began to pay attention to what I ate and to eat something healthy and small every couple of hours. 
I even accepted the fact that my hair, which I had spent decades straightening, was naturally wavy and looked its best that way. And I didn’t just lose the 15 lbs. I gained, I dropped an entire pants size.

Five years later, I feel fitter then I have at any time since I turned 30. 
More importantly, I found that I don’t only look and feel better, my health has improved. 
My cholesterol levels dropped and I even ran the New York City Marathon this year to celebrate my 55th birthday and raise money for a very deserving charitable organization. 
And, while turning 50 gave me a shock, now that I am 55 I am happier than ever before.

I loved the earlier decades of my life but I rushed through them. I was more insecure then and less happy about how I looked and felt. 
Like many women, I sought approval from everyone except myself. Now, when I look in the mirror, I see a woman who is brimming with confidence, enthusiasm, and energy. I am happy with who I am and with how I look — including my crow’s feet, which are a part of the story of my life.

So many of us fear aging when we should embrace it. But the greatest lesson I learned on my quest for reinvention is we need to feel comfortable in our own skin, whatever age we are. 
Whether you are 49, or 62, or 75, you need to decide that you are going to be the fittest, healthiest and best-looking 49, 62, or 75-year-old there is. 
For too long, women have been tricked into seeing 50 as the end of the road when, instead, we should be viewing it as the start of a new life, one in which we are truly comfortable with who we are. Instead of retreating from the world, we can embrace our place within it.

Turning 50 did more than save my life. It put me on the path to a new one.

From a recent Times newspaper article on Chronic Pain (see Page 7)

Article supplied with kind permission of the BOA publication ‘Osteopathy Today’, June 2010, Vol.16.5., Author Theresa Devereux

“I have seen this treatment approach work again and again and again – ME is a
terrible illness but it’s just waiting for osteopathy to show what we can do.”
In the spotlight with Dr Raymond Perrin
Dr Raymond Perrin is a Manchester-based osteopath who has come to prominence for his
work with Myalgic Encephalomyelitis (ME) otherwise known as Chronic Fatigue Syndrome
(CFS). He qualified from the BSO in 1984 and for the last 21 years has dedicated himself to
the research of ME and the development of a system of manual diagnosis and treatment
which he claims has helped hundreds of patients and cured many.
He has established a Fund for The Osteopathic Research into ME (F.O.R.M.E) which has raised
over £250,000 and in 2005 was awarded a Doctorate by The University of Salford for his thesis
on CFS/ME.
In 2007 Raymond published a book – The Perrin Technique – How to Beat Chronic Fatigue
Syndrome/ME (1) and his work is being taken seriously by the medical profession. Last year he
made presentations to The International Association of CFS/ME in Reno, Nevada, the World
Congress of Psychosomatic Medicine in Turin and the First World Congress of Neurobiology and
Psycho-pharmacology in Greece.
Raymond, how did your journey with ME start?
At the end of the eighties I was heavily involved in sports medicine and was treating a top cyclist
who had been out of the saddle for 7 years because he had ME. He came in with a back problem
which I treated and explained to him that I couldn’t do very much for his ME – at that time it
was known as yuppie flu and considered very much a psychological problem. His back problems
settled down and rather unexpectedly so did his ME to the extent that within a few months he
had no symptoms at all. He was convinced it was down to my treatment so I thought: well if I
have helped him, how have I? And that’s what started me on this quest.
Considerable controversy surrounds the cause of ME and there is no generally accepted theory
– what do you believe is happening?
There are many theories about ME – some with good evidence – and I think what I’ve done is
bring many of those theories together. I believe the key lies in a problem of the drainage system
of the brain and CNS – a system which most of the medical world have no idea exists. Drainage
of the waters of the brain into the lymphatic system is something Still and Sutherland talked
about and recent work at Southampton University has proved the system does exist – in fact
they are currently looking at it as a possible root cause of Alzheimer’s.
So how does drainage of cerebro spinal fluid into the lymphatic system occur?
There is no true lymphatic system in the CNS but CSF drains through peri-vascular spaces in the
cranium around the optic, trigeminal, auditory and particularly the olfactory nerve through the
cribiform plate in the ethmoid bone and into the lymph. It also drains into the paraspinal
lymphatics via the peri-vascular spaces that lie along the spine.
I believe what is happening in ME is that the drainage system stops working and therefore you
get a build up of toxins in the brain that can’t drain out through any other method. It can be
caused by a structural problem in the spine – trauma, developmental or even a congenital
weakness. But mostly the cause is a disturbance of the afferent sympathetic supply and you find
all ME suffers have a long history of sympathetic overload either emotional, physical, postural,
environmental or immunological for many years preceding the onset of symptoms. With all ME
patients there is a definite weakness in the cranial rhythmic impulse and all have problems in
the thoracic spine greater than the norm.
What is the mechanism by which the flow malfunctions?
The sympathetic nervous system, the thoracic duct, the diaphragm, the lymphatic system and
the hypothalamus all have a role. It would take too long to explain here but in summary
overstimulation of the sympathetics can cause the thoracic duct to pump lymph the wrong way,
away from the main drainage point at the subclavian vein, and back into the lymph system. This
can damage the lymph vessels and valves to the extent that it can cause a flow of lymph back
into the CNS. There’s a build up then of poisons in the brain to which the hypothalamus is
particularly vulnerable (because it is not protected by the blood:brain barrier) so it becomes
irritated – dysfunctional and as controller of the sympathetic nervous system causes further
over-stimulation of the sympathetics.
Where do those toxins in the brain come from?
Those toxins can often be post-infection or inflammatory and notably involve large protein
molecules called cytokines which are produced in response to a virus, other infection or
inflammation and have been linked to ME for years. Some toxins can enter the body in the form
of pollutants such as organophosphates used in pesticides. Also neurochemical changes due to
too much stress can become toxic to the central nervous system.
Is there any evidence in patients of this backflow?
That backflow is seen physically and felt physically by the presence of varicose lymphatics which
we have been trying to prove exist. You feel this in every single patient who has ME and in a few
cases you can see them – in fact I’ve produced the very first picture of a varicose lymphatic which
you can see in my book. We’ve tried to scan them but that’s been unsuccessful because
lymphatics are very difficult to scan.
What do they feel like?
Very specific, not just a lump or bump but a series of lumps and bumps going in one direction
like a chain going along a vessel. The skin overlying is a normal colour.
You have observed a 5-sign diagnostic criteria for ME … can you explain?
I’ve come up with five signs that are all always present in all ME patients. They are:
– Varicose lymphatics
– Perrins point – which is sensitivity to gentle pressure at a point slightly superior and lateral to
the left nipple due to sensory crossover from sympathetic nerve irritation in both the lymphatic
vessels plus the cardiac plexus.
– Coeliac plexus tenderness
– Longstanding thoracic spinal problems with tenderness at T4/T5/T6 segments
– Disturbance of the regular sacro/cranial rhythm.
This diagnostic criteria is about to be researched formally and you’ve just received a
commendation from the local NHS research ethics committee?
Yes, it’s a combined project with North Manchester General Hospital and the University of
Central Lancashire and we have some very good people on board including the Consultant
Rheumatologist in charge of the Fatigue Clinic, a Professor of Physiotherapy, the Head of
Statistics at the University and a Professor of Bio-engineering. It will be a blinded comparative
study comparing my diagnostic criteria with the current conventional approach to diagnosing
Currently ME is diagnosed by exclusion which involves an exhaustive and expensive process of
tests and examinations to rule out other causative diseases – anaemia, hormonal problems,
myasthenia gravis, glandular fever etc.
If we can prove that my criteria is as reliable as the conventional approach in the diagnosis of
ME we will have a good case to present to NICE for integration into the NHS based on
effectiveness and cost savings. If we are successful it could really open the door for more
funding for more extensive research into my treatment approach
What research have you already done to back up your hypothesis?
My first paper was published in the British Osteopathic Journal in 1993 (2) which led to my first
clinical trial with Professor Jack Edwards, a world-renowned bio-engineer and Dr Pat Hartley, a
leading health psychologist published in The Journal of Medical Engineering and Technology(3) in
1998. The aim was to evaluate the effectiveness of osteopathic treatment on symptoms
associated with ME and the results were positive. It received world-wide interest although the
scientific community were critical of the fact that we didn’t use double-blind randomly
controlled trials. There were faults in the research – the sample numbers were not as big as we
wanted because funding is always a problem and it was not randomised as much as it should
have been but the main thing is it showed a very high success rate.
The second clinical trial looked at the possible mechanisms for improvement – what are we
actually doing physiologically and anatomically in the treatment? It hasn’t been fully published
but last year I presented the paper to The International Association of CFS/ME in Reno, Nevada
and a paper on the MR imaging from this second study has just been published in the British
journal of Radiology.(7)
How seriously is your work being taken?
A lot of the research into ME has been directed at looking at a viral cause – the thinking is more
on the infectious or psychological side and the structural/mechanical side is largely ignored.
The general trend in the ME associations is that they don’t like supporting one particular
treatment approach and GOsC has a rule that they don’t support one particular osteopath.
However I do receive referrals from GPs and some specialists who over the years have seen
many of their patients improve with my technique. Also the PCTs’ online magazine Primary Care
Today ran an article on my work a few years ago with some PCTs funding patients’ treatment.
And I’ve had some interesting recognition from government. The Gibson enquiry, an all-party
review into ME in 2007, was interested in my work and the final report mentioned my diagnostic
criteria as something worthy of future research because of its potential as a very simple and
cost-effective way of diagnosing ME.
Can you tell me something of your treatment approach?
The theory and treatment has been an evolution over the years of noticing common patterns in
ME patients and finding things that worked and stopping and asking why? I started looking at
ME very much as a spinal problem then became aware of the lymphatic involvement but found
that a lot of the traditional lymphatic drainage techniques made patients worse.
The treatment involves simple effluage techniques directed toward the subclavian veins. I work
on the paraspinal muscles relaxing off the soft tissue to reduce the general tone and
sympathetic tone. Some work on the diaphragm and cranial work to open up the drainage
pathways for CSF and to get the rhythm going in a functional passive way.
We offer supplements – vitamins and minerals, Evening Primrose Oil and an Omega-3 fatty acid
– EPA (eicosapentaenoic acid) which have both been shown to speed up healing of the cell
membranes in the brain that are damaged by the toxic chemistry.
On diet, after years of experience, I recommend a rotation diet – eat lots of different types of
food, reduce the dairy and wheat but don’t cut it out altogether – eat a little bit of everything
with small regular meals preferred.
There is a mind element so you find NLP (Neuro Linguistic Programming) or EMDR (Eye
Movement Desensitisation and Reprocessing) can help but ME is much more than just a
psychological problem.
Lifestyle changes are important and I prescribe regular specific exercises and self-massage to
back up the osteopathic treatment.
What success rate do you have with patients?
We help about 90% of patients that come to us and I would say we can discharge about 30% as
fully cured. 70% need other things as well – the problem lies in patients who continually produce
further toxins or are in an environment where there’s a lot of toxicity or a lot of stress-producing
chemical changes which are toxic or they have a chronic infection or inflammation that can go
on and on.
There are some who just don’t follow instructions and there are a few whose symptoms are so
severe they might need a lot of other treatment before they start with us. Sometimes they are
not still suffering from ME but the effects of having ME for so long and major disease is setting
But I have seen this treatment approach work again and again and again – ME is a terrible
illness but it’s just waiting for osteopathy to show what we can do.
….but will osteopathy be able to? How are the current advertising restrictions affecting you?
Last year I attended a meeting at the GOsC where a group of us discussed scope of practice
within the profession. I told the meeting that osteopathy has to expand beyond the joint and
muscular ailments to allow future research into other conditions that may benefit from our
techniques. As long as ethically approved research has taken place and that the treatment is
evidence-based I think we as a profession should shout loud and clear from the rooftops
about the range of conditions we can help without claiming miracle cures! Let the scientific
argument do the talking.
With sincere thanks to Dr Raymond Perrin DO.
(1) The Perrin Technique – how to beat chronic fatigue syndrome/ME by Dr Raymond
(2) Perrin R,N. 1993 Chronic Fatigue Syndrome, a review from the biomechanical
perspective, British Osteopathic Journal; vol xi.
(3) Perrin RN, Edwards J and Hartley P (January/February 1998) an evaluation of the
effectiveness of osteopathic treatment on symptoms associated with myalgic
encephalomyelitis. A preliminary report. Journal of Medical Engineering and
Technology, 22(1), 1-13
(4) Perrin RN. Lymphatic Drainage of the Neuraxis in Chronic Fatigue Syndrome: A
Hypothetical Model for the Cranial Rhythmic Impulse. Journal of the American
Osteopathic Association, 107(06), 218-224. 2007
(5) Perrin R, Tsaluchidu S. Integrating biological, psychological and sociocultural variables in
myalgic encephalomyelitis: onset, maintenance and treatment. Panminerva Medica
51(03) Suppl. 1, 88, Sept 2009
(6) Perrin R. EPA and The Perrin Technique: A combined approach to treating myalgic
encephalomyelitis. Annals of General Psychiatry. 9 (Supplement 1):S25, 2010
(7) Perrin R, Embleton K, Pentreath VW, Jackson A. Longitudinal MRI shows no cerebral
abnormality in chronic fatigue syndrome. Br J Radiol. 2010 May;83(989):419-23