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.

Happy, healthy kneesRunner’s knee, jumper’s knee, housemaid’s knee (yes, it does exist!) and so on – the list of painful complaints that can affect this complicated joint is as long as your arm. Problem knees are surprisingly common in people of all ages, placing severe restrictions on both movement and lifestyle as a whole.

Strong and stable joints

On a day-to-day basis, we expect great things from our knees. As the largest joint in the human body, the knee basically forms a sort of hinge  where the thigh bone (femur) and shin bone (tibia), meet. This enables the leg to bend, straighten and generally move freely so we can run, twist, jump, fall over and so on. Knees must be also strong and stable enough to support our weight, even if it increases. These joints are ably assisted in their task by bones and soft tissue including muscles, cartilage, ligaments and tendons – all of which have the potential to go awry.

The knee joint may be a sophisticated mechanism but it’s still relatively easy to injure. For example, a sudden increase in intensity or duration of exercise can temporarily damage the bone, muscle or ligaments. Problem knees can lock, click, catch, give way or refuse to straighten. More gradually developing pain, especially in older people, points to conditions such as osteoarthritis. Here, the cartilage facilitating smooth movement between the femur and tibia gradually wears away, forcing both surfaces to rub together and resulting in pain and stiffness.

It’s all a bit of a catch-22. With persistent knee pain, most people’s instinct is to rest the knee and avoid putting any weight on the joint, therefore taking less exercise. While this would appear to be a sensible thing to do, if not diagnosed and treated, long-term weakness of the surrounding leg muscles can slowly develop.

Looking after problem knees

So, what should you do if you suddenly develop painful knees? Here are a few initial things that you can try at home:

  • The key is basically RICE: rest, ice, compression, elevation. This means, at the very least, not irritating the joint and, at best, giving the joint a chance to recover under its own steam;
  • When icing, use ice wrapped in a wet towel for 5 minutes and remove for 10 minutes, repeating twice more;
  • Sit, rather than stand, with the leg elevated, to avoid putting weight on the knee – rest as much as you can;
  • If suffering with acute or severe pain, in the short term, take painkillers such as Paracetamol;
  • If you feel up to it, try some gentle exercise, such as walking at a pace that does not aggravate your symptoms or non-weight bearing exercise such as swimming;
  • If your knee pain is still present after several days or is getting worse, why not book an appointment with Osteopath Robin Kiashek to see if we can find the cause of your discomfort and get you back on the road to recovery.

exercise on prescriptionI am a keen advocate of the benefits of exercise as part of the journey to health restoration. I therefore wholeheartedly back the government scheme that means NHS patients will be prescribed exercise as part of ongoing treatment for certain conditions.

The workouts are set for patients who suffer from obesity, heart disease, stress, diabetes, osteoporosis and back pain. It has also been created for pensioners who have suffered accidents or falls.
In a bid to make the country healthier and to cut hospital waiting lists, the schemes are making aerobics, yoga, weight training and swimming either free or discounted for up to ten weeks at a time.

For many of the patients who visit my clinics, this kind of help and support is extremely welcomed. The sheer fact that exercise is now classed as a treatment plan and not just an advisory action will almost certainly change its level of importance in patients’ minds. If a doctor prescribes a patient antibiotics, then they will take the prescribed course – the same commitment is now likely to start evolving for exercise.

Department of Health guidance has been provided to doctors which highlights precisely what can be described for certain patients. Insurance cover and legal responsibilities (for patients who attend the gym under prescription) have also been addressed. Exercise specialists published by Fitness Industry Association will take legal responsibility while patients are exercising under these prescription workouts.

I know that all biological systems work in conjunction with one another and I am positive that a national increase in exercise will result in fewer people needing medical treatment for illness or disease. It will also go a long way towards placing a higher value on regular physical exercise, the importance of maintaining good health and working on the notion of prevention rather than cure.

I have always been interested in the power of exercise. In 1995, I researched the “exercise on prescription” model with 60 GPs and wrote a dissertation entitled “The effects of exercise on clinical depression”. The “exercise on prescription” model being trialled then enabled GPs and allied healthcare professionals to refer patients with conditions such as hypertension, diabetes and depression, for a monitored exercise regimen instead of prescribing medication.

Just like I believe our biological systems do not work in isolation, neither does treatment. By looking at both the cause and treatment of conditions in more entirety, perhaps we can start to get the whole country healthier.

As an osteopath with clinics in Central London and North London, I’m always interested in people’s perceptions and attitudes towards, diet, exercise, environment, medicines, remedies and treatments, as these are fundamental elements of an individual’s take on health and fitness.

As I’ve said on many occasions, a good level of education and knowledge about these sorts of topics is generally not very common, with a lack of easy to understand information available to all. The AsapScience YouTube video below makes some very valid points about aspects of this general lack of understanding.

A couple of minutes into the presentation, it talks about perceptions of Natural versus Synthetic and explains why the difference between the two is not all that cut and dried. Natural chemicals aren’t always good for you and man made chemicals aren’t always inherently dangerous. This is especially prevalent when looking at the whole area of food and GM crops. Are fears about GM foods justified? After all, for as long as humans have been on the planet, we have selectively chosen and bred plants or animals with desirable traits, such as sweeter fruits or better disease resistance. Isn’t that genetically modifying foods?

Information and misinformation about GM and the entire natural versus chemical comparison does, in my opinion, need to be put into perspective. Not all natural foods are good for you and not all chemically enhanced foods are bad for you. This isn’t just a case of one man’s meat is another man’s poison; this is all about balance and perspective. Watch the video and see what you think.

Walk In The ParkAccording to a recent study into the physical effects of the brain when interacting with nature, a walk in the park can improve your mental health. The study, which has been conducted as part of the Emmett Interdisciplinary Program in Environment and Resources at Stanford University, has observed physical changes taking place in the brains of people visiting nature, especially in those people who normally live in an urban or built-up environment.

Various studies have shown that people living in more urban locations have much less access to green spaces and are much more susceptible to anxiety, depression and other mental illnesses, when compared to people living in more rural locations, who have unlimited access to nature. As an Osteopath in Central London, I see this a lot and think that there’s a real connection between exercise, environment and health.

Within this study, conducted by Gregory Bratman, a graduate student at Stanford, it’s been proven that people living near parks and city dwellers who visit more natural environments on a regular basis have lower levels of stress hormones after exposure to the great outdoors than people who have not recently been for a stroll in the park or taken part in an outdoor activity within a greener environment. What’s less clear is why green spaces have this calming effect on brains and whether or not any more permanent exposure can improve emotional and mental health.

In an early part of the study, Bratman and his colleagues found that volunteers who walked briefly through a greener landscape at the Stanford campus were more attentive and happier afterwards, than volunteers who strolled for the same amount of time near heavy traffic, however, the study did not examine the neurological mechanisms that might underlie the effects of being outside in nature, and so the team set about a second study.

Within the second study, the team focused in on the effects that a walk in nature might have on individual walkers’ positive or negative moods. To do this in a scientific way, the study zeroed in on ‘brooding’, which is a recognised state amongst cognitive scientists and is described as a metal state of morbid rumination. Essentially, from time to time, we all experience brooding, mostly when we keep going over things that have recently gone wrong with aspects of our lives. Continued negative pondering is not a healthy state for the mind to get into and brooding can be a precursor to depression and, as previous studies have already proven, is disproportionately common among people who live in the City compared to country dwellers.

The study set out to look for signs of morbid rumination as it manifests itself in increased brain activity within the subgenual prefrontal cortex. Tracking activity within this portion of the brain before and after walks in nature, could establish a link between exercise activity within a greener environment and changes in the brain related to mood and mental health.

In the study sample, 38 healthy, adult city dwellers were questioned to determine their normal level of morbid rumination. Each volunteer also had their subgenual prefrontal cortex scanned, with blood-flow tracking used to record stimulation of brain activity.

With half of the participants randomly assigned to a 90 minutes ‘park’ walk and the other half assigned to a more urban walk, with traffic and noise, the conditions for the test were set and after the walks, participants were questioned again and the brain scan information was updated and compared.

The results showed that walking within an urban setting increased blood flow to the subgenual prefrontal cortex and participants levels of ‘broodiness’ increased or remained largely unchanged.

However, volunteers who had taken part in the nature-trail walk, showed slight but meaningful improvements in their mental health, when re-questioned, and blood flow within the subgenual prefrontal cortex was much less, suggesting a more rested and less stressful walk. In other words, getting out into natural environments could be an easy and fairly quick way to improve moods and maintain a healthier mental state.

Perhaps you could try this for yourself? Make an honest appraisal of how you feel mentally on a scale of one to ten and then go for a 90 minute walk in the park and then honestly apprise yourself afterwards, using the same scale and whatever criteria you feel you can identify and compare. Even if you don’t notice a difference in your mood, there is no downside and you’ll have walked for 90 minutes, (around 10,000 steps), which is what the World Health Organisation suggests you should walk in a day to maintain a healthy mind and body.

There is an increasing body of scientific evidence to support that being physically active can help us to be healthier. However, not only can exercise have a positive effect on our health, it can also make us feel happier.

It is believed that exercise increases the levels of serotonin, dopamine and norepinephrine in the body which are naturally produced chemicals. An increased level of these chemicals has been shown to reduce stress, anxiety and depression.

As part of my Osteopathic BSc (Hons) Medicine and Naturopathic degree I undertook a study on ‘The effects of Exercise Training on Clinical Depression’, ahich was overseen by the founder of ‘Exercise on Prescription’ GP Dr Hanratty.

In addition to the physical and mental health benefits, taking exercise can also be socially beneficial.

Get outdoors and take some exercise

We are fortunate in North London to have a number of great places to get outdoors and take some exercise. On our doorstep here in Muswell Hill N2 and East Finchley N10 is Alexandra Park.

The Park is conveniently located for the surrounding areas of Finchley and Highgate. You can get more information about Alexandra Park and directions here.

Walking is a great form of exercise

A great form of exercise is walking and in North London we have access to many walking paths all around us. One such example is the Highgate and Hampstead circular walk .

The Northern Heights Circuit, as it is known, is a nine mile long self-guided trail, taking in 350 points of interest around Highgate, Hampstead and Hampstead Heath. It is broken into sections e.g. Section 1 is 2 miles long and runs between Highgate Village to Kenwood House. Section 2 is 1 mile long and runs between Highgate Village to Parliament Hill Fields.

With such great locations there’s no excuse for not getting outdoors and taking some exercise.

A recent study undertaken at Cambridge University found that a lack of exercise kills twice as many people as obesity. The study of 334,000 people found that a persons life could be prolonged by taking a modest amount of activity. It also indicated that the people who would gain the most would be the least fit.

The study is a stark reminder of the impact that an increasing sedentary lifestyle is having on people’s lives.

While the study found that taking a twenty minute walk a day would cut the risk of premature death by almost a third, Ulf Ekelund, who led the study believes that we should be looking to do more than this.

The most recent Government guidelines advises Britons to take 150 minutes of exercise or ‘moderate activity’ every week or 75 minutes of vigorous exercise. Moderate activities include such things as taking a brisk walk, gardening and dancing are included in this group  while vigorous exercise would   include playing sport, running or aerobics.Unfortunately in another survey it was found that a third of people can’t even manage to walk for 30 minutes over 7 days.

Take a walk in North London …

As an experienced North London osteopath I treat patients who are suffering pain and discomfort often brought on by their lifestyle.

Exercise can have so many beneficial effects on our health and wellbeing, so it is important to tale time out to fit it into our busy schedules.

All you have to do is take a brief walk. We are very fortunate in North London to have many places to get out and about in our local area. Just on our doorstep in Muswel Hill is Alexandra Palace. The Park is conveniently located to the surrounding areas including East Finchley and down the road we have Hampstead Heath.

So go ahead and take a walk, all you need is a 20 minute walk a day and you will improve the quality of your life.

If you are suffering pain or discomfort and you would like further information on how I may help you or to book an Osteopathy appointment at my osteopathy clinic in North London please feel free to send me a message or call me on 020 8815 0979. I also have a clinic in Central London should this be more convenient for you.


There is a lot of advice out there on how to be fit and healthy and there is also a lot of advice on what is unhealthy. We all know that fruit and vegetables are healthy foods as much as we know that ice cream is not. We know that exercising is good for you whilst doing nothing isn’t. As a leading osteopath in London W1 I just want to highlight the last point, in particular a lack of activity.

Inactivity is bad for you

There has been a lot said in the news about inactivity and its negative effect on your health. Reports have shown that long periods of sitting down is more damaging to your body than obesity and that going to the gym after hours if inactivity doesn’t reverse the effect. A particular concern for me as an experienced osteopath in London W1 is the negative effect inactivity is having on the strength of our skeletal structure, but there are many other negative effects from inactivity.

What to do about it?

Luckily the solution is simple. Get moving. Here is a useful video giving 9 tips that may save your life ’

If you are suffering pain or discomfort and you would like further information on how I may help you or to book an Osteopathy appointment at one of my osteopathy clinic in London W1 please feel free to send me a message or call me on 020 8815 0979. I also have an osteopathy clinic in North London should this be more convenient for you.