Postural Issues

Postural Issues

Postural problems, including pain, can have different causes or backgrounds. It can be caused by one or a combination of the following:

Sitting Down

These days we spend a huge amount of time sitting down, be it commuting, at work, while eating, watching telly. That creates tightness and tension on muscles that flex the body in general and, in turn, weakness on muscles that extend the body.


On the other hand, some of us who have been exercising for years tend to develop a side that is stronger than the other. This creates differences between muscles on the right and left side, which can lead to a postural issue.

Childhood Habit

Kids tend to sit anyway they feel comfortable as children are generally more flexibile than adults. As time goes by awkward postures can give way to shortness/strength in certain muscles and elongation/weakness in others; leading to dysfunction above and below the area. Unilateral sports (tennis) can also create dysfunctional muscle patterns between right and left sides; this can become more prominent in adult life.

Available Treatments:



Postural Treatments

Some of the most common Postural Issues we treat here at CBR Clinics are:

Neck Pain

Neck pain is a common problem, with two-thirds of the population having neck pain at some point in their lives. Although felt in the neck, it can be caused by numerous other spinal problems. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the spine. Joint disruption in the neck creates pain, as does joint disruption in the upper back.

The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of your neck and head. The lower joints in the neck and those of the upper back create a supportive structure for your head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain.

Foot Pain
Foot pain can be a disabiliting problem originating from different backgrounds. The most common type of foot pain is Plantar Fasciitis, which occurs when the long, flat ligament on the sole of the foot (Plantar Fascia) stretches irregularly and develops small tears that cause the ligament to become inflamed. The pain can be on the heel, arch and sole of the foot. It is described as dull, aching or sharp, and can be easily reproduced by flexing the toes upwards to tense the fascia.
It usually develops gradually starting with pain specifically on the inside of the heel, slowly spreading towards the sole of the foot causing the individual to limp when walking. Heel pain accompanies physical activities and may also occur when taking the first steps after getting out of bed or after sitting for a long period of time.

It is known that the biomechanics of the foot/ankle/leg can contribute to the symptoms of Plantar Fasciitis. Usually it is found that the athlete “over pronates” turning the foot inwards, when running or walking which involves an excessive rolling of the inner arch of the foot, stressing the Achilles tendon.

Hip Pain

The hip joint is a very mobile joint formed by the articulation of the rounded head of the thighbone (femur) and the cup-like acetabulum of the pelvis. It forms the primary connection between the bones of the lower limb and the trunk and pelvis.

Hip pain is not just felt in the hip itself. Some people may feel pain in the groin, lower back, or legs or from the muscle of the hip joint itself. This is ‘referred pain’, which is where pain experienced in one area of the body is actually generated in another region. It is important that referred pain is diagnosed correctly. Other related signs of hip problems, that should be reviewed by a doctor include:

Hip pain that persists beyond a few days
Hip pain that occurs at night, or while resting
Not being able to stand in one place for too long
Swelling of the hip or the thigh area

Pain from the hip joint is often felt in the groin. This may feel like a tightening or throbbing in the inner thigh. Pain over the outside of the hip is usually not caused by a hip joint problem, and is more commonly related to Trochateric Bursitis or a trapped nerve in the lower region of the back, causing lower back pain as a consequence.

Stiffness and grinding in the hip are typically symptoms of hip arthritis, which is a wearing away of the normal smooth cartilage within the hip joint. This can leave bone to grind against bone. Stiffness can also be experienced by patients who have childhood conditions that cause an abnormally shaped hip joint, such as Congenital Hip Dislocations (Dysplasia), or Legg-Calve-Perthes Disease.

A limited motion of the hip in normal activities can result from a damaged or deformed hip joint. For example, the degenerate bone and subsequent related pain from hip osteoarthritis often makes it painful for a person to carry out the full range of hip movements. Some people may have trouble bending their hip to put on their socks or shoes, or lifting the leg to walk upstairs.

More commonly seen in people who participate in such sports as ice hockey, football, golf and ballet are at higher risk of developing a hip labral tear (rupture of the ring-like structure that helps to hold the femur in place). Structural abnormalities of the hip also can lead to a hip labral tear, accompanied by cyst formation. Symptoms include hip pain or a “catching” sensation in your hip joint. Initial treatment may include pain relievers and physical therapy. Using arthroscopic techniques, surgeons can remove loose fragments from within the joint and trim or repair the hip labral tear.

Knee Pain

The knee joint joins the thigh with the lower leg and consists of two articulations: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body and is very complicated. The knee is a pivotal hinge joint, which permits flexion and extension as well as a slight rotation. Since in humans the knee supports nearly the whole weight of the body, it is vulnerable to both acute injury (ligament sprain, muscle strain, meniscus tear) and the development of diseases.
Knee pain can be caused by trauma, misalignment, and degeneration as well as by conditions like arthritis. The most common knee disorder is generally known as patellofemoral syndrome. The majority of minor cases of knee pain can be treated at home with rest and ice but more serious injuries do require surgical care. One form of patellofemoral syndrome involves a tissue-related problem that creates pressure and irritation in the knee (patellar compression syndrome) causing pain.

The second major class of knee disorder is Patella Tendinopathy, where the patella (knee cap) tendon becomes dysfunctional and inflamed.

Age also contributes to disorders of the knee. Particularly in older people, knee pain frequently arises due to osteoarthritis. In addition, weakening of the muscles around the knee may contribute to the problem.

Cartilage lesions can be caused by:
Accidents (fractures)
Muscle injuries
The removal of a meniscus
Anterior cruciate ligament injury
Posterior cruciate ligament injury
Posterolateral corner injury
Medial knee injuries
Considerable strain on the knee.

Any kind of work during which the knees undergo heavy stress may also be detrimental to cartilage. This is especially the case in professions in which people frequently have to walk, lift, or squat. Other causes of pain may be excessive on, and wear of, the knees, in combination with such things as muscle weakness and overweight.

Common complaints are a painful, blocked, locked or swollen knee. Sufferers sometimes feel as if their knees are about to give way, or may feel uncertain about their movement.

Trigger Points

Between the skin and muscles there is a thin layer of soft tissue called fascia. When the fascia is stressed from overuse or trauma it can tear and adhear together. These adhesions are called “Trigger Points” and decrease muscle flexibility and contractibility. That in turn leads to an increase in muscle stiffness and tenderness, a decrease in range-of-motion and pain. The imbalance created by Trigger Points can go as far as create deformities in posture, such as ribcage twist, a difference in shoulder height, and pelvic torsions. Moreover, they can lead to injury.
The only way to treat Trigger Points is by breaking them down so that the muscle can rebuild with fresh and “clean” muscle fibers. We use Shockwave Therapy in our clinical setting to help break down Trigger Points, and results can be seen in as little as 5 minutes.

Shockwave Therapy is proven to deliver results when treating Trigger Points 3 times as fast when compared to conventional treatments.

What causes Trigger Points?

  • Overuse
  • Trauma
  • Muscle weakness and/or imbalance

How do you know you have them?
Most people have Trigger Points on between their shoulder blades, as they sit on a chair 8 hours a day in front of a computer. Muscles fatigue and quickly build up adhesions. You might have felt “knots” on your back which felt like peas when pressed on. Those are Trigger Points.

Sports enthusiasts are known for building Trigger Points due to extensive training. Runners usually have them in their calves and IT band, for instance. Swimmers will build some around the rotator cuff muscles. Muscle usage in general will often lead to Trigger Points, and if left untreated they often lead to injuries.

The main signs of Trigger Points are:
Knots” or “pea-like” spots on muscles
Local pain and/or tenderness
Muscle stiffness and lack of flexibility

Shoulder Pain
Shoulder pain is one of the most common reasons for GP visits. Because the shoulder is such a movable joint, it has a high risk of instability. This instability can lead to many different problems, being the most common the Subacromial Impingement.
The Subacromial Impingement occurs whenever there is narrowing in the space inside the shoulder joint. Normally the soft tissues (bursa and tendons) have enough space to slide inside the shoulder, but due to inflammation these structures swell up, contributing to the loss of space. This loss of space causes the bones to pinch the soft tissues, causing the impingement to occur.

Other common shoulder conditions include:

  • Frozen shoulder
  • Adhesive capsulitis
  • Bursitis
  • Tendinitis
  • Instability
  • Arthritis
  • Fractures
Plantar Fasciitis
Plantar fasciitis is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, located at the bottom of your foot, connecting the heel bone to the toes. It acts like a shock-absorbing bowstring, supporting the arch of the foot.

Individuals usually experience stabbing pain that usually occurs in the first steps in the morning. The pain eases off once the foot limbers up, but it may return after long periods of standing or after getting up from a seated position.
Plantar fasciitis is particularly common in runners. In addition, people who are overweight and those who wear shoes with inadequate support are at risk of plantar fasciitis.

What causes it?
If tension on plantar fascia (bowstring) becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed. The most common risk factors that cause Plantar Fasciitis are:

Age: plantar fasciitis is most common between the ages of 40 and 60.

Certain types of exercise: activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and dance aerobics — can contribute to an earlier onset of plantar fasciitis.

Faulty foot mechanics: being flat-footed, having a high arch or even having an abnormal pattern of walking can adversely affect the way weight is distributed when you’re standing and put added stress on the plantar fascia.

Obesity: excess pounds put extra stress on your plantar fascia. In additon there are theories that obesity causes inflammation.

Occupations that keep you on your feet: factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can irritate their plantar fascia.

stabbing pain on heel and/or sole of the foot
pain that is worse in the mornings and eases off with movement
pain when standing after periods of inactivity

Sciatic Pain
Sciatic Pain, also know as Sciatica, is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body. Pain can be severe in prolonged exposure to cold weather.

Although sciatica is a relatively common form of lower back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. This point is important, because treatment for sciatica or sciatic symptoms often differs, depending upon the underlying cause of the symptoms and pain levels. It can be caused by a compression of the sciatic nerve roots caused by a herniated (torn) or protruding disc in the lower back.

What our clients say…

3 doctors mis-diagnosed me with RSI (including a private hand ‘expert’)… CBR diagnosed me correctly as having neck issues before I even arrived – just from my description of symptoms… I just hope I remember to go to a Physio first before a doctor when I next get pains in my joints.

Charlie S.

A very professional team and detail-minded treatment, which provides patient a comprehensive approach for speedy recovery. Reasonable price and nice follow-up. Highly recommended to any Londoners or the tourists.

V. Man

My visit to Bruno are really effective on my back right on the same day. He is a great profesional as well as a really warm person to deal. He make you feel calm and relaxed at the consultation. I have recovered strength on my arm thanks to his treatments. I will definitely recommend anyone to go to his clinic.

Maria A.

Peter was very professional! He identified my problem area, gave me excellent advice and exercise to do. I left feeling very positive, will definitely recommend him to people.

C. Cole

I have been treated by Silvia for a shoulder pain. She is an amazing osteopath, very profesional, knowledgeable and a nice person. Silvia is very easy going and explains things extremely clearly.I have been back a few times since and always had fantastic results. I cant recommend CBR Clinic highly enough. Thank you Silvia for making my shoulder much better!

Natalie H

I have been having treatment at CBR Clinics for over 3 months now and I can honestly say that it is one of the best investments in myself I have made. I have had a bad back for a long period which stems from lots of sport and the office job. After seeing Lyndsy Mills my back has recovered and mornings tend to be much easier 🙂 I would recommend to friends, family and work colleagues.

James B.

A very professional team and detail-minded treatment, which provides patient a comprehensive approach for speedy recovery. Reasonable price and nice follow-up. Highly recommended to any Londoners or the tourists.

V. Man

Really good support throughout the 3 weeks of physio. Great selection of take-home exercises and advice that helped me recover and get back to playing sport a good week before I thought I’d be able to. Would definitely recommend to anyone who’s looking for top quality treatment.

M. Batstone

Bruno & his team are professional, efficient, knowledgeable in a number of different disciplines, treatment was effective and Bruno charming. The clinic’s location is very convenient being directly opposite Waterloo station. Disabled parking is availabe in street behind the clinic.

Patricia P.

I’ve been going to CBR for a few years now and have been treated by three of their staff in that time – all great, especially Bruno. I love the fact you can book online and they’re open late most nights and around on thr weekend too. My current treatment is under Nick who specialises in headaches from which I suffer, not just treating the pain but trying to get me to a position where I don’t have to visit too often. How many osteos do that?

Saffron B.

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