What is Osteopathy?

One of big questions I always get asked in clinic is… “What’s the difference between a Physiotherapist, Chiropractor and Osteopath?”

Well, to be honest, in modern conservative therapy, osteopaths, physios and chiropractors will (generally) all work in a very similar way. Historically, there are philosophical differences in our practices, but in modern practice, we all utilise up to date evidence-based research to plan effective treatments to help individuals with a variety of musculoskeletal problems.

As an osteopath, the second most common question I get asked is… “What is Osteopathy? That’s just to do with the back/bones isn’t it?”

My response is, that it is way more than just the bones.

Osteopathy is a complementary, manual therapy that is used as a way of diagnosing and treating a wide range of musculoskeletal dysfunctions and injuries. It is based on the principle that the well-being of an individual depends on the bones, muscles, ligaments and other connective tissues functioning smoothly together.

Many of the ailments and injuries that I see in clinic are, to some degree, influenced by an imbalance in the smooth functioning of the body. This imbalance can often cause us to compensate and use other areas to help the movement or action that we are undertaking, whether that’s walking, squatting, or even sitting at a desk.

In an initial assessment, the osteopath will assess an individual by undertaking a thorough case history and clinical examination to better understand the likely cause of your pain and symptoms. To do this, an osteopath will assess your muscles and joints using a variety of techniques such as touch, movement, physical mobilisation, stretching and massage.

Once an issue is diagnosed the osteopath will then utilise a variety of therapeutic interventions including: massage, exercise rehabilitation, taping, acupuncture whilst also providing you with educational advice to help you self-manage your injury or problem.

If you want an assessment or wish to discuss how osteopathy could help you, then feel free to get in touch with the information below.

Tom Nottingham

[email protected] 

Mobile: 07551424370

The Importance of Glute Activation

Strong and properly functioning glutes will serve to improve your performance in any activity involving hip extension (e.g. squatting, deadlifting, running and jumping) and help prevent pain and injury from occurring to the knees and lower back.


The gluteal muscles are made up of three separate muscles that make up your butt!  These muscles are:

  • Gluteus Maximus
  • Gluteus Medius
  • Gluteus Minimus

Physiologically, the gluteus maximus is the strongest muscle in the human body!

Glute Muscles Illustration


The primary functions of the gluteal muscles are to:

  • Abduct the hip
  • Extend the hip
  • Externally rotate the hip

They also play an important role in stabilising the sacroiliac joints.


Why is glute activation typically a problem for people?

Most people spend a huge proportion of their time in a position of hip flexion (sitting down).  An inactive lifestyle is a sure-fire way to create glute dysfunction.  Extended periods of time in this posture over the long term will lead to negative adaptations in the hip flexor muscles.

Shortened hip flexors don’t allow for full hip extension, which is where your glutes are able to contract with the most force.  Additionally, being an antagonistic pair, short and tight hip flexors will actually inhibit your glutes.  The actual physical compression associated with sitting on your gluteus maximus will also impair blood flow and neuromuscular function.

Another reason the gluteus maximus has a tendency to shut down is because this can be easily enabled by the body through compensation patterns.  Most compound lower body movements can be performed by overworking other muscle groups: squats using the spinal erectors and quadriceps, and deadlifts using the spinal erectors and hamstrings.  If you often experience hamstring cramp or lower back discomfort when performing simple glute bridges then this is you!

When we begin working with a new client for the first time, glute function is one of the very first things we address and almost always we find issues.  We have to address the issue of glute activation by utilising specific exercises, stretching out the hip flexors and teaching effective mental cues.


How does a weak gluteus medius cause back pain?

When you are walking or running, as you plant your left foot your left gluteus medius is responsible for controlling the height and stability of the right side of your pelvis.  If this muscle is weak and not functioning correctly, the right side of the pelvis will dip, causing side-bending of the lumbar spine, resulting in compression of the left side facet joints and intervertebral discs.  Over time, many repetitions of this pattern can lead to damage to structures and chronic pain.

In the same scenario, the body can try to compensate for the weak gluteus medius by over-working the quadratus lumborum muscle of the opposite side.  This means when planting the left foot the weak left gluteus medius causes the right quadratus lumborum (muscle to the side of the lower back) to tug upwards on the right side of the pelvis to stabilise the lumbar spine.  This pattern of compensation will eventually lead to shortening of the muscle, resulting in trigger points and pain.


How to address weak and dysfunctional glutes?

It is important for most people to perform hip flexor stretches and glute activation exercises as frequently as possible, especially prior to exercise.

Two important static hip flexor stretches:

  • Half-kneeling hip flexor stretch

Statically contract the glutes on the side that you are stretching

  • “Sofa stretch” for the rectus femoris

Flexion at the knee targets the hip flexor that crosses both joints.  Statically contract the glutes on the side that you are stretching 


Five important glute activation exercises:

  • Double-leg glute bridge

Do not hyperextend the lumbar spine

  • Side lying hip abductions

Do not let the pelvis roll backwards

  • Side lying clams

Do not let the pelvis roll backwards

  • Quadruped bent leg hip extension

Flex and extend from the hip.  Keep the lumbar spine neutral throughout

  • Monster walks

Forwards, backwards and side-to-side walks with a strong glute band around the knees

 glute blog pic

Adding a strong and high quality glute band to any double-leg lower body compound exercise in your warm up will serve to increase the activation of your gluteus medius.  Here is a link to the product we use with our clients at Elitas.

Top 20 Things I Wish I Knew When I First Started Training (Part 3)

Volume 11 – 15


11) Stop chasing the rainbow!

“I’ll be happy when…

…I have a six-pack

…I can bench more than my mates

…I am a size 10

…I am skinny.”  The list goes on.


Trust me when I say most people will never be truly happy when it comes to their physique, regardless of the level of their success. The same is often true in business and personal finance.  We always want more, it is in our nature as human beings


Take some of the best physique competitors, athletes or models in the world and ask them to criticise an area of their body and you will always find an answer.  Be the best that you can be, and always regard your health and happiness as your number one priority. Getting strong, feeling great and being happy should always be the goal!  If your goal is to impress others by how you look, then you are doing it for the wrong reasons.  Do it for you and nobody else!


12) Most fitness classes are poorly structured

Unfortunately many instructors design or structure group workouts and classes with theatrics in mind – “what is going to appeal to prospective clients?”.  Chuck a drill sergeant-type instructor into a fitness studio with thumping music and flashing lights with loads of wacky dance moves and explosive jumping and you’ll draw the crowd, but often classes such as body combat, Zumba and circuits are put together with no regard for structural balance, mechanics or to a person’s individual needs and injury limitations.


Although there are certainly good instructors out there, they are few and far between. Forcing immobile office workers with poor posture, mobility and movement quality to jump up and down and perform loads of push ups, box jumps and burpees is excellent for getting them sweaty and out of breath, but not for training longevity.


A smart workout should always address your limitations and weak points whilst addressing your goals and 90% of all exercise classes fail to achieve this.


13) If you follow the: “I will start over on a Monday crowd”, you will almost definitely fail.

In my many years working in the fitness industry I have lost count of the amount of people who have almost broken down in tears, telling me how unhappy they are with their body and their health. They seem at their wits’ end and promise me that they would be willing to travel to the ends of the earth just to achieve their goals. I completely sympathise, as I totally appreciate how hard it is to stay lean and healthy in today’s world of fast food, long working hours and never-ending stress.


It does however completely baffle me that people will have a complete blow-out at the weekend after making such promises, promising themselves that they will start on the Monday; following some misguided misbelief that Monday is a mysteriously magical day.  If it is important and it matters to you, START RIGHT NOW!  You cannot claim to want something really badly and then not be willing to change right now!


If right now does not work for you, start on a Saturday. Having a couple of days off work allows you to train, shop for food and plan. Scrambling about on a Monday morning when you are late for work, searching for your gym gear and having no time to prep for food is just a recipe for failure.


14) Prowler and sled workouts are the absolute granddaddy of fat loss!

Fancy plodding along on a treadmill for an hour everyday? Cross trainer for 90 minutes?  No thank you I would rather bathe in raw sewage!


The solution: Try loading up a prowler or sled with 100kg+ and pushing hard for bouts of around 40-60 seconds. This builds strength whilst putting the least amount of strain on your joints compared to traditional cardio. There is no eccentric loading so you can’t really get sore, and we’ve had individuals with severe hip, back and knee problems get a good workout in whilst working hard with no aggravation.  The prowler in particular builds real world mental toughness, works the often-neglected glutes hard and works your lungs to the point of exhaustion whilst heavily taxing your metabolic systems, which are so crucial for blood glucose management. The minimal time investment of sled/prowler sprints over long-term aerobic exercise is another big win!


15) The deadlift has the greatest total impact on your recovery.

Nothing stalls your strength training progress quicker than absolute maximal deadlifting.   If you train the deadlift more than once per week and then aim for a PB every time, you will stall very quickly in nearly all of your lifts. Due to the huge demands on your central nervous system you will quickly burn out and you risk serious injury. It is best to max out on a 1RM no more than 2-3 times per year as an advanced athlete and never train to failure.  Always leave at least one rep in the tank unless you are performing the odd, infrequent test. Training in the 80-90% 1RM category works well!


On the flip side I don’t like deadlifting for more than 10 reps with any appreciable loads. These Crossfit workouts involving 50 deadlifts in quick succession are a sure-fire way of wearing your intervertebral discs down as fatigue alters your technique.  1-6 reps is the sweet spot!


In my experience, deadlifts can be the very best and very worst exercise for you, so it is important to implement them intelligently. This is where a good coach with a high level of experience is warranted!


If you would like any assistance from us in getting stronger, fitter and leaner then please contact us on [email protected].  We have two gyms in Chichester, West Sussex.  We currently help everyone from professional athletes to individuals in their 70s and above and those with disabilities.


Our clients’ goals range from simple weight loss to ultra-distance marathon training.  Our membership gym is in Oaklands Park and our private personal training gym can be found in the City Business Centre, Basin Road.




Why Elitas Fitness Oaklands is the Best Gym in Chichester Part 2

In part 2 of our blog series explaining why Elitas Fitness Oaklands is the best membership gym in Chichester, we are continuing to focus on equipment provision.


As mentioned in part 1, we have a whole host of cable stations and selectorised machines.  They permit a huge degree of versatility in upper body training.  When ordering these machines we specified that every weight stack be equipped with two micro adjusters, each weighing one third the weight of an individual plate.  This means that on every weight stack in our gym there are two increments in between every weight plate, which is particularly useful for progression when performing less mechanically favourable exercises (i.e. exercises requiring only light weights).  For example, if you are performing a cable external shoulder rotation with two plates, in order to increase the load in most gyms you must make a 50% jump in weight to reach the third plate.  However, at Elitas Fitness Oaklands there are two intermediate weights to progress onto before going for the third plate.  Enabling people to progress in this way makes a huge difference to training results.


Our Watson Dumbbells

Our Watson Dumbbells


When choosing our gym equipment, one of the first things on our list was a set of Watson dumbbells.  Not all dumbbells are created equal, and these are the best of the best.  They are the most comfortable dumbbells to use: the knurling on the grip is coarse enough to optimise your performance but not sharp enough to cause damage to your hands.  They are also far smaller than other dumbbells when matched for weight, meaning you will never be limited by the size and awkwardness of your dumbbell.  The smaller size also permits you a much greater range of motion on certain exercises, which can really accelerate muscle growth while improving long term joint health.  These dumbbells are also calibrated to within a gram of their supposed weight.  I have worked in a gym in the past where a “40kg” dumbbell was actually heavier than a “42.5kg” dumbbell!  Due to their design, it is also impossible for Watson dumbbells to become loose or come apart, so you will never be tightening your dumbbells up in between sets or worrying about anything falling on your head while lifting!


Our entire gym floor area is covered with dense 12mm thick rubber matting.  This means you can drop dumbbells, deadlift and even perform Olympic lifts in any available space.  Underneath the dense rubber is a solid concrete floor, which means the surface is all flat and even.  Most gym floors suffer from dents and holes from dropped weights, meaning you can be squatting with one foot lower than the other or trying to deadlift with a bar that keeps rolling away from you.


England Rugby Team

England Rugby Team


We are not solely about weight training.  We also have a conditioning section consisting of Wattbikes and a Concept 2 rowing machine.  These are, in our opinion, the two most effective indoor conditioning tools available.  Wattbikes are the chosen indoor training tool for most of the world’s top cycling federations, as well as the top teams and athletes from other sports, such as the England rugby team.  They are second to none when it comes to the accuracy and reliability of the data they produce; whether you are measuring your peak power output or assessing left leg/right leg discrepancy following an injury.  We have achieved such outstanding fat loss results with clients at our personal training facility that Wattbikes were a must for our Chichester membership gym.


Wattbikes at Elitas

Wattbikes at Elitas


We have also included a number of specialist pieces of equipment and accessories that you will struggle to find anywhere else.  We have 14 separate pull-up stations, each of which provides a number of different grip positions.  A variety of pull-up grips is essential to optimise development of your upper back and elbow flexors.  Five of our pull-up stations are also two inches thick, which is great for developing grip and forearm strength: excellent for grappling sports such as BJJ and rugby.  Our adjustable pull-up handles, which double up as a dip station, also rotate freely.  This allows you to supinate your hands as you pull, enhancing recruitment of the biceps brachii and reducing the chance of developing over-use injuries at the elbow and shoulder.


Pull Up Bars

Pull Up Bars


Adding to the versatility of our gym, we possess the widest range of cable attachments possible: multiple width lat pulldown bars, a number of different cable row attachments, rotating triceps pushdown handles and many more.  We have also purchased multiple of the most popular attachments (ropes and single handles) to minimise the chance you will have to wait for anything in our gym.


Another often overlooked component of any gym is the variety of different bars.  We have two Eleiko Olympic weightlifting bars with perfect grip, oscillation and spin if you are serious about your weightlifting.  We also have two Eleiko powerlifting bars, with a much deeper knurling for a stronger grip.  These will never bend out of shape from heavy lifting!  We know how important variety is so we also have a safety bar and a trap bar from Watson.  These add variety to your squat and deadlift and the safety bar enables you to squat with upper body injuries.  It is also more comfortable to perform certain assistance exercises with, such as good mornings.


Eleiko Barbell

Eleiko Barbell


With all of this fancy gym equipment, it is easy to overlook the absolute basics; however, we know how important these are to your training experience.  We have more than enough barbell collars (along with a mountain of spares!) and every rack has a full set of weight plates, so you will never have to waste time hunting around the gym only to find someone has then stolen your bar!  We have provided weight plates going down into increments as small as 0.5kg, so you can always select the exact weight you need and make tiny jumps.  We also have a good provision of boxes and steps: these seemingly insignificant additions permit endless variations of barbell movements as well as enabling the vertically challenged to reach the chin up bars!


Our Watson Trap Bar

Our Watson Trap Bar


Our gym was set up by experienced strength and conditioning coaches who all happen to be gym rats themselves.  It was not set up by men in suits.  Our insight into what is important and what is normally neglected has enabled us to put together the perfect facility for effective training.


Part 3 is coming soon, where I will continue to show you what makes this the best gym in Chichester.


If you would like to come in for a chat about training then please contact us on [email protected] or 01243 920536.