“Everything’s connected.”

It’s one of those phrases we hear all the time.

Usually just before someone tells us turmeric will solve all our problems or recommends a juice cleanse involving kale and ingredients you can’t pronounce.

But when it comes to the human body…

…it actually is true.

Proprioceptive Deep Tendon Reflex Therapy (PDTR) is one of the most fascnating approaches I’ve studied because it looks at how the nervous system organises movement.

As an osteopath, one of the things I love most about my job is that no two people are the same.

Two people can walk through the clinic door with exactly the same shoulder pain.

One needs help improving the movement of a joint.

Another needs to rebuild strength.

Another needs reassurance that movement is safe.

And another may have a nervous system that’s become so protective it’s changing the way their whole body moves.

The question I’ve always found fascinating isn’t simply:

“Where does it hurt?”

It’s:

“Why has your body chosen this strategy?”

That curiosity is what first led me to Proprioceptive Deep Tendon Reflex Therapy—usually shortened to PDTR.

No… it isn’t the catchiest name in healthcare.

Whoever named it clearly wasn’t in marketing.

But behind the long name lies a fascinating way of thinking about movement, pain and the incredible intelligence of the nervous system.

The Body Isn’t a Machine

For years we’ve tended to think about the body rather like a car.

Bad shoulder?

Replace the part.

Tight muscle?

Stretch it.

Weak muscle?

Strengthen it.

And while those approaches absolutely have their place, I’ve gradually come to think the body is much less like a machine…

…and much more like an orchestra.

Imagine listening to an orchestra where the violins are slightly out of time.

You wouldn’t automatically assume the violin was broken.

You’d probably wonder whether the conductor had misunderstood the music.

The same can be true of the human body.

Muscles don’t make decisions.

Joints don’t make decisions.

Tendons don’t make decisions.

The nervous system does.

Every movement you make is the result of millions of tiny conversations happening between your body and your brain every single second.

The World’s Busiest Conversation

Close your eyes for a moment.

Now touch your nose.

Hopefully you managed it without poking yourself in the eye.

You didn’t need to watch your hand because your brain already knew exactly where it was.

That’s called proprioception.

It’s often described as our “sixth sense.”

It’s the remarkable ability to know where our body is in space without looking.

You use it every day without giving it a second thought.

Walking downstairs.

Typing on a keyboard.

Putting a jumper on.

Standing on one leg while attempting to put a sock on without falling over.

(Admittedly, that gets a little more entertaining as we get older.)

Your body is constantly collecting information.

Where are my feet?

How bent is my knee?

How much pressure is going through this ankle?

Am I balanced?

Am I safe?

Thousands upon thousands of sensory receptors are continuously feeding information back to your brain.

Which brings us to one of the concepts I find most useful when thinking about movement.

Information In… Decisions… Information Out

Every second of every day, the nervous system is working through a remarkably simple—but incredibly powerful—cycle.

First comes the input.

Your eyes, inner ears, muscles, tendons, joints, skin and internal organs are all collecting information about what’s happening both inside and outside your body.

Think of them as thousands of tiny reporters sending updates to headquarters.

Some report movement.

Some report pressure.

Some report stretch.

Some report balance.

Some report potential danger.

Together they create an astonishing amount of information.

Next comes processing.

This is where the brain earns its keep.

It doesn’t simply collect information—it compares it with previous experience, predicts what is about to happen and decides how best to respond.

Contrary to what many people think, the brain’s primary job isn’t movement.

Its primary job is survival.

Every decision it makes is based on one question:

“Am I safe?”

If the answer is yes, movement is usually smooth, efficient and effortless.

If the answer is “I’m not sure”…

…the brain may choose protection instead.

Finally comes the output.

That output might be movement.

It might be muscle tension.

It might change your posture.

It might alter your breathing, your balance, your heart rate or even your digestion.

And sometimes…

…the output is pain.

Everything you do—from picking up a cup of tea to running a marathon—is the result of this continuous conversation between sensory information, brain processing and the response the brain sends back to the body.

This conversation never stops.

Not while you’re walking.

Not while you’re sleeping.

Not even while you’re reading this article.

Which raises an interesting question.

What happens if some of the information reaching the brain isn’t as clear as it could be?

So, Where Does Proprioceptive Deep Tendon Reflex Therapy (PDTR) Fit In?

This is where I think PDTR becomes really interesting.

If the brain makes decisions based on the quality of the information it receives, then it makes sense to ask another question:

What if some of that information isn’t quite right?

Imagine you’re driving somewhere you’ve never been before.

Your satnav tells you to turn left.

You confidently turn left…

…and find yourself driving into a farmer’s field.

The car isn’t broken.

The steering works perfectly.

The engine is running beautifully.

The problem wasn’t the output.

The problem was the information the satnav was using.

The nervous system can work in a surprisingly similar way.

Every movement you make depends on the brain receiving accurate sensory information before deciding how to respond.

If that information is altered—perhaps following an injury, a fall, repetitive strain or other stresses—the brain may choose a movement strategy that’s designed to protect you.

That’s often exactly what we want in the early stages of an injury.

Protection is clever.

Protection helps us heal.

The interesting question is what happens when that protective strategy continues long after it’s needed.

Protection Isn’t the Enemy

One thing I always explain to patients is that the body is incredibly intelligent.

It’s never trying to make life difficult.

It’s trying to keep you safe.

If you’ve ever sprained your ankle, you’ll probably remember limping.

You didn’t consciously decide to limp.

Your nervous system decided for you.

It changed your movement to protect the injured tissues.

Brilliant.

Exactly what it should have done.

But occasionally the body becomes so good at protecting us that it carries on using those protective strategies even after healing has taken place.

Perhaps one muscle starts working harder than another.

Perhaps you shift your weight slightly differently.

Perhaps you avoid rotating your neck without even realising it.

Over time these tiny changes can influence the way the whole body moves.

The amazing thing is that most of these adjustments happen completely outside our conscious awareness.

Looking Beyond Where It Hurts

One of the things that attracted me to PDTR is that it encourages clinicians to think differently.

Instead of asking only:

“Where does it hurt?”

it also asks:

“Why has the nervous system chosen this response?”

That shift in thinking can completely change the way we assess somebody.

Pain in the shoulder may involve the shoulder.

But the nervous system doesn’t think in isolated body parts.

It thinks in movement.

It thinks in protection.

It thinks in survival.

As osteopaths, we’re already trained to look at the body as a connected whole.

PDTR builds on that philosophy by paying particular attention to the way sensory information influences movement and protective reflexes.

What Happens During a PDTR Assessment?

If you’re imagining complicated machines, flashing lights or electrodes attached to every part of your body…

…don’t worry.

A PDTR assessment is very hands-on.

Like any osteopathic consultation, it begins with listening.

Your story matters.

When did the symptoms begin?

How have they changed?

What makes them better?

What makes them worse?

From there, I’ll assess how your body moves and responds.

PDTR uses specific testing procedures to explore how different sensory inputs may influence muscle responses and movement patterns.

The aim isn’t to find a “magic point” or a single cause for every problem.

Instead, it’s to gather more information about how your nervous system may be organising movement.

Like putting together pieces of a puzzle, each test adds another clue.

Sometimes those clues confirm exactly what I’d already suspected.

Sometimes they point me in an entirely different direction.

That’s one of the reasons I enjoy using PDTR—it encourages curiosity rather than assumptions.

Is PDTR Just About Muscles?

Not at all.

Although muscles are often what we notice first, they’re really the final performers in the orchestra.

Remember the conductor?

Muscles simply play the notes they’re given.

Before a muscle contracts, countless decisions have already been made by the nervous system.

Information has been gathered.

Compared with previous experience.

Filtered.

Prioritised.

Processed.

Only then is the instruction sent out.

Movement is simply the end result of that conversation.

That’s why I find it so fascinating.

Rather than seeing muscles, joints and connective tissues as separate systems, PDTR reminds us that they’re all communicating through the nervous system every second of every day.

The better that communication, the better the brain’s opportunity to make efficient decisions.

And better decisions often lead to better movement.

Why I Chose to Learn PDTR

If you’ve read some of my other blogs, you’ll probably have realised that I enjoy asking questions.

Sometimes far too many questions.

One of the things I love about osteopathy is that we’re encouraged to stay curious. The human body is wonderfully complex, and every patient teaches us something new.

Healthcare is constantly evolving.

Ideas that seemed revolutionary twenty years ago are now accepted as everyday practice, while some older ideas have rightly been challenged as our understanding has improved.

I think that’s exciting.

It means we’re always learning.

PDTR is one of the approaches that has captured my interest because it encourages us to think deeply about the relationship between sensory information, movement and the nervous system.

Research into PDTR continues to develop, and I’m looking forward to seeing how our understanding grows over the coming years. Like many emerging approaches, it’s an area where clinical experience and ongoing scientific investigation are helping to shape future understanding.

For me, learning never stops.

Whether that’s osteopathy, pain science, rehabilitation, Pain Reprocessing Therapy or PDTR, every new piece of knowledge helps me become a better clinician.

Not because one technique replaces another.

But because every tool offers another way of understanding the person sitting in front of me.

Who Might PDTR Be Appropriate For?

Every patient is different, so there’s no simple checklist.

However, PDTR may form part of my approach when someone has:

• Persistent or recurring pain.
• Movement that doesn’t quite feel “right.”
• Symptoms that keep returning despite previous treatment.
• Pain that seems to shift from one area to another.
• Ongoing compensatory movement patterns following an injury.
• Problems that don’t appear to fit neatly into one muscle or one joint.

That doesn’t mean PDTR is the answer to every problem.

Far from it.

Sometimes the solution is strengthening.

Sometimes improving mobility.

Sometimes improving sleep, reducing stress or simply giving the body more time to heal.

As an osteopath, my job isn’t to fit every patient into one treatment approach.

It’s to understand what’s driving your symptoms and choose the most appropriate treatment for you.

PDTR is simply one of the tools that may help me do that.

Looking to the Future

One of the reasons I find neuroscience so fascinating is that we’re still only scratching the surface.

Every year we learn more about how the brain receives information, predicts movement and protects the body.

We’re beginning to appreciate that pain, balance, coordination and movement aren’t isolated systems.

They’re all connected.

The nervous system links every muscle, every joint and every organ into one remarkable communication network.

Understanding that network is one of the great frontiers of modern healthcare.

Whether we’re talking about osteopathy, rehabilitation, pain science or PDTR, I believe the future lies in understanding not just the body itself, but the information flowing through it.

The better we understand that conversation, the better we can help people move, recover and live with confidence.

A Final Thought

When I first qualified as an osteopath, I thought treatment was largely about finding the painful bit and making it feel better.

The longer I’ve been in practice, the more I’ve realised that the painful bit is often only part of the story.

The body is constantly adapting.

Constantly protecting.

Constantly learning.

Every movement you make is the result of an extraordinary conversation between your brain and your body.

Sometimes that conversation flows beautifully.

Sometimes it becomes a little muddled.

Approaches like PDTR encourage us to listen more carefully to that conversation.

I find that an exciting way of thinking about healthcare.

Not because it claims to have all the answers.

But because it reminds us to keep asking better questions.

After all, every great discovery in healthcare has started with someone asking…

“I wonder why that happens?”

And I suspect the nervous system still has plenty of fascinating answers waiting to be discovered.

Could PDTR Be Right for You?

If you’re experiencing persistent pain, recurring injuries or movement that simply doesn’t feel as natural or comfortable as it once did, a thorough assessment is always the best place to start.

During your consultation, we’ll take time to understand your symptoms, examine how your body moves and discuss the most appropriate treatment plan for you. That may include osteopathic treatment, rehabilitation exercises, advice on movement, PDTR, or a combination of approaches tailored to your individual needs.

My aim is never simply to treat where it hurts.

It’s to understand why your body has chosen that strategy in the first place.

If you’d like to explore whether PDTR could form part of your treatment, I’d be delighted to help.

“The body isn’t simply a collection of muscles and joints. It’s a continuous conversation between the body and the brain. The clearer that conversation becomes, the greater the opportunity for efficient movement, confidence and recovery.”

Further Reading

International Association for the study of pain

Z-Health Performance

The post Understanding Proprioceptive Deep Tendon Reflex Therapy (PDTR): Your Body’s Hidden Conversation: appeared first on Daniel Baines Osteopathy.

“If my scan is normal, why does it still hurt?”

It’s one of the questions I hear most often in my osteopathy clinic.

Sometimes it comes from someone with back pain that’s been hanging around for years. Sometimes it’s a sore shoulder that should have settled months ago. Occasionally it’s someone who’s seen every healthcare professional under the sun, collected enough exercises to fill a ring binder, and still wakes up wondering why their body hasn’t got the memo that it’s supposed to be better.

If that sounds familiar, you’re certainly not alone.

For a long time, both patients and healthcare professionals thought pain worked rather simply.

Something gets damaged.

It hurts.

It heals.

The pain goes away.

Job done.

Except… life isn’t always that tidy.

Many people continue to experience pain long after tissues have healed. Others have scans showing disc bulges, arthritis or worn joints but have very little pain at all.

That raises an interesting question.

If pain isn’t always directly related to tissue damage, what else could be going on?

That’s where modern pain science—and something called Pain Reprocessing Therapy (PRT)—starts to become really fascinating.

First Things First… Your Pain Is Real

Before we go any further, let’s clear up one of the biggest misunderstandings.

When people hear that the brain plays a role in pain, they sometimes think they’re being told:

“It’s all in your head.”

That isn’t what Pain Reprocessing Therapy says.

Not even close.

Pain is always real.

Whether you’ve just stubbed your toe on the coffee table (which somehow always seems to happen in the dark), strained your back lifting a heavy box, or have been living with persistent pain for years, the pain you experience is genuine.

The important thing to understand is this:

Pain is always produced by the brain.

That might sound surprising, but it’s actually true for every type of pain.

Your finger doesn’t create pain.

Your knee doesn’t create pain.

Your back doesn’t create pain.

Those tissues send information to the brain, but it’s the brain that decides whether to produce pain as a way of protecting you.

Most of the time, it gets that decision absolutely right.

Occasionally, however, it becomes a little… overprotective.

Your Brain: An Excellent Bodyguard

Imagine you’ve hired the world’s best bodyguard.

For the first few months they’re fantastic.

They stop genuine threats.

Keep you safe.

Always alert.

Then something changes.

They start tackling the postman.

Jumping in front of Labradors.

Escorting you away from your own front door because someone looked suspicious.

The bodyguard hasn’t become lazy.

Quite the opposite.

They’re working overtime.

They’re simply seeing danger where there isn’t any.

Our nervous system can behave in a remarkably similar way.

After an injury, illness or period of stress, the brain can become increasingly sensitive to signals coming from the body.

Movements that were once completely safe begin triggering warning signals.

The alarm system gets stuck on high alert.

From the brain’s perspective, it’s trying to help.

Unfortunately, the result can be persistent pain that continues long after tissues have healed.

So, What Exactly Is Pain Reprocessing Therapy?

Pain Reprocessing Therapy is a treatment approach designed to help people whose persistent pain appears to be maintained, at least in part, by an overprotective nervous system rather than ongoing tissue damage.

Rather than fighting the pain or trying to ignore it, PRT helps people understand how pain works, reduce fear around symptoms, and gradually teach the brain that certain movements and sensations are safe again.

Think of it as updating your brain’s software.

The hardware—the body—may be perfectly capable.

The software is simply running an outdated programme that still believes you’re in danger.

The goal isn’t to convince yourself that nothing hurts.

The goal is to help the brain make more accurate predictions about what’s actually happening in the body.

And remarkably, our brains are capable of doing exactly that.

They change throughout our lives.

Which means that if the nervous system can learn pain…

…it can also learn safety.

Can the Brain Really Learn Pain?

At first, the idea sounds a little strange.

Surely pain is simply a sign that something is damaged?

Sometimes, yes.

But not always.

The brain is constantly learning. It’s one of the things it does best.

Think about learning to drive. At first, everything feels awkward. You’re trying to remember which pedal is which, checking your mirrors every five seconds and wondering why everyone else seems to know what they’re doing.

Fast forward a few years and you’re halfway home before you realise you’ve been singing along to the radio and can’t remember the last five miles.

Your brain has built incredibly efficient pathways through repetition.

It does the same with language, riding a bike, tying your shoelaces… and, occasionally, pain.

When we injure ourselves, pain is incredibly useful. It encourages us to protect the injured area while tissues heal. In most cases, as healing takes place, the alarm system settles down and life carries on.

Occasionally, though, the nervous system doesn’t get the message.

The brain continues to predict danger, even though the original injury has healed.

It’s rather like a smoke alarm that now goes off every time you make toast.

The alarm isn’t broken.

It’s simply become a little too sensitive.

But Surely Pain Means Something Must Be Wrong?

Not necessarily.

One of the most fascinating things about pain science is that pain and tissue damage don’t always match.

Some people have significant arthritis on an X-ray and very little pain.

Others have scans that look almost completely normal but experience severe, persistent pain.

Neither person is imagining it.

It simply reminds us that pain is much more than a measure of what’s happening in our tissues. It’s the brain’s best estimate of how much protection the body needs.

Sometimes that estimate is spot on.

Sometimes it’s a little overcautious.

Phantom Limb Pain: A Remarkable Example

One of the clearest examples of this is phantom limb pain.

Imagine someone has had a leg amputated.

The leg is no longer there.

And yet they can still experience pain in that missing foot.

How is that possible?

Because the pain isn’t being produced by the missing tissues.

It’s being produced by the brain.

The pain is completely real, but it shows us that pain isn’t simply a signal travelling from body to brain. It’s an experience created by the brain after interpreting information from many different sources.

Once you understand that, the idea that the brain can sometimes continue producing pain after healing starts to make much more sense.

The Placebo and Nocebo Effects

Here’s another example.

You’ve probably heard of the placebo effect.

Someone believes a treatment is going to help them, and their symptoms genuinely improve—even if the treatment itself has no active ingredient.

This isn’t people pretending.

Brain scans show measurable changes. The brain releases its own pain-relieving chemicals and alters the way pain is processed.

The opposite can happen too.

This is called the nocebo effect.

If we believe we’re badly damaged, fragile or that a movement is dangerous, the brain can actually increase pain as a protective response.

Our expectations matter.

Our previous experiences matter.

What healthcare professionals tell us matters.

None of this means pain is “psychological.”

It means the brain is constantly weighing up information and deciding how much protection we need.

What Sort of Conditions Might Involve Neuroplastic Pain?

Pain Reprocessing Therapy isn’t aimed at one specific diagnosis. Instead, it’s about understanding the processes that may be maintaining symptoms.

Conditions where an overprotective nervous system may play a role include:

• Persistent low back pain where scans don’t fully explain the symptoms.
• Long-standing neck pain.
• Persistent shoulder pain after tissues have healed.
• Some tendon problems that don’t settle as expected.
• Widespread pain such as fibromyalgia.
• Irritable bowel syndrome (IBS).
• Persistent pelvic pain.
• Some persistent headaches and migraines.
• Temporomandibular (jaw) pain.
• Persistent fatigue where appropriate medical causes have been investigated.
• Persistent postural-perceptual dizziness (PPPD).
• Some symptoms associated with functional neurological disorder (FND).
• Pain that seems to move around the body or changes dramatically from day to day.

This doesn’t mean these conditions are always caused by neuroplastic changes.

Far from it.

Two people with exactly the same diagnosis may have very different reasons for their symptoms. One person’s pain may be largely driven by ongoing tissue irritation. Another person’s nervous system may have become highly sensitised. Many people have a mixture of both.

That’s why assessment is so important.

As an osteopath, my first job is always to understand what’s driving your symptoms. Pain Reprocessing Therapy isn’t a replacement for a thorough assessment—it becomes an option only when it’s appropriate.

So, What Happens During Pain Reprocessing Therapy?

If you’re imagining incense, chanting or me asking you to hug a tree… don’t worry.

A session is actually very practical.

We begin by understanding your story.

When did the pain start?

What makes it better?

What makes it worse?

Have there been injuries, illnesses, stressful periods or significant life events around the time your symptoms developed?

We’ll also look at movement, beliefs about pain and any fears that may have built up over time.

That isn’t because I think the pain is “psychological.” It’s because our experiences, emotions, previous injuries and expectations all influence how the nervous system responds.

Depending on what’s appropriate, treatment may include:

• Understanding how pain is created.
• Learning why the nervous system sometimes becomes overprotective.
• Gentle movement and behavioural experiments to help rebuild confidence.
• Techniques to reduce fear around symptoms.
• Developing a different relationship with pain rather than constantly fighting it.

For many people, simply understanding why they’re hurting is incredibly powerful. When pain starts to make sense, it often becomes much less frightening.

Is There Good Evidence for Pain Reprocessing Therapy?

Pain science has changed dramatically over the last two decades, and we’re learning more every year about how the brain and nervous system contribute to persistent pain.

Pain Reprocessing Therapy is one of several approaches that has shown encouraging results for carefully selected people with persistent pain, particularly when symptoms appear to be maintained by an overprotective nervous system.

Like all healthcare, it’s not a miracle cure.

It isn’t appropriate for everyone.

And it doesn’t replace a thorough medical assessment.

But it does offer hope for people who have been told, “Your scan looks fine,” while still living with very real pain.

One of the things I like most about PRT is that it doesn’t ask people to ignore their symptoms.

Instead, it helps them understand them.

Knowledge really can change the experience of pain.

Why I’m Interested in Pain Reprocessing Therapy

If you’ve read some of my other blogs, you’ll probably know I enjoy understanding why things happen.

I’ve always been fascinated by the way the body heals and adapts. The more I’ve learned about modern pain science, the more I’ve realised that the nervous system often plays a much bigger role than we once thought.

As an osteopath, I’ll always value hands-on treatment, movement, exercise and helping people become stronger and more confident in their bodies.

Pain Reprocessing Therapy doesn’t replace those things.

For me, it complements them.

It’s another tool that helps explain why some people recover quickly while others continue to struggle despite doing “all the right things.”

The exciting part is that our brains remain adaptable throughout life.

Just as the nervous system can become more protective…

…it can also become less protective.

That means change is possible.

A Final Thought

One of my favourite things about science is that it’s always evolving.

Ideas that seemed impossible twenty years ago are now supported by research. At the same time, today’s understanding will continue to improve as we learn more.

Pain Reprocessing Therapy isn’t about dismissing pain.

It’s about taking pain seriously enough to ask a bigger question.

What if the pain isn’t a sign that your body is broken, but a sign that your nervous system has become overprotective?

For some people, that simple shift in understanding can be the beginning of recovery.

If you’ve been living with persistent pain and feel as though you’ve run out of answers, I’d be happy to explore whether Pain Reprocessing Therapy could form part of your treatment.

The first step isn’t deciding whether PRT is right for you.

The first step is understanding why you’re in pain.

Once we understand that, we can decide together what the best path forward looks like.

Could Pain Reprocessing Therapy Help You?

If you’ve been living with persistent pain and feel as though you’ve tried everything, it can be hard to know what to do next.

Pain Reprocessing Therapy isn’t the right approach for everyone, but for some people it offers a completely different way of understanding why pain persists and, more importantly, how recovery can begin.

As with all my treatments, the first step is a thorough assessment. Together, we’ll explore your symptoms, your history and your goals before deciding on the most appropriate treatment plan. That may involve hands-on osteopathy, exercise and rehabilitation, Pain Reprocessing Therapy, or a combination of approaches tailored to you.

If you’d like to find out whether Pain Reprocessing Therapy could be appropriate for your situation, I’d be delighted to help.

You can learn more about my treatments, or get in touch to arrange an initial consultation.

Please note: Pain Reprocessing Therapy is not appropriate for every type of pain. A thorough assessment is always needed to identify whether symptoms are likely to relate to ongoing tissue injury, medical conditions, or an overprotective nervous system. If there are signs that further medical investigation is needed, these should always take priority.

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It’s a type of osteopathic treatment that feels quite different from what many imagine when they think of “manual therapy.”

There’s no force, no cracking – just a quiet, subtle way of helping the body find its own balance again.

At my clinic in Hastings, cranial sacral therapy is one of the approaches I use most often – particularly for people with long-term tension, headaches, or stress-related pain.

So, what actually happens during a session, and how does it work?

A Subtle but Powerful Approach

Cranial sacral therapy (sometimes called cranial osteopathy) is based on the idea that the body constantly expresses gentle, rhythmic motion – a kind of inner tide.

When this motion becomes restricted, through injury, stress, or long periods of strain, it can affect the body’s ability to self-regulate and heal.

During treatment, I use very light touch to listen to these subtle patterns.

By gently supporting areas of tension or imbalance, the body often begins to reorganise itself – releasing what it no longer needs to hold.

Patients often describe the experience as deeply relaxing.

Some notice warmth, soft movement, or a feeling of space opening through the body.

Others simply feel calmer and more grounded afterwards.

What Cranial Sacral Therapy Can Help With

This approach can be suitable for a wide range of issues, including:

• Headaches and migraines
• Neck and shoulder tension
• Stress and fatigue
• Jaw (TMJ) discomfort
• Back or pelvic pain
• Support after illness or injury

It can also be a good choice for people who prefer a gentler approach, or who are sensitive to stronger techniques.

How It Differs from General Osteopathy

While traditional osteopathic techniques might involve joint articulation, soft tissue massage, or movement exercises, cranial work is more about listening than doing.

The pressure used is often no heavier than the weight of a hand resting on the skin.

Both approaches share the same foundation – understanding how structure and function are connected – but cranial osteopathy focuses more on the body’s subtle rhythms and the nervous system’s response.

Many people find that combining the two can be very effective: using structural techniques to ease movement, and cranial work to calm and integrate.

What to Expect in a Session

A session usually lasts around 45–60 minutes.

You’ll lie comfortably, fully clothed, on the treatment table while I gently assess how different parts of your body are moving and responding.

Treatment is deeply individual – no two sessions are exactly the same.

The aim isn’t to “fix” something from the outside, but to help your body find its own balance and resilience again.

Most people leave feeling relaxed, lighter, or more centred.

Sometimes the changes are subtle at first – improved sleep, less tension, a calmer state – which then unfold over the next few days.

Why People Choose Cranial Work

In a world that often pushes us to go faster, cranial sacral therapy offers space to slow down.

It’s a way to listen to what the body’s been holding onto, and to allow genuine recovery to happen from within.

For many, that calm, connected state becomes the first real step towards longer-lasting change.

Book a cranial sacral session

If you’d like to experience this approach for yourself, you can book an appointment online or contact me for a chat.

I offer cranial sacral therapy and osteopathic treatment across Hastings, St Leonards, Bexhill and Rye.

Cranial Sacral Therapy FAQs

The post What Is Cranial Sacral Therapy and How Does It Work? appeared first on Daniel Baines Osteopathy.

Dan has a Masters degree in Osteopathy and is an Anatomy in motion and Neurokinetic therapy practitioner and Yoga anatomy teacher. In his spare time he can be found exploring everything dance and movement based. He runs his ‘Daniel Baines Osteopathy’ clinics from Hastings, Eastbourne and the One Aldwych hotel health club on the Strand in London.

What, when and where was your first experience of complementary therapies?

While I was touring with the show Stomp the rough and tumble of flipping around a stage with dustbin lids strapped to my hands left me with a string of chronic injuries. I was lucky enough to meet a fantastic therapist who patched me up, and enabled me to extend my career by another 3 or 4 years. That experience inspired me to study osteopathy.

What made you decide to treat others?

I love working with people and am intrigued by the human body. I love the challenge of unravelling the story behind a patient’s presentation and to understand the compensations that have led them there. Most importantly I love being a small part in an individual’s journey to rediscovering their potential for pain free human movement. What and incredible honour.

What influenced your treatments the most?

I am blown away by osteopathic philosophy, however it was a chance meeting with my now good friend Chris (a non osteopath) that really inspired me my on my current journey and led me study Anatomy in Motion and then Neurokinetic therapy. He constantly challenges me to think outside of the box when treating and never ceases to amaze me when I get the chance to sit in and watch him work.

Describe holistic in less than 10 words

As soon as holism is described it has boundaries which prevent you from seeing outside of the box. In ten words holism to me is:

‘Being in the moment without rules or preconceptions and asking why’ 

(ok that was 11).

What role do your therapies play in the way you live?

Movement never lies, so I constantly watch people as they walk down the street, train in the gym or stand at a bus stop. I have found myself following people with a curious limp or interesting gait pattern and mapping there movement in my body to try and understand how they feel and to embody their pain. I guess it has kind of taken over how I live and turned me into a ‘movement stalker’. How very worrying.

What do you hope your clients to experience when they get treated by you?

My sessions are unconventional from a time and treatment perspective. By the end I want my clients to understand why they have pain, have home work to help manage it and have enjoyed the process of unravelling their jigsaw.

What is the most rewarding thing about what you do?

I get to geek out every day exploring the potential of the human body, while helping people move out of pain. 

Do you eat ice cream, drink coffee or any guilty pleasures?

Yes, yes and yes!

I am currently off alcohol for 2 months, but my weakness is King Cobra beer (hard to find but oh so worth it when you do) and Zaibatsu restaurant on Trafalgar Road in Greenwich (check it out on trip advisor and you will see why).

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Carrot muffins are a throw back from the days when I used to travel off to sunny destinations teaching on fitness retreats. We had an incredible chief called Michael who would whip up the most delicious meals that were gluten free, dairy free and sugar free. After a long day of working out in the Mediterranean sunshine there was nothing better than relaxing around a large table and putting the world to rights over one of his incredible feasts.

These gluten free, sugar free carrot muffins would often make an appearance and were always one of my favourites. Over the years I have proceeded to tinker with the ingredients to include even more goodies while staying loyal to his original concept. They take about 15 minutes to mix together and 25 minutes to cook. I have put a few additional notes next to the ingredients regarding their health benefits so whip a batch up for friends or family and know you are doing them good in the process. Enjoy!

Carrot muffins- Ingredients:

• 4 decent sized organic carrots coarsely grated 
• 200g Doves gluten free flour (many people are sensitive to gluten, resulting in stomach cramping, bloating and inflammation)
• 3 eggs (organic where possible as this cuts down on exogenous hormones and antibiotics)
• 1 tsp of baking powder
• 1 tsp of baking soda
• 2 tsp of vanilla extract
• 2-3 tsp of cinnamon (I like to be generous. It improves insulin resistance, lowers blood glucose, reduces ‘bad’ cholesterol, and is a powerful antioxidant)
• 80g coconut oil melted (improves good cholesterol and has been shown to have anti viral and bacterial properties)
• 1 banana chopped into small pieces 
• 100g raisins
• 2 scoops collagen powder (I use Great Lakes collagen powder. It is great for repair and regeneration of skin, hair, muscle tissue and gut lining)
• 3 tsp Chia seeds (loaded with antioxidants and fibre, high in protein, high in omega 3s and helps reduce inflammatory markers. Chia seeds are a real super food so sprinkle them on everything.)

Instructions:

Pre heat oven to 180 degrees centigrade

Mix all the ingredients together well in a large bowl

Divide into 12 lined muffin tins

Cook for 25 minutes

Try resisting nibbling straight away unless you have an asbestos tongue which is immune to red hot raisins.

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This was a great question posed by my last patient on Friday as we started to delve back through his 50 year plus case history.

Functional medicine – what it is not

In order to answer ‘what is functional medicine?’  it is probably best to start with what it is not.

Functional medicine is not about treating your disease or your presenting problems. You are not your symptoms. Symptoms are merely clues that are whispering to us (sometimes very loudly) that we need to go back in time to understand what has bought you here. If you took your car to the garage with a red light flashing on the dashboard you would be somewhat disappointed if the mechanic simply disconnected the light and said “problem solved it doe not flash any more,” yet this is exactly what we do with our health every day.

Conventional Approach

• Baby feels unwell – out comes the Calpol
• Head aches – take an aspirin
• Acne – take a birth control pill
• Appendix pain – remove it
• Menopause symptoms – take hormones.

All of these symptoms and many more are red lights flashing on the dashboard and these are the whispers we want to listen to and ask why. They are all gifts which if we choose to unwrap them can lead us to a healthier and happier future.

It all starts with your case history

Whether I am working mechanically with muscles and joints or looking under the bonnet with a functional medicine approach, the journey begins with a thorough case history. Where did things start to unravel? What pushed you off centre and then how did life accumulate on top of this. I am looking for the root cause/causes of an inflammatory cascade which can then effect your hormones, pain, digestion, mood and immunity. If you have IBS, fibromyalgia or thyroid issues the process is always the same. Lets leave the diagnosis on the bench for a moment, get out a pen and paper and go back along your time line.

My example

To give you a demo I am going to use myself as an example. Through each decade of my life I am going too explore 5 different categories:

1. Illnesses: Infections, viruses, parasites, hospitalisations, and surgeries
2. Stresses: Family, school, work, relationships
3. Toxins: Heavy metals, moulds.
4. Food sensitivities and recurring allergies
5. Medications past and present: corticosteroids, antibiotics, etc what were they for and did they help?

Age 1-10

• Straight out of the womb I did not want to breast feed (I was a little bugger even back then). Breast is indeed best as every baby is born with a leaky gut and it is the colostrum in mother’s milk that helps heal it ready for solids and the various infections that twill inevitably come our way as we get older.
• Repeated urinary tract infections and antibiotics (UTIs are often a sign of candida infections)
• Repeated antibiotics as a child for a suspected case of bacterial meningitis 
• Mumps, Chicken pox and Measles

Age 10-20

• Family stress as my parents divorced mixed in with the usual angsts of being a teenager
• The mandatory STD associated with university life and another course of antibiotics to get on top of it
• A fungal foot infection aged 18 that would just not shift

Age 20-30

• I began dancing and training people so I began a 100 hour work week that lasted for over 3 years.
• I began to get acid reflux
• A touring lifestyle that involved late nights and poor diet as we lived out of hotels (and night clubs!)
• Oral thrush infection and white coated tongue
• Sore throats
• Multiple joint pain and consecutive injuries
• Chronic fatigue
• No longer able to get enough adrenalin in my body to get me up on stage and through a performance
• I had to retire from dancing

Age 40+

• Brain fog
• Gut issues: bloating and IBS symptoms
• A voyage of self discovery to get on top of things.
• The thought I would have to settle for just feeling older and this was the nature of being over 30

Tying my case history together

My presenting problem was chronic adrenal fatigue and discomfort that meant I could no longer do what I loved. Scouring through my timeline the first whispers were already there by the time I was 2 weeks old. 

My gut never got a chance to heal and much of my mother’s gut microbiome (the bacteria that lives  in harmony with us) never made it across (if you fancy a great read on the topic I would thoroughly recommend 10% human: How Your Body’s Microbes Hold the Key to Health and Happiness) A good dose of antibiotics made sure that any ‘good’ bacteria became collateral damage leaving what should have been a sterile small intestine with the starts of candida over growth. The signs of Candida overgrowth are urinary tract infections, thrush, fungal foot infections, brain fog and a white coated tongue – a clean sweep! 

Candida overgrowth then affected my digestion by creating lesions in the gut wall (leaky gut) allowing undigested proteins to enter my blood stream causing inflammation and autoimmune responses. Add in high stress (physical and emotional) and I was the perfect storm for a catabolic stress response which broke down anything made from collagen (my predisposition to injuries and further gut wall break down). 

My solution at the time was to increase my coffee intake and sugar intake to get me up in the morning and keep me going into the evening. My friendly Candida loved the added sugar it was being lovingly fed and the coffee further stressed my adrenals. The end result, my adrenals went on strike.  In order to prioritise survival my adrenals sacrificed the production of sex hormones (inability to gain muscle plus the libido of a door mat) and they struggled to make cortisol causing uncontrolled inflammation, whole body joint pain and the inability to get the adrenalin needed to get me up on stage each night. What a mess. 

What was the medical solution – corticosteroids and the chronic pain clinic to understand the complex nature of pain so that I could live with it in harmony. In other words: disconnect that flashing light! Still being the obstinate bugger who refused to breast feed aged 1 week I chose instead to look under the bonnet.

Conclusion

• You are not your disease
• You symptoms are whispers which you might want to listen to
• Those whispers are gifts
• Go back through your timeline paying attention to infections, stresses, toxins, food sensitivities and medications
• Figure out where your inflammatory cascade began.

Treat that root cause and watch the red flashing light go out on its own.

The post Functional medicine – looking for health appeared first on Daniel Baines Osteopathy.

On a wet October morning many moons ago, I found myself sitting in a run-down classroom in the basement of the London School of Osteopathy in Whitechapel. I was waiting with anticipation for my first ever osteopathy lecture. I was primed and ready (although be it slightly nervously) for an in-depth anatomy and physiology lecture when in walked an elderly gentleman who unpacked his notes, shuffled them and began to gently talk on the history and principles of Osteopathy.

For a fresh-faced 1st-year student who was eager to learn about bones, joints, and muscles I left day 1 feeling a little deflated. I wanted to understand the human body, not the philosophy of a chap called A.T Still who had been working as a ‘bone setter’ in the mid 1800’s. It turned out that this young and naive grasshopper had plenty to learn.

As I continued on my 5-year journey of studying I began to realise that that first lecture was the foundation stone on which I would lay the rest of my knowledge and would prove invaluable as I ventured out into private practice. I have since added to (and sometimes subtracted from) this list of core beliefs as I have learned from some brilliant minds who have inspired and caused me to question and adapt my thinking. Here are just a few of the principles that have survived the cut and guide me everyday in my clinic.

Core beliefs 1:

Your body is the ultimate healer and not me. The work we do in a session can create the space for change but the real healing occurs due to your amazing body afterward.

Core beliefs 2:

Creating a cooperative space where health practices will be done ‘by you’ as well as ‘to you’ (the more traditional method) empowers people to become fascinated by their body and to take control of the treatment wheel themselves. It means that there is always a little homework to do, but when the textbook (your body) is so interesting who wouldn’t want to flick through the pages.

Core beliefs 3:

The nervous system is fast becoming a buzz word in therapy and rightly so. Even though it was initially mentioned as one of the osteopathy’s founding principles (“the nervous system unifies the body’s activities”) advances in contemporary neuroscience are now allowing us to make quick and often dramatic changes in a clinic to enhance this brain-body connection – exciting times ahead!

Core beliefs 4:

“No pain no gain” is out and “no pain all gain” is in. If every time you move you expect to grimace then you will set up a predictive pattern (Pavlovian response) and the expected discomfort will become a self-fulfilling prophecy. By working within your pain-free parameters (the 70% rule from Qigong becomes important here) your nervous system can take a huge sigh of relief and come back from being on high alert.

Core beliefs 5:

Health does not have to be complicated – move a little more and with more variety, eat fresh food, sleep well and find ways to manage stress (not always easy in the 21st century). Follow these four suggestions and you will be amazed at how great you start to feel. You only have one you so treat it well.

Core beliefs 6:

As an adjunct to the above, we could all do with moving a little more frequently and more vigorously, in fact, the only thing that current research can agree on is that physical activity is good for our health as well as for those of us experiencing pain. Over 150 years ago A.T. Still famously said “to find health should be the object of the doctor. Anyone can find disease”, so I encourage people to put me out of business, lace up their trainers and get moving!

Core beliefs 7:

Pain is a cry for help from your body/mind saying I need a hand. As crazy as it seems pain does not always mean that there is actual damage to your tissues, it can simply be a warning that something has to change. Quite often revisiting the advice in point 5 can illuminate a path forward.

Core beliefs 8:

Pain can feel catastrophic but can also be reframed (as I found when out I finished my dancing career) to be a great teacher and motivator as well. Pain is here to protect us and to be able to observe it as such can be the first step to making peace with it and working with it instead of against it.

Core beliefs 9:

It can take years to decide to change, but change itself happens in a millisecond

Core beliefs 10:”

Whether we are 8 weeks old or 80 years old we all crave safety. Ultimately my job is to help people feel safe, strong, adaptable and resilient

So here we have my current top 10. It is a work in progress so I am sure there will be more added in the future, but for the time being these seem to be serving well.

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Feel free to read on and have a rummage through my therapy closet:

Anatomy in Motion is the ever-evolving brainchild of Gary Ward. Its aim is to unlock the incredible potential that lies within every human body. By observing the body movement during walking it is possible to identify joints, muscles, and postures that are being compromised with every step we take. Alongside a thorough case history, it is then possible to paint a picture as to why there is a pain in the system. It is a way that provides peace of mind and the first step towards healing. The solution is to offer back movement to the body, and if the body finds value in this it accepts it (often immediately). It is as if the body has forgotten how to use certain patterns and it just needs a gentle reminder that movement would be so much easier this way.

Osteopathy is a system of diagnosis and treatment for a wide range of medical conditions. It works with the structure and function of the body and is based on the principle that the well-being of an individual depends on the

We believe that for your body to work well, its structure must also work well. Osteopaths work to restore your body to a state of balance, where possible without the use of drugs or surgery. They use touch, physical manipulation, stretching and massage to increase the mobility of joints, to relieve muscle tension, to enhance the blood and nerve supply to tissues, and to help your body’s own healing mechanisms. Osteopaths train for 4-5 years and are governed by the General Osteopathic Council.

P-DTR or Proprioceptive Deep Tendon Reflex therapy (…a bit of a mouthful) uses manual muscle testing to assess and treat your neurology. Simply (ish) put, we have nerve receptors around our body which continually feed back information to the brain about what is going on. We have nerve receptors that monitor stretching, pain, temperature and even tickle and itch sensation. Once the brain receives this information it then processes it and sends back a message to the muscles to act. For instance if we burn our hand, the heat receptors in the hand send a message to the brain, and our brain sends a message back to the muscles of the arm and hand saying “WITHDRAW!”. This is a marvellous system, however where we start to encounter problems is when the receptors send back faulty information to the brain. Faulty information in results in faulty information out, which can lead to muscle weakness, pain and compensation. P-DTR allows us to break this cycle and prime the system to better accept movement.

The Integrated Systems Model (ISM) is the latest addition to my training and I am so excited about it. Diane Lee is a physiotherapist who is not only versed in all the current research but who also has a ridiculous level of clinical expertise to boot. There has been a lot journeying back and forth to Vancouver to be mentored by her but worth every mile.

So what is the Integrated Systems Model (ISM)? Diane would describe it as “just good old physiotherapy” but I think she is underselling her model. It is all about getting to the root cause of your complaint (even if we have to start looking at the other end of your body!) treating it and reintegrating back into movement – just the kind of therapy I love.Diane is also renowned for her work with post pregnancy issues such as back pain, pelvic pain, prolapse and incontinence and is creating ground breaking work in these areas. Her teachings have really helped me help my mother 40 (something) years after my birth. It is nice to be able to undo some of the damage I created four decades ago!

Neurokinetic therapy (NKT) was developed by David Weinstock in San Fransisco. This brilliant concept of modified muscle testing enables muscle patterns to be assessed and compensations to be understood. Traditional therapy often favours releasing tight joints and massaging sore muscles, however this approach fails to understand why they are working so hard in the first place and often results in chasing pain instead of its cause. If a joint manipulation helps for a couple of days, but then stiffness starts to return, then the joint is restricted for a reason. NKT provides a sophisticated assessment and treatment modality that helps to understand the cause of these poor movement patterns and instantaneous feedback that guides your journey to pain free movement.

Functional Range Conditioning (FRC) was created by Andreo Spina to train joints and everything that supports them. If only someone had created an evidence based system to become stronger and more mobile when I was a dancer! FRC gives people the prerequisites to move well in what ever sport or activity they should choose. The system begins by making sure that each and every joint can move well, while simultaneously strengthening and controlling this new found movement with appropriately challenging exercises. Ultimately this isolation is integrated into movement patterns to train the nervous system and control your new range. Apart from the numerous acronyms used to describe the movements, FRC is incredibly simple in its intention, but oh so powerful. Here is a link to the CARs routine Andrea developed as a daily practice. I use it myself and with my personal training clients daily.

The Perrin technique was created by the Osteopath Dr Raymond Perrin who has spent over 30 years researching and treating ME and fibromyalgia. His research has demonstrated that both diseases are as a result of lymphatic back flow to the brain resulting in toxic overload which would explain the many varied symptoms experienced. I spent some time with Dr Perrin in his clinic in Manchester and his enthusiasm and knowledge was infectious. He taught me how to combine manual techniques to regulate the sympathetic nervous system and stimulate the lymphatics and cerebrospinal fluid in order to pump away this toxic overload. I believe his work empowers sufferers not only with an understanding of the disease but also teaches simple self treatments so that the work we do in clinic can continue between sessions.

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The post Functional sacroiliac joint assessment appeared first on Daniel Baines Osteopathy.

Anatomy

Before opening the Pandora’s box that is the sacroiliac joint, lets start with the basics. What is a joint? A joint is the space between 2 bones. If you think about the hip joint, the two bones involved are the thigh bone (femur) and the pelvis. In this example the shape of the joint (a ball and socket) allows movement to occur in a big three dimensional circle and any combination of movement within.

The sacroiliac joint is a slightly different beast and to understand it we need to first look at the pelvis. The pelvis is made up of two halves,each half made up of 3 fused bones called the ilium, ischium and pubis. The front of the 2 pelvic bones are joined together at the pubic symphysis by strong ligaments (if you’ve ever been pregnant you might have cursed this joint) and at the back we have the junction that joins the sacrum at the bottom of the spine into the pelvis – the infamous sacroiliac joints.

What are the roles of the sacroiliac joints

The roles of the sacroiliac joints are to channel the force of the ground coming up through our legs and the weight of our body coming down through our spine, as well as to stabilise the junction between the pelvis and spine. The weight of our upper body and whatever we happen to be carrying passes down the spine until it comes to the junction of the sacroiliac joints where it now has the option of being shared, via the pelvis, down our 2 legs. The sacroiliac joints transmit this force and dampens it on the way through like a pair of mini shock absorbers. This journey can also be reversed as seen when our foot hits the ground and force is passed up.

How do they it do it?

For these joints to do their job effectively they need incredible strength, and this begins with the architecture of the bones themselves. The 2 wings of the ilia create a beautiful funnel into which the wedge shaped sacrum nestles snuggly, while the rough joint surface of the bones enable them to lock into place like the cogs of a clock. A motor way of ligaments and muscles then surround the joints to fortify their strength during the critical moments of movement when they are exposed to the most load. There has been much wonderful work recently that has looked at how muscles are set up to work as fascial slings, enabling muscular contraction to create force closure and thus stability. We will look at some  of these patterns in the following vlog.

So do the sacroiliac joints move?

If you ever want to see fireworks outside of Guy Fawkes night, drop this question into a room full of therapists, light the touch paper and watch from a safe distance.

In a nutshell the answer is yes. There is no way near the same range of motion as a hip joint and as we age this movement is reported to become even less (until in some it can eventually even fuse) however without it we have bit of a problem. To figure out why the sacroiliac joints must move we need to go back to the anatomy of the pelvis and realise how it has evolved to function more efficiently. If our pelvis did not need to move it would be infinitely stronger if it was made up of one whole bone instead of two halves with a pubic symphysis at the front and a sacrum wedged between the two ilia. To understand why it is as it is, I want you to stand up and place your fingers just under the 2 knobbly bits on the front of your hips called the ASISs (anterior superior iliac spines of the pelvis) and cup the rest of the pelvis in a c-shape with your palms. With your hands in place now go for a little walk around the room and notice how these bones start to rock up and down with each step you take. Now repeat the walk and try to do so without letting the pelvis move at all. You should have found the latter near impossible (unless you were wearing a very tight pencil skirt) and instead noticed that your pelvis nods in opposition as your pelvic ring rotates, drops and hikes in response to the pull of your lower limbs as you move. If your pelvis was in fact solid it would have to shatter with each step you took!

The problem we face is that because the motion is so small and we can have both too much or not enough of it, we need an assessment that allows us to know when and where to start treating …

…and with that little teaser I will leave you on the edge of your seat until the next functional assessment video.

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