The problem with 10,000 steps a day

morning strollIt’s recommended that we take 10,000 steps a day. However, a recent study conducted at Stanford University found that the global average for steps taken per day is 4,961. Though the UK’s average is above this stat, it’s a far cry from the suggested amount.

But the 10,000 steps figure is not based on science in any case. It originated in a Japanese marketing campaign for a new step counter in the 1960s. Most people find it hard to do 10,000 steps in a day anyway. The good news is you don’t have to. You can get even better benefits from a less arduous programme.

Research shows that three 10 minute brisk bouts of walking a day will achieve the aim of getting your heart beating faster which reduces the risk of diabetes, cardiovascular disease and some cancers. It will also help with back pain. You should aim to walk fast enough to be out of breath enough so you can’t sing but can still talk.

Walking has many benefits, besides reducing the risk of heart disease and back pain it can help you sleep easy! Where you can, swap walking on pavements for paths in green spaces or along the seafront, you’re likely to improve your mood, get the creative juices flowing and reduce feelings of depression. With so many lovely green areas and the coast in and around Brighton and Hove, a little change in your daily routine can do wonders for your wellbeing!

A good walking technique is key to ensure your back is properly supported. Tighten your stomach muscles to engage your core and support your entire body weight. Spinal alignment is vital; try to stand up straight and keep your chin parallel to the ground. Let your arms swing naturally and roll through your foot from heel to toe.

It’s also a good idea to shorten your strides; this will reduce the strain on your knees, calves and shins. Make sure you get the right technique as you start off so that bad habits don’t develop! Getting the right footwear is key to ensuring you establish a good walking method. When buying shoes you’re going to walk in make sure you go at the end of the day as your feet will be a little swollen meaning you’ll purchase the right size. It’s important that your toes have room to move and that your heel doesn’t slip. This will give you ample support both in your ankle and further up in your lower back.

Try incorporating a walk into your daily routine. By releasing endorphins and boosting vitamin D levels, walking’s benefits will leave you feeling refreshed and energized as well as strengthening your core and back muscles.

As part of your next appointment, we can measure your foot size so that you can get the correct sized walking shoes.

Little-known cause of back pain starts in childhood and is entirely preventable

Back pain often comes on apparently without reason. In fact, one possible cause might stretch all the way back to childhood. Hove dentist, Pieter Grobbelaar, tell us how teeth and jaw problems can be behind chronic pain.

The jaw joint (TMJ) and pelvic joints (sacro-iliac joints) both work in conjunction with one another, compensating for one another when either joint becomes misaligned writes Pieter Grobbelaar. With an abnormal bite the TMJ becomes dysfunctional and this creates instability at the weight bearing sacro-iliac joint in the pelvis. This leads to poor body posture which can cause low back pain, neck pain, headaches and other health problems.

The majority of children (75%) now have crooked teeth, incorrect jaw development and other orthodontic problems, which is evident from 3-5years of age, are not caused by big teeth in small jaws or hereditary factors. However, rather than blame genetics for crooked teeth and poor jaw development, modern research has produced evidence that points to other causes.

Concordia dental healthcare has recognised that Soft Tissue Dysfunction or poor myofunctional habits such as mouth breathing, incorrect tongue position, reverse swallowing and thumb sucking are the real causes of malocclusion and poor cranio-facial development.

The restricted development limits the space available for erupting teeth and prevents them from emerging into their natural position.

75% of growing children are affected and most commonly will presents with crooked teeth, undeveloped facial and jaw bones, TMJ (Temporomandibular joint) dysfunction and poor body posture.

Mouth breathing is abnormal and is one of the causes of Sleep Disorder Breathing (SDB) problems.

SDB in children has been recognised as causing widespread health, developmental and behavioural problems, including snoring, gasping, cessation of breathing such as Obstructive Sleep Apnoea (OSA) and interrupted sleep, which can result in drowsiness during the day as well as behavioural problems in children. Additionally, as well as being detrimental to the development of the face, jaws and teeth, if left untreated paediatric SDB can lead to significant and serious health problems causing poor quality of life later in adulthood.

If a child breathes through their mouth during the day or while sleeping at night, the tongue drops to the bottom of the mouth, which results in upper and lower jaw development problems. Allergies, asthma and open mouth posture also cause the jaws to develop incorrectly.

Incorrect dental and facial development can be detected at an early age, but so often no treatment is recommended. It is well known that the majority of our children do not develop their jaws and face correctly. This results in crowded teeth and underdeveloped faces.

Braces and extracting teeth in teenage years does not solve the underlying problems behind the causes of crooked teeth and incorrect facial development.

The balanced cranium provides the anchor points for the tension membranes which support the brain. The rhythmic pulsing of the brain as it expands and contracts, when breathing, provides the basis for the sacro-occipital pump which circulates cerebo-spinal fluid.

One of the most important aspects of normal cranial function is the position of the jaw. When the lower jaw (Mandible) comes in contact with the upper jaw (Maxilla) the movement should be symmetrical, simultaneous and even. This constitutes normal cranio-dental function. When the jaw becomes distorted the entire balance of the cranium is put in jeopardy.

A misaligned jaw will change the bite plane and ultimately the bite, affecting the cranium, TMJ, muscle balance, normal spinal mechanics and pelvic stability.

Good cranial development is needed for optimum neurological development.

The cranium consists of 28 bones, any distortion will affect transmission within the brain, cranial nerves and ultimately the nervous system.

Cranial development is 65% completed at age 8 years and 95% completed at 12 years of age, therefore it’s essential that intervention occurs as early as possible assisting cranial development to its optimum genetic potential.




Dr Pieter Grobbelaar BChD

Founder and Principal Dentist of Concordia Dental,

51-53 Church Road Hove



Exercise mistakes that make your back worse

Most back exercises are great for the back and it doesn’t seem to matter much what exercises you do as long as you stay active. But some exercises can be harmful and actually damage your back. So whether you like the gym, Pilates, yoga or a sport it is important to know the good and the bad. Matthew was recently interviewed about just this topic by Stu Girling from Love Yoga Anatomy. Stu trains yoga teachers and practitioners on safe ways to do yoga.

One of the exercises that does more harm than good is forward bending despite the fact that lots of people do it to stretch their back. As we bend forward huge pressure builds on the lower discs. As you bend from the waist, if the lumbar spine is held in neutral, with its natural forward curve, the pressure on the disc is reduced. If you round your lower back as you bend forwards then the discs are vulnerable. The jelly inside the disc gets forced backwards and can cause cracking in the outer disc wall. If this carries on it can cause a disc bulge or a “slipped disc”.




If you bend, as in a yoga forward fold, over and over again then it can cause injury. It is like repeatedly bending a credit card, a white line appears and ultimately it breaks.

Many people with back pain feel that their back is too stiff and want to stretch it. A better goal for exercises is the right mix of flexibility and stability. If your back is too stiff and this causing pain then the solution is to unlock the spinal joints with chiropractic manipulation or mobilisation. If, however, your problem is too much flexibility then we work to stabilise your spine.

No click chiropractic is here

If you don’t like the clicking or popping associated with chiropractic manipulation then you are not alone. Lots of people don’t like the feeling or the sound as it can be a bit scary even though it is actually quite safe. So we have developed a range of techniques and procedures that get the same great results with back pain and neck pain but without the clicking – our No Click Chiropractic.

We use a special high-tech instrument, the Impulse iQ, which gently mobilises the joints by a soft tapping at just the right frequency to loosen up the stiffness. It is completely safe and is one of the reasons people choose us as we are the only clinic in the area to use them.

The Impulse iQ is a computerised adjusting instrument that has been developed to help us identify the problem areas and measure the spine’s response to the treatment. With this technology, spinal problems can be treated precisely with comfortable chiropractic adjustments that are 100x faster than traditional manual adjustments.



Key Features of the iQ

  • Extreme Speed – 100x faster than traditional manual adjustments
  • Equipped with a motion sensor to measure how well the problem area is functioning
  • The technology regulates the treatment in real-time to your body’s natural frequency
  • Auto-sense technology signals the device to stop the treatment when function is restored

Key Benefits of the iQ

  • Treating you at your body’s natural or resonant frequency allows us to use less force to accomplish the adjustments
  • Comfortable treatments
  • No twisting, turning or popping
  • Fewer side effects – i.e. soreness


FDA Registered, UL Listed, ISO 13485 Certified Medical Device

Surprising facts about back pain and arthritis of the spine

Brighton chiropractor, back painBack pain is surrounded by myths which often cloud simple facts. People with back pain are often told is that “it is just wear-and-tear and you’ll have to put up with it” or “it’s probably arthritis. What do you expect at your age”. This is not very helpful and often is plain wrong.

Many back sufferers are unclear if it is arthritis or not and what the best treatments and self-help strategies are. The surprising news is that arthritis is not as important as a cause of back pain as we once thought.



What is arthritis of the spine?

When people say arthritis of the spine they are mainly talking about osteoarthritis. This is the most common sort and occurs in almost everyone as we get older. There are characteristic changes to the discs, vertebrae and spinal joints. The first sign on an X-ray or MRI scan is a loss of fluid from the jelly in the centre of the discs, especially of the lower lumbar spine. The discs then lose height and in the advanced stages can almost disappear. This is why we get shorter as we get older. The spine responds to these changes by growing bony spurs to buttress the ageing discs which give the spine a bumpy shape on X-ray and other imaging. The discs in the lower back carry the most load so this is probably why they have these changes first.

The spinal joints are prone to osteoarthritis too. First the non-slip surface of the cartilage covering the bones gets roughened and pitted as it wears a bit. The joint may make more noise as it moves so you may hear more clicks and crunching sounds. Sometimes it sounds like grit in the joint although this is rarely painful. In the advanced stages extra bone growth occurs here too and this can be seen as bony spurs on imaging. The range of movement of the joint decreases and this leads to loss of flexibility as we get older. 

Arthritis does not cause more back pain

The good news is that as horrible as these changes appear they have not been shown to cause an increase in back pain. Imaging of people with back pain shows that they have the same levels of osteoarthritis in the back as people of the same age without back pain. So what is going on?

It is likely that arthritis in the spine does not cause pain directly. It may, however, make it more likely that spinal joints will lock up and this can cause pain. As locking of the spinal joints is a common cause of back – so-called facet joint syndrome- it seems that the effect of osteoarthritis is lost in the frequently occurring condition. Spinal manipulation and mobilisation by our chiropractors and physiotherapists unlock the joints that cause the pain and is an effective treatment for most back pain.

There is one a rare side effect of osteoarthritis where the bony spurs get so big that they press on the nerves. If they press on the nerves that go down the leg it can cause sciatica symptoms. If compression occurs around the spinal cord this can cause a condition called spinal stenosis. Then pain and numbness can occur in both legs especially after walking a short distance. Manual treatment and exercises can help but surgery is rare but sometimes necessary.

In addition to osteoarthritis there are many other sorts of arthritis. This includes rheumatoid arthritis which is an aggressive, auto-immune disease in which inflammatory changes attack the spine and other joints. Fortunately it is an unlikely cause of back pain. The other significant but also rare form of spinal arthritis is ankylosing spondylitis. This is also an inflammatory disease which is more common in men and causes progressive spinal stiffness and pain. Both rheumatoid arthritis and ankylosing spondylitis are diagnosed with a blood test and can be treated with medication. If we think you may have this sort of condition we will refer you back to your GP. 

If you would like a free consultation to find out if arthritis might be contributing to your back pain then give us a call or book online above.


Facet joint osteoarthritis and low back pain in the community-based population.

Kalichman L1, Li L, Kim DH, Guermazi A, Berkin V, O’Donnell CJ, Hoffmann U, Cole R, Hunter DJ.

Spine (Phila Pa 1976). 2008 Nov 1;33(23):2560-5. doi: 10.1097/BRS.0b013e318184ef95.

Why an accurate back pain diagnosis is essential

Back pain is not one condition but several conditions causing similar symptoms. A muscle spasm, disc derangement and a spinal joint dysfunction all cause low back problems that can refer pain down to the buttock and leg and a skilled chiropractor or physio can tell which problem it is likely to be. Whilst several conditions can co-exist an accurate diagnosis is important because the treatment is different for all three.

The diagnostic confusion is made worse by the different experts who treat back pain because they often use different terminology to describe the same thing, recommend different treatment based on their area of expertise and frequently ignore the evidence that their approach has been shown to be ineffective and so leave you, the patient, in pain and more confused about what is wrong.

Most back pain is caused by irritation to:

  1. joints,
  2. discs,
  3. muscles or
  4. nerves of the spine.

This irritation happens with repetitive minor trauma such as bending and lifting or, more rarely, by a single traumatic injury such as a fall or accident. It can also be caused by inactivity which causes the joints of the spine to stiffen up and the back support muscles to become weak such as sitting at a desk for long periods.

If the joints of the lower back get stiff they are less able to carry out normal movements and this can lead to further joint irritation, stiffness and pain. This is often called Facet Joint Syndrome. The nerves around the stiff joints get irritated too and fire off alarm signals into the nervous system which can cause further symptoms such as tingling and pain referred down to the hips and legs. This can mimic sciatica.

Occasionally, the nerve irritation can cause muscles in the legs to weaken and this can lead to problems in the hips and knees. How this occurs isn’t clear but anyone with hip or knee problems seeing us here at Sundial will get a thorough muscle and spine check-up.

We treat back pain with an effective step by step programme to rebuild strong and healthy backs so you can lead an active and fulfilling life.


Get started today with a free consultation…

Book now



Bare as you dare – how sunbathing prevents back pain

The sun is shining; it’s warmed up; time to take your clothes off!

If you are suffering from ongoing back pain, then you could be deficient in Vitamin D. This hormone is responsible for a wide range of processes in the body including bone and muscle function. A commonly missed cause of back pain is Vitamin D deficiency, especially over a long winter. At least 50% of people in the UK show signs of vitamin D deficiency and many will have increased back pain as a result.

Common signs of vitamin D deficiency

  • muscle and bone aching
  • pain sensitisation, lower pain threshold
  • fatigue
  • depression
  • weakness
  • muscle soreness after exercise

Vitamin D is essential for bone formation as it helps your body absorb calcium from food. If you don’t have enough Vitamin D you can get a condition called osteomalacia. The dull, aching pain associated with osteomalacia most commonly affects the lower back, pelvis, hips, legs and ribs. This pain can be worse at night, or when you’re weight bearing. Vitamin D deficiency may cause morning back pain in some people too.

How much Vitamin D is enough?

There are various ideas about what the minimum blood levels for Vitamin D are required. This is a measure in nanomoles per litre of blood (nmol/L). Severe deficiency is anything below 25nmol/L, but anyone below 50nmol/L is considered deficient. Optimum health is often thought of a being above 85 nmol/L although more than 125nmol/L can be required for some people.

How can you get enough Vitamin D?

Fortunately, it is easy to get enough Vitamin D for free as you make it in your skin. Sunlight contains ultraviolet (UVB) rays that stimulate Vitamin D production. UVB rays also cause sunburn, however, so it is important to avoid over-exposure. If you cover up or use sunscreen, you will not produce Vitamin D so only aim for short exposure.

A sensible approach is to aim for 10-30 minutes exposure on as much bare skin as you dare, depending on how sensitive your skin is, several times a week when the sun is strong enough; in the UK that is from April to September. Full body sun exposure with no sunscreen will produce up to 20,000iu (500 μg) in 30 minutes. More importantly, once you have made enough Vitamin D your skin stops producing it so you can’t get too much.

Vitamin D supplements

Over the winter or for if you are severely deficient then supplements are the only way to go. In your diet oily fish such as salmon, mackerel and sardines provide some vitamin D but you would, for example, need to eat 20 tins of salmon a day to get 5000iu.

Here at Sundial we recommend a liquid Vitamin D supplement which is highly absorbable and inexpensive. The chewable calcium based supplements from ordinary shops are often too low in Vitamin D to help much.


  • Vitamin D deficiency is common and can cause back pain
  • Safe sun exposure on bare skin from April to September is beneficial
  • Taking a good quality supplement over the winter prevents deficiency

For more information and references:


Half of people in the South East fail to prevent or manage back pain

Low back stretchPeople in the South East encouraged to stay active this Chiropractic Awareness Week

This Chiropractic Awareness Week (8th – 14th April) the British Chiropractic Association is encouraging people in the South East to keeping moving, after finding that 42% of people in the South East don’t take any steps to look after their back health.

The findings come from a survey conducted by the BCA, which unearthed that 25% of people in South East don’t take any action when they experience back or neck pain and 13% wouldn’t seek help from a health professional if they were experiencing these issues.

Chiropractic Awareness Week aims to educate people about the easy ways they can avoid or alleviate back pain, which on average 80% of the nation has experienced. Regularly changing posture and remaining seated for no longer than 30 minutes at a time are just a couple of the simple ways to prevent or reduce pressure on the back.

According to the BCA’s survey, when it comes to back and neck pain, they found that people in the South East:

  • 42% don’t take any steps to look after their back health
  • Only 58% have taken preventative steps to protect themselves from developing back or neck pain
  • 82% have experienced back or neck pain
  • 13% wouldn’t seek help from a health professional for back pain and, 31% would wait a month or longer
  • Only 13% would make changes to their daily routine if experiencing back or neck pain
  • 18% choose their mattresses bases on price, rather than comfort

Matthew Bennett from Sundial Clinic in Brighton, commented on the findings:

“There are so many people in South East living with neck or back pain because they don’t know what preventative steps they can take, so we want to shine a light on the simple changes which can help. Chiropractic Awareness Week is designed to educate everyone on the best ways to prevent and tackle back or neck pain, from changing up your posture when sat at a desk, to sleeping on the right mattress.”

“Easy changes to your day-to-day life can make a significant difference, but if your pain doesn’t reduce or is prolonged, you should always see a health professional for further guidance.”

Matthew Bennett’s top tips for keeping on top of neck and back pain include:

  • Keep on moving: Physical activity can be beneficial for managing back pain, however it’s important that if this is of a moderate to high intensity that you warm up and down properly to get your body ready to move! If a previous injury is causing you pain, adapt your exercise or seek some advice. Activities such as swimming, walking or yoga can be less demanding on your body, while keeping you mobile!
  • Take a break: When sitting for long periods of time, ensure you stand up and move around every 30 minutes. When at work, also make sure your desk is set up to support a comfortable position. This is different for everyone so if you don’t feel comfortable in your current set up, try altering the height of your chair or screen.

Other things which people can bear in mind include:

  • Lifting and carrying: Remember to bend from the knees, not the waist when lifting heavy items. Face in the direction of movement and take your time. Hold the object as close to your body as possible, and where you can avoid carrying objects which are too heavy to manage alone, ask for help or use the necessary equipment.
  • Sleep comfortably: The Sleep Council recommends buying a new mattress at least every 7 years. Mattresses lose their support over time, so if you can feel the springs through your mattress, or the mattress is no longer level, your mattress is no longer providing the support you need. Everyone has different support requirements, so when purchasing your mattress ensure it is supportive for you. If you share a bed and require different mattress types, consider two single mattresses which are designed to be joined together, to ensure you both get the support you need.
  • Straighten Up!: The BCA has created a programme of three-minute exercises, Straighten Up UK, which can be slotted into your daily schedule to help prevent back pain by promoting movement, balance, strength and flexibility in the spine.

If you have back pain book in for a free consultation

  • Queens Road, Brighton 01273 774114
  • Kemptown, Brighton 01273 696414


Brighton Half Marathon runners’ offer

After running the Brighton Half Marathon on Sunday you may still be getting muscle soreness or other aches and pains. Simple muscle soreness will get better over the next few days and massage can help speed this up. If you have a more persistent or painful niggle then you probably want to know whats wrong and what to do about it.

We understand how annoying aches and pains can affect your running and can even stop you doing what you love. You don’t have to put up with it.

We’ll give you 50% off your next physio or massage session here at Sundial for all Brighton Half Marathon runners.

  1. Book an appointment for a massage or physio session
  2. Get a customised treatment plan based on our review
  3. Take the first step towards pain free running

50% off your next physio or massage session – Book now

Download Top Tips to Beat Running injuries pdf

We have treated thousands of runners over many years and have been the clinic partner for the Brighton Half Marathon for the last four years.
Achilles tendon massageOur patients say:
A sequence of physiotherapy and home exercises continued over the next few weeks and gradually the condition improved until it completely cleared.
Lee Ashton

He tried various techniques with me to find exactly what worked for me. We tried different physio exercises to build up the strength in my knees and the pain has reduced massively. I am really grateful for his help, and the lovely team at Sundial who are always welcoming and kind.
Charlotte S

50% off your next physio or massage session – Book now

Sundial at Brighton Half Marathon fundraiser

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Click here to watch video

Sundial supports the Sussex Beacon which provides specialist care and support for people living with HIV. Last Sunday we provided the massage at their flagship event – the Brighton Half Marathon as we have done for the last four years. This year we had 40 physio students, massage therapists and Sundial staff at the run from early morning on a beautifully sunny day giving pre-race massage and Rocktaping.

The atmosphere was buzzing as runners warmed up and stretched with some showing signs of nervousness as this was their first big running event. Some had not run 13.1 miles before and, judging from their faces at the end, may not again! Still, after a rest, a massage and general TLC most seemed to have perked up as they left the Sundial massage tent on Madeira Drive, right on the seafront.

Massage is helpful for recovery after a long run. In fact, it has proven to be the most effective treatment.  It helps ease the tight muscles and cramps that can occur and reduces swelling from traumatised joints and ligaments too.  Delayed onset muscle soreness (DOMS) is common after exercise, especially if you are not used to it. Whilst the runners may have been tired immediately after the Brighton run the worst muscle soreness usually kicks in the next day or even up to day three after the half marathon. The soreness can last for several days and is worse if the muscles are used again. If this is you, it is a good idea to rest with short occasional short walks to keep your flexibility. Anything that increases blood flow to the muscles can help recovery and this is where massage can help. Also, hot baths can help too.  You can add a large cup of Epsom Salts too as the magnesium is absorbed through the skin and can help muscle soreness.

One treatment for DOMS that has been hitting the headlines recently is curcumin which is the main ingredient in the spice used a lot in Indian cooking – turmeric. Interestingly, muscle strength also improved as well as the moderate to large reductions in muscle pain.

If you have muscle soreness after running then ice baths are unlikely to help. This will be welcome news to anyone who, like me, thinks you would have to be mad to climb into icy water. I’d rather have sore muscles.

Unfortunately, static stretching or warming up the muscles before or after exercise does not prevent the soreness from occurring. The best way to avoid DOMS is to gradually increase training before strenuous exertion to allow your muscles to build and adapt. This, of course, is not news. Anyone who has trained for a marathon or a half’ will know the benefits of a long steady training programme. So if you are thinking of taking part next February then best plan several months of training.


If you took part in the Brighton Half Marathon we are offering 50% off a massage or physio session here at Sundial. Book online above or call us.




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Curcumin study

Vitamin D