Ribollita. A great winter soup. Italians swear this helps fight the flu/colds, at least that’s what we have been told!

One of my favourite dishes during winter is the ribollita. Perfect for using up old, stale but good quality bread, and easy to put together with seasonal veggies for next to nothing. It’s not minestrone, it’s a beautiful thick, bread-based soup with no pasta in it. You’ll love it even more with a good glug of extra virgin olive oil, and mark my words, make enough for the next day because the flavours are even better! as it isn’t brothy and it has no pasta in it.

It’s very much Italian peasant food and would have been eaten a lot in the days of no central heating and lots of hard manual labour. This recipe embraces the heart and soul of what peasant cooking is all about cheap, tasty power food that warms your soul and keeps you well.

Dr Shane Heslop

Osteopath.  City Osteopathy

INGREDIENTS

                     1 pound dried cannellini beans

    • 2 tablespoons extra-virgin olive oil
    • 1 large sweet onion, small-diced
    • salt
    • 2 large carrots, small-diced
    • 3 celery stalks, small-diced
    • 1/2 large butternut squash, peeled and small-diced (2 cups)
    • 1 head garlic, cloves separated, peeled, and thinly sliced
    • 1 can San Marzano tomatoes, drained
    • Bouquet garni: 2 bay leaves plus a couple sprigs each of fresh sage, oregano, flat-leaf parsley, and thyme, tied together with twine
    • 1 tablespoon crushed red pepper flakes
    • 1 pound cavolo nero (a.k.a. dinosaur kale or Tuscan kale), leaves torn into small pieces, stems finely minced
    • 3 cups torn country bread, toasted
    • 1 1/2 cups finely grated Parmigiano-Reggiano cheese
  1. Place the beans in a large bowl and add cold water to cover by 3 inches. Cover the bowl and soak the beans in the refrigerator overnight.
  2. The next day, pour the beans and their soaking liquid into a slow cooker. Add enough fresh water to cover the beans by 2 inches, cover with the lid, and cook on the high setting for 4 hours.
  3. Place a very large sauté pan over medium heat. Add the olive oil, and when the oil shimmers, add the onion. Season with salt and cook for 5 minutes, stirring every minute or so, until softened. Add the carrots, celery, butternut squash, and garlic, and cook for 5 more minutes, until starting to soften. Transfer the vegetables to the slow cooker. Add the tomatoes, crushing each one in your hand as you add it. Add the bouquet garni, 1 tablespoon salt, and 1/2 tablespoon of the red pepper flakes. Cook on the low setting for 3 hours.
  4. Uncover the slow cooker, remove the bouquet garni, and add the kale, bread, 1 cup of the Parmigiano-Reggiano, and the remaining 1/2 tablespoon red pepper flakes. Stir the soup well, season with more salt to taste, and serve with the remaining Parmigiano-Reggiano sprinkled on top.

Dr Nia May discusses SLEEP, why, how, what to do…

Sleep!  For many, an elusive thing that is often not making a large enough appearance through the week, for others it comes easily … for most it is rarely prioritised and is put to one side for that extra half hour of Netflix, that late night phone call, or just bumbling about because of an active mind after a demanding day.

Many hours of study and research have gone into sleep – sleep quality, sleep length, the effects of sleep deprivation, this list goes on.  Out of this, it is still very difficult to treat people with lasting sleep disturbances, however there are some clear guidelines about why we might want to begin re-prioritising our sleep health, and how we can help ourselves to get better quality sleep when our head hits the pillow.

Below are some interesting pointers to the why’s and how’s of sleep – you may be a tired new parent, or a late-working accountant who to some extent is not able to fully control the reasons they are not getting their regular rest hours.  Even if this is you, or a near match, there is often small things that can help to make the most of what we can get.  Remember, more important than the quantity of sleep in hours, is the quality of sleep – meaning what happens within us when we are sleeping.

5 things you may not know that sleep is important for

  • Weight loss via fat loss (what?! Yes!)
  • Recovery and repair
  • Mental agility, focus and performance at work
  • Emotional intelligence
  • Long term health

5 tips to help your sleep quality

  • Turn off your screens at least two hours before bed – this includes kindle on the tablet, games on the mobile phone, texts, internet browsing … the lot.  Why? – the blue light from screens is the worst culprit for ruining a good restful sleep.
  • Keep your bed as a sleep space, not a work space. – your osteopath will give you ‘the look’ anyway if you reveal that you have been doing all your assignments, reports, and admin on the laptop whilst sitting on your bed … not good for your spine, not good for your aching muscles, not good for your eyes, not good for your concentration … and not good for getting to sleep once you get back into bed to attempt some shut-eye.  This includes watching television in bed.
  • Get a routine rolling! – our bodies looove routine, we are a creature of cycles – hormonal cycles, blood pressure cycles, and yes, sleep-wake cycles.  Having a regular routine before bed helps to align your physiological state with your wish to sleep. This can be as simple as a calming hot drink an hour before bed; a gentle movement routine if you are enjoying your yoga or other type of practise; reading (not on a screen!) for a set amount of time – the list really is endless of what you could incorporate into your (short or long) evening routine.
  • Support your thinking-mind to switch off – the power of lists.  Busy lives are aligned with busy minds, and thoughts of things to do and not to forget have a habit of fighting for attention and disturbing sleep.  Try keeping a notebook next to your bed and, perhaps as part of rolling out an evening routine, try writing a list of things of things to set down out of your mind, with the comfort that having written them down in your list you will be able to come back to them at a more realistic time.  Even if you wake up during the night and think of yet another pressing thing, writing this down can help you to get back to sleep. (meditation has also been shown to improve sleep quality, lower stress and improve cognition over time – it can help to reduce that ‘mental chatter’)
  • Is what you eat helping or hindering you? – As a rule, independent of your chosen way to eat, certain foods will not help your sleep life.  Caffeine disturbs your normal sleep cycle meaning that even if you think you sleep normal hours after that post-prandial coffee, you will not get the benefits of a full night’s sleep.  Caffeine even six hours before sleep can make you lose up to an hour of sleep quality even if you are asleep.  Have a caffeine curfew, I recommend stopping having caffeine at least eight hours before bed.  Other things to think about are MSG, as well as getting enough of the ‘goodies’ such as potassium, magnesium, etc.

Look out on our City Osteopathy blog for more information coming about how to support healthy sleep, as well as lots of top information on many other interesting and worthwhile topics!

Dr Nia May Osteopath Melbourne

Patients beliefs about their Low Back Pain. Dr Matthew Franz, Osteopath, delves deeper into the science behind pain…

LET’S TALK…. People’s beliefs about their back pain and what is actually happening

Dr Matthew Franz, Melbourne Osteoapth @ City Osteopathy

 

In today’s society, lower back pain is often described as a result of issues built up over time with a direct cause. Sometimes this can be the case, however it’s the way we interpret our back pain and the pain science behind it that has recently come into a more prominent view point.

Louis Giffords Mature Organism Model via NOIjam.com

Have I lost you yet?

Well to break things down a little, the word ‘pain science’ can be described as “ The nervous system’s processing of their injury, in conjunction with various psychosocial aspects, determines their pain experience”. (Louw et al., 2011) The way I look at pain science myself, is the way we interpret our own pain. It can be the way we recognise it and then construct it in our mind, which then determines the way our body reacts to it, as seen above.

For example you will notice that every time you have a sore back, you won’t bend down as it tends to hurt. However over time your brain has associated this action with pain and interprets it as harmful to the body. So you don’t perform that movement to the best of your ability, which in turn develops a feedback loop.

It is crazy how many times people describe their back pain as being caused by a slipped disc or weak core. They have been conditioned to think that these are the issues that have caused their back pain. It might play a factor however its the health professionals that influence them into thinking they need constant treatment in order to feel better.

 

I’m bursting the bubble and telling you that back pain is normal thing! It is how we manage your back pain that makes the difference.

What are you trying to get at then?

A systematic literature review of MRI findings on people with spinal related changes in their back WITHOUT SYMPTOMS by Brinjikje, W., Luetmer, P.H., Comstock, B., et al. found that:

  1. The study suggests that imaging findings of degenerative changes, such as disk degeneration, disk signal loss etc are generally part of the normal ageing process rather than pathologic processes requiring intervention.
  2. That >50% of asymptomatic individuals 30–39 years of age have disk degeneration, height loss, or bulging. This suggests that even in young adults, degenerative changes may be incidental and not causally related to presenting symptoms.
  3. The results from this systematic review strongly suggest that when degenerative spine findings are incidentally seen (ie, as part of imaging for an indication other than pain or an incidental disk herniation at a level other than where a patient’s pain localises), these findings should be considered as normal age-related changes rather than pathologic processes.

So what can we do about it?

My advice is to first stop worrying about the pain and look at how we can address it. Look at the the factors that may be affecting it and how can we have control over it. This allows you to gain a better understanding of what is actually going on.

I understand it may hurt and play up from time to time, however the way we view our pain will help toward healing it. This combined with proper management and treatment, staying healthy and stretching are all very important. As osteopaths we can get you to the point of feeling comfortable about your pain and hopefully get you feeling better sooner rather than later!

Dr Matthew Franz Osteopath at City Osteopathy

References

Brinjikji, W., Luetmer, P., Comstock, B., Bresnahan, B., Chen, L., Deyo, R., Halabi, S., Turner, J., Avins, A., James, K., Wald, J., Kallmes, D. and Jarvik, J. (2014). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology, 36(4), pp.811-816.

Louw, A., Diener, I., Butler, D. and Puentedura, E. (2011). The Effect of Neuroscience Education on Pain, Disability, Anxiety, and Stress in Chronic Musculoskeletal Pain. Archives of Physical Medicine and Rehabilitation, 92(12), pp.2041-2056.

Dr Lyndon Clarke, summer in heaven!

Dr Lyndon Clarke osteopath, what an inspiration! Knowledge, Grace and Power Workshop – 2 weeks ago I went to a 3 day workshop in the beautiful rolling hills of the Yarra Valley.

It was guided by four facilitators that help you understand your emotions and ultimately harness love and connectedness instead of fear. Every day we stretched, meditated, did kundalini techniques, danced, and uncovered deeper sides to ourselves with role-play exercises. Not to mention ate divine and healthy spreads of food. We looked into deep belief systems that drive our behaviour, and formulated a vision of how we want to feel, as well as learning how to ‘check in’ with our emotions along the way. A beautiful experience. My parents sold their house in Healesville that I grew up in from the age of 7 (grade 2), so Australia day weekend we had a last hoorah with extended family. Here we went to TarraWarra Museum of Art on the outskirts of Healesville with my extended family, featuring Patricia Piccinini & Joy Hester. It was a quirky expression of love. Very appropriate considering my workshop and such a special last hoorah.