How Common Are Back Problems?

You might not know what the word "iatrogenic" means, but I'll bet you've experienced it.

If you've ever had lower back pain, gone to the GP who has sent you for a scan and been told that you've got a bulge, or a slipped disc, and so you'd better be really careful, so that's what you've done but now you're really depressed because you're worried about your discs slipping...that's an example of iatrogenesis.

Or if you have gone to see your doctor because of some pain in your shoulder, and the GP has told you it's chronic and sent you to a pain clinic, and the pain clinic has told you that you just need to meditate a bit and think differently but that's just annoyed you and you feel both angry and abandoned. That’s an example of iatrogenesis.

Iatrogenesis is the effect a medical or health professional can have on a person that is detrimental to the patient. Perhaps an more obvious one is an infection you might pick up in hospital...but it doesn't just apply to infections. It can apply to physical injuries too.


See, when you get sent for a scan, and come back being told that you have bulging discs, or slipped discs, what you don't get told is that degenerative change to the spine is really common in people who otherwise appear perfectly healthy and don't think they have any back problems.

There was a big systematic review of this information, and it produced some really interesting findings. 37% of 20 year olds, 52% of 30 year olds, 68% of 40 year olds, 80% of 50 year olds, 88% of 60 year olds and 93% of 70 year olds who reported having no back problems displayed disc degeneration through an MRI scan.


30% of 20 year olds, 40% of 30 year olds, 50% of 40 year olds, 60% of 50 year olds and 69% of 60 year olds, who reported having no back problems, were shown to have some degree of bulging to their discs in their spine.

When we are told something is wrong, we automatically assume the worse...especially since health professionals will often dumb things down because they are trying to help! Disc degeneration is often reduced to "crumbling spine"...hardly any wonder you'll sit down and not move if you're told that's happening....even if before the scan you didn't think anything was wrong.

Bulging discs sound even more scary, doesn't it? Is it going to pop out of your back, or burst? What does that mean? What you probably won't be told is that if 60% of perfectly healthy 50 years old have bulging discs.

MRI scanners are awesome bits of kit. They keep getting better and TV cameras. 50 years ago, TV cameras weren't able to pick up lots of detail, and even if they could, your TV couldn't display it. Now we have HD filming, and HD TVs, and talk show hosts are all upset because now their spots and pores and stray facial hair can be seen in glorious high definition! They were always there...we just couldn't see them before.

MRI scanners are the same. We can see more than ever before tiny changes, and although we shouldn't get freaked out about them, and we shouldn't let the results of spinal scans affect our lives, of course we do. And then we slip into a downwards spiral of "I can't" and "I'd better be careful" and "It might go"...and before you know it, all exercise and activity stops and then we end up in actual trouble that we wouldn't have got into at all if we only hadn't had the scan.

Its why the BMJ advises against scans for certain types of musculoskeletal conditions...if it does show anything it is likely to actually do more harm than good.


So what does all this mean if you're suffering from musculoskeletal pain? What should you do? At the risk of sounding unhelpful, try not to let it take over your life, if you can avoid it. There’s absolutely no reason not to see your GP (or your friendly soft tissue therapist!) but remember that if a scan comes back showing a problem, its likely to be very common and was there before you have the pain (rather than assuming it's the cause of it).

This is why at State 11 we try and help you think differently about any ongoing or chronic injury. We're really proud of how we incorporate a positive and enabling mindset into what we do and we think it's vitally important, just as much as a stretch we might put into your hamstrings or applying some tape to your shoulder. So for us, it's not a "bad" back, it's just a back that's painful at the moment. It's not a "dodgy shoulder", it's just a shoulder that is in need of some support. And most importantly, you aren't a collection of symptoms and aches. You're a whole person, and our job is to support you getting better.

Further reading: Here's the systematic review we mentioned:

Small Businesses For Beginners

There are a lot of books about starting a business. There are even more “online courses” where for a low low special offer price, you can learn what to do and what not to do to become a successful business. Funnily enough, even before you hand over your credit card, you can see that the advice is different, and normally involves paying even more money to gain “secret” information. 

I started buying some of the books. I bought some marketing books and some business books - but everyone said something different, and also everything involved a “click funnel” where you hand over your email address and I send you some “information of value”. Then we’ll have a huge mailing list and I just need to do another course about how to do emailing marketing and would I like to pay for that now or later?


I got a bit tired and disheartened in the end. We’re soft tissue therapists, not wannabe marketers. I don’t like it when I get lots of useless junk email, so I can’t imagine you would. You’ve not got the time for it, and we simply haven’t got the brass neck to do it.

Likewise, we should be hassling you for reviews. Review us on Facebook, review us on Google, like and share our posts! When a small business tells you that this is something that is vital, they’re not lying. A good review tells other people that we do know what we’re doing, and it lets us know we’re doing it right. But you guys are busy, and it feels wrong to pester. Again, not got the brass neck for it.  

So we try and be different here at State 11. We offer appointment times that are useful to our clients, rather than “you’ll have to book the afternoon off work” times. We encourage people to call or text us if they want to have a chat before booking. Yes, we use some stock photography but we also show you who we are and tell you about us so that you’ll feel comfortable when you come see us and talk about that probably you’ll suffered with and that your doctor dismissed. We take card payments even though it costs us more to deal with than cash because it’s easier for you - we don’t want to make you go into town to the cash machine. We use RockTape and Rock Sauce, but if you can buy it cheaper elsewhere than from us, we’ll tell you. 


In the future, we plan to expand the services we offer, based on what our clients express desire for and what we think will help people stay well. So we’ve partnered up with Mad Diet, a Scottish independent company that offers just five very high quality supplements. We’ve used them and noticed a real difference - so you’ll be able to buy them from us. No mark up, simply a service that means you don’t need to wait for delivery or pay postage.

We’re also going to tie in with Weleda, a cruelty free, natural beauty company. They make some of the best arnica products and body oils we’ve found - so if you’ve got bumps or bruises, or want to do some self massage at home (or just really like the effect it has on your skin), you can get it from us. Again, as part of being honest and transparent with you, you can buy some Weleda products from the supermarket for the same price as from us. Not all of it - supermarkets won’t have access to the whole range - but you can buy from Waitrose or Amazon if you like (although we’d obviously prefer you to buy from us). And again, we don’t mark up the prices - we’ll be selling to you at the same price we paid. 

So thats where we are, half way through February. Quite a lot of likes on Facebook, some nice reviews here and there and some of our clients recommending us to others. We could be doing better - of course we could - but we’d be doing a whole lot worse without your support. So thank you, from Greg and Vic here at State 11


Sports Massage

Today I got asked what a “soft tissue therapist” does. I explained that I assess and treat chronic and minor injuries using a variety of specialist techniques.

The person asking didn’t really understand until I mentioned that one of the techniques I use is massage. “Oh, you do sports massages!” they exclaimed. I didn’t bang my head against the wall, but it was close.

I don’t like the term “sports massage”. It’s a nonsense term in itself, as you can’t actually massage a sport, so it should really be an “athlete massage”, or at least “sports injury massage”.

But my main issue is that it’s a term used to cover up poor work by badly trained masseuses. Yes, some people have good “sports massages”, but lots don’t, or worse, they come away hurt and in pain. I’ve even seen massive bruises and people unable to walk properly following sports massages.

In fact I’ve written a whole page about it here.

“ Soft Tissue Therapy, I said!”  

Soft Tissue Therapy, I said!” 

I really don’t like being associated with that. I’m a professional and I take a great deal of pride in making people feel better. We (Greg and I) love fixing people.

But we need to pay the bills too. We love how our clients recommmend us, but in the age of Google and Facebook, we need to be found online too, otherwise not enough clients, and then the bank forecloses, and then we won’t be able to help anyone!

People know the term sports massage, so we use it, even though it’s like saying Leonardo Da Vinci dabbled in painting or that Mozart occasionally hammered the piano keys.

“It’s a bit like that”, was my answer. But later (after they’d left, of course), I realised that what we do - what soft tissue therapy is - actually is what people think a sports massage is. We assess, treat, offer rehabilitation advice, reducing pain and increasing mobility and happiness.

It’s just that sports massage so often isn’t that.

The Royal Canadian Air Force Exercise Plans (5BX and XBX)


The RCFs XBX and 5BX plans have popped up in the news again after Dame Helen Mirren told the Daily Telegraph that she followed the exercise plans. Far be it from me to suggest this was just an opportunty for them to publish a picture of her in a bikini!

Although I’m sure she’s a very nice lady, I’m not quite convinced that she pulls off her physique by doing 11 minutes of exercise a day, but it’s a very busy world for most of us, and (for the most part) some exercise is better than none.  

The plans were designed in the 1950s by a Dr  Orban and released to the Royal Canadian Airforce In 1961. Unusually for the time (and even more unusually now) they don’t require any equipment. 

The plans were incredibly popular, and were released in books in both their original forms and various modified form by various personal trainers turned exercise gurus across the world.

Poor Dr Orban didn’t see a penny (or cent) from the success of his plans as he’d created them in his role as a civil servant. 

If you’d like to read or even try the plans, we have the originals available for download here 

Why We’re Different - And Why That’s Good!


Our little business hasn’t been around long. Perhaps that worries you. Many people value experience and the reassurance of someone who has been doing the same thing forever.

But experience can become stagnation - and in the field of soft tissue therapy and pain management, there’s simply too many advances being made to stick to outdated or superceeded techniques. 

Because there’s a difference between experience and knowledge. We hold Level 5 Soft Tissue Therapy qualifications - the highest Soft Tissue Therapy qualification you can achieve (most people offering massages will have a Level 3 qualification - that’s about the same as a GCSE).

We’re in the business of fixing people, but we’re also in the business of being scientifically curious. We’re not afraid to try new methods if we think it will help our clients. That’s why we use kinesiology tape, and why we’ve experimented with myofascial  decompression and floss band work. It’s why we’re going to offer shamanic healing and hypnotherapy. Yes, it might be a bit “alternative”, but we know all these things help - we wouldn’t offer it otherwise.


Our awareness of the latest research is why we don’t use phrases like “weak back” or “bad leg” - we know that what we say affects how you feel about your body’s capabilities, and that can affect how you move and ultimately how you heal. 

Our desire to achieve the best results for our clients might mean we ask them to move in unusual ways to actively stretch certain muscles. It’s a bit different from the “traditional” massage where some lotion gets rubbed around and there’s acres of white towels, but we get results. 

Even our “relaxing massage” clients find themselves being offered new waxes that have different properties, and different background sounds that help induce certain brainwave patterns. Yes, we could play traditional piano style spa music - but why do that when we can encourage a deeper relaxation by playing different sounds? 


We’ll be the first to admit, we’re not for everyone. The people we help are adventurous and curious and willing to trust us, even if we’re asking them to step away from the conventional methods - and in return, we provide them fabulous results.

So if you’d like us to help you, you can book an appointment or get in touch with us. 

GP & NHS Physiotherapy availablity

The BBC has put together a map of GP availability across the U.K., based on the number of patients per G.P. We don’t do too bad here, and certainly better than we used to in Cambridgeshire.


Of course, what we were interested in was the availability and waiting list time for soft tissue therapy. The NHS lumps this all under “physiotherapy”, and ominously makes multiple comments about waiting lists for their treatment being “long”. The local hospitals - which appear to be the access points for NHS physiotherapy - don’t have any waiting list data at all.

I suppose describing all MSK (musculoskeletal) issues as needing a physiotherapist makes things easy (it’s also probably much appreciated by the Chartered Society of Physiotherapists), but it’s a bit like saying you need to see the head mechanic at a garage if your car’s headlights need changing; you *might*...but for a lot of people, that level of advanced, specialist help isn’t necessary.

Soft Tissue Therapists are not physiotherapists (or chiropractors, or osteopaths), nor do we pretend to be.

A Level 5 Soft Tissue Therapist can assess and treat both soft tissue injuries and chronic conditions and offer advice about avoiding injury in the future. This is the highest level of recognised Soft Tissue Therapist training; it is well worth asking any “sports masseuse” or masseuse what level training they have.

As Level 5 therapists, we can - and do - help with shoulder, back, neck, joint and muscle pain. We can - and will - point you to other specialists if we can’t help.

Unfortunately, we are not a treatment that you can get free on the NHS; although it’s our hope that one day that will change!

Optimising Sleep For Night Shift Workers

Sleep is massively important for good physical and mental health, but today’s 24 hour society means more people than ever are working night shifts.  

There isn’t a huge amount of science and research into how best to cope - basically because ultimately it’s bad for you - but the BMJ published an interesting paper.

The main points were: 

  • Working at night disrupts the circadian rhythm and can lead to the accumulation of a sleep debt, impairing performance and health

  • Full circadian adaptation to night shift work is not possible in the short term

  • Night shift workers should be aware of reduced performance during critical tasks and on the journey home

You can read the full article