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High heels and other hidden health risks in your wardrobe

July 12, 2016

High heels, flip flops, heavy handbags and statement necklaces are all staple items in a woman’s stylish wardrobe, but they are causing damaging health problems in the pursuit of being fashionable.

Here’s my advice for avoiding potential health risks caused by accessories:

High heels

Everyone likes high heels, but women who repeatedly wear them can suffer from Achilles tendonitis. The Achilles tendon is the long thin tendon that runs from the base of the calf muscles down to the heel bone. This can become extremely painful due to chronic shortening of the calf muscles by repeatedly wearing high heel shoes.

One of the consequences of heeled shoes that most women are aware off is, the increased risk of developing bunions and calluses in the high heel. This is normally associated with the narrow toes associated with these shoes, pushing the front of the foot into the shoe and crowding the toes.

The good news is that as long as it is only temporary use, you should not necessarily damage your foot. You are more likely to develop bunions if you have a family history and are genetically predisposed to the condition. And, wearing high heels may accelerate bunion development.

The solution is to avoid wearing high heels for extended periods of time and use sensible shoes in concert with your heels. If the problems are long standing, then there is always a relatively straightforward surgical solution.

Flip flops

Flip flops can lead to plantar fasciitis, a very painful condition, which produces pain in the sole of the foot and in the heel; mainly on the inside of the foot. The plantar fascia is a thick sheet of tissue that runs from the heel to the ball of the foot, supporting the deep layers of muscles and tendons in the foot.

The lack of arch support and cushioning combines with the way you walk in flip flops can predispose you to this condition.

The condition is normally diagnosed clinically by the position of the pain, local tenderness over the plantar fascia, medial bundle of the plantar fascia and is confirmed with an ultrasound or MRI scan.

Treatment of the condition is usually straightforward with a physiotherapy programme working on stretching up the plantar fascia and calf muscles and returning to more cushioned, supportive footwear and avoidance of impact activities.

If the symptoms fail to respond to these simple stretching measures, alteration of footwear and activities, then ultrasound guided steroid injections can be administered.

Heavy handbags

Women’s handbags, like men’s briefcases can carry an enormous amount of material that can be surprisingly heavy. The way they are carried over the shoulder can predispose to the development of chronic shoulder pain, namely inflammation and impingement of the rotator cuff.

Patients may end up with pain at night and it may cause sleep disturbance, using their arm at or around shoulder height. There may also be the development of crepitus or noises arising from the shoulder girdle as the arm is moved.

Referral to an appropriate specialist is recommended. Clinic diagnosis is made, the condition is confirmed with imaging, including ultrasound and MRI scan. Fortunately, around 80 per cent of cases, the condition responds well to a combination of physiotherapy, postural instruction and steroid injections into the subacromial space.

To help avoid developing the condition with a heavy bag, try to unload heavier objects from the bag and change shoulders.

Heavy necklaces

There is a growing tendency for increased popularity of heavier necklaces. This combined with the use of heavier handbags can produce further protraction of the shoulder, curvature in the upper dorsal or thoracic spine and hyperextension of the lower cervical spine tending to have the head thrust forwards.

This can place a lot of strain on the base of the neck causing lower cervical pain. These two issues combined, with classic poor posture in a desk-based work environment produces a range of conditions that will cause pain in the base of the neck, upper dorsal spine, pain and impingement in both shoulders. All these things produce impingement in the shoulders.

Physiotherapists, personal trainers and orthopaedic surgeons are seeing more and more patients with pain from these areas. It is also very important to try and improve one’s posture and biomechanics by straightening up the cervical and thoracic spine. Stretching out the chest muscles, work biomechanics with workstation assessments, postural instructions and regular stretching will all help to relieve pain and symptoms.

Overuse injuries afflicting tennis players

June 8, 2016

I enjoy a game of tennis – I used to play at club level myself and my father actually played at Wimbledon, but tennis can be a very competitive and intense game. Eager new players and even seasoned professionals can put their bodies under repetitive stress, which is why most tennis injuries are overuse injures.

Overuse injuries are the opposite of acute injuries. In other words, rather than there being one event, which will injure the structure in a shoulder girdle for example, repetitive movements such as serving thousands and thousands of times would chronically damage a structure.

Ahead of this year’s Wimbledon Tennis Championships 2016, it’s essential that players’ rigorous training sessions put them through their paces, but at the same time, do not cause injury.

Tennis players often develop rotator cuff syndrome, which is inflammation and tearing of the rotator cuff. They can develop labral tears, which is damage to the cartilage around the socket, and SLAP lesions, which is where the bicep tendon starts to pull on the top of the socket in the ball. The socket part of the shoulder girdle and osteoarthorsis of the acromioclavicular joint are also common injuries.

However, a large number of tennis injuries can be treated non-surgically: Around 80 per cent of the aforementioned shoulder injuries can be managed conservatively or non-operatively using a combination of physiotherapy, strengthening exercises and guided injections into the subacromial space and/ or acromioclavicular joint. If patients are unfortunate enough to fail to respond to this or if they have tearing of the tendons, then they need an arthroscopic surgical repair.

Common tennis injuries

Tennis elbow is a condition that causes pain around the outside of the elbow. It is a common and debilitating problem, which represents inflammation and partial tearing of the attachment of the forearm extensors to the outer tip of the elbow. Risk factors for tennis players include poor grip, wrong size racquets, insufficient shock absorption in the racquet and the strings being too tight. Optimising all of the above, carrying out regular forearm stretches and using comprehensive forearm supports are all helpful.

The rotator cuff tendons are an inner tube of tendons that come off the socket of the shoulder blade and grip around the ball of the humeral head, which is the main part of the ball, and socket element of the shoulder girdle complex. This inner tube of tendons is very important but is also prone to injury as the shoulder is very mobile. The commonest type of rotator cuff tenderness involves one of these tendons, called supraspinatus, which is the top of the tendon that make up this tube of tendons. This particular tendon gets inflamed and rubs beneath something called the subacromial arch.

My advice to tennis players to help prevent some of the most common injuries would be to work on their training techniques, maintain flexibility and strength.


Football knee injuries could end a player’s season

May 24, 2016

Over two-thirds of footballers injure themselves on the field, and with knee injuries being the most common football injury, players are more worried about these injuries than concussions for fear it could end their season.

Arsenal striker, Danny Welbeck is the latest victim of knee injury and he’s now facing a lengthy layoff, which has been described as a “big loss” for the England team as they gear up for UEFA Euro 2016 this summer.

Players are seen to be more prone to knee cartilage tears and ligament injuries as they are extremely common amongst footballers, as are patellar femoral injuries, i.e. pain in the front of the knee.

It is also difficult for players to prevent cartilage tears as it is a contact sport and players are getting fitter, faster and bigger. However maintaining flexibility is important, remaining agile and optimising strength in the knee.

More and more cartilage tears are being repaired rather than resected. This optimises the chance of the player returning to pre-injury fitness levels and reduces the risk of them developing arthritis in later life. There are also more meniscal tears being repaired now and it is currently estimated that approximately 30 per cent of meniscal tears are repairable.

My advice to footballers to prevent injury is that they should maintain flexibility and strength. An awful lot of premier division footballers are already taking up yoga for this very reason.

Stem cell treatments revolutionising healthcare

April 22, 2016

Stem cell treatment, otherwise known as autologous stem cell transplantation, harvests the patient’s own stem cells from their abdominal fat or bone marrow. These cells are then introduced at a later date to ‘kick-start’ the immune system and fight off any harmful cells.

Simon Moyes, one of the UK’s finest surgeons, is a consultant orthopaedic surgeon offering stem cell treatments for the likes
of cartilage repair and regeneration. Simon comments, “I am particularly interested in stem cell treatments for the likes of cartilage repair and regeneration. It is being hailed
as revolutionary to medicine with stem cell research and treatment is moving at a fast and exciting pace.“

Simon has undertaken his own research into current developments in stem cell technology for cartilage regeneration over the last two years. In the past twelve months, Simon has specifically looked at a number of manufacturing companies specialising in orthopaedic products that have developed systems to utilise stem cells taken from bone marrow. He is currently working with these companies to assess the efficacy of new regenerative orthopaedic treatments.

Simon adds: “One of the manufacturing companies I’ve been speaking with is Regeneus, which recently underwent a trial in Sydney whereby stem cells were taken from a patients’ fat and injected into arthritic knees and to augment other arthroscopic joint restoration surgery. In 80 per cent of patients, the injection into arthritic knees produced an 80 per cent reduction in arthritic symptoms.”

Simon is also working with colleagues
at the University College London, to look at further enhancing stem cell techniques and stem cell banking.

 Simon’s own stem cell experience

Simon was introduced to Natural Biosciences by colleagues in the UK and eventually travelled to Zürich in 2013 as part of a
trial for Natural Biosciences, a company specialising in the production of stem cell derived micro vesicles.

The treatment involved harvesting fat derived stem cells then expanding them in
a laboratory, stressing them to release micro vesicles and then injecting them either focally or intravenously depending upon the need. Natural Biosciences treatments aim to use these micro vesicles for multiple uses including the treatment of arthritis but also optimising organ function. Simon has a number of friends and patients who have also travelled to Switzerland for similar treatments. The team from Natural Biosciences are relocating to the UK.


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Time at work affected by shoulder pain

April 13, 2016

There are around 33 per cent of Londoners who have suffered from shoulder pain according to new research conducted independently.

The January 2016 study, which assessed over 1,000 London respondents, has highlighted this specific health issue to Londoners. The research found that 11 per cent took time of work due to shoulder pain.

Shoulder pain is extremely common as evidenced by the research. There has been data to suggest that 70 per cent have consulted their GP regarding shoulder pain.

As we age, the tendons degenerate and become thickened. The more we use our shoulders, the more they are likely to get worn and torn. These three factors combine to cause attrition and inflammation of the rotator cuff (muscles in the shoulder joint) producing rotator cuff syndrome, inflammation and tearing. If your pain is disturbing your sleep or preventing you undertaking ordinary day to day activities or has lasted for more than two to three weeks, you should visit your doctor.

The most common causes of shoulder pain in my practice are rotator cuff syndrome, osteoarthritis of the acromioclavicular joints and glenohumeral joint, frozen shoulder and trauma. The causes are multi factorial and partly down to the shape of the individual bones in the shoulder.

Treatments for shoulder pain depend upon the aetiology of it. Most patients with shoulder pain can be managed conservatively, non-operatively with physiotherapy, injections and exercise treatment. This is probably the case in 80 per cent of the patients I see. The rest may require arthroscopic or minimally invasive surgery.

Treatment of shoulder conditions is evolving at an exciting pace with regards to arthroscopic procedures available for shoulder reconstruction and physiotherapy techniques.

A lot of shoulder pain can be aggravated by poor posture, work-related activities, sports and often postural or activity modification can help alleviate shoulder symptoms both now and in the future.



Simon Moyes discovers Namibia

April 1, 2016

Simon Moyes discovers Namibia


Simon Moyes loves adventure and loves the beauty of Mother Africa. Simon is one of the United Kingdom’s leading Orthopaedic Surgeons based at the acclaimed Wellington Hospital in St Johns Wood. Mr Moyes’ orthopaedic interests are of arthroscopic and minimally invasive treatments of the knee, shoulder, foot and ankle.

Simon has also shown great interest and contributed towards the recent advancements made in stem cell technology, which is the ”miracle cure” on everyone’s lips right now. Recent reports and studies have outlined how the revolutionary treatment can provide life-changing results for condition.


Simon’s trip on Namibia, excluding Business class flights on Air Namibia, from Europe and return, starts at NAD199 873.47 per person.

Personal Africa has created the most beautiful trip to Namibia for this acclaimed surgeon of note.

On arrival in Windhoek from Johannesburg Simon will be flying on a Private Flight from Eros Airport to Soussusvlei and on arrival at the airstrip, he will be transferred through vivid scenery to Little Kulala, situated at the foot of the majestic Soussusvlei dunes, a private entrance to the Namib and Naukluft Park, makes Kulala Desert Lodge the closest location to Soussusvlei with magnificent views of its famous red dunes, mountainous scenery and open plains.

Having enjoyed three days at Little Kulala, Simon will be flying on by private flight to the Etosha National Park.

On arrival at Ongava Airstrip, Simon will transfer to Ongava Private Game Reserve. Little Ongava is perched on a crest of the hill, commanding magnificent vistas of the plains stretching for miles to the horizon.

Having enjoyed three nights in the magnificent Ethosa National Park, Kaokoveld in a relatively undeveloped region that takes in the harsh beauty of the Skeleton Coast and the coppery sands of the Northern Namib Desert, here he will meet the Damara, Herero and Himba people each day with their unique custom, tradition and rituals all displaying the cultural diversity of Namibia.




Set amongst shady trees on the banks of the Kunene River, Serra Cafema is one of the most remote camps in Southern Africa, its Portuguese name originating from the mountains that dominated the Northern sky line, Simon will fall asleep to the sound of rushing water, wild by day, he explores one of the driest deserts in the world.

After three enjoyable nights, Simon will fly directly to the Skeleton Coast, landing on the Hoanib Airstrip and will transfer to Hoanib Skeleton Camp.

Known by the bushman as the “land God made in Anger’’, the Skeleton Coast is remotest at the best. Thousands of miles of sandy desert dotted with shipwrecks meet the cold waters of the Atlantic and somehow an amazing array of wildlife and flora manages to survive in this harsh but beautiful environment. Hoanib Skeleton Coast Camp offers the beauty of large en suite tent with shaded outdoor lounges all of which slope down to the almost-always dry Hoanib River.

Simon will enjoy exploring diverse land by taking game drives along the rivers narrow ribbon of vegetation where a surprising wealth of desert-adapted wild life can be found: Elephant, Giraffe, Gemsbok and Springbok with glimpses of Lion and Brown Hyena.



Namibia is one of the most rugged, beautiful and diverse lands in the world which is exactly why such an acclaimed London Surgeon is taking time out to discover the timeless beauty of Mother Africa.

Each year, Simon carries out approximately 500 arthroscopic/minimal invasive operations and is interested in researching and developing new arthroscopic techniques.

These include arthroscopic shoulder stabilisations and rotator cuff repairs, arthroscopic treatment for ankle arthritis and instability arthroscopically assisted knee ligament reconstruction and cartilage repair.




Increase in rugby injuries forcing players into early retirement

March 1, 2016

Rugby is a fast-moving and high intensity team sport that has the highest risk per player/hour of injury of all sports. As many as one in four rugby players will be inured during the season, with approximately half of all injuries occurring while a player is tackling or being tackled.

Rugby injuries are not just becoming more common but they are becoming more serious, with more concussions being recorded. The consequences of these injuries are evident from the number of players who are being forced to retire early.

As injury rates rise, so does the risk of players accumulating multiple micro-injuries, which can pre-dispose the players to early osteoarthritis of various joints. Repeated concussion-related head traumas as well as physical damage to their joints can debilitate them for life. Managers and players should therefore think further than just the win at the end of the game.

We have seen an increase in incidences of severe shoulder injuries, knee injuries and ankle injuries, and this is something I have seen a great deal of amongst the doctors and physiotherapists that I work closely with.

The main reasons behind the injuries in the game are that rugby players themselves are becoming more professional and their training is becoming more elite. Their focus is to sustain a “sleep, train, eat” mode. As the players get bigger, stronger and faster, when they collide there is more power and kinetic energy behind these collisions and hence such collisions are more likely to produce injuries.

Certain “tricks” are also being used by players as they are coming into a collision which can make the opponents’ potential injury from such collision worse. Typical examples of this would be pushing down on top of the back of an opponent’s shoulder as he is coming in for a tackle which would make the shoulder more likely to dislocate or the tendon tear.

The players, managers, doctors and physiotherapists involved in looking after the players are all very aware of the risks of this high impact game. A general “straw poll view” of the potential ways for reducing injury rates is to somehow try and improve the skill of the players and techniques to avoid such injuries although this is clearly difficult. The only other line would be for the referees to be more alert to some of the tricks used to exacerbate injuries.