Pain during pregnancy – Osteopathy help is at hand.

pain during pregnancy Health in Motion

Are you experiencing muscle or joint pain during pregnancy?

If you are pregnant and experiencing muscle or joint pain in your back, pelvis and or hip joints, then help is at hand.   If you have muscle or joint pain during your pregnancy, you may book an appointment at our clinic at any point during your pregnancy.    This post covers how we determine that your pain originates from the muscles and joints and how osteopathy can help you with these symptoms during pregnancy.  Pain for any other reason during pregnancy is not expected and may need further investigation.

Is it normal to have pain during pregnancy?

Generally, it is expected that you may experience some discomfort during pregnancy as your body adapts to accommodate your growing baby.  The back will be pulled into a different shape; the bladder will become compressed, lung capacity will be reduced in the latter stages, and finding a comfortable sleeping position will become increasingly difficult.  Ankles and wrists may swell; gradually movement will become more awkward until after the baby is born.  This is what is expected and each woman will experience different levels of discomfort.  Pain during pregnancy is not expected and should be investigated further.

Osteopathy examination of pain during pregnancy

If you visit Health in Motion Osteopaths due to back, pelvic or hip pain, we will do a quick examination to determine that whether or not we can help you.  If we cannot,  we will advise you where to go.  The following are questions we will ask you during your examination.

Do you feel ill?

Illness may cause any of the following symptoms; fever, headache, sore throat, abdominal or pelvic bloating and tenderness; diarrhea; vomiting; unusual vaginal discharge any other change in bowel and bladder habits.  If you are getting any of these symptoms, with or without pain, then you should consult with your GP (or out of hours service) in the first instance.  If you have direct access to your Midwife service, then you could speak to them in the first instance.   If you have any severe symptoms, you should make a judgement of whether your condition warrants the help of the emergency services.  Because you are pregnant – it may be best to be over cautious if in doubt.

Have you had a traumatic incident?

This could include anything from a low impact trauma to heavy impact trauma.  In the case of heavy impact (fall down the stairs; road traffic incident; fall on the back or your bump) – seek help from the emergency services.  Once you have been checked out and it is determined that mother and baby are fine, you make seek help from an osteopath for any resolved pain resulting from traumatic injury

Low impact injury may occur from repeatative activities such as  excessive walking, excessive standing, housework, even excessive sitting.  During pregnancy, a low impact activity may cause you more pain than you might expect.   If this is the case, then this would be a good time to visit the osteopath for help.

Has your pain come on gradually or unexpectedly?

If you had a history of back pain that has been dormant for a while, Pregnancy might cause a flareup.  Is is able possible that you have never experienced any muscle or joint pain prior to pregnancy and go on to suffer disproportionally during pregnancy.

Does your pain seem to be in your muscles and/or your joints?

If your answer is yes to one or both of the last two questions, osteopathy is likely to be able to help you.  During your first consultation, we will examine you to determint that nothing more serious is causing your pain.   Once we are certain that your pain us due to excess strain of the muscles and or joints, we will continue with effective and gentle treatment to enable your pregnancy to continue more comfortably.

Osteopathy targets the causes of pain during pregnancy.

There are 3 main changes in the body that might cause you to experience muscular or skeletal pain during pregnancy

  1. The Ligaments are softening with the release of the Relaxin hormone.  In some women, this alone will cause pain, sometimes very early on in the pregnancy.  Some women already have soft joints before pregnancy and the release of Relaxin may cause joints – especially in the pelvis – to become painful.  Pelvic pain for this reason might be referred to as Symphysis Pubis Disorder (SPD).
  2. The shape of the body is changing. The ligaments in the back, rib cage and pelvis are taking advantage of the relaxin which enables the body to stretch and change shape to accommodate the growing baby.  This also causes weakness in certain points in the body, which means repetitive use of the body to carry out normal daily activities can cause irritation where they may not have done during pregnancy.  For example, the back may ache after sitting at a desk, when before it did not.
  3. The baby is growing and fluid is expanding in the body.  This expansion in the body can cause compression of nerves ( as in sciatica) and blood vessels (as in carpal tunnel syndrome)

The usual sites of muscle and joint pain during pregnancy

Low back pain during pregnancy

is a very common site of skeletal pain in pregnancy.  The normal inward curve of the lower back becomes gradually more exaggerated, causing increased tension in muscles and stain in the ligaments.  The increased tension and strain can trigger painful spasm in the muscles of the lower back, also causing you to feel stiff, especially in the morning.  Read more about Low back pain.

Symphysis Pubis and Pelvic Girdle pain during pregnancy

Women with Symphysis Pubis Disorder or Pelvic Girdle pain (PGP) can experience anything from mild symptoms in the later stages of pregnancy, to severe pain and impaired function relatively early in the pregnancy.  The NHS website estimates that 1 in 5 pregnant women will suffer from PGP.   The NHS website recommends physical therapy, such as osteopathy for example, for pain management.  Depending on the severity of the symptoms and the extent of ligament laxity involved, we have been able to make many women more comfortable during pregnancy.

Hip pain during pregnancy

Read more from us about Hip Pain

Neck and Shoulder pain during pregnancy

Read more from us about neck pain,

Ribcage and Chest pain during pregnancy

Read more from us about Ribcage / chest pain

Wrist and Hand pain during pregnancy

Read more from us about Wrist and Hand Pain

Ankle, Foot and Leg pain during pregnancy

Read more from us about Ankle and Foot Pain

How Osteopathy helps to relieve muscle and joint pain during pregnancy

When you come for treatment at Health in Motion Osteopath, you will experince a range of manuel therapy techneques,  selected by us to maximise comfort for you and your developing baby.  At your first appointment, our questions and examination will confirm your pain is muscular or skeletal pain, and not of another cause.  We will discuss our treatment approach for you and start your treatment.  Our techniques are gentle and the comfort of the mother and baby is always our primary consideration.  We will also give you exercises to do, which are appropriate for your condition and your stage of pregnancy.

Benefits of the Osteopathic Treatments during pregnancy:

  • Gentle stretching and delicate movement of joints can be effective in relieving joint pain in the back, pelvis and hips.
  • Improving circulation and lymphatic drainage can help with painful wrists, ankles and legs.
  • Mobilisation techniques of the ribcage and upper back can help with diagphragm function and digestion (reduced heart burn).

Strategies to alleviate muscle and joint pain during pregnancy

If you a preparing to get pregnant, take action to gently strengthen and mobilise your body.  If you are already physically fit, just keep doing what you are doing.  If you are out of shape, commit to gentle regular exercise such as walking more during your commute to work; swimming;  or pilates.

During Pregnancy – continue gentle physical activity such as swimming, ante natal yoga, walking, pelvic floor exercises, breathing exercises.

Avoid strenuous activity such as lifting or moving heavy objects.  Your ligaments are vulnerable to over stretching and painful strain during pregnancy.

Sleep and sit on supportive furniture.  A soft mattress may not give you the support you need. Read more from us about mattress choices.

Related links

Osteopathy treatment for babies at Health in Motion Osteopaths

Osteopathy for Pregnancy and Post Natal care

Cranial Osteopathy

Osteopathy and ÖTILLÖ Swimrun

Osteopathy assisted Matt to complete the ÖTILLÖ Swimrun after knee surgery

About the  ÖTILLÖ Swimrun

It is a team-sport based on two persons travelling through nature and time, completely dependent of each other. The team alternates between running and swimming along a pre-marked course in nature; it can be between islands or between lakes. As a team you race within 10 metres of each other, you share the experience, the fun, the beauty and the suffering. Swimrun is emotion!

 

Example of hard work and dedication.
Very well done Matt and thanks for the feedback!

“I came to see Lola at Health in Motion 3 months before the ÖTILLÖ swim run event I was entered into. Having had a knee op last October I was particular concerned about being able to complete the event without pain and long term damage. I also live with extremely tight hams and calf muscles, so lots to fix.
Lola and the team listened to my needs and with a combination of treatment and exercise/rehab plans got me to the start line ready to compete. I was particularly impressed with how I was advised to go back to very light exercise and stretching initially, do not rush into the longer distance prep etc.
I cannot stress how amazing this pre and post activity routine improved my training.
The event was last Sunday and was a success. 29km of trail running and 9k of open water swimming around the Isles of Scilly. I feel fine now. This is down so much to the treatment and preparation plan prepared by Health in Motion. Thank you!!!”

Clinic Open days over the Christmas and New Year

At this time of year, our clinic gets amazingly busy with people seeking treatment while they have a few days off work.  Therefore I am taking the time, before things get too busy, to let you know the days the clinic will be open and closed over the Christmas and New Year period.  If you know anyone that can use our help during this time, please pass on the information.

Health in Motion Osteopaths Open days over Christmas

Saturday 22nd December – Open (Lola, Eds, Emanuele)

Monday 24th December – CLOSED

Tuesday 25th December – CLOSED

Wednesday 26th December – CLOSED

Thursday 27th December – Open (Eds, Emanuele)

Friday 28th December – Open (Eds)

Saturday 29th December – Open (Eds, Emanuele)

Monday 31st December – Open (Eds)

Tuesday 1st January – CLOSED

Wednesday 2nd to Saturday 5th January – Open (Lola, Eds)

 

We have an out of hours service that will take calls and book appointments while we are closed or unable to pick up the phone.  Any voice messages  are immediately emailed to us so we can respond to them as soon as is practical. Call the usual phone number for our out of hours answering service 020 8991 5280.  You may also book appointments online here.

 

Other News

If you are interested in buying gift voucher for friends and family, please see details of our current special offers here.

Please continue to support Health in Motion Osteopaths by referring us to people you know can use our help.  Patient referral works well for us and we are eternally grateful for those of you who do this.  You can engaging with us (if that’s your thing) on social media regarding updates, special offers and events.

Twitter @health_n_motion

Instagram @health_n_motion

Facebook @himosteo

Osteopathy Winter Gift Voucher Sale 2018 in Pitshanger, Ealing

Health in Motion Gift Voucher Sales 2018

Osteopathy Gift Voucher Sale 2018
Health in Motion Osteopaths Gift Voucher Sale 2018

Osteopathy Gift Voucher Sale starts 1st November 2018

Sales price vouchers may be redeemed from the 1st January and are valid for a further 12 months.  Chose from our selection of gift packaging for your vouchers, free of charge.

1 voucher  – originally £63 each, reduced to £60

2 vouchers – originally £63 each, reduced to £58 each

3 plus vouchers – originally £63 each, reduced to £53 each

The sale will be on until 20th December or until all the allocated number of vouchers are sold, which ever comes first.

To reserve your order of gift vouchers please use the contact form, call us on 020 8991 5280 or pop into the clinic at any time up to and including 20th December 2018.

Late night shopping every Wednesday

Did you know that ordinarily, the clinic is open most evenings until 8pm.  This gives our patients and visitors the ideal opportunity to purchase products and gift vouchers from our shop.  Our gift vouchers are a great gift for Christmas and other occasions.  Health in Motion Osteopathy Gift Vouchers make the ideal present for people who value experience over products.  Your giftee will have the choice of one of the following consultations;

Osteopathy – ideal for those who need analysis and treatment for physical complaints such as sciatica, knee pain, etc;

Sports Therapy – ideal for those aiming to achieve greater physical performance;

Deep Tissue Manipulation for those who carry a chronic tension in their muscles.

There is no need to decide on the treatment type when you buy.

 

GDPR Privacy Policy Updated May 2018

Who needs to know about our updated GDPR Privacy Policy?

Read our GDPR Privacy Policy
Read our GDPR Privacy Policy

 

 

Emails are going out to all our existing and lapsed patients to let them know about our GDPR Privacy Policy.  Lapsed patients have been invited to read the policy due to our Record Retention Policy.  Our records are kept for 7 years after the date of your last appointment.  If you are a prospective patient, you can read our privacy policy before booking your first appointment to ensure you’re happy with it.

Our GDPR Privacy Policy is for your benefit

The new regulations under GDPR benefit you in the following way;

  1. Our legal justification for retaining and using your data is explained.
  2. You have increased rights regarding our use of your data.
  3. We must explain the steps we have taken to keep your information secure.
  4. We must inform you and the regulators of any data security breaches immediately.

Do you need to take any further action regarding our GDPR Privacy Policy?

Click here to read our updated privacy policy.  Since the past 4 years, we have asked our new patients to agree to email communication and marketing when they register at the clinic.  We ask patients to give their consent again if they have not had an appointment in the previous 12 months.  This practice will continue to ensure you agree with our policy and agree to accept email marketing which you may opt out of at a future date.  If you currently receive our marketing emails then you may op out or select the type of content you are interested in.  We tend to send out the following types of email communication; Special Offers, New Services, Special Promotions.

 

Mother’s Day Gift Vouchers

Mother’s Day Gift Vouchers available at Health in Motion Osteopaths

For a Mother’s Day treat, why not give her a gift voucher for treatment at our clinic.  She can redeem the voucher at a future date in exchange for one of our treatments.

Treatment choices for Mother’s Day

We offer a range of treatments that can be combined to suit your Mum’s needs.

Structural Osteopathy

This is a physical treatment useful in the treatment of acute or chronic conditions affecting the muscles and joints. Lola, Eds and Anjy will be on hand to provide this treatment.

Cranial Osteopathy

Lola or Anjy would be delighted to provide this treatment for your deserving mother.  Cranial Osteopathy is a gentle hands on treatment that seeks to restore the function of the parasympathetic nervous system.  The parasympathetic nervous system powers healing and restorative processes in the body.  These processes, such as the immune system,  may become compromised by long term stress.

Sports Therapy

If your mum needs help preparing for her next marathon, tennis tournament or triathlon, a sports therapy session with Eds, Lola or Anjy will hit the spot.  Your Mother may have a new or old injury that is interfering with her progress.  She  may just need some massage and manipulation to ease her hard working muscles and joints.

Deep Tissue Massage

Your mum may need nothing more that a strong treatment for achy muscles and joints.  This is a delicious treatment that Eds or Lola will be happy to provide.

Acupuncture or Fire Cupping

This is treatment based on the ancient tradition of Chinese Medicine. Teresa is registered with the British Acupuncture Council.

 

How do I get this wonderful, life affirming Mother’s day gift?

Gift presentation envelopes and gift boxes are supplied free of charge.   A blank cards is also provided for you to write your heart felt message.  Pop in the the shop to buy this wonderful gift for your mother.

 

 

Featured Product – Shoe Insoles available at our clinic

Shoe insoles supplied by osteopathy clinic

Shoe Insoles – Supplied by Health in Motion Osteopaths

 

Shoe insoles – slim profile and very supportive

 

 

 

 

 

 

Why do we love these shoe insoles?

Shoe insoles can be a cost effective way to help our patients improve the mechanics of their feet.  This is true for those required to be on their feet all day; or take part in high impact sports / activities; or have a painful condition affecting their feet or ankles.  Our patients often complain that off shelf or even bespoke insoles can be too bulky to fit in many of their shoes.  Also bespoke shoe insoles (orthotics) prescribed and made by a podiatrist are often very expensive.

We have therefore sourced a full length shoe insole that is strong enough to give the required support, thin enough to fit in a variety of shoe types (from flat court shoes to boots) and will not make a huge financial dent.

The Slimflex green shoe insole sells at our shop for up to £20 and can be used “off the shelf” or customised for more complicated foot corrections.  In most cases we have sold them “off the shelf” without further correction.  We sometimes assess our patient’s gait and add a wedge to correctly tilt the feet (supination or pronation).  In most cases we provide treatment and tailored exercises to minimize the need for further correction to the shoe insole.

If you need a shoe insole for sports shoes, we may need to source a firmer version depending on the sport and other factors.

Call for advice and a consultation if you believe you are in need of a shoe insole.  You may also request a call back.

Product Features & Benefits:

  • Ideal initial introduction to orthotic therapy, perfect for first line treatment.
  • Perforated under layer to increase breathability and reduce the risk of hyperhydration.
  • High arch profile.
  • Hard wearing top cover.
  • Exceptional value for money.
  • Ideal to trial different postings at budget friendly prices.
  • Moulded EVA with a deep heel cup which allows greater foot control and correction when used with Podotech wedges.
  • Heat moulding possibilities which allows for off-loading implementation.
  • Antimicrobial cover to reduce odour and microbial colonisation.

 

Practitioner Usage tips:

  • Try using Slimflex Green with a 3.5 degree rear foot wedge.
  • Try using Slimflex Green with a kinetic wedge for a Hallux Limitus presentation.
  • Use a Slimflex Green orthotic with a Podotech 6mm heel component to treat achilles insertional tendonitis.

 

Osteopathy treatment for chest pain following flu or cold

Osteopathy Treatment for Chest Pain following Flu or Cold
Osteopathy Treatment for Chest Pain Following a bout of Flu or Cold

Chest Pain following Flu or Cold 

In recent years Flu and bacterial infection – such a Cold – seem to be more disruptive to our nation’s health and are getting increasingly difficult to shake.   Once the severe stage of these illnesses have  been allayed, many sufferers are experiencing debilitating chest pain – extending suffering further.  During the “Flu season” our clinic has received a significant increase in the  number of patient complaining of chest pain following a flu or cold – mainly during the recovery phase of these infections.  Osteopathy has been beneficial in helping these patients.

Symptoms of Chest Pain following Flu or Cold

Our patients have reported acute pain at various locations in the chest wall.  The chest wall is boarded  by the collar bones, down to the start of the abdominal area.  To each side are the ribs which extend from the spine at the back of to the breast bone at the front.

Due to the location – our patients, in these case, have been caused some distress as pain is easily aggravated by motion of the rib cage, the back and the shoulders.  Normal inhalation and exhalation (breathing in and out) – which must continue is the main aggravating factor.  Deep breathing, coughing or sneezing, causes increasing discomfort. Getting comfortable at night has also been reported to us as problematic.

How does Chest Pain Occur as a result of Flu or Cold?

Joint and muscle pain in the chest or spine caused by Viral Infection

Viruses may cause joint pain through a number of mechanisms that depend on various factors such as your gender, age, genetics, infectious history, and immune response.  The joints of the ribcage include the costo-chondral joints with the breast bone at the front of the body, the costo-vertebral joints – where the ribs attach to the spine, and for the purpose of this specific complaint, we would also include the upper back section of the spine.

Viruses are able to initiate rheumatic symptoms through different mechanisms. The presence of the virus and its injury to tissue elicits the process of inflammation which can cause swelling, pain, heat and redness over the affected joint. This is referred to as reactive arthritis, which is self limiting and should resolve on its own.  Depending on your immune system – this complication will last longer in some individuals compared to others.

Reactive arthiris is an autoimmune condition that develops due to an infection. It can affect people of all ages,including children. Research suggests you are more likely to develop this condition if you have a particular gene, HLA-B27.

Patients with pre-existing joint injury or dysfunction may notice an increase in symptoms after an infection due to a naturally occurring chemical called cytokines which helps to fight the infection. This causes inflammation in the joints and muscles which results in pain. If there is an area that is already weak due to local dysfunction, this area tends to be more probalmatic when suffering from an infection.

Chest Pain caused by repeated coughing or sneezing

The process of coughing or sneezing requires movement from the all components of the chest wall – the joints at the front and back of the ribcage, the spine, the muscles between the individual ribs and even muscles in the neck which assist in the elevation of the ribcage.  There is a huge coordination of muscles and joints, triggered by a reflex to eliminate the irritants caused by infection.  Given the lightning speed of the cough and sneeze – the huge coordination effort, and the fact that it is happening repeatedly while you are ill – this rapid action can cause repetitive strain to the soft tissues involved – i.e. muscles, ligaments, tendons, joint surfaces.

Some patients may have pre-existing joint or tissue dysfunction in the chest wall or spine, which they may or may not be aware of.  Therefore they have sub-optimised mechanics for repeated coughing and sneezing and therefore at greater risk of this kind of injury.  This is true of anyone who has a desk bound job or any other reason for a weak upper body posture.

Pain may also be felt in the upper back, lower back, neck and shoulders as a result of flu or cold.

 

Chest pain caused by Intercostal muscle spasm

Repeated use of the muscles in and around the ribcage can result in tightened fibres and spasm.  As a consequence this causes irritation to the nerves positioned between the ribs (intercostal spaces).  This repetitive motion of sneezing and/ or coughing requires the ribcage to work harder than usual.  Also, muscles can become stiff during an enforced period of bed rest, thus increasing the risk of injury.

If you have intercostal muscle spasm, you may experience:

– Pain underneath or between the shoulder blades

– Pain that radiates around the side into the chest

– Pain that occurs when sneezing or coughing

– Pain in the upper thoracic (upper-mid back) or lower cervical regions (neck).

 

Central Chest Pain

Central chest pain is commonly referred to as costochondritis. This condition arises due to inflammation of the cartilage in the rib cage and usually affects the cartilage where the upper ribs attach on to the sternum (breastbone). Individuals suffering from this condition may experience mild symptoms which can cause the chest to feel tender to touch or some pain when pressure is applied on the chest cartilage. However, in some cases the symptoms may be severe and cause radiating pain down limbs and debilitating chest pain which can intefere with an individuals daily life.  Patients with pain at the front of the chest wall will find working at a desk very painful.

 

Osteopathy Approach to chest pain following flu or cold

At the clinic we would first seek to establish the cause of the chest pain or any other pain felt to be caused as a result of the recent bout of flu or cold.  Pain that is caused by the Rheumatoid or other bio-chemical affects of the cold /flu should be allowed to run their course.  Pain killers such as paracetamol may be useful, consult with a pharmacist or GP if you are on other medication.  We would advise that you remain hydrated to facilitate your recovery

Pain that is caused by mechanical dysfunction – as described the latter 3 sections above – can be treated at our clinic.  Our techniques will help alleviate the symptoms of muscles spasm or joint pain caused by repetitive strain and / or prolonged bed rest.

We will also give you prescription of gentle exercises to help your recovery and advised on nutrition if necessary.

 

Call the clinic for advice or to book an appointment if you are suffering any pain following a bout of the flu or cold.  You may also use our contact form and we will respond with a call or email within 48 hours of receipt.  Appointments can also be booked online.

Osteopathy and Trigger Point Headaches

Trigger Point Headaches
Anjy Chahal, Registered Osteopath, Ealing

Anjy Chahal’s research into Trigger Point Headaches continues to inform her practice in this area.  Her insights are shared in the post below.

 

Tension Headaches

Tension headache is the most common type of headache and is usually described as a pain that feels like a tight band round the head, or a weight on top of the head. Sufferers may also feel pain along the neck and shoulders which can last from 30 minutes to several days, or may re occur depending on the severity. The most common causes of tension headaches are muscular tension, associated postural fatigue and stress.

Migraines

A migraine is usually a severe headache felt as a throbbing pain on one side of the head, with other symptoms such as visual aura and nausea. Migraine tends to cause more disability than tension headaches. 1 in 10 people suffer from migraine headaches and associated symptoms. Migraine attacks can vary in occurrence and intensity, they can last from 4 up to 72 hours depending on the individual.

What are Trigger Points? 

The term trigger point refers to a sensitive area in a muscle or fascia that becomes painful when direct pressure is placed upon it. This direct compression can cause local and referred pain. For example, when the muscle at the top of your shoulder has a trigger point it will refer pain up the side of your head and neck which can cause headaches or amplify an existing headache – as in a Migraine attack.

Trigger points are classified as either active or latent; an active trigger point is always tender and causes a clinical complaint, it initiates a local twitch response of the muscle fibres when stimulated with compression and prevents full lengthening of the muscle. Latent trigger points are pain-free  neuromuscular lesions that are usually associated with muscle overuse.

Trigger Point Headaches 

Trigger Point Headaches may be involved in both tension headaches and migraine. The mechanism is as follows.

Trigger points in the muscles at the base of the skull (suboccipital muscle group) are the most common cause of tension headaches. The suboccipital group work to keep your head balanced on top of your spine. Due to the constant use of this area, the muscles surrounding the head and neck overwork which then lead to the build up of muscular knots.  Trigger points are usually a common feature in tension headaches.

When trigger points refer pain they can trigger a  migraine attack in a person who has a history of Migraine headaches. Research shows that the longer the history of migraines, the more trigger points occur in the muscles and therefore the more frequent the attacks.

How can Osteopathy help Trigger Point Headaches? 

Osteopathy can help by using various techniques  such as mobilisation, stretching and trigger point release therapy in order to help relieve the muscles and surrounding tissues.

Trigger point release focuses on releasing the muscular tightness and shortening of the muscles via cycles of isolated pressure and release. Dry needle treatment (also known as medical acupuncture) can also be used to release trigger points.  This intermittent pressure encourages the muscle fibers to release these trigger points by calming neuromuscular over stimulation.

Osteopathy treatment can almost always alleviate tension headaches.  In Migraine, osteopathy may help to reduce the severity of attacks where trigger points are a feature of those headaches.

Clinic Closure Christmas and New Year 2017/18

The clinic will be closed on the following days over the Christmas and New Year period.  Same day appointments are usually available but it is advised to call ahead to book.  To make advance or same day appointments call 02089915280.  You may also book online here.

Sunday 24/12/17Closed
Monday 25/12/17Closed
Tuesday 26/12/17Closed
Sunday 31/12/17Closed
Monday 1/1/18Closed
Tuesday 2/1/18Open 12:40 to 20:00