Chelsea Russell

Sleep is one of the first things I ask about, if it’s not already one of the first things a patient brings up. Most people already have a pretty good sense of whether they’re sleeping well or not. What I’m usually trying to understand is what happens through the night and how they feel when they wake up.

If someone is waking up with back pain, numb hands or feet, neck pain, headaches, stiffness, or they just can’t seem to get comfortable, then I usually want to look at their sleeping position and whether a few small changes could help.

Sometimes it’s as simple as a pillow between the knees, something to hug, changing the height under the head, or adding a bit more support under the legs.

It really doesn’t have to be fancy. I’ve seen plenty of expensive pillows end up collecting dust because they just weren’t the right fit for that person.

And this is one of those things I’ll come back to if it still seems relevant. If someone’s feeling better and sleeping comfortably, great. If they’re still waking up sore or uncomfortable, then it’s probably still worth looking at.

Sometimes home care is less about adding more and more, and more about making what you’re already doing every night feel a little better.P

A lot of what shapes a practitioner isn’t taught in school.

School matters. Scope matters. But I think every practitioner becomes different because of everything that happens around that education too.

For me, that started early. I was around healthcare a lot as a kid because of my mom and her chronic illness, so I saw different practitioners and different ways of doing things long before I became one myself. Then came school, placements, mentors and eventually my own patients.

All of that changes you. The cases that go well, the ones that make you question yourself, and the moments you realize you don’t have the answer. That’s why two people can graduate from the same program and still become very different practitioners.

I think about healthcare like building something. A bridge or a hospital doesn’t come together because one person knows everything. Everyone has a different piece, and it only works when those pieces work together.

A nurse, a physiotherapist, a chiropractor, a physician, an RMT and a manual osteopathic practitioner can all look at the same person and notice different things. That doesn’t make one of us right. Usually it means the person may benefit from more than one perspective.

To me, being a good practitioner isn’t about knowing everything. It’s knowing my scope, knowing when something isn’t appropriate for me to treat, and being comfortable saying, “I think someone else needs to be involved here too.” Sometimes good care is a referral. Sometimes it’s supporting the work that’s already being done instead of competing with it.

My lens is one lens. My education, my patients and my own life shaped it, and another practitioner brings a completely different mix. That’s exactly why collaboration matters.

Different roles
Different lenses
Same person in front of us

I may upset a few people with this one, including the version of me from five or six years ago. I’m not sure I would have believed it until I started practicing differently myself. A lot of practitioners I’ve met have landed in the same place.

I believe in mobility, stretching and hands-on treatment. I use hands-on treatment every day.

But two things can be true at once. Something can make you feel better and still not be the whole answer to a chronic problem.

A joint doesn’t work by itself. It needs enough range, and the ability to actively use and control that range. Strength, coordination, load, leverage, fatigue and what’s happening above and below that joint all matter.

And the tissue that feels tight or works the hardest isn’t always the thing that needs releasing. Sometimes it’s working hard for a reason.
That doesn’t mean we never treat it. It means I want to know why it keeps needing help.

If one tire keeps wearing unevenly, you can keep replacing the tire. Eventually you probably want someone to check the alignment.
So if you’ve been getting weekly massage, physio, chiro, manual osteopathy or anything else for a long time, and the same area keeps needing the same thing, it’s reasonable to ask:

-Why does this keep coming back?
-What happens above and below it?
-What happens under load, or when I’m tired?
-Can I actively control the range I have?
-Is anything I’m doing helping me need treatment less?

I’m not arguing against hands-on care. I’m arguing for a bigger conversation about why something helps, how long it helps, and what comes next.

When I look at how a joint moves, I’m looking at what’s around it, too.

1. MUSCLES help you move and support your joints. When they tighten and relax, they also help move blood and lymph.
2. TENDONS connect muscles to bones. They pass the muscle’s pull to the bone so you can move.
3. LIGAMENTS connect bones to other bones. They help support joints and keep them from moving too far. They also help your body sense where a joint is.
4. NERVES carry messages between your brain, spinal cord and body. They help you move and feel. They need to slide and adjust as you move.
5. BLOOD VESSELS carry blood around your body. Blood brings oxygen and nutrients, takes away waste and carries heat.
6. LYMPHATIC VESSELS collect extra fluid from your tissues and return it to your blood. Moving your muscles and breathing help this fluid move.

These parts share space and work together.

I look at how you move and how it feels, not just how far you can move.

Using the range you can control can also help support blood and lymph flow. Having more range doesn’t always mean better flow.

With hypermobility, a joint may move far without feeling strong or steady. Building strength and control can help you feel more supported when you move.

Whether you have extra range or feel stiff, I think it’s important to understand what’s happening before asking you to do more.

When did “I can get through it” become the standard?

I hear it in clinic all the time. And I’ve caught myself saying it too.

Being able to keep going doesn’t mean it’s easy. You’re allowed to bring it up before it becomes something you can’t ignore.

A few things I didn’t get to in the video: I review your notes so you don’t have to start from scratch every time. You can ask questions before booking, change positions, take a break, or tell me something isn’t working. And whatever we plan together has to make sense for your actual life.

I could keep talking for hours about the little things that shape a visit. A lot of them come from what I saw growing up with my mom, and from my own experiences since.

She would have been 62 today. 🤍

I use hands-on treatment every day, with humans and animals, so this isn’t me saying passive care doesn’t have value.

What I question is when temporary change becomes the whole plan.

If the same area keeps needing to be stretched, mobilized, manipulated, adjusted or “released,” at some point I want to understand why.

Because whether I’m looking at a person, a horse or a dog, the body is still dealing with anatomy, physiology, structure, function, load, leverage and force.

Basic physics still applies.

If one area is doing more work, another area may be doing less. If a joint has a lot of available range but poor control, the tissues around it may be working harder to create support. If something is repeatedly overloaded, treating only the place that hurts may not tell us what the whole system is doing.

That’s where I keep coming back to the body as a unit.

What range is available?

What can actually be controlled?

What happens under load?

What changes with fatigue?

What is happening above and below the symptomatic area?

What is compensating?

What is overworking?

And what is the body trying to accomplish with the strategy it has chosen?

Because structure affects function, function affects load, and load changes how tissues adapt.

So yes, maybe stretching helps.

Maybe mobilization helps.

Maybe manipulation helps.

Maybe hands-on treatment gives relief.

But then what?

What are we doing with that change?

What are we asking the body to learn?

What can the patient -or the animal - actually build from there?

For me, that’s where assessment, home care, progressive loading, control and education become so important.

If I keep doing the same thing and getting the same temporary result, I don’t want to blame the body.

I want to reassess the plan.

The body is not just the place where the symptom showed up. It is a whole system managing force, movement and load.