Q&A with soft tissue injury specialist & osteopath Alex Orfanides

On days I'm in clinic, I wake up, get ready for the day and go and try and fix as many patients as I can! Then I come home, try to take care of myself a little bit and fall asleep.

It's a long story but to simplify it, I was really physically broken! I was 16 or 17, had constant joint pain, shoulder pain, wrist pain, knee pain, knee ache that would keep me up at night, stomach issues, eye issues, teeth issues. And eventually through a series of events I realised that there were ways I could positively affect my body. I didn't have to live with shoulder pain or wrist pain. And that's when my obsession with what I do started because I think of the life I could have had if I didn't realise that you can fix a lot of these chronic injuries. And that's what led me to get into it, was my own personal journey.

What differentiates me is my clinical approach: I try to keep everything principles-based, physiology-based. Most of my treatment interventions follow two principles: One, is inducing a controlled, inflammatory, micro-trauma response in the tissue to give it an opportunity to remodel better and two, is taking advantage of a property called mechanotransduction, where we try to get that tissue remodelling better than it did before!

The biggest challenge in my work is how close it is to my heart sometimes. I jokily say that I wake up equal parts furious and inspired - I see patients who often don't need to be in pain and don't need to have suffered for so long. After getting these really, really good clinical results, it frustrates me that it's taken them so long to get to this point and that they've suffered.

I think the biggest mistake I see people make is looking for this simplified advice. You see people who say "I have to do this amount of strength training or this many reps because this is what my programme says" instead of listening to their body. One of my favourite phrases is body literacy, so it's the idea of knowing how to listen and read your body and working with what your body brings to you on a different day instead of imposing on it what you think it should do!

I keep it simple because I like to keep it evidence-based as much as possible. So, sleeping more and better sleep quality. Often with my patients - since I work with athletic and hypermobile individuals - is getting enough calories in, so eating enough. And I would say prioritising it just like you floss and brush your teeth. Dentists have convinced us to care daily for our teeth - we use our musculoskeletal system even more than we use our teeth, why do we not prioritise caring for it in the same way?

My favourite Zooki is Vitamin D Zooki, and the reason is there's a lot of research when it comes to the many positive effects of vitamin D, but especially in pain modulation. So because I've dealt with chronic pain, and because I work with patients with chronic pain and we often see vitamin D deficiencies, especially in this part of the world, it's a really easy thing you can improve, it's a really easy win that's really evidence-based and safe for most people to do (of course everyone should check with their doctor, about everything!) But additionally as well I like Vitamin D Zooki because it's a liquid, so a lot of people with hypermobility or connective tissue disorders struggle to absorb things. For me personally, I prefer to go with a liquid if possible because I think it's more likely I'll absorb it.