Saturday, August 19, 2017

Defining Common Muscle And Joint Injuries

By Dr. John A. Papa, DC, FCCPOR(C)
Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  Common mechanisms of injury include slip and fall or collision-impact type accidents, overstretching a body part, twisting awkwardly, or performing repetitive movements.  This can cause pain, stiffness, and swelling in a joint and/or muscle, leading to injuries such as sprains, strains, and contusions.
A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Common locations for sprains are the ankle, wrist, and knee joints.

A strain refers to a stretching or tearing of a muscle or tendon.  Muscles are responsible for producing force and causing motion, whereas tendons are the tough fibrous extensions of muscle that attach to bone.  A strain injury can occur when the muscle-tendon complex suddenly or powerfully contracts, or when it is overstretched.  This is called an acute strain.  Overuse of certain muscles over time can lead to a chronic repetitive strain.  Strains are commonly referred to as “pulled muscles” or "tendinitis".  The shoulders, forearms, low back, and leg regions are common locations for strains to occur.

Contusions are commonly called “bruises”, and occur when small blood vessels in the skin, muscles, or bones are subjected to trauma. 

Sprain, strain, and contusion injuries can exist on their own or in combination with each other.  Initial conservative management and first aid of these injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  This can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  With a mild injury you should experience progressive improvement within 2 to 3 days.  You should gradually begin using the injured area after this time.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks. Moderate injuries usually require 4 to 12 weeks to heal and may require basic rehabilitative treatment and exercises.  Severe injuries will take longer to heal.  Healing times may also vary depending on a persons age, physical condition and general health.

You should seek immediate medical care under the following circumstances:  a popping sound heard during the injury accompanied by a feeling of joint instability or inability to weight bear; obvious evidence or suspicion of a broken bone, fracture or joint dislocation; or injuries at risk for infection.  For less serious injuries that do not subside, you should contact a licensed health professional who deals in the diagnosis and treatment of muscle and joint pain.  They can determine the cause of your pain and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance. For more information on managing muscle and joint injuries, visit

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Monday, August 14, 2017

Common Chiropractic Misconceptions

By Dr. R. Greg Lusk, DC

Over the years, I have been asked many questions about chiropractic and have heard patients describe their complaints and symptoms in interesting ways.  While some of these inquiries or descriptors are quite unique and create an "inner" smile as I hear them, many of them are very common and recur frequently.  However, they often contain wording that is misleading or create mental images that are not very accurate.  I will attempt to clarify a number of them below.

#1 - I threw my back "out" or I'm "out of alignment".  These are two of the most frequent statements I hear when someone is in pain or their spine just doesn't feel right.  However, the spinal joints are not actually "out" which would strictly mean they're dislocated, with associated ligament and other soft tissue damage.  If that were the case, the pain and/or movement difficulty would likely be exponentially more and you wouldn't be in my office but at the hospital.  The mechanism to cause such an injury would be severe, such as a motor vehicle accident or fall, which is not the situation with most cases of spinal pain.  Instead, it is more likely that other tissue changes have occurred, such as stiff muscles, inter-vertebral disc pressure imbalances, or an inflamed joint, that are causing you symptoms and/or to move differently.  Our bodies often then compensate to unload painful structures making you feel "crooked".  This is important to understand so treatment expectations are realistic as it's not just a matter of putting a joint back "in".  Trust me, I wish it were that easy!

#2 - "Once I start seeing a chiropractor do I have to keep going back?"  This is a frequent belief that people have and one that often prevents some from consulting with a chiropractor in the first place, as they're not prepared to begin their lifelong chiropractic routine.  There is no truth to this however.  After the initial assessment a diagnosis will be made and then a treatment plan should be determined in collaboration with the patient.  Typically, if someone will respond well to treatment they respond early on, without absolutely needing months and/or years of treatment on a very frequent basis.  Some patients do elect for "maintenance" or "supportive" care however, once the initial pain level has largely improved, as they note they feel better with treatment.  Often, the many activities we do on a daily basis are contributing factors to becoming "tight" in either our neck or back, and play a role in recurring episodes of pain and stiffness.  Having that tension addressed periodically, with once per month being a frequent schedule, is reasonable and aimed at preventing a flare-up.

#3 - "I'm in so much pain I think I need an x-ray".  I can understand why someone might come to the conclusion that the amount of pain they're experiencing reflects the degree of injury that may have occurred, but that is most often not the case.  Often, there is no traumatic mechanism to suggest a fracture, no indication of infection, no symptoms associated with a more serious illness, such as cancer, and no other indications.  Therefore, there is nothing obvious to rule out, which an x-ray would serve to do.  Pain is a complex neuro-physiological process that is not solely dependent on tissue damage.  It is not uncommon to see a client in extreme pain get rapidly better, exceeding the healing rate of any known condition, which supports the notion that there's more to the pain story than just an injured body part.

This article is for general information purposes only and is not to be taken as professional medical advice.

Wednesday, August 9, 2017

Prevention And Management Of Neck Pain

By Dr. John A. Papa, DC, FCCPOR(C)

Most adults can expect to experience some neck pain in their lifetime.  The cause of neck pain is often multi-factorial, meaning that there is usually no single cause.  Once an episode of neck pain happens, some individuals will find it is a persistent or recurrent condition.  However, there are management strategies that can be employed to minimize the negative impact of neck pain.
Below are some tips on prevention and management of neck pain.
·        Protect your neck while you sleep by choosing a pillow that will help support the head, neck, and shoulders.  This will keep them in alignment and minimize stress and strain.
·        Be smart when working at a workstation/desk.  The workstation/desk should be at elbow height.  Use of an adjustable chair can help meet this need.  Computer monitors should be at eye level for easy viewing.  Do not cradle the phone between your head and shoulder.  Use of a headset or the speakerphone feature will keep your hands free and allow you to multi-task in a safe manner.  Be sure to take regular breaks every 20 to 40 minutes that allow you to stand, walk around, and stretch your neck and upper back.
·        Avoiding cigarette smoke can be helpful.  The reduced blood circulation found in smokers deprives spinal discs of vital nutrients which can lead to premature degeneration.  Smoking may also provoke disc herniation with coughing, and cause general damage to the musculoskeletal system through direct chemical irritation and chronic inflammation.  Exposure to secondhand smoke during childhood may also increase the risk of developing neck problems later in life.
·        Drinking water brings vital nutrients to neck muscles and decreases the risk of cramps and strains.  Water also helps to protect neck joints by providing lubrication and cushioning.
·        Eliminate poor posture which can strain the muscles and joints in the neck.  While sitting, make sure that your weight is evenly distributed on your seat, your shoulders are not rounding forward, and you are not slouching.  Your head should be resting on your torso and not poking forward.
·        Engaging in regular physical activity and exercise will help keep your neck strong.  This can include general cardiovascular conditioning, along with postural, stretching and strengthening exercises for the neck and upper back.
·        Get professional help for your neck pain.  The following treatments have been identified as being helpful for most cases of neck pain:  education, exercise, mobilization, manipulation, acupuncture, and soft tissue therapy.  The scientific literature does not identify any “best” treatment that is effective for everyone.  Trying a variety of therapies or combination of therapies may be required to find relief and help manage neck pain.
If you are having difficulty managing neck pain symptoms, contact a qualified health professional who can prescribe appropriate therapy, rehabilitation and self-management strategies specifically for your circumstance.  For more information, visit
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Friday, August 4, 2017

Understanding Bursitis

By Dr. John A. Papa, DC, FCCPOR(C)

A bursa is a thin, slippery sac found around a joint that releases lubrication called synovial fluid.  Its primary function is to provide cushioning between bone and surrounding soft tissue, such as skin, muscles, ligaments and tendons.  Under normal circumstances, the bursa provides a smooth surface that allows for minimal friction with movement between these structures.
The term "bursitis" refers to any inflammation or irritation of the bursa.  When this occurs, the bursa loses its gliding capabilities, and becomes thickened and swollen.  As a result, the added size of the swollen bursa causes more friction within an already confined space, and the smooth gliding bursa becomes gritty and rough.
There are approximately 160 bursae in the body.  Fortunately, only a handful of them usually develop bursitis. The most common areas to get bursitis include the shoulder, elbow, hip and knee regions.  Less frequently, bursitis may also occur in the wrist, buttocks, heel and big toe.  Symptoms of bursitis include swelling, pain, and tenderness in the affected region.  This may also be accompanied by reduced range of motion and strength which can lead to a significant decrease in physical functioning.
There are several factors that can contribute to the development of bursitis.  Activities that result in repetitive overuse or prolonged and excessive pressure on a body region are a common culprit.  An example of this would be constant overhead lifting using your shoulders or continuous kneeling on a hard surface with your knees.  A bursa can also become injured as a result of a blunt trauma or fall such as slipping on ice and landing on your hip.  Bursitis is more common in adults, especially in those over 40 years of age.  As soft tissues age they become less elastic and durable making them more susceptible to overuse and traumatic injuries.  Other possible causes and risk factors for developing bursitis which may require additional medical management include infection from an opening on the skin surface, rheumatoid arthritis, gout and diabetes.
Conservative self-care strategies for reducing the pain of bursitis should initially involve relative rest from any painful activities and ice application.  Altering or eliminating the situations that contributed to the bursitis is also important.  This may include activity modification such as using the correct technique, tools, and/or equipment.  In addition, taking breaks to relax overworked muscles and joints, and performing exercises to strengthen the body can also be effective.
Bursitis that does not respond to self-care strategies may require professional treatment.  This can include acupuncture and electrotherapeutic modalities to decrease pain, manual and soft tissue therapy to assist in healing, and specific rehabilitative conditioning training for the affected muscles and joints.
If you are having difficulty with a case of bursitis, a qualified health professional can prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Monday, July 31, 2017

Exercise And Over-Training Syndrome

By Dr. John A. Papa, DC, FCCPOR(C)
Many individuals strive to incorporate more exercise into their daily routine and for good reason.  Regular exercise has long been identified as an essential element of good health due to its ability to positively affect every organ and structure in the body.  However, if done in excess, exercise can also lead to negative health consequences such as over-training syndrome (OTS).
OTS occurs when there is an imbalance between exercise training and the body's ability to recover. This typically occurs when exercise volume (the total amount of exercise performed) and intensity (the total amount of effort exerted) are both too high for an extended period of time.  Therefore, it is important to find the correct balance between exercise volume and intensity.  A good exercise program should allow you to exercise on a regular basis without "burning out".
It is important to recognize the signs and symptoms of OTS which may include:
·        Performance related issues such as:  decreased strength, endurance, and power; poor workout recovery; an inability to complete workouts.
·        Physical symptoms such as:  an increased resting heart rate; persistent aches and pains in muscles and joints; repetitive strain injuries.
·        Health related symptoms such as:  frequent headaches; chronic fatigue; gastrointestinal distress; menstrual irregularities; decreased recovery from and/or increased susceptibility to colds, sore throats, and other illnesses.
·        Mood and behavioural changes such as:  insomnia; loss of appetite; increased irritability; depression; decreased motivation to exercise.
Below are some useful tips that can help overcome or minimize the chance of OTS:
1.    Rest is essential for recovery.  This may include absolute rest from all exercise activity or increasing the recovery time between exercise bouts.  Proper rest allows for the body's important biological systems to recover, repair and recharge.
2.    Change your training method.  Look at the cumulative stress of the exercises performed.  Use a variety of exercises when training specific body regions and avoid continuous training without proper recovery.  Change your program frequently and find the right balance between exercise volume and intensity.
3.    Check your nutritional status.  Your body needs the proper nutrients to function optimally.  Inadequate intake of carbohydrate and protein can lead to muscle fatigue and poor muscle tissue repair.  Healthy fats are needed to produce hormones that regulate many body functions.  Dehydration can contribute to muscle cramping and joint pain.  Avoid nutrient deficient foods such as trans-fats and refined sugars and starches which put physical stress on the body.
4.    Get professional help:  Overcoming OTS is not always simple.  There are healthcare practitioners who can treat physical injuries and provide advice on nutrition and proper exercise training techniques.
Recognizing the signs and symptoms of OTS and knowing how to avoid or minimize its effects can ensure that you can continue to enjoy the many health benefits exercise has to offer.  For additional information on exercise, nutrition, and improving your physical health, visit
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Tuesday, July 25, 2017

Ice Therapy For Muscle And Joint Injuries

By Dr. John A. Papa, DC, FCCPOR(C)
Ice therapy is an effective self-care treatment strategy for muscle and joint injuries.  It is commonly  used for acute injuries (within the first 72 hours), but can also be very helpful in managing flare-ups of chronic problems, and as a preventative measure following activities or exercise.
Ice therapy reduces the amount of swelling and inflammation at the injury site and also acts as an anesthetic to provide pain relief.  Icing as soon as possible after an injury will help with speeding up recovery time, and minimize the chances of secondary problems such as muscle spasm and joint irritation.
Below are some helpful  tips that should be followed when using ice therapy:
·        Crushed ice and ice cubes are ideal sources of ice because they easily mold around an injury site and can stay cold for long periods of time.  Commercial ice/gel packs and frozen vegetable bags are good secondary choices when crushed ice or cubes are not available.
·        Use compression when applying ice to an injury site.  Compression is most easily achieved with an elastic tensor bandage to add support and slow swelling.  The principles of elevating and resting the injured site should also be followed during initial injury management.
·        Ideal ice application time is 10 to 20 minutes.  There should also be a period of 10 to 20 minutes or more where there is no ice application before icing is done again so that skin temperature can return to normal.  This cycle can be repeated as often as necessary within the first 24 to 72 hours after injury or activity.
Below are some precautions that should be followed with ice therapy:
·        Ice should never be applied directly over the skin for a prolonged period of time as this can damage skin tissue.  A wet towel can safely be used as a barrier between the ice and skin and acts as an excellent conductor of cold.
·        Ice should never be applied on blisters, open cuts or sores.
·        Ice should not be applied before exercise or activity as this impairs your body’s ability to detect proper joint and muscle function, making one more susceptible to further injury.
·        Ice therapy should not exceed the treatment time recommended as prolonged exposure can reverse the positive effects of ice and can lead to possible frostbite.
·        Special care must be taken when icing the elbow, wrist, knee, or foot as superficial nerves in these areas can become irritated or damaged with prolonged icing.
·        People hypersensitive or allergic to cold and those who have a circulation problem should avoid ice.
If you have a muscle and joint injury that is not resolving, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit  From all of us at the New Hamburg Wellness Centre, have a safe and enjoyable summer!
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Wednesday, July 19, 2017

9 Benefits Of Getting Your Exercise In The Pool, Lake, Or Ocean

Canadian Chiropractic Association

Summer is well underway and water activities are in full-swing. Whether it’s at a nearby lake, beach, or swimming pool, it’s time to talk about water exercises and why they’re good for you.
Here are nine benefits of exercising (particularly swimming) in water:
  1. There’s low impact on your joints: Water gives you buoyancy—i.e., you float! This decreases the impact on your joints, so when you swim or exercise in the water, you have a lower risk of injury.
  2. It does a better job at keeping you cool: Working out can cause you to overheat, especially in the summer. Exercising in the water helps the body cool off faster and reduces the risk of overheating. If the water is warm, it may not help keep you cool, but it does help increase blood circulation, which is a plus when exercising.
  3. Water has built-in resistance: Because you’re moving your body through water instead of through air, you’re working harder. This resistance is great for building all-around strength and endurance.
  4. You can adjust the resistance: Depending on your speed, position, or form in the water, the resistance you face is dynamic. For example, the more streamlined your swim stroke, the faster you’ll travel with less resistance. If you’re jogging or running in water, particularly if it goes higher than your waist, you’re getting much more resistance (this is often done if you’re training to improve your running speed, strength, and endurance when you’re on land).
  5. It gets easier over time: The more knowledge and skill you have with respect to swimming, the more efficient your body becomes when moving through the water. This translates to less energy and effort exerted, and greater speed. The good news is that the more you learn, practice, and condition your body, the easier swimming will be.
  6. You can incorporate rest: You don’t have to stop exercising in the water to give your body a rest during a workout. If you’re swimming, you can add resting strokes like sidestroke or elementary backstroke for a minute or two (or a lap or two in the pool) until you recover.
  7. You can increase intensity slowly: The benefit of swimming is that you can make gradual changes to your routine without much effort. Simply increase the time spent swimming continuously and take shorter rest breaks—or replace your breaks with rest strokes (see tip #6) as you build up your swimming regime.
  8. It’s great for keeping joints limber and toning muscles: Since exercising in the water is so low impact, your joints stay nimble. With the built-in resistance of the water, swimming is great for keeping your muscles toned.
  9. It offers support for the whole body: Not only is exercising in the water low-impact, it’s also excellent for support. Bonus: it supports your back! You don’t have to worry about the weight of your body on your spine or your posture when you move your body through water. If you’re not a swimmer, you can still use the water for gentle exercise: do some walking workouts waist-deep in a swimming pool to take the pressure off your joints and back while still getting movement.
So, take the pressure off, hit up your local beach or pool, and go for a swim! Before you take a dip, check out our safety tips on swimming both in pools and open water.
Always remember to stay hydrated when you exercise. If you’re swimming outdoors this summer, be sure to remember to be safe in the sun and heat.
Talk to your family chiropractor to find out what types of exercises are right for you.