Wednesday, June 20, 2018

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 www.nhwc.ca.

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.

Thursday, June 14, 2018

Hip Pain And Prevention


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

Hip pain often limits physical activities such as walking, running, squatting, and going up and down stairs.  It can also create problems with sleeping and sitting positions.

Depending on what the source of the hip pain is, symptoms can be felt in a number of  different regions which may include:  the low back, deep in the hip joint, on the outer aspect of the hip, in the groin, at the front of the thigh, and in the buttocks.  Listed below are some of the conditions that commonly cause hip pain:

·     Osteoarthritis results from the protective layers of cartilage in the hip becoming worn over a period of time, leading to change in the composition of the bone underneath the cartilage.

·      Osteoporosis is a disease of bones that decreases bone mass and strength, making them more fragile and susceptible to fracture.  Hip fractures usually occur in older individuals after a fall injury.

·     Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  Ligament injuries (sprains) can occur when these structures become over-stretched or torn, often during activities where there is a direct blow to the hip or there is an awkward fall or twisting motion involving the hip.

·     Tendons are strong tissues that anchor muscles to bones, and these structures can become over-stretched or inflamed around the hip joint leading to tendonitis and muscular strains.

·       Bursitis can involve several fluid-filled structures in your hip that help provide more cushioning in the joint.  Repetitive hip strain and blunt trauma to the hip bursa are two common causes of bursitis.

·     Injuries and conditions in the low back can radiate symptoms into the hip region.  This includes things such as osteoarthritis, sprains and strains, disc herniations, sciatica, and spinal stenosis.

Below are some useful tips that can help individuals avoid or minimize the chance of hip pain and injury:

1.      Maintain a healthy bodyweight to decrease the overall stress on your hips.

2.    Wear appropriate footwear that supports your activities and helps maintain proper leg alignment and balance.

3.      Prepare your hips for physical activity by stimulating the joints and muscles, and increasing circulation.  This can be accomplished with a quick cardiovascular warm-up and gentle stretching of the muscles in the hips, thighs and lower legs.

4.  Choose activities that are "hip friendly" for you.  This may include low impact activities such as swimming, walking or cycling.  Remember to start slowly and build up the intensity gradually.

5.   Strength, balance, flexibility, and core exercises can train your body to better support your hips and avoid injuries.

If you have hip pain that limits your daily functioning, you should contact a licensed health professional who deals in the diagnosis and treatment of hip pain.  For additional information on hip pain and treatment of muscle and joint injuries, visit www.nhwc.ca.

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, June 4, 2018

Solutions for Overcoming Poor Sitting Posture


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

An ideal posture allows an individual to maintain an efficient, strong, and balanced position while interacting and adapting to their physical environment.  Good postural habits can help decrease abnormal and excessive physical strain on the body, thereby minimizing the chance of injury.

Unfortunately, modern technology has significantly influenced our daily postural habits, which has resulted in having people sit more often and for longer periods of time.  Individuals exposed to these sitting positions may adopt a poor posture that includes losing the natural hollow of the low back, rounding or slouching of the upper back and shoulders, and a forward head poking position.

Less than ideal posture puts cumulative compression, stretch, and shear forces on the body.  The cumulative effects of sitting are often offset by the body’s ability to compensate.  However, even in the absence of pain, these compensatory changes may begin a vicious cycle of unbalanced motion, muscle and joint stress, and secondary areas of discomfort.  As a result, the physical consequences of chronic poor posture can lead to symptoms such as muscle and joint stiffness, nerve pain, headaches, shoulder pain, neck pain, upper and lower back pain.

Listed below are some potential solutions that can minimize the chance of postural injury, specifically as it pertains to the sitting position:

1.    Pay attention to how you sit by making sure weight is evenly distributed in 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.

2.   Take a break from sitting with 10 to 30 second stretch or posture breaks every 20 to 40 minutes.  Some activities such as computer work, talking on the phone, and business meetings can also be done while standing.

3. The use of a properly designed workstation (i.e. adjustable chair and desk), along with ergonomic tools and assistive devices (i.e. speakerphones, foot stools, lumbar supports) can help maintain mechanically advantageous positions while working in a seated position.

4.    Avoid unnatural positions such as looking down, awkward twisting, or slouching for long periods of time as this can cause unnecessary strain.  A simple solution may be to bring your smartphone, tablet, or book closer to eye level, or adjusting your seat position to help you maintain a more natural/neutral position.

5.    Engaging in regular physical activity and exercise can keep your body strong and help overcome the effects of cumulative strain associated with poor posture.  Exercise activities can include general cardiovascular conditioning, along with postural, stretching and strengthening exercises for the neck, shoulders, upper and lower back regions.

Prolonged sitting and poor posture can undeniably cause real physical change and breakdown in the body.  If you have ongoing pain as a result of postural strain, you should contact a licensed health professional who deals in the diagnosis and treatment of these conditions.  For more information visit www.nhwc.ca.

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, May 30, 2018

Common Conditions Of The Shoulder Joint


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

The shoulder is one of the largest and most complex joints in the body.  It is anatomically designed to allow for an individual to perform a wide range of movements and activities.  This versatility, along with the high physical demands placed on a shoulder can also make it vulnerable to breakdown and injury.

Listed below are some of the conditions that commonly cause shoulder problems:

·  Osteoarthritis: Results from the protective layers of cartilage in the shoulder becoming worn over a period of time, leading to change in the composition of the bone underneath the cartilage. This process may also be related to previous injury/trauma to the shoulder joint.

·   Frozen Shoulder:  Also known as adhesive capsulitis, this condition is a painful and persistent stiffness in the shoulder.  It is believed to be caused by thickening, swelling, and tightening of the flexible tissue that surrounds the joint.  Symptoms can vary greatly and can last anywhere from several months to several years.

·     Rotator Cuff and Soft Tissue Injuries:  The rotator cuff is a group of muscles and tendons that provide stability and rotational movements of the shoulder joint in a balanced fashion.  Other shoulder muscles are responsible for different ranges of motion of the upper arm (humerus) and proper positioning and movement of the shoulder blade (scapula) along the ribcage.  An injury can occur to any of these muscles which can lead to shoulder problems.

·      Mechanical Conditions:  Scapular dyskinesis is a mechanical term used to describe irregular movement of the shoulder blade.  It can be an early sign that a shoulder problem may develop, or it may already be accompanied by pain or dysfunction in the shoulder.  A mechanical change in shoulder blade movement can be associated with a variety of problems including an internal pinching of soft-tissue structures (impingement), irritation of the cushioning bursa (bursitis), or a feeling of the shoulder dislocating with certain movements (instability).

·      Traumatic Injuries:  Vigorous lifting, pushing, and pulling activities, or a fall onto or blow to the shoulder can result in ligament sprains or muscle strains.  More significant injuries can result in shoulder dislocations and separations, rotator cuff and soft tissue tears, cartilage labral tears, and fracture.

Balanced and stable movements are key to a healthy shoulder.  If this does not occur, there is potential for many shoulder problems to exist simultaneously at any given time.  For example, an individual may strain their shoulder from heavy lifting.  The shoulder strain may be causing pain, but it can also be accompanied by pain and weakness from impingement and bursitis that may arise from the irregular movement pattern of the shoulder.  Therefore, it is important that a proper evaluation is performed to best guide the treatment of shoulder conditions.

If you suffer from a shoulder problem that is limiting your daily functioning, contact a qualified health professional who can prescribe appropriate therapy, rehabilitation, and self-management strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

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, May 28, 2018

Safe Gardening Tips To Prevent Injury


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


Spring is upon us and so is the arrival of the gardening season.  Raking, lifting, digging, and planting can be strenuous activities.  Below are some simple tips that can help you avoid and prevent injury during the gardening season.

1.  Prepare your body for physical activity with a warm-up.  Climbing stairs, marching on the spot, or going for a quick walk around the block are examples of excellent warm-up activities that can completed in as little as five to ten minutes.  Follow this with some gentle stretch exercises such as knee to chest, shoulder, forearm and wrist stretches.  Your muscles and joints will appreciate this prior to being asked to do work.

2.    Use the right tools for the tasks to be performed.  Always make sure that tools are a comfortable weight and size for you.  There are many ergonomically designed tools which are lightweight, with long padded handles and spring action mechanisms that can reduce strain and effort.  Carts and wheelbarrows minimize the need for lifting and carrying, reducing your risk of physical injury.

3.    Proper lifting means bend the knees, keep the back straight and brace!  Use your leg and arm muscles to do the lifting while keeping your back straight.  Maintaining the natural and neutral curves of your back is important, as this is its strongest and most secure position.  Contracting and bracing your abdominal muscles during lifting improves spinal stability and decreases the chance of injury.  Avoid twisting and turning by positioning yourself accordingly.  Be sure to lift slowly and smoothly with the load close to your body and do not jerk with your lifts.

4. Alternate activities and change positions.  Once you begin, take turns alternating between heavy chores such as digging, and lighter less physically demanding tasks such as planting, every 10 to 15 minutes.  Avoid prolonged working postures.  Changing hands frequently when you rake, hoe or dig prevents muscle strain and joint stress on one side of the body.

5.   Drink plenty of water before, during and after gardening activity.  Dehydration affects your energy level and physical functioning.  Staying hydrated decreases the risks of cramps and strains, and helps to protect joints by providing lubrication and cushioning.

6.    Preparing for the elements and pacing.  Select comfortable, thick-soled, protective shoes that support your arches to reduce joint pain and aching muscles.  To protect from sun exposure, apply sunscreen, and wear a wide-brim hat.  Wear loose and comfortable clothing.  Work at a safe pace and know your physical limits.  Stop gardening immediately if you feel chest pain or persistent muscle or joint pain.

In the event that you suffer a muscle or joint injury while gardening that does not subside, you should contact a licensed health professional who deals in the diagnosis and treatment of these injuries.  For more information, visit www.nhwc.ca.

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, May 22, 2018

What Does It Mean To Have Degenerative Joint Changes?


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


Have you had a joint problem and been told that you have "degeneration" or "degenerative changes"?  What exactly does this mean?  Is this something that can be fixed?  Let's take a closer look at two common types of degenerative changes and some potential management strategies that can be employed.

1.    Degenerative Joint Disease (DJD) is also known as osteoarthritis, and is the most common form of arthritis.  Weight-bearing joints such as the hips and knees are most commonly affected, but DJD can affect any area of the body, including the hands, neck, and low back.

Most joints in our body have smooth cartilage surfaces that glide against each other, which allow two or more opposing bones to move freely and perform a specific set of movements.  A joint becomes "degenerated" or arthritic when there is wearing down of these cartilage surfaces, and a change in the composition of the bone underneath the cartilage occurs.  An arthritic joint does not mechanically function like it is supposed to.  This may result in a number of symptoms including:  muscle tightness and weakness, joint pain and stiffness, decreased ranges of motion, creaking in the joints, swelling, inflammation, and joint thickening (i.e. finger nodules, bunions).


2.  Degenerative Disc Disease (DDD) specifically affects the spinal discs between each vertebrae and is also considered an arthritic disorder.  Spinal discs allow for some movement between vertebrae, and they also absorb compressive, tensile, and shearing loads with everyday activities.

      The centre of the disc, called the nucleus pulposis, is jelly-like and mostly made up of water. The outside of the disc, called the annulus fibrosis, is tough and thick and contains the nucleus pulposis.  Over time, the water content of the spinal disc diminishes, causing it to dry out and become fibrotic (tough and brittle).  As the disc becomes fibrotic it can develop tears.  This breakdown can result in disc herniations, the development of bony spurs, and sciatica.

Risk factors/causes for DJD and DDD are typically multi-factorial, meaning that there is usually no single cause, but rather a combination of several different factors.  These risk factors/causes may include but are not limited to: advancing age, genetic predisposition, mechanical overload from occupational and recreational activities, direct injury to the affected region, cigarette smoking, lack of exercise, and being overweight or obese.

Degenerative changes can result in debilitating symptoms for some individuals and can be managed a number of ways.  Maintaining an ideal body weight through a healthy diet and regular exercise consisting of strength, flexibility, and endurance training can reduce the risk of pain and subsequent disability.  Treatment from licensed health professionals who utilize manual mobilization therapies, soft tissue therapy, electrotherapy, acupuncture, exercise and rehabilitation strategies can also significantly help to decrease pain by restoring normal muscle and joint motion, and promote healing of arthritic or injured areas.

In the event that you suffer from degenerative joint changes, you should contact a licensed health professional who deals in the diagnosis and treatment of these conditions.  For more information, visit www.nhwc.ca.

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.