Thursday, February 15, 2018

Preventing Falls

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

A fall causing serious injury can occur to anyone at any time.  Since most trips, slips and falls happen in and around the home, it is a good idea to fall-proof your home with the following measures:

In the Halls and on the Stairs
·        Install non-slip strips on the edge of each step.
·       Secure loose carpet.  Make sure hallways and stairs are cleared of anything that you can trip over (i.e.books, shoes, bags).
·     Replace burnt-out light bulbs so that you always see where you are going.  Night-lights in halls and stairways can also be helpful.
·        Install handrails on both sides of staircases inside and outside the home.

In the Bathroom
·         Use non-slip mats inside and outside the bathtub and shower.
·         Install grab bars next to your toilet and in the tub or shower.

In the Kitchen
·         Put commonly used items on lower shelves and cabinets so a step-stool is not needed.
·         Replace loose scatter mats with rugs that have a rubber backing.

·       Keep a shovel and covered bucket of sand or salt near the doorway in winter to safely handle slippery conditions.
·      Keep steps and pathways clear of clutter such as yard tools, snow shovels, newspapers and wet leaves.
·      Don’t juggle parcels while trying to enter the house.  Never carry more than is reasonable.  Instead, make a few trips from the car with smaller packages.

More tips
·        Quickly dry up any wet areas on the floor to prevent slipping.
·        Wear shoes with good support and non-slip soles.
·        Always sit down to put on or take off shoes and clothes.
·        Employ extra caution when using ladders and step-stools.
·    Regular exercise can help improve your strength, balance and coordination.  Making your body stronger is one of the best ways to prevent falls.  Exercises such as yoga, Tai Chi, resistance training, bicycle riding, and power walking are great examples.

The following may be especially important for older individuals:
·      Maintaining a healthy diet and not skipping meals can increase your energy and strength.  Missing meals can lead to weakness, irritability and dizziness.
·    Have your MD or pharmacist review your medications.  Some medications can cause dizziness and weakness, which can affect your balance and perception.  Make sure that your MD or pharmacist explains all of the possible side effects of your medications.

Although the risk of falling increases as you get older, there are some simple things people of all ages can do to prevent falls.  In the event that you fall and suffer a muscle or joint injury that does not subside, you should contact a licensed health professional.  For more information, visit  The author credits the Canadian Chiropractic Association (CCA) in the preparation of this educational information for use by its members and the public.

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, February 5, 2018

The Basic Characteristics Of Exercise

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

Regular exercise has long been identified as an essential element of good health.  Below is a brief summary regarding some of the basic characteristics of a balanced exercise program.

·   Cardiovascular exercise improves the body’s capacity to deliver oxygen to working muscles and organs.  It is also a great way to help lose weight and control blood sugar levels.  Swimming, interval training, cycling, jogging, and power walking are a few examples.  It is recommended that an individual engage in a minimum of 15-30 minutes of cardiovascular exercise at least three times per week.

·      Resistance or strengthening exercise enhances a muscle’s ability to contract and do work.  Strengthening exercises can vary from using fitness machines, simple dumbbells at home, rubber bands, or your own body weight.  Improving or maintaining strength is important for preserving and building bone density.  This can assist in preventing osteoporosis and decrease the risk of fracture from falls.  Strengthening exercises can also boost metabolism and help keep a healthy body weight.

·      Flexibility exercise helps to maintain a joint’s complete range of motion.  Stretching is the most familiar form of this type of exercise but it can also include activities such as Tai Chi, Pilates, and Yoga.  Individuals with arthritic conditions can find this type of exercise extremely beneficial in helping them cope with stiff and painful joints.  This type of exercise can also prepare the body for physical activity to help minimize the risk of injury.

The exercise components of intensity, duration, and frequency will influence how one progresses through an exercise program.  For example, someone performing the cardiovascular portion of their exercise program of walking will find that after a short while they are able to walk quicker (intensity), longer (duration), and 5 days a week instead of 3 (frequency).  This same person also finds that they are progressing in their resistance program because they can now lift a heavier dumbbell (intensity), 10 times instead of 6 (duration), and 4 times a week instead of 2 (frequency).  A simple explanation for all of this is that your body is learning through exercise how to adapt to these positive stresses being placed upon it.  In order to keep progressing, the body must have a new stimulus placed on it every once in a while.  Of course there are limits to this, and sometimes switching the nature of the exercise you perform can be an adequate change in stimulus, resulting in continued health benefits from exercise.

A lifetime of regular cardiovascular, resistance, and flexibility exercise is ideal, but it is never too late to start!  If you are over 35, have been sedentary for some time, or have a specific health condition or limitation, consult with a knowledgeable health care provider before beginning any new exercise program.  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.

Wednesday, January 31, 2018

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/or intensity (the total amount of effort exerted) are 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.

Sunday, January 28, 2018

Can I Move Myself Better?

By Dr. R. Greg Lusk, DC

When we experience joint, soft tissue (i.e. muscle, ligament, tendon), or nerve pain, we've become conditioned to expect an anatomical diagnosis from a healthcare practitioner, which speaks to the structural source of our pain. A low back "disc bulge", a "sacroiliac joint sprain", a "pulled muscle", and a "pinched nerve" in the neck are a few such examples. While there is value to labelling the problem as being from a specific piece of our anatomy, which aids in treating in the appropriate area and not being misled by radiating or referred symptoms, it often doesn't tell the full story. Particularly with respect to our backs and necks, it is not easy to specifically say which tissue is the pain source as our diagnostic tests are poor at selectively stressing only one type of tissue at a time. Also, imaging such as x-rays and MRIs often come back normal or have findings that may or may not be part of the problem. As a result, a vague diagnosis such as Nonspecific Mechanical Low Back Pain is very common as it is all encompassing with respect to possible mechanical sources. However, adding a functional diagnosis often clarifies the clinical picture and offers much more value to the pained individual.

What is a "functional" diagnosis? It is the process of identifying movements and/or activities (i.e. functions) that produce or aggravate symptoms, as well as those that may reduce or even abolish symptoms. Patients will often be asked about these activities in an attempt to discover consistencies. Using low back pain as an example, does bending forward, sitting, getting up from sitting, and/or washing dishes cause pain? If so, bending the spine forward (i.e. flexion) is an "intolerant" position which produces pain as it is a consistent biomechanical position in all of these activities, versus the neutral low back position where the back is relatively flat with a slight curve inward toward the belly button. Conversely, does standing, walking, and/or lying on your back make the back pain relatively better? These activities all share spine extension (i.e. bending backward) as the more dominant position, thereby making spine extension a "preferred" direction. The opposite scenario is also possible, with spine extension being aggravating while flexion is relieving, while at other times the situation isn't entirely clear. To aid your healthcare provider in determining these mechanical sensitivities it can often be helpful to keep a record, or diary, of your pain. When symptoms are present or elevated, record the activity you have been doing so the relative spine biomechanics can be deduced.

In addition to any therapies or approaches that may be provided to a patient with low back pain to help with symptoms, which includes medication(s), spinal manipulation, exercises, acupuncture, massage therapy, among many others, knowing the intolerant and preferred spinal positions plays a crucial role in recovery. It empowers the patient with information so they can stop "picking the scab" and perpetuating their pain. Furthermore, the preferred direction of spinal loading is often relieving to pain, completely resolving symptoms in some cases. Exploring spinal loading directions and sensitivities in a clinical setting can form part of the patient assessment and guides patient recommendations. Arming someone with an independent method to control and possibly remove symptoms can help expedite recovery and provides a tool for preventing recurring episodes in the future, as there is a greater appreciation for the effects of directional spinal loading.

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

Monday, January 22, 2018

Preventing Cold-Related Injuries During The Winter

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

Physical activity during the winter season can place unique demands on the body that can predispose you to injury.  The good news is there are strategies that can be employed to help prevent cold-related injuries.

Below are some of the common injuries that can occur during the winter season:

·     Soft tissue injuries including sprains, strains, and contusions.  Cold weather decreases the elasticity of soft tissues making them more prone to injury during activity.  Ligaments and muscles in the back, upper and lower extremities are commonly injured.  Falls in slippery conditions can also contribute to injury.

·     Exposure injuries include frostbite and hypothermia and occur when individuals do not wear attire that is appropriate for the weather conditions and physical activity performed.

·    Blisters can form due to the friction of wet gloves and/or wet socks with poorly fitting footwear.

·     Sun-related injuries can also occur in the winter months and cause sunburn and snow blindness.

·    Technical injuries can happen when physical activities are performed with:  inadequate technique/training; unsuitable equipment; and/or poor preparation/planning.

Below are some of the strategies that can be used to prevent cold-related injuries:

·   Warm up and prepare your body for physical activity by stimulating the joints and muscles, and increasing blood circulation.  Also consider exercise training to help prepare you for winter activity.

·     Dress for the elements by wearing insulated lightweight clothing with multiple layers.  This will allow you to add or subtract layers as needed.  Attire that is waterproof can help keep you dry and reduce the risk of heat loss.  Insulated gloves, footwear, and headgear can also help keep you warm.  Shoes and boots with solid treads and soles can help minimize the risk of awkward twisting, slips and falls.

·     Protect yourself from the sun by applying sunscreen regularly.  Your eyes should also be protected with UV blocking sunglasses.

·   Use safe snow shoveling techniques.  Get professional training and advice while learning the skills of a particular activity such as skiing or snowboarding to help minimize the chance of injury.

·      Equipment considerations may include using an ergonomic snow shovel, having sporting equipment properly fitted for your body type, or wearing a helmet during activities.

·      Preparation is critical.  For example, be aware of changes in weather forecasts that can influence safety.  Intermittent thaws and subsequent freezing can give way to ice build-up under foot increasing the risk of back twisting, slips and falls.  Coarse sand or ice salt can help give your walkways and driveways more traction.  Planning for physical activity is also important.  For instance, adequate nutrition and hydration before, during, and after activity can optimize energy levels and improve overall physical functioning.  This will help reduce fatigue and chance of injury.

Recognizing some of the common injuries that occur during the winter months and knowing which precautions to take can ensure that you enjoy physical activities safely in cold weather.  For additional information on health and wellness, 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, January 15, 2018

Understanding The Inflammatory Response

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

The inflammatory response is a natural phenomenon that enables our bodies to fend off various disease-causing organisms, harmful toxins, and physical injury.  It is a protective and restorative process that helps keep us healthy - most of the time.  Unfortunately, when inflammation becomes excessive or uncontrolled, we begin to see chronic inflammation which can lead to poor physical health.  Learn more about how the inflammatory response can affect your health.

When you catch a cold, sprain your ankle, or are exposed to an environmental pollutant such as cigarette smoke, a chain of events are triggered in your body known as the “inflammatory cascade”.  The familiar signs of normal inflammation - local redness, swelling, heat, pain, and loss of function - are the first signals that your immune system is being called into action.  Pro-inflammatory hormones are released at the injury site, which stimulates the release of white blood cells, antibodies, and other chemical compounds that help initiate the healing and repair process.  Inflammation that starts and ends as intended signifies the proper and essential inflammatory response.

Chronic inflammation occurs when there is an inflammatory response of prolonged duration (weeks, months, indefinite).  It is accompanied by simultaneous attempts at healing and repair and inevitably causes tissue damage.  Over time, it may become more difficult for the body to heal and repair tissue in areas of chronic inflammation.

Symptoms of chronic inflammation can include persistent pain, fever, fatigue, weakness, and irritability.  Chronic inflammation has also been linked to undesirable health conditions such as heart disease, diabetes, symptomatic osteoarthritis, and irritable bowel syndrome.  Listed below are some natural ways to manage and avoid chronic inflammation:

·     Use the right fuel:  Avoid foods that can be a source of chronic inflammation in the body such as refined sugars, trans fats, and allergens.  In contrast, omega-3 fats which are found in fish oils have an inflammation suppressing effect.  Anti-oxidants, found in most fruits and vegetables are natural compounds that help protect the body from harmful free radicals and inflammation.

·     Exercise works like medicine:  Endorphins released by the body during exercise can have anti-inflammatory properties.  Exercise also regulates insulin levels and body weight.  Being overweight increases inflammation in the body.  Fat cells are efficient factories for producing key inflammatory elements, and burning calories through exercise shrinks those cells.

·     Sleep and stress management:  Poor sleep quality increases body inflammation.  Regular restful sleep allows for important biological systems to recover and recharge.  Prolonged stress, whether it is emotional or physical, can be a source of chronic inflammation.  Finding an effective outlet for dealing with stress is important for managing this source of inflammation.

·     Be mindful of your habits and environment:  Avoiding exposure to pollution and toxic fumes such as cigarette smoke will help minimize inflammation in the body.

·    Treat muscle and joint injuries:  These injuries can be a major source of inflammation.  Many individuals experience the benefits of therapies such as acupuncture, massage therapy, and chiropractic care for these structural causes of pain and inflammation.

For additional information on natural inflammation management and improving your 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.

Monday, January 8, 2018

Motor Vehicle Accident (MVA) Rehabilitation

The New Hamburg Wellness Centre offers emergency access to care for individuals who have sustained injuries in a motor vehicle accident (MVA).  This access is prompt, usually within 24-48 hours during the business week, and in some cases sooner.

You do not have to see a medical doctor to start receiving treatment for a motor vehicle accident injury at our centre.   Our doctors are specially trained to assess your MVA-related injuries and prescribe the appropriate therapy.  We are capable of immediately initiating your claim and starting rehabilitation and treatment for your injuries.  Our centre is also a licensed service provider with the Financial Services Commission of Ontario (FSCO) and is able to bill your auto insurer directly for your treatments.

MVA injuries are not limited to just Whiplash injuries of the neck.  Any body part can be injured.  Our experience, examination protocol and treatment regime is specifically tailored to treating MVA-related injuries, including headaches, neck pain, mid back pain, low back pain, and soft tissue injuries.  Our unique, multi-faceted approach has successfully rehabilitated hundreds of individuals who have sustained MVA-related injuries.

Current scientific research demonstrates that those injured in a MVA recover most successfully if they remain active in their activities of daily living (ADLs).  Individuals may require treatment to help control pain, and instruction on specific exercises to help during their recovery.

Our centre has the ability to utilize a combination of the following treatment modalities to help you recover quickly and completely:

  • Rehabilitative Exercise and Physical Therapy
  • Registered Massage Therapy
  • Medical Acupuncture
  • Laser Therapy
  • Chiropractic Care
  • Active Release Therapy
  • Graston Soft Tissue Therapy
  • Electrotherapy


Q:  Do I need a referral from my insurance company or medical doctor to receive treatment for my MVA injuries?
A:  No.  Chiropractors are primary health care providers and are readily accessed.

Q:  If I undergo care, will my insurance rates increase?
A:  No.  Your rates will not increase as a result of an injury claim only.

Q:  How much will care cost?
A:  Under the present legislation there is no net out-of-pocket expense for care.

Q:  I was involved in an accident, and had little stiffness the next day, is it worthwhile to undergo care?
A:  In a number of instances there is a delayed onset of symptoms that can take weeks to show up after a seemingly innocent fender-bender.  A thorough examination by an experienced practitioner can help determine if any treatment is required.

If you have any questions that need to be addressed regarding injuries you have sustained in an MVA, please do not hesitate to contact our office.