Thursday, November 27, 2014

Treatment & Prevention Of Whiplash Injuries

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

The unique forces generated during a motor vehicle collision (MVC) cause more than 100,000 whiplash cases in Canada each year.  This article will specifically focus on the treatment and prevention of whiplash injuries.

The term WAD (Whiplash Associated Disorder) is used to describe a range of injuries that can be attributed to whiplash.  This may include:  neck pain, whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.

WAD Grades 1 and 2 represent the majority of whiplash cases and are amendable to conservative management.  Early treatment and consultation can greatly improve the recovery process and prevent future complications and chronic pain.  Effective treatment strategies may include: pain controlling modalities such as electrotherapy and acupuncture to help facilitate and promote activity and functioning; manual and soft tissue therapy to assist in the healing of injured tissues; education on how to safely re-integrate into activities of daily living; and rehabilitative exercises that may include range of motion, flexibility, strengthening, and balance/coordination training.  An independent home exercise program should also be provided.

The goal of treatment is to get the injured individual back on their feet and up to their normal level of activity.  The majority of people with WAD Grades 1 and 2 experience no significant disruption to their normal activities of daily living.  Some may experience a temporary disruption to their normal activities, but usually improve after a few days or weeks.  Occasionally, symptoms may persist over a longer period of time.  A return to normal activities of daily living may be assisted by active treatment and rehabilitative exercise prescription as described above.

Included below are some tips that may help prevent a MVC and/or whiplash injury (courtesy of the Alberta College and Association of Chiropractors):

1.    Drive defensively.  Always anticipate the actions of other drivers.

2.    Wear your seatbelt at all times.
 
3.    Make sure your headrest is positioned properly, that is, the top of the headrest should be no lower than the top of your ear.  If more than one driver uses the car, remind each other to always check the headrest height.

4.    Never operate cell phones or other electronic equipment while driving.

5.    When road conditions are poor (i.e. icy, wet, dark, or crowded), slow down accordingly.

6.    Be sure your car is always in good working order, particularly your brakes, tail lights, headlights, and directional signals.

7.    Engage in regular physical activity consisting of cardiovascular, strength, and flexibility training.  This will help keep your body strong and offer some protection in the event your are involved in a MVC.

If a whiplash injury is interfering with your activities of daily living, consider chiropractic care.  A chiropractor can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for you.  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, November 26, 2014

Understanding Whiplash Injuries

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

Whiplash is a common injury that can be experienced following a motor vehicle collision (MVC).  There are more than 100,000 whiplash cases in Canada each year.  The unique forces generated during these collisions can stress biological tissues and result in pain and decreased functioning for those affected.  This article provides a review of whiplash specifically focusing on the mechanics of injury, the associated symptoms, and general guidelines for the evaluation of any accompanying injuries.

Although rear-end collisions are the most commonly reported mechanism of whiplash injury, an injury may also occur following side and head-on collisions.  The forces generated from these types of impacts thrust the head (and to a lesser extent the entire body) back and forth, much like a snapping whip.  Injury results because the body is unable to compensate adequately for the speed of head and torso movement from the acceleration forces generated at the time of impact.  This will put stretch, compressive and shear stresses on biological tissues such as muscles, ligaments, joints and nerves.  As a result, this can generate pain symptoms, and affect range of motion, strength, coordination, and balance.  The onset of whiplash symptoms may immediately follow a MVC or may gradually develop over the first 24-72 hours.  A later onset of symptoms does not necessarily indicate a more serious injury.

Neck pain is frequently associated with whiplash injuries.  However, the whiplash mechanism may also cause injury and symptoms that include: whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.
 The term WAD (Whiplash Associated Disorder) encompasses all of these potential symptoms and is commonly used to grade the degree of injury present.  Of the four Grades of WAD, Grades 1 and 2 represent the majority of whiplash cases.

Evaluation of whiplash injuries should include a proper medical history, along with a physical examination consisting of inspection, palpation for tenderness, range of motion, strength, neurological, orthopaedic and functional testing.  Signs of serious injury, such as fracture, are usually evident in early assessments and may require further diagnostic testing such as x-ray, CT scan, or MRI.  Chiropractors are healthcare professionals skilled in the diagnosis and treatment of whiplash injuries and are commonly involved in the management of WAD.

When an individual sustains a whiplash injury, injured tissues can become stiff and weak when they are not used, which can further exacerbate pain symptoms.  Therefore, a return to daily activities after whiplash injury is extremely important for successful healing as extended rest may prolong recovery.  Healing and a return to daily activities may be facilitated with active treatment and rehabilitative exercise prescription.  Join us tomorrow when we specifically take a closer look at the treatment and prevention of whiplash 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.


 

Monday, November 24, 2014

Straighten Up Canada! The Importance of Good Posture for Spine Health

Canadian Chiropractic Association



Do you remember being nagged as a child to sit up straight at school or the dinner table? Do you still find yourself slouching at your computer or bending your head forward for long periods while using electronic devices? Canada’s chiropractors want you to Straighten Up! Good posture helps to prevent backache and muscular pain, allows your body to use less energy for daily tasks, helps to decrease wear on joints and prevent arthritis, and increases the flexibility and stress tolerance of your spine. Good posture also makes you look and feel great.

What are some examples of poor posture?

Hollow back occurs when the natural curve of your lower back is increased, also called hyperlordosis. When your lower back is arched, it causes your ribcage to protrude and forces your pelvis out of the neutral position, causing your tailbone to point backwards. When these bones are out of alignment, it weakens your abdominal muscles, your hip flexors and your hamstrings. All this together may lead to uneven distribution of pressure on the vertebral discs.
 
Hollow back can lead to low back pain, deconditioned and weak muscles in the back and abdomen, and other musculoskeletal conditions, such as knee pain.
 
Perhaps you are very aware of your posture and work hard to stand straight and tall. Be careful! Good posture shouldn’t be hard work. If you are standing “at attention” all the time (hypokyphosis), your head may protrude and your shoulder blades may tend to be forward and tilted. As well, this posture increases the natural curve of your lower back, pushes your hips forward, and probably causes you to stand with your knees “locked” or slightly hyperextended. This will weaken your abdominals and hamstrings and shorten your hip flexors, causing them to feel tight.
 
Hypokyphosis can result in low back pain, thoracic (mid-back) pain and possibly hip and knee pain.
 
So, remember to stand tall (but not too tall!). Keep your spine neutral and abdomen braced – imagine tensing and stiffening your abdomen to prepare for an incoming impact. Don’t lock your knees – keep them slightly bent and make sure you wear good quality shoes if you are on your feet a lot. It will probably feel awkward at first, but your body will adapt and soon it will be second nature to look and feel great!

Wednesday, November 19, 2014

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 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.

Sunday, November 16, 2014

Chiropractic Care to Treat & Prevent Sports Injuries

Canadian Chiropractic Association

 
Often we hear of professional athletes suffering a traumatic, possibly career ending, injury. The public debate on whether or not they can resume play can go on for weeks. However, it isn’t only the professionals that sustain injuries while practising the sport they love. Weekend warriors, amateur athletes and those living active lives also run the risk of getting hurt. Most of the time, with a proper warm up, awareness to form and appropriate equipment, athletes of all stripes are able to play safely. Yet, injuries can happen when you least expect it due to an accident or even an underlying condition that may necessitate treatment.
 
According to Statistics Canada, a 2010 community health survey showed that 66% of adolescent injuries were related to sports. Also, among working-age adults, sports and work were the main source of injuries (47%).
 
How Do Sports Injuries Happen?
Sports and exercise are great ways to keep healthy, but there are often risks involved. Most often, excessive training, inappropriate training methods or perilous exercise equipment can be a cause of injury, but structural abnormalities and muscle imbalances/weakness can also be culprits leading to injury, including the ankles, knees, elbows, shoulder or spine.
 
Commonly, sports injuries are caused by traumatic force to a joint in motion causing hyperextension or hyperflexion. One such injury is a torn Anterior Cruciate Ligament which results from a quick deceleration, hyperextension or rotation of the knee joint that may or may not involve contact with another person. Such injury, and others, may cause significant pain and debilitation taking you away from the sports that you enjoy. Chiropractors, as MSK experts, can help prevent and manage sports-related injuries. Click here to explore specific sports injuries treated by chiropractors.
 
Chiropractic Treatment for Sports Injuries
In Canada, chiropractic has a long and vibrant history of treating recreational and professional athletes. To further their expertise in treating sports injuries and enhancing athletic performance, Doctors of Chiropractic can complete a two-year post-graduate residency program or Master’s that will enable them, upon successful completion of the exam, to qualify for the sports specialists (CCSS) from the Royal College of Chiropractic Sports Medicine.
 
Chiropractors are trained to assess, diagnose and manage sports-related injuries as part of their core competencies. In fact, through a comprehensive history and physical examination, chiropractors can help determine the cause of pain and dysfunction as well as recommend an appropriate plan of management. Conservative care offered by chiropractors, dependent on the injury and mechanism, may include joint manipulation and mobilisation, soft tissue therapies, adjunct modalities, rehabilitation and individualized exercises and lifestyle advice to restore proper function, enhance healing of damaged tissue and reduce pain. Chiropractors can also help, in partnership, determine the best strategy to return to play.
 
Preventing Sports Injuries
Injury prevention is key. Before starting a new exercise program or sport, visit your chiropractor to determine what measures can be taken to prevent injury or enhance performance. Click here to find a chiropractor near you.

Thursday, November 13, 2014

The Chiropractic Patient Experience

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

In last week's article “An Introduction to Chiropractic Care”, we specifically focused on the training and education of chiropractors, regulation of chiropractic, and the scope of chiropractic care.  This article will focus on the chiropractic patient experience written specifically from the author’s perspective of what patients experience at his private practice.  Individual chiropractic experiences may vary in different chiropractic settings dependent on practitioner interests, experience, education, and training.

Chiropractors provide diagnosis, treatment and management of disorders arising from the musculoskeletal system (joints, muscles, tendons, nerves, and bones), such as back pain and neck pain.  Before any treatment is commenced on a prospective chiropractic patient, there are several steps that are taken to ensure the case is one that can be helped with chiropractic care.

First, a thorough Medical History is taken which documents an individual's specific complaint and may also include questions concerning past surgeries and illnesses, medication use, general and family health history.  Second, a Physical Examination is performed consisting of orthopedic, neurological, and range of motion testing.  X-rays may also be ordered to help determine the source of pain or dysfunction.  Third, a Diagnosis and Prognosis is provided to the patient to let them know if their complaint(s) can benefit from chiropractic care.  If the complaint will not benefit from chiropractic care, a referral is made to the appropriate health discipline.

For all complaints that may benefit from chiropractic care, a proposed treatment plan is communicated to the patient, including type of treatment and duration.  Factors taken into consideration when developing a treatment plan for a particular individual include age, sex, severity and duration of complaint, lifestyle and environmental factors, physical health and fitness, medication use, and any other relevant health conditions.  In addition, factors relating to patient concerns and preferences are also taken into account, because patients always have a choice as to the type of care they wish to receive.
 
Chiropractors are trained to offer multi-modal physical therapy incorporating the use of different techniques commonly employed in combination with each other to decrease pain, stimulate healing, and restore overall function.  Chiropractic adjustments and mobilizations are just one mode of therapy utilized by chiropractors (but not with every patient), to restore normal motion and functioning in joints.  Soft tissue therapy is used to alleviate muscle spasm, decrease scar tissue, and increase pain free ranges of motion.  Electrotherapy involves the application of relaxing therapeutic electrical current or sound waves to the area of injury, dysfunction, or pain (i.e. TENS, interferential current, ultrasound).  Acupuncture can be used to promote healing, decrease pain, and control inflammation.  Rehabilitative exercise prescription may also be used to improve balance, coordination, strength, flexibility, and posture.

Contemporary chiropractic care provides many options for prospective and current patients seeking effective and safe therapy for their musculoskeletal complaints.  Additional chiropractic resources can be found at:  (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).

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, November 7, 2014

An Introduction To Chiropractic Care

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

Chiropractic is one of the largest primary contact health professions in Canada.  Approximately four and a half million Canadians use the services of a chiropractor each year.  Despite the professions growing popularity, there are still many in the public who don’t exactly know what services a chiropractor performs or what qualifications and training they possess.  This article is the first of a two part series introducing the chiropractic health discipline and the profession’s role in the health care system.

A large majority of patients who seek chiropractic care do so for complaints of the musculoskeletal system (joints, muscles, tendons, nerves and bones).  Chiropractors provide diagnosis, treatment and management of these complaints which may include but are not limited to:  back pain, neck pain, sciatica, whiplash, osteoarthritis, migraine and tension headaches, upper and lower extremity complaints, along with repetitive strain, sport, work and motor vehicle injuries.

Chiropractic practitioners undergo a rigorous course of study similar to that of other health professionals.  Training involves a minimum of three years undergraduate university education, followed by another four years of intensive academic and clinical education at an accredited chiropractic college.  Becoming licensed to practice chiropractic requires all eligible candidates to pass national and provincial examinations before applying to the Licensing Board.  Specialized post-graduate training enables the chiropractors of today to offer their patients additional treatment options.
 
Chiropractic in Canada is regulated by provincial statute in all provinces (The Chiropractic Act, 1991), created in accordance with the Regulated Health Professions Act (RHPA, 1991).  Chiropractors along with medical doctors, dentists, psychologists, and optometrists have the legislated right and obligation to communicate a diagnosis and to use the title doctor.  The College of Chiropractors of Ontario, like the colleges in each of the other provinces, is similar to the regulatory bodies for other health professions.  It is responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.
 
Chiropractic is well recognized within the health care system.  Chiropractic care is covered by the Workplace Safety and Insurance Board (WSIB) for occupational injuries, by automobile insurance in the event of a motor vehicle accident (MVA) injury, and by many Extended Health Care (EHC) plans.  A medical referral is not necessary to access chiropractic care.  Chiropractic adjustments are just one mode of therapy utilized by chiropractors today (but not with every patient).  Some chiropractors are also trained to employ other forms of physical therapy such as acupuncture, electrotherapy, soft tissue therapy, and rehabilitative exercises.  If your complaint is not something that would respond favorably to chiropractic care, a referral is made to the appropriate health professional.

Additional chiropractic resources can be found at: (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).  Join us next week for the second part of this series on chiropractic where you will learn about the chiropractic experience from a patient’s perspective.

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, November 3, 2014

Winner!

 
THANK YOU
 
FROM THE NEW HAMBURG WELLNESS CENTRE TEAM!
 
 
 
 
 
 
We sincerely appreciate your votes and support for the 2014 Record Readers' Choice Awards.
 
New Hamburg Wellness Centre was awarded the following:
 
·               Favourite Alternative Medicine Clinic - DIAMOND
 
 
·               Favourite Chiropractic Clinic - PLATINUM

·               Favourite Massage Therapy Clinic - PLATINUM
 
 
Come visit us at 338 Waterloo Street, Unit 9 in New Hamburg.
New patients are always welcome.
519-662-4441