Friday, June 23, 2017

Muscle And Joint Injury First Aid

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

Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  This can cause pain, stiffness, and swelling in a joint or muscle, leading to injuries known as sprains, strains, and contusions.  Initial conservative management and first aid of such injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation) outlined below.
 
PROTECTION:  Immobilize the injured area to protect from further injury.  This can be accomplished with the use of an elastic wrap, brace, splint or sling.  Walking aids such as crutches or a cane can be useful to help you get around.
 
REST:  To ensure proper healing, rest the injured area and avoid activities that cause pain.  Do not restrict all activities completely.  Other regions of your body can still be used.  This will help prevent physical de-conditioning.  An attempt should be made to return to regular or modified activities as soon as possible provided it does not put you at risk for further injury.
 
ICE:  Ice cubes, frozen vegetable bags, or commercial ice/gel packs are examples of cold sources that can be molded or applied to an injury site immediately.  Icing will help to reduce pain, swelling, and inflammation in the injured tissues.  Ice application should not exceed 10 to 20 minutes at a time.  Allow for skin temperature to return to normal before ice is reapplied.  This cycle can be repeated as often as necessary within the first 24 to 72 hours.  Ice should never be applied directly over the skin for a prolonged period of time as this can damage the skin.  A wet towel can safely be used as a barrier between the ice and skin and acts as an excellent conductor of cold.  Do not apply ice to blisters, open cuts, or sores.  Individuals hypersensitive to cold and those who have circulation problems should avoid ice.
 
COMPRESSION:  Compress the injured area with an elastic tensor bandage.  This will help decrease swelling.  Do not wrap the bandage too tightly as to cut off circulation.  You should not feel an increase in pain with compression.
 
ELEVATION:  Elevate the injured area (whenever possible) above the level of the heart, especially at night.  Gravity helps reduce swelling by draining excess fluid.
 
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.
 
By using the P.R.I.C.E. principle after an injury, you can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  In the event that you suffer from ongoing muscle and joint pain following an injury, you should contact a licensed health professional who can diagnose your condition and prescribe appropriate therapy, exercises, 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.

Monday, June 19, 2017

Understanding Tennis And Golfer's Elbow

By Dr. John A. Papa, DC, FCCPOR(C)
 
The elbow is a complex joint that allows movements of flexion, extension, and rotation.  Most daily activities require a combination of these actions to produce motion in the arm, forearm, wrist, and hand.  Two common elbow injuries include Tennis Elbow (TE) and Golfer's Elbow (GE).  Both of these elbow conditions can cause pain and weakness which results in functional limitations with gripping, pushing, pulling, and lifting activities of the affected arm.

Tennis Elbow (TE) is medically known as lateral epicondylitis and causes the outer part of the elbow tobecome sore and tender.  This typically affects the muscles and tendons that extend the fingers and wrist, and roll the forearm outwards.

Golfer's Elbow (GE) is medically known as medial epicondylitis and causes the inner part of the elbow to become sore and tender.  This typically affects the muscles and tendons that flex the fingers and wrist, and roll the forearm inwards.

TE and GE can affect anyone involved in activities that require rapid and/or repetitive motion of muscles and joints in the forearm, wrist, and hand.  It is more likely to happen if these movements are combined with awkward posture(s), excessive force, poor technique, and using the wrong equipment or tool.  Occasionally, a direct blow to the elbow may be a causative factor.  Physical deconditioning can also make individuals susceptible to these conditions.

As a result, TE and GE can affect a broad variety of people including:  trade workers such as electricians, painters, and carpenters; recreational athletes such as tennis players and golfers; and labourers such as cleaners and assembly line workers.  Computer use, and even hobbies like gardening and knitting can be associated with TE and GE.

It is important to establish an accurate diagnosis of TE or GE.  This can be accomplished by performing a proper medical history, along with a physical examination.  Other causes of elbow pain may include: fractures, bursitis, arthritis, sprains, nerve irritation, or referred pain from the neck and/or shoulder region. 

Chiropractors are healthcare professionals skilled in diagnosing and treating muscle and joint conditions such as TE and GE.  Initially, relative rest and altering or eliminating the conditions that contributed to the injury is important.  This may include making changes to a work station, using the correct tools/equipment, and taking breaks to relax overworked muscles and joints.  Treatment options include laser therapy, acupuncture, electrotherapy, taping, bracing, specialized soft tissue therapy, and manual joint mobilization.  In addition, a comprehensive rehabilitation program should also include stretching and strengthening exercises that target the muscles of the forearm, upper arm, shoulder and upper back.

If elbow pain is keeping you away from your favourite activities, consider chiropractic care.  A chiropractor will assess your symptoms, diagnose your condition, and recommend a treatment plan to put you on the road to recovery.  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, June 14, 2017

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.

Tuesday, June 6, 2017

Common Back Pain Myths

By Dr. John A. Papa, DC, FCCPOR(C)
 
80% of all Canadians will suffer from at least one significant episode of back pain in their lives.  Below are some of the common myths surrounding back pain and what modern science has to say about them.
 
Myth 1:  If you’ve injured a disc (i.e. herniation, rupture), you must have surgery.
Truth:  Surgery to relieve back pain should only be used as a last resort.  Even if specific testing reveals a damaged disc, recovery often results without surgery.  An injured disc in the back may become inflamed and put pressure on nerves and surrounding pain sensitive structures.  Non-surgical treatment aims at minimizing pain and discomfort from joint irritation and muscle spasm, and prescribing specific exercises to help with recovery.
 
Myth 2:  Most back pain is caused by injuries or heavy lifting.
Truth:  Injuries caused by heavy lifting do not account for all back pain.  In up to 85% of cases, individuals can’t recall a specific incident that brought on their back pain.  Back pain can result from a single exposure to a bending or twisting incident or it can be small cumulative loads placed on the spine over time.  Scientific research also links the following risk factors to back pain: smoking, being overweight, poor posture, poor physical fitness, and stressful life events.
 
Myth 3:  X-ray images, CT and MRI scans can always identify the cause of pain.
Truth:  Even the best imaging tests cannot identify a muscle spasm or ligament sprain that may be the cause of pain.  Imaging is usually reserved for special cases such as those suffering trauma in a fall or accident, surgical candidates, unresolved cases of severe chronic back pain, and suspicion of underlying tumor, infection or other serious disease.
 
Myth 4:  If your back hurts, you should take it easy until the pain goes away.  Bed rest is the mainstay of therapy. 
Truth:  Clinical data indicates that individuals who remain active do better than those who try bed rest.  Remaining active means continuing with daily activities as tolerated and easing back into a regular routine.  Activities may have to be modified while recovery occurs, but movement is important for recovery provided it does not put the individual at risk for further injury.

 
Myth 5:  Diagnosing back pain is simple and straightforward.
Truth:  The causes of back pain can be complex and difficult to diagnose.  There are many biological tissues that can generate pain in the back.  These may include muscles, ligaments, bones, nerves, and joints.  Quite often it is a combination of several or all of these structures that can manifest into back pain, and potentially radiating pain into the buttock or leg regions.  Sometimes stress and depression can also contribute to back pain.  A licensed health practitioner who deals with back pain is best trained to diagnose the source(s) of your problem and prescribe appropriate therapy when required.  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 30, 2017

How to Choose The Right Mattress

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

Choosing the right mattress can go a long way in determining the quality of your sleep.  Using a mattress that does not provide adequate support and comfort can also be a significant source of muscle and joint pain, especially in the shoulder, back, and hip regions.

The right mattress is usually defined as any mattress that helps a person sleep well, so that they wake up feeling rested and without pain and stiffness.  However, there is no single best mattress for everyone as there are a variety of factors that go into choosing the right mattress.

Below are some useful tips that can help you find the mattress that's right for you:

·        Consider how your mattress is made.  Mattress support is determined by the internal architecture of the mattress.  This can include innerspring coil mattresses (most common), memory foam, latex, and air mattresses.  Each offer different degrees of support and comfort.  Some manufacturers also include additional padding on top of the mattress for extra comfort, but this may not be necessary for all individuals.
 
·        Sleep experts recommend replacing your mattress on average every 8-10 years or sooner.  Look for visible sagging and/or material breakdown as a sign to replace your mattress.  Over time, mattresses collect dust mites and other germs that can exacerbate allergies and impact sleep.  In addition, our bodies change over time and an old mattress that had originally been comfortable may no longer be providing the comfort and support it once did.
 
·        Your physical health and your mattress.  Sleeping with painful conditions such as osteoarthritis, hip bursitis, and degenerative disc disease can be minimized by choosing the right mattress.  You can also incorporate additional sleep positioning tips to get the most comfort out of your mattress.

·        Try before you buy.  Lay on a variety of mattresses (i.e. firm, medium, pillow top) for at least 10-15 minutes in several simulated sleep positions to get a sense of how the mattress feels.
 
·        Shop at stores that specialize in mattresses.  These stores will offer a diverse range of choices and other important factors such as manufacturer and comfort warranties.
 
·        The right mattress achieves a balance between comfort and support.  A mattress that is too firm may cause pain in pressure points such as the hips.  A mattress that is too soft may not offer enough support and cause pain and stiffness.  Most people do well with a medium-firm mattress.  However, at the end of the day, a person's overall comfort level will determine which mattress is right for them.

If you experience muscle and joint pain that is causing difficulty with your sleep, 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.

Friday, May 26, 2017

4 Exercises To Relieve Your New-Mom Backache

Ontario Chiropractic Association (OCA)


Now that you’re a new mom, you may have more important things to worry about than your newfound back pain but ignoring it will not make your mommy duties any easier. The already demanding tasks of bending, carrying and feeding are even more challenging when your backache is holding you back.


While carrying your bundle of joy for nine months, your abdominal muscles have stretched to make room for delivery. This is a common cause of back pain in new moms because your back muscles now have to work overtime to support your spine and keep you upright.
 
Here are 4 core exercises you can do with your little one to help decrease the ache.

Pelvic Bridges
  • Lie on your back, bend your knees and put your feet flat on the ground.
  • Place your baby on your pelvis with their back against your thighs.
  • While holding your baby in place, slowly push your hips up towards the ceiling.
  • Hold this position for 3 to 5 seconds.
  • Keep your abdominals tight to avoid sagging your lower back. Inhale as you slowly lower your body back to the starting position.
  • Repeat 8 to 12 times.

Plank
  • Lay your baby on the ground, face up, while kneeling in front of them.
  • Place your forearms on either side of your baby and lift your body off the ground.
  • Keep your back in neutral spine position and engage your core by contracting your abdominal muscles. Avoid letting your hips fall or stick up in the air.
  • Hold for 10 seconds, working your way up to 30 seconds.
  • Repeat 3 to 5 times.

Stabilizer
  • Laying on your back, bend your knees at a 90 degree angle with your feet in the air.
  • Stabilize your baby so they are resting on your shins and hold onto their hands.
  • Engage your core and hold this position for 10 seconds, working your way up to 30 seconds.
  • Repeat 8 to 12 times.

Arm & Leg Extensions
  • Get down on all fours with your baby lying on their back and parallel to your chest.
  • Engage your core and slowly lift and extend your left arm and right leg at the same time while maintaining a neutral spine position.
  • Hold this position for 3 seconds, then lower your limbs and give your baby’s belly a tickle as you return to starting position.
  • Repeat on the opposite side, lifting right arm and left leg.
  • Repeat 8 to 12 times.

Before getting back to business, consult your postnatal practitioner and get cleared to return to exercise. You’ll also want to make sure that your newborn can hold their head up on their own if you’re going to include them in these exercises. If your back pain prevents you from performing these exercises or persists after trying them, visit your chiropractor to develop a treatment plan for your recovery.


 

Thursday, May 18, 2017

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.