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 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, 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 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, 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 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, 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 www.nhwc.ca.  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.

Thursday, July 13, 2017

Heel Fat Pad Syndrome

By Dr. John A. Papa, DC, FCCPOR(C)
 
Heel Fat Pad Syndrome (HFPS) refers to damage or disruption of the fatty pad that sits under our heel bone (calcaneous).  This structure is approximately one inch thick and is made up of fatty tissue enclosed by ligamentous chambers.  The purpose of this structure is to absorb shock and cushion the heel bone.  If the fat pad is displaced or thins, then its ability to protect the heel bone from impact is decreased, which can result in heel pain.
 
HFPS is commonly misdiagnosed as plantar fasciitis.  Plantar fasciitis symptoms tend to be located towards the inner front portion of the heel and can extend into the arch of the foot, whereas symptoms of HFPS are characteristically located in the centre of the heel and described as a deep, dull ache that feels like a bruise.  Other symptoms characteristic of HFPS include central heel pain that is aggravated by prolonged periods of standing and barefoot walking on hard surfaces.  It is also possible to have both plantar fasciitis and HFPS present at the same time.
 
There are several factors that can contribute to the development of HFPS.  Trauma to the heel from high impact sports or a forceful blow to the heel from a fall can cause injury to the fat pad.  Repetitious chronic overload from activities such as running, jumping or prolonged walking and standing can also cause injury which can be exacerbated by the use of improper footwear.  It is known that the fatty heel pad breaks down as we get older which can make an individual susceptible to this condition.  Carrying extra pounds can also break down the protective fatty tissue under the heel bone.
 
Self-care strategies for reducing the pain of HFPS include: relative rest from any painful activities; ice application; and gentle stretching of the achilles tendon, and calf muscles.  Gel or “donut pads” placed under the affected heel(s) in shoes may also provide relief.  Long-term strategies may include activity modification and weight loss where applicable.
 
HFPS that does not respond to self-care strategies may require professional treatment.  This can include electrotherapeutic modalities to assist in healing, manual and soft tissue therapy to supporting structures, therapeutic taping of the heel, and specific rehabilitative  exercises for the muscles and joints of the lower leg and foot.  Supporting the foot with proper footwear and correcting faulty foot mechanics can decrease excessive strain on the fat pad.  A custom made orthotic with a deep heel cup design to cradle and cushion the fat pad may also be helpful for decreasing symptoms.
 
It is important to establish an accurate diagnosis of HFPS.  Other causes of heel pain may include stress fractures, achilles tendonitis/bursitis, arthritis, gout, or nerve irritation.  If you are having difficulty with heel pain, 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 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.


Saturday, July 8, 2017

Drink Water For Healthy Living

By Dr. John A. Papa, DC, FCCPOR(C)
 
The average person’s body is composed of approximately 70% water.  The body's water supply is responsible for and involved in nearly every biological process.  Human beings can survive without food for thirty to forty days, but without water, we would not be able to live beyond three to five days!
 
Below are some interesting facts about the role of water in the human body and the health benefits of adequate water intake.
 
1.    Regulation of body functions.  Water is essential for respiration, digestion, nutrient absorption, and elimination of waste products and toxins from the body.  Water is also responsible for healthy circulation, and controlling body temperature through perspiration.
 
2.    Signs of dehydration.  If not enough water is consumed, toxins can build up in the body resulting in many negative side effects.  The consequences of inadequate water intake/dehydration may include:  muscle and joint pain, cramping, headaches, fatigue, digestive problems, inflammation, and poor functioning of many organs.
 
3.    Helpful for weight loss.  Water is a great fluid replacement for high calorie drinks such as alcohol and sodas/carbonated drinks.  Drinking water before meals can also help kickstart metabolism and act as an appetite suppressant.
 
4.    Support for the Musculoskeletal (MSK) system.  Water brings vital nutrients to muscle tissue to support performance and decrease the risks of cramps and strains.  Water also helps to protect our joints by providing lubrication and cushioning.
 
5.    Better productivity at work.  Your brain consists of 90% water.  Therefore, proper hydration helps you think better, be more alert and focused, and feel more energized.
 
6.    Look younger with healthier skin.  Your skin is the largest organ in the body.  Water helps to replenish skin tissues by improving circulation to skin cells, maintaining elasticity, and moisturizing from the inside out.
 
7.    Feel healthier.  Consuming plenty of water can help maintain proper immune functioning, and can prevent or improve symptoms of the common cold, flu, arthritis, kidney stones, constipation, and many other conditions.
 
How much water is enough?  This is not an easy question to answer and can be dependent on many factors.  A general rule of thumb to follow is to consume 0.5-1 litre of water daily for every 50 pounds of body weight.  Special consideration for greater water consumption must be taken into account for those who are engaged in vigorous activity or exercise, and during the warmer months when more water is lost through perspiration.  Additional considerations must be taken into account for those who consume caffeine, alcoholic beverages, and certain medications, as these substances can act as diuretics and actually drain your body of water.
 
Looking at the color of your urine is an easy way to determine whether or not you are consuming enough water.  As long as you are not taking riboflavin (vitamin B2), which fluoresces and turns your urine bright yellow (it is also in most multi-vitamins), then your urine should be a very light-coloured yellow.  If it is a deep yellow then you are likely not drinking enough water.
 
Proper hydration is key for optimal functioning.  For additional information on improving your health, visit our website at 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.