Monday, June 23, 2014

Ice Therapy For Muscle & 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
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 16, 2014

Are You Putting Your Best Foot Foward?

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

Much like tires on a car give a vehicle a foundation of support for stability and performance, our feet function to do the same for us. When tires get old and worn, and don’t offer the same support and stability that they once did, we simply replace them. Unfortunately we cannot replace our feet! Our only option is to give them the correct mechanical support so that they can continue to function as they were intended to. Learn more about how important your feet are for structural health and how custom orthotic therapy can alleviate many problems caused by faulty foot mechanics.

The feet are an individual’s contact points with the ground, so how they support the rest of the body is critical. Our feet have nearly 100 individual working parts, which all have to function together when we stand, walk, run and jump to provide proper stability and balance. When a small problem develops in our feet, the subtle changes in the way we walk can cause a chain reaction of adjustments in our posture and walking mechanics. These changes can put stress on joints in our feet, and higher up in the body, and can lead to more serious problems.

Custom orthotic therapy allows one to correct faulty foot mechanics by normalizing motion and offering shock absorption. Orthotics are mechanical aids that fit into your shoes as comfortably as an insole – and they have the advantage of having been custom made from precise imprints of your feet. Orthotics work on your feet much like glasses work on your eyes – they decrease stress and strain on your body by bringing your feet into proper alignment. This helps rebalance your feet and reduces pain and discomfort by enhancing your body’s natural movements. Some individuals may experience obvious symptoms of faulty foot mechanics which may include but are not limited to: localized foot pain, bunions or hammer toes, arch or heel pain, leg, ankle, hip, and knee pain, and back pain. Others may not have obvious symptoms of faulty foot mechanics but may still benefit from orthotic therapy to prevent long-term problems. This may include individuals who spend a good portion of the day standing or walking on hard surfaces, individuals with a family history of foot related problems, and individuals who participate in sports such as tennis, golf, basketball, volleyball, or running on a regular basis. Faulty foot mechanics arise for different reasons ranging from genetic predisposition, to the normal aging process where ligaments, muscles and joints fail to support our bodies like they once did.

Heel spurs and plantar fasciitis are a very common cause of heel pain. These problems usually occur in pronated feet (feet that roll inward). Pronation forces the heel to strike the ground abnormally, and places abnormal stress on the heel and plantar fascia (the soft tissue at the bottom of the foot), resulting in pain that will become progressively worse. A custom made orthotic is constructed to allow the heel to strike the ground in the correct manner by minimizing pronation, cushioning the heel, and supporting the arch. This is just one example of how custom orthotics function to normalize faulty mechanics and foot function. Custom orthotics can also help with other painful conditions such as foot pain caused by bunions or hammer toes, shin splints, knee pain, hip pain, and low back pain. Many athletes find custom orthotics helpful for increasing athletic efficiency, and protecting the heel, arch, and forefoot from the unnatural and increased stresses that sporting activities produce. Older individuals who have experienced the effects of aging on the body may find that custom orthotics can keep the foot from turning and twisting while walking, making each step secure and pain free. In diabetics, pressure sores and chronic painful areas are best treated with supportive custom made orthotics featuring modern materials that can eliminate pain, shield and protect painful areas, and decrease the chance of ulcerations occurring.

Prescribing and dispensing custom foot orthotics for an individual is usually a three-step process. The first step is a history and physical examination, which gathers information about occupational, recreational or sporting activities. Pain symptoms are investigated through a physical exam involving muscular assessment and range of motion. A postural exam is also performed to assess overall alignment. Computer analysis can help identify what your feet are doing at every part of the walking cycle, and give additional information about the mechanical functioning of your feet. Foam impressions or plaster casts of your feet allow for specific imprints of your feet to be sent to the orthotic lab, detailing information about your arch and heel specifications. A comprehensive and systematic approach to custom orthotic therapy yields excellent results and high consumer satisfaction.

While simple, commercially made devices such as heel cushions, or shock absorbing insoles for shoes can be purchased over-the-counter in drug stores or other retail establishments, they are made for the general public and may not be addressing the specific needs of your feet. The most effective orthotics are custom-designed devices specifically crafted to meet the needs of the particular individual. Mechanical dysfunction in our feet has the ability to put undue stress on other parts of the body, predisposing us to wear and tear and injury. Do not forget that the proper functioning of your feet is paramount in ensuring structural health, and that correction and prevention is key in ensuring that you are indeed putting your best foot forward!

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 11, 2014

Preparing Your Body For Golf Season

By:  Dr. John A. Papa, DC

Warmer weather signals the start of summer and golfers can’t wait to get on the course to start their season.  Good preparation can go a long way in helping to avoid and/or minimize the chances of suffering a muscle or joint injury while playing golf.  Included below are some tips to improve your game and prevent the pain!

1.    Prepare physically by including flexibility and strengthening exercises as part of your training and practice routine.  Muscles act as important shock absorbers and help prevent strains and sprains of vulnerable regions such as the back, along with the shoulder, elbow, wrist, hip, and knee joints.

2.    Warm-up and cool-down both before and after your game.  Include gentle stretching and range of motion exercises, as well as a brisk walk or gentle jog to loosen the muscles and joints.

3.    Nourish your body by staying hydrated.  Drink plenty of fluids before, during and after your game and steer clear of caffeine and alcohol as they further dehydrate you.  Dehydration affects your energy level and your physical functioning.  Consider bringing nutritious snacks to help maintain your blood sugar levels during play.
4.    Use a wheeled golf cart for carrying heavy clubs.  Alternate every hole by pushing or pulling your golf cart to help prevent cumulative strain on your body.  If you must carry your golf bag, use both shoulders straps.  This will spread the weight across a greater area.  If there is only one strap, alternate sides frequently.  If you find that your bag is getting too heavy, put it down and take a break.

5.    Prepare for the elements.  Golf requires long periods of standing.  Choose a golf shoe that fits comfortably while providing adequate support.  This may help prevent knee, hip, and lower back pain.  To protect from sun exposure, apply sunscreen and wear a wide-brim hat.  Wear loose and comfortable clothing.  Know your physical limits.  Playing too much too soon is one of the most common causes of golf injuries, so build your tolerance and pace yourself.
6.    Whether it is your golf clubs or your golf swing, golf can be a very technical sport.  Ensure that your clubs are  the right height and grip.  Select irons with large heads and graphite shafts to lessen vibration.  Adopting a golf swing based on your physical and biomechanical capacity is important.  Take lessons to learn the correct swing technique and avoid unnecessary injuries.  A golf professional can help you with club selection and technique.
In the event that you suffer a muscle or joint injury while golfing 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.

Wednesday, June 4, 2014

Safe Gardening Tips To Prevent Injury

By:  Dr. John A. Papa, DC, FCCPOR(C)

Spring is upon us and so is the arrival of the gardening season.  Raking, lifting, digging, and planting can be strenuous activities.  Below are some simple rules and precautions that can be followed to help avoid and prevent injury during the gardening season.
1.    Warm up:  Prepare your body for physical activity by stimulating the joints and muscles, and increasing blood circulation.  Climbing stairs, marching on the spot, or going for a quick walk around the block can serve as excellent warm ups in five to ten minutes.  Follow this with some gentle stretch exercises such as knee to chest, forearm and wrist stretches.
2.    Use the right tools:  Make sure you select the correct tool for the task to be performed.  Always make sure that tools are a comfortable weight and size for you.  There are many ergonomically designed tools, which are lightweight with long padded handles and spring action mechanisms that can reduce strain and effort.
3.    Proper lifting means bend the knees, keep the back straight and brace!  Use your leg and arm muscles to do the lifting while keeping your back straight.  Maintaining the natural and neutral curves of your back is important, as this is its strongest and most secure position.  Contracting and bracing your abdominal muscles during lifting improves spinal stability and decreases the chance of injury.  Avoid twisting and turning by positioning yourself accordingly.  Be sure to lift slowly and smoothly with the load close to your body and do not jerk with your lifts.
4.    Alternate activities and change positions:  Once you begin, take turns alternating between heavy chores such as digging, and lighter less physically demanding tasks such as planting, every 10 to 15 minutes.  Avoid prolonged working postures.  Changing hands frequently when you rake, hoe or dig prevents muscle strain and joint stress on one side of the body.
5.    Preparing for the elements and pacing:  Select comfortable, thick-soled, protective shoes that support your arches to reduce back pain and aching muscles.  To protect from sun exposure, apply sunscreen, wear a wide-brim hat and drink plenty of water.  Wear loose and comfortable clothing. Know your physical limits. Stop gardening immediately if you feel chest pain or persistent back or joint pain.
In the event that you suffer a back, neck, or joint injury while gardening that does not subside, you should contact a licensed health professional who deals in the diagnosis and treatment of muscle and joint pain.  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.