Thursday, August 28, 2014

Choosing The Right Backpack For Your Children

By:  Dr. John A. Papa, DC, FCCPOR(C)

 
Carrying a poorly designed or overloaded backpack can place excessive weight on a child’s growing spinal column.  This type of daily physical stress can lead to potential irritation and injury of the spine, joints, and muscles resulting in postural changes, back pain, and headaches.

Parents and children can avoid injury by following these simple rules with respect to choosing, packing, and carrying a backpack.

1.    Pick the correct size:  Choose a backpack that is proportionate to body size and not larger than needed.  The top of the backpack should not extend higher than the top of the shoulder, and the bottom should not fall below the top of the hipbone.

2.    Choose lightweight material:  Select a backpack made of light material.  For example, vinyl or canvas instead of leather.

3.    Strap it up:  The shoulder straps should be at least two inches wide, adjustable, and padded.  Ensure that they do not cut into or fit too snugly around and under the arms.  A hip strap or waist belt helps to effectively redistribute as much as 50 to 70 percent of the weight off the shoulders and spine onto the pelvis, balancing the backpack weight more evenly.

4.    Padding goes a long way:  A backpack should have a padded back for added protection and comfort.  Pack odd-shaped items on the  outside so they do not dig into the back.

5.    Pack it right:  Contents should be evenly distributed, with the heaviest items packed closest to the body.  This reduces the strain, as the weight is closer to the body’s centre of gravity.

6.    More pockets are better:  Choose a backpack that has several individual pockets instead of one large compartment.  This will help to distribute the weight evenly and keep contents from shifting.

7.    Wheels and handles:  Explore other backpack options such as a backpack with wheels and a pull handle for easy rolling.

8.    Weight is everything:  Backpacks should never exceed 15 percent of a secondary school child’s body weight or 10 percent of an elementary school child’s body weight.

9.    Handle with care:  Children should learn to squat or kneel to pick up their backpacks, and use their legs by bending at the knees and not twisting the back when lifting.  Backpacks can be placed on a counter, chair or table before they are put on.  Slinging backpacks on one side of the body may place excessive stress on the joints and muscles of the mid and lower back.
 
Parents should ask their kids to report any pain or other problems resulting from carrying a backpack.  If the pain is severe or persistent, seek care from a qualified health professional.  For more information, visit www.nhwc.ca.  The author credits the OCA 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, August 13, 2014

Taking Care Of Your Feet

By:  Dr. John A. Papa, DC, FCCPOR(C)

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 move can cause a chain reaction of adjustments in our posture and walking mechanics, which can lead to symptoms such as: localized foot pain, arch and heel pain, along with ankle, knee, hip, and back pain.
 
Protecting your feet and choosing proper footwear can go a long way in preventing injury and pain.  Below are some helpful tips that can ensure your feet are protected and functioning to the best of their ability.

·        Choose footwear that is appropriate for your foot type.  For example, people with low arches, called pronators, will need a shoe that provides some degree of stability.  A shoe with good cushioning is important for people with high arches, called supinators.

·        Select a footwear store with knowledgeable staff who can provide advice on the shoe that best suits your activity, body structure and type of foot.  Shop in the afternoon or evening, as your feet tend to accumulate fluid and swell throughout the day.  What may have been comfortable earlier in the day could now feel tight later in the day.

·        Remember that not all shoes are created equally.  The same shoe sizes can have different fits depending on the maker.  Be sure to try several sizes to find the most comfortable shoe.

·        Avoid buying shoes that you feel need a break-in period.  Shoes should be comfortable from the first time you put them on.

·        Don't cheap out on your shoes!  Better quality shoes may cost more but will pay off in terms of support and sturdiness.  A mid-priced shoe may offer the best value.

·        Do not hesitate to replace footwear after excessive wear as it may not be providing you with proper support and stability.

·        Consider custom orthotics to help support your foot.  Orthotics are mechanical aids that fit into your shoes as comfortably as an insole and 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.

·        Remember to exercise regularly and try to maintain a healthy weight.  Extra weight adds extra stress on your feet, knees, hips, and back.

In the event that you suffer a muscle or joint injury related to your feet that does not subside, you should contact a licensed health professional.  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, August 2, 2014

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.