Wednesday, July 29, 2015

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
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.

Thursday, July 23, 2015

Tennis Elbow...Minus the Tennis!

By Dr. Greg Lusk, DC

"Tennis Elbow" is the common term for lateral epicondylitis, which refers to an overuse muscle strain injury of the tendons that attach to the outside of the elbow.  This is in contrast to "golfer's elbow" where pain is experienced on the inside of the elbow.  Despite its name, most cases of tennis elbow are not related to tennis but to other causes of stress and strain to the elbow.  Repetitive gripping or leveraging activities are common culprits as muscles involved in these activities attach to the bony bump on the outer elbow.  Occupations or activities with repetitive hand use, such as carpentry, weight training, and even constant computer mouse use can contribute to development of this condition.

The symptoms of tennis elbow may include pain at the bony bump on the outside of the elbow and possibly down the back of the forearm to the wrist.  Pain is often experienced with gripping activities and even things as simple as holding a cup of water can become quite painful, requiring the assistance of the other hand to support the load.
Early on (i.e. within the first few weeks), self care efforts such as icing, avoiding aggravating activities, and the use of pain medications may be sufficient to ease the pain.  However, if the pain persists, which is quite common, it would be appropriate to seek treatment to help get things under control.  In fact, the longer this condition lasts the less likely the pain is due to inflammation in the soft tissues but rather to degenerative changes in the tendon.  This is true for all tendon injuries and at least in part explains why long term ice and anti-inflammatory medication use may not be effective beyond their "pain killing" benefits.

Management of a degenerated tendon is different than that of an inflamed tendon as the tendon structure has become disorganized and scar tissue is present, in the absence of inflammatory markers.  Healing and regeneration of the tendon must be facilitated and conservative treatment to assist this may involve the following techniques and strategies. 

·        Manual or tool-assisted soft tissue therapies are effective at breaking up scar tissue, improving blood and lymph movement in the tissues, decreasing tissue tension, and improving relative movement of one tissue across another.  Also, the micro trauma caused by the soft tissue treatment itself helps to restart the healing process with the end goal being a healthier, more properly organized tendon structure.

·        Eccentric exercises.  This refers to the part of an exercise movement where the muscle is lengthening while maintaining control of the weight.  Research shows this increases protein production in the tendon which is important for healing.

·        Other treatments, such as acupuncture or electrotherapies, may help at promoting healing and managing the associated pain.

·        Adequate rest is important to let the structural damage to the tendon heal.

·        Looking at the aggravating activities and modifying things to decrease the load imposed on the tendon.  In the case of tennis, there may be swing or footwork improvements that can be made which will decrease strain at the elbow.

 On a final note, if the above ideas or other treatments directed at the elbow are not yielding positive results after a fair trial period, it would be worth having your shoulder and neck assessed as anatomy located here can cause pain at the elbow and may be the ultimate source of stubborn elbow pain.

This article is for general information purposes only and is not to be taken as professional medical advice.

Monday, July 20, 2015

How to Enjoy Summer Activities Without Back Pain

Canadian Chiropractic Association

The summer months are generally active for everyone. There are events and day trips, added work around the house and summer sports activities, for example, that require us to be more physically active than we would be in the winter months. That being said, the extra activities can put additional strain on our backs that can result in pain and stiffness and hamper our planned activities.
We’ve prepared a few tips to ensure you’re aware of situations that could pose a risk for developing back pain so you can enjoy summer to the fullest, pain-free.
1. Taking the family out for day trips
If you’re taking your family out for a fun-filled day to the park, zoo or amusement park, back pain might be the last thing you’re worried about. However, while carrying extra packs, bending, twisting or even picking up small children, you’re bound to experience aches and pain. Through all the chaos of your family day out, it’s important to be aware of the strain you are putting on your back and take frequent breaks.
2. Enjoying a day on the golf course
If you decided to take a Friday afternoon off to enjoy a day of golf in the sunshine, you’re definitely lucky! Warm up before your game with a few quick stretches and stay hydrated in the warm sun. Be aware throughout the game that you maintain proper posture and take breaks as needed to avoid fatigue or excessive strain.
3. Hosting outdoor parties
For many Canadians, backyard BBQ’s and pool parties are a summer staple. These events can be a lot of fun, and safety isn’t always top of mind. But let’s take a couple of things into consideration: lifting heavy objects to rearrange furniture for extra room or participating in summer sports. It’s important to relax and have fun, just exercise caution when partaking in summer activities with potential for risk.
4. Activities on the water
A weekend or day on the lake is the perfect way to spend hot summer days. Exhilarating watersports like tubing and wakeboarding are really fun, but can also cause serious back injuries. Before you hit the water, ensure that you are well-aware of the risks involved and be safe!
Depending on what you have planned for summer, you don’t want one day of fun to ruin the following day or the rest of your summer. It only takes a few moments to evaluate the situation and decide whether or not it’s worth it to continue. Take extra care during the summer months to warm up, focus on good posture, and exercise sound judgement when evaluating the risk of injury.

Wednesday, July 15, 2015

Plantar Fasciitis: A Common Source Of Heel Pain

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

Plantar fasciitis is caused by injury to the plantar fascia, which is the tendon-like soft-tissue along the bottom of the foot that connects your heel bone to your toes.  This condition is a common source of heel pain that can be quite disabling.
Plantar fasciitis usually develops gradually, but it can also come on suddenly.  Sharp, knife-like pain on the inside-bottom part of the heel is often characteristic.  Pain and discomfort can also extend into the arch of the foot.  Heel pain tends to be worse with the first few walking steps in the morning, and after extended periods of sitting or inactivity.  If plantar fasciitis becomes severe or chronic, heel and/or arch pain will be present with all weight bearing activities, and may result in secondary areas of discomfort in the foot, knee, hip or back due to compensatory movements.
Under normal circumstances, your plantar fascia acts like a shock-absorbing rubber band, supporting the arch of your foot.  Excessive tension and repetitive stretching can create small tears in this soft-tissue fascia, causing it to become irritated or inflamed.  This may occur with activities that require running, jumping or prolonged walking and standing.  Improper footwear can make the plantar fascia more susceptible to stretch and strain during these activities.
Faulty foot mechanics may also contribute to the development of plantar fasciitis.  Individuals with flat feet or those who excessively pronate (role feet inward) will experience added strain on their plantar fascia.  Old lower extremity injuries such as ankle sprains and fractures can increase susceptibility due to altered lower limb movements.  Being overweight is also a risk factor.  Carrying extra pounds can break down the protective fatty tissue under the heel bone, causing heel pain and putting additional mechanical load on the plantar fascia.
Self-care strategies for reducing the pain of plantar fasciitis include: ice application; rolling a tennis ball or soup can from your heel and along the arch of your foot; and gentle stretching of the achilles tendon, calf muscles, and plantar fascia.  Gel or “donut pads” placed under the affected heel(s) in shoes may also provide relief.
Plantar fasciitis that does not respond to self-care strategies may require professional treatment.  This can include electrotherapy, manual and soft tissue therapy, and specific rehabilitative exercises for the foot and lower leg.  A custom made orthotic may also be helpful by minimizing pronation, cushioning the heel, and supporting the arch.
It is important to establish an accurate diagnosis of plantar fasciitis.   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
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 13, 2015

Fit Tips

Canadian Chiropractic Association

Being active can help you maintain a healthy weight, reduce blood pressure, build strong bones, relieve stress, and maintain flexibility and good posture. Recreational sport is a great way to enjoy the many benefits of physical activity whether you pick up a hockey stick, golf club, raquet, or paddle, get on a bike, or put on your running shoes! The important thing is to get moving. Canada’s Olympic athletes know that everyone who gets physically active is a winner. Here are some tips and inspiration from our top performers and Canada’s chiropractors to help you avoid injury and get the most from your favorite sport.
Warm Up
Before jumping in the pool, hitting the field or picking up a golf club, take a full 20 minutes – no less – to warm up. Your warm up should include deep breathing exercises, gentle stretching and range of movement exercises, as well as a brisk walk or easy jog to loosen and warm the muscles and joints.
Learn the Proper Technique
Learn the right technique for your sport from the beginning. Using the wrong sport-specific technique can create incorrect muscle memory and can make it difficult to break bad habits. Poor technique can also cause injury to your joints and muscles.
“Chiropractic care has reduced my recovery time from injuries and lessened my susceptibility to injury. I would recommend a physical assessment and chiropractic maintenance to anyone who is serious about their sport.”
 –Daniel Igali, Wrestling World Champion and Olympic Gold Medalist 
Use the Right Equipment
Make sure your equipment is the right fit, height and capacity for you to avoid a sports-related injury. Recreational athletes should have their equipment professionally fitted and checked before starting out.
Avoid Over-Training
Too much. Too fast. Too soon. Over-training is one of the most common causes of recreational athletic injuries. Take your time and work up to it slowly before pushing yourself too hard. Remember – rest is as important as training. Take a training break and give your body a chance to recover.
“Taking care of injuries is important, but what is just as important is ’tuning up’ your body to ensure a great performance every time you go out. I was so impressed with my chiropractic care throughout my rowing career, that I became a chiropractor myself.”           
– Dr. Derek Porter, Rowing World Champion and Olympic Gold Medalist
Cool Down
Cooling down after a work out is just as important as warming up. Take 20 minutes for a brisk walk or slow jog, and stretch out your muscles and joints before heading for the change room or the car.
Drink Fluids
Drink plenty of fluids before, during and after physical activity – even in cold weather. Remember that once you are thirsty, you are already starting to dehydrate. Dehydration affects your energy level and your physical functioning.
“As a full-time athlete, I rely on my body to make a living, so it always has to be at its best. Chiropractic care is an important part of keeping me in the best condition so I can perform at an optimal level.”
– Perdita Felicien, Sprint Hurdles World Champion and Olympian
Strength Training
Strength training will help you keep your spine and other body joints functioning optimally. It will also build muscle that is an important shock absorber and helps to prevent strains and sprains.
Check your Attitude
Not every elite athlete brings home a medal, but they are all winners. The right attitude is good for your performance and your overall health. Have fun!
“Bobsleigh is a pure power sport – joints especially take a beating. Knees, back, ankles, elbows are constantly being abused through our weight training and sprinting. By having a regular chiropractic assessment, potential problem areas can be identified and worked on before they lead to greater problems.”
–Pierre Lueders, Bobsleigh World Champion and Olympic Gold Medalist
Maximize Muscle & Joint Function
Maintaining good muscle and joint range of motion and mobility will contribute to your athletic performance and help prevent injury. Restrictions in muscle and joint functioning can hamper your technique and may lead to painful strains and sprains.
“Chiropractic was an important part of my athletic training. It helped keep my body in line and that allowed me to drive with my legs and pry with my lower back. It also helped facilitate recovery and prevent injury.”
–Marnie McBean, Rowing World Champion and Olympic Gold Medalist
Treat Injuries Promptly
If you suffer an injury or experience pain that lasts longer than your usual post-workout soreness, ice the area to reduce swelling and inflammation, and consult a chiropractor.

Tuesday, July 7, 2015

Protect Your Body During The Summer Season

By:  Dr. John A. Papa, DC, FCCPOR(C)

The summer season is upon us, which for many individuals, means spending time outdoors and becoming more physically active.  Whether you’re an aspiring athlete, a serious nature lover, or someone who enjoys fun in the sun, there are special precautions that need to be taken to protect your body during the summer season.

1.    Drink plenty of water: The body’s water supply is responsible for many important functions such as digestion, controlling body temperature, and protecting our joints by providing lubrication and cushioning.  In warmer temperatures, we lose more water from the body through increased perspiration.  The consequences of inadequate water intake/dehydration may include: headaches, fatigue, digestive problems, joint pain, muscle pain and cramping.  Therefore, special care should be taken to replenish fluids lost during the summer season.  Limit diuretics such as caffeinated and alcoholic beverages which actually drain the body of water.

2.    Get just enough sun:  Appropriate sun exposure can provide many health benefits associated with the natural production of Vitamin D.  Avoid sunburn which is a result of overexposure to the sun’s UV radiation and can contribute to certain skin cancers, and a premature aging and wrinkling of the skin.  To protect yourself, apply sunscreen regularly, wear a wide-brim hat and light-colored clothing that covers your exposed skin.  Your eyes should also be protected with UV blocking sunglasses.  Outdoor activities and sports should be limited to the early morning or late afternoon when UV rays are not as strong.  Be cautious on cloudy days, as your skin is still susceptible to burn under these conditions.

3.    Think safety first:  Water sports and other outdoor activities should always be performed with safety in mind.  This means wearing a life jacket in deeper water or if you are not a strong swimmer.  Parents should always keep a watchful eye on young children around water.  Diving into shallow or unknown waters should never be performed to eliminate the chance of serious spinal injury.  Running on pool decks may result in serious slip and fall injuries.  When bicycling or in-line skating, be sure to wear bright reflective clothing and protective headgear.  Wearing appropriate footwear for the activities you are performing will give you balance, support, and protection.

4.    Prepare your body for activity and exercise:  There are many activities made more enjoyable during the summer season such as gardening, walking, running, swimming, canoeing, bicycling, and golfing to name a few.  Prepare your body for physical activity by stimulating the joints and muscles, and increasing blood circulation with a proper warm-up.  If you have been inactive for a period of time, gradually ease into activity and take it slow.

Following the above rules and safety tips can go a long way in protecting your body during the summer season.  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.