Monday, August 29, 2016

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 irritation and injury of the spine, joints, and muscles, which can potentially result 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, nylon, 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  The author credits the Ontario Chiropractic Association (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.

Monday, August 22, 2016

Pain Is A Roadblock To Your Family Vacation

Ontario Chiropractic Association (OCA)

For many families, a road trip is an essential part of any summer vacation.

Unfortunately, muscle and joint pain doesn’t take days off, quickly turning this joyful time into a painful one.
Whether you’re lifting heavy luggage or simply sitting in the car for extended periods of time, it’s very common to experience back, neck, shoulder and other joint pain at some point during your travels. Since having fun should be your highest priority, its important to maximize your enjoyment by ensuring that you’re being as safe as you can be.
Did you know?

Sitting for long periods of time can be very harmful to your body. Even in the most comfortable cars, certain pressures and forces from awkward positions can result in restricted blood flow.
To increase your chances of a pain free trip
  • Choose the right luggage Choosing a bag with wheels and a handle goes a long way to ligthen your load. Alternatively, quality backpacks are a good option as they distribute weight more evenly than other types of luggage.
  • Get comfortableSeat adjustment is critical for avoiding pain on the road. Make sure to adjust the seat to fit you comfortably. If neccesary, roll up a towel or pillow and place it between your lower back and the seat for more support.
  • Bring iceBring a cooler filled with ice packs to help relieve pain on the road. If you need to ice your back, limit it to 15 minutes at a time.
  • Make frequent pit stops
    his gives everyone a chance to stretch and change out of a seated position for a short period of time. Each stop also provides an opportunity to refresh and reduce tension that has been building up in your body.
How to lift your luggage properly
  • Break the action upWhen loading a suitcase into a car or truck, try lifting it onto a chair or step-stool first, rather than doing it all in one motion
  • Use your legsWhen lifting your luggage, first get close to the load and stand with your feet shoulder-width apart
    Bend at the knees and let your leg muscles do the lifting, rather than your back
  • Avoid twistingInstead, turn your feet in the direction you are headed and turn your entire body in that direction.

Monday, August 15, 2016

Defining Common Muscle And Joint Injuries

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

Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  Common mechanisms of injury include slip and fall or collision-impact type accidents, overstretching a body part, twisting awkwardly, or performing repetitive movements.  This can cause pain, stiffness, and swelling in a joint and/or muscle, leading to injuries such as sprains, strains, and contusions.
A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Common locations for sprains are the ankle, wrist, and knee joints.
A strain refers to a stretching or tearing of a muscle or tendon.  Muscles are responsible for producing force and causing motion, whereas tendons are the tough fibrous extensions of muscle that attach to bone.  A strain injury can occur when the muscle-tendon complex suddenly or powerfully contracts, or when it is overstretched.  This is called an acute strain.  Overuse of certain muscles over time can lead to a chronic repetitive strain.  Strains are commonly referred to as “pulled muscles” or "tendinitis".  The shoulders, forearms, low back, and leg regions are common locations for strains to occur.
Contusions are commonly called “bruises”, and occur when small blood vessels in the skin, muscles, or bones are subjected to trauma. 
Sprain, strain, and contusion injuries can exist on their own or in combination with each other.  Initial conservative management and first aid of these injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  This can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  With a mild injury you should experience progressive improvement within 2 to 3 days.  You should gradually begin using the injured area after this time.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks. Moderate injuries usually require 4 to 12 weeks to heal and may require basic rehabilitative treatment and exercises.  Severe injuries will take longer to heal.  Healing times may also vary depending on a persons age, physical condition and general health.
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.  For less serious injuries that do not subside, you should contact a licensed health professional who deals in the diagnosis and treatment of muscle and joint pain.  They can determine the cause of your pain and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance. For more information on managing muscle and joint injuries, 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.

Wednesday, August 10, 2016

Considerations For Shoulder Pain - Part 2

By Dr. R. Greg Lusk, DC

Last month's article introduced causes of shoulder pain and focused on the structure and general function of the shoulder through ranges of motion.  As a ball and socket joint, it high-lighted the importance of the ball staying well centred in its socket as you move your arm, so as to avoid injury or irritation to the various soft tissues around the shoulder.  That being said, it is possible to have "damage" to your rotator cuff without any symptoms.  Research using diagnostic imaging (i.e. MRI/ultrasound) has shown that up to 40% of elite overhead athletes have asymptomatic rotator cuff tears.  They are also found in the general population at an increasing frequency with advancing age.  Up to 1 in 5 people aged 60 to 69 and 31% of those aged 70 to 79 have been shown to have symptom free cuff tears.  This clearly shows that normal function can be preserved despite structural changes and offers encouragement that satisfactory function can be restored after an injury even when incomplete healing occurs.

So, this begs the question "What can be done to preserve or optimize shoulder function?"  Maintaining good posture is a good place to start.  This allows the shoulder blades, the "sockets", to move as they should, stay out of the way, and keep "the ball" well positioned.  To illustrate this, stand with an intentionally poor posture with your mid back and shoulders hunched as much as possible.  Now try to raise your arms forward and up as high as you can and take note of your range.  Then, stand with good posture - back erect and your shoulders pulled back slightly - and raise your arms again.  If done properly you should notice that the range of your shoulder motion is greater with better posture.  The shoulder blades can tip backward as needed and not be limited by the rib cage, thereby allowing your arms to end up near your ears.  Therefore, if you need to reach high for things or are doing overhead exercises, be sure to start with a good posture.  A good overall posture also decreases strain on the neck, which is often an overlooked source of pain that is perceived at the shoulder.
Improving mid back mobility is also important.  While lifting your arms as described above, your mid back should extend slightly to assist the motion.  However, this area of the back, the thoracic spine, is commonly stiff due to the many hours we spend being sedentary with a slouched body position and doesn't move as freely as needed.  Fortunately there are a number of things you can do to improve mobility here.  Starting simply, you could lie on the floor with a small, rolled-up towel lying under and across your mid back.  As you relax and lay flat this will arch your back slightly, and you can also adjust your body up or down to target different areas.  To get more aggressive over time you can use a foam roller to increase the arch even further.

Maintaining the health and flexibility of shoulder soft tissues, rotator cuff muscle strength and stability, and other shoulder blade motions are additional aspects of a well functioning shoulder.  However, unlike the above considerations that are almost universally applicable, what may be needed for each individual is quite variable and is best assessed on a case by case basis by a skilled health care professional.

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

Friday, August 5, 2016

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
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, August 2, 2016

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
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.