Monday, August 28, 2017

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.

Wednesday, August 23, 2017

Quick And Easy Stretches To Prevent Golf Injuries

Ontario Chiropractic Association

The strain and effort required to play golf should never be underestimated. Forgetting to warm up can cause unnecessary injury and an unwanted visit to a health professional.
Here are a few easy stretching techniques that can be done in 5 minutes to help you get in the game without the pain.

Saturday, August 19, 2017

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.

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
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
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.