Treatment and Prevention of Whiplash Injuries
By Dr. John A. Papa, DC, FCCPOR(C)

The unique forces generated during a motor vehicle collision (MVC) cause more than 100,000 whiplash cases in Canada each year.  This article will specifically focus on the treatment and prevention of whiplash injuries.

The term WAD (Whiplash Associated Disorder) is used to describe a range of injuries that can be attributed to whiplash.  This may include:  neck pain, whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.

 

WAD Grades 1 and 2 represent the majority of whiplash cases and are amendable to conservative management.  Early treatment and consultation can greatly improve the recovery process and prevent future complications and chronic pain.  Effective treatment strategies may include: pain controlling modalities such as electrotherapy and acupuncture to help facilitate and promote activity and functioning; manual and soft tissue therapy to assist in the healing of injured tissues; education on how to safely re-integrate into activities of daily living; and rehabilitative exercises that may include range of motion, flexibility, strengthening, and balance/coordination training.  An independent home exercise program should also be provided.

The goal of treatment is to get the injured individual back on their feet and up to their normal level of activity.  The majority of people with WAD Grades 1 and 2 experience no significant disruption to their normal activities of daily living.  Some may experience a temporary disruption to their normal activities, but usually improve after a few days or weeks.  Occasionally, symptoms may persist over a longer period of time.  A return to normal activities of daily living may be assisted by active treatment and rehabilitative exercise prescription as described above.

Included below are some tips that may help prevent a MVC and/or whiplash injury (courtesy of the Alberta College and Association of Chiropractors):

1.    Drive defensively.  Always anticipate the actions of other drivers.

 

2.    Wear your seatbelt at all times.

 

3.    Make sure your headrest is positioned properly, that is, the top of the headrest should be no lower than the top of your ear.  If more than one driver uses the car, remind each other to always check the headrest height.

 

4.    Never operate cell phones or other electronic equipment while driving.

 

5.    When road conditions are poor (i.e. icy, wet, dark, or crowded), slow down accordingly.

6.    Be sure your car is always in good working order, particularly your brakes, tail lights, headlights, and directional signals.

 

7.    Engage in regular physical activity consisting of cardiovascular, strength, and flexibility training.  This will help keep your body strong and offer some protection in the event your are involved in a MVC. 

 

If a whiplash injury is interfering with your activities of daily living, consider chiropractic care.  A chiropractor can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for you.  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.

Massage Therapy Questions & Answers

1. Q: What should I expect on my first visit?
   A: On your first visit, your Therapist will take a confidential health history, which will guide them in performing an assessment. This will help them understand your current physical condition, medical history, lifestyle and stress level. Once this is completed, the Therapist will prescribe a treatment plan which will be explained to you before treatment starts.
   
   
2. Q: Will I have to undress?
   A: The degree to which you undress is dependent on the treatment and your comfort level. Your Therapist will communicate your treatment plan to you and the areas of your body that will be treated. Your Therapist will briefly leave the room for you to prepare for treatment if required. Once the Therapist leaves the room, most people undrape down to their underpants and cover themselves with a sheet. Your privacy will be protected at all times. The Therapist is trained to drape towels or sheets discreetly over areas of the body not involved in the treatment.
   
   
3. Q: Is massage therapy painful?
   A: There may be some injuries or conditions that may be uncomfortable. During the course of treatment, there will be continual communication between the Therapist and client on whether the pressure is too deep or soft. The Therapist is well trained and experienced in modifying technique and pressure to ensure maximum patient comfort is attained. Most people actually find massage therapy to be very relaxing and therapeutic.
   
   
4. Q: How long do massage treatments last?
   A: Massage therapy treatments can last 30, 45, 60, or 90 minutes. The length of treatment depends on several factors including patient comfort, number of areas being treated, and the specificity of therapeutic goals. The Therapist will discuss with you what treatment time may be best for you.
   
   
5. Q: Is massage therapy covered by insurance?
   A: Yes. If you have Extended Health Care (EHC) insurance you may be eligible for all or part of your treatment to be reimbursed. In some instances, insurance plans may require a physician's referral prior to the start of treatments. Your employer, human resource representative, or union will be able to provide information as to the details of your coverage for massage therapy under your EHC plan. Massage Therapy may also be covered by your automobile insurance company in the event of a motor vehicle accident, and by Veterans Affairs Canada, in the case of war veterans.

Understanding Whiplash Injuries

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

Whiplash is a common injury that can be experienced following a motor vehicle collision (MVC).  There are more than 100,000 whiplash cases in Canada each year.  The unique forces generated during these collisions can stress biological tissues and result in pain and decreased functioning for those affected.  This article provides a review of whiplash specifically focusing on the mechanics of injury, the associated symptoms, and general guidelines for the evaluation of any accompanying injuries.

Although rear-end collisions are the most commonly reported mechanism of whiplash injury, an injury may also occur following side and head-on collisions.  The forces generated from these types of impacts thrust the head (and to a lesser extent the entire body) back and forth, much like a snapping whip.  Injury results because the body is unable to compensate adequately for the speed of head and torso movement from the acceleration forces generated at the time of impact.  This will put stretch, compressive and shear stresses on biological tissues such as muscles, ligaments, joints and nerves.  As a result, this can generate pain symptoms, and affect range of motion, strength, coordination, and balance.  The onset of whiplash symptoms may immediately follow a MVC or may gradually develop over the first 24-72 hours.  A later onset of symptoms does not necessarily indicate a more serious injury.

Neck pain is frequently associated with whiplash injuries.  However, the whiplash mechanism may also cause injury and symptoms that include: whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.  The term WAD (Whiplash Associated Disorder) encompasses all of these potential symptoms and is commonly used to grade the degree of injury present.  Of the four Grades of WAD, Grades 1 and 2 represent the majority of whiplash cases.

Evaluation of whiplash injuries should include a proper medical history, along with a physical examination consisting of inspection, palpation for tenderness, range of motion, strength, neurological, orthopaedic and functional testing.  Signs of serious injury, such as fracture, are usually evident in early assessments and may require further diagnostic testing such as x-ray, CT scan, or MRI.  Chiropractors are healthcare professionals skilled in the diagnosis and treatment of whiplash injuries and are commonly involved in the management of WAD.

When an individual sustains a whiplash injury, injured tissues can become stiff and weak when they are not used, which can further exacerbate pain symptoms.  Therefore, a return to daily activities after whiplash injury is extremely important for successful healing as extended rest may prolong recovery.  Healing and a return to daily activities may be facilitated with active treatment and rehabilitative exercise prescription.  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.

Air Travel Comfort Tips

By:  Dr. John A. Papa, DC

 

Comfort is not usually the first word that comes to mind when someone mentions flying.  Sitting cramped in a small space for a long plane ride can also lead to muscle and joint pain.  Here are some helpful tips for a more enjoyable voyage.

Choose the Correct Seat - Some airlines fill the plane from front to back, so ask for a seat in the back row to increase your chances of having an empty seat next to you.  If the arm rests lift up, you might even be able to lie down.  Aisle and emergency exit seats maximize leg room and are less claustrophobic.  If you are susceptible to motion sickness, request a seat over the wings and try to schedule flights on larger airplanes.

Keep Moving - Moving around is good for your circulation and helps to prevent swollen feet and ankles.  Wear loose clothing and walk about the cabin periodically every 60 to 90 minutes.  Wear shoes you can slip off easily.  Every so often, draw circles with your toes and contract your calves to help prevent blood from pooling in your legs.  Tapping your feet can also help increase circulation and reduce the chance of muscle cramping.
 

Stretch it out - Try not to place anything under the seat in front of you so you can stretch your legs out.  Quick and easy stretches also include standing up and raising your arms above your head, rotating your shoulders back and forth, and moving your head side to side.

 

Keep Good Posture While Seated - Position your lower back against the back of the chair to obtain the greatest amount of support for your spine.  A rolled sweater or blanket can also be used for added support.  Make sure that your weight is evenly distributed on your seat, your shoulders are not rounding forward, and you are not slouching.  Support your neck and head with a pillow if necessary and avoid awkward positions if trying to rest or sleep.  Try not to stay in one position for a long period of time.

 

Additional Tips

·       Eat Right - Eat a light, non-fatty meal just before you leave for the airport.  Avoid caffeinated beverages and fried food.  This can make handling turbulence a little easier.

·       Handling Pressure - Chewing gum, yawning or sucking on hard candies can help to relieve the pressure that builds up in your ears as the airplane ascends and descends.  This is not recommended for toddlers.  For young children, sipping a drink may help.

·       Prevent Dehydration - The air in most airplanes can dry out your skin and cause eye and nasal dryness.  Take a moisturizer with you for your skin and wear glasses instead of contact lenses to prevent eye dryness.  Drink enough water and steer clear of caffeine and alcohol as they further dehydrate you.  Alcohol can also interfere with your ability to sleep.

In the event that you suffer from ongoing muscle and joint pain following your trip, you should contact a licensed health professional.  For more information, visit www.nhwc.ca.  The author credits the 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.

Fight Common Male Cancers With These Foods

 

Cancer diagnoses are all too common. Most men know someone who’s been personally affected by the disease. According to Cancer.ca, roughly 45 per cent of men will develop it in their lifetime and cancer has already surpassed diseases of the heart as the main cause of death among Canadians in 2007.

But there are a number of foods packed with nutrients known to fight cancer. A look at some of the most common cancers among men and the best eats to arm your self against the life-threatening illness:

 

For the prostate: Go for garlic

According to research by Cancer.ca, the most common cancer among men (apart from non-melanoma skin cancer) is prostate cancer. Though it might not help your breath, garlic is thought to help prevent the disorder. Men’s Health UK highlighted a study in the Journal of the National Cancer Institute that made the case for eating about three cloves a day. They found that men that did had a 50 per cent lower risk of prostate cancer than those who chowed down on less than 2 grams.

For the lungs: Something fishy

Though lung cancer is the second most prevalent cancer among both men and women, rates are higher among guys. Carnivores with a weakness for cigarettes should take note of research cite in Reader’s Digest: the combination of smoking and animal fats appears to promote lung cancer. However, the omega-3 fatty acids prevalent in foods like salmon, sardines and mackerel “appears to minimize the effect.” Better yet, just ditch the tobacco habit altogether.

For the colon: Fiber’s your friend

In the United States, the Center for Disease Control and Prevention has listed colon and rectum cancer the third most prevalent cancer among men. Sure, it may be located in an embarrassing part of your body, but the Center believes rates could be “cut by as much as 60% if all people aged 50 years or older received regular screening tests.” Fiber has long been touted as one of the best ways to keep digestive health in check, but it need not be limited to bland breakfast cereals. Realage.com suggests eating more Mexican-inspired dishes: high-fibre foods like beans and brown rice can help fend off colon polyps which can lead to colon cancer.

For the bladder: Tomato power

Next on the Center for Disease Control and Prevention list of most common cancers among men is cancer of the bladder. Fortunately, tomatoes are one of the best foods you can eat to prevent both bladder and prostrate cancer. Livestrong.com points out that the it is one of the few foods stocked with the antioxidant lycopene, which is thought to reduce the risk of bladder cancer. Though fresh tomatoes contain more of the antioxidant, we can’t help but think a garlicky tomato sauce on top on high-fibre pasta would make for an excellent, cancer-fighting entrée.

 

http://ca.screen.yahoo.com/blogs/infused/fight-common-male-cancers-with-these-foods-172250508.html

Lab Rat - Hands on Your Heads
By Dr. Sean Delanghe, DC

Want to run more efficiently? Peter Grinbergs, head coach of Wilfrid Laurier University’s cross-country team, has a suggestion: Put your hands on your head. Grinbergs’s Hands on Head (HOH) system, developed after 30 years of coaching, involves a series of drills that focuses on diagnosing and correcting stride inefficiencies. His athletes will follow up hard workouts with light strides, walking high knees and barefoot drills - all with their hands firmly placed on their heads.

 

“If you take [the arms and shoes] away, it forces the athletes to learn what their deficiencies are,” says Grinbergs, who has coached six Olympic athletes using variations of this system. “Through practice, a corrective process occurs,” he says, adding that arms and shoes can sometimes hide flaws in running form. During an HOH session, he tells athletes to keep their upper body still. Grinbergs says this helps to establish a balanced core, decreases unnecessary arm motion, and prevents the body from moving side-to-side or up and down while running. The HOH walking high knees helps to identify key issues, such as tight hamstrings or weak hip flexors, which shortens our stride.
                   

While the HOH system is not scientifically proven, much of what Grinbergs has implemented draws parallels to what scientists in the field have discovered. For instance, a group of Australian researchers summarized the factors that we know contribute to running economy. One of the key areas is running kinematics, or how a runner moves. The research has shown that running economy improves when you keep your motion moving forward, as opposed to upward, while also keeping arm and core movements to a minimum. In other words, if you bounce less, stop swinging your arms so much, and stay centred, you will go faster without exerting any extra energy. These are all factors the HOH system is designed to identify and correct.
                   

Researchers have also shown that flexibility plays a crucial role in running economy. A runner who is too flexible will lack the free, spring-like energy a stiff muscle and tendon can provide, making them less economical. By contrast, a number of studies have also shown that runners who lack flexibility will be equally inefficient. Once again, the HOH system seems to be in line with this research as it encourages runners to develop an appropriate stride length in a functional way. Although the HOH system may parallel what the science is showing, it isn’t a miracle drill. Grinbergs says the system is not a quick fix and doesn’t work for everybody. It’s also evident that these drills are by no means a replacement for other key components to your training. You still have to do your intervals, and there is no substitute for mileage and consistency.
                   

Grinbergs’s method, when implemented as a supplement to consistent training, is paying off for many of his athletes. “Ever since I have been using HOH, my upper body movement has become much more efficient while running,” says Ben Flanagan, who represented Canada at the 2011 Youth World Championships. Flanagan’s 1500m PB has dropped by 16 seconds to 3:52.46 since implementing the HOH technique. The system is also great for beginners and recreational runners. After a hard workout, try taking your shoes off, putting your hands on your head, and walking with high knees for 50m and then running for 50m. Be sure to keep your upper body still. Follow this up with a 100m jog recovery and repeat 6 times. Stick to the plan for a few months, and you should see some positive changes in your stride.

The Basic Characteristics of Exercise
By:  Dr. John A. Papa, DC, FCCPOR(C)

Regular exercise has long been identified as an essential element of good health.  Below is a brief summary regarding some of the basic characteristics of a balanced exercise program.

Aerobic or endurance exercise improves the body’s capacity to deliver oxygen to working muscles and organs.  Swimming, cycling, jogging, and power walking are a few examples.  It is recommended that an individual engage in a minimum of 30 minutes of endurance exercise at least three times per week.  Aerobic and endurance exercise benefits the cardiovascular system.  It is also a great way to help lose weight and control blood sugar levels.

Resistance or strengthening exercise enhances a muscle’s ability to contract and do work.  Strengthening exercises can vary from using fitness machines, simple dumbbells at home, rubber bands, or your own body weight.  Improving or maintaining strength is important for preserving and building bone density.  This can assist in preventing osteoporosis and the risk of fracture from falls.  Strengthening exercises can also boost metabolism and help keep a healthy body weight.

Flexibility exercises help maintain a joint’s complete movement or range of motion.  Stretching is the most familiar form of this type of exercise but it can also include activities such as Tai Chi, Pilates, and Yoga.  Holding a sustained stretch for 15 to 30 seconds can provide modest flexibility gains.  This type of exercise becomes especially important when preparing the body for any physical activity to help minimize the risk of injury.  Individuals with arthritic conditions can find this type of exercise extremely beneficial in helping them cope with stiff and painful joints.

The exercise components of intensity, duration, and frequency will influence how one progresses through an exercise program.  For example, someone performing the endurance portion of their exercise program of walking will find that after a short while they are able to walk quicker (intensity), longer (duration), and 5 days a week instead of 3 (frequency).  This same person also finds that they are progressing in their resistance program because they can now lift a heavier dumbbell (intensity), 8 times instead of 5 (duration), and 4 times a week instead of 2 (frequency).  A simple explanation for all of this is that your body is learning through exercise how to adapt to these positive stresses being placed upon it.  In order to keep progressing, the body must have a new stimulus placed on it every once in a while.  Of course there are limits to this, and sometimes switching the nature of the exercise you perform can be an adequate change in stimulus, resulting in continued health benefits from exercise.

A lifetime of regular aerobic, resistance, and flexibility exercise is ideal, but it is never too late to start!  If you are over 35, have been sedentary for some time, or have a specific health condition or limitation, consult with a knowledgeable personal trainer or health care provider before beginning any new exercise program.

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.