All posts by sikorskychiro

Chronic Neck Pain Linked to Breathining Dysfunction

Breathing is so easy how can we do it wrong. Well, you can, and it can lead to neck pain. I have found that most patients who have neck pain have some form of breathing function. Most show 90% of my neck pain patients breathing exercise to help them breath better.

Here’s the finding from a study; Patients with chronic neck pain have reduced respiratory muscle strength and pulmonary function compared with asymptomatic individuals, and this difference could be clinically meaningful.

  • IMPLICATIONS FOR REHABILITATION
  • Respiratory dysfunction has been observed in patients with chronic neck pain.
  • Patients with chronic neck pain present a decrease in respiratory muscle strength and pulmonary function compared with asymptomatic individuals.
  • Respiratory pattern disorders should be considered in the clinical context of chronic neck pain.
  • Interventions focused on respiratory muscle training could be helpful for this population

Call Sikorsky Chiropractic Clinic at847-695-0464 or schedule online!

López-de-Uralde-Villanueva I, Del Corral T, Salvador-Sánchez R, Angulo-Díaz-Parreño S, López-Marcos JJ, Plaza-Manzano G. Respiratory dysfunction in patients with chronic neck pain: systematic review and meta-analysis. Disability and Rehabilitation. 2022 Jul 6:1-2.

Chest or stomach breather? How an altered breathing pattern causes pain

Chest or stomach breather? How an altered breathing pattern causes pain

Belly breathing

The way you breathe impacts you from a muscle and joint perspective. Poor breathing mechanics can lead to neck pain, core stability issues, low back pain, and other issues. Who knew that a simple in-out process could be so complex?

Normal breathing, also known as lung ventilation, is an automatic and seemingly effortless action. Breathing involves inspiratory (breathing in) expansion and expiratory (breathing out) contraction of the rib cage. The act of normal breathing has a relatively constant rate and volume, or amount of air that enters the lungs.

However, breathing is a coordinated effort! The act of breathing requires our lungs to expand as well as a series of coordinated muscle efforts. Starting from the chest wall, the rib cage, movement of large and small muscles, nerve signaling, ligament stretch, and even the spine. Although we often think of our lungs as being within our chest, the top of our lungs extends quite high: almost to the very base of our neck and shoulders.

When breathing issues arise and the lungs aren’t the cause, other sources like the muscles and bones must be taken into consideration. In medical literature, the term “dysfunctional breathing” refers to a group of disorders: paradoxical breathing (upper chest breathing), erratic breathing, breath holding, and breathing too deeply or erratically (hyperventilation syndrome). For this article, we will focus on the first: paradoxical breathing. While these disorders can create significant oxygenation deprivation problems, the focus of this article will be on the biomechanical effects of poor breathing mechanics.

It is important to assess breathing mechanics to determine if someone is using the appropriate muscles to engage in this vital task. Breathing is a complex activity involving the rib cage, joints of the spine and ribs, ligaments, connective tissues, muscles, and the lungs. Breathing performance is drastically affected if one or more of these structures are injured, damaged, or otherwise unable to work properly. One such common condition is upper chest breathing.

What is chest breathing?

Paradoxical breathing, or chest breathing, is a sign that you aren’t breathing properly. Chest breathing refers to chest, midback, and lower neck muscles that become overworked due to poor biomechanics.

Normal breathing involves expansion and contraction of the rib cage with our breath. Breathing also uses the diaphragm, a dome-shaped muscle located at the base of our rib cage below the lungs and heart. The diaphragm is a major muscle mover that works with the lungs to inhale and exhale. During inhalation, the lungs expand, and the diaphragm pushes down to make room for the lungs to expand with air. This presses the rib cage outward. During exhalation, the diaphragm muscle moves up to its starting position, which helps move air out of your lungs and brings the ribs inward.

During paradoxical breathing, this action is reversed. During inhalation the lungs still expand but, the diaphragm contracts. During exhalation, the lungs relax, but the diaphragm expands.

As a result, the chest and lower neck muscles become overactivated. This targeted group of muscles work together to compensate for the diaphragm. They help inflate the lungs by pulling on the rib cage to expand the upper portion.

These extra, or accessory breathing muscles in the chest and lower neck still have their own responsibilities to perform as they help with our breathing activity. The result is tight, achy muscles that aren’t effective at either job. The upper back and thoracic spine may also become stiff due to poor muscle engagement from the diaphragm, resulting in muscle tightness. Sometimes, this can even extend into the low back!

By itself, chest breathing is not necessarily a bad or pathological condition. Certain scenarios are noted for chest breathing: some examples include a sudden sprint across a lawn or a pang of anxiety while taking a test. However, when chest breathing becomes our normal method of breathing, the result is the upper chest expanding and contracting with each breath while the abdominal area does not function properly. The diaphragm is not used well during chest breathing.

What can happen from chest breathing?

Chest-focused breaths tend to be short and quick. Chest breathing uses only a small portion of the lungs and delivers a relatively minimal amount of oxygen to the bloodstream. The result is poor oxygenation to the body’s soft tissues.

In addition, excessive chest breathing causes the muscles of the chest, neck, upper back, and lower back to work too much. This can lead to tightness and strain to these areas due to overuse. The muscles become tight and ropy to the bare eye.

Chest breathing is a form of diaphragmatic dysfunction that can have many causes including trauma to the chest wall, mineral deficiencies, weak respiration muscles, sleep apnea, and nerve injury.

Symptoms of chest breathing can include:

  • Frequently waking up at night
  • Shortness of breath
  • Excessive sleepiness that doesn’t respond to additional sleep
  • Diminished or poor exercise performance
  • Muscle soreness in the neck and chest
  • Abnormally fast breathing
  • Poor posture in the upper back
  • Rounded shoulder posture
  • Tight musculature along the front of the neck

Do I have chest breathing?

Maybe.  Here is a simple test and exercise you can do at home to improve your breathing.

Description: Breathing test to assess if patient is a stomach breather or chest breather.
How to perform:

  • Lay on a comfortable surface on your back with your knees bent.
  • Place one hand on your chest and the other hand on your stomach.
  • Take 5 normal deep breaths and take notice of your breathing.

Up to 80% of breathing should come from the belly rising and falling; 20% should come from the chest rising and falling.

Chest breathing is more dominant than belly breathing when the belly barely moves. Here, the upper chest expands more than the abdomen, and the shoulders elevate towards the ears during inspiration. Excessive chest breathing causes overuse of the neck musculature and can lead to pain syndromes in the neck, shoulders, and upper back.

Here is a video from our friends at ChiroUp you can reference for proper breathing patterns initiated at the abdomen:

Breathing Evaluation – YouTube

How can I learn more about changing my chest breathing?

There are a few quick exercises you can perform to help begin retraining your diaphragm and other breathing muscles to work effectively.  Here’s a common one:

Corrections for Chest Breather:

  • Place a light book over the stomach and focus on elevating and lowering it during inspiration and expiration.
  • Lay on back.
  • Push belly outward.
  • Pull belly button down towards floor.
  • Repeat ten repetitions for two sets.

If your chest breathing has occurred over time or because of trauma, nerve injury, or other causes, other interventions may be required.  It is not uncommon to manage this condition with targeted exercises, postural improvements, and even changes to your workplace setup to help proper muscle function.

How we address chest breathing

Our goal is to not only provide you with the correct diagnosis of your breathing pattern, but also determine the underlying root cause and create an individualized treatment plan specifically for you.  We have many tools in our toolbox to conduct an effective evaluation and create an appropriate treatment. 

Conservative care is a keystone for our Boca Raton Sports Chiropractic practice. We have many treatment options for you! A few ones include specific stretches for muscles and tendons of the affected muscle, joint mobilization of the thoracic spine near the ribs, tendon loading and specific exercises to strengthen the surrounding muscles, hands-on soft tissue work into muscles, changes in exercise routine or modifications at work or at home, home exercise and stretching programs, and more.

All of these depend on if your chest breathing is caused by poor biomechanics of the muscles and joints. If your chest breathing is caused by mineral deficiencies, we may need to co-manage your care with a primary physician or specialist to determine the best course of action to address the root cause. If there has been trauma to the chest wall, such as a motor vehicle accident, a full examination is imperative and may require imaging. The best way to determine your treatment approach is to make an appointment in our office for a full evaluation.

If you are dealing with poor exercise performance due to chest breathing, muscle tightness of the chest wall, upper back, or neck, excessive daytime sleepiness, or other symptoms of chest breathing, give us a call. We are happy to evaluate you and often can provide you with a same-day examination.

Call our Sikorsky Chiropractic Clinic at 847-695-0464 or schedule online!

Piriformis Syndrome: It’s not about the tennis ball

When you have lower back pain, it sometimes can travel down to your leg.


Do you have leg pain, pain in the buttock?

You could have Piriformis syndrome.

Piriformis Syndrome: It’s not about the tennis ball

It’s true, placing a tennis ball in a chair and leaning your back on it helps a lot.


Pain in the buttocks? Then you may have heard about placing a tennis ball in a chair and sitting on it. The pressure from the tennis ball helps to relax gluteal muscles and relieve pain. But why is this? The answer is something called piriformis syndrome.

Piriformis syndrome is a common neuromuscular problem traditionally caused by spasm or enlargement of the piriformis muscle, resulting in compression or pressure on the sciatic nerve.1 The sciatic nerve starts in your low back and travels near the piriformis, which is a deep muscle in your buttock.2 The piriformis muscle attaches from the lowest part of your spine (sacrum) and travels across diagonally to your hip. And chances are, if you’re sitting while reading this blog, you’re sitting on your piriformis
muscle right now!

As the sciatic nerve travels down toward your leg, it has a chance to become compressed underneath the piriformis muscle.2 In most people, the sciatic nerve travels deeply and safely beneath the piriformis muscle. However, approximately one-fourth of the population is more likely to suffer from piriformis syndrome because their sciatic nerve passes through the muscle.

When the piriformis muscle is irritated or goes into spasm, it may cause painful compression of the sciatic nerve. Think of a tightening noose around someone’s neck – that’s how the sciatic nerve feels when compressed by an overly tight or injured piriformis muscle.


The piriformis is the powerhouse of our buttocks and a wonderful companion to the rest of the gluteal muscles unless injury, muscle spasm, or anatomical anomalies occur.2,3 If this occurs, piriformis
syndrome can result. What does Piriformis Syndrome feel like?
This neuromuscular condition is a genuine pain in the rear: Tenderness, numbness, and pain in the buttocks that extends down the back of the leg are the most common symptoms.


Other symptoms of piriformis syndrome include:
· Discomfort while sitting
· Pain while climbing stairs or walking
· Restricted motion in the hip
· Pain, numbness, or tingling traveling toward the foot
· Pain or burning-like sensation that worsens with flexion, adduction, and internal rotation of the hip


Symptoms often increase when you are sitting or standing in one position for longer than 15-20 minutes. Changing positions may provide temporary relief. You may notice that your symptoms increase when you walk, run, ride a bicycle, climb stairs, ride in a car for long periods of time, sit cross-legged, or get up from a chair.

What is NOT Piriformis Syndrome?
Piriformis can be mistaken for sciatica, an inflammation of the sciatic nerve that comes from the low back and travels down the back of the leg toward the foot. Piriformis syndrome pain may be burning or aching in nature like sciatica symptoms, with pain in the posterior gluteal region migrating down the back of the leg.4 However, the cause of sciatica compared to the cause of piriformis syndrome is distinctly different. There are various reasons why sciatic nerve entrapment occurs, but when it is caused specifically by the piriformis muscle, it is called piriformis syndrome.

There can be other conditions that happen alongside piriformis syndrome. Although these secondary conditions do not directly cause the piriformis to tighten along the sciatic nerve, they can contribute to
or complicate the problem.

These include:
· Sacroiliac pain. Because the piriformis muscle also arises from the capsule of the Sacroiliac (SI) joint, the association between piriformis syndrome and SI joint pain exists.4
· Femoroacetabular impingement (FAI).5 This distinct hip joint problem is caused by a change in the shape, or anatomy, of the major hip joint. The result is decreased internal rotation of the hip, which may contribute to contracture (tightening) of hip and gluteal muscles, and subsequent compression of the sciatic nerve.


What causes Piriformis Syndrome?
The onset of Piriformis syndrome may begin suddenly because of an injury or develop slowly in response to repeated irritation. Common causes of piriformis irritation or spasms can result from a strain, a fall
onto the buttocks, or catch oneself from a “near fall.” In other instances, the process may begin following repetitive microtraumas such as long-distance walking, stair climbing, or sitting on the edge of a hard surface or a wallet. In many cases, a specific triggering event cannot be pinpointed. The condition is most common in 40-to-60-year-olds and affects women more often than men. Your Doctor of Chiropractic is the best person to take a history and perform a physical and orthopedic
examination to determine if you have piriformis syndrome. If you or someone you know is diagnosed with piriformis syndrome, the good news is, most cases are best and easily treated with conservative,
non-invasive interventions.


What is the best way to treat Piriformis Syndrome?
Pain and discomfort arising from piriformis syndrome is one of the most treatable varieties and is relieved by the type of treatment provided in our office. Treatment may include stretching, myofascial
release, and correction of underlying biomechanical dysfunction.
You may need to temporarily limit activities that aggravate the piriformis muscle, including hill and stair climbing, walking on uneven surfaces, intense downhill running, or twisting and throwing objects
backward. Changes in body position and ergonomics may include changing your sitting posture, not sitting on one foot, and taking frequent breaks from prolonged standing, sitting, and car rides. Other
forms of treatment may include aquatic therapy, physiotherapy, or a referral and co-management with another provider for NSAID medication or injections. Thankfully, surgical release of the piriformis
muscle and decompression of the sciatic nerve is the last resort, and for good reason – most cases respond well to conservative care.4,5
References

  1. Martin, H. (2017). Deep gluteal space syndrome. Chicago Sports Medicine Symposium: World Series of
    Surgery. Session XV: Hip Session II- Extra-Articular Hip and Pelvis Pathology.
  2. Cass, S.P. (2015) Piriformis syndrome: a cause of nondiscogenic sciatica. Curr Sports Med Rep.
    Jan;14(1):41-4.
  3. Fishman, L.M., Dombi, G.W., et al. (2002). Piriformis syndrome: diagnosis, treatment, and outcome–a
    10-year study. Arch Phys Med Rehabil. Mar;83(3):295-301.
  4. Carro, L.P., Hernando, M.F., et al. (2016). Deep gluteal space problems: piriformis syndrome,
    ischiofemoral impingement, and sciatic nerve release. Muscles Ligaments Tendons J. Dec 21;6(3):384-
    396.
  5. Newman, D.P., and Zhou, L. (2021). Piriformis Syndrome Masquerading as an Ischiofemoral
    Impingement. Cureus. Sep 16;13(9):e18023.

Can a wallet cause lower back pain?

The answer is yes. Sitting on something like this can cause lower back pain. 

 This can cause you to become lopsided with a rounded, banana-shaped spine.   This hunch-like position puts more stress on the back and spine and can even cause a slouchy posture with slumped shoulders.   Muscles work harder to compensate, and joints become stiff and achy.  

The sciatic nerve gets pinched between your wallet, your gluteal muscles, and your hip. Even after a short time, the sciatic nerve can become irritated, causing discomfort that ‘zings’ down the back of the leg and into the heel.  This condition is so commonplace that it has earned the nickname, “wallet neuritis,” describing the inflammatory response that happens to the sciatic nerve due to sustained compression.

What to do? 

Your best bet is to remove it from your back pocket
entirely before you sit down or get in your car.  You could switch your
wallet to your front pocket – but be warned that prolonged use of a wallet in this position can also pinch a nerve between the thigh and torso, especially when you’re in a car.  This can create discomfort as well. While at work, place the wallet in your desk, locker, or somewhere safe. You should also avoid anything bulky and stick to slim wallets or money clips that hold only the essentials.

If you’re having lower back pain call or click to make appointment.

Does Foam Rolling help with muscle stiffness?

The answer is…….. Yes. Foam rolling helps decreases soreness by decreasing muscle stiffness

Here’s a great study showing the effectiveness of foam rolling. Foam rolling is a great way to do some self-care. Whether you’re working out, gardening, or doing household chore. Muscles can get sore and tight.

Foam rolling is an easy and effective way to help break up and relieve. You can foam roll after a workout or in front of the tv at the end of the day.

Foam Rolling Prescription: A Clinical Commentary – PubMed (nih.gov) The Acute and Prolonged Effects of Different Durations of Foam Rolling on Range of Motion, Muscle Stiffness, and Muscle Strength – PubMed (nih.gov) Effects of 5-Week Foam Rolling Intervention on Range of Motion and Muscle Stiffness – PubMed (nih.gov)

Can Inversion Table help lower back pain?

Inversion Table for stretching and pain relief.

A question I get all the time is: do Inversion tables help with back pain?

This study finds that Inversion tables can help lower back pain & spinal traction. Spinal Traction is a form of stretching. Inversion table provides pain relief in your lower back. An inversion table is not for everyone.

The 2-year surgery rate in the inversion participants in the registry (21%) was significantly lower than in the matched control group (39% at two years and 43% at four years). It was also lower than the surgery rate in the other 2 control groups. [Conclusion] Inversion therapy relieved symptoms and avoided surgery.

Lower back pain can be treated by a variety of treatment. Chiropractic, physical therapy, medication, home exercise. Inversion tables might also be part of your treatment. It can’t hurt and might help you improve your pain.

INVERSION LOWERS DISC SURGERY RATE BY NEARLY HALF 

Mendelow AD, Gregson BA, Mitchell P, Schofield I, Prasad M, Wynne-Jones G, Kamat A, Patterson M, Rowell L, Hargreaves G. Lumbar disc disease: the effect of inversion on clinical symptoms and a comparison of the rate of surgery after inversion therapy with the rate of surgery in neurosurgery controls. Journal of Physical Therapy Science. 2021;33(11):801-8. Link 

Fat Stacks = Back Pain?

Can a wallet or a purse cause back pain?

“Purses are for girls, and back pockets are for boys.”

If you grew up with this train of thought for how to carry your wallet, then you might also know it’s a tough habit to break. 

Yet, despite being taught that wallets go into our bags or back pockets, we weren’t told that stashing our stuff could be bad for our backs or joints.  Who knew that sitting on a bunch of folded bills or stashing coins and lip balm in a shoulder bag can wind up causing aching shoulders, back, and neck pain?

Rather than teach us how to live better, we had consumerism marketing masquerading as advice.  The result: new purses were bought to help alleviate shoulder pain, and new jeans were purchased whenever the back pocket wore out.

How does using a purse or sitting on my wallet affect me? 

Carrying heavy shoulder bags, sitting with a wallet in your back pocket, and even heavy backpacks have one major consequence in common: lopsided posture.  Slipping your wallet into the back of your jeans or into your shoulder bag (which can also carry emergency bandages, spare pens, and the weight of a thousand other things to do) causes uneven weight distribution on the spine, hips, and shoulders.  Sitting with one hip higher than the other due to the bulk of a wallet creates a lopsided tilt of the pelvis or the sitting bones.  Something similar happens with a heavy purse: lopsided weight is consistently carried on one shoulder, weighing down one side compared to the other.  

The result is a person sitting lopsided with a rounded, banana-shaped spine.  This hunch-like position puts more stress on the back and spine and can even cause a slouchy posture with slumped shoulders.   Muscles work harder to compensate, and joints become stiff and achy.  

Sitting on a wallet or carrying a shoulder bag can also affect the nerves of our body.  Carrying a heavy bag over the shoulder can strain the muscles and nerves of the neck in an area called the brachial plexus.  Pinched nerves in this area can result in tingling and numbness down the arm, into the hand, and down to the fingertips. 

A similar effect happens from sitting on a wallet: the sciatic nerve gets pinched between your wallet, your gluteal muscles, and your hip. Even after a short time, the sciatic nerve can become irritated, causing discomfort that ‘zings’ down the back of the leg and into the heel.  This condition is so commonplace that it has earned the nickname, “wallet neuritis,” describing the inflammatory response that happens to the sciatic nerve due to sustained compression.

Even the thinnest wallet and lightest of shoulder bags can create these symptoms.

What can I do about it?

If you love your wallet or carrying a bag, however, all is not lost!  Some simple changes in your daily routine will help you keep using your cute clutch, nifty clip, or the leather wallet you received as a birthday gift.

If you must carry a bag, keep it to just the essentials: pare down your carrying case to make it more lightweight.  If you can, invest in a bag with a wide-banded strap that crosses diagonally over the torso.  This design helps balance weight between your shoulder blades, chest, and pelvis, and even helps prevent theft by making your bag harder to steal.  Consider switching to lighter gauge materials such as nylon, long-strand cotton, or canvas that are also durable with wear and functional to use.  At the very least, alternate shoulders to prevent one side from maintaining the bulk of the weight.

Waist bags (or fanny packs as some call them) are fantastic to avoid the shoulder region altogether.  Plus, there are many fashionable styles that are also functional!

For wallet users, your best bet is to remove it from your back pocket entirely before you sit down or get in your car.  You could switch your wallet to your front pocket – but be warned that prolonged use of a wallet in this position can also pinch a nerve between the thigh and torso, especially when you’re in a car.  This can create discomfort as well. 

While at work, place the wallet in your desk, locker, or somewhere safe. You should also avoid anything bulky and stick to slim wallets or money clips that hold only the essentials.

The bare minimum advice is to alternate back pockets to carry your wallet if you must use the back pocket to carry your wallet (or a similar object) at all.  This helps evenly distribute the lopsidedness when sitting as well as wear-and-tear on your pants.

What if that’s not enough?

We can take care of you at Sikorsky Chiropractic and Fitness. We perform a detailed history of your injury, followed by a functional movement assessment and examination.

If you have been carrying a purse or sitting on your wallet for many years, this may be a cause of shoulder pain, low back pain, and even pelvic imbalances. We recommend scheduling a chiropractic visit to evaluate any muscle aches, imbalances, or joint problems you may have.  We can help identify postural compensations or spinal fixations that result from wallet and shoulder bag ergonomics and provide other alternatives to keep you functioning, feeling great, and your belongings safely stowed where you need them.

References

1. Siddiq, M., Jahan, I., & Masihuzzaman, S. (2018). Wallet Neuritis – An Example of Peripheral Sensitization. Current rheumatology reviews, 14(3), 279–283. 

2. Lutz, E.G. Credit-card-wallet sciatica. JAMA. 1978;240(8):738.

3. Viggiani, D., Noguchi, M., Gruevski, K.M., Carvalho, D.D., and Callaghan, J.P. The Effect of Wallet Thickness on Spine Posture, Seat Interface Pressure, and Perceived Discomfort During Sitting. IISE Transactions on Occupational Ergonomics and Human Factors. 2014;2:83–93.

4. “Heavy backpacks and children.” Southwest Scoliosis Institute. Retrieved from https://scoliosisinstitute.com/heavy-backpacks.

5. Rempel, D.M., and Diao, E. Entrapment neuropathies: pathophysiology and pathogenesis. J. Electromyogr. Kinesiol. 2004;14(1):71–75.

6. Mwaka, E.S., Munabi, I.G., Buwembo, W., et al. Musculoskeletal pain and school bag use: a cross-sectional study among Ugandan pupils. BMC Res Notes 7, 222 (2014).

7. Amyra Natasha, A., Ahmad Syukri, A., Siti Nor Diana, M. K., Ima-Nirwana, S., & Chin, K. Y. (2017). The association between backpack use and low back pain among pre-university students: A pilot study. Journal of Taibah University Medical Sciences, 13(2), 205–209. 

Want to live longer? Have strong hands.

In a previous blog posting , I posted about the association between handgrip strength and Morbidity (the rate of disease in a population) and mortality(the number of deaths in a population during a given time or place ).

I have this same tool for myself. I use it almost all day every day.

Here are three more studies that show the link between hand strength and disease.

The first study shows the link between hand strength and sickness and death. The first study showed there was sufficient evidence that hand strength was a predictive link all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and problems associated with hospitalization. That’s a pretty impressive list

The second study used a dynamometer(handheld testing tool) to test hand strength. The authors of the study found that patient with greater differences from side to side shows an increased morbidity risk. The greater the difference the greater the risk.

The third study showed: Assessing hand grip strength asymmetry, as another potential biomarker of impaired muscle function, may provide novel insights for predicting instrumental activities of daily living limitations. Future research should continue examining how strength asymmetries, and other aspects of muscle function beyond maximal strength, factor into the disabling cascade.

Grip Strength: An Indispensable Biomarker For Older Adults

Handgrip Strength Asymmetry and Weakness Are Associated With Future Morbidity Accumulation in Americans – PubMed (nih.gov)

Handgrip Weakness and Asymmetry Independently Predict the Development of New Activity Limitations: Results from Analyses of Longitudinal Data from the US Health and Retirement Study

What is Metabolic Syndrome

Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke and type 2 diabetes.

Having metabolic syndrome increase your chances of getting heart disease. Heart disease includes coronary heart disease it is often caused by the buildup of plaque, a waxy substance, inside the lining of larger coronary arteries. This buildup can partially or totally block blood flow in the large arteries of the heart

To have the diagnosis of metabolic syndrome. A patient has to have 3 out of 5 of these following conditions.

  1. Elevated waist circumference Men greater then 40 inches.
  2. Elevated Triglycerides: greater then 150
  3. Reduced HDL cholesterol: less than 40mg/dl for men and less than 50mg/dl for woman
  4. Elevated Blood Pressure: greater then 130/85 mm Hg
  5. Elevated Fasting Glucose: greater then 100 mg/dl

I like this diagram, it puts together how many diseases can link together to cause another condition.

The relationship between adiposity, inflammation, insulin resistance and athleroschlerotic vascular disease. Image Credit: (Boden, 2009) T2DM(diabetes) dyslipidemia ( abnormal

How do you treat Metabolic syndrome? It’s hard to but easy to answer. Get Healthy

  1. Start to exercise. Walking 30 minutes a day is great way to start.
  2. Get adjusted to ensure your body is functioning the best it can.
  3. Improve your diet. Eating plenty of vegetables, fruits, lean protein and whole grains. A Purification Program is a great way to jump start your weight loss. I like the Purification Program from Standard Process.
  4. Learn how to cook health meals.
  5. Limiting saturated fat and salt in your diet
  6. Lose weight
  7. Drink water instead of soda or fruit juices
  8. If you smoke, stop.
  9. Reduce alcohol consummation. Start with a 30 day alcohol free challenge and go from there.

Do you want to be fit and healthy at 80? 2.0

Can you be fit and healthy at 80? The answer is yes.

So how can you be fit and healthy at eighty? So what exercise should I do? What type of exercise will help me stay healthy or will help me become more healthy? You’re going to find out.   

The type of exercise will depend on what the end goals are. If you’re going to run a marathon it will be different than if you want to be a bodybuilder. This article will discuss exercising in the context of health and improving one longevity. 

Generally, speaking exercise can fall into two broad categories: Cardiorespiratory fitness and Strength/muscle mass. Both of these play the role of improving life span. The scientific literature shows that morbidity and mortality risk increase as fitness levels decline with age. Sarcopenia is associated with adverse health outcomes. 

Now for some definitions.

What are morbidity and mortality? Morbidity is the condition of suffering from a disease or medical condition. Mortality is the state of being subject to death. 

Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory (heart and associated blood vessels) and respiratory (Lungs) systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. Mitochondria are inside most cells and they make energy.

Muscular strength can be defined as the ability to exert force to overcome resistance In other words the ability to pick up or move objects around. 

Muscle mass is the amount of muscle in your body, including skeletal muscles, smooth muscles, and cardiac muscles. 

Loss of muscle mass and strength is known as Sarcopenia.  

Let’s talk about cardiorespiratory fitness

Cardiorespiratory fitness is measured in VO2 max. VO2 max, or maximal oxygen consumption, refers to the maximum amount of oxygen that an individual can utilize during intense or maximal exercise.  

Have you ever gone up a flight of stairs ran for the bus and got out of breath? You just tested your VO2 max. The better your VO2 max the better you’re able to exchange oxygen (O2) in the body. 

Here’s a study association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. The study found “The adjusted mortality risk of reduced performance on exercise treadmill test was comparable to, if not greater than, traditional clinical risk factors (eg, coronary artery disease, smoking). Importantly, there was no upper limit of the benefit of increased aerobic fitness”. So having poor cardiorespiratory fitness is as dangerous as smoking for your health and life span.  That right having low cardiorespiratory fitness is as dangerous as smoking.  The study broke down the participants into low, below average, average, high, elite. Going from just being low to being below average is a 50% reduction in mortality over a decade. If you then go from low to above average it’s about 60%  above average, it’s about a 60% or 70% reduction in mortality.   

How can we improve VO2 max? 

Well, it’s cardio. Any type of cardio, walking, rowing, or riding the bike. Any exercise that gets your heart rate up. You don’t have to do a bone-crushing workout every day to improve or keep your VO2. About 20 minutes once a week would be a good amount. So if walking is your form of cardio find a big hill and do hill repeats (walk up the hill quickly) and then walk down, let your heart rate recover, and do it again. The same principle can go for riding a bike. Go hard for 1 minute and then recover and repeat. Do that once a week and that will help your V02 max and improve your oxygen exchange.

Doing this type of cardio once a week is great for your health. Some tips start slow, no need to do 20 hill repeats the first time out. 

Start with 3-5 reps and build from there. If you feel any chest pain or thing that does not feel normal a call your doctor or heart doctor (Cardiologist). If the discomfort is too bad go to the ER. 

Now the other days you train, your cardio should be different. You should be training Zone 2. Zone 2 is steady training just coming above the easy zone, It’s not moderate or anything above. The main benefit form zone 2 heart rate or zone 2 power is that it builds an aerobic base and endurance. The best formula to figure out Zone 2 heart rate is the following;

(Your age)-180= Target heart rate.

I’m 48 years old so my target heart rate is 133. (180-47=133)

The benefits of Zone 2 training are, increased mitochondria (the power plant of the cell), increased mitochondrial efficiency, lower heart rate, lower blood pressure, and finally help with insulin resistance.

So doing both types of cardio will help you balance your cardiorespiratory fitness. A good ratio is 80% zone 2 and 20% hard. 

Strength/Muscle mass

Sarcopenia, or the decline of skeletal muscle tissue with age, is one of the most important causes of functional decline and loss of independence in older adults. An average person can lose 1-4% of their lean mass (muscle) and year. 

Figure 9. Strength loss with aging in literature (Keller and Engelhardt, 2013).

If you have low muscle strength, then you have probable sarcopenia. 

As we age we replace our muscle fibers with fat and connective tissue. 

So the muscle loses its ability to contract (contractile function) and muscle metabolic function. Muscles need lots of energy, so they use a lot of blood glucose (sugar). If a person has less muscle then they use less sugar/blood glucose leading to insulin resistance and then type 2 diabetes

Two ways to see how well you’re doing are the sit-to-stand test and grip strength test. This study Strength, But Not Muscle Mass, Is Associated With Mortality in the Health, Aging and Body Composition Study Cohort.  The authors used sit-to-stand test and grip strength test, in their study to see how strength affects Mortality.

 Low muscle mass did not explain the strong association of strength with mortality, demonstrating that muscle strength as a marker of muscle quality is more important than quantity in estimating mortality risk. Grip strength provided risk estimates similar to those of quadriceps strength.  

The ability to get out of a chair without using your arms is very important. This movement is a squat. If you trip over a sock while going to the bathroom at night you need the strength in your leg to prevent you from falling and potentially hitting your head or breaking a bone when you fall.

30-second Chair Stand test is a great way to test how strong your legs are.  Try it out and see if you’re at risk for falling.  If you are get to work and improve your muscle strength in your legs.

 Fall death rates in the U.S. from 2007 to 2016 for adults aged 65 and older. (CDC)

Fall death rates in the U.S. from 2007 to 2016 for adults aged 65 and older. (CDC)

From 2007 to 2016, 10 years, we saw the deaths per 100,000 in the United States as a result of falls go from about 46 to 60 (That’s a 30% increase). At this rate, by 2030, we’re going to see seven fall deaths every hour

The other day I slipped on some clothes my kids left on the stairs. What stopped me from falling down the stairs? Grip strength, the ability to grab the railing and stop my fall.

Fall death rates in the U.S. from 2007 to 2016 for adults aged 65 and older. (CDC)

Fall death rates in the U.S. from 2007 to 2016 for adults aged 65 and older. (CDC)

From 2007 to 2016, 10 years, we saw the deaths per 100,000 in the United States as a result of falls go from about 46 to 60 (That’s a 30% increase). At this rate, by 2030, we’re going to see seven fall deaths every hour

The other day I slipped on some clothes my kids left on the stairs. What stopped me from falling down the stairs? Grip strength, the ability to grab the railing and stop my fall.

Grip strength.

Grip strength is harder to test but it is still important. So, start working on hand strength by carrying heavy objects or get yourself a hand gripper. Carrying heavy objects for a workout is called a farmer’s carry. Farmer carries are good for your core as well as your hand/grip strength.

Get a Grip! – YouTube https://youtu.be/NXaQcKYeloY

Pushing, Pulling, Squatting & More! – YouTube (Farmer’s Carry)

So as we age it’s critical to work on maintaining muscle mass and strength to improve the quality of our lives. The stronger we are the more muscle we have the lower the morbidity and mortality. It’s never too late to start. It’s better never to stop building muscle.  

Figure 15. Paddon-Jones Curve.

A lot of people think that there’s a linear or gradual decline in muscle mass or muscle size as we age. The reality is that it’s a lot more staggered as you get into older age…if you’re injured or if you’re bedridden, for example, that accelerates the decline.

Much like saving money the more you have when you retire the more you have to withdraw from.  So start now and build as much muscle as possible.  Your life could depend on it.

So where to start:

  1. Get off the couch, the hardest lift is lifting yourself off the couch.
  2. Get outside and walk. It’s easy and free. 
  3. Find a big hill and walk up and down it once a week.
  4. Start lifting weights. A gallon of milk/water is a great start. If you need an idea on what to do go over to our YouTube page.
  5. Start doing Chair squats. Here’s a link to show how to do them
  6. Find something heavy and do farmers carries or static holds till you feel the burn.
  7. Anything is better than nothing.
  8. Come in or Call I would love to help.  Dr. Steve