A consequence of a fall could be a hip fracture. Quarter of individual experiencing a hip fracture will pass away within a year, and a half will be unable to return to their previous level of function. Thes statistic underscore the urgent need for fall prevention.
Almost 40% of people over 70 fall at least once a year. 1 in 5 of these falls result in serious injury.
Last year, 300,000 Americans fractured their hip after falling.
Nearly 25% of those who fracture their hip will be dead within a year.
50% of them won’t return to their prior level of function.
Why do the elderly fall at increased rates?
Falls may occur due to a combination of factors, including a lack of balance and weakness in the supporting musculature. Poor balance may lead to the act of falling, but it is the weakness within the foot and leg that results in the inability to recover from falling. Weakness in the legs can lead to falls down the stairs. Weakness in the feet and calf can lead to falling during the initiation of walking.
Below are some simple exercises that you could use to strengthen your muscles in your leg to help lower your risk of falling.
1)www.cdc.gov/falls/facts 2)Snow C, Shaw J, Winters K, Witzke K. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2000 Sep 1;55(9):M489-91.
The “pop” sound during an adjustment, arises from inside a joint after moving the joint past a restricted range of motion (ROM). These sounds are called a cavitation.
What is a cavitation?
Cavitation sounds result from the separation of joint surfaces, which results in a rapid decrease in intra-articular pressure (cavitation), which results in degassing of synovial fluid (mostly carbon dioxide), the creation of a cavitation bubble within the joint, and the sound itself is the result of bubble collapse. An Adjustment Separates the spinal joints call facets joints. There is synovial fluid in the inside the facet joints. The following happens to create the cavitation.
Resulting in a rapid decrease in intra-articular pressure (cavitation)
Degassing of synovial fluid (mostly carbon dioxide)
Creation of cavitation bubble within the joint
The sound itself is either the result of bubble collapse (like popping a balloon) or bubble formation/tribonucleation (like pulling a suction cup off of a window).
I have ordered a lot of MRIs during my chiropractic career. I have order less as I progressed thru my years of practice. I have found that most people will have some changes on an MRI. The most common finding includes, arthritis, disc bulging and disc hernation.
If your over 40, good chances that you’ll have some changes/finding on an X-Ray of MRI. I can only think of two recent patient that had no finding on their MRI.
Does a finding on an MRI mean it’s the pain generator? No, it does not. As a doctor we should treat the person in front of us and not an image.
If the symptoms warn it or patient fails to progress at all, then advanced imaging might be needed. The most common advanced Image is an MRI. Magnetic Resonance Imaging (MRI) is a non-invasive imaging technology that produces 3d images of the body.
Here a great study that showed most people have finding and asymptomatic
“We performed MRI examinations on 98 asymptomatic people. The scans were read independently by two neuroradiologists who did not know the clinical status of the subjects. To reduce the possibility of bias in interpreting the studies, abnormal MRI scans from 27 people with back pain were mixed randomly with the scans from the asymptomatic people.”
“On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.”
So, if you have finding on a MRI and are having symptoms. maybe the pain is coming from the finding or maybe it not. The important thing is to treat the person as a whole and not just a finding.
Ref.:
N Engl J Med. 1994 Jul 14;331(2):69-73. Magnetic resonance imaging of the lumbar spine in people without back pain. Jensen MC1, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS.
The Clam exercise in a great exercise to help with strengthening the hip and lower back. Hip and Back pain can be helped with the Clam exercise.
The exercise above is a nice variation to focus on the buttock more. By placing the foot in front of the other foot will internally rotate the hip and turning off the front muscle making the back muscle (Glute Medius) the primary muscle doing the movement.
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:
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!
Companies adopting the “standing at your desk” culture want to create an active workspace which is more collaborative and productive. This type of work environment is very attractive to a new generation who actively hedge against the burdens of disease later on in life.
To clarify, there is a difference between voluntary standing at your desk culture and occupational standing jobs. The former is clearly voluntary, and the employee can sit down when stressed. The latter makes it mandatory to stand at your desk for the duration of your work.
A study by the American Journal of Epidemiology found that workers who stand for long periods of time were at a higher risk of heart disease compared to their seated counterparts.
This means that even standing should be done in moderation at work.
For you to benefit from the “standing at your desk” culture, avoid common mistakes like pushing yourself to stand for long. You don’t have to stand all day to stay healthy. Start with 15 to 20 minutes a day and build up to two hours a day then four hours. They are called sit/stand desks for a reason, because you can adjust them to accommodate you when you are seated or standing.
To make it more bearable, you can play some music or interact more with your colleagues.
Also, makes sure the desk is the right height. If it’s too short you’ll ruin your posture but too high and you will feel it in your neck and arms. The correct position is having your elbow no more than 90 degrees and your eye line directly opposite your computer screen or just below.
On top of that, you want to pay attention to your posture to eliminate the chances of lower back pain. The right posture creates an S-curve to your spine. Using a standing mat gives you more comfort on the balls of your feet and reduces fatigue to the legs.
Experts recommend standing for 30 minutes per hour in order to get the type of health benefits you are looking for. This approach gives you half an hour of rest and half an hour standing to strike the best balance.
Some people believe that you don’t need a sit/stand desk to stand regularly. They believe that water and coffee breaks, bathroom breaks, and moving from one department to another to interact with a colleague provide plenty of standing opportunities to promote good health.
However, with the presence of phones and e-mails, we rarely have to get off our chairs at work to go and ask a colleague a question in person. Besides, how many bathroom breaks do you take? According to the Society for Human Resources Management, you can use the standing desk to promote an active workforce without relying on snacks and bathroom breaks to fill the gaps.
Finally, for the standing at your desk culture to succeed, there has to be a commitment to the initiative from the top down.
For example, it’ll be very difficult to encourage staff to stand at their desk or even use the trendy workstations with bicycles or treadmills attached when the managers never go near those things. After all, no one wants to seem like they are exercising when they should be working.
When an office decides to go down the path of an active working environment, everyone should be involved. Remember: standing desks are a powerful investment in employee wellness and health.
Body is designed to sit and stand throughout the day. There are many ways to get your standing throughout the day without the need for a sit-to-stand option.
Sit-to-stand options can be useful and make the ability to stand more readily available. If you do have this options, here is what you need to look out to ensure proper utilization.
Most start at 15-20 mins within the hour in the beginning then it grows.
4-6 hours per day after 30 days.
Start off slowly- taking breaks.
Listen to your body.
The flat surface and flat shoes (no heels!)
Weight distribution right below hips and arms at a right angle looking straight ahead and slightly down.
