Tag Archives: chiropractor

Stand Up

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. 

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.
    • Don’t do continuous 8 hours of standing. 

Understanding lower back pain.

I treat a lot of lower backs. Many times the cause of the pain is from moving incorrectly. Bending or twisting wrong 10,000 time can lead to acute pain, much like a fall or car accident can.

Half of my job as a chiropractor is teaching patients how to move and use their body correctly again.

The following information is from a great book meant for the non-physician to help resolve their own back problems. The book is by Stuart McGill PhD and is called “Back Mechanic: The secrets to a healthy spine your doctor isn’t telling you.”

Back Mechanic by Stuart McGill - A Comprehensive Review
The book cover., Back Mechanic: The secrets to a healthy spine your doctor isn’t telling you.”

I highly recommend this book if you have suffered or are currently suffering from low back pain.  I have taken multiple classes from him.  A lot of what I teach patients comes from his research.  The end goal is to remove the stressors and spare your spine with proper movement and strengthening exercises.

“Many back pain sufferers would experience a huge breakthrough in their recovery if they only realized that is was their flawed movement patterns that kept them pain-sensitive. Much like a scab forming on our skin, our backs are constantly trying to patch and health themselves. We, however, by continuing to repeat harmful movement patterns in our daily lives cause re-injury. We are essentially “picking the scab.” It is unreasonable to expect the body to heal if we continue to provoke it in the same way that led to the original injury. Continued provocation of pain sensitizes the nerves so that the pain is triggered with even less stimulation. Remove the provocative motions and we can find the solution.

Here’s how pain sensitivity works: people increase their sensitivity through repeated stressful and painful loading. These muscles and joints are loaded with sensors: pain sensors, pressure sensors, force sensors, chemical sensors. Some detect carbon dioxide; some detect pain, some sense histamine for inflammation. Human joints are packed with sensors that relay position and movement information to the brain. These signals travel along the sensory nerves. Along the highway of nerves, there are checkpoints or “gates,” at junctions. According to the Gate Theory of Pain, the idea is, to flood the checkpoint with “good information,” in other words, signals associated with pain-free movement. In this way, there is no more room for the pain signals as they are crowded out.

The sensation of this simple pain-free motion dominates the information traffic on your sensory nerves with feel-good kinesthetic sensory information that identifies position, length, and force. Finding and repeating pain-free motions in your back will cause the remaining painful activities to hurt less. Read the previous sentence again – it really is that important.

By discovering and engraining positive movements for your back, you will find that the pain often dissipates and then disappears entirely. This is because when we remove pain triggers and stop “picking the scab” we give our tissues a chance to rest, heal and regenerate. Simultaneously our sensors for pain are actually being desensitized. Master this, and you have mastered your back pain.

For those of you that have a known type of injury, a name to attach to your condition, your personal recovery strategy should always begin with avoiding the aggravating posture for your unique spine is key to getting yourself back on track.

Various symptoms of back pain have a distinct and known cause (although this information is not widely known making this book uniquely valuable). Injuries can be avoided if we avoid the injury mechanism itself. Here’s a recap of some pain avoidance strategies, as well as an introduction of some that will be discussed later. The knowledge in this chapter will provide the foundation that will help you:

  1. Locate and eliminate the cause of your pain- get an appropriate assessment that provides a specific diagnosis (Make an appointment or start with reading chapter 6).
  2. Increase your consciousness around what movements and postures cause you pain.
  3. Develop replacement postures and movement patters that enable you to function pain-free.
  4. Stabilize your torso, core, and spine to remove painful spine joint micro-movements.
  5. Develop a daily exercise plan that includes walking.
  6. Mobilize your hips and use your hips to lift.
  7. Learn to create power at the ball and socket joints (hips and shoulders).
  8. Learn exercises that are based on patters of movement: push, pull, lift, carry, lunge, squat, etc.
  9. Make healthy spine choices when sleeping, sitting, or engaging in more demanding activities.

You’re on your way to learning the secrets of a pain-free lifestyle! Let’s make it happen!

An Example of Gait Changes After Treatment

I recently posted a research journal that stated that after an injury patient’s gait might need to be retrained. Here is an example of a patient with a dysfunctional gait:


Take a look at this patient’s gait. Watch her left leg and then watch the right leg. The left knee tracks outward. Look at the patient’s knee. It points outward right instead of pointing forward. Look at the patient’s foot. This patient is towing off laterally and not getting into her big toe.

The second video is after treatment of adjustment to her foot, ankle and lower back, plus a week of home exercises along with some mental corrections. Patient was cued on the changes in her gait and how to improve the lower extremity function. We practiced in the office and the patient was sent home with some homework.


This is an example of how gait retraining can help improve a patient’s function. Strengthening the body is very important but strengthening dysfunctional movements will not progress the patient towards optimal.

Lower Crossed Syndrome

Lower crossed syndrome is something I see -or a version of it- in almost every lower back patient I treat.

If one muscle is weak another muscle has to do more and becomes over worked. In turn becoming tight and painful. I’ve heard this about 1,000 times- “I keep stretching muscle ‘x’ but it’s always tight.” Maybe it’s not a stretching problem. It could be a strengthening problem. By strengthening the weak muscles you will help “turn off the overactive muscles”. I have not had a patient with chronic pain that had strong abdominal muscles. It’s a very common problem.

When the abdominal muscles are inactive and not supporting the spine, while the spinal erectors are pulling the lumbar spine forward, it results in something called hyperlordosis. This means that the spine in the lower back has an exaggerated curve, which can result in accelerated degeneration of the joints of the spine.

At the same time, the hip flexors are facilitated and are chronically tight while the gluteus muscles are inhibited and have reduced activation. This leaves the back muscles to do most of the work to extend the spine instead of the gluteus muscles keeping the pelvis level. The muscle of the back are good a stabilization and less effective as a prime mover. The overuse causes painful and tight muscles.

Treating a patient who has a lower cross syndrome, is three parts:

1) Chiropractic adjustments help improve spinal biomechanics 2)Then education on the correct exercise to strengthen weak muscle and stretches to the tight muscle. 3) Poor movement patterns will be addressed. Improving how a patient moves will help prevent injuries in the future.

If you think you’re suffering from lower crossed syndrome call the office today! We will get you on the road to recovery.

Chiropractic Care Lowers Opioid Use

Chiropractic is the best choice for drug free health care. The United States opioid epidemic is well documented. (1) Seeing a chiropractor is a great way to treat pain without pain medicine. Chiropractic care with a good home exercise program is a great way to treat most conditions. Throw in some movement correction and ergonomics now we’re talking about great care.

“Patients with spinal pain who saw a chiropractor had half the risk of filling an opioid prescription.” Pain Medicine (2)

“Offering (chiropractic) services in primary care may help to address pain and disability, and hopefully limit external referrals, advanced imaging, and opioid prescriptions.” Journal of Primary Care & Community Health (3)

“Compared to patients with neck pain who saw a primary health care provider, patients with neck pain who initially saw a conservative therapist were 72%-91% less likely to fill an opioid prescription”  Archives of Physical Medicine and Rehabilitation (4)

Here at Sikorsky Chiropractic we use adjustments, exercises, ergonomics, movement corrections to help patients become pain free.

Chiropractic first, medicine second , surgery last resort. We are always putting the patient first.

  1. The United States opioid epidemic – PubMed (nih.gov)
  2. Whedon JM, Toler AW, Kazal LA, Bezdjian S, Goehl JM, Greenstein J. Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain. Pain Medicine. 2020 Mar 6. Link
  3. Prater C, Tepe M, Battaglia P. Integrating a Multidisciplinary Pain Team and Chiropractic Care in a Community Health Center: An Observational Study of Managing Chronic Spinal Pain. J Prim Care Community Health. 2020;11:2150132720953680. doi:10.1177/2150132720953680 Link
  4. Louis CJ, Herrera CN, Garrity BM, McDonough CM, Cabral H, Saper RB, Kazis LE. The association of initial provider type on opioid fills for individuals with neck pain. Archives of Physical Medicine and Rehabilitation. 2020 May 11. Link

Lack of Sleep Makes You Crave Sweets

Not getting enough sleep can have negative effects on your health. They can be weakened immune system, increased risk for diabetes, heart disease and poor coordination. Add one more increased craving for sweets.

Insufficient sleep is linked to increased caloric intake and to obesity.

In a randomized crossover study, 24 people slept for either five or eight hours per night for three consecutive nights.  The shorter sleep increased objective sweet-taste preference and intake of calories and carbs at the buffet meal.

While shorter sleep was associated with an overall increase in caloric intake, it affected different individuals very differently. Some ate a lot more (up to +679 kcal), but some actually ate less (down to −261 kcal).

One of the simplest thing you can do to improve your health is to sleep 7-8 hours a day.

Acute Sleep Curtailment Increases Sweet Taste Preference, Appetite and Food Intake in Healthy Young Adults: A Randomized Crossover Trial – PubMed (nih.gov)

DISC HERNIATIONS RESOLVE BY THEMSELVES THE MAJORITY OF THE TIME!

Another study that shows Lumbar disc herniations can reabsorb. This is great news. Disc herniation can get better with chiropractic care, better body mechanics and hard work ( home exercises). So everyone that was told they need surgical intervention it might not be true!

Lumbar disc herniation (LDH), a common disease, is often treated conservatively, frequently resulting in spontaneous resorption of the herniated disc. The incidence of this phenomenon, however, remains unknown.

CONCLUSIONS:

The phenomenon of LDH reabsorption is well recognized. Because its overall incidence is now 66.66% according to our results, conservative treatment may become the first choice of treatment for LDH. More large-scale, double-blinded, randomized, controlled trials are necessary to study the phenomenon of spontaneous resorption of LDH.Key words: Lumbar, disc herniation, spontaneous resorption, conservative treatment, incidence, country, meta-analysis, systematic review, observational studies, study designs.

https://www.ncbi.nlm.nih.gov/pubmed/28072796/?fbclid=IwAR3-YyZ5tpTq1xDUE0Yv0MTTIEJbHGWayZqEjU45J4R8nT0ptDl0ejEzQvQ

Different Types of Muscle Strains

Uncovering the Facts of Different Types of Muscle Strains

Have you ever experienced a muscle strain?  What is a muscle strain, anyway?

A muscle strain is an uncomfortable injury or trauma to the belly of a muscle.  Minor strains often result in a stretch to the muscle, like pulling a rubber band.  More severe strains can overstretch the muscle to the point where the muscle can have a partial or even complete tear.  Strains often occur in the low back or hamstring muscles1, but any muscle in the body is vulnerable to a strain injury! 

Strain injuries do not discriminate.  Many athletes, active lifestyle, and sedentary individuals suffer from muscular strains.  They can occur in various scenarios ranging from repetitive or overuse injuries like running or throwing a baseball, or sudden onset situations such as lifting a heavy box while moving.  Many people often describe a muscle strain as feeling like a “pulled” muscle, and they are not wrong – a muscle strain often results from a muscle being pulled too hard by outside forces2!

While strains occur to muscles, they have a cousin you may know as well: the sprain.  Sprains have a similar stretching mechanism of injury, but sprains happen to ligaments instead of muscles.  For the sake of this article, we will keep it simple and discuss muscular strains; however, an injury is sometimes also considered a sprain/strain because there may be a strain to the muscle and a concurrent sprain of ligaments at the joint.

Muscular strains can be put into two categories: chronic overuse, and acute traumatic strains.  

An overuse strain can be confusing at first because there is no single “event” that can be pinpointed that resulted in pain or injury.  A traumatic strain injury, on the other hand, often has a single and significant event results in injury; think of lifting a TV and suddenly, your low back goes into spasm!  Ouch!

Over-Use Strain (Chronic)

The Cumulative Injury Cycle

The Cumulative Injury Cycle3 represents the process in which over-use injuries and pain may occur.  This cycle is not limited to a particular activity, but anything you do repetitively!

The chronic cycle begins with Overwork, such as the long duration of sitting or longer-distance running.  Yes, even long periods of sitting can overwork muscle groups in addition to increasing your chances of developing deep vein thromboses, diabetes, and undoing the benefits of exercise.3  The engagement of muscle groups in the same activity – day in, day out – may lead to muscular imbalances and Weak, Tight, and Tense soft tissues, like muscle.2,3

These weak and/or tight muscles lead to excessive Friction, Pressure and Tension to the local muscles, ligaments, tendons, and fascia2.

In turn, this results in Decreased Circulation and Swelling and Hypoxia (lack of oxygen) to the area.  The lack of proper oxygenation to our soft tissues results in the formation of Adhesions and/or Scar Tissue to the area, which decreases the function of the local structures.  

Think of these adhesions like a tube of superglue that leaks out and gets into the carpet.  The nice fibers of the carpet are no longer smooth, and the carpet is not as effective in cushioning your feet due to gluing the synthetic fibers together.

Overworked, weakened muscles, coupled with excessive friction and tension and decreased circulation, result in a vicious cycle that both weakens and tenses muscles and soft tissue.  The cycle keeps on churning until the body sends off the alarm system that something is wrong.

At some point in your life, you probably stepped on something painful.  You may not have known it was even on the ground, waiting to ambush the bottom of your foot, until you stepped directly on it.  Our bodies can act very similarly.  We do not know something isn’t working correctly us until our internal alarm system goes off.  That alarm system comes in the form of pain!

Now that we know how chronic and repetitive injuries can occur with strains, what about severe episodes?

Acute Strain

The dreaded acute or traumatic strain.  It is a sudden onset of extreme discomfort or pain, and it can be life-altering for a stretch of time depending on the “grade” of your strain.  Strains can come at different levels, known as Grades4; in particular, Grades I, II, and III.  Read on to learn more about the different grades or levels of injuries for strains:

Grade I Muscle Strain

In a Grade I muscle strain, the muscle or tendon is overstretched and may have small tears to the muscle, like papercuts.  You may have mild pain with or without swelling.  Grade I strain is also called mild muscle strain.  For Grade I muscle strain, simple home remedies, such as applying RICE (rest, ice, compression, elevation) therapy may be just enough to manage symptoms.  These are usually self-resolving in a small time frame, although can be uncomfortable during the healing process.

Grade II Muscle Strain

Also called moderate muscle strain, Grade II strain occurs when the muscle or its tendon is overstretched with more of the fibers torn.  Symptoms may include marked pain with swelling.  The area of injury is tender and uncomfortable to the touch and may include bruising.  Movement can be difficult to perform because of the level of discomfort and muscle involvement.

Grade III Muscle Strain

Grade III strain, or severe muscle strain, is the most serious among the three grades of muscle strains. Most of the muscle fibers are torn!  In some cases, the muscle is completely torn or ruptured, resulting in a potential loss of function.  Pain, swelling, tenderness, and bruising are usually present.  Movement is usually difficult.

Moderate and severe muscle strains should be seen by a qualified health care provider, such as a chiropractor, for a thorough evaluation!

Now that you know about the different levels of muscle strains, what can be done to help prevent this kind of injury in the first place?

Preventative Measures

Here are some corrective strategies to decrease the chances of the over-use strain or acute traumatic strain injuries.

Keep in mind, even if everything is as perfectly as possible, you still may end up with strains and sprains if your sport or activity is strenuous in nature.  Even the best preparation cannot fully prevent injury, but it certainly can cut down on the chances of it happening!  Some things we can do are:

Corrective exercises: This will help combat against muscular imbalances that cause biomechanical issues and increased strain on the body.

Micro-breaks: Break up the repetitions of your activity or sport.

Ergonomics: Well-fitted sporting equipment, changes in exercise gear, or alterations to a work environment may be necessary to reduce the likelihood of injury.

Proper Technique: Less strain on the body from optimal efficiency and performance.

Rest and Recovery: Helps get the body back to a steady state and prevents excessive fatigue.

Equipment: Key to performance, efficiency, and reduction of strain on the body.

Should injury occur regardless of these factors, there are things you can do to ensure your body heals.  Anyone can get a strained muscle, and the amount of time you need to fully heal depends on the individual and the type of injury.5

Treatment Options

If a strain injury does occur, there are many treatment options one can consider in addition to the afore mentioned PRICE1,4,6 methods.  In our office, we typically utilize traditional therapeutic modalities such as electrical muscle stimulation, taping, ice, etc.

In addition, we provide 3 key treatment options that not all clinics do, and they are as follows. You can click on each one for more detailed information on our treatment interventions:

  1. Types of soft tissue treatment
    1. Active Release Tech.
    2. Graston
    3. Deep Tissue massage
    4. Ultra sound and IFC (Electrical Stimulation)
    5. Active stretching’s

It is important to see a doctor if you have a painful sprain or strain to get the appropriate evaluation and treatment.  Your knowledgeable chiropractor may also suggest changes to your exercise routine, sport habits, computer or desk setup, or other lifestyle factors to help improve your recovery.

References     

  1. Muscle strains. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/muscle-strains/symptoms-causes/syc-20450507. Accessed October 2020.
  2. Walls R.M., et al. General principles of orthopedic injuries. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed October 2020.
  3. Leahy, P.M. Cumulative trauma disorder defined. Retrieved from http://www.sportdc.com/art/leahy_art.shtml. Accessed October 2020.
  4. Mangusan, D. “Back muscle strains.” Retrieved from http://www.physiotherapynotes.com. Accessed October 2020.
  5. “Sprains and strains.” National Institute of Arthritis and and Musculoskeletal and Skin Diseases. Retrieved October 2020 from: https://www.niams.nih.gov/health-topics/sprains-and-strains
  6. Sprains, strains and other soft-tissue injuries. American Academy of Orthopaedic Surgeons. Retrieved from https://orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries. Accessed October 2020.

Ankle pain for two weeks started during an exercise class.

Dorsiflexion is a important movement that occurs in the ankle. Dorsiflexion the ability for the ankle to bend upward towards your head. We need a minimum of 10 degrees to have good functioning ankle. Its common to lose this motion. Pointing our toes down is called plantar flexion. Look at this patient feet. The left ankle lost its dorsiflexion.

I want to thank the patient for lettings me use these pictures.

Loss of range of motion can be treated with with adjustments and home exercises. Look at how much better the ankle bends after an adjustment to the foot and ankle. This patient responded very well. He is young and the problem was not going for too long so he responded super well.

Patient was also given one strengthening exercise as well as a stretching to do at home to help him heal faster.

We treat ankle pain all the time here at Sikorsky Chiropractic. If you’re experiencing any pain or an injury to your ankle give the office a call!

Images used with the patients permission.

After an injury, GAIT OR RUNNING RETRAINING HAS TO BE DONE

If you’re suffering from a running injury or a sports related injury, doing your rehab exercise might not be enough. When I’m treating patients with a running or sports related injury, I always look at the patient’s running form or the activity that caused there pain to see what is causing their injury. Squatting with weight on your back is another common cause of pain I see. After the exam and watching the patient movement during the sport of their choice, then the teaching starts. I try to improve there the patient form hopefully preventing the injury again.

There is no reason to return to your activity strong but still performing the activity poorly.

There is a study below that confirms this approach.

If you have an injury or are concerned about your form please contact the office! We can help you reach your peak performance.

Mirror Gait Retraining for the Treatment of Patellofemoral Pain in Female Runners Authors: Willy RW, Scholz JP & Davis IS Author’s Affiliations: Division of Physical Therapy, Ohio University, Athens Ohio; Department of Physical Therapy, University of Delaware, Newark, DE; Spalding National Running Centre, Harvard Medical School, MA, USA. Publication Information: Clinical Biomechanics 2012; 27(10):1045-51