Another study showing that obese patients who got COVID-19 had a worse outcome . COVID-19 has brought to light that the more unhealthy you are the, the worse the outcome will be for you.
Now is the time to get healthy. Start exercising! No matter what you do, it’s better than nothing. Make small changes to our diet and finally start to sleep more. These simple things can help change your life and put you on the road to health. It might not stop you from getting COVID-19 but you’ll be better able to fight off the infection.
American Heart Association analyzed data from patients hospitalized with COVID-19 at 88 US hospitals enrolled in the American Heart Association’s COVID-19 Cardiovascular Disease Registry with data collection through July 22, 2020. BMI was stratified by World Health Organization obesity class, with normal weight prespecified as the reference group. They found:
“Obese patients are more likely to be hospitalized with COVID-19, and are at higher risk of in-hospital death or mechanical ventilation, in particular, if young (age ≤50 years).” say the study authors. “Obese patients are also at higher risk for venous thromboembolism and dialysis.”
If you need any help with your quest for health, call the office to make an appointment and together we can make a plan to improve your health. Now is the time to start so what’s holding you back? Pain? I can help with that as well!
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:
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.
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
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
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
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.
The one sure thing about Covid-19 is the more unhealthy you are the worse the outcome will be if you get Covid-19.
Fat male stomach
According to the CDC: Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. Severe illness from COVID-19 is defined as hospitalization, admission to the ICU, intubation or mechanical ventilation, or death.
91 percent of Covid_19 deaths in Cook County had comorbidities. Comorbidity rate of Cook County victims with COVID-19 listed as primary cause of death, Mar. 16 – Jan. 1 (Wirepoints Source: Cook County Medical Examiner)
It found: “The SARS-Cov-2 infection has become pandemic, overlapping with obesity and its co-morbidities. Obesity and its co-morbidities create an unfavourable inflammatory environment that enhances the risk of severe COVID-19. Therefore, obesity must be recognised as an independent risk factor for COVID-19 severity to better define public health policy and protect susceptible individuals, including specific social distancing measures. These measures can also contribute to preventing collapse of the health care system. Further research should define proper therapeutics for COVID-19, and nutritional therapy is an essential measure for treating COVID-19 in patients with obesity.”
Losing weight and getting healthy-along with the standard practices of social distancing, mask wearing, washing your hands and keeping your hands from your face and mouth- will help you fight Covid-19!
The visual that comes to mind when thinking of low back pain is a person half-bent over with a hand on the sore spot of their back. Many of us have experienced low back pain, and you may recall feeling severely limited or even helpless during the acute phase of your last episode. Feelings of pain and helplessness are some of the reasons why low back pain is of the most common causes for patients to seek emergency care!1
In fact, over 80% of people have experienced at least one episode of low back pain in their lives, and up to a quarter of adults have experienced low back pain in the last three months2,3! That’s pretty… painful to think about, actually.
On top of this, chronic low back pain is considered the second most common form of disability worldwide,3 and one of the most common causes for adults to see a family physician.4
In the past, patients were told to “take it easy” during a flare-up of low back pain. They may have been prescribed bed rest by their family physician, thinking that avoidance of movement would help relax spasming muscles and ease pain to more tolerable levels.
However, times have changed. Treatment guidelines instead recommend specific exercise4, gentle stretches, and other ways of staying active during the recovery process. Total bed rest is to be avoided.
In my practice everyone who come in with lower back pain get homework (exercises) to do. No mater how much pain they are in.
Why the change?
Part of the reasoning is anatomical. Two types of muscles exist in our backs: superficial muscles (or surface muscles) and deep muscles5.
Superficial muscles are used to perform motions like bending and twisting. These muscles are strengthened by exercise that places stress on the muscles. Think of the person at the gym lifting weights: they’re building and growing these superficial muscles.
Photo by Sabel Blanco
Deep muscles, on the other hand, help stabilize the spine and maintain posture. Physical activity such as yoga, walking, and more, helps keep them in shape. Picture the jogger going for a mile or two before breakfast: they’re working on deep muscle strength.
A common scenario is bending over to pick something off the floor. You may hear a “pop” in your low back, followed by pain and muscle tightness. You’re bent over, unable to fully stand upright, and your world suddenly hurts no matter what you do. You go to bed – and stay there, unable to move because movement equals pain. You call out of work because you can’t get out of bed. You remain largely sedentary for a week, under the guise of “waiting it out.”
When a person goes on lengthy bed rest, the deep muscles in the back will weaken and begin to lose mass and strength. This is a process known as atrophy.6
As the pain subsides and the person feels some improvement, activity is slowly resumed. In order to do this, the body will recruit the bending, twisting, superficial muscles to help stabilize the back. Although they can function in this capacity, superficial muscles are NOT well-adapted for this function! These superficial muscles will tire more easily, resulting in impaired normal movement or motor control.
This can place abnormal stress on the structures in the spine such as joints and muscles, as well as joints and muscles in other areas of the body, increasing the risk for additional musculoskeletal injuries.7,8
There are specific exercises that help strengthen the stabilizing muscles that lie deep in our bodies, close to the spine. Doctors of chiropractic regularly prescribe exercise to address an acute flare-up of low back pain and may suggest general activities, such as swimming or walking, to improve your overall fitness.8
Some specific exercises, known as McKenzie exercises, are especially effective for patients who are suffering from an intervertebral disc injury.4 “McKenzie exercises” is a term you may not be familiar with. Yet. But hang with me. They have become a staple in the conservative management of low back pain. They entail simple exercises that have very profound impacts on a patient’s low back pain. They are named after Robin McKenzie, the physical therapist who first began using them.
McKenzie exercises are designed to be used after a thorough evaluation from your medical practitioner. In fact, McKenzie refers to a method of mechanical diagnosis and series of therapeutic exercises prescribed based on the determined diagnosis. The exercises I will be teaching here are simply one protocol of McKenzie exercises. It is the most commonly followed protocol; however, it will not help every low back pain patient. This is also not a substitute for a mechanical examination. Instead it is a tool for patients in acute pain seeking relief until obtaining professional care.
In their most basic form, McKenzie exercises are most effective for patients suffering from intervertebral disc injuries. Disc injuries can cause a variety of low back symptoms from intense back pain to pain radiating into a lower extremity. These exercises may reduce the intensity of the pain and in some patients, eliminate it completely.
When you are experiencing a disc bulge or herniation, the disc material will often protrude posteriorly. While there are other kinds of disc injuries, these are the most common. Disc injuries are extremely prevalent in today’s population. Many who seek medical care for these injuries will be told their options are rest or surgery. Although in some severe cases surgery is necessary, the body has the ability resorb the disc naturally. McKenzie exercises are a mechanical tool that patients can use to help the body resorb this disc.
McKenzie extension exercises work because they force the spine to go into an extended position (when referencing the lumbar spine this means an “arched” back position.) This arch will actually cause the two vertebrae to close down over the disc at the posterior aspect. This was visualized in the anatomical section of the course. This “closing” of the disc space can actually cause the protruding disc material to retract back into the spine and relieve many of the symptoms associated with a lumbar spine disc injury.
Before performing these exercises there are a few things you should pay attention to:
While performing the exercises it is common to experience pain throughout the exercise. Often after multiple repetitions the pain intensity will begin to decrease. If you perform the exercises and the pain gets worse and stays worse these exercises may not be right for you.
If you are experiencing symptoms into your lower extremity, these exercises may also help reduce those symptoms. As you perform repetitions, pay attention to the intensity of the pain in your leg. Has it been improving? Does the pain travel as far as it did when you began? If either of these occur continue with more sets and repetitions. These exercises may be right for you. It should be noted that even if symptoms in the lower extremity begin to trace back up the leg or decrease, it is not uncommon to simultaneously have increased pain in the low back. It sounds counterintuitive, but increased back pain is not always a bad sign when the pain in your leg is improving. Typically, when there is radiating pain in the lower extremity, to get rid of the pain completely (from the leg AND back) the leg pain must be eliminated first. While performing these exercises, we often see the pain tracing up the leg towards the back becoming more intense, but over a smaller surface area. The smaller the area of pain, regardless of intensity, the closer you are to abolishing it completely
How do we perform these exercises?
You can begin these exercises in a standing or prone (on your stomach) position. When standing you will put your hands at the base of your spine and drive your hips forward. The goal is to push your hips over your toes or past them. Take the stretch to the point of pain or until you are unable to go any further and repeat.
If you are on your stomach, keep your hips on the floor and bring your hands up to your chest as if you are doing a push up. Push your chest up, going as far as you can without lifting your hips. If you are in a lot of pain, you may only move a couple inches. Do not force yourself through the pain. Let each repetition gradually improve your range through these exercises.
A good place to start is with 3 sets of 10 repetitions. If the pain increases after three sets, it may not be the right exercise for your condition. If you experience no change or even mild improvement, perform more repetitions to see if you can create lasting improvement. For many patients these exercises may not only help decrease overall pain but also are useful for mitigating flare ups.
Remember these are just one of many different types of McKenzie exercises. You may require a different direction or progression of exercises. This is a great place to start if you are on your own but remember – it is highly recommended to get a proper evaluation from a McKenzie practitioner to determine exactly which exercises will treat your individual ailment.
References
Casiano, V.E., and De, N.K. (2020). Back pain. StatPearls. StatPearls Publishing: 2020 Jan.
Allegri, M., et al. (2016). Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research, 5, F1000 Faculty Rev-1530.
Casazza, B. (2012). Diagnosis and treatment of acute low back pain. Am Fam Physician; 85(4): 343-350.
Netter, F. (2011). Atlas of human anatomy. Philadelphia, PA: Saunders/Elsevier.
Dirks, M.L., et al. (2016). One week of bed rest leads to substantial muscle atrophy and induces whole-body insulin resistance in the absence of skeletal muscle lipid accumulation. Diabetes 65; (10):2862-75.
Belavy, D.L., et al. (2007). Superficial lumbopelvic muscle overactivity and decreased contraction after 8 weeks of bed rest. Spine 32(1), E23-E29.
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.
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
Take a look at this x-ray. Can you see how uneven the pelvis is? This is caused by an anatomical short leg. The spine is showing signs of degeneration (arthritis) as well as the left hip.
Frontal x-ray taken standing. The left side is the low side. Posted with permission.
So can a short leg cause back pain? The answer is yes. I have seen this multiple times in my practice. There are two major causes of a short leg. One can be functional. A function can be from twisting of the pelvis or tight or weak muscles. An example of this would be standing in a hole with one leg. There is no difference in the bone length in the leg but the pelvis can be uneven. The second can be an anatomical. This occurs when the one of the leg bone is a different size then the corresponding one. Think of a table with one leg a shorter then the others. Both can be treated with chiropractic care and home exercise but the way they are treated is different.
This patient had an accident when he was young that effected his Tibia (shin bone). This causes one of his legs to become a different length and cause an uneven pelvis. Years of walking and daily actives with a severely uneven pelvis lead to arthritis, disc degeneration and chronic pain.
Posted with permission. The left tibia is the one with injury. Posted with permission.
Things that happen to our legs/feet can effect our spine. The body is great at compensating until it can’t. A broken bone that heals shorter than the opposite one will lead to changes in how the body moves causing increased biomechanical stress leading to break down. The break down can be of the muscle, bone, cartilage or disc.
I want to thank the patient for permission to post these picture.
New research has re-affirmed that weakness of one cervical muscle group is closely tied to chronic neck pain. This unit is also implicated as a provocative factor for cervical radiculopathy, cervicogenic headache, and cervicogenic vertigo.
A 2020 JMPT study re-affirmed that weakness of the deep neck flexors is common in cervical radiculopathy patients:
“Current results confirmed the presence of cervical multifidus and longus colli muscle atrophy in subjects with chronic radicular neck pain.” (1)
The deep neck flexors include four muscles that lie behind the trachea on the front of the cervical spine. The group includes the longus colli, longus capitis, rectus capitis, and longus cervicis. Due to their proximity to the spine and their short length, the muscles are primary stabilizers of the cervical spine.
If you’re experiencing neck pain contact the office! We help ease neck pain every day.
Amiri-Arimi S, Bandpei MA, Rezasoltani A, Javanshir K, Biglarian A. Asymmetry of Cervical Multifidus and Longus Colli Muscles Size in Participants With and Without Cervical Radicular Pain. Journal of Manipulative and Physiological Therapeutics. 2020 Mar 1;43(3):206-11.
Dr. Steve Sikorsky | Chiropractic Care Elgin, Illinois
