Tag Archives: wellness

Low Back Pain Part 1

Understanding and Preventing Your Low Back Pain

About 80% of Americans suffer debilitating low back pain at some point in their life. This fact is staggering, yet it doesn’t have to be this common. The key to staying out of this group of low back pain sufferers comes down to one word: Prevention.  If I had to choose one common problem amongst all low back pain sufferers, it would be bad low back position during common activities such as brushing your teeth, bending over, picking up a small child, exercising and sitting.

The lumbar spine, which is the lower part of the spine, is meant to have a natural curve to it that displaces the forces of gravity, weight, etc. evenly and minimally. When this natural curve is straightened, or reduced, the forces on the discs, muscles, and ligaments of the low back are significantly increased. For example, sitting without maintaining the natural curve increases the forces on those structures by 30%-40%!

There are many conditions that can be covered under the umbrella of low back pain, but in this article, we will cover the following conditions for the sake of this informational handout. The keys of prevention of low back pain are as follows:

  • Understand your symptoms and risk factors
  • Body Preparation and Positioning
  • Proper Activities of Daily Living
  • Corrective Exercises
  • Treatment Considerations

Common Low Back Conditions

Lumbar strains and sprains

A lumbar strain is when an injury occurs to the muscles of the low back. A sprain, on the other hand, is an injury to the ligaments or joints; both, however, have similar pain and symptom patterns. When these muscles or ligaments become injured, it can lead to dysfunctional movements, and cause instability in the spine. Patients suffering from this diagnosis often have pain when attempting to walk, sit, exercise and can even occur during sleep.

The main physical causes of this condition are:

  • Overexertion
  • Falls
  • Poor movement mechanics
  • Poor posture
  • Heavy lifting

However, with proper education, you can protect yourself from many of these causes. The primary sufferers of this condition, especially chronic cases, often are in poor physical condition with weak stabilizing muscles. A comorbid factor of this condition is often a desk job that involves sitting for most of the day. This type of patient usually has poor sitting posture, which can lead to a weakening of your spinal erectors and destabilize the spine, contributing to the condition. The importance of a strong core and training your spinal muscles cannot be overstated.

In cases where the injury stems from a problem related to overuse, poor posture or improper exercise, there are steps that can be taken to help avoid these injuries from happening. Proper instruction about your postural habits can reduce the detrimental effects of sitting on the spine, as well as education about correct lifting form can reduce these episodes of low back pain and help you build a healthy spine.

If you are having back pain or want some guidance on how to prevent back pain please call the office. We will be happy to help!

Mattress buying Guide

Buying a mattress can be quite a daunting task. One of the most frequent questions I get is which mattress is the best to purchase. This blog post is designed to help you make a better decision.

There is an endless amount of options, materials, and features available making it difficult to determine which mattress is right for you.  The average adult sleeps for eight hours a night; this means that you could be spending up to a third of life lying on your mattress, making this purchase all the more important.

The first question to ask yourself is do you need a new mattress? The average lifespan of a mattress is 5-10 years. Many manufacturers will have warranties that extend beyond the 10-year range, but for most the 8-year mark is when it is time to look at replacing the mattress. However, if you wake up every morning feeling sore or with back pain that tends to resolve within 15-30 minutes of being awake, this could indicate that you should be looking to replace your current mattress.

Unfortunately, there is not a one size fits all for mattresses. Everybody has a different body type, a different way to sleep, and experiences comfort differently. Some people will require a softer mattress and others will prefer a firmer mattress. In the end, this is personal preference and very subjective. We will provide you with some general guidelines to consider when testing out mattresses but there is no replacement for going to the store and testing out different options yourself. We recommend when testing mattresses, you lie on them for at least 10 minutes as this will give you a much clearer indication to its comfort level and how your body responds to its level of support.

The Ten Minute Test

What is the ten minute test? Can you lie on the mattress for ten minutes comfortably without moving? How can you sleep on the mattress for 6-8 hours a night if you can’t lie comfortably for ten minutes? If you can’t your body is telling you something.

Another factor to consider when purchasing a mattress is whether your purchase has a comfort guarantee. Even after doing all your due diligence and testing it in the store you may notice after a couple night’s sleep you will realize the mattress you selected simply is not right for you. Some companies offer a comfort guarantee in the event you decide you are not satisfied with your mattress (typically within 30 or 90 day periods). Every guarantee is different, and some have fees associated with the return. Therefore it is important to understand the fine print associated with any specific guarantee. This guarantee will protect your purchase and ensure that you will not be spending the next eight years waking up with a sore back from sleeping on the wrong mattress.

It is also important to understand the cost associated with mattresses. Prices vary widely and range anywhere from $200 to $5000 +. Unfortunately, price does not always correlate with quality or the right mattress for you. It is recommended that you budget at least $800-1000 for your new mattress. This budget should be enough to purchase a quality mattress that fits your needs but also one that is built to last you the 8-10-year range.

Once you determine your budget the next step is to figure out which style mattress best suits your needs.

Innerspring mattress: The innerspring mattress is also known as a coil mattress. It is arguably the most traditional style of the mattress and currently one of the most common mattresses on the market. It is typically a firmer mattress style, and the individual coils can offer quality support for your back. The “coil counts” on innerspring mattresses tend to indicate better comfort and support as the number increases. With that in mind as long as you have a minimum coil count of 400 the difference in higher count mattresses is typically nominal.

Memory foam mattress: Memory foam mattresses mold to the contour of your body better than any other type of mattress.  This results in fewer pressure points when you are sleeping. These mattresses tend to be by and large a softer mattress, but that still depends on the model you purchase as some brands make firmer memory foam models.  It can also serve to absorb movement, helping decrease the disturbance of sleeping with a partner. One of the main drawbacks of a memory foam mattress is that it tends to absorb heat and can be a very hot mattress to sleep on.

Latex Mattress:  Latex mattresses tend to be firmer, with bouncy support throughout the mattress. One of the main features of a latex mattress is that the material remains cooler as the latex foam does not absorb heat the same way that memory foam does.  Latex mattresses are often considered to be a good option for a patient suffering low back pain due to their combination of softness and support. A latex mattress will also provide the same feeling of a foam surface similar to the memory foam however it the contouring of a memory foam mattress.

Pillow Top: A pillow top mattresses do not indicate a type of mattress rather, it describes the addition of soft layer sewn on top of the mattress. They can be any one of innerspring, latex or memory foam mattresses underneath the pillow top layer. This results in a softer, more cushioned top surface with a firmer base of support.

These are the main categories of mattresses, but there are many other variations on the market. One final style to consider is an adjustable mattress. These mattresses can change the firmness from firm to soft at the touch of a button. This provides you with the ability to try different levels of firmness until you find the right amount for you. Many of these beds also have adjustable bed angles which can further customize your sleep experience.

Firm or Soft mattress?

Now that we’ve discussed what styles of mattresses exist, the next step is determining whether you need a firmer or a softer mattress. Everyone’s preference is different however there are several factors that we can look at to help guide our decision.

The size of the individual sleeping on the mattress is the first important factor. If you are a lighter person, then a pillow top mattress is likely not a good fit. To maximize the pillow top, you must be heavy enough to compress the top layer to be supported by the underlying material of the mattress.

If you are a lighter individual, you will look for a softer top layer. That way you can benefit from the lower supportive layer of the mattress. Typically, the denser the top layer, the more uncomfortable a lighter person will be.

If you are a heavier individual, then you will aim for a denser top layer and a firmer mattress. This is the case where a pillow top mattress may be a good option. For heavier people who are still looking for that soft feel while they sleep, they can look at a pillow top mattress, which offers the soft cushion with a firmer coil supporting them under the top layer.

Side sleepers, Back sleepers, Belly sleepers

The next important factor in choosing your mattress style is your sleeping style. Everyone sleeps differently, from side sleepers, to back sleepers, to belly sleepers (although this is not recommended for the health of your back) everyone sleeps in a different position.

For a side sleeper, it is typically recommended that you look for a soft to the medium mattress. The mattress must be soft enough for you to sink in but also offer enough underlying support that prevents having pressure points in the back and neck. Your body has curves, and you want your new mattress to support all those curves while you sleep to eliminate any risk of soreness when you wake up.

Back sleepers, on the other hand, tend to require a medium to a firm mattress. When sleeping on your back, it is essential that the mattress offers an adequate amount of support and firmness or you will run the risk of sinking in and sleeping in a poor posture. The worse your sleeping posture is the increased likelihood that you will wake up with back pain.

Finally, stomach sleepers tend to need the most support. This sleeping position puts the spine in a vulnerable position as the slightest angle from sinking into the mattress can lead to sleeping associated back pain. Therefore, if you must sleep on your stomach, aim for a firm mattress that avoids any pressure points. If you are a stomach sleeper who constantly wakes up with back pain, we recommend trying to slowly change your sleep posture to your side or back. Although, it is never easy to make such a change often this is the best option for the long-term care for your back.

These are simple guidelines that you can use to help decide on your new mattress purchase, but it is not a replacement for physically trying the mattress yourself. Comfort is always subjective, and you will not know what your style preference is until you try one for yourself.  Remember to take your time and test as many options as possible, not only is it a financial investment but it is also an investment in your long-term health and well-being.

https://www.mattressnerd.com/mattress-buying-guide/ https://sleepopolis.com/guides/how-to-choose-a-mattress/ https://www.consumerreports.org/cro/mattresses/buying-guide/index.htm

Lifestyle factors can effect mortality and life expectancy

Who doesn’t want to live longer? I bet almost everyone would take the opportunity to live longer if they could. Did you know adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in US adults?

The things we do every day can influence how long we live. So do we have to do some bio hacking or a super detox to live longer? Fortunately it much easier then that. Simple things can improve our health and make us live longer. So what are they?

  • Never smoking ( that was easy right?)
  • Regular physical activity! This can include walking or lifting weight.
  • Healthy diet. Mom said eat your vegetables and you’ll be healthy. She was right. Maintain a normal BMI. Obesity will lower how long you can live.
  • Moderate alcohol consumption. Less consumption the greater improvement in health.

Doing these thing can prolong life expectancy at age 50 years by 14.0 and 12.2 years for female and male US adults

See you don’t have to become a vegan or run ultra marathons to improve your health and live longer. The one thing I would add is make sure you are sleeping 7-8 hours a day. Lack of sleep can effect you negatively.

If you need help jump starting a healthier lifestyle call the office. I can help!

Here’s the study. Lots of great graphs and details. https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.117.032047 Conclusion of the study: Adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in US adults.

How do shoes effect development of motor skills in children?

New research published in Frontiers of Pediatrics found that children and adolescents who spend most of their time barefoot develop motor skills differently from those who habitually wear shoes. 👟 Further, they found the habitually barefoot children had noticeably better jumping and balancing skills compared to those who wore shoes habitually.

Walking barefoot not only has influences on developing proper biomechanics, but also has great influences on the brain 🧠. Walking barefoot allows for greater sensory afferentation to the brain, from the feeling of grass between their toes to balancing on pebbled sidewalks.

Try to give your young children enough time without shoes!

Zech, Astrid, et al. “Motor skills of children and adolescents are influenced by growing up barefoot or shod.” Frontiers in pediatrics 6 (2018): 115.
https://doi.org/10.3389/fped.2018.00115

Can sleeping cause pain? Part One: The Shoulder

Yes, sleeping in a “bad” position can cause you to have pain. Here are some shoulder positions that could contribute to pain and also recommended solutions that could help prevent pain and help with the healing process.

1. Rotator Cuff Syndrome

Many patients have pain in the shoulder when they sleep. One of the most common complaints for patients with shoulder pain is the inability to sleep on the effected side.

There are some common positions that can contribute to shoulder pain. For example, sleeping with the arm in the overhead position. This could lead to impingement of the shoulder muscles. Another position would be sleeping with arm under the pillow while on your stomach. Both of these positions can chronically impinge the rotator cuff (shoulder muscles).

Here are some examples- minus the PJ’s- that could cause shoulder pain.

Solution: Avoid sleeping on the affected side. Consider sleeping supine(on your back) , or with the affected side up, placing a pillow or towel between the arm and body for support and to minimize the effects of traction ischemia. If you have trouble sleeping on the opposite side of the pain you could sleep with something (pillow or towel) between you and the bed. See below for examples.

A towel can be used under the effected arm. It can be adjust to various size.
Using the towel under the rib cage help takes pressure off the shoulder. Adjusting the towel size can help you find a more comfortable postion

Some of you might be thinking ‘I’ve slept in this position my whole life and I have no problems.’ That’s great and you might never get shoulder pain from these positions!

Like always, one size does not fit all but if you do have problems the above advice could help with healing faster.

If you’re experiencing pain in your shoulder or need help with sleeping positions please call the office and make an appointment. We can help!

What type of running shoe should I get part 1

I’m going to do a multi-part blog on running and running shoes! Running and advice on the proper shoe are topics often brought up in my clinic so why not share for easy reference?

Starting with part one:

Here one question I get often:  I’m going to start to run to get in shape, so what brand (x) of running shoe?

There so many variables that go into the question.  Your biomechanic faults/deficiencies, anatomical variants,  the current level of your strength, the current level of fitness, what is your running form/style. Plus add in what you do for a living.  A construction worker has different stress on the body then a person who sits at a desk all day.

In my opinion, it’s better to start with yourself.  First, improve your body and then work on your running mechanics.   After, try to find the best style of running shoe based on comfort.

I like to take a “ground-up” approach.   The first thing to do is to make your foot and lower extremity better.  Fixing any joint dysfunction and then working on making your body stronger and more flexible is a great start.

Next is to improve your running form. I would video record the person running and make any necessary correction.  RUNNING is a SKILL and will need to be practiced.  

After doing all of the above, the patient will be less likely to get injured.  Plus it will be easy to find the right running shoe.

NSAIDS (ibuprofen and Naproxen) increase the risk of acute myocardial infarction. AKA heart attack.

Another reason to see a chiropractor! Chiropractic is the safest non-drug treatment for your pain. A recent study links the use of non-steroidal anti-inflammatories (NSAIDS) with increased risk of heart attack.

All NSAIDs, including naproxen, were found to be associated with an increased risk of acute myocardial infarction. Risk of myocardial infarction with celecoxib was comparable to that of traditional NSAIDS and was lower than for rofecoxib. Risk was greatest during the first month of NSAID use and with higher doses.

Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data https://www.bmj.com/content/357/bmj.j1909

When Is Standing Too Much?

When Is Standing Too Much? The new craze in standing at your desk has many asking if standing is for them, and how long should they stand for? Does everyone need a standing desk?

Standing can help with neck and back pain if done correctly!

If you get a sit to stand desk don’t start standing for 8 hours right away.  

Most start at 15-20 mins within the hour in the beginning then it grows to 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.

The human 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.

How much protein do you need per day?

How much protein do you need per day?

As with most things in nutrition, there’s no simple answer. Your individual needs will depend on your health, body composition, the main goal you have, and level of physical activity (type, intensity, and duration). Even when taking all of this into account, you’ll end up with a starting number, which you’ll need to adjust through self-experimentation.

Daily requirements are expressed in grams of protein, either per kilogram of body weight (g/kg) or per pound of body weight (g/lb).

  • If you’re of a healthy weight and sedentary, aim for 1.2–1.8 g/kg (0.54–0.82 g/lb).
  • If you’re of healthy weight, active, and wish to keep your weight, aim for 1.4–2.2 g/kg (0.64–1.00 g/lb). Try for the higher end of this range, as tolerated, especially if you’re an athlete.
  • If you’re of healthy weight, active, and wish to build muscle, aim for 1.4–3.3 g/kg (0.64–1.50 g/lb). Eating more than 2.6 g/kg (1.18 g/lb) is probably not going to lead to greater muscle gains, but it can minimize fat gains when “bulking” — i.e. when eating above maintenance in order to gain (muscle) weight.
  • If you’re of healthy weight, active, and wish to lose fat, aim for 2.3–3.1 g/kg (1.04–1.41 g/lb), skewing toward the higher end of this range as you become leaner or if you increase your caloric deficit (hypocaloric diet).
  • If you’re overweight or obese, aim for 1.2–1.5 g/kg (0.54–0.68 g/lb). You do not need to try to figure out your ideal body weight or your lean mass (aka fat-free mass). Most studies on people with obesity report their findings based on total body weight.
  • If you’re pregnant, aim for 1.66–1.77 g/kg (0.75–0.80 g/lb)
  • If you’re lactating, aim for more than 1.5 g/kg (0.68 g/lb)
  • If you’re vegan or obtain most of your protein from plants, then protein requirements may be higher due to the inferior protein quality (both the EAA profile and bioavailability) of plant-based proteins relative to animal-based proteins.

https://examine.com/nutrition/how-much-protein-do-you-need/#summary1

Congratulations, Bob!

bobmiller

We want to say a huge congratulations to one of our amazing patients! Bob recently completed the “Strolling Jim” UltraMarathon. This race included 4,000 feet of elevation, 4,000 feet of decline and a total of 41.5 miles! What an accomplishment, Bob! We are so proud of you!
We also received the message below from Bob after his race. We are so glad we could be a part of your journey. 🙂
“Thank you to Dr Steve and Nickie for, without whom, I could not have achieved my goal of finishing my latest UltraMarthon of over 40 miles and 4000 ft elevation AND 4000 of decline. Thank you Dr and Nickie!!!!!”

If you’re training for a race Dr. Steve can help! Call the office and get race ready!