Video explanation, demonstration, and further detail over at:
Movement Monday: Countering Anterior Dominance
Video explanation, demonstration, and further detail over at:
Movement Monday: Countering Anterior Dominance
The phrase move it or lose it has been around for years and for good for reason. The concept is contingent upon the process of adaptability or plasticity. Without moving or utilizing certain processes within our bodies, over time we lose it. On the flip side, when we utilize certain muscles or nervous system connections known as pathways, we have the ability to strengthen them.
This concept can be simply understood by looking at what happens when you work out or don’t work out a muscle. If you are constantly doing curls, naturally your bicep will grow as it is your body’s way of adapting to the increased demand. However, if you don’t use your bicep, another muscle, or various pathways in your brain, the muscle or process will become weakened or atrophied and could quite possibly go away completely. This is your body’s clever way of adapting. In our miraculous design, the body is designed to be as efficient as possible. Lack of an activity provides feedback that we don’t need to devote any energy or memory to this process; thus not moving it or using it, leads to losing it.
While the topic of utilizing different, diverse neurological pathways leading to plasticity is a main concept behind Functional Neurology and adjunct therapies like Lumosity, what we are talking about today is literally making sure you move as much as possible. In particular, we are speaking of trying to avoid long periods of uninterrupted sitting as much as possible.
Mounting research has implicated extended periods of uninterrupted sitting as a major determent to your health. We are not just talking about a culprit behind back pain, neck pain and headache. We are not just referring to it being a contributing factor to various diseases or conditions like osteoarthritis, diabetes, and obesity. The eye opener here should be the fact that research has shown that regardless of your fitness level, individuals who spend their days logging long hours of uninterrupted sitting actually have SHORTER LIFE SPANS.
I don’t know about you but that’s all I need to hear to perk up and pay attention. Being someone who has always been active and involved in some level of daily fitness or sport activity, it is quite alarming (yet logical) to hear that even if you do get a good workout in multiple times per week, if you’re logging long hours at a desk without moving, you may just meet your maker sooner than expected.
I say logical because when you think about it, it does make sense that what we do the majority of our day (sitting) would have more of an impact that what we do a fraction of the day (a workout). Studies out of NASA on the determents of microgravity situations that the astronauts find themselves in when they travel to space found the most comparable Earth situation to be sitting.
From a biomechanical perspective, there are a variety of reasons this position is bad news. Your anterior muscles become shorted. There are muscles in your lower half that connect to your spine and anchor to your pelvis or hip. From prolonged, uninterrupted sitting these muscles eventually begin to shorten due to the flexed forward position. Now when you stand up these muscles can pull down on your lumbar spine, creating the sensation of back pain and the misconception that standing up is the problem. While standing up does actually cause the individual discomfort, it is actually due to the prolonged sitting and subsequent shortened muscles that the dysfunction and manifestation of pain as a symptom occurs. This is a prime example of what we talked about in the previous post of going beyond addressing the pain or symptom and fixing the breakdown that led to this symptom in the first place.
If we move up the spine and throw in the fact that prolonged sitting is usually taking place at a desk or car, we begin to flex forward in the upper portion of your body as well. This shortens the muscles of your anterior shoulder and chest and gives you that hunched forward, kyphotic thoracic spine, and anterior head carriage. The muscles on the posterior side now become over worked as they must fight even harder to hold you upright. This leads to that mysterious shoulder and neck pain that you experience after a long day at work.
Lengthening, overworking and weakening the posterior side muscles from uninterrupted sitting and poor posture leads to the breakdown in function that we touched on in last week’s post that so often leads to back pain and other dysfunction. It is these posterior chain muscles (think low back muscles, glutes, hamstrings, calves, etc.) that are designed to keep us upright and moving smoothly, efficiently and pain free through space. When the front side muscles become shortened and the back side muscles become lengthened and weakened we begin to not only assume poor posture but a faulty movement pattern that predisposes us to other injuries at proximal and distal locations throughout the body.
Actual sitting is also the worst position for your lower back. This makes sense too if you think about it. When we stand, our body weight is distributed through our spine and pelvis to the lower extremity where we have numerous muscles designed to assist in this matter. When we sit we have removed everything from the upper portion of the pelvis down as far as support goes. Now our low backs must support the entire weight of the upper half of our body. This load is heavily placed upon the discs in between the individual vertebrae of our spine leaving them dehydrated and compressed. It is a major reason behind the widespread and seemingly “normal” degenerative disc disease and osteoarthritis seen in our heavily seated culture, but not in others.
Another pitfall of the effects of prolonged sitting is that due to the flexed forward, anterior posture assumed, you actually close down the space available for your organs to function correctly. Full chest expansion (and thus filling capacity of the lungs) is impeded and you are no longer able to take in as much oxygen. This leads to widespread systemic consequence because as we know, virtually all function within the body requires oxygen. Organs within the abdomen can become compressed and deprived of optimal blood flow leading to dysfunction within the liver, digestive tract, reproductive organs, etc.
Hopefully all of these reasons are enough to spark some interest in learning what you can proactively do to make sure you are not included in the “normal” range of society. It is currently estimated that some 80% of the population will, at some time or another, suffer chronic low back pain. This widespread prevalence does not exist in other countries that are not sitting all day, every day. This should tell us something. I don’t know about you, but if “normal” is having an 80% chance of low back pain, I want no part of it. I also don’t want any part of the other issues sited in the previous paragraphs.
Stay tuned for our next post which will illuminate some simple steps you can begin to implement as far as breaking up the sitting and doing what you can to avoid these seemingly “normal” issues.
Have a great weekend.
One of the most desired and effective soft tissue treatments we utilize at Clarke Chiropractic and Wellness is that of active release therapy or ART. My Crossfitters swear by this form of therapy and we normally implement it to some degree or another on every patient.
So what is it?
What we are talking about here is a soft tissue technique whereby the practitioner applies pressure in a specific direction to a specific area of an involved muscle or ligament while the patient then moves through a specific range of motion. You may note by my use of the 3 “specifics” that proper application of this technique requires a thorough knowledge and understanding of human anatomy and the mechanics of all individual muscles.
It goes way beyond simply massaging a painful area, and includes identifying and addressing all other structures involved with the problematic area.
For example, one of the most common problem areas most athletes come in for is the shoulder, and it’s usually due to anterior or front side shoulder pain. Rather than directing all treatment at the spot of pain manifestation, the entire shoulder complex is addressed, sometimes including up to 10 separate muscles. The shoulder complex, like many joint complexes in the body is just that, complex; and addressing all of the muscles that contribute to its function is key to not only alleviate discomfort, but to ensure the issue doesn’t resurface.
How does it work?
By taking a specific contact on a muscle or ligament, the practitioner anchors that tissue in place. Then, by having the patient move through a precise motion (usually taking the tissue from a shortened or contracted position to an elongated or extended position) tension is created at the site of the practitioners contact.
Benefits to this include breaking up adhesions or scar tissue build up that may be causing discomfort or limiting full range of motion. Having pain is one thing and is usually the reason people come visit us in the first place, so addressing it is always a priority.
But restricted range of motion due to chronically shortened or tight muscles can be the underlying issue behind a multitude of issues, including pain.
Muscles that are constantly tight, contracted or constantly working means they tend to build up lactic acid which causes the perception of pain. This can also lead to compensatory postural changes and movement patterns in order to continue to function despite the limited mobility. This can also lead to accelerated degeneration or early arthritis due to suboptimal posture and movements.
Reduced range of motion also leads to a reduction of blood and waste removal from the area. You see, the heart pumps blood to our structures but the body relies on gravity; more so, movement to return that deoxygenated blood to the heart. Without proper movement you now open the door for more swelling which can than place pressure on surrounding tissues, causing more problems.
You also need full range of motion to rid yourself of inflammation. Just as the veins rely on movement to bring blood back to the heart, the lymphatic system (your waste removal system) relies on movement to pump all the nasty, pain- provoking, inflammatory mediators out of dodge.
Another variation of ART we implement is that which incorporates something referred to as “nerve flossing.” That’s right. It’s not just for your teeth. Many times, nerves and other soft tissue can become “stuck” or irritated by adhesions or simply by a tight muscle.
The term “flossing” comes into play because we essentially pin the area where the nerve is presumed “stuck” and then have the patient move in a way that allows the nerve to slide back and forth as the fluoride-free floss does between your teeth. This method can be quite advantageous for people experiencing a variety of symptoms including carpal tunnel symptoms, sciatic complaints, neck, shoulder, and elbow pain.
These are just some of the benefits of properly applied ART. We could fill pages and pages with a broader explanation and other benefits. Feel free to research on your own or give us a call if you have any questions.
As with all treatments, this particular technique serves as a worthy adjunct to the total package of neurologically based chiropractic care and nutrition. As described in the previous paragraphs, ART can be part of a perfect marriage of healthcare delivery in finding a way to breakthrough to those stubborn aches and pain.
If you or someone you know has been unnecessarily dealing with pain and have tried other methods with limited success, I invite you to call us and try a fresh approach to natural and holistic healthcare.
When you’re ready, I’m here to help.
Posted in Chiropractic, Running, Sports
Tagged active release therapy, ART, Carpal Tunel, crossfit, elbow, inflammation, neck pain, nerve flossing, pain, sciatica, shoulder pain
In today’s day and age, most of us can’t avoid spending way too many hours in front of a computer monitor. Unfortunately, the posture and repetitive movement that this encourages is one that causes excessive stress on body parts like the hands, wrists, elbow, shoulders, neck, and back. This contributes to discomfort, fatigue and even outright pain.
Fortunately, there is a way to limit this stress put on your body and potentially reduce or eliminate the discomfort and fatigue. This is done through the implementation of proper ergonomics. Ergonomics is a discipline that involves arranging the environment to fit the person in it. This can be done anywhere but for the sake of this post, we will hit you with a few easily implementable tips for the office setting.
Adjust the height of the chair so feet rest flat on the floor, the thighs are parallel to the floor, and the knees are about the same level as the hips.
Adjust height of armrests so the arms can rest at your sides during typing, allowing for relaxation and a natural “drop” of the shoulders. Shoulders should not be elevated in anyway by the armrests.
The top of the screen should be at or just below eye level when you are seated in an upright position to avoid encouragement of forward translation of the head and shoulders. The monitor should also be directly in front of you to avoid excessive twisting of the neck.
KEYBOARD AND MOUSE
The angle between your elbows and forearms should be as close to 90 degrees as possible, with forearms parallel to the floor and keyboard directly in front of you.
Try to avoid resting your wrists or hands on the edge of the keyboard while typing or on the mouse when you are not using it. While using the mouse, make sure your wrist is in a neutral position.
The mouse, keyboard, and every other thing on your desk that you frequently use should be positioned close to you to avoid excessive reaching.
AVOIDING EYE STRAIN
You may be unaware of it, but little changes can help you avoid unwanted eye strain throughout the day. This eye strain can lead to headaches and increased forward head posture.
Monitor should be approximately 18-30 inches from the eyes (depending on the size of the monitor).
Reduce Glare by:
Positioning the monitor at a right angle from the window.
I know you love that window in your office, but closing the blinds also reduces the glare.
The worktop surface should have a matte finish (think desk blotter if you have a shiny desk).
GET UP AND MOVE
It is imperative that you break up the long periods of sitting. Sitting is actually one of the worst positions for your back and can also lead to blood pooling in legs and feet. Taking a quick break from sitting every 20 to 40 minutes is key.
Practice “dynamic sitting.” Make sure there is enough room underneath the desk to move your legs. If you do find yourself seated for extended periods of time, utilize a lumbar support or a rolled towel to support the natural curve of your lower back.
Getting up and walking to the bathroom or to get some water (the two go hand in hand and you should be drinking more water anyway) are an easy way to keep it moving. If you need to stay at your station, simply stand up and perform a stretch like the Bruegger’s Stretch demonstrated here:
Please do not underestimate the power of some of these simple changes. Anytime I work with a patient, we always address the work station set-up through pictures provided by the patient or checking it out in person. If you’re curious about your personal space or feel like those around you would benefit from a work space makeover, please contact me as we are now accepting patients and providing free ergonomic evaluations for all local businesses. This is a standard part of your individual treatment plan when you become a patient, but a free office wide evaluation can be done as well.
As with all things, proper ergonomics is just one piece of the puzzle. Couple this with a thorough chiropractic evaluation addressing overall posture, balance and any other issues you may have going on and you are making a strong proactive statement about regaining control of your health and ultimately your life. Again, feel free to contact me if you’re interested in getting started.
Remember, a proper, less strenuous work station promotes better posture and less discomfort. Better posture promotes better breathing (more oxygen) and less needless strain on numerous muscles, each leading to less fatigue and pain, and clearer, more creative thinking. This means your work gets done faster and at a higher level. Sounds like a bonus for employee and employer alike.
Posted in Chiropractic, Health & Wellness
Tagged Brevard County, chiropractic, ergonomic, ergonomic evaluation, headache, Low Back Pain, neck discomfort, neck pain, pain, posture
About two weeks ago I was scanning the Florida Chiropractic Society’s website when I saw an article stating that the AMA (American Medical Association) recently came out with a report stating that chiropractic care should be sought prior to resorting to surgery. This is actually a big deal due to the fact that the AMA has been a longtime opponent of the chiropractic profession as a whole.
(This isn’t some chiropractic conspiracy theory, this is fact. Look up the Wilk v. AMA anti-trust suit or better yet check out the documentary Doctored for an interesting and somewhat disturbing history lesson.)
My initial reaction to this headline was one of surprise and refreshment. This is a sign of progress that the mainstream medical community is acknowledging chiropractic care as effective, and better yet, the option to be pursued prior to seeking surgical intervention.
The article specifically states that patients try chiropractic services and other conservative options such as acupuncture and physical therapy for the treatment of low-back pain. According to the article, surgery is not usually needed and should only be considered if other therapies have failed.
The emphasis here should be on the bolded phrase above. For many conditions, surgery is not usually needed and the risk often outweighs the reward. A clear picture of what’s best for the patient becomes clouded when third party payers form alliances with the medical community and all too willingly cover these procedures. This diverges from a patient centered care plan and directs us towards a dangerous, money motivated business at the patient’s expense.
Other examples of this include current scientific evidence not supporting the medical necessity for surgical intervention in idiopathic juvenile scoliosis, yet the procedure continues to be performed highly due to it being reimbursed by insurance. These are kids we are talking about here.
Another example is the ever so popular carpal tunnel surgery. I cannot tell you how many people I’ve met that were advised to undergo this procedure. Not taking into account that this condition is highly misdiagnosed and responds extremely well to conservative care. Yet the procedure is pushed for a profit and the alternatives are dismissed as “quacks” despite the low success rate of the surgical procedure.
Last week I met a gentleman that had undergone back surgery (spinal fusion at L5-S1) and it wasn’t pretty. He had a well localized, non-radiating pain in his lower back for approximately three years, which lead him to a consult with a surgeon.
Since the surgery, this poor soul has now developed a new, more intense, stabbing pain in a different location (right SI Joint). He wears a brace, limps slowly with an awkward, dragging gait, and can no longer carry out many of his activities of daily life, including lifting and standing for too long. What’s worse is that the surgeon reassured him of his well-being pre-op, boasting a convoluted and misleading 90% success rate.
Did you know that the failure rate of back surgery is so high that there is an actual diagnosis and medical code for it? Failed back surgery syndrome or post laminectomy syndrome is a name given to the condition when pain (many times worse than before) persists long after surgery. Now an individual is left with an irreversible structural change and the dreaded thought of repeated surgeries.
Yesterday I received a text from a longtime friend advising me to check out Dr. David Hanscom on coasttocoastam.com. Dr. Hanscom is an orthopedic spinal surgeon who has turned to a more natural and holistic initial approach to chronic pain after being disheartened by a system filled with multiple surgeries on the same patient. He discusses how in med school they are taught the aforementioned 90% success rate for spinal surgery, when in actuality he and all his colleagues were boasting a 25% success rate at best.
The hopeful sign of progress here is the symbolism of a potential rectifying reversal of the medical model. The current status quo has patients opting for pills or surgery prior to traveling the conservative route.
Too often we see patients come in the door helpless and ravaged from trying everything else first. Doesn’t it make sense to go the non-invasive, non-habit forming and side effect-less route first? Shouldn’t we be trying everything possible before cutting someone open and inserting hardware or providing them with life altering pills?
I commend the AMA for no longer ignoring the facts and shedding light on the truth, even if it does have the potential to cut into their piece of the pie. Recognizing chiropractors as a top alternative for back pain is a start, but if you read my posts, you know we can do so much more. Understanding and taking advantage of the intricate relationship the spine and our joints have with the nervous system opens the door to potentially effect almost all bodily function and provides physiological explanation for the previously mislabeled “chiropractic miracles.”
Manual practitioners like chiropractors should not be considered “alternative” at all, but the exact opposite. A well trained chiropractor can provide explanations and potential treatments for numerous ailments well beyond back and neck pain. Pigeonholing the profession to one or two conditions is a disservice to all and leaves the door open for continued reliance on harmful drugs and risky surgeries.
But like I said, it’s a start.
The good thing is, you have the choice to pursue both options. The information is out there. The treatment is available. It is your responsibility to choose. Don’t get me wrong, sometimes drugs or surgery are necessary and can be life saving. However, in many cases, they should be considered the “alternative” or last resort, and non-invasive therapies like chiropractic, the first line of defense.