Fibromyalgia and Exercise

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Are there differences in lifestyle between people with vs. without fibromyalgia (FM)?

A recent study found women with FM found spend more time engaged in sedentary behaviors and less time in physical activity. In the study, researchers followed 413 female patients with FM and 188 age-matched healthy female controls. Researchers used three different approaches to access physical activity: a triaxial accelerometer to examine sedentary time, time spent in physical activity, and step counts.

They discovered those who suffered from FM spent an average of 39 more minutes per day in sedentary activity and 21 fewer minutes per day in light physical activity, 17 fewer minutes per day in moderate physical activity, and 19 fewer minutes per day in moderate-to-vigorous physical activity. In addition, those with FM took a mean of 1,881 fewer steps that those without FM.

Now, this isn’t really a surprise given the fact that people with FM are in pain and more likely to have difficulties sleeping and tolerating prolonged activities. After comparing the sufferers to the non-sufferers, the researchers found only 21% of FM patients vs. 46% of non-FM controls achieved the recommended 150 minutes/week (a little over 20 min. / day) of “moderate-to-vigorous” physical activity. They also found that only 16% vs. 45%, respectively, walked the recommended ≥10,000 steps per day.

One of the BEST forms of exercise for most people is walking. A walking program should be a staple exercise. It’s important to note that this should be GRADUALLY introduced so as to avoid an overuse injury—strain or sprain of the muscles and joints. This gradual introduction into activity is ESPECIALLY important for the FM sufferer as overuse injuries can make them afraid to do something that can REALLY help when done correctly!

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How do Chiropractic adjustments help my neck pain?

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We all know what it’s like to have neck pain—whether it’s after a long drive, pinching the phone between the head and shoulder, star-gazing, or from talking to someone who is seated off to the side. There are many causes of neck pain, but the question of the month is, how do chiropractic adjustments help neck pain? Let’s take a look!

Chiropractic, when broken down into its fundamental Greek derivatives, means “hand” (cheir) and “action” (praxis). The technique most often associated with chiropractic is spinal manipulation where a “high velocity, low amplitude” thrust is applied to specific vertebrae in the spine, which does several things: 1) It restores mobility in an area with restricted movement; 2) It stimulates the sensory “neuroreceptors” in joint capsules, which has a muscle relaxing reflex effect; 3) It can affect surrounding neurological structures in certain parts of the spine such as the parasympathetic (cranial & sacral regions) and sympathetic (mid-back) nervous systems, which can have beneficial effects on the digestive system, cardiovascular system, and other body systems not typically thought about when seeking chiropractic care.

Joint manipulation is not new, as it can be traced back to as early as 400 BCE. The profession of chiropractic began in the later 1800s and has grown in popularity ever since. There is now an overwhelming body of evidence that supports spinal manipulation as both a safe and highly effective treatment for neck and back pain, headaches, and many other maladies.

It’s important to note that there are many different types of manual therapies that chiropractors utilize when caring for neck pain patients. There are “low-velocity, low amplitude” or non-thrust techniques that do NOT produce the “crack” that is frequently associated with chiropractic adjustments. The term “mobilization” is often used when referencing these non-thrust methods, and this often incorporates a combination of manual traction (pulling of the neck), left to right and front to back “gliding” movements usually starting lightly and gradually increasing the pressure as tolerated. In many cases, a doctor of chiropractic may utilize a combination of manipulation and mobilization as well as “trigger point therapy” (applying sustained pressure over tight “knots” in muscles), depending on a patient’s needs.

Low speed collision; what happens?

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You may have heard the comment, “If there’s no damage to the car, then there’s no injury.” Unfortunately, that does not always seem to be the case.

There are MANY factors that affect the dynamics of a collision and whether or not injury occurs. A short list includes: vehicle type and design, speed, angle of collision, momentum, acceleration factors, friction, kinetic and potential energy, height, weight, muscle mass, seat back angle and spring, head position upon impact, etc.

Consider Sir Isaac Newton’s Third Law of Motion: “For every action there is an equal and opposite reaction.” This law applies to a car accident at any speed. Using the analogy of hitting a pool ball into the corner pocket straight on, when the cue ball stops, its momentum is transferred to the target ball which accelerates at the same speed…hopefully into the corner pocket!

This example is not quite the same as an automobile collision because the energy transfer is very efficient due in part to the two pool balls not deforming (crushing or breaking) on impact with one another. If either ball did deform, more energy absorption would occur and the acceleration of the second ball would be lower.

In fact, in the United States, vehicle bumpers are tested at 2.5 mph with impact equipment of similar mass with the test vehicle’s brakes disengaged and the transmission in neutral. National Highway Transportation Highway Safety Administration (NHTSA) vehicle safety standards demand that no damage should occur to the car in this scenario.

However, energy transfer occurs very quickly and with a greater amount of force when there is no vehicle deformation (damage). As a result, a greater amount of energy (described as G-force) is directly transferred to the occupants inside the vehicle—increasing the risk of injury. A 1997 Society of Automobile Engineers article provided an example in which the same 25 mph (12 m/s) collision resulted in a five-times greater force on the occupants of the vehicle when the crush distance of the impact fell from 1 meter to .2 meters.

So be aware that even low-speed impacts can still place quite a bit of force on your body, even if the bumper of your car doesn’t have a scratch on it.

Is my Shoulder Pain a SITS Tear?

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One of the most common causes of shoulder pain is a rotator cuff (RC) tear. To determine just how common this is, one study looked at a population of 683 people regardless of whether or not they had shoulder complaints. There were 229 males and 454 females for a total of 1,366 shoulders. (The participants’ average age was 58 years, ranging from 22 to 87 years old.)

The research team found 20.7% had full thickness rotator cuff tears. Of those with shoulder pain, only 36% had tears found on ultrasound. Of those without shoulder pain, 17% also had tears! Risk factors for an increased for tearing of the rotator cuff include a history of trauma, the dominant arm (ie your right arm if you’re right handed), and increasing age.

In a review of radiologic studies of 2,553 shoulders, researchers found full-thickness rotator cuff tears in 11.75% and partial thickness tears in 18.49% of the subjects for a total of 30.24% having some degree of tearing. In this group, about 40% of tears were found in pain-free shoulders. The researchers concluded that rotator cuff tears are common and frequently asymptomatic.

Both of these studies support the necessity to FIRST consider the patient’s clinical presentation and then correlate that with the imaging results. In other words, the presence of a RC tear on an image (usually MRI or ultrasound) does NOT necessarily mean there is pain (and vise versa)!

So what other things could be causing the shoulder pain? There are many: impingement, tendonitis, bursitis, muscle strain, capsular (and other ligament) sprain, frozen shoulder, and osteoarthritis (the “wearing out” type). Also, rheumatoid arthritis, lupus, polymyalgia rheumatica and other autoimmune types of “arthropathies,” fibromyalgia, a herniated cervical disk, shoulder dislocations, whiplash injuries, and more!

Most importantly, we must NOT forget to include referred pain to the shoulder from an impaired heart (such as coronary heart disease or heart attack), lung, liver, or gall bladder as these problems commonly refer pain to the shoulder and may represent a MEDICAL EMERGENCY!

Meditation and Chiropractic

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With growing evidence that meditation has significant health benefits, a 2016 study by a team of researchers from the United States, Spain, and France sought to explain how and why meditation actually works.

The study investigated the difference between “mindful meditation” in a group of experienced meditators vs. “quiet non-meditative activity” in a group of untrained control subjects. After eight hours of mindfulness practice, the meditation group showed a range of genetic and molecular differences, which in turn correlated with faster physical recovery from a stressful situation.

According to researchers, this is the first time a study has documented a rapid alteration in gene expression within meditating subjects. Interestingly, the researchers observed these changes in the SAME genes that anti-inflammatory and pain-killing drugs target! Thus, they speculate that mindful-based training may benefit patients with inflammatory conditions! This and prior studies have prompted the American Heart Association to endorse meditation as an effective cardiac preventative intervention.

Meditation has been found to be helpful for many conditions including stress management, lowering high blood pressure, heart disease, and depression. You can incorporate meditation into your life with three simple meditation exercises! The initial advice is “…go slow and be compassionate and gentle with yourself.” Your mind will try to wander (called our “default mode”) which consumes about half of our day, so try to focus (called “focus mode”)!

1)  WALKING MEDITATION: At a slow to medium pace, focus on your feet. Notice how your heel hits the ground and then feel the roll of your foot followed by the big toe pushing off prior to the swing phase. Feel for stones under the foot and other interesting sensations. If your mind starts to wander (default mode), gently bring your attention back to your foot (focus mode). You WILL get better with practice, and you’ll soon find it much easier to “focus” during stressful situations!

2)  NOVEL EXPERIENCES: It’s much easier to lose focus on the people you see everyday vs. those seen only one time a month. The next time you arrive home from work, pretend you haven’t seen your spouse/friend in 30 days. Give them your undivided attention. Then, try this on co-workers and other people you see every day. Believe me, they WILL notice a difference!

3)  GRATITUDE EXERCISES: When you’re not in their presence, focus on a person’s face and send them a “silent gratitude” for being in your life. Try this on family members, friends, co-workers, and others!

What to expect from a trigger point massage

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A treatment with Bryan is very user friendly. And, no, you don’t have to remove any clothing. However, bringing a t-shirt and a pair of shorts or sweats is recommended.

 

The first time you come for a treatment you will be asked to fill out a Client History form. Bryan will go over the information you provide, asking for more detail and discussing the type of pain you are having and its location.

 

The treatment itself involves locating the Trigger Points in the muscle or soft tissue and applying a deep focused pressure to the Point. This will reproduce the pain and the referral pattern that is characteristic of that pain.

 

The treatment will be uncomfortable at first, but as the Trigger Points release, the pain will decrease. The pressure will always be adjusted to your tolerance level. If, at any time, you feel too uncomfortable you can ask Bryan to ease off a bit.

 

Depending on your specific problem, Bryan may also use some stretching and / or range-of-motion techniques, as needed.

 

After treatment, it is usually recommended that the client apply moist heat to the area treated.