Whiplash and Your Posture

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Posture assessment is a key component of the chiropractic examination, and the posture of the head and neck is especially important for a patient recovering from a whiplash injury. Forward head carriage describes a state in which the head sits more forward on the shoulders than it should. In order for the muscles in the neck and shoulders to keep the head upright, they must work harder. This added strain can increase one’s risk for neck pain and headaches, which is why retraining posture is a key component to the management of neck pain and headaches in patients with or without a history of whiplash.

Forward head carriage also increases the distance between the back of the head and the headrest in the seated position, especially when the seat is reclined. In a rear-end collision, a gap greater than a half an inch between the head rest and the back of the head increases the probability of injury due to the greater distance the head can hyperextend as it rebounds backwards into the headrest.  This makes posture correction of forward head carriage an important aspect of treatment from both a preventative and curative perspective.

So this begs the question, can forward head carriage be corrected?  The simple answer is “yes!” One study evaluated the effects of a 16-week resistance and stretching program designed to address forward head posture and protracted shoulder positioning.

Researchers conducted the study in two separate secondary schools with 130 adolescents aged 15–17 years with forward head and protracted shoulder posture. The control group participated in a regular physical education (PE) program while the experimental group attended the same PE classes with the addition of specific exercises for posture correction. The research ream measured the teens’ shoulder head posture from the side using two different validated methods and tracked symptoms using a questionnaire. The results revealed a significant improvement in the shoulder and cervical angle in the experimental group that did not occur in the control group.

The conclusion of the study strongly supports that a 16-week resistance and stretching program is effective in decreasing forward head and protracted shoulder posture in adolescents.  This would suggest that a program such as this should be strongly considered in the regular curriculum of PE courses since this is such a common problem.

Doctors of chiropractic are trained to evaluate and manage forward head posture with shoulder protraction. This can prove beneficial in both the prevention as well as management of signs and symptoms associated with a whiplash injury.

Teens & Headaches? What?

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In 2016, researchers at Curtin University in Perth examined the seated posture and health data of 1,108 17-year olds in an effort to determine if any particular posture increased the risk of headaches/neck pain among late adolescents.

Among four posture subgroups—upright, intermediate, slumped thorax, and forward head—the researchers observed the following: participants who were slumped in their thoracic spine (mid-back region) and had their head forward when they sat were at higher odds of having mild, moderate, or severe depression; participants classified as having a more upright posture exercised more frequently, females were more likely to sit more upright than males; those who were overweight were more likely to sit with a forward neck posture; and taller people were more likely to sit upright.

While they found biopsychosocial factors like exercise frequency, depression, and body mass index (BMI) ARE associated with headaches and neck pain, their data did not suggest any one particular posture increased the risk of neck pain or headaches more than any other posture among the teenagers involved in the study.

This is noteworthy as studies with adults do indicate the risk for neck pain and headaches is greater in individuals with poor neck posture. In particular, postures such as forward head carriage, pinching a phone between the ear and shoulder, and prolonged neck/head rotation outside of neutral can all increase the risk of cervical disorders. This suggests that in younger bodies, the cause of neck pain and headaches may be multifactoral and not limited to just poor posture and that treatment must address all issues that may increase one’s risk for neck pain/headaches in order to reach a desired outcome.

The good news is that chiropractic has long embraced the biopsychosocial model of healthcare, looking at ALL factors that affect back and neck pain and quality of life. Through patient education, spinal manipulation, mobilization, exercise training, the use of modalities, and more, chiropractors can greatly help those struggling with neck pain and headaches!

Condition Of The Month: Thoracic Joint Restriction

T Spine Joint

Your spine is made up of 24 bones stacked on top of each other with a soft “disc” between each segment to allow for flexibility. Normally, each joint in your spine should move freely and independently. When one or more of your spinal vertebra is slightly misaligned and restricted, we call this condition a “spinal segmental joint restriction”. A “thoracic joint restriction” means that this misalignment or restriction is located in your upper or mid-back region.

To help visualize this, imagine a normal spine functioning like a big spring moving freely in every direction. A spine with a joint restriction is like having a section of that spring welded together. The spring may still move as a whole, but a portion of it is no longer functioning.

Joint restrictions can develop in many ways. Sometimes they are brought on by an accident or an injury. Other times, they develop from repetitive strains or poor posture. Being overweight, smoking, strenuous work, and emotional stress can make you more susceptible to problems.

Restricted joints give rise to a self-perpetuating cycle of discomfort. Joint restriction causes swelling and inflammation, which triggers muscular guarding leading to more restriction. Since your spine functions as a unit, rather than as isolated pieces, a joint restriction in one area of your spine often causes “compensatory” problems in another. Think of this as a rowboat with multiple oarsmen on each side. When one rower quits, the others are placed under additional stress and can become overworked.

Joint restrictions most commonly cause local tenderness and discomfort. You may notice that your range of motion is limited. Movement may increase your discomfort. Pain from a restricted joint often trickles around your rib cage or up & down your spine. Be sure to tell your chiropractor if your symptoms include any chest pain, shortness of breath, unusual cough, indigestion or flu- like complaints.

Long-standing restrictions are thought to result in arthritis – much like the way a slightly misaligned wheel on your car causes premature wearing of your tire.

You should recognize that your problem is common and generally treatable. Chiropractic care has been shown to be the safest and most effective treatment for joint restrictions. Our office offers several tools to help ease your pain. To speed your recovery, you should avoid activities that increase your pain. Be sure to take frequent breaks from sedentary activity. Yoga has been shown to help back pain sufferers so consider joining a class or picking up a DVD.

Pregnancy and Low Back Pain?

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Did you know that 50-72% of women have low back pain (LBP) and/or pelvic pain during their pregnancy but only 32% do something about it? Let’s look closer!
 
 
 
Pregnancy-related low back pain (PLBP) can be a highly debilitating syndrome that accounts for the most common cause of sick leave for pregnant women. In 2004, Americans spent $26.1 billion dollars in an effort to find relief from back pain during pregnancy. Statistics show one out of ten women will experience daily DISABLING LBP for at least two years following delivery.
 
 
 
Because of the limited number of treatment options available for the pregnant woman due to mother and fetus safety, and given the high propensity of potentially disabling PLBP that can significantly limit function and quality of life, chiropractic care seems to be a natural choice for this patient population! Obviously, pharmaceuticals and surgery are NOT appropriate options for the expectant mother, even during the post-partum breast-feeding time period. Chiropractic offers a non-invasive and safe approach to managing lumbopelvic pain that uses many different approaches.
 
 
 
In a 2009 research paper, 78 women participated in a study that investigated disability, pain intensity, and percent improvement after receiving chiropractic care to treat pregnancy-related PLBP. Here, 73% reported their improvement as either “excellent” or “good.” For disability and pain, 51% and 67% (respectively) experienced clinically significant improvement! Researchers followed up with them eleven months later and found 85.5% reported their improvement as either “excellent” or “good!” For disability and pain, 73% and 82% (respectively) experienced clinically significant improvement!
So, what’s causing LBP in pregnant women? Because of the biomechanical changes that occur in the low back and pelvis over a relatively short amount of time during pregnancy, especially in the second and third trimesters, common pain generators include (but are not limited to): the sacroiliac joint, facet joints, shock-absorbing disks, and the many connecting muscles (strains) and ligaments (sprains). During the later stages of pregnancy, the hormone Relaxin prepares the pelvis for delivery by widening the pelvic girdle, which can also be problematic.
 
 
 
Treatment options within chiropractic often include spinal manipulation, lumbopelvic exercises, patient education, posture correction, massage, an SI belt, soft tissue mobilization, and more. Exercises that target the transverse abdominus, multifidus, and pelvic floor muscles help to stabilize the lumbopelvic region. The American College of Obstetricians & Gynaecologists recommends exercise at least three times a week during pregnancy, and studies report NO obstetric complications (pre-term labor, premature ruptured membranes, or changes to maternal or neonatal weight) with exercise.
 
 
 
So, the answer is clear! When PLBP strikes, seek chiropractic care to safely and effectively manage the pain and disability and so you can ENJOY YOUR PREGNANCY!!!
We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honoured to render our services.

Why Does My Back Hurt?

It’s been said that if you haven’t had back pain, just wait, because (statistically) some day you will! The following list is a list of “causes” that can be easily “fixed” to reduce your risk for a back pain episode.
1. MATTRESS: Which type of mattress is best? The “short answer”: there is no single mattress (style or type) for all people, primarily due to body type, size, gender, and what “feels good.” TRY laying on a variety of mattresses (for several minutes on your back and sides) and check out the difference between coiled, inner springs, foam (of different densities), air, waterbeds, etc. The thickness of a mattress can vary from 7 to 18 inches (~17-45 cm) deep. Avoid mattresses that feel like you’re sleeping in a hammock! A “good” mattress should maintain your natural spinal curves when lying on your sides or back (avoid stomach sleeping in most cases). Try placing a pillow between the knees and “hug” a pillow when side sleeping, as it can act like a “kick stand” and prevent you from rolling onto your stomach. If your budget is tight, you can “cheat” by placing a piece of plywood between the mattress and box spring as a short-term fix.
2. SHOES: Look at the bottom of your favorite pair of shoes and check out the “wear pattern.” If you have worn out soles or heels, you are way overdue for a new pair or a “re-sole” by your local shoe cobbler! If you work on your feet, then it’s even more important for both managing and preventing LBP!
3. DIET: A poor diet leads to obesity, which is a MAJOR cause of LBP. Consider the Paleo or Mediterranean Diet and STAY AWAY from fast food! Identify the two or three “food abuses” you have embraced and eliminate them – things with empty calories like soda, ice cream, chips… you get the picture! Keeping your BMI (Body Mass Index) between 20 and 25 is the goal! Positive “side-effects” include increased longevity, better overall health, and an improved quality of life!
4. EXERCISE: The most effective self-help approach to LBP management is exercise. Studies show those who exercise regularly hurt less, see doctors less, have a higher quality of life, and just feel better! This dovetails with diet in keeping your weight in check as well. Think of hamstring stretches and core strengthening as important LBP managers – USE PROPER TECHNIQUE AND FORM; YOUR DOCTOR OF CHIROPRACTIC CAN GUIDE YOU IN THIS PROCESS!
5. POSTURE: Another important “self-help” trick of the trade is to avoid sitting slumped over with an extreme forward head carriage positions. Remember that every inch your head pokes forwards places an additional ten pounds (~4.5 kg) of load on your upper back muscles to keep your head upright, and sitting slumped increases the load on your entire back!
We have only scratched the surface of some COMMON causes and/or contributors of back pain. Stay tuned next month as we continue this important conversation!
We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.

What the heck is a trigger point?

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What is a Trigger Point?

Trigger Points (TP’s) are defined as a “hyper-irritable spot within a taut band of skeletal muscle. The spot is painful on compression and can evoke characteristic referred pain and autonomic phenomena.”1

Put into plain language, a TP is a painful knot in muscle tissue that can refer pain to other areas of the body. You have probably felt the characteristic achy pain and stiffness that TP’s produce, at some time in your life.

TP’s were first brought to the attention of the medical world by Dr. Janet G. Travell. Dr. Travell, physician to President John F. Kennedy, is the acknowledged Mother of Myofascial Trigger Points. In fact, “Trigger Point massage, the most effective modality used by massage therapists for the relief of pain, is based almost entirely on Dr. Travell’s insights.”2 Dr. Travell’s partner in her research was Dr. David G. Simons, a research scientist and aerospace physician.

Trigger Points are very common. In fact, Travell and Simons state that TP’s are responsible for, or associated with, 75% of pain complaints or conditions.1 With this kind of prevalence, it’s no wonder that TP’s are often referred to as the “scourge of mankind”.

Trigger Points can produce a wide variety of pain complaints. Some of the most common are migraine headaches, back pain, and pain and tingling into the extremities. They are usually responsible for most cases of achy deep pain that is hard to localize.

A TP will refer pain in a predictable pattern, based on its location in a given muscle. Also, since these spots are bundles of contracted muscle fibres, they can cause stiffness and a decreased range of motion. Chronic conditions with many TP’s can also cause general fatigue and malaise, as well as muscle weakness.

Trigger Points are remarkably easy to get, but the most common causes are

TP’s (black X) can refer pain to other areas (red)

Sudden overload of a muscle

  • Poor posture
  • Chronic frozen posture (e.g., from a desk job), and
  • Repetitive strain

Once in place, a TP can remain there for the remainder of your life unless an intervention takes place.

Trigger Points Not Well Known

With thousands of people dealing with chronic pain, and with TP’s being responsible for — or associated with — a high percentage of chronic pain, it is very disappointing to find that a large portion of doctors and other health care practitioners don’t know about TP’s and their symptoms.

Scientific research on TP’s dates back to the 1700’s. There are numerous medical texts and papers written on the subject.

But, it still has been largely overlooked by the health care field. This has led to needless frustration and suffering, as well as thousands of lost work hours and a poorer quality of life.

How Are Trigger Points Treated?

As nasty and troublesome as TP’s are, the treatment for them is surely straight-forward. A skilled practitioner will assess the individual’s pain complaint to determine the most likely location of the TP’s and then apply one of several therapeutic modalities, the most effective of which is a massage technique called “ischemic compression”.

Basically, the therapist will apply a firm, steady pressure to the TP, strong enough to reproduce the symptoms. The pressure will remain until the tissue softens and then the pressure will increase appropriately until the next barrier is felt. This pressure is continued until the referral pain has subsided and the TP is released. (Note: a full release of TP’s could take several sessions.)

Other effective modalities include dry needling (needle placed into the belly of the TP) or wet needling (injection into the TP). The use of moist heat and stretching prove effective, as well. The best practitioners for TP release are Massage Therapists, Physiotherapists, and Athletic Therapists. An educated individual can also apply ischemic compression to themselves, but should start out seeing one of the above therapists to become familiar with the modality and how to apply pressure safely.

1 Simons, D.G., Travell, D.G., & Simons, L.S. Travell and Simons’Myofascial Pain and Dysfunction: the Trigger Point Manual.

Vol. 1. 2nd ed. Lippincott, Williams, and Wilkins, 1999.

Patellofemoral Pain Syndrome

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Patellofemoral pain syndrome (PFPS), also called “Runners Knee”, describes the symptom complex of knee discomfort, swelling, or crepitus that results from excessive or imbalanced forces acting on the joint. It is the most common cause of knee pain in the general population, affecting an estimated 25% of adults.

PFPS is most commonly related to lateral tracking of the patella. The patella has a natural tendency to migrate laterally due to the pull of the quadriceps and the slight natural valgus of the lower extremity. A new study in the Journal of Sports Medicine (1) provides additional confirmation that when managing patellofemoral pain syndrome, clinicians must address two critical yet often overlooked issues.

This study concludes that PFPS and dynamic knee valgus do not arise primarily from knee dysfunction, rather from hip abductor/ external rotator weakness and/or foot hyperpronation.

“The most effective intervention programs included exercises targeting the hip external rotator and abductor muscles and knee extensor muscles.” and “PFPS patients with foot abnormalities, such as those with increased rearfoot eversion or pes pronatus, may benefit the most from foot orthotics.”

Since gluteus medius and VMO weakness are key factors in the development of PFPS, strengthening exercises that target those muscles prove most effective. Stabilization exercises may include pillow push (push the back of your knee into a pillow for 5-6 seconds), supine heel slide, terminal knee (short-arc) extension, clam, glut bridge, semi-stiff deadlift, posterior lunge, and monster walk.

Myofascial release and stretching should be directed at hypertonic muscles, including the TFL, gastroc, soleus, hamstring, piriformis, hip rotators, and psoas. Myofascial release or IASTM may be appropriate for tightness in the iliotibial band, vastus lateralis, posterior hip capsule, and lateral knee retinaculum.

Manipulation may be necessary for restrictions in the lumbosacral and lower extremity joints. Hypermobility is common in the ipsilateral SI joint with restrictions present contralaterally. Evidence has shown that patellar tracking braces, i.e. BioSkin® or PatellaPro®, may lead to better outcomes.

Lifestyle modification may be necessary to reduce pain-provoking endeavors, especially running, jumping and other activities that induce a valgus stress. Athletes should avoid allowing their knee to cross in front of their toes while squatting. Arch supports or custom orthotics may be necessary to correct hyperpronation. Runners should avoid cross-over gaits and change shoes every 250 to 500 miles.

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#pain

#kneepain

#chiropractic

#fitness

#sports

#wellness

#fitness

#healthyliving

#healthychoices

#Winnipeg

References

1. Petersen W, Rembitzki I, Liebau C. Patellofemoral pain in athletes. Open Access Journal of Sports Medicine. 2017;8:143-15

The Importance of Proper Desk Posture: How to Maintain Health and Productivity

Photo by Emirhan Albayrak on Pexels.com

In today’s digital age, many of us spend a significant portion of our day sitting at a desk, working on a computer. While this lifestyle is common, it can lead to various health issues if proper posture is not maintained. Poor desk posture can cause back pain, neck strain, headaches, and even long-term musculoskeletal problems. This blog post will outline the importance of proper desk posture and provide practical tips to help you maintain a healthy, productive work environment.

Why Proper Desk Posture Matters

1. Reduces Back and Neck Pain: Improper posture, such as slouching or leaning forward, places undue stress on the spine and neck muscles. Over time, this can lead to chronic pain and discomfort. Maintaining proper posture helps to distribute weight evenly and reduce strain on these areas.

2. Improves Breathing and Circulation: Slouching compresses your chest and lungs, making it harder to breathe deeply. Proper posture opens up your chest, allowing for better oxygen flow and improving circulation throughout your body.

3. Enhances Concentration and Productivity: When your body is aligned correctly, you are less likely to experience discomfort and fatigue. This can enhance your concentration, allowing you to stay focused and productive throughout the day.

4. Prevents Long-term Health Issues: Consistently poor posture can lead to serious long-term health issues, such as herniated discs, muscle imbalances, and even nerve compression. Proper posture helps to prevent these conditions, promoting overall health and well-being.

Tips for Maintaining Proper Desk Posture

1. Choose the Right Chair: Your chair plays a crucial role in maintaining proper posture. Choose a chair that supports the natural curve of your spine, has adjustable height, and provides adequate lumbar support. Your feet should rest flat on the floor or on a footrest, with your knees at a 90-degree angle.

2. Position Your Monitor at Eye Level: Place your computer monitor directly in front of you at eye level. This prevents you from tilting your head up or down, which can strain your neck. The top of the screen should be at or slightly below eye level, and about an arm’s length away from you.

3. Keep Your Back Straight: Sit back in your chair with your back straight and shoulders relaxed but not slouched. Use a lumbar cushion if necessary to support the natural curve of your lower back.

4. Adjust Your Desk and Keyboard: Your desk should be at a height where your forearms are parallel to the floor when typing. Keep your keyboard and mouse close enough that you don’t have to stretch to reach them, and ensure your wrists are in a neutral position.

5. Take Regular Breaks: Sitting in the same position for extended periods can lead to stiffness and discomfort. Take short breaks every 30 minutes to stand up, stretch, and move around. This helps to alleviate tension and improve circulation.

6. Maintain a Neutral Head Position: Keep your head aligned with your spine, avoiding the tendency to jut your chin forward. Imagine a string pulling your head upwards to maintain a neutral and relaxed position.

7. Use Proper Lighting: Ensure your workspace is well-lit to prevent eye strain. Position your monitor to avoid glare from windows or overhead lights. Consider using a desk lamp with adjustable brightness to reduce eye fatigue.

Incorporating Ergonomics into Your Workspace

Ergonomics is the science of designing a workspace that fits your body’s needs and promotes comfort and efficiency. Here are a few ergonomic tips to enhance your desk posture:

1. Ergonomic Accessories: Invest in ergonomic accessories such as a keyboard tray, an adjustable monitor stand, and a footrest. These tools can help you customize your workspace to suit your body’s requirements.

2. Desk Arrangement: Keep frequently used items within easy reach to avoid excessive stretching or twisting. Arrange your desk so that your phone, documents, and other essential items are conveniently accessible.

3. Proper Chair Adjustment: Adjust your chair’s height so that your feet are flat on the floor, and your thighs are parallel to the ground. Ensure the armrests are set at a height where your shoulders are relaxed, and your elbows are at a 90-degree angle.

Conclusion

Maintaining proper desk posture is essential for your health, productivity, and overall well-being. By making simple adjustments to your workspace and being mindful of your posture, you can prevent the discomfort and long-term health issues associated with prolonged sitting. Remember, your body is designed for movement, so incorporate regular breaks and stretches into your routine to stay active and healthy. Prioritize your posture today to enjoy a more comfortable and productive work environment tomorrow.

Managing Upper Crossed Syndrome with Chiropractic Care and Ergonomic Adjustments

Your posture is a cornerstone of your overall health, influencing everything from musculoskeletal function to internal organ function. Poor posture can lead to chronic strain and discomfort, affecting your daily life and long-term well-being. One common postural issue is known as “upper crossed syndrome,” characterized by excessive tightness in the shoulders and chest paired with weakness in the neck and mid-back muscles. This imbalance forces the shoulders to roll inward and the head to protrude forward, creating a cascade of negative effects throughout the body.

To grasp how upper crossed syndrome wreaks havoc, envision your spine as a sturdy telephone pole and your head as a heavy bowling ball atop it. When the bowling ball is positioned directly over the pole, minimal effort is needed to maintain balance. However, if the pole tilts forward and the ball threatens to roll off, the muscles must work tirelessly to prevent it from falling. This constant effort places undue strain on the muscles of the neck and upper back, leading to chronic discomfort and potential complications.

The repercussions of upper crossed syndrome extend beyond mere discomfort. It can contribute to a host of issues including neck pain, upper back pain, headaches, temporomandibular joint (TMJ) pain, and even arthritis over time. This postural distortion is particularly prevalent among individuals who spend prolonged periods at computer workstations, where slouching and forward head posture are common.

Addressing upper crossed syndrome requires a multifaceted approach aimed at correcting muscular imbalances and optimizing workstation ergonomics. Chiropractic care plays a pivotal role in this process, offering targeted interventions to restore postural alignment and alleviate associated discomfort. Through manual adjustments, chiropractors can realign misaligned vertebrae and alleviate pressure on nerves, facilitating improved posture and function.

Additionally, chiropractors provide guidance on stretches and exercises tailored to address muscle tightness and weakness characteristic of upper crossed syndrome. These exercises aim to elongate tight muscles, such as the chest and front shoulder muscles, while strengthening weakened muscles, particularly those in the neck and mid-back. By restoring muscular balance, chiropractic care helps alleviate strain on the spine and promote better postural alignment.

In conjunction with chiropractic interventions, modifying your workstation ergonomics is crucial for preventing and managing upper crossed syndrome. Simple adjustments, such as raising the computer monitor to eye level, using an ergonomic chair with proper lumbar support, and taking regular breaks to stretch and move, can significantly reduce strain on the neck and back muscles.

By addressing the root causes of upper crossed syndrome through a comprehensive approach that includes chiropractic care and ergonomic modifications, you can effectively manage discomfort and prevent long-term complications. Prioritizing good posture and seeking timely intervention from a chiropractor can help you maintain optimal musculoskeletal health and enjoy a more comfortable, pain-free lifestyle.

The Surprising Health Benefits of Good Posture

The importance of good posture extends beyond mere appearance, encompassing a multitude of health benefits that are often overlooked. By maintaining proper alignment of bones and joints, good posture helps reduce stress on ligaments, minimizing the risk of injury. Moreover, it prevents muscle strain, overuse, and pain, promoting overall musculoskeletal health.

Efficient posture also conserves energy, as muscles are utilized more effectively and efficiently. This not only enhances physical performance but also reduces fatigue and promotes endurance. Additionally, by decreasing abnormal joint wear, good posture helps preserve joint integrity and function over time.

Furthermore, research has highlighted the far-reaching implications of posture on mental and emotional well-being. Poor posture has been linked to increased feelings of depression, potentially exacerbating mood disorders and negatively impacting mental health. Moreover, posture can influence the function of the digestive tract, with slouched postures potentially impeding digestion and exacerbating gastrointestinal discomfort.

Beyond physiological effects, posture plays a pivotal role in shaping confidence levels and managing stress. Maintaining an upright posture has been associated with heightened self-assurance and a greater sense of control, while slouched postures may contribute to feelings of insecurity and stress.

In summary, good posture serves as a cornerstone of overall health and well-being, exerting profound effects on both physical and mental health. By prioritizing proper posture habits, individuals can optimize their musculoskeletal health, reduce the risk of injury, and enhance their overall quality of life.