Physio

Hamstring Problems?

~ Dr. Robert Speirs DC ~ Leave a comment

Glute Ham Raise.gif

A great injury prevention movement is the glute-ham raise. Done after a warm up and prior to competition it will significantly reduce the odds of hamstring strains in running athletes in sports like Soccer, Football and Sprinting.

To perform the movement:

Begin in a tall kneeling position on a cushion or pillow.

Partner grabs and holds ankles to ground or hook your feet under a stable surface.

Keeping your torso neutral and your thighs in line with your body, bend forward at the knees, using your hamstrings to control the speed of your forward bend.

Go as far as you can without cramping, pain or falling to the ground.

 

What Exercises Should I Do For Fibro?

~ Dr. Robert Speirs DC ~ Leave a comment

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​Fibromyalgia (FM) is a very common, chronic condition where the patient describes “widespread pain” not limited to one area of the body. Hence, when addressing exercises for FM, one must consider the whole body. Perhaps one of the most important to consider is the squat.

If you think about it, we must squat every time we sit down, stand up, get in/out of our car, and in/out of bed. Even climbing and descending steps results in a squat-lunge type of movement.

The problem with squatting is that we frequently lose (or misuse) the proper way to do this when we’re in pain as the pain forces us to compensate, which can cause us to develop faulty movement patterns that can irritate our ankles, knees, hips, and spine (particularly the low back). In fact, performing a squatting exercise properly will strengthen the hips, which will help protect the spine, and also strengthens the glutel muscles, which can help you perform all the daily activities mentioned above.

The “BEST” type of squat is the free-standing squat. This is done by bending the ankles, knees, and hips while keeping a curve in the low back. The latter is accomplished by “…sticking the butt out” during the squat.

Do NOT allow the knees to drift beyond your toes! If you notice sounds coming from your knees they can be ignored IF they are not accompanied by pain. If you do have pain, try moving the foot of the painful knee about six inches (~15 cm) ahead of the other and don’t squat as far down. Move within “reasonable boundaries of pain” by staying away from positions that reproduce sharp, lancinating pain that lingers upon completion.

There are MANY exercises that help FM, but this one is particularly important!

Carpal Tunnel Syndrome #3

~ Dr. Robert Speirs DC ~ Leave a comment

​This week, we will conclude our three-part series on important facts regarding carpal tunnel syndrome (CTS).

CTS TREATMENT OPTIONS (continued): Aside from the carpal tunnel, there are several places where the median nerve can become compressed as it travels from the neck, down through the shoulder, through tight muscular areas of the upper arm and forearm, and finally through the carpal tunnel at the wrist. In order to achieve good, long-lasting results, treatment must focus on relieving compression at any point along the course of the nerve. This is why chiropractic works SO WELL as it addresses ALL of these areas using manual adjustments, muscle release techniques, and even physical therapy modalities.

CTS PREVENTION: Because there are multiple causes of CTS, prevention must be tailored to each person. For example, if the patient has diabetes mellitus, maintaining a proper blood sugar level is very important because the blood becomes thicker as the sugar levels increase and it simply cannot pass through our small blood vessels (capillaries), especially those located in the feet and hands. This can eventually lead to the need for amputation due to poor circulation and contribute to the numbness associated with diabetic neuropathy.

Similarly, low thyroid function results in a type of swelling called myxedema that can cause or worsen CTS, and keeping the thyroid hormone balanced in the bloodstream is very important. Managing other conditions that create inflammation or swelling, such as rheumatoid and other types of arthritis, will also help prevent CTS from developing or worsening.

Carpal tunnel syndrome can also occur during pregnancy due to the hormonal shifts similar for those taking birth control pills. The PRICE treatment options presented last month can be very helpful for the pregnant mother and represent important non-medication self-care approaches.

Certain occupations that require fast, repetitive work and/or firm gripping can result in carpal tunnel syndrome because of the friction that results in swelling that occurs when the muscle tendons inside the carpal tunnel rub excessively fast together (kind of like starting a fire with two sticks). Modifying the work task until the swelling is controlled is VERY important, as discussed last month.

Other preventative measures include exercises that keep the muscles and tendons in the forearm and inside the carpal tunnel stretched so that the tendons easily slide inside their respective muscle tendon sheaths. This is accomplished by placing the palm side of the hand (elbow straight) on a wall with the fingers pointing downwards while reaching across with the opposite hand and pulling the thumb back until you feel a good firm stretch. Hold this position for 5-10 seconds or until the forearm muscles feel like they are relaxing. Repeat this multiple times a day.

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 Carpal Tunnel Syndrome, we would be honored to render our services.

Carpal Tunnel

What Causes Low Back Pain?

~ Dr. Robert Speirs DC ~ Leave a comment

​236

Low back pain (LBP) can arise from disks, nerves, joints, and the surrounding soft tissues.
To simplify the task of determining “What is causing my LBP?” the Quebec Task Force recommends that LBP be divided into three main categories: 1) Mechanical LBP; 2) Nerve root related back pain; and 3) Pathology or fracture. We will address the first two, as they are most commonly managed by chiropractors.
Making the proper diagnosis points your doctor in the right direction regarding treatment. It avoids time wasted by treating an unrelated condition, which runs the risk of increased chances of a poor and/or prolonged recovery. Low back pain is no exception! The “correct” diagnosis allows treatment to be focused and specific so that it will yield the best results.
Mechanical low back pain is the most commonly seen type of back pain, and it encompasses pain that arises from sprains, strains, facet and sacroiliac (SI) syndromes, and more. The main difference between this and nerve root-related LBP is the ABSENCE of a pinched nerve. Hence, pain typically does NOT radiate, and if it does, it rarely goes beyond the knee and normally does not cause weakness in the leg.
The mechanism of injury for both types of LBP can occur when a person does too much, maintains an awkward position for too long, or over bends, lifts, and/or twists. However, LBP can also occur “insidiously” or for seemingly no reason at all. However, in most cases, if one thinks hard enough, they can identify an event or a series of “micro-traumas” extending back in time that may be the “cause” of their current low back pain issues.
Nerve root-related LBP is less common but it is often more severe—as the pain associated with a pinched nerve is often very sharp, can radiate down a leg often to the foot, and cause numbness, tingling, and muscle weakness. The location of the weakness depends on which nerve is pinched. Think of the nerve as a wire to a light and the switch of the nerve is located in the back where it exits the spine. When the switch is turned on (the nerve is pinched), and the “light” turns on—possibly in the outer foot, middle foot, inner foot, or front, back or side of the thigh. In fact, there are seven nerves that innervate or “run” into our leg, so usually, a very specific location “lights up” in the limb.
Determining the cause of your low back pain helps your doctor of chiropractic determine which treatments may work best to alleviate your pain as well as where such treatments can be focused.

Whiplash and Your Posture

~ Dr. Robert Speirs DC ~ Leave a comment

WRD 2.gif​

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.

What is Whiplash?

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​Up Trap Ext

Whiplash is an injury to the soft-tissues of the neck often referred to as a sprain or strain. Because there are a unique set of symptoms associated with whiplash, doctors and researchers commonly use the term “whiplash associated disorders” or WAD to describe the condition.

WAD commonly occurs as a result of a car crash, but it can also result from a slip and fall, sports injury, a personal injury (such as an assault), and other traumatic causes. The tissues commonly involved include muscle tendons (“strain”), ligaments and joint capsules (“sprains”), disk injuries (tears, herniation), as well as brain injury or concussion—even without hitting the head!

Symptoms vary widely but often include neck pain, stiffness, tender muscles and connective tissue (myofascial pain), headache, dizziness, sensations such as burning, prickly, tingling, numbness, muscle weakness, and referred pain to the shoulder blade, mid-back, arm, head, or face. If concussion occurs, additional symptoms include cognitive problems, concentration loss, poor memory, anxiety/depression, nervousness/irritability, sleep disturbance, fatigue, and more!

Whiplash associated disorders can be broken down into three categories: WAD I includes symptoms without any significant examination findings; WAD II includes loss of cervical range of motion and evidence of soft-tissue damage; and WAD III includes WAD II elements with neurological loss—altered motor and/or sensory functions. There is a WAD IV which includes fracture, but this is less common and often excluded.

Treatment for WAD includes everything from doing nothing to intensive management from multiple disciplines—chiropractic, primary care, physical therapy, clinical psychology, pain management, and specialty services such as neurology, orthopedics, and more. The goal of treatment is to restore normal function and activity participation, as well as symptom management.

The prognosis of WAD is generally good as many will recover without residual problems within days to weeks, with most people recovering around three months after the injury. Unfortunately, some are not so lucky and have continued neck pain, stiffness, headache, and some develop post-concussive syndrome. The latter can affect cognition, memory, vision, and other brain functions. Generally speaking, the higher the WAD category, the worse the prognosis, although each case MUST be managed by its own unique characteristics. If the injury includes neurological loss (muscle strength and/or sensory dysfunction like numbness, tingling, burning, pressure), the prognosis is often worse.

Chiropractic care for the WAD patient can include manipulation, mobilization, and home-based exercises, as well as the use of anti-inflammatory herbs (ginger, turmeric, proteolysis enzymes (bromelain, papain), devil’s claw, boswellia extract, rutin, bioflavonoid, vitamin D, coenzyme Q10, etc.) and dietary modifications aimed at reducing inflammation and promoting healing.

* 83% of those patients involved in an MVA will suffer whiplash injury and 50% will be symptomatic at 1 year.
* 90% of patients with neurologic signs at onset may be symptomatic at 1 year.
* 25- 80% of patients who suffer a whiplash injury will experience late-onset dizziness
* Clinicians should be observant for radiographic signs of instability, including interspinous widening, vertebral subluxation, vertebral compression fracture, and loss of cervical lordosis.
* Horizontal displacement of greater than 3.5 mm or angular displacement of more than 11 degrees on flexion/extension views suggests instability

What to do about FM #pain?

~ Dr. Robert Speirs DC ~ 4 Comments

​Fibromyalgia (FM) is a very common condition affecting approximately ten million Americans (2-4% of the population)—with a ratio of about four women to each man with the disease. Part of the diagnosis and treatment challenge is that many of the complaints associated with FM occur in ALL of us at some point, such as fatigue, generalized whole body aches/pains, non-restorative sleep, depression, anxiety, etc. So what is the difference between the FM sufferer and those without it? Let’s take a look!

The primary distinction between patients with FM and the “rest of us” has to do with the word “chronic.” This term means “…persisting for a long time or constantly recurring; long-standing, long-term.” In fact, the term “fibromyalgia” is described as a complex chronic pain disorder that causes widespread pain and tenderness that may present body wide or migrate around the body. It is also known to “wax and wane over time,” meaning it flares up and down, off and on.

The diagnosis of FM is typically made by eliminating every other possible cause. Hence, after blood tests and x-ray or other imaging, the ABSENCE of other problems helps nail down the diagnosis of “primary fibromyalgia.” Then there is “secondary fibromyalgia,” which is DUE TO a known disorder or condition such as after trauma (like a car accident), rheumatoid arthritis, migraine headache, irritable bowel syndrome, “GERD” (which is heart burn due to reflux), pelvic pain, overactive bladder, tempromandibular joint dysfunction (jaw pain, with or without ringing in the ears), or stress. It’s also often accompanied by anxiety, depression, and/or some other mental health condition.

It should be clearly understood that there is no “cure” for FM. It has also been widely reported in many studies that the BEST management approach for FM is through a TEAM of healthcare providers. This team is frequently made up of primary care doctors, doctors of chiropractic, massage therapists, mental / behavioral specialists, physical therapists, and perhaps others (acupuncturist, nutritionist, stress management specialists, and more).

The “general” treatment approach is typically done with medications, cognitive behavioral therapies (CBT), gentle exercise, and manual therapies. Additionally, patients are encouraged to participate in the healing process via self-management strategies that focus on reducing stress and fatigue, optimizing diet, and developing a consistent sleep habit.

Think of the role of the chiropractor as a strong member of the team. A doctor of chiropractic can offer many of the known methods of managing FM described above, as their training includes diet and nutrition, stress management, exercise training, and ability to provide “whole person care.” Treatments delivered in the chiropractic setting like spinal manipulation, mobilization, and massage offer GREAT relief to FM patients! Again, coordinating care between various providers is the best approach, but you need someone willing and able to do that. A doctor of chiropractic is a great choice!

It is very difficult to manage FM on your own. Let a doctor of chiropractic tailor a treatment plan that is appealing to you and your specific interests. Managing FM is definitely NOT a “…one size fits all” approach like an inhaler is for asthma. Each individual’s situation is too highly unique!60+ Yoga

Can Chiro Help My Headache?

~ Dr. Robert Speirs DC ~ Leave a comment

​Migrane

Everyone, well at least almost everyone, has had headaches from time to time, and we all know how miserable they can make us feel. In fact, at some point in time, 9 out of 10 Americans suffer from headaches that range between mild and dull to throbbing, intense, and debilitating, sometimes to the point of requiring bed rest in a dark, quiet room.

The common reflex is to reach for that bottle of pills and pray the headache subsides so you don’t have to call in sick and lose another day of productivity when you have so much to do. Unfortunately, between the side effects of many medications designed to help headaches and the pain associated with the headache, this approach is frequently NOT the answer. So what is?

The good news is that many studies have identified spinal manipulation therapy (SMT), the main type of care utilized by chiropractors, as being very effective for popular types of headaches—in particular tension-type headaches that arise in the neck. An important 2001 study reported that SMT provided almost immediate relief for headaches that arose in the neck with SIGNIFICANTLY fewer side effects and longer-lasting results compared with commonly prescribed medications.

Another interesting study that found similar results included tracking the prevalence/frequency of headaches after treatment stopped. The authors of the study reported the patients receiving SMT had continued to experience sustained benefits throughout the following weeks, and even months, in contrast to those in a medication treatment group where headaches came back almost immediately after they discontinued treatment.

The most commonly prescribed medication for tension-type headaches are non-steroidal anti-inflammatory drugs (NSAIDs). Common over-the-counter options include ibuprofen (Advil, Nuprin, etc.) and Aleve (Naproxen). For those who can’t take NSAIDs because of blood thinning and/or stomach-liver-kidney problems, doctors commonly prescribe acetaminophen (Tylenol), but it can be hard on the liver and kidneys, especially when taken over time.

So, what can you expect from a visit to a chiropractor for your headaches? The typical approach begins with a thorough history and examination with an emphasis of evaluating the neck and its associated function. Your doctor of chiropractic may also perform tests designed to reduce pain and some that provoke a pain response to identify the “pain generator” or cause!

Because each patient is unique, the type of care provided will be individually determined based on the findings, the patient’s age, comfort, and preference of both the provider and patient.

So, the next time you find yourself reaching for pills because of headaches, remember that there are better options! Give chiropractic a try. You’ll be GLAD you did!!!

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 neck pain or headaches, we would be honored to render our services.

What is Cervical Spondylosis?

~ Dr. Robert Speirs DC ~ Leave a comment

CSpine

​Cervical spondylosis (CS) is another term for osteoarthritis (OA) of the neck. It is a common, age-related condition that you will probably develop if you live long enough. Or, if you suffered a neck injury as a youth, it can develop within five to ten years of the injury, depending on the severity. According to the Mayo Clinic, CS or OA affects more than 85% of people over 60 years old, and that is probably a conservative estimate!

Common symptoms associated with CS/OA vary widely from no symptoms whatsoever to debilitating pain and stiffness. For example, when CS crowds the holes through which the nerves and/or spinal cord travel, it creates a condition called spinal stenosis that can result in numbness, tingling, and/or weakness. In severe cases, this can even affect bowel or bladder control (which is an EMERGENCY)!

CS occurs when the normal slippery, shiny cartilage surfaces of the joint(s) gradually thin and eventually wear away. Bone spurs often form, which results from the body trying to stabilize an unstable joint. In some cases, the spurs can actually fuse a joint, which often helps reduce pain. (Bone spurs can also form if the intervertebral disks or shock-absorbing pads between the vertebrae are injured or become dehydrated due to arthritic conditions.)

Risk factors associated with CS include: aging, injury, years of heavy lift/carry job demands, and jobs and/or hobbies that require the neck to be outside of a neutral position (like years of pinching a phone between the ear and shoulder). Genetics and bad habits (like smoking) also play a role in CS. Obesity and inactivity also worsens the severity of CS symptoms.

The good news is that even though most of us will have CS, it is usually NOT a disabling condition. However, CS may interfere with our normal activities. Depending on its location, pain may feel worse in certain positions, like when sneezing or coughing or with movements like rotation or looking upwards.

Stiffness is a common symptom, which can vary with weather changes. Too little as well as too much activity can be a problem, but the BEST way to self-manage CS is to keep active! Range of motion exercises, strength training, and walking all help reduce the symptoms of CS.

Doctors of chiropractic are trained to identify CS/OA. Gentle manipulation, mobilization, nutritional counseling, exercise training, modalities (and more) can REALLY HELP!

I have Low Back Pain. Why?

~ Dr. Robert Speirs DC ~ Leave a comment

265​

Low back pain (LBP) can arise from disks, nerves, joints, and the surrounding soft tissues. To simplify the task of determining “What is causing my LBP?” the Quebec Task Force recommends that LBP be divided into three main categories: 1) Mechanical LBP; 2) Nerve root related back pain; and 3) Pathology or fracture. We will address the first two, as they are most commonly managed by chiropractors.
Making the proper diagnosis points your doctor in the right direction regarding treatment. It avoids time wasted by treating an unrelated condition, which runs the risk of increased chances of a poor and/or prolonged recovery. Low back pain is no exception! The “correct” diagnosis allows treatment to be focused and specific so that it will yield the best results.
Mechanical low back pain is the most commonly seen type of back pain, and it encompasses pain that arises from sprains, strains, facet and sacroiliac (SI) syndromes, and more. The main difference between this and nerve root-related LBP is the ABSENCE of a pinched nerve. Hence, pain typically does NOT radiate, and if it does, it rarely goes beyond the knee and normally does not cause weakness in the leg.
The mechanism of injury for both types of LBP can occur when a person does too much, maintains an awkward position for too long, or over bends, lifts, and/or twists. However, LBP can also occur “insidiously” or for seemingly no reason at all. However, in most cases, if one thinks hard enough, they can identify an event or a series of “micro-traumas” extending back in time that may be the “cause” of their current low back pain issues.
Nerve root-related LBP is less common but it is often more severe—as the pain associated with a pinched nerve is often very sharp, can radiate down a leg often to the foot, and cause numbness, tingling, and muscle weakness. The location of the weakness depends on which nerve is pinched. Think of the nerve as a wire to a light and the switch of the nerve is located in the back where it exits the spine. When the switch is turned on (the nerve is pinched), and the “light” turns on—possibly in the outer foot, middle foot, inner foot, or front, back or side of the thigh. In fact, there are seven nerves that innervate or “run” into our leg, so usually, a very specific location “lights up” in the limb.
Determining the cause of your low back pain helps your doctor of chiropractic determine which treatments may work best to alleviate your pain as well as where such treatments can be focused.