Winnipeg

CTS Warning Signs

~ Dr. Robert Speirs DC ~ Leave a comment

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Headaches are REALLY common! In fact, two out of three children will have a headache by the time they are fifteen years old, and more than 90% of adults will experience a headache at some point in their life. It appears safe to say that almost ALL of us will have firsthand knowledge of what a headache is like sooner or later!

Certain types of headaches run in families (due to genetics), and headaches can occur during different stages of life. Some have a consistent pattern, while others do not. To make this even more complicated, it’s not uncommon to have more than one type of headache at the same time!

Headaches can vary in frequency and intensity, as some people can have several headaches in one day that come and go, while others have multiple headaches per month or maybe only one or two a year. Headaches may be continuous and last for days or weeks and may or may not fluctuate in intensity.

For some, lying down in a dark, quiet room is a must. For others, life can continue on like normal. Headaches are a major reason for missed work or school days as well as for doctor visits. The “cost” of headaches is enormous—running into the billions of dollars per year in the United States (US) in both direct costs and productivity losses. Indirect costs such as the potential future costs in children with headaches who miss school and the associated interference with their academic progress are much more difficult to calculate.

There are MANY types of headaches, which are classified into types. With each type, there is a different cause or group of causes. For example, migraine headaches, which affect about 12% of the US population (both children and adults), are vascular in nature—where the blood vessels dilate or enlarge and irritate nerve-sensitive tissues inside the head. This usually results in throbbing, pulsating pain often on one side of the head and can include nausea and/or vomiting. Some migraine sufferers have an “aura” such as a flashing or bright light that occurs within 10-15 minutes prior to the onset while other migraine sufferers do not have an aura.

The tension-type headache is the most common type and as the name implies, is triggered by stress or some type of tension. The intensity ranges between mild and severe, usually on both sides of the head and often begin during adolescence and peak around age 30, affecting women slightly more than men. These can be episodic (come and go, ten to fifteen times a month, lasting 30 min. to several days) or chronic (more than fifteen times a month over a three-month period).

There are many other types of headaches that may be primary or secondary—when caused by an underlying illness or condition. The GOOD news is chiropractic care is often extremely helpful in managing headaches of all varieties and should be included in the healthcare team when management requires a multidisciplinary treatment approach.

Trigger points in the deltoid muscle.

~ bryancobb ~ Leave a comment

The deltoid is the the muscle that is most often thought of as the “shoulder.” It is the diamond shaped muscle that caps the shoulder joint. It originates on the clavicle, the acromion, and the spine of the scapula. It inserts on the deltoid tuberosity of the humerus. As a whole unit the deltoid laterally abducts the humerus at the glenohumeral joint. The anterior portion of the delt forward flexes the arm, as well as horizontally flexing the arm across the chest. Since the deltoid is involved in almost all shoulder movements it is especially prone to trigger points. Points in the anterior deltoid refer into the anterior and lateral shoulder. Trigger points in the posterior deltoid refer pain into the posterior shoulder with spillover down the lateral arm.

He barely hit me; why does it hurt?

~ Dr. Robert Speirs DC ~ Leave a comment
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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.

What is a Migraine? What can I do about them?

~ Dr. Robert Speirs DC ~ Leave a comment

A “migraine” is an intense throbbing headache that may be accompanied by nausea, vomiting, and sensitivity to light or noise. Adult women are three times more likely than men to experience migraines. The frequency of migraine headaches usually peaks between age 30 and 40, and attacks decrease thereafter. The onset of a new migraine headache after age 50 is rare.

Migraine headaches are caused by a combination of nerve irritation and enlargement of the blood vessels in your brain. Migraines tend to run in families and sufferers have inherited a sensitive nervous system from their parents. Patients who are overweight or have other vascular risk factors are more likely to suffer from migraines.

Migraines are set off by “triggers” and the headache occurs when the number of triggers reaches a critical threshold. This can be likened to a glass of water that overflows at a certain point. Known triggers include: neck tightness, stress, smoking, strong odors (i.e. perfumes), bright or flickering lights, fluorescent lighting, too little or much sleep, head trauma, weather changes, motion sickness, cold (ice cream headaches), lack of activity or exercise, overexertion, fatigue, eyestrain, dehydration, hunger, fasting, and hormonal changes, including menstruation and ovulation. Certain medications, including hormones or oral contraceptives are known triggers. A detailed list of foods that trigger migraines is provided below.

About 20-33% of people who get migraines have warning symptoms, called an “aura”, before their actual headache attack. Aura symptoms develop slowly over five to 20 minutes and can last up to an hour. The most common aura is a band of absent vision with an irregular shimmering border. Some patients report numbness or tingling in their arms or face. Be sure to tell your doctor if you experience any confusion or decreased consciousness with your headache. Other signs to watch for include: abrupt headaches that develop and peak very quickly, headaches that develop following a head injury, light-headedness, dizziness, difficulty speaking, difficulty swallowing, difficulty walking, fever, rash, or any “new” headache that is significantly different from your prior headaches.

Many patients benefit from the types of treatment provided in this office. Research has shown a “significant reduction” in migraine frequency and intensity through chiropractic care. Your home management will focus on avoiding “triggers” and stress. You should begin keeping a headache diary to help you track and eliminate triggers. Patients who experience migraines are more susceptible to other types of cardiovascular disease, like heart attack and stroke. Be sure to choose a “heart healthy” diet (i.e. limit sodium and fats) and keep your weight controlled. Eat at regular intervals and stay well-hydrated as hunger and dehydration are known triggers.

Your doctor may talk to you about supplements like Feverfew (125mg/ day), Riboflavin (400mg/ day), Magnesium (400-600mg/ day) and Co-enzyme Q10 (100mg 3x per day) that have been helpful in preventing headaches for some migraine sufferers. The American Headache Society recommends that patients avoid overuse of medication to control their headaches, (no more than 2 doses per day, 2 days/week) as this can lead to more frequent “rebound” headaches. Do not begin or discontinue any new vitamins or medications without talking to your doctor first, especially if you are nursing or pregnant.

Trigger points in the pectoralis minor muscle.

~ bryancobb ~ Leave a comment

The pectoralis minor is a small strap like muscle that is underneath (deep) to the pectoralis major. It originates on the third to fifth rib, near the costal cartilages. It’s insertion is on the coracoid process of the scapula. It acts to draw the scapula forward, downward, and inward at nearly equal angles ( think of rounding or shrugging your shoulders forward). This muscle is very often shortened and tight in people due to the high prevalence of desk jobs. This muscle pulls the shoulder blade forward resulting in the muscles in the back(rhomboid and mid traps) being chronically strained. Trigger points that form in the pec minor primarily refer pain over the anterior chest and shoulder, with spillover down the medial arm. Trigger points in the left side can mimic angina.

The Bird Dog

~ Dr. Robert Speirs DC ~ Leave a comment

Bird Dog

Today we are going to look at one of the most effective exercises to protect your lumbar spine from discogenic injury, the bird dog. A great way to work on both posterior chain and rotational stability, the bird dog is safe, effective and simple.

  • Get on your hands and knees (four point position) with your knees and hands, hip and shoulders width apart.
  • Your back is in neutral position (slightly arched) and your chin must be tucked in.
  • Activate your lower abdominals (transversus abdomini) by bringing your belly button inward and by activating your pelvic floor muscles 20 to 30% of maximal contraction.
  • Maintain a steady abdominal breathing while you simultaneously lift one leg backwards and the opposite arm overhead keeping your back in neutral position.
  • Return to the initial position and repeat with the other leg and arm.

2 sets of 10 reps as part of your regular core/stability routine will have you well on your way to a life-proof low back!

Image and instructions from physiotec.ca 

Trigger points in the pectoralis Major muscle.

~ bryancobb ~ Leave a comment

The pectoralis major or “pecs” is commonly thought of as the chest muscle. It originates on the clavicle, sternum, costal cartilage , and the external oblique aponeurosis. It inserts on the intertubercular groove of the humerus. Its main actions are to adduct the shoulder and to internally rotate the humerus. This muscle gets chronically shortened by a rounded shoulder forward posture such as from prolonged sitting. Tightness in this muscle can cause strain in the rhomboids and traps. When trigger points form in this muscle they refer pain into the anterior shoulder, as well as the anterior chest and medial aspect of the arm. Trigger points in the pecs can also cause nipple hypersensitivity. Trigger points in the left pec muscle can mimic heart pain.

Lumbar Spine Stabilization

~ Dr. Robert Speirs DC ~ Leave a comment

L Spine Stabilization

This is a great way to increase the stability of your lower back.

  1. Lie with your stomach over a therapeutic ball while stabilizing yourself with your feet and arms and keep your head in line with your body.
  2. Tighten your abdominal muscles to flatten the spine by pulling your belly button towards your back and hold the contraction throughout the exercise.
  3. Bend one knee and lift it up towards the ceiling.
  4. Lower the leg and repeat on the other side.

 

CTS at Night.

~ Dr. Robert Speirs DC ~ Leave a comment

​For those who have carpal tunnel syndrome (CTS), it’s no surprise that CTS is frequently most expressive during the night, often to the point of interrupting sleep and/or making it difficult to fall back to sleep. So why is that?

The primary reason for nighttime CTS symptoms has to do with the wrist, as it is very difficult to sleep with the wrist held in its “ideal” or least irritating position. In fact, most people favor “curling” the back of the hand under the chin or bending the hand/wrist backwards under the head. When the wrist is bent in either direction, it can increase the pressure inside the wrist, which can generate the various symptoms associated with CTS.

One study evaluated the pressure inside the carpal tunnel while participants slowly moved their wrists. The researchers found many movements didn’t need to exceed 20 degrees before the pressure increased enough within the carpal tunnel to generate symptoms.

Because it doesn’t take a lot of movement to build up excessive pressure in the wrists of those with CTS, many doctors recommend the use of a “cock-up splint” for the non-surgical treatment of CTS in order to help keep the wrist in a neutral position.

Wrist posture is also an important factor during the day. One study looked at typing on a tablet PC, which allowed people to work in non-traditional settings. As screen size reduced, the posture required to type became more limited and accelerated the usual rate of pain onset in the neck, elbows, and wrists.

This study also looked at three different positions used when working on touch-screen devices: desk, lap, and bed. The healthy subjects completed six, 60-minute typing sessions using three virtual keyboard designs: standard, wide, and split. The researchers monitored the position of the wrist, elbow, and neck while the participants typed and followed up each session with questionnaires designed to measure discomfort.

The research team reported that typing in bed required greater wrist extension but resulted in a more natural elbow position than typing at a desk. The angled split keyboard significantly reduced the wrist deviation vs. the standard or wide keyboard designs. All three regions—the neck, elbow, and wrist—exhibited more movements (13% to 38%) towards the end of the one hour sessions, which correlated with a significant increase in pain in every body region investigated. Overall, using a wider keyboard while sitting at a desk was the most tolerable position among study participants.

 

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Trigger points in the rhomboid muscles.

~ bryancobb ~ Leave a comment

This is another common muscle to get trigger points. It originates on the spinous processes of the T2-T5 vertebrae. It inserts on the medial border of the scapula. It’s main actions are to adduct the scapula pulling it back toward the spine, and to rotate the glenohumeral joint downward. This muscle also prevents wining of the scapula. This muscle is often overloaded by a sitting posture where the shoulders are rolled forward such as when using a computer. The Rhomboids are often weak and under trained in people. Trigger points in this muscle cause pain and ache in the upper back between the shoulder blade. Strength trading for this muscle is necessary to help prevent postural overload.