Prevention of RSIs

As I have discussed previously our bodies are designed to move. The topic under scrutiny is not called repetitive motion injuries. Moving properly is not only not going to injure you, but it is also essential to good health. So, the first and best way to avoid repetitive stress injuries is to MOVE IN A WAY THAT AVOIDS REPEATEDLY STRESSING YOUR BODY.

If you are new to doing something ask others what they do to make a task less stressful for the body. Most workplaces can benefit financially by having ergonomics lectures or posters or education for their employees. If you don’t have them, discuss this with your company. There are additional benefits to moving properly. You are less tired, work more efficiently, and you are better able to cope with mental stresses. We are more productive workers and cost less in health care if we prevent injury through proper education.

carpal-tunnel-wrist-braceIf you have been doing something wrong for too long, you develop a bad habit. Breaking that habit can be uncomfortable. Have you ever tried sitting up straight at your computer for a whole day. At the end of the day your muscles are sore. They aren’t used to doing things the right way. Your body has adapted to your poor posture and lost good functionality. As with getting in shape you can’t have the perfect body in one day. Start slow, and be consistent with your attempts to change your bad habits.

The second way to prevent RSIs is to allow your self RECOVERY TIME. There is a physics principle called creep – to slip or gradually shift position or to change shape permanently from prolonged stress. This principle is in effect with our ligaments and tendons. Within 20 min. of staying in the same position our ligaments begin to accept the stretch placed on them as normal. To counter creep we should move periodically. After all we were designed to move. So recovery time, every 20-30 min. get up, do something different. Stretches are a easy to do at this time. It doesn’t have to be long especially if you weren’t doing anything too strenuous. Ninety seconds should be adequate recovery time.

Another part of recovery time is your sleep. Sleep is when your body spends its energy recuperating from previous damage you have done to it. So, to avoid RSIs get plenty of sleep.

Third, your body can’t repair its self with out the building blocks it needs. A GOOD DIET is key to preventing RSIs. Some key foods in not only prevention but also recovery from RSI’s are: Vitamin C, fish and greens such as spinach. I should get my nutritionist friends to write a proper diet for connective tissue health, but if you are eating a variety of food, and not a lot of junk, you should be fine.

The last two things to do are common sense. EXERCISE with the goal to improve in the three areas of: strength, endurance, and flexibility. Last, DON’T OVER DO IT.

IN SUMMARY … To prevent RSIs:

1 Use Proper Motion

2 Get Proper Recovery Time

3 Eat Right

4 Exercise and Stretch

5 Don’t Over Do It

Who’s at risk for RSI

Most vocations are at risk for RSI. That really is the truth. In just about everything that we do there is risk. If you compiled a list of all the scary media stories out there you’d find that just about everything can cause cancer, and everything you do could kill you, but doing nothing could kill you too. It’s important when discussing who is at risk to remember that life is worth living, and we should not stop that which we enjoy or that which supports us merely because there is risk.

“The greatest glory in living lies not in never falling, but in rising everytime we fall.”- Nelson Mandella

So, yes, YOU are at risk of getting a repetitive stress/strain injury, if you don’t already have one. Most people will injure themselves in this way at some point. In fact, though most people don’t realize it most back aches are RSIs. Probably the most common cause for people to visit the chiropractor is facet syndrome (sprain/strain) due to repetitive stress. We use the joints in our back more than any other joint in our body they are constantly under stress, and if one of those joints is not moving properly over and over again, the body will try to compensate, but unless the dysfunction is addressed you guessed it, RSI!

Chiropractors just like medical doctors tend to get into a niche of treatment. Myself I like the niches of pregnant patients and performance artists. I see the upper back and elbow RSIs of violinists, trumpeters, and other musicians. I see the lower back RSIs of dancers, and artists just like I see the carpal tunnel patient who types on their computer 8 hours a day. Just like any other chiropractor I can usually treat anything that walks through my door, but if you’ve had a longstanding condition that you just haven’t been able to rid yourself of you may want to seek out someone with experience. It can be hard to find the right one, because we don’t “specialize” in any particular treatment it’s just what we usually see more of. Ask around and you’ll find the right doc for you. Beyond special cases most chiropractors will be able to treat any RSI you have. The musculoskeletal and nervous systems, after all, are what our training focuses on.

So, if you’re wondering who’s at risk, it’s you. Don’t quit your job or stop playing golf, just be aware, and treat your body with the respect it deserves. I’ll tell you some things you can do to prevent RSIs in my next post. Just be warned, most of it you already know, you’ve just been too lazy to do it.

Carpal Tunnel or Double Crush Syndrome

Carpal Tunnel Syndrome (CTS) is an over diagnosed and often misdiagnosed condition.  Research has indicated that surgery or wrist supports for carpal tunnel syndrome are not very effective when additional compression of the nerves is occurring in either the shoulder or neck.  In order to treat a condition you must find the root cause.  For CTS like symptoms, the cause is often at the nerve root.

Image from: American Chiropractic Clinic Vietnam website

When a nerve is compressed only a little bit there are sometimes no noticed symptoms.  However, when you compress a nerve a little bit in multiple locations the results don’t just add up they can multiply.  This is termed Double Crush Syndrome (DCS).  For the nerves in our arms this means if you have a little neck problem and a little shoulder problem, then that minuscule problem at the wrist may be exaggerated.  The nerves to our hands run a gamut.  They come out from the neck joints, travel through the often tight scalene muscles, between the collarbone and the first rib, through the armpit, down the arm and through the carpal tunnel.  At all of these choke points nerves can be compressed.  It is therefore very important to find where the cause or causes of the injury are to determine whether you truly do have CTS or if it’s a DCS.  Especially before slit your wrists (with a surgery). The standard of care for carpal tunnel treatment is, conservative care first.  Chiropractic is conservative care, and chiropractors are trained in diagnosis and treatment of percisely these neuromusculoskeletal conditions. Chiropractors will usually treat these symptoms by manipulating the wrist, elbow and neck as well as utilizing massage, ultrasound therapy, wrist supports, and other modalities.   According to The University of Maryland Medical Center:

“…studies support the use of chiropractic treatment for CTS. In the first study, 25 individuals diagnosed with CTS reported significant improvements in several measures of strength, range of motion, and pain after receiving chiropractic treatment. Most of these improvements were maintained for at least 6 months. A second study compared the effects of chiropractic care with conservative medical care (wrist supports and ibuprofen) among 91 people with CTS. Both groups experienced significant improvement in nerve function, finger sensation, and comfort. The researchers concluded that chiropractic treatment and conservative medical care are equally effective for people with CTS”

If chiropractic is equally effective, and has less side effects, shouldn’t you go visit your chiropractor for that hand pain and numbness you’ve been feeling.

Don’t Let Your Computer Beat You Up

How Not to Do It

How Not to Do It

Everyone uses computers now.  We use them at work, at home, at play, our children at school are using them.  As a result of this relatively new activity I see more and more injuries related to it.  Who would have thought that sitting all day could injure you.  Some common computer related injuries are Carpal tunnel Syndrome and other Repetitive Stress Injuries, facet syndrome in the low back and in the neck, upper cross syndrome, and just general back and neck pain.

You can avoid or reduce these problems with a few simple modifications to your computer use.

  1. Take the time to modify your workstation for you.  Especially if there are multiple users of your computer as often happens at home, make sure that you adjust it for you.  At home make sure to educate your family on these tips also.
    • Position the monitor so that the top of the screen is at or below eye level.  If you can’t adjust the monitor try adjusting your chair a little.  The monitor should also be in line with your keyboard so that you are not having to turn to see the screen while you type.
    • Make sure your chair supports you.  Chairs with lumbar support are good, but they must fit you.  You can use towels or pillows or purchase tailored items to fit your back.  You’re chair should have arm rests that fit you.  They should not push your shoulders up or let them hang down.  The back of your knees should be an inch or two in front of the chair, not touching, and your feet should be able to touch the floor or be supported in some way.
    • Keep your mouse close to your keyboard so that you don’t have to hang your arm out away from your body to use the mouse.
    • Use computer settings and lighting to keep text visible for you, not to small so that you end up leaning into the screen just to be able to read it.
  2. Your wrists should be in a neutral position while typing or using your mouse rather than angled up or down.
  3. Limit the time that you are on the computer or take frequent breaks.  This doesn’t mean that you have to get up and waste time for 15 min.  You can take a break by standing up for a second and touching your toes.  Clench your hands into fists and then stretch them out.  Do some wrist exercises.  Twist in your chair to get full spine range of motion.  These things only take a few seconds, and if you remember to do them 3 times an hour you will avoid the effects of creep on you soft tissues.
  4. Drink plenty of water (not soda, or coffee).  Eat a balanced diet and get regular exercise.Good computer posture

Your chiropractor can help you to prevent and reduce computer related injuries.

Computer Users and Chiropractic

I did tech support  before becoming a chiropractor.  I know how hard it can be on the body.  We often talk about having a cushy office job.  If any of you have ever tried it then you know that doing nothing for a long period of time can be very hard, emotionally, mentally, and physically.  Perhaps even harder than an active job.  Office workers will often sit for 8 hours straight.  This can lead to structural weakness in our bodies.  Especially when we do it with poor posture.

Office workers often experience low back pain caused by normal daily activities because the ligaments in their low back have stretched to accommodate the slouch, and are therefore not able to handle regular activities.  They also often get upper back or neck pain from poorly set up work stations leading to poor posture.  Arm symptoms include tingling, numbness and pain.  Often over diagnosed carpal tunnel syndrome symptoms may develop.  These are some of the more common symptoms related to office workers.

These problems are not without solution.  And the solution is relatively easy, it just takes effort.  Don’t sit in the same position for more than 20 minutes.  Stand up every half hour at least for 5 minutes.  You don’t have to exercise, though that would be great.  Set a timer to remind you.  Stretch before and after your shift, your arms and wrists, your back and legs. Do a full 10 minutes of something to get you moving again.

Talk to your boss to see if he will allow time for this kind of thing.  I promise if he’s a good boss and you don’t abuse it he’ll be happy to have a healthy and more productive worker.  You may even implement a company wide policy.  Your company may even have reduced rates for workers compensation coverage for doing it.  If your employer is hesitant invite a local chiropractor to come talk about the benefits of a program like this to the company.  Companies loose millions each year because of back pain.  Time off, unproductive time, etc…

If it’s too late, and you already have these symptoms, your chiropractor can help.  It’s all about function, and a chiropractor can help restore that function, so that you can get back to living life.

How Long Does it Take to Heal?

Healing is hard work and you may not even recognize it.

Wound Healing

Some parts of our body heal quicker than others. This usually depends on how complicated they are and how able supplies are to get there, in other words, the blood supply. Parts with more blood supply heal more quickly. This is why a cut in your mouth heals so much faster than one on your hand. This is also why muscle strains heal faster than ligament sprains. Muscles have good blood supply and ligaments have very little.

Four-Stages-of-Wound-HealingWhen you scrape your hand or your elbow you can see part of the healing process and how long it takes. You can see the wound 4-6 weeks later still healing. With even a very mild sprain your body requires 2-4 weeks for you to regain full mobility and for swelling to fully go away. After this time you can return to full activity, but you are still not fully healed. Even though you can’t see the process your body is expending extra energy to heal for months after an injury and it is more vulnerable than usual during this healing time even 6 months after the initial injury.

There are some things that you can do to help your body to heal faster and better no matter the injury.

Things to Avoid

  • Medication. NSAIDS in particular like acetaminophen or ibuprofen. While masking your pain, have also been shown to inhibit the healing process of joints and soft tissue (Some of the research here).
  • Alcohol
  • Smoking
  • Stress

Things to do

  • Eat right. When you are injured your body has to build a whole new section of you and it needs the proper nutrients to do this. If you are eating healthy things your body will be able to get what it needs faster.
  • Get in shape. This is a preventative healing booster. When you are already healthy your body is better able to handle new injuries and doesn’t have to fight with a sluggish system.
  • Keep moving. When your body is in the inflammatory phase movement will help in transporting waste and nutrients. When in a repair phase movement will help your brain to know what areas need the most support and how to align the fibers for most effective function. You don’t want to over do it, but you want to keep using your injured part as much as is reasonable.
  • Get adjusted. If the communication of your body to and from the brain is inhibited your healing can be poor or slowed
  • Have a positive attitude. People with a positive outlook heal faster and are less likely to re-injure.

Chiropractic for Moms

Mom as a profession can be hard on the body.  One of the advantages of being a mom however is that you are able to adjust your activities to prevent problems.  A disadvantage is that there is no down time.  It is always easier to prevent than to recover.

The physical problems a mom experiences are also highly related to the age of her children.  A mom with young kids will need to remember you’re going to be going to the floor a lot.  If you don’t bend from the knees you will likely develop low back issues.  Don’t always use the same arm to carry.  When the kids are too young to help with the cleaning you’re going to be doing a lot of it.   Watch your posture while cleaning.  When you are pregnant your body puts out hormones to relax the ligaments, and it does a great job, which means repetitive motions are more likely to sprain or strain.  So, while pregnant you will want to avoid repetitive twisting like vacuuming and doing the dishes.  Just remember, that you really get behind in your work when you have to take time off to recover.  Focus on bending at the knees, and don’t be afraid to ask for help.

As the children grow you become a chauffeur, and sitting at the wheel can be hard on the back.  Put as many trips into one as possible.  Stopping at each appointment will give you a chance to stretch your legs and back.  As they grow they will be able to help with some of the messes that they make.  Remember their bodies will recover faster than yours, and they will be up and jumping on your bed while you try to get some rest.  Get them doing as much of the work as they can.  Sure they don’t do it very well, but they’ll learn, and besides, it’s easier to guard prisoners while they’re working.

Fam Crop

For the mom of my children.

If momma ain’t happy ain’t nobody happy!  Take care of your self.  If you need time to go work out, make sure you find a way to do it.  If you need treatment, get it.  The earlier you seek treatment the better.  Treatment is easier if you can relax.  Come alone if you can.  If you can’t, most doctors offices will have a place for children to play.  If you come see me, I’m happy to have kids color a picture for my door, or watch a movie in the other room. It’s important that you take a time out for your health care.

Healthcare On A Budget – Part III Conservative Care

Get CONSERVATIVE CARE FIRST. It’s cheaper. There are almost always more than one way to treat any given condition, and some of them will not work.  That’s just the nature of healthcare.

Conservative treatment means that you use the best tool to get the job done with the least amount of risk. The most obvious example is if you have low back pain, the most conservative treatment is to stay active but take it easy. Or you could go to a surgeon to get an MRI and multiple other test to determine if the back pain is surgical. That seems kind of ridiculous.  It’s easy to see when you use extreme examples like that. It may not be so easy when comparing things like chiropractic adjustments to prescription medication.

If you were to walk through the levels of care and note the risk involved it may become clear. Let’s use the same example of back pain. Chances are in a day or so you’ll be back to normal if you just stay as active as you can but take it easy. That has very little physical risk, but does cost you a sick day or two. Hot packs and massage cost a little more and have a little more risk.

If the problem is not improving with the most conservative option move up the chain. You should be examined by a doctor. The least expensive physician with the most training in musculoskeletal conditions is a chiropractor. Chiropractic has little more risk than a massage and does not introduce foreign chemicals, needles or a scalpel into your body. The cost of chiropractic is limited to what happens while you are in the office, there is no additional charge for medication. When you leave the office you feel better. You don’t have to go to the pharmacy and pay more so that you might be able to mask the symptoms.

Generally speaking cost is relative to risk. Food for thought: the cheapest back surgery is going to be about $50,000 that’s over 1200 chiropractic visits in my office. How long would it take you to use that many visits?

How to Make a First Aid Kit – Preparation

Having a good first aid kit is a good way to keep healthcare costs down. I was asked to write a post about how to have a useful first aid kit.  The hard part of that request is the term “useful.”  Items are only useful if you have the knowledge of how to use them.  The most important first aid item is knowledge.  Knowing what to do when someone bumps their head or has a fever may save you a trip to the ER and a lot of money.  Remember you are only providing first aid.  Any bandage or wrap that you put on will be taken off when you are seen in the Emergency Room.

PERSONAL CARRY KIT

IMG_2860I carry emergency supplies with me almost every where I go.  In my back pack I have a small pouch where I keep a ziplock bag containing, a barrier breathing device for CPR, glucose tablets for diabetics, Benedryl for allergic reactions, baby aspirin for heart attacks, butterfly bandage strips for severe cuts, small LED flashlight, pocket knife,  a glow stick, a compass, and a lighter.  The last few are the boy scout in me, but the rest are what I consider my duty because of my knowledge.  All chiropractors go through first aid and emergency courses for health care professionals, and should be able to respond in an emergency.  If you don’t know how or why to use emergency items then it doesn’t help to carry them.   I recommend everyone be willing to do their best in emergencies, nothing more is required.   If you want to learn more I highly recommend it, but remember “with great power comes great responsibility.”

HOME KIT

Sterilite DrawersYour first aid kit should be readily accessible, out of sight of children and the only place that you keep medical items.  If you have things all over they are difficult to keep track of, and hard to direct people to in an emergency.  My home kit is more of a closet.  I have my doc bag with stethoscope, etc. and then a plastic drawer set organized and full.

Most home kits should include: bandages of all sizes (band-aids all the way up to large abdominal pads), surgical tape to hold the bandages in place, wrapping bandages such as rolls and triangle bandages for wrapping or immobilizing, glucose tablets or hard candy for diabetics, self contained burn dressings, antibiotic ointment to reduce infection risk, baby aspirin for a heart attack, emergency blanket, CPR breathing barrier, instant cold compress, non-latex gloves, Benadryl for allergies, scissors, tweezers, a thermometer and any other essential personal health care items that family members may require such as an EpiPen, inhaler, or other prescription medications.

Some extra items that people like to keep in their home kit are: Essential oils, vitamins, an AEDUV-C sterilizer, alcohol, hydrogen peroxide, duct tape, superglue, saline/eye solution and water.  There are many more things that you can keep and my closet has most of them.  Any extra items usually require extra knowledge, but it is easy to acquire and often free.  The Red Cross is a great place to start, but many companies, communities and colleges have educational courses that you can also take.  Most modern kits that you purchase come with a first aid instruction booklet that can help you use the kit, but you don’t want to wait until an emergency happens to read the book.

ADDITIONAL RESOURCES:

American Red Cross Smartphone App

Red Cross First Aid Kit, How to guide

Boy Scouts of America First Aid Merit Badge Book

First aid for common household problems – WebMD

Healthcare On A Budget – Part II – Education

EDUCATION is the second way to save yourself healthcare dollars. This education comes in many forms. First you need to learn the basics of first aid and home care. If you know how to treat basic injuries and how to recognize when things are beyond your ability then you will save many trips to the ER. You can get a basic first aid manual from your local library, free online training, or contact your local boy scout troop and see if you can earn your first aid merit badge. In educating your self create an emergency kit, stock it and know how to use all of the items in it.

Learn when to call the doctor. Often times a fever doesn’t mean you need to call. As a general rule fevers aren’t worrisome until they are over 103 degrees and only then if they don’t respond to fever reducing medication like Tylenol (recommendations are different for young children). Learn when a cough, or fever, or sore throat, or ear ache, etc is bad enough to call. More often than not your body will cope just fine and there is nothing a doctor can do. You’ll save money if you know when those times are.

Stay informed about what conditions are “going around” and be prepared for them. If you’re not sure what’s going around call your local hospital or just a public school.

Learn where you can get the cheapest help. Your chiropractor is much cheaper than the emergency room, and trained in diagnosis. Just checking into the ER is going to cost you significant money. You can usually see me for a full treatment plan for the amount that a single ER visit costs. Nothing’s worse than going to the emergency room and having them tell you I’m sorry there’s nothing that we can do, and then getting the bill from them for that nothing that they did.  A chiropractor will not treat you when a bone is sticking out or when you’ve cut off a finger, but when the case is questionable learn who you can turn to for the least cost.