Category Archives: Chiropractic

Scoliosis

Human-Spine-Picture 2

“Normal” Spine – side view and from the back.

The spine normally has curves that help it to absorb shock. These normal curves can be seen when looking at your spine from the side. It curves back in the neck, forward in the area of the shoulders and ribs, then back again in the low back and then forward at your pelvis. When looking from the front or back there should be no curve in a “normal” spine.

Scoliosis is rated by the size or degree of the curve. The greater the degree the worse the curve. Anything less than 10 degrees is not usually noticed and for an actual diagnosis doctors usually don’t give you one unless the degree is greater than 20.  Your spine will usually stop growing at about age 18-24 and so does the degree of scoliosis unless you are sedentary and spinal degeneration can increase the angle

Scoliosis is an abnormal lateral curvature of the spine. it is not a disease just as having a small nose is not a disease, but it can predispose you to problems, just like a small nose may make it harder to breath or may cause you to be more likely to have certain nasal problems.

There are a few methods that are used to treat scoliosis.  There is bracing which while most research is inconclusive one recent study shows a decrease in the degree of curvature, but does not address functional improvement in the individual’s quality of life and can have negative impacts on the ribcage. Braces had recently begun to be abandoned as a useful treatment, but new research may change that. Surgery is effective at improving quality of life in some patients, but only in extreme cases and the risks are severe.

Physical Therapy is a treatment option that does emphasize function. It focuses on helping your body to cope with the strain that the scoliosis places on it through exercise and stretching for motion. This is a great start. The treatment with the best outcomes that I’ve seen for scoliosis is chiropractic. Chiropractors can prescribe braces if needed, they also do the physiotherapy work with a patient, but they also focus on joint mobility. The research for chiropractic does show show moderate corrections of 5-10 degrees with chiropractic adjustments. There are cases where chiropractors have seen complete correction, but those are the rare cases most get only moderate improvement. While sometimes the spine cannot be lined up perfectly chiropractors can help it to function better in what ever shape it’s in.  

If you have scoliosis you will always be more predisposed to certain injuries, but that’s just a good excuse to take better care of yourself than most people, and that’s not a bad thing.

More Research on the Topic Here

Comparing Education

I’ve addressed this topic in the past using other peoples research.  For this post I was able to sit down and discuss education with a DPT a DO and some MDs.  With that and a little bit of research of 8-10 school course catalogs I’ve come up with the following comparison chart.  Please leave your comments and corrections if you have any.  It was difficult to compare the schools because the clinical education is so varied and can’t truly be put into a catalog.  I have taken the liberty of approximating the hours because some schools even of the same type varied so much.  This table is just to give you an idea of how the education compares between these particular health professions.   I threw in the Bachelors of Science degree just for comparison.  In most cases the BS is required prior to these doctoral degrees.

Clock Hours

Each degree has its different focus.  Even without the obvious clinical courses here are some example courses and their approximate semester credits by degree, to show the different emphasis.Course Comparison

I was at first shocked that the Doctor of Physical Therapy program was about the same as a BS because speaking with the students they said that they spent much more time than in undergraduate studying, but then I realized that it is only a 3 year program.  While they do cram a lot into their program it is still significantly less than all of the other Doctoral programs, and that is reflected in their scope of practice.

I gathered much of my information for the DPT from the University of North Florida website and discussions with their admissions dept.  Much of the DO data was from A.T. Still University’s curriculum here.  DC info was f rom Palmer and UWS.  MD Info was the most difficult to locate as many of their programs cannot easily compare line by line or even school by school.  I tried to rely on interview information with MDs as well as admissions staff.  One site I did use was for the University of Oklahoma Health Sciences Center.  This information was gathered in 2012.  Since that time DC programs have added over 500 clock hours and DPT programs have removed more than 250 clock hours.

Where’s Your Wallet? Sciatica and Piriformis Syndrome

There is a problem that Chiropractors treat all of the time.  I have decided to take a more proactive approach to treating it by educating you.  The problem is your wallet.  Have you looked at your wallet recently?  Many are an inch thick or more.  Most people carry their wallet in their back pocket.  Then they sit on that wallet sometimes all day long, causing their pelvis to be shifted on one side for the majority of the day.  They then come into my office with pain in their back and hips and sometimes even sciatica or piriformis syndrome.  What seems obvious to me does not to someone who has kept their wallet there for years and never had a problem.  Sometimes it just takes a pair of eyes looking from the outside to see the obvious.

I’ve been treating these types of complaints for a while now, and I counsel people about their wallet. In my office we are now being proactive and letting everyone know.  Just a small poster with a picture of me from behind, sitting, and then another identical picture of me with a small one inch object under my right hip is enough to see the problem.  I don’t even have to tell people about it. They can see it.

If you’re wanting to change this in your life it just takes consistency like building any good habit you’ll forget for the first little while, but keep it up and you’ll remember that your wallet is in your side pocket and stop reaching around back eventually.

More Help for Weak Posture – Exercises

The biggest mistake people make when trying to improve their posture is forgetting to strengthen postural muscles.  They just sit up straight then after about 20 min they’re back to slouching because their muscles cannot maintain it.  I have some exercises that I’ve used for years to strengthen posture.  Here are some of the exercises that I recommend.  Here are some others that I’ve presented in a prior post. Give them a try and see how your posture improves.

Chin Tucks (For Anterior Head Postures)

Chin Tucks Full

  1. Looking forward retract your chin straight back, not down. You can use your hand to push it back if needed.
  2. Hold in that position for 5-10 seconds.
  3. Bring your chin strait forward and then back as before holding again for 5-10 seconds.
  4. This exercise can be overdone and you will feel a little sore the next morning if you do, so perform these chin retractions no more than about 5 times a day with 10 reps each time.

Shoulder Retraction (For Rounded Shoulder Postures)Shoulder Protraction-Retraction

  1. With your arms out in front of you retract just your shoulders back and down bringing the shoulder blades together.
  2. Keeping your shoulders back and down pull your elbows back in a slow rowing motion.
  3. Still keeping your shoulders back and down bring your elbows back to a straight position.
  4. Then return your shoulders to a forward position and repeat.
  5. This exercise is more mental than physical. It is designed to remind your brain to use these lower muscles to stabilize your upper back.

These exercises are for informational purposes and are not intended to be a substitute for examination, diagnosis and treatment by your physician chiropractic or otherwise.

Real Preventative Health Care Means Teaching Children

Public Health Nerd Alert: National Public Health Week 2014.

This week is National Public Health Week!  I am a huge supporter of Public/Preventative Health even though I disagree with the way it is usually presented (in the form of vaccinations, screenings, and government legislation or mandates).  I strive daily in my practice to improve the health of the public.  

How do you prevent or reduce obesity, diabetes, the flu, high blood pressure, cavities, STDs, low back pain, cancer, etc…?  The answer is not a vaccine, or early screening.  The real way to prevent most disease, injury and illness is by teaching our children how to live well.  Their bad habits are not as deeply ingrained as adults.  We’ve all tried to change our eating habits or get into shape, quit smoking, strengthen our posture or any number of other bad habits that affect our health.  Most of us have failed more often than succeeded.  I’m not encouraging giving up as adults.  Don’t stop trying to improve your health, but teaching children will also help you.

We may not be able to change the world instantly, but teaching a few children can change the world  in a generation.  Every generation wants to improve life for the next generation.  We want our children to have it better and to be better than we were.  If we worked hard to teach our children behaviors that help reduce health risks, in a few generations obesity and high blood pressure could be rare conditions.  This week I will present some small ideas to teach children that can have a huge impact.  Teach one child and see the difference.

adults-like-childrenGet kids off of the couch.  One way to do this that is beneficial for you is to invite them to play with you.  That means that you have to get off of the couch or out of the computer chair and go show the children how you played as a child.  Build a blanket fort, dig in the sandbox, chase a ball, wrestle in the grass, climb a tree, pull out your old skateboard or bike.  Being active will help prevent everything from obesity and high blood pressure to diabetes and low back pain. Our bodies are designed to move.   We develop painful, and at times, life threatening conditions when that design is inhibited. When you improve your function, your symptoms also improve. Chiropractic is here to facilitate and support that design.  Teach children to move.  Ask your chiropractor for help.

Repetitive Stress/Strain Injuries…A Series

Our bodies were designed to move, to function, repeatedly. In a normal, healthy body using proper motion there is no such thing as a repetitive strain injury (RSI) like carpal tunnel syndrome or tennis elbow. RSIs only happen when our bodies are used improperly. Just as a screw driver makes a lousy hammer our body and it’s parts have specific functions. You can use the back of a screwdriver to hammer in a nail, but it won’t be as effective and you may damage the screwdriver.

RSIs have many factors in their development. As implied in the name there is more than one stress or strain that we put our body through before we notice the injury. Some (not all) of the many factors in RSIs are; improper motion, too great a load, inadequate recovery time, inadequate nutrition, poor overall health and poor nerve function due to subluxation. None of these factors are truly separate, but it is easier to discuss each of them that way.

  • Improper motion – Our joints and muscles work best in a certain way. If we try to make them work a different way we may be successful, but not without a cost in efficiency and or injury. We all know that we should lift with our legs and not with our backs. Our back could do it, but we put a greater strain on the joints, discs, and muscles of our spine, and it is an inefficient use of energy. It puts us in a position of possible injury.
  • Too great a load -Structurally when we lift something heavy our joints and our muscles are stressed and may be damaged. If not extreme, our bodies can cope with that, they build up the muscle and bone and we become stronger. If we lift something too heavy for our muscles or joints we are likely to be injured.
  • Inadequate recovery time – When we stress our bodies they need to recover, resupply, and possibly repair. Some times that takes seconds, and sometimes it can take much longer. Our bodies have a ready supply of energy that can be used, and when that supply is exhausted we have a back up supply (our fat). It takes time for our body to move these chemicals and their waste products into and out of the cells that need them. If we do not give our body the needed time for recovery we are more likely to be injured.
  • Inadequate nutrition – Our bodies will use what ever they have. Some things supply better building blocks, or more efficient energy. You are what you eat. If our body does not have the best supplies then it cannot function properly, and improper function leads to injury.
  • Poor overall health – Have you ever noticed that fit people can do things easier? They recover faster, they lift more, they run farther, and if they eat the wrong food sometimes their body is able to cope with it better. If our muscles and joints are strong and well used then they are able to do more work, if not they will likely get injured.
  • Subluxation – If your nervous system is not functioning efficiently all of the other body processes will be less effective and more likely to be injured.

If you have a RSI you need to address all of the factors related to it. You need to make sure that you are moving properly if it’s carpal tunnel syndrome from computer use, you need to address how you hold yourself when you type, how long you type without rest, if your body is in good condition, what kind of diet do you have, is your keyboard right for you, do you have proper nerve function to handle the stress?

It is not always easy to see all of the factors of a RSI. That is one reason to seek professional help. Someone trained to work with the structures affected by RSIs. Chiropractic is a good choice. Chiropractor’s training has an emphasis on the structure and function of your body. They have less training when it comes to your liver or pancreas, but when it comes to motion, a chiropractor should be your starting point.

Next time…What does chiropractic treatment do and, why is it effective for RSI?

Chiropractic New Years Resolutions

Calendar 2015It’s that time of year again.  New Year, new you, a blank 365 page book to write.  How your year will go is all up to you.  Of course you can’t control everything, but you can always choose to do and be the best that you can with what you have.

Your body is one of your greatest assets, and if it’s not performing at its best then nothing will be as good as it could be.  That raise that you’re going to get is useless if you can’t enjoy the activities it will allow.  The best vacation ever is ruined by back pain that sidelines you.

On the other side of the scale even mundane things are so much better when you feel not just pain free, but healthy.  How much more can you get done when you come home after a long day and still feel energized?  It’s so much more fun to be able to play with the kids all day rather than dragging behind them with a headache.

Talk with your chiropractor and see how you can work to your health goals.  They can help you lose weight, quit smoking, touch your toes again, get those headaches or back pains under control or even improve your golf swing or race time.  Anytime you see your chiropractor you should set a goal with them, discuss a plan, and then carry it out with their help.  Goals are always easier to achieve with outside support.  Let your chiropractor support your health this year.  Start now.

Chiropractors Manage It, But You Didn’t Know – Obesity

IMG_27012Obesity is a gateway condition leading to such heavy hitters as coronary heart disease, type 2 diabetes mellitus, various types of cancer, gallstones, and disability. It is within the scope of practice and training for chiropractors, and is a perfect fit for the chiropractic treatment model.  Regular chiropractic appointments allow for follow up, increased accountability, and provide needed structural care for your changing body.

Most people know when they are overweight, but some don’t, and even more don’t know what the term overweight means. The classifications for weight usually involve a screening system such as Body Mass Index (BMI).  BMI attempts to estimate percentage of body fat. The calculation to determine BMI is mass divided by height in meters squared (kg/m2). There are many BMI calculators that will do the math for you. The National Institute of Health has a great one that you can use.

The corresponding classifications are:

Classification BMI Score
Underweight Below 19
Normal 19-25
Overweight 25-30
Obese 30-40
Morbidly Obese Greater than 40

People are overweight for different reasons, and each reason needs to be addressed differently.  The best way to manage weight is the way that works for you. There is no one method that works for everyone. Most diets are safe and work, but usually only lead to temporary weight loss. It is important to choose the method that you want to use so that you have responsibility and accountability.  The most important thing to address is willingness. Most importantly the person must desire to lose weight and be willing to begin the process. Most people know it’s bad to be overweight and know that they should lose weight, but guilt or poor self-image are not helpful motivators for true lifestyle change. You will not be able to lose weight until you really want to and are willing to accept assistance. 

Goal setting should start simple and be written. The more actions that you take (even small ones) the more likely you are to accomplish your goal, so even accomplishing the simple goal of not drinking soda for one meal is a success that you can build on. Some simple suggested goals are: asking 3 people to help you, signing up for a race or event, or even setting a goal to write down some goals. Goals don’t have to be big and the more goals achieved the better you feel about being able to accomplish future goals.  Goals can be as easy as parking at the far end of parking lots whenever going shopping. For more examples of how to increase physical activity visit ChooseMyPlate.gov or see your chiropractor.

In any change of habit or self-improvement it is always a good idea to enlist friends. They are good to be accountable to. They are good support, and may even join in the cause.  If the lifestyle isn’t maintained for long enough or enjoyable enough to make permanent, then the benefits will also be short lived. It is important to make changes permanent. 

Chiropractors may give guidance and suggestions or just provide education to a patient on nutrition or the risks of obesity. All chiropractic schools provide basic nutritional education, but most do not provide the education required to adequately address eating disorders such as Bulimia or Anorexia.

Some great financial news is that most insurance companies recognize weight issues as a health condition and will pay for your treatment.  Some will even provide help with gym memberships.  In an effort to decrease costs one provision of the new health reform law requires insurance companies to cover obesity screening and counseling with no patient cost-sharing. The New year is an excellent time to discover a new you.  Go see how your chiropractor can help.

 

Sitting at a Desk is a Pain

balance-ball-chairWe sit a lot.  Most people sit at work.  We sit for recreation or entertainment.  We sit to drive, and we sit to eat.  Many people ask me the question, “what kind of chair should I get for work?”  Unknowingly they are asking the wrong question.  They really want to take care of their back and they’ve probably heard the fad news of the day that “Sitting is the New Smoking” or that standing or treadmill desks are the way to go.  There are kneeling chairs, exercise balls for sitting.  Balls mounted on chairs, reclining chairs and setups that you can climb inside.  Most of these devices are great, but I haven’t found a single one that you can’t sit poorly in.  You can even slouch on a ball.  The key is not what we sit in, though it can help to get good sitting furniture.

There are really only two ways to avoid the problems that come with sitting, the first way is to sit properly with good posture, however posture is supported by our muscles.  No one, no matter how well trained can sit indefinitely without those muscles getting fatigued.    Most of us are poorly trained and return to poor sitting posture after less than 20 minutes.  I highly recommend core training and exercises to improve our postural endurance, but like the different chairs it is not enough by its self.

tr800-dt7_fullviewThe only method that is manageable and within the reach of almost everyone is to sit for shorter periods of time.  That doesn’t mean to rush out and buy a standing desk or a treadmill work station.  You just have to limit your sitting to the period of time that your muscles and joints can handle at any given time.  For most people that means standing up 2-3 times per hour just to stretch or move.  You could walk to another cubicle to deliver a message, go get a drink, do 5 jumping jacks, or just stretch for 30 seconds and then get back to proper sitting.  Try it for a day.  Set a 20 minute timer and every time it goes off, pause what you’re doing, get up and move for 30 seconds.  You’ll be amazed at how you feel and how much more productive you can be even though you are taking more breaks.