Low Back Pain and Balance Exercises

You may recall last month, we talked about the relationship between low back pain and balance, particularly our unfortunate increased tendency to fall as we "mature." This month, we're going to look at ways to improve our balance by learning specific exercises that utilize the parts of our nervous system that regulate balance or, proprioception. Particularly, our cerebellum (back of the brain that regulates coordination), the vestibular system (the inner ear where the semi-circular canals are located), the ascending tracts in our spinal cord (the "highways" that bring information to the brain from our feet and the rest of our body), and the small "mechano-receptors" located in our joints that pick up our movements as we walk and run and sends that information through our nerves, up the spinal cord tracts to the brain. Here are some very practical exercises to do, "...for the rest of our lives." Start with the easy ones!

1. Easy (Level 1): Standing eyes open/closed - Start with the feet shoulder width apart, look straight ahead to get your balance and then close the eyes and try not to sway counting to 30 by, "...one thousand one, one thousand two, one thousand three, etc." Repeat this with your feet closer together until they touch each other. You can make this harder by standing on a pillow or cushion -- but don't start that way!
2. Medium (Level 2): Lunges - from a similar starting position as #1, step forwards with one leg and squat slightly before returning back to the start position. Repeat this 5x with each foot/leg. As you progress, you can take a longer stride and/or squat down further with each repetition. You can even hold onto light dumbbells and/or close your eyes to make it more challenging.
3. Hard (Level 3): Rocker or wobble board exercises - use a platform that rocks back & forth or, wobbles in multiple directions. Rock back and forth, eyes open and then closed, once you get comfortable on the board. You can rotate your body on the board, standing straight ahead (12 o'clock) followed by 45 degree angles as you work your way around in a circle at 45 degree increments (12, 1:30, 3, 4:30, 6, 7:30, 9, 10:30 and back to noon). Repeat these eyes open and closed. The Wii Balance board is a fun way to exercise - check that out as well.

You can "improvise" and mix up different exercises and create your own routine. Just remember, stay safe, work slowly until you build up your confidence and keep challenging yourself.

We realize you have a choice in whom you choose for healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Weekly Health Update

Mental Attitude: Attitude And 100 Years.
Critical life events and personal history, along with how people adapt to stressful situations and cope with them are crucial to explaining successful aging. Personality also determined how well centenarians reacted to life stress and change, and therefore whether they were as happy in their old age as they were when young. Healthy 100-year-olds had personalities that are open and conscientious.
Current Gerontology and Geriatrics Research, Dec 2010

Health Alert: High Blood Pressure In Children!
Children in disadvantaged socio-economic situations are more likely to deal with the kinds of daily stresses that can lead to hypertension at an early age. 1.5% to 4% of children have serious hypertension, 6.5-8% have elevated blood pressure that could be cause for concern.
Canadian Federation for the Humanities and Social Sciences, Nov 2010

Diet: Fruits, Vegetables And Cancer.
A panel review concluded the evidence that fruit and vegetable consumption lowers risk for certain cancers was probable. The evidence was not strong enough to receive a grade of convincing, which is the best grade possible. It was agreed that weight management and physical activity has emerged as very important factors in cancer prevention, and that alcohol consumption significantly raises the risk. Diet is only one aspect of living for lower cancer risk. Scientists estimate if healthy diets are combined with regular physical activity and weight management, about 1/3 of the most common cancers could be prevented - that's almost 350,000 cases in the US every year.
American Institute for Cancer Research, Dec 2010

Exercise: Preventing Sports Injuries.
This review underscores the value of neuromuscular training in preventing sports injuries. It was concluded, on the basis of the results of seven high-quality studies, there is evidence for the effectiveness of proprioceptive/neuromuscular training in reducing the incidence of certain types of sports injuries among adolescent and young adult athletes during pivoting sports.
Medicine & Science in Sports & Exercise, March 2010

Chiropractic: Great For Headaches.
Most people associate chiropractic with back pain, but many other ailments can be cared for with chiropractic. In one study patients with chronic cervicogenic headache received either chiropractic care (neck adjustments) or a minimal light massage. The chiropractic group improved much more than the light massage group.
The Spine Journal, Feb 2010

Wellness/Prevention: Polluted Air Increases Obesity Risk?
Animals exposed to the fine-particulate air pollution had larger and more fat cells in their abdominal area and higher blood sugar levels than did animals eating the same diet but breathing clean air. According to the EPA, roughly one out of every three people in the US is at a higher risk of experiencing health effects related to the presence of polluted air.
Ohio State University Dec 2010

Weekly Health Update

Mental Attitude: Meditation And Health.
Psychological changes that occur during meditation are associated with telomerase activity, an enzyme important for the long-term health of cells. Telomerase activity was 33% higher in the white blood cells of those who meditated. Meditators showed increases in psychological qualities as perceived control (over one's life and surroundings), mindfulness (being able to observe one's experience in a nonreactive manner) and purpose in life (viewing one's life as meaningful, worthwhile and aligned with long-term goals and values). They also experienced decreased neuroticism, or negative emotionality.
Psychoneuroendocrinology, Nov 2010

Health Alert: Health Advice For The Cold.
Be extra vigilant during the cold season and check on vulnerable people who could be at risk. Cold weather can be a problem for anyone, especially older people, children, people with a disability and those with long-term illness. Ice and snow is likely to lead to an increase in the number of people presenting with sprains and fractures as a result of slips and falls on icy roads and footpaths. People should pay a visit to elderly neighbors. The elderly can be particularly prone to hypothermia and pneumonia when temperatures dip so ensuring they have enough heat and hot food and regular hot drinks is particularly important.
Department of Health, Dec 2010

Diet: Fruits And Vegetables Win Again.
Children who eat lots of fruits and vegetables lower their risk of having stiff arteries in young adulthood. Arterial stiffness is associated with atherosclerosis, which underlies heart disease. When arteries are stiff, the heart works harder to pump blood. Eating fewer vegetables in childhood is associated with higher pulse wave velocity as an adult. The association remains when adjusted for cardiovascular risk factors like high-density lipoprotein, (good cholesterol) and low-density lipoproteins (bad cholesterol).
American Heart Association, Nov 2010

Exercise: Yoga Could Help Improve Prison Environment.
Prisoners can benefit from yoga because it is a practice which helps to foster understanding, self-acceptance, peace and wellbeing. Prisons are highly stressful environments and yoga may offer prisoners a much needed physical and mental release of the tension of prison life, paradoxically turning prison cells into places of retreat, where prisoners can develop self-discipline and concentration skills.
University Of Leicester, Dec 2010

Chiropractic: Chiropractic Making A Difference.
For the treatment of low back and neck pain, the use of chiropractic care resulted in a reduction in the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs.
Journal of Manipulative and Physiological Therapeutics, 2005

Wellness/Prevention: Myocardial Infarction And Insomnia.
Poor-quality sleep is a known risk factor for cardiovascular disease. Since it can affect remission after an infarction, the risk of complications rises and a vicious circle may be set in motion. Infarction seems to cause neuron loss at the level of the brainstem, which leads to insomnia.
Sleep, Nov 2010

They all have something very important in common with YOU!

What Do The World’s Greatest Athlete, The World’s Greatest Basketball Player, The World’s Greatest Cyclist, The World’s Greatest Mixed Martial Artist and The Author Of The Self-Help Bible “Think and Grow Rich” All Have In Common With YOU?

Dear Patient,

As you can see, I’ve put a whole bunch of pictures of some of the world’s greatest athletes, actors and celebrities on the top of this letter. Why have I done this?

I have done this because they all have something very important in common with YOU.

What is it? Everyone pictured above… and too many others to fit on this page… and YOU… utilize Chiropractic care to ease pain, relieve stress and strain, perform better and attempt to live life to the fullest.

But the amazing thing is: Many people today are very limited as to what type of doctors they can see. This comes from restrictions imposed by HMOs or personal finances. Too often, insurance companies make personal and medical choices that should be made by you and your Doctor.

But everyone in the pictures above is pretty much exempt from the restriction of insurance and HMOs. They have enough money to choose any type of healthcare and Doctor their little heart desires. And many of their careers depend on optimal performance. So it really tells you something when they all choose Chiropractic care to be part of their lifestyle.

And not only that…some even credit Chiropractic as being responsible for their massive success. For example, Winner of the decathlon and named world’s greatest athlete in 1996, Dan O’Brien had this to say: “If it were not for Chiropractic, I would not have won the gold medal.”

And check out world famous author and self-help guru Napoleon Hills personal health success formula from when he was 85:

“I eat sparingly, work enthusiastically in a labor of love, love generously, and take Chiropractic adjustments once a week whether I need them or not.”

Hill is also quoted as saying:

“I take Chiropractic adjustments regularly… not to get well, but to keep from getting sick.”

Well said Mr. Hill!!!

You know, it’s amazing how far we’ve come since the days when Chiropractors were viewed as quacks and put in jail for attempting to help people. And it’s nice to see more people than ever benefiting from all that Chiropractic has to offer.

That’s why, if you haven’t been in to see me in a while, you might want to take this opportunity to give us a call and schedule your next appointment. Nothing is more important than your health.

And if you have any friends or loved ones that could use our treatments, just give them this letter and tell them to give us a call. Make sure you tell them to mention your name. And as you already know – we will take the very best care of them.

Have a great month… and we look forward to seeing you soon!

Sincerely,
Brad Butler, D.C.

P.S. Don’t think if you come in for a treatment you are going to "Be Like Mike"… or… be as good looking as Warren Beatty or Madonna. I’m a Chiropractor – not a magician!!!

Weekly Health Update

Mental Attitude: Employees Lie About Stress.
Millions of workers feel forced to lie to their bosses about having to take stress-induced sick leave. Talking about workplace pressures remains a huge taboo. Stress has forced 19% of workers to call in sick, yet 93% say they lied to their boss about the real reason..
MIND, Nov 2010

Health Alert: Biological Changes In Suicidal Patients.
Depressed and suicidal individuals have low levels of the stress hormone cortisol in their blood and saliva. They also have substances in their spinal fluid (cytokines) suggesting there is increased inflammation in the brain. The levels were highest in those who had been diagnosed with major depression or who had made violent suicide attempts.
Lund University, AlphaGalileo Foundation. Nov 2010

Diet: Watch Out For Fructose.
Excessive amounts of fructose, present in added sugars, may play a role in high blood pressure, diabetes, obesity, and chronic kidney disease. Dietary fructose is present primarily in added dietary sugars, honey and fruit. With the introduction of high fructose corn syrup in the 1970s, an increased intake of fructose has occurred and obesity rates have risen simultaneously.
Journal of the American Society of Nephrology, November 2010

Exercise: The Race Against Age.
Impairments to health and physical performance are not primarily a result of aging but of unfavorable lifestyle habits and lack of exercise. Sporty elderly people have a life expectancy almost 4 years higher and are often faster than younger athletes.
Deutsches Aerzteblatt International, AlphaGalileo Foundation, December 2010

Chiropractic: Medical Care vs. Chiropractic Care.
Chiropractic management demonstrated decreases of 60.2% in-hospital admissions, 59.0% hospital days, 62.0% outpatient surgeries and procedures, and 83% pharmaceutical costs when compared with conventional medicine. This clearly demonstrates that chiropractic non-surgical, non-pharmaceutical approaches generates reductions in both clinical and cost utilization when compared with Primary Care Physicians using conventional medicine alone.
Journal of Manipulative and Physiological Therapeutics, 2007

Wellness/Prevention: Biodiversity Important For Human Health.
Global biodiversity has declined at an unprecedented pace since the 1950s. Current extinction rates are 100-1,000 times higher than in past epochs, and are to increase a thousand times more in the next 50 years. Expanding human populations can increase contact with novel pathogens through activities such as land-clearing for agriculture and hunting for wildlife. The loss of biodiversity - from beneficial bacteria to charismatic mammals - threatens human health. Species losses in ecosystems result in increases in pathogens. The animals, plants, and microbes most likely to disappear as biodiversity is lost are often those that buffer infectious disease transmission. Those that remain tend to be species that magnify the transmission of infectious diseases.
Nature, Dec 2010

Health Update: Neck Pain - Where Does it Come From?

Neck pain is a very common problem that can come from, well, a lot of places. It can come from laying crooked while watching TV, it can come from sleeping in a draft, it can come as a response to a cold or flu, it can hurt because of a sinus infection ("referred pain"); it can arise from an injury like car accidents, it can come from over lifting or carrying, it can come from pinching the phone between your ear and shoulder, or it can even come from "stress." Rare, but dangerous, causes include bleeding inside the head during a stroke or, neck pain due to a heart attack. Obviously, these must be emergently evaluated and treated. There is even a category of causation called "insidious" or "idiopathic" which means we DON'T KNOW where the neck pain is coming from! It's important to understand that neck pain is a symptom, not a disease which means we have to identify the cause...if we can! This is why a detailed evaluation i s required.

These are some common causes of neck pain (please refer to the pictures below):

• Degenerative Disk Disease (DDD): Over time (years), repeated injuries to the neck can result in DDD. The small "shock absorbers" that lie between the vertebral bodies lose their water retaining capabilities, become narrow, and less flexible, which is a common source of neck pain (and stiffness).
• Mechanical Neck Pain: Any condition that does not involve the pinching of nerves can be placed in this category. There are 2 small joints called "facets" that lie in the back of the vertebra that are a common source of neck pain. "Sprains" or injury to ligaments that hold bones together and "strains" or, injury to muscles and/or tendons that move the bones are also grouped here.
• Pinched nerves: Results in pain down the arm. There are 2 primary causes:
  • Herniated disk (HD): Think of a disk like a jelly donut. When the jelly "leaks" out and pinches a nerve (resulting in arm pain), that's an HD.
  • Bone spurs off the front of the facets &/or back edge of the vertebra can also pinch a nerve, resulting in the classic arm pain.
• Spinal stenosis: (2-types)
  • Central: A narrow spinal canal pinches the spinal cord creating pain, numbness and/or weakness in the arms &/or legs.
  • Lateral: Narrowing of the hole where the nerve exits creating arm pain, numbness or weakness, if the nerve is pinched (like an HD).

Of course, there are many other causes of neck pain, but these are quite common and should be first considered when evaluating a patient with neck pain.

We realize you have a choice in where you choose your healthcare services and truly appreciate the trust and confidence shown by choosing our services! We look forward in serving you and your family when the need arises.

Health Update: What Happens in "Whiplash?"

Whiplash is a slang term for an injury that occurs to the neck after the head has been literally "whipped" either forwards and backwards or sideways after a sudden jar. Therefore, this can occur from a slip / trip and fall, a bar room brawl, as well as from the classic car accident or motor vehicle collision. But what REALLY happens in a "whiplash" injury? To answer this, let's talk about: 1. The mechanism of injury; 2. The different types of injuries; and 3. The treatment options.

1. The Mechanism of injury: Let's take the example of a rear-end crash from a motor vehicle collision (MVC). In this scenario, the "target" vehicle is struck from behind by the "bullet" vehicle propelling it forwards.

All of this occurs in LESS TIME than what we can NORMALLY voluntarily contract a muscle, which takes about 500 msec., so even when we anticipate the impending crash and we brace ourselves, we can't really stop our neck from going through these movements.

2. Types of injuries: The term "sprain" refers to ligament (tough non-elastic tissue that holds bone to bone) injury and "strain" muscle/tendon (elastic tissues that move our bones) injury. There are 3 grades of sprain & strains (mild, moderate, and severe). When these tissues are injured, there is usually a loss of movement and neck pain but not arm numbness or pain. When there is nerve injury, there is arm pain, numbness &/or weakness and generally, this is more serious but usually manageable without the need for surgery. When fractures occur, it's either stable or unstable and may require surgery &/or a rigid collar.

3. Treatment: Most whiplash injuries are safely managed by chiropractic approaches (fractures are the exception). Studies have shown that early movement results in a better result than wearing a collar or, not allowing movement. Therefore, gentle mobilization and manipulation approaches "...as soon as tolerated" favor a better outcome or result. There are many different techniques we use to help speed up the recovery process. Prompt treatment is important!

We hope this information is appreciated! We realize that you have a choice in where you chose to go for your health care needs. We truly appreciate your consideration in allowing us to help you through this potentially painful recovery process.

Health Update: Fibromyalgia, I Have It... Now What?

"...I was told by my doctor that I have fibromyalgia and I don't know what to do. I've noticed that over the last couple of years that I've been having a progressively harder time doing simple tasks that I used to take for granted like folding laundry, ironing, cooking, cutting up vegetables, sewing, driving a car, holding a book, and even sleeping has become very challenging. I have to take many breaks while I'm doing these tasks and even take a nap in the middle of the day. I never used to have to do that! My family doctor initially seemed interested in helping me. He listened to me, took some blood, took some x-rays, and then said '....everything looks fine.' His conclusion was that I must have fibromyalgia - I've never even heard of that! He prescribed many different drugs. One was to help me sleep but all it did was knock me out to the point where I couldn't get up in the morning and felt so groggy that I couldn't function. Then, he tried this other one and I felt like I wanted to crawl out of my skin! I've tried 3 or 4 different drugs and the side effects were all worse than what I'm dealing with, without the drugs. He finally concluded, '...you'll just have to learn how to live with it.' Well, thank you very much, doctor! Tell me HOW to do that?"

That feeling of helplessness and not knowing what to do next is a common complaint among fibromyalgia (FM) sufferers and the fact is, many patients with FM simply CAN'T just "...learn to live with it," and need guidance.

One such patient recently presented in such situation. After a detailed history, the chiropractor checked her vital signs, performed a physical exam that included observation, palpation, range of motion, physical performance testing, orthopedic and neurological tests and then sat down to discuss the findings and what specific things chiropractic could offer her. The chiropractor laid out a treatment that consisted of the following:

1. Leg length correction: she had a 12mm short right leg, a tipped pelvis with a compensatory curve in the low back. Heel lifts were recommended.
2. Foot orthotics: she had flat feet and rolled in ankles that were altering her gait pattern.
3. Exercises: she was quite deconditioned (out of shape) and needed help with flexibility, strength and endurance, balance/coordination, and aerobic function.
4. Spinal manipulation: She had areas in her spine that were not properly moving and she had to compensate and use other parts too much, setting up faulty movement habits.
5. Nutritional counseling: She was consuming too many glutens (wheat, oats, barley, rice) which can make you feel tire/fatigued/"wiped out" all the time. She was placed on a strict gluten-free diet and encouraged to use of several nutrients.

They discussed "realistic goals." This was probably the MOST important part for her. She was told NOT to expect a "cure" but rather, a means of "controlling" FM. It was emphasized that expecting "too much" will set her up for disappointment and treatment failure. They discussed ways she could control or minimize the symptoms of FM and what the role of chiropractic played in that management process. They also discussed finding a family doctor who was willing to work with her chiropractor.

She is doing very well, independent of regular doctor visits, and is for the first time in a long time, happy with her ability to control her FM condition.

We recognize the importance of including chiropractic in your treatment planning and realize you have a choice of providers. If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Health Update: Low Back Pain and Balance

What do low back pain and balance have to do with each other? Well, a lot! First (and most obvious), poor balance can lead to falling, which is the number one cause of injuries after the age of 70 (which includes low back pain). Unfortunately, as we age, we lose both balance AND bone density - a double whammy when it comes to falling as this combination can result in fractures of the vertebra which commonly occur in the lower back region. Below is a chart that shows what the "normal" length of time we should be able to stand on one foot (eyes open and eyes closed):

Age	Eyes Open	Eyes Closed
20-59	30 sec	25 sec
60-69	23 sec	10 sec
70-79	14 sec	4 sec

As this chart illustrates, over time, we rapidly lose our ability to balance, especially when we close our eyes. In fact, many of us cannot stand on one leg with our eyes closed for more than a few seconds well before the age of 59! Try it! Stand up in a corner of a room or in a doorway where you can grab onto the wall or door jams if you lose your balance. (We certainly do not want you to fall during this test!) Look at your watch or a clock with a second hand and count out loud in time with each second on the clock, "one thousand one, one thousand two, one thousand three, ....."-- you get the idea. Once you have the rhythm down, try counting first with your eyes open for up to 30 seconds and then try it again but with the eyes closed. Quite different, isn't it? Now switch legs and try it again - eyes open first and then eye closed counting in time with the passing of each second. If you're not pleased with you performance, try it over again a few times. If you're like most of us, you may feel a little inadequate right now. Most of us need to start including some "balance exercises" into our daily routine.

So, why is it that we lose our balance so easily as we age? This is mostly because we become less active or, more sedentary as we advance in age, partially because we're not interested in doing activities that require balance, but also because of fears, like of falling down. Remember, when we were young(er), we romped around and bounce off walls and fell all the time. It was "routine" to come home from school with grass stains on our knees and backyard sports always resulted in falling, sometimes pretty hard! Rolling down a hill to purposely getting dizzy was quite attractive to us as kids - but certainly not now! In fact, getting on the floor to play with the grandkids usually leaves us sore for at least a few days. Now, I'm not suggesting we all run out and start rolling down hills, jump up and down or purposely fall down but, including active "balance" exercises into our daily routine should be THE LEAST we shou ld do. So, go for a brisk walk or a slow jog, ride a bike, walk in the park on uneven ground - it's good for our "proprioception!"

Weekly Health Update

Mental Attitude: Anger Makes People Want Things More.
Anger is an interesting emotion for psychologists. On one hand, it's negative, but it also has some features of positive emotions. One study found associating an object with anger actually makes people want the object - a kind of motivation that's normally associated with positive emotions.
Psychological Science, Nov 2010

Health Alert: People Emitting CO2?
Every person emits two tons of carbon dioxide a year, representing 20% of total yearly emissions.
International Journal of Life Cycle Assessment, 2010

Diet: Vitamin C and The Stomach.
Vitamin C can decrease the risk of H Pylori bacterial infection, which has been linked to peptic ulcers and stomach cancer. Good sources of Vitamin C include: citrus fruits, asparagus, broccoli, spinach, green peppers, tomatoes, potatoes and cabbage.
Journal of American College of Nutrition, 2003

Exercise: Lifestyle And Heartburn.
Patients with heartburn may benefit from lifestyle interventions rather than just medication. Gastro-esophageal reflux disease (GERD) affects 20-40% of the population. One study gave patients who took prescribed medication for GERD symptoms a 1.5 hour educational session each week, over four weeks. Participants were encouraged to record their symptoms, look at their diet, learn about managing stress, set goals for themselves involving healthy exercise and identify their three biggest problems relating to GERD. Following the intervention, patients felt more in control, believed their treatment could help them, experienced fewer symptoms, were less concerned about their illness and had a greater understanding of and were less affected by their reflux than before the intervention.
British Journal of General Practice, Nov 2010

Chiropractic: Do Not Wait.
Question: If your car was out of alignment would you wait to get it fixed? Answer: No. The same principle holds true with your body and spine. If it is misaligned, or not moving properly, wouldn't you want to get it corrected before it became a major problem?

Wellness/Prevention: Another Reason To Stay Slim.
People with obstructive sleep apnea (OSA), a sleep disorder associated with obesity, have more non-calcified or "bad" plaque in their coronary arteries. Patients with OSA also have a significantly higher prevalence of vessel narrowing and more extensive vessel involvement. 89% of OSA patients have narrowing in at least one vessel, compared to 59% of non-OSA patients.
Radiological Society of North America, Nov 2010