Wednesday, December 18, 2013

Can The Weather Effect Back & Neck Pain?

Why do some people seem to be able to predict coming rains based on their aches and pains? It's a question I hear from my patients every time weather changes are on the horizon. It's true that many people with back pain, neck pain or other joint complaints are often surprisingly accurate in predicting when storms are approaching, and believe it or not, there is some validity to their weather forecasting abilities.

The phenomenon is nothing new. As early as the 5th century B.C., Hippocrates suggested many illnesses were related to changes in the weather. Since then, a number of musculoskeletal disorders have been identified as being especially sensitive to changing weather conditions, including osteoarthritis, tension headaches, back pain and fibromyalgia.

A variety of meteorologic factors have been suggested as the culprit, including temperature, precipitation, humidity, thunderstorms and increased ionization of the air. But while reliable conclusions about the link between weather and musculoskeletal pain have yet to be established due to the lack of controlled studies, most research points to the lowered atmospheric barometric pressure that often precedes storms and other weather changes.

rain In one of the first empirical studies on the effect of weather on joint pain, published in 2010 by the International Journal of Biometeorology, researchersestablished a direct connection between low barometric pressure, inflammation and joint pain in rats. For the study, scientists artificially produced a state of chronic inflammation in the feet of lab rats, mimicking the clinical features of neuropathic pain in humans. When the rats were placed in a low-pressure environment, they exhibited signs of exacerbated foot joint pain not seen in their control counterparts.

Additional research has demonstrated the same phenomenon occurs in humans. For instance, a 2002 study from the Journal of Spinal Disorders and Techniques concluded that "back pain may be aggravated by atmosphere depression in patients with lumbar disc disease." And a 2007 study from the American Journal of Medicine determined that "changes in barometric pressure are independently associated with osteoarthritis knee pain severity."

Various mechanisms have been proposed to account for this relationship, but the most likely explanation involves the expansion of fluid in swollen joints following fluctuations in barometric pressure. Inflammation due to dysfunction, disease or injury will lead to swelling in and surrounding a joint. Because materials of varying densities are affected differently by pressure changes, drops in barometric pressure expand this extra fluid more than the muscle, ligaments and connective tissue that make up the joint capsule, stretching sensitized tissues and activating a nociceptive (pain) response.

A good illustration for the layperson is a balloon in a barometric chamber. If the pressure outside the balloon drops, the air on the inside expands and stretches the walls of the balloon. When the same happens to a swollen joint, the expansion stretches soft tissue, irritates nerve endings and causes pain.

It's important to note that this contraction and expansion of excess fluid in joints is happening on such a small scale that it cannot be quantified by any scientific means and the process is therefore entirely theoretical. But whatever the mechanism, the takeaway is that some degree of inflammation must already exist, whether we are aware of it or not, for barometric pressure changes to lead to joint pain. Weather changes can't cause pain by themselves; they can only exacerbate inflammation that's already there. After all, not everyone experiences pain when a storm is brewing, and those who do don't experience pain in every joint.

It really drives home what chiropractors have been saying for decades: The absence of pain isn't the same as good health! So while there's validity to the idea of "aches and pains mean coming rains," anticipation of weather changes shouldn't interfere with patients' motivation to decrease underlying inflammation with the things they actually can control. Sunny days ahead are no substitution for proper exercise, good diet and supplementation, and regular chiropractic care.

Wednesday, December 4, 2013

Finding The Right Pillow To Prevent Neck Pain

A common source of neck pain is sleeping wrong due to our pillows.

But what is the best pillow for you? It depends. 

If you sleep on your back or stomach (I don't recommend sleeping on your stomach EVER), then a down feather pillow should be fine. 

Side sleepers would most likely benefit from a memory foam pillow with contoured rolls and/or wings.

Check out this video to help you decide which is best for you:


Tuesday, November 26, 2013

How to Avoid Sitting Too Much and Moving Too Little

Partly due to rising health costs and the awareness that sitting for long periods has a negative effect on health, there is some significant motivation to get workers out of their chairs and on their feet. In addition to the stated health benefits, people tend to be more productive when they work on their feet.
Even the American Medical Association (AMA) recognizes that prolonged sitting is bad for you. The AMA recently adopted a new policy on sitting at work. It is now urging employers and others to make alternatives to sitting available to workers. AMA board member Dr. Patrice Harris said, "[giving] employees alternatives to sitting all day will help to create a healthier workforce."

A Nation of Obese Sitters

So, is sitting a healthy thing to do? It would appear not! At least not for long periods of time. In spite of significant evidence, the plain fact is we have become a nation of sitters. We sit at work, sit on the way to and from work, sit while we eat, and sit during the evening while watching TV. Among some of the other negative aspects of prolonged sitting, there is a correlation between the amount of time spent seated and the development of obesity. It's really no wonder we are becoming a nation of obese sitters.
In addition to its recent policy on sitting at work, the AMA just saw fit to make obesity a disease, rather than a lifestyle choice. Interesting call! On a personal note, I've considered myself to be far too short for my weight most of my life. However, I don't consider that I have a disease; never have. Rather, I credit my own situation to more calories going in than going out. Labeling obesity as a "disease" sort of takes the personal-responsibility part out of the equation.
So, back to the sitting thing. There is ample evidence that sitting, whether at work or at home watching TV, has a negative effect. Studies show that prolonged sitting leads to an increase in childhood obesity, diabetes and even attention problems.
An interesting study was published a few years ago in the Archives of Internal Medicine. The study was conducted at Duke University and looked at the impact of obesity on worker's compensation costs. Workers with a body mass index (BMI) greater than 40, filed twice as many worker's compensation claims, had seven times higher medical costs, and lost 13 times more time from work when compared to non-obese workers.

Tools to Help Fight the "Sitting" Epidemic

In an attempt to curb the sitting epidemic, the American Heart Association (AHA) is promoting a new device. It's actually a smartphone app, Hotseat. It is designed to do one thing: Get people out of their seats for a few minutes throughout the day.
I'm not in the habit of promoting products, but this one has me intrigued. A pilot study by the AHA found that 71 percent of the app users took more breaks from sitting during the workday. Additionally, nearly 87 percent of the workers said that using the app made them more aware of the time they spend sitting.
Those using Hotseat set up an individual break profile, one that they feel comfortable and capable of doing. They then set up the number of breaks they want to take and when they want to take them. Each break is approximately two minutes in length. Rather than a fixed schedule, the app syncs the breaks with the worker's calendar. Nifty use of a smartphone. Fran Melmed, the creator of the Hotseat app, says it is designed to combat "sitting disease."
One other thing that seems to help is the treadmill desk. I wrote about this in an earlier article, but it's important to re-emphasize, because it does get people out of their chairs. The treadmill desk consists of a treadmill that is set up as a standing workstation.
Perhaps the most important thing you can do is move more. Don't spend too long in any one position. Take the stairs rather than the elevator. Park far enough away from the store that you are forced to walk a bit. Take walks after lunch and dinner.
I'm always amused when a worker who has injured his/her back is given a temporary work assignment that involves seated work. The opportunity to sit at work is considered to be "light work." In reality, it comes with its own price.
I'm personally pleased to see the interest in the negative effects of sitting. Prolonged sitting leads to a variety of health problems, from obesity to back pain to postural fatigue. It behooves all of us, doctors and patients alike, to move around more.

Wednesday, November 6, 2013

Commuting Your Health Away

 Driving is one of the biggest problems leading to back and neck pain I see in the office everyday. Vibration from the car and road alone causes breakdown in the body, not to mention the stress impact effects.
Unless you're a work-at-home member of the labor force (which has its own health risks, by the way), most of us commute from home to work and back again at least five days a week. From a health perspective, research suggests commuting is bad news, and it goes beyond the stress associated with those bumper-to-bumper, road-rage meltdowns you find yourself experiencing ... but somehow think you can handle day after day, week after week, year after year.
According to several recent studies, commuting – particularly longer times spent commuting – has a negative impact on weight, blood pressure, sleep quality / amount and heart disease. One study suggested the longer the commute, the higher the commuter's body-mass index, waist circumference, diastolic and systolic blood pressure, and metabolic risk factors. Another study found that high blood pressure, stress and heart disease were more likely in people who commuted more than 30 miles a day. And in a third study, researchers concluded: "Commuting long distances negatively impacts one's ability to capture adequate sleep."
The Telecommuting Age isn't necessarily solving the commuting health crisis, either; after all, even as more people work from home, the population at large continues to do more driving and less transportation by other means (bikes, foot, etc.). More time in cars, less time exercising - another recipe for health disaster.
commute The solution, if there is one, is to find ways to make your commutes as short, stress-free and infrequent as possible. Here are a few suggestions:
  • Map it out: If there are multiple routes to your job, try some trial and error to determine which one gets you to and from work in the shortest – and least painful – amount of time.
  • Try 40 in 4: If your employer / state allows, ask about a possible four-day, 10-hour-a-day workweek option. You'll find that the 10 hours aren't a major drain, and you'll appreciate the extra day away from work – and out of the traffic jams.
  • Carpool: Yes, you're still spending time in a car, but at least you aren't always the one driving (and dealing with other drivers); and you're also not alone with your traffic frustrations, all of which contribute to stress.
  • Schedule it & stick to it: A likely explanation for why longer commutes lead to higher weight, etc., is not only that commuters sit in a car too long, but also that by the time they get home, they have little time – or perhaps interest – in exercising. Schedule in exercise before or after work and stick to the routine. It will help counter some of the effects of your commute, including stress.
For many people, commuting is a reality, and depending on the job opportunity and living situation, they can't change the distance to and from work. But that doesn't mean you're destined to a life in the slow lane and its debilitating health effects. Talk to me if you need  more information.

Wednesday, October 23, 2013

Beating Breast Cancer One Step At A Time

October is breast cancer awareness month, so I wanted to focus on a subject that is close to my family since my wife is a breast cancer survivor. 
There are many benefits to being active, but now women can prevent one of the most common cancers - breast cancer - by simply moving more. And, you'll be able to reduce your back and neck pain too at the same time!
The more physical a woman is and the more she incorporates activities such as walking, the more likely she will not develop breast cancer, according to two new studies.
In the first study, published online last week in Cancer Epidemiology, Biomarkers & Prevention, researchers with the Epidemiology Research Program at the American Cancer Society began by turning to a huge trove of data maintained by the cancer society. The database includes detailed health and medical information from more than 73,600 post-menopausal women, age 50 to 73, who enrolled in the study in the early 1990s. For almost two decades, they completed follow-up questionnaires every two years.
The questionnaires asked whether and how they exercised. About 9 percent reported never exercising. A few said that they exercised vigorously and often, typically by running, swimming or playing singles tennis. Most walked, usually at a pleasant pace of about 3 miles per hour. About half of the group reported that such strolling was their only form of exercise. Over the course of the study, 4,760 of the women enrolled developed breast cancer, according to the study.
The study found that those women who walked at least seven hours per week, usually distributed as an hour a day, had 14 percent less risk of developing breast cancer than those who walked for fewer than three hours per week, a significant reduction in risk.
exercise Meanwhile, those few women who were the most active, exercising up to 10 hours each week, had a 25 percent less risk of developing breast cancer than those women who exercised the least.
In another study published in Cancer Epidemiology, Biomarkers & Prevention, scientists from the School of Public Health at the University of Minnesota divided several hundred sedentary, pre-menopausal women into two groups. One group remained sedentary, while the other began a moderate aerobic exercise program that continued five times a week for 16 weeks.
At the start and end of the four months, the researchers collected urine and tested it for levels of estrogen and various estrogen metabolites, the substances that are formed when estrogen is broken down by the body. In this study, those volunteers who remained sedentary showed no changes in the ratios of their estrogen metabolites after four months. But, among the group that began exercising, the levels of one of the metabolites fell and another rose, shifting the ratio in ways that are believed to indicate less chance of breast cancer. The women also lost body fat and gained muscle.
If you are looking to get in shape and lower your risk of breast cancer put on your walking shoes.

Wednesday, October 9, 2013

No Shortage of Back Pain

Back pain, back pain, everywhere there's back pain. Back pain is second only to the common cold as the most frequent cause of sick leave, accounting for approximately 40% of all work absences. It's also the most common reason for filing workers' compensation claims (about 25% of all claims filed in the U.S.).

How bad is the situation? A study in the American Journal of Public Health analyzed data from a national health interview survey and found over 30,000 respondents who reported daily back pain of one week or more in the 12 months prior to the survey. From this data, the authors estimated that more than 22 million people suffer from back pain that lasts one week or more; these cases result in an estimated 149 million lost workdays.

These estimates didn't even include workers who reported back pain of less than one week, or who missed work for the entire study period! If you've managed to escape back pain to this point, it's probably just a matter of time until you're caught. But if you do get caught and need relief, feel free to call me to see what can be done.

Guo HR, Tanaka S, Halperin WE, et al. Back pain prevalence in U.S. industry and estimates of lost workdays. American Journal of Public Health, July 1999: Vol. 89, No. 7, pp1029-1035.

Wednesday, September 25, 2013

School Backpacks and Back Pain? Here's What To Do...

Day after day, year after year, children trot off to school carrying a significant burden with them: their backpack. Backpack weight is a major health issue, and it's only getting worse. Here's what you can do about it.
Do you know what's in your child's backpack, how much it weighs, or how that weight is affecting their neck, shoulders, back and spine? You need to know, because studies suggest far too many children are carrying far too heavy loads to and from school, and with serious consequences.
For example, a 2003 study in Spine found a significant relationship between the incidence of lower back pain among schoolchildren (ages 12-18) and both the weight of their backpacks and the amount of time the backpacks were used. Some backpacks were inordinately heavy; 18.9 percent of the students surveyed carried backpacks that weighed more than 20 percent of the student's body weight when full.
In another study, published in the same journal a year earlier, four of five children said their backpacks were heavy, and two-thirds said they felt fatigue when carrying theirs. The study also showed that lifetime prevalence of low back pain was related to the amount of time children carried backpacks on their shoulders.
Not very good news, is it? So, what can you do as a parent to help your children in this regard? Here are a few simple suggestions courtesy of National University of Health Sciences in Lombard, Ill.:
  • Make sure your child's backpack weighs no more than 10 percent of their body weight.
  • Also ensure that it doesn't hang more than 4 inches below their waistline.
  • Urge your child to wear both shoulder straps. The straps should be adjustable so the backpack can be easily fitted to your child's body

Wednesday, September 11, 2013

Think Before You Drink

 A common source of back pain and pain associated with arthritis is due to excessive weight gain. If you are a soda drinker, just cutting out this beverage (even the "diet" ones too!) can result in quick weight loss and help you gain control over back pain. But if that weren't enough for you to give up sodas, below are even more reasons and health benefits: 

10 Reasons to Stay Away from Sodas and Energy Drinks
  1. The average soda has no nutritional value - only sugar, carbonated water, caramel color, natural flavors, caffeine, phosphoric acid and high-fructose corn syrup.

  2. According to Harvard researchers, the risk of childhood obesity increases 1.6 times with each additional daily serving of soda consumed.

  3. Soda adds more sugar to a typical 2-year-old's diet than cookies, candies and ice cream combined.

  4. Numerous studies indicate that the sugar and acids in soda may cause tooth decay.

  5. According to some household cleaning Web sites, soda can be used as a toilet cleaner and rust and grease remover.

  6. A soda can.
  7. A Harvard study of teenage athletes identified a strong association between soda consumption and bone fractures in 14-year-old girls.

  8. An average can of soda has 35-38 mg of caffeine and as much as 13 teaspoons of sugar.

  9. Most energy drinks contain about 80 mg of caffeine, along with other legal stimulants like guarana and ginseng.

  10. Certain energy drinks contain huge blasts of caffeine (up to 280 mg) - almost triple the caffeine in a cup of coffee.

  11. Energy drinks can boost heart rate and blood pressure, increase anxiety, dehydrate the body and cause insomnia.

Thursday, August 29, 2013

Getting Back on Your Feet After an Ankle Sprain

In the U.S. alone, 23,000 people sprain their ankle each day, resulting in 1.6 million doctor office visits annually. The direct and indirect costs (e.g., lost days from work) associated with treating ankle sprains exceed $1.1 billion annually. To make matters worse, these numbers do not take into account the long-term disability often associated with ankle sprains. In a 10-year follow-up of patients suffering ankle sprains, 72 percent showed signs of arthritis in the ankle joint. Ankle problems can even be a source of dysfunction and pain in the lower back!

Given the serious long-term consequences associated with ankle sprains, it is important to identify which individuals are prone to injury. Although numerous factors have been proven to correlate with the development of ankle sprains (such as high arches, impaired balance, tight calves, and decreased cardiovascular fitness), by far, the best predictors of future ankle sprain are prior ankle sprain and being overweight. In fact, overweight athletes with a prior history of ankle sprain are 19 times more likely to suffer another ankle sprain. Because force centered on the ankle can exceed seven times body weight, even a few extra pounds will greatly increase your potential for ankle sprain.
Conversely, previous ankle sprain can result in impaired coordination and calf tightness that can increase your potential for reinjury. In a three-dimensional study of motion in the foot and ankle while walking, individuals with a prior history of ankle sprain had reduced ground clearance during swing phase in the foot was tilted in excessively when it hit the ground.

ankle sprain Regardless of the degree of ligament damage, the goal of treating an ankle sprain is to restore strength, flexibility, proprioception, and endurance as quickly as possible during the first few days following injury. The following is a popular treatment protocol for managing ankle sprains that should be discussed with your doctor of chiropractic if you suffer a sprain or are prone to sprains. Your doctor may utilize the following to help you get back on your feet.

Phase 1: Unable to bear weight
  • Compressive wrap with U-shaped felt balance around fibula. Change every four hours
  • Active abduction / adduction of toes for five seconds; repeat 10 times
  • Write out alphabet with toes, five times per day
  • Stationary bike, 15 minutes per day
  • Ankle rock board, seated (off-weight-bearing), 30 circles, performed clockwise and counterclockwise two times per day. Perform on uninjured ankle while standing for three minutes. This has been shown to increase proprioception in the contralateral limb
  • Mild grade 3 and grade 4 mobilization of the joints of the foot and ankle
Phase 2: Can walk with minimal discomfort; sprained ankle has 90 percent full range of motion
  • Mobilize all stiff joints in the lower extremity and pelvis
  • Band exercises in all planes; three sets of 25 in each direction
  • Double-leg and then single-leg heel raises on the involved side, three sets of 10 reps, two times per day
  • Standing closed-eye balance, 30 seconds, five times per day
  • Standing single-leg ankle rock board, one minute, five time per day
  • Closed kinetic-chain exercises
Phase 3: Can hop on involved ankle without pain
  • Running at 80 percent full speed; avoid forefoot touch-down
  • Mini-tramp; three sets of 30 jumps forward, backward and side to side. Begin on both legs; progress to single-limb
  • Plyometrics on a 50 cm and 25 cm box, positioned 1 meter apart. Jump from one box to the ground, then to the other box, landing as softly as possible. Three sets of five reps.
Besides the standard exercise routines, it is also important that problems with balance be addressed. The simple addition of an inexpensive foam balance pad can significantly lessen the risk of injury. In one study, there was a 77 percent decrease in the rate of reinjury when overweight athletes with a prior history of ankle sprain performed balance training on a foam stability pad for five minutes on each leg for four weeks. Another study from the Netherlands found that individuals treated with balance-board exercises reduced their subsequent reinjury rates by 47 percent.

Because foam pads and balance boards do not put your foot through a full range of motion, I recommend a rock board that forces your foot to tilt in more than it tilts out (which is how your ankle is designed to move). The board places your foot in the position of a future sprain and then forces you to use your muscles to pull yourself out of the risky position. At first, perform this exercise while seated; after a few days, it can be done while standing.

The improvements in proprioception associated with balance-board training can be enhanced by skin taping.
Perhaps the best way to restore proprioception is with manipulation of the calcaneocuboid and talocrural joints, which can be done by your doctor of chiropractic. The importance of incorporating manipulation into a protocol for managing ankle inversion sprain is supported with research in which manipulation resulted in an improved progression of forces throughout the foot during stance phase. In performing a placebo-controlled study of 52 athletes presenting with grade 2 ankle sprains, these authors determined that ankle adjustments produced a clinically significant redistribution of load throughout the foot.

Tuesday, August 20, 2013

What to Do About Whiplash- Prevention and Treatment Strategies

Whiplash is the most common injury associated with motor vehicle accidents, affecting up to 83 percent of those involved in collisions, and is a common cause of chronic disability. The Quebec Task Force (QTF) on Whiplash Associated Disorders defines whiplash as "bony or soft tissue injuries" resulting "from rear-end or side impact, predominantly in motor vehicle accidents, and from other mishaps" as a result of "an acceleration-deceleration mechanism of energy transfer to the neck." It is estimated that as many as four per 1,000 people may experience a whiplash-related injury and associated pain syndromes. The overall economic burden of whiplash injury, including medical care, disability and sick leave, is estimated at a staggering $3.9 billion annually in the U.S. alone.
The mechanism of injury suggests that whiplash may occur as a result of hyperextension (excessive backward bending) of the lower cervical spine (neck) in relation to a hyperflexion (excessive forward bending) of the upper cervical vertebrae, producing a force of impact "whipping" through the body. The result is soft-tissue damage, inflammation and muscle spasm.
whiplash skeleton Whiplash is associated with a wide variety of clinical symptoms including neck pain, neck stiffness, arm pain, jaw pain, headaches and paresthesias (tingling/numbness), problems with memory and concentration, and psychological distress. Symptoms of whiplash may not present until several weeks after the causative incident. Frequently people experience little pain and discomfort in the early stages. However, after several weeks the body begins to manifest symptoms. It is this delayed onset of symptoms and lack of early treatment intervention which may cause the condition to become chronic and debilitating.
Whiplash Prevention
While a whiplash injury may be unavoidable if you're involved in a crash, there are simple but effective precautions you can take to minimize the risk. As they say, an ounce of prevention is worth a pound of cure.
Head restraint: If more than one person uses a car, it is better to adjust the head restraint for each driver and make sure that it's positioned according to the convenience of each driver. Not adjusting the head restraint for each driver greatly increases the likelihood of injury. The head restraint must be locked when driving. If the head restraint is not locked, it may move during an accident, taking away protective support when needed most and resulting in substantial injuries to the neck.
Evidence suggests that being the driver increases the chances of head injury by double and also shows that women suffer from whiplash injuries more than men because they tend to sit more upright and closer to the steering wheel. A study by Brian Stemper, PhD, assistant professor of neurosurgery at the Medical College of Wisconsin in Milwaukee, found: "Auto head restraints positioned less than 2.4 inches (6 cm) from the back of the head kept ligament stretch within the physiologic range - meaning that no injury would occur. However, as the restraint distance increased beyond 2.4 inches, the ligaments began to exceed failure thresholds, meaning that whiplash injury was more likely to occur."
Seat belt: Although the seat belt in and of itself will not prevent whiplash, it does help to prevent your body from lurching completely forward during a car crash, even a low-impact crash. The simple act of buckling up is responsible for approximately a 60 percent reduction in accident fatalities. So buckle up to save your life and protect your neck.
Neck exercises: Whiplash affects the neck muscles. The stronger the muscles, the less affected by sudden movement your neck will be. Engage in neck exercises to strengthen the soft tissues of the neck. Exercise won't prevent whiplash, but it can make you less susceptible to the forcible forward and backward neck jolts. Isometric resistance exercises for the neck are easy to do and highly effective in strengthening the supportive musculature of the neck. Your doctor can provide you with specific neck-strengthening exercises.
Treatment Options
Whiplash injuries are difficult to treat for many reasons. Complex interactions of psychosocial, legal and physical factors make effective treatment highly variable. However, there are many therapeutic options available to help whiplash related injuries. Initial treatment traditionally includes a soft cervical collar to restrict cervical range of motion and prevent further injury. Overall rest and motion restriction may hinder progress in the long run, so it is best to seek out professional help in resolving symptoms. That's where your chiropractor comes in.
Chiropractic: Chiropractors are the single largest group of practitioners treating whiplash injuries, and they do it well: For example, one study found chiropractors were effective at relieving whiplash pain more than 90 percent of the time. Chiropractic care focuses on relieving soft- tissue spasm, inflammation and pain by restoring proper motion in the spinal column. Due to the force impact of whiplash, the spinal column can misalign and cause pain. By performing manipulation to the spinal column, chiropractic can help restore normal function and movement to the affected areas.
neck adjustment Depending on their treatment style and your specific case, your chiropractor may decide to utilize additional treatment options in addition to chiropractic, either in their office or via a referral. Here are some of those potential treatments, all with the single goal of relieving your pain and managing your whiplash symptoms in the most effective way possible – and without requiring pain-relief medications, which are perhaps the most common "treatment" option for whiplash sufferers, despite the fact that they provide only short-term relief and may create more problems than solutions in terms of the potential side effects.
Massage Therapy: Massage is one of the most effective therapies for releasing muscle tension and restoring balance to the musculoskeletal system. Massage therapy can help relax the muscles, increase and maintain range of motion, decrease stress and tension, increase circulation, and prevent and break down scar-tissue formation. Ideally, therapy should start as soon as the acute, inflammatory phase is over (about 72 hours after the injury). A massage technique called cross-fiber friction can be used to encourage the body to lay down the connective tissue in the same direction as the originally damaged tissue. This proper alignment causes smaller amounts of the connective tissue to be needed and allows for a fuller range of motion upon recovery.
Physical Therapy: Physical therapy is an effective treatment option for whiplash, especially when combined with other treatments, such as bracing. Physical therapy techniques can help restore proper function and movement of damaged tissues. Physical therapy includes both passive and active treatments. Passive treatments help relax you and your body. They're called passive because you don't have to actively participate. You'll probably start with passive treatments as your body heals and/or adjusts to the pain. But the goal of physical therapy is to get into active treatments. These are therapeutic exercises that strengthen your body so that your spine has better support.

Wednesday, July 31, 2013

Fish Oil Causes Prostate Cancer? Don't Believe the Media Hype

There has recently been a surge in media coverage regarding a study that allegedly examined the effects of fish oil supplementation on prostate cancer expression. But quite to the contrary, the subjects in this study were not supplemented with fish oil or put on a fish-rich diet, which means that it is completely inappropriate to suggest fish-oil supplementation causes prostate cancer.
As the study authors explained, they did a blood test on 834 subjects who developed prostate cancer in the SELECT Trial and measured fatty acids in plasma phospholipids. After a blood draw, the fatty acids were measured as a percentage of total fatty acids in plasma phospholipids, and included omega-3, omega-6 and trans-fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). While the .04 percent increase in EPA levels and the .1 percent increase in DHA levels in prostate-cancer patients may be statistically significant, the clinical relevance of such small differences remains unknown and was not discussed in the study. Despite this unknown, news reports irresponsibly suggested that consuming fish and fish oil supplements may be a cause of prostate cancer and that men should be careful not to eat too much fish.
omega-3 The more appropriate conclusion would be that since controls (study subjects without prostate cancer) and prostate cancer patients have nearly identical plasma phospholipid levels of omega-3 fatty acids, it is not likely that an association between fatty acids and prostate cancer can be identified in this study. Other dietary and lifestyle factors are likely to be involved. Consider that prostate cancer is rare in Inuit Eskimos, who consume a traditional diet that includes extremely large amounts of omega-3 fatty acids.
Unfortunately, the media scare about eating fish and taking fish oil has been pervasive. Why would the media be so irresponsible? It is either due to ignorance – or perhaps a new prostate cancer treating/preventing medication may be in the works. This notion may not be so far-fetched. Consider that statins are now often recommended as a preventive strategy for people with total cholesterol below 200 mg/dl.

Thursday, July 18, 2013

Fatigue Fighters: 4 Great Ways to Stay Energized

Whether you're a night owl enjoying the social scene until early morning; a compulsive couch potato destined to watch the boob tube until the clock strikes midnight (or beyond); a parent – new or seasoned – struggling to find enough time in the day to relax, much less sleep; or an overworked, overstressed office worker resigned to daily desk doldrums, fatigue is something we all fight on a daily basis. For some, all that's required is a few extra hours of sleep a night; for too many others, it requires changing your behavior permanently to make relaxation the priority and put fatigue on notice. Here are five ways to fight fatigue and improve your mental and physical health:
  1. Put your body in motion: Regular exercisers understand that the secret to long-term energy actually comes from expending energy through exercise. Counter-intuitive to non-exercisers and even new exercisers, of course, but a simple strategy for building energy that lasts throughout the day. Not only does the act of exercising naturally “wake you up” from your fatigue-draining day, but it also encourages the production of endorphins, chemicals that reduce pain perception and improve mood. What's more, the more muscle you build and the higher your metabolism, the more your body can handle the demands of your busy day – giving you more energy to get out there and show off your great physique.

  2. Fatigue Eat to win: This is an easy one when it comes to energy production, but unfortunately, it's ignored on an ever-increasing basis. Fast foods, processed snacks and nutrition-deficient meals not only provide short-term energy that quickly fades, leaving you fatigued – not to mention hungry, which can lead to overeating and weight gain (a definite energy-sapper); the sugar and fat content of many of the foods Americans commonly eat also “weigh us down,” literally and figuratively, draining us of our physical ability (and mental desire) to do anything except lie down and take a nap. In short, our eating habits are a recipe for disaster when it comes to staying energized. The solution is straightforward: Replace some of those burgers and shakes with nutrient-dense fruits, veggies, whole grains and lean proteins that provide your body with an all-day source of energy.

  3. Get into a sleep rhythm: Research suggests that the amount of sleep you get is less important than the regularity and quality of sleep when it comes to proper restoration / rejuvenation. That means if you get eight hours of sleep a night, but it's interrupted by barking dogs, crying babies or countless trips to the bathroom, there's a good chance you'll be fighting fatigue more than the person who only gets six hours a night, but does so in peaceful, uninterrupted fashion. What's more, timing is pivotal when it comes to sleep: go to bed at about the same time every night (and wake up at about the same time every morning) and you'll find yourself more refreshed and energized than if your sleep schedule varies widely.

  4. Get away: Pure and simple, if you never have a chance to relax and restore your energy levels, you'll gradually wear down until the meter's on empty. Whether it's taking a few vacations away from the office – and the city you live in – every year; reserving 15-20 minutes a day to read a good book, soak in the bath or just take a walk and process your day; or reminding yourself that the paperwork on your desk can wait until tomorrow, keep your energy levels high by making some you time to remind yourself that life is great – and so much more rewarding when you've got the energy to enjoy it.

Wednesday, July 3, 2013

Common Exercise Mistakes And How to Correct Them Before You Injure Yourself

Did you know that more than 60 percent of people who begin working out for the first time, or pick it up again after taking some time off, hurt themselves in the first month? That's significant for several reasons, not the least of which is if you are hurt, how are you going to keep working out and reach your fitness goals? The most important goal when undertaking any exercise program is not to build muscle, burn fat, increase cardiovascular capacity, or anything else. Those are important, but the number-one priority is to keep from being injured. That's the only way you'll have a real chance of reaching your fitness goals.
The right way versus the wrong way to exercise; now this is a topic that needs to be discussed more often. Just the other day, a friend of mine told me she had injured her chest muscle while doing Pilates. Of course, her training was unsupervised; in her case, she was following along with a DVD. She went to the hospital and was diagnosed with a torn chest muscle. Who would think someone could seriously injure themselves by doing Pilates on a DVD? It happens more frequently than you think. And if you can hurt yourself doing Pilates, you can definitely hurt yourself while working out at the gym lifting weights or using any of the equipment.
It's a Question of Form
Common Exercise Mistakes All of my patients know I am a stickler for form. I don't care how much weight you are lifting or how many times you can perform an exercise; if your form is not correct, you need to reduce the amount of weight you are using and/or slow down. I'm a stickler on form for two important reasons:
#1 Safety (Injury Prevention). Correct form is key when doing any exercise. In fact, it's the first thing you must master! If not, you will eventually injure yourself. If you aren't sure if you are doing something correctly, please get a competent professional to assist you.
#2 Effectiveness. If you want to get the most out of your workouts, you have to use correct form. There is a right way to exercise and a wrong way to exercise, and this applies to each and every exercise you perform. Exercising is an art form that takes years to master. But let's face it; the average person does not see it that way, and that is why so many injuries occur and/or motivation disappears.
Most people have no clue how to do a proper squat, push-up, lunge, leg press, chest press - you get the idea. Lack of proper form is the number-one cause of injuries. Most people in the gym look around for someone who has a body they want and then try to mimic the same exercises the person is doing. Sometimes the person they are looking to as an example does have the correct form, but that doesn't mean you can mimic it correctly. It may have taken them years to learn how to do it the right way. But most of the time, the person they are looking too as a model saw someone else do the exercise and they are doing it wrong as well. It's a vicious cycle.
The general rule for repetitions and sets is straightforward: If you are trying to gain muscle or get stronger, you want to do low reps and higher sets. For example, you may be doing a leg press and you are trying to get stronger (hypertrophy), so you put on a heavier weight and do 6-8 reps per set for 4-5 sets. On the other hand, if you are just trying to build endurance and lean out, then you should do higher reps and lower sets; typically 15-20 reps per set for 2-3 sets. Now there are some middle reps and sets as well, like 10-12 reps/5-6 sets, but these are the basic rep/sets. The point is, it's important to understand how different sets, reps and even the types of exercises you perform affect your body. Again, talking to an exercise specialist will help you determine the best way to achieve your fitness goals.
Right Way, Wrong Way: 9 Exercise Mistakes
  • Lat pulldown. The wrong way: pulling bar behind neck can cause serious injury to the shoulder. The right way: Pulling bar down in front of you while squeezing your back muscles (the rhomboids and latisimus dorsi).
  • Push-ups. The wrong way: You should never have a dip or arch in your back or lock your arms. The right way: Arms should be underneath you and not locked, back parallel to the floor. Engage your "core" the entire time (squeeze your glutes and draw in your belly button).

  • Walking lunges. The wrong way: When performing a lunge, extending the front knee past the front foot will cause injury at some point. The right way: When you are in a split stance, go straight down and do not let your front knee go past your foot.

  • Leg press. The wrong way: Your knees should not be by your ears; that is not a position your knees are used to being in, especially under heavy weight. The right way: Keep 80 percent of the weight in your heels; press out and go a little past 90 degrees.

  • lady doing push-up
  • Abs (crunches). The wrong way: Pulling the head up as you're doing a crunch. The right way: Relax your head and bring your shoulders off the ground, engaging your abs and rotating your hips to the ground.

  • Squats. The wrong way: Knees coming forward over your toes. The right way: Perform this exercise as if you were sitting back on a chair and putting 80 percent of your weight on your heels. Then lean slightly forward so you won't fall back.

  • Chest press. The wrong way: Lifting the weight using your back (high arch). The right way: Keep your back flat and relax your shoulders while lifting the weight.

  • Cardio. This isn't really a specific exercise, but it still is something that lots of people do wrong in the gym: doing an hour or more of cardio. No, I'm not crazy; the only people who should do an hour of cardio are marathon runners. If you aren't planning to be in a marathon anytime soon, then I wouldn't do an hour. In fact, I recommend high-intensity training - for example, a 30-second sprint or quick walk followed by a 60-second jog, then another 30-second sprint, and so on; repeat that cycle about 10-12 times and you will get way more out of your cardio workouts in half the time. It works, trust me. Try it!

  • Frequency: Being too zealous and working out 6-7 days a week for an hour or more each time. Your body needs rest and repair after a workout, so pace yourself and make exercise a healthy habit, not an obsessive one. If you don't take this advice, you will start to develop chronic injuries or just get burned out and stop working out, which is not what your exercise program was designed to achieve.
Start Off Right
And let's not forget about the right and wrong way to exercise in general. As I mentioned earlier, exercise is an art form and since most of us have not taken the time to master the proper techniques, we should get some expert advice prior to working out. Most gyms have personal trainers who will give you a free consultation and show you some basic machines and correct postures. Your doctor can also be a good source of information, particularly if they specialize in exercise and rehabilitation protocols. After all, you wouldn't just jump into a pool and expect to start swimming, right? Learn the right way to exercise from day one. When it comes to fitness goals, it isn't about how quickly you achieve them, because more often than not, going too quickly will end up being the slowest, most painful route. Exercise the right way, stay safe, and enjoy the journey.

4 Movements to Avoid When Exercising
  1. Using jerking motions, especially when lifting. Speed is fine when done appropriately, but you should always have fluid motion and proper form when performing any and all exercises; otherwise you could strain or even tear something.
  2. Using body parts not required for the exercise. Have you ever seen people doing biceps curls and rounding their shoulders or arching their backs? Those are just two of the big no-no's that can lead to injury.
  3. Locking out your knees or elbows. Never lock your joints when working out; keep them slightly bent so the weight will not be transferred to the joints.
  4. Arching your back. Picture someone on the barbell bench press, lifting a weight that is actually too heavy for them. Chances are that eventually, they will start arching their back. Sooner than later, that back is going to give out and they won't be able to exercise for days, weeks or even longer.

Tuesday, June 18, 2013

The Truth About Salt

So what's the deal with salt? You know you need some of it, but everywhere you see advertising and headlines telling you to eat less of it. You might have salt cravings but you feel guilty indulging in them because you've heard from everyone, the government to personal trainers to your mother-in-law, that salt is bad for you. The way headlines sound, you'd get the impression that eating a bag of chips will raise your blood pressure enough to have a stroke right then and there! I once had an 11-year old sit next to me, watch me salt my scrambled eggs and ask me if didn't I know that salt was bad for me! So let's see what's actually accurate amongst all the headlines, advertising, special interests, and advice.
Like all the topics I've written about, it's not that simple to say salt is "good" or bad". One thing to keep in mind is that salt is so vital for human health that "sal" is the basis of the word "salary" because people used to be paid in salt. Sodium and chloride are both vital minerals, used for nerve transmission/impulse conduction, fluid balance, and muscle contraction. Not having enough sodium will cause hyponatremia, a life-threatening condition that happens when someone sweats out too much sodium, or drinks too much water, and upsets the fluid balance.
Salt is a prime determinant for taste in food (along with fat) and 80% of the salt we consume is in processed foods, making it difficult to avoid. The message promoted by both the National Heart, Lung, and Blood Institute (NHLBI) and the National High Blood Pressure Education Program (NHBPEP), a coalition of 36 medical organizations and six federal agencies is that everyone, not just people will hypertension, would benefit from a daily intake of 2400 mg or sodium (6 grams of salt, or about 1 teaspoon) per day, which is 4 grams less than our current average. The problem lies in the fact that the research does not conclusively show that a reduction helps with blood pressure and actually shows that low levels could lead to health problems. "You can say without any shadow of a doubt," says Drummond Rennie, a JAMA editor and a physiologist at the University of California, "that the NHLBI has made a commitment to salt education that goes way beyond the scientific facts."
salt One of the first studies that showed how diet lowered blood pressure was a Duke University clinician who, in the 1940's, showed he could successfully treat hypertension with a low-salt, peaches-and-rice diet. If patients' hypertension didn't improve, Kempner said it showed, protestations notwithstanding, that the patient had clearly fallen off the diet. It was cited for decades as evidence that low sodium diets could treat hypertension, but there are a couple of very large problems that were conveniently overlooked — Kempner's diet was also low in calories and fat, as well as high in potassium, and those are all factors that are also known to lower blood pressure.
A major problem with some of the biggest studies involving salt are that they are epidemiological studies, which are known for showing a correlation and not actual causality. As I mentioned in my article "That Study Is Wrong: The Truth About Research", epidemiologists even suspect their own studies and call it a "pseudoscience". In this particular field, it would be fair to say that there is so much bias that researchers will not consider research that doesn't support their own position, and combined with the tendency to cite research, accurate or not, creates a case that looks as if a position has more "evidence" than it actually does. For example (and there are many), in 1991, a 14-page epidemiological study was printed in the British Journal of Medicine, concluding that the salt-hypertension link was "substantially larger" than previously thought. That same year, researcher John Swales, former director of research and development for Britain's National Health Service, dissected the study so completely that no one at the European Society for Hypertension's conference was left unclear by how shoddy the research was. And yet 2 years later, that same paper was cited repeatedly by the U.S. NHBPEP as compelling evidence to reduce sodium intake. In fact, Swales repeats this thought in a paper in 2000, saying, "Reviews biased by the inclusion of nonrandomized studies exaggerate the apparent blood pressure fall… Nevertheless, citation analysis shows that they are quoted much more frequently than rigorous reviews reaching more negative conclusions. This appears to be the result of an attempt to create an impression of scientific consensus."
Here's the first thing: there ARE some people for whom salt it problematic, but there is no test for "salt sensitivity" and even the condition itself is not fully clarified. It may be related to race (one study saw an association with African-Americans), or gender, or age, as well as a possible genetic link. However, because you cannot predict who is salt-sensitive, we're left with creating generalized recommendations that may not actually benefit sensitive individuals, but may also harm the rest of the population.
So how does lowering salt intake cause harm? Let us count the ways, starting with cardiovascular disease. While hypertension is often blamed as a cause for heart disease, low sodium has been directly linked multiple times to increased cardiovascular deaths, and another 2011 study confirmed this. In fact, this last study also saw that sodium levels didn't predict hypertension, and that any association between blood pressure and sodium didn't actually translate into less morbidity or better survival.
Low salt diets also increase cholesterol and triglycerides in the blood. In fact, people with Type 2 diabetes are more likely to die prematurely on a low-salt diet, due to cardiovascular disease. A Harvard study showed that low-salt diets were linked to an immediate onset of insulin resistance. And yet doctors are consistently recommending salt restriction diets to diabetics.
In studies with the elderly, sodium restriction can be especially damaging. It has been shown that low salt intake leads to more falls and broken hips, and decreased cognitive abilities. Hyponatremia (too low sodium) is commonly found in geriatric patients , and yet it is repeated ad nauseum that older people should be lowering their salt intake.
You may not realize this, but this is not necessarily new information. There have been articles in the New York Times about the dangers of low salt intake and the research supporting it in 2010 and again in 2013.
Sodium intake hasn't changed much in decades, and that certainly seems to stand true in research: in studies measuring urinary sodium excretion, spanning 5 decades, over 30 countries, and over 50,000 subjects, the normal range of sodium excretion is 3,500 mg/day. This last study also points out that renin-angiotensin-aldosterone system (RAAS) is a protective mechanism to PREVENT the loss of sodium. As sodium is clearly the backbone of extracellular fluid, ensures adequate blood volume, arterial pressure and ultimately organ perfusion, to make recommendations below 2760 mg/d (which activates the RAAS reaction) assumes that basic biology is being ignored, and that lowered intakes are not harmful (and clearly there is plenty of research showing this). McCarron et al. (2009) saw in this 26-year study that since sodium can't be stored, it is tightly regulated by the body, regardless of how much is in the diet, and "that public health initiatives designed to lower intakes of this nutrient by altering the food supply are destined to fail."
What IS true is that little to no distinction is being made between the salt in processed foods and what is found naturally in fresh foods or what you might add at the table. The main sources of sodium in the U.S. diet are grain mixtures (mainly pasta, breads and rolls), and processed meats like frankfurters, sausages and lunch meats. This would be why the famous DASH diet (Dietary Approaches to Stop Hypertension) with it's emphasis on generous amounts of fresh fruit, vegetables and dairy is effective for lowering blood pressure — it is simply removing most sources of processed foods. It's also considered by many to be a preferable alternative to across-the-board sodium restriction.
Which is also exactly what is seen in research — studies that looked at fresh food, cooked at home, (with salt added for flavor) saw no impact on blood pressure but people who ate out frequently, and ate processed foods regularly had a much higher incidence of hypertension. If hypertension is a concern, it would be good to also boost potassium, as inadequate potassium will still cause hypertension, even if eating a low-sodium diet. Potassium is so available in foods that you can't really get it as a supplement — and, you guessed it, it's highest in fresh foods like leafy greens, bananas, avocados, melons, mango and prunes. Additionally, weight loss and reduction of alcohol intake are known to be extremely effective at reducing blood pressure.
The current U.S. recommendations are 2,300 mg/day. The American Heart Association would prefer that everyone consume as little as 1,500 mg/day, clinging to antiquated research long since disproven. In fact, in light of the overwhelming evidence, the Department of Health and Human Services will be revising the sodium guidelines in 2015. In the meantime, bring back your common sense about food, and avoid "quick fixes" with store-bought food and eat as much fresh food and food that YOU prepared as often as you can. And hand this article to your mother-in-law the next time she makes a comment as you are salting your eggs!

Wednesday, June 5, 2013

Stress and Back Pain: The Link

Stress is a part of life, and so is back pain. Ironically, stress is a leading cause of episodic back pain. Your body experiences a cascade of physiological responses during chronic stress setting the stage for injury. The human body is genetically programmed to respond to stressful situations by stimulation in a survival part of your brain known as the limbic system. Otherwise known as the reptilian or primal brain, it is responsible for the emotional "flight or fight" (run or stand and fight) response to negative stimuli. Your brain response functions the same in stressful situations regardless of the source and extent of the threatening stimuli. The limbic brain does not recognize differences between types and degrees of stress. It simply reacts. Your body releases hormones (chemical messengers) which cause a physical reaction to stress; shortness of breath, sweating, increased heart rate, muscle tension, tightness or stiffness in joints, etc., in preparation for survival reaction. So whether you are about to be chased by a rabid dog, cut off in traffic, or had a tough day at work the same response occurs. The same negative physical impact also occurs on the body. There are several different types of stress and learning how to control them can make all the difference. You have physical stress (lack of exercise, illness, sleep habits, etc), mental stress (how you deal emotionally with life) and chemical stress (nutritional and environmental).
Stress and Back Pain Stress alters breathing patterns by causing you to breathe more from the chest/lungs than the diaphragm. This altered pattern increases tension in the neck and upper back leading to poor posture, muscle tightness and headaches. The diaphragm is a dome shaped muscle that sits in the lower part of the ribcage underneath the lungs. Optimal breathing patterns should occur from the diaphragm first, followed by the lungs. Most often people have dysfunctional patterns where this sequence is reversed. Breathing is the foundation for relaxation. Learn to control your breathing and you will have discovered a secret weapon of relaxation and stress reduction. To check your breathing pattern lie on your back with knees bent. Close your eyes and place one hand on your abdomen and the other on your chest. Take a deep breath in through your nose. The lower hand should move first and the upper hand second. If the upper hand moves first you have an altered breathing pattern. Luckily it is fairly easy to learn how to breathe again properly. In our quick tip help guide below you will learn how to restore normal breathing patterns.
Stress increases tension in the body 24/7. It is like flipping the light switch on for self- protection, muscle tension and tightness. Think about how stiff and tight you feel when walking across ice. Your body tenses up in anticipation of falling and is trying to protect you from injury. Imagine how your muscles would feel if you were in this constant state of tension for weeks at a time. It would not feel good! That is what chronic stress is doing. Stress increases production of specific hormones known as cortisol and adrenaline located in the adrenal glands. These are two small glands that rest on top of the kidneys, one on either side. Cortisol is nicknamed the "stress hormone" and it can cause many negative reactions in the body if it is unbalanced. Chronically elevated levels of cortisol and adrenaline will cause increased inflammation in the body. In essence, your own body begins to turn on itself.
So what are some simple and effective tips you can start doing today to help alleviate stress? Below are suggestions for helping physical, mental and environmental stress in your life.
Nutrition: Eat healthy and eat often to control blood sugar levels. When you wait long periods between meals, you have a spike of a hormone known as insulin. This hormone controls how fast sugar enters your bloodstream after eating. Big surges in insulin occur when you wait too long between meals which may increase stress on your body chemistry. You can get cravings and mood swings. Eating only three meals a day is insufficient in keeping this delicate balance of hormones in check. It is recommended to eat three meals a day, mixed in with 2-3 healthy snacks. You will notice a renewed sense of energy and vitality with regular feedings.
Mental: Take some "me" time every morning before you start the day. Use this time to reflect on yesterday and plan out today's events. With the craziness of non-stop information overload in today's society it's more important than ever to take quiet moments. Set your alarm 15-minutes early and wake up to silence. Do not turn on the television or open the newspaper. You may find that problems which have plagued you suddenly become more manageable and put into perspective. When was the last time you sat in a room without white noise all around? Try it and see what happens.
Physical: Learning how to breathe with your diaphragm takes some practice, but in time it will become second nature. Practice the following technique on a daily basis for 3-5minutes. Lie on your back, putting a pillow support under your knees to relax your lower back. Place one hand on your abdomen and the other on your chest. Slowly inhale through your nose and make sure the only hand to move is the one on your abdomen. Try to keep the hand on your chest as still as possible. Exhale through pursed lips and repeat. You may become temporarily lightheaded after your first few, but this is a normal response to the increase in oxygen uptake by the body. Do this before bed time and you will have a more restful sleep leading increased recovery and regeneration.
You do have power over your body. Simple changes in your life to help reduce stress can have a profound impact on your health. Take back control of your life from pain. Empower yourself to feel good again mentally and physically. Start with the simple strategies above and when you feel the positive difference you will want more for yourself.
To decrease the stress in your life, you can always talk to me about your concerns.

Wednesday, May 29, 2013

When Technology Causes Pain

It's all parents can do these days to keep their overstimulated, technology-crazed children from spending all day on their smartphones, laptops, tablets and video game consoles. While technology continues to improve our lives in many ways, not the least of which is our ability to access information – a good thing when raising our children, if appropriately managed – a major drawback of the same technology is repetitive-stress injuries. Hour after endless hour typing, texting and scrolling can put the arms and wrists in particular at risk for injury; not to mention how poor posture caused by hunching over a keyboard or peering into a tiny screen can impact the back, neck and shoulders.
Case in point: A recent study of teens (12-16 years old) found that "compared with those using the computer less than 3.6 hours / week, computer use of ≥ 14 hours / week was associated with moderate/severe increase in computer-associated musculoskeletal pain at all anatomic sites, and moderate / severe inconvenience to everyday life due to low back and head pain."
health alert You might think that 14 hours a week or more of computer use is a little extreme, but not if you consider that's only two hours a day. Teens in particular likely spend that much, if not much more, on a computer every day, whether doing homework or browsing the Internet.
Solving the problem involves several strategies:
  • Limit screen time whenever possible, or at least limit the amount of time your teen spends on the computer at any given stretch.
  • Speaking of stretching, teach them to take breaks every 1/2 hour or so to stretch and ensure they haven't been sitting in one position for too long.
  • Talk to your doctor of chiropractic about the best ways to minimize injury risk. Your chiropractor can give you and your teen advice on proper posture and other tips for avoiding pain in the Age of Technology.

Tuesday, May 7, 2013

Spring Into Action: Clean Out the Pantry

Most of us think of our closets when we talk about spring cleaning. But what about our pantry and fridge? Because our diet can drastically change from winter time into the warmer months, cleaning out our pantry and fridge during springtime is a good habit to pick up.
The key things to think about for a fridge and pantry clean up are your health goals. Is your blood sugar or cholesterol too high? Do you have food sensitivities or allergies that require abstinence from certain foods? Do you have a few pounds you'd like to loose?
Once you've established your health goals, then it's a good time to start looking through your cupboards and refrigerator. There are general categories of foods that you should throw out and there are typical foods that you should make sure you keep well-stocked in your fridge and pantry. Let's start with what to throw out.
These are the typical categories of foods to toss out:
  1. Frozen pre-made desserts like ice cream, popsicles, and cakes
  2. Processed, pre-packaged foods
  3. Sugar or sugar substitutes
  4. Diet or regular soda
  5. Cookies and chips
  6. Pre-made processed sauces or dressings
spring cleaning Basically, I want you to throw out the processed foods in your fridge and pantry…even the ones labeled 'low calorie' or '100 calorie' type packs or snacks.
In general, processed foods worsen cholesterol, sugars and weight. They also are typically chock full of typical food sensitivities or allergens. So, even if you're not sure what you are sensitive to, these processed foods won't be making your weight, health, or intestinal tract very happy.
The typical things you should keep in your fridge and pantry are:
  1. A variety of rainbow-colored vegetables (frozen is fine and potentially more cost-effective as long as they are not frozen with sauces already drenched on them)
  2. Organic white meat of chicken or turkey
  3. Wild fish
  4. Raw nuts
  5. Sparkling or still water (you can keep fresh lemon or lime around to add natural flavors to water)
  6. Organic teas
  7. If you must have red meat, such as if you are iron deficient, you should aim for bison meat over beef since it is lower in saturated fats
  8. Legumes
  9. Quinoa or faro
  10. Crudité and hummus dips
  11. Balsalmic vinegar and olive oil with spices to make your own dressings
  12. Fresh popcorn made yourself (no prepackaged popcorn)
  13. If you must have something sweet, you can make fresh juices from fruits and freeze them for popsicles
  14. Agave nectar and stevia are better sweet substitutes
These are just some ideas to get you started. But if you'll notice, the key difference is that I want real foods made by Mother Nature in your fridge and pantry. Many of these foods are easy to grab and eat just as they are without a lot of prep time. So, throw out those pre-packaged processed foods and put in your life these wholesome foods that Mother Nature meant for you to eat…if you do, you'll be seeing a healthier, slimmer you by the summer!

Wednesday, April 24, 2013

Make Shape-Up Simple: 3 Invigorating Exercises

It's late April, months since you dedicated yourself to those New Year's resolutions, one of which was to get off the couch and get into the best shape of your life. So, how are you doing four months into 2013? Chances are you're like too many other resolvers who gave it their "best" shot for a few weeks in January, then hit a stumbling block and decided 2014 sounded like a better starting point.
Don't waste a whole year when a new body, a new attitude – a new you – is closer than you think. Get ready for summer fun and beyond with these three invigorating exercises you can do today (at least three times a week is even better!):
1. Burpees: Technically this exercise is called the squat thrust, but you'll remember it by it's common name – and by the fact that it's not just for the lower body; you'll get great full-body results from performing this four-part exercise. From a standing position, drop quickly into a squat position, hands on the ground. Then extend your feet back in one motion (essentially a push-up or plank position). You can do a push-up here first; otherwise, return to the squat position in one quick motion, then it's back to the standing position. To challenge yourself, you can also jump as high as possible, arms outstretched, at the end of each burpee (when returning to the standing position). Try to do as many as you can, building to sets of 15-20 with minimal rest in between sets.
exercise 2. Sprinting in Place: This is a basic exercise that yields big benefits, and you can do it just about anywhere. With arms and knees slightly bent, back neutral (don't round your low back or shoulders), run in place as fast as you can for 20 seconds. Stop for 10 seconds max., then repeat. Make sure you're keeping your knees bent and are using your arms during the movement. You're working not only your calves, hamstrings and glutes, but also your triceps and biceps. Feeling brave? Then alternate 20-second sprints with 20 seconds of jump rope or push-ups (see below) to get a true full-body workout.
3. Push-Up Variations: Everyone knows how to do a push-up, right? Well, try one of these fun, challenging variations: 1) Every time you lower your chest toward the floor, bend one knee up toward that side of your body. Alternate knees / sides every push-up (do each repetition slowly at first until you get the hang of it.) Maintain form throughout, making sure not to bend your back or put too much weight on your shoulders. You'll get a chest / upper-body workout and a core-tightening, ab-crunching, glute-toning workout at the same time. 2) Set the timer on your smartphone or watch for 3 minutes. Your goal is to do as many push-ups as possible before the clock runs out. You choose the strategy, including how many to do for your first set, how long a break to take between sets, etc. But watch out: You'll find yourself fatiguing quickly after that first set!

Wednesday, April 10, 2013

5 Ways to Survive the Worst Allergy Season Ever

Spring is in the air – literally, in the form of massive pollen levels that are causing an historic spike in cases of seasonal allergy, also known as allergic rhinitis. In fact, health experts are calling this the worst allergy season on record, which means the tactics you overlooked last year to survive the sneezing, coughing, runny nose, itchy eyes and various other symptoms may require real attention this time around. Bad news for spring-lovers who can't wait to emerge from their winter cocoons and enjoy the outdoors. After all, who wants to smell the flowers when doing so causes you to feel miserable?
If you're an allergy sufferer who's used to "getting away" with minimal attention to allergy avoidance, this is definitely not the year to push the envelope. With an early spring and record pollen levels, you could be asking for trouble – big trouble. Here are five ways to minimize your risk of succumbing to seasonal allergies this year:
1. Pick your spots: One of the best ways to minimize your exposure to allergens such as pollen is to make smart choices. For example, pollen levels tend to be highest in the morning or when it hasn't rained in awhile. And let's not get started on wind, which can not only circulate pollen, but also tends to cause allergy-like symptoms – a bad combination that can ruin your day.
allergy season 2. Keep it out: Unless you've got a garden in your living room, the good news about pollen is that it's outside, which means you can take a few simple steps to keep it there. For starters, keep windows closed whenever possible (especially if it's windy). If you've been out, change your clothes once you get in the house, and try not to repeat-wear clothing. If it's been a particularly bad day in terms of pollen and/or you've spent most or all of the day outdoors, you may want to throw your clothes directly into the washer. And speaking of that garden in your living room, avoid bringing flowers into the house – unless putting a romantic gesture on display is worth the allergy symptoms that may accompany it.
3. Seek shade: The eyes are often the hardest hit by allergy symptoms. No one wants to spend their day rubbing watery, itchy, dry, red eyes, and trust us, it doesn't look good when you're making that big presentation in the boardroom. Two tips: 1) Wear sunglasses whenever you're outside during allergy season. (This is also a good idea because with spring comes sunnier skies, putting your eyes at risk for sun damage if they aren't protected.) 2) Carry saline drops to keep your eyes moist throughout the day, which will help when pollen, dust, etc., inevitably attack your field of vision.
4. Clean up: It's amazing how many health issues can be minimized with the simple act of washing your hands, and when it comes to seasonal allergies, it's a great recommendation. During allergy season, it becomes even more important because pollen and other irritants transfer easily from your hands to your face / mouth if you're not careful (much like germs that cause the common cold).
5. Eat smart: Research suggests vitamin C, which is found in a variety of fruits and vegetables, in addition to being available in supplement form, provides an antihistamine benefit that may help minimize allergy symptoms. (Histamine is released from cells as part of an allergic reaction.) Probiotics or "healthy bacteria," found in yogurt and increasingly added to a number of food products, also may reduce allergic symptoms caused by exposure to pollen. And don't forget that in general, a balanced diet high in antioxidants and other immune-boosting compounds helps your body defend whenever it's attacked – even by allergens.

Wednesday, March 27, 2013

Bed Rest for Your Back Pain? Not the Best Idea...

Upwards of 80 percent of adults suffer at least one episode of back pain in their lifetime, which means you've already felt the pain, are feeling it now or will feel it before you know it. And chances are good that, like so many others, your first thought will be to get off your feet, lie down and rest. Unfortunately, evidence suggests that unless the pain is severe or accompanied by other symptoms, such as pain radiating down the legs, rest is exactly the opposite strategy if you're trying to relieve your back pain.
If you're suffering from back pain, staying active is an important piece of advice to follow in the majority of cases. That means avoiding bed rest, prolonged stretches of sitting, standing or inactivity; and doing all the things you usually do, within reason (no heavy lifting or intense physical activity, including twisting or other dramatic movements that could make the pain worse).
While it may sound counterintuitive, abundant research suggests activity can help reduce the pain and shorten recovery time in most cases of noncomplicated back pain. In fact, one study that summarized findings from an international task force on back pain stated, among other findings / recommendations: 1) bed rest is contraindicated in subacute and chronic cases of low back pain; in acute cases, bed rest should neither be enforced nor prescribed; and if authorized (based on pain indication), bed rest should be for the shortest duration possible.
power walk The theory is relatively simple, if you think about it: Inactivity can make your spine and back muscles tight and stiff, increasing the pain, particularly when you bend or stretch. Prolonged inactivity can also make you weaker, not to mention that evidence suggests the longer you stay in bed with pain, the more likely that your pain will become chronic / more disabling, often because you avoid moving for fear it will exacerbate the pain.
Of course, the first step when suffering back pain is to make a visit with a health care provider who can evaluate your pain, make sure there's nothing more serious going on, and then offer treatment and self-care recommendations (including activity) to help relieve it. Enter your doctor of chiropractic, the experts in treating spinal pain.

Wednesday, March 13, 2013

Another Reason To Avoid Epidural Injections

Another Reason to Avoid Epidural Steroids

While the uproar surrounding tainted steroid injections causing fungal meningitis has left the mainstream news after months on the front pages, hundreds of reported illnesses and far too many deaths, it's high time for a reminder of why epidural steroids – tainted or not – shouldn't be so commonly prescribed for back pain. According to a study in the research journal Spine, which compared spine patients who received epidural injections to patients who did not receive injections, steroids "were associated with significantly less improvement at 4 years among all patients with spinal stenosis."
In other words, patients who received the injections were in worse shape after four years than patients who did not receive injections – regardless of whether either type of patient ultimately underwent surgery to "relieve" their pain. Not exactly an endorsement of epidural steroid injections or surgery. What's more, patients in both groups had similar initial symptoms / pain scores, dispelling the notion that patients who received injections had worse initial pain or a worse condition than non-injected patients.
Epidural Steroids Spinal stenosis is a narrowing of the open spaces in the spine. As you might expect, this can put pressure on the spinal cord and nerves, leading to neck or back pain. It is most commonly caused by wear and tear over time, which puts you at higher risk as you get older (particularly over age 50 or so).
Spinal stenosis and other conditions that cause back pain and related symptoms often don't require medication, injections or surgery. Your doctor of chiropractic is an ideal health care provider to visit first if you're suffering from back pain, particularly since research suggests your odds of undergoing spine surgery are much lower if your initial health care provider is a chiropractor versus a spine surgeon.

Thursday, March 7, 2013

Dr. Gene A. Bergmann, Chiropractor

"The Back and Neck Pain Relief Doctor"

109 N Vermont Ave.
Glendora, CA 91741

(626) 914-2359

Web Site 

Why We Are Fat, and What Can Be Done About It

You know you've done it — seen someone morbidly obese and thought to yourself, "Why couldn't they just control themselves?" or stood in the supermarket, comparing people's carts to how they look, or any other myriad of judgments we have when we see someone who is overweight. Many of us have this overly simplified view that it's just a matter of exercising more and eating less, that it's the First Law of Thermodynamics with it's "calories-in-calories-out" model. I'm here to tell you that you couldn't be more wrong.
"But it's the fault of the fast food restaurants!" people cry out. Soda! Larger portions! High fructose corn syrup! Yes, that's all true. It's also because we spend more time in front of computers with less exercise, we eat out more, and we eat more processed food, right? There are a lot of reasons, and many of them are reasonably accurate. But there's a bit more to the picture than you realize.
Let's start with some basics, and ones that are irreconcilable truths. The first one is, our systems are designed for times of feasting and times of starvation. There is no getting around that. Remove those periods of starvation, and our systems start to break down with the caloric overload. And once our systems are broken, it can be nearly impossible to get them completely "fixed". The other fact is that there are a lot of weird "things" in our environment nowadays that our system doesn't know how to handle, and those molecules are causing changes from the genetic level on up (that's what the study of epigenetics looks at — the impact of "foreign" molecules on cellular processes). Bring those two pieces together and we have a virtual tidal wave of obesity, and no way to turn it around.
fat person Most people know that, at some point, calories DO count. The problem is (and Weight Watchers has finally realized this) that a calorie is not just a calorie. A carbohydrate calorie, for example, comes with insulin (which, when present in the blood stream, completely prevents you from burning fat). If you eat too much protein, your body will turn it into fat as well. And not all fats are calorie-bombs that make you fat: coconut oil and it's medium and short-chain fatty acids gets burned in your body as quickly as carbohydrates and won't turn into fat. So the model of "calories-in-calories-out" isn't fully accurate because you are not a furnace. Calories count, sort of, but not totally.
Then there's the low-carb movement, of which I am a proponent. I made a very popular video about blood sugar and how we progress to diabetes on YouTube ( but it basically comes down to this: we were given a certain amount of "points" for carbs in our lifetime, and most people have used those "points" up by the time they're 30 years old. Which means that after that, carb intake starts to cause biochemical breakdowns, insulin resistance, hormonal imbalances, and all the problems that are associated with too much insulin and too much glucose in the body. This is a big foundation for our practice, and, without question, can improve a lot of symptoms that people struggle with, as well as reverse blood sugar imbalances. And yet, that's not the whole problem either. So what else is "broken" that is contributing to our obesity problem?
Sometimes it's an easy change — the way most people exercise, for example, is often not helping them lose weight. Studies have consistently shown that the 45-60 minute cardio session people are doing simply makes them hungrier, and they end up eating more. Spending 30 minutes walking, for example, is definitely better than nothing, but your body gets accustomed to easy exercise like that. On the flip side, high intensity exercise done over a longer time (think spin classes) can increase inflammation which then contributes to weight gain (or, at least, inhibits weight loss). Exercise, without question, is beneficial in many, many ways, and we are large proponents of varying forms of exercise, but if you think it's going to help you with weight loss, well… just check out all the overweight people training for marathons. You can't tell me they need more exercise!
Here's a crazy one you might not have heard: did you know that if you have the wrong type of gut bacteria, those bacteria can cause weight gain? In studies done with morbidly obese people, it was observed that certain strains of bacteria more efficiently extracted calories and nutrition out of food than others. , It just depends on what combination of gut flora you have — that same handful of crackers you eat may or may not have the same caloric impact on the next person. And how do we have such wildly differing gut bacteria? Well, the average child, by the time they start school, has had 20 different antibiotic prescriptions. How many have you had over your lifetime?
Which brings us to the direct impact of antibiotics on obesity. This research study bluntly said, "…both antibiotics and probiotics, which modify the gut microbiota, can act as growth promoters, increasing the size and weight of animals. The current obesity pandemic may be caused, in part, by antibiotic treatments or colonization by probiotic bacteria." That's right — conventionally raised animals are treated with antibiotics AND probiotics so that they gain weight. In fact, these researchers pointed out that conventionally-raised feed-lot animals are treated with antibiotics and probiotics to cause weight gain and they wanted to see if short-term antibiotic treatment to humans, given after endocarditis, caused weight gain (it did). Another reason to buy grass-fed beef and pasture-raised chickens.
Of course, there is always the issue of hormones. About 10% of the population has hypothyroidism and that's always an area to check when working with weight gain. But why is there such an epidemic of hypothyroidism? Is it the lack of iodine in the diet? High stress (the stress hormone cortisol inhibits T3)? High estrogen levels (often from insulin resistance, and estrogen inhibits T3 as well)? Fat cells actually make their own estrogen, so take a look around you and think about how much estrogen might be in someone's system. Or what about xenoestrogens — chemicals that act like estrogen in the body? They also will contribute to obesity. What about adrenal disorders like Cushing's? It's rare, but imagine if all of a sudden you started gaining weight, and yet people told you it's because you were eating too much. And then it took the doctors years to figure out you had a hormonal problem like Cushing's. Yes, you'd feel hopeless too. You are probably starting to see that these hormonal issues don't stand by themselves, but can be interwoven with other hormonal problems or other issues altogether.
What about the metabolic damage that comes with a history of dieting? Yo-yo dieting (which, for most people, happens over years) severely stresses the thyroid. When caloric intake is low, the metabolism slows down, and it ultimately starts to stay low. So if you have patients who have a history like this, they may always struggle with weight, even if they are doing all the right things.
Then there's stress. Muffin top is a common complaint for many people, but what most people don't realize is that the stress hormone cortisol is responsible for that central obesity. And stress looks very different than most people think it does. I will talk to many of my patients about carbs, and they will lose weight around their middle when they change their diet, but that's because a high-carb diet is stressful for the body. Stress isn't just your job, or how you react to situations — it's also how much sleep you get, because not enough sleep is an independent risk factor for obesity. , It's how much inflammation you have, whether it's from chronic pain, unknown food intolerances, intestinal permeability, allergies, low-level sinus infections that you know (or don't know) you have, teeth and mouth problems like gingivitis or untreated periodontal disease, over-exercising… the list goes on and on. This is probably the biggest area that people don't deal with, because many of them don't realize the impact or the need to change.
Wait! We're not done yet! Let's look at the issues with chemicals that are KNOWN to cause health and weight issues — polychlorinated biphenyl (PCB's), dichlorodiphenyltrichloroethane (DDT), and Bisphenol A (BPA). While PCB's and DDT are, thankfully, a bit more limited in society now, the prevalence of BPA and its health risks should shock you. BPA has been directly linked to obesity , , hormone disruptions , and increased risk of cancer, especially breast cancer . While it only take about 3 days to clear from the body, the problem lies in our continuous exposure to it, as it's found in most plastics (like those disposable water bottles, take-out containers, plastic wrap, food storage containers), as well as food and soda cans. When you microwave in plastic, or put hot food in plastic containers, or drink water in containers that were exposed to heat (think about how those cases of water are shipped in trucks) you begin to get a sense of where you ingest it. Even worse, it's found in credit card receipt paper and other thermal papers. In fact, paper money also carries BPA from rubbing up against it in your wallet. And the most vulnerable victims are children and babies, as their immature livers cannot process this chemical to clear the body as well as adults.
What about prescribed medications? Entire classes of drugs are known to cause weight gain and ironically, one class of them is anti-depressants. Tricyclic antidepressants (TCA's), selective serotonin reuptake inhibitors (SSRI's), and monamine oxidase inhibors (MAOI's) all have been known to increase weight in at least 25% of people taking them. Of course birth control pills are known to cause weight gain, beta blockers, and, of course, steroids, will also increase weight. And, according the CDC, 22% of children are on prescription meds, 30% of teenagers, 88% of people over 60 years old are on at least one medication, and one-third of them are on five or more. If you are 20 to 59 and are on a medication, statistically it's probably an anti-depressant.
Can you start to see how some of these things tie together? Like antibiotic use damaging the gut biome, causing intestinal permeability, resulting in the body reacting to food proteins that should have stayed in the gut, causing inflammation around the body. Here's another example: high-carb intake causing insulin resistance, in turn causing high estrogen (which just by itself causes weight gain — why do you think they inject estrogen into cattle?), which then interferes with thyroid function. Or someone is on a prescription med, doesn't eat ideally, and then has an injury that prevents exercise. And we look at them and think it's that they're undisciplined and lazy.
Then, of course, there are factors like Vitamin D levels contributing to obesity, leptin resistance causing people to never feel full, and how diet sodas increase obesity even more than regular sodas. And naturally, people are quick to say that obesity can be genetic, but you want to think about that: have our genes really changed in the last 25 years? No, they have not, but a lot of other things have. Put all of these factors together in some combination, add in the cultural pulls we have in TV commercials, that we have the cheapest food in the world (literally and nutritionally), a subsidized farming culture, food marketing to children, and a plethora of other factors, and you can see that it's simply wildly inaccurate (not to mention statistically ineffective) to tell people to count their calories and exercise more.
So what SHOULD people do? Well, no matter what, sugar and insulin cause huge amounts of damage so people should manage their carb intake. People should do short, intense exercise, like intervals. All the different elements that affect stress need to be looked at and addressed, including finding hidden infections, coaching people on lifestyle practices, and supporting adrenal health. Proper thyroid panels need to be run (TSH is not enough), training people to not automatically get antibiotics, learning how to repair gut flora… yes, there are many avenues to work with, but hopefully this has opened your eyes to the complexity of the situation, and you can begin to unravel this tangle for people. Believe me, they will be beyond grateful.