1.) Women have a better sense of smell than men. 2.) When you take a step, you use up to 200 muscles. 3.) Your ears secrete more earwax when you are afraid than when you aren’t. 4.) The human brain has the capacity to store everything you experience. 5.) It takes twice as long to lose new muscle if you stop working out than it did to gain it. 6.) The average person’s skin weighs twice as much as their brain. 7.) Every year your body replaces 98% of your atoms. 8.) On average, there are 100 billion neurons in the human brain. 9.) The lifespan of a taste bud is ten days. 10.) Dentists recommend you keep your toothbrush at least 6 feet away from a toilet to avoid airborne particles caused by flushing. 11.) Your tongue is the only muscle in your body that is attached at only one end. 12.) Your stomach produces a new layer of mucus every two weeks so that it doesn’t digest itself. 13.) It takes about 20 seconds for a red blood cell to circle the whole body. 14.) The pupil of the eye expands as much as 45% when a person looks at something pleasing. 15.) Your heart rate can rise as much as 30% during a yawn. 16.) Your heart pumps about 2,000 gallons of blood each day. 17.) Your heart beats over 100,000 times a day. 18.) Your hair grows faster in the morning than at any other time of day. 19.) Your body is creating and killing 15 million red blood cells per second. 20.) You’re born with 300 bones, but when you reach adulthood, you only have 206!
Whiplash and Memory Impairment
23 AprIn addition to neck pain and stiffness, individuals who experience sudden acceleration
and deceleration of the head and neck—such as during a whiplash injury—may also develop
symptoms more commonly associated with brain injury, including memory impairment. These
cognitive symptoms can persist for a year or more in some patients and may significantly affect
daily functioning, including the ability to attend school or pursue a career. Why can memory
impairment occur in patients with whiplash-associated disorders (WAD), and is it possible to
reduce the risk of long-term problems following an automobile collision?
It’s important to understand that the brain does not rest directly against the inside of the
bony skull. Instead, it is supported by protective layers called the meninges and cushioned by
cerebrospinal fluid. This arrangement allows the brain to tolerate normal movement while also
offering limited protection during minor impacts. However, during a whiplash event, the rapid
forces placed on the body can cause the brain to continue moving within the skull as the head
and skull are suddenly pushed in the opposite direction. As a result, the brain may sustain strain
or injury to key structures involved in memory formation and storage, even if the head does not
directly strike an object.
Researchers have also proposed that memory impairment in patients with WAD may not
always stem from structural injury within the brain itself. In some cases, cognitive symptoms
may be influenced by pain-related interference with normal brain function. Persistent pain
signals from injured tissues—often in the cervical spine—can affect attention, concentration, and
memory. Encouragingly, studies have observed that cognitive symptoms in some patients
improve as neck pain and soft-tissue injuries recover.
To facilitate recovery, it’s important for treatment to begin soon after injury—ideally
within a few days, or immediately if symptoms are severe or there is concern for serious injury.
Research suggests that early, active management (preferably within 96 hours) is associated with
better outcomes than delaying care for several weeks. Chiropractic management of whiplashassociated disorders typically focuses on a combination of manual therapies, therapeutic
modalities, targeted exercises, and patient education. The goals are to restore normal motion to
injured tissues, reduce pain, and encourage patients to remain active within comfortable limits
while avoiding excessive fear-based activity restriction, which can increase the risk for chronic
symptoms.
If memory impairment is present and does not improve over time, referral to appropriate
specialists—such as a neuropsychologist or cognitive behavioral therapist—may be
recommended as part of a comprehensive care approach.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
Wrist Tendonitis vs. Carpal Tunnel Syndrome
16 AprWhen an individual experiences symptoms like pain, numbness, tingling, and weakness in the thumb,
index finger, middle finger, thumb-side of the ring finger, and part of the palm, the first thought may be carpal
tunnel syndrome. While it’s the most common peripheral neuropathy, other conditions with overlapping
symptoms must be ruled out during the initial physical examination. One potential contributing cause of carpal
tunnel-like symptoms is cervical radiculopathy.
Five nerve roots exit the lower cervical spine and combine into a structure called the brachial plexus,
from which the median nerve emerges and continues down the arm to supply sensation and muscle function to
part of the hand. Compression or irritation of several of these nerve roots—most commonly C6, C7, and C8—
can result in downstream symptoms in the arm and hand that closely resemble carpal tunnel syndrome.
In one study that included 866 patients with either suspected cervical radiculopathy or carpal tunnel
syndrome, researchers found that roughly one-in-four had both conditions. Another study examining patients
on a surgical waiting list for carpal tunnel release reported that a significant percentage also showed
degenerative changes in the cervical spine near the level where the C6 nerve root exits, suggesting that
coexisting neck pathology may contribute to hand symptoms in some cases.
If a patient presents with suspected carpal tunnel syndrome, how might their chiropractor determine if
cervical radiculopathy may be an underlying cause or contributing factor? First, the chiropractor will review
the patient’s intake history for clues such as whether hand symptoms flare during episodes of neck discomfort;
symptoms are felt anywhere between the neck and hand; numbness extends into the pinky or outer side of the
hand; certain neck positions worsen symptoms; if there’s coexisting neck pain or stiffness; if there is the
presence of headaches or shoulder blade pain; and if there is any history of neck trauma.
During the physical examination, several orthopedic and neurologic tests may be performed to
evaluate for possible cervical radiculopathy. These may include cervical distraction (gentle upward traction is
applied to the head to determine whether arm symptoms improve); the upper limb tension test (specific arm
and neck movements are used to reproduce or alter symptoms); and cervical range-of-motion testing to assess
whether certain neck movements, particularly at end range, provoke arm or hand symptoms. The chiropractor
may also assess deep tendon reflexes to identify asymmetries between sides; perform upper extremity strength
testing to evaluate for myotomal weakness; and conduct dermatomal sensory testing of the thumb (C6), middle
finger (C7), and pinky (C8) to determine whether sensory changes follow a cervical nerve root pattern rather
than an isolated median nerve distribution.
If cervical radiculopathy is identified as a contributing factor, treatment will focus on restoring normal
movement and function to the affected joints and surrounding tissues to relieve pressure on the involved nerve
roots. This may include manual therapies, therapeutic modalities, traction, nighttime bracing (when
appropriate), and specific exercises or stretches to perform between visits. Many patients experience
significant improvement with conservative care. However, if findings suggest a condition outside the
chiropractor’s scope of care or if more invasive treatment is required, referral to an appropriate medical
specialist will be recommended.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
Hip Pain Characteristics That Can Inform Diagnosis
9 AprThe hip is a ball-and-socket joint in which the femoral head meets the pelvis, supported by
several layers of cartilage and other soft tissues that allow for a wide range of motion. While this
design provides mobility, it also creates multiple opportunities for instability and irritation that can
result in what is generally referred to as hip pain. However, there are many potential causes of hip
pain, and the specific characteristics of a patient’s symptoms can help guide the healthcare
provider—such as a doctor of chiropractic—on what to evaluate during the physical examination.
Anterior (front) hip pain may suggest osteoarthritis, particularly in middle-aged and older
individuals with gradual symptom onset and pain that increases after prolonged sitting or walking. In
contrast, younger and more athletic adults who present with groin pain that worsens during hip
flexion and rotation may have femoroacetabular impingement or a labral tear. Sport collisions or
other forms of trauma can also result in hip flexor muscle strains that produce pain in the front of the
hip.
Lateral (side) hip pain is often associated with greater trochanteric pain syndrome, especially
in middle-aged women who report discomfort when lying on the affected side. In many cases, there
is no clear inciting injury, and the area may be painful or tender when touched or palpated.
Posterior (back) hip pain is less commonly due to a primary hip joint condition and is more
often referred from another structure. Potential sources include the lumbar spine, sacroiliac joint
dysfunction, deep gluteal syndrome (also known as piriformis syndrome), or strain or tendinopathy at
the proximal hamstring attachment.
Certain red-flag conditions require urgent referral to an emergency department or specialist.
These include femoral neck fracture—typically in older adults with osteoporosis or after a fall or
trauma—often presenting with inability to bear weight and a shortened, externally rotated leg; septic
arthritis, which may involve fever, severe joint pain with movement, and elevated inflammatory
markers on blood or joint fluid testing; and avascular necrosis, in which interruption of blood supply
to the femoral head causes bone tissue death, potentially leading to joint collapse, chronic pain, and
limited mobility (often requiring MRI for diagnosis).
The good news is that many causes of hip pain, aside from these red-flag conditions, respond
well to conservative chiropractic care. Treatment is often multimodal and may include a combination
of manual therapies such as manipulation, mobilization, and soft-tissue techniques; therapeutic
exercises and stretching; temporary activity modification followed by gradual return to normal
activities; physiotherapy modalities to support healing; and nutritional recommendations aimed at
reducing inflammation. If dysfunction in an adjacent area, such as the low back or knee, is
contributing to the hip condition, these regions may also need to be addressed to achieve the best
outcome
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
A Role for Chiropractic in Managing Chronic Rhinosinusitis
6 AprChronic rhinosinusitis is an inflammatory condition of the nasal and sinus lining that lasts
longer than twelve weeks. It’s estimated that roughly 10–12% of adults in the United States are living
with chronic rhinosinusitis at any given time, with many experiencing symptoms for years. Managing
the condition can be challenging, as it’s driven by a mix of contributing factors that may include
chronic inflammation of the sinus lining, immune dysregulation, lingering microbes, structural
factors, and environmental exposures such as air pollution and cigarette smoke. Because the
accumulation of fluid and inflammatory material in the sinuses is a key component of the disease
process, treatments that help facilitate drainage may provide symptom relief. To that extent, therapies
provided by doctors of chiropractic may have a role in caring for some patients with chronic
rhinosinusitis.
Manual therapies performed by chiropractors can help address fluid build-up both directly
and indirectly. Specific techniques such as lymphatic drainage use gentle manual pressure and
stretching to stimulate lymphatic vessels that help move excess fluid out of tissues, which may
reduce pressure and congestion. Tightness in the muscles and soft tissues that attach to the head and
neck can also restrict normal fluid movement. For this reason, myofascial release, mobilization, and
manipulative therapies aimed at restoring normal motion in the face, head, neck, and upper back may
be beneficial for some individuals.
This potential benefit is illustrated in a case series involving 14 patients with chronic
rhinosinusitis who also experienced craniofacial pain. Those who received manual therapy to address
craniofacial dysfunction over a seven-week period reported improvements in both craniofacial pain
and the severity of their sinus symptoms, while patients in a comparison group that did not receive
hands-on care reported no meaningful improvement.
Additional studies suggest that manual therapies may help improve sinus drainage, reduce
facial pain and pressure, enhance nasal airflow, and improve quality of life—particularly when
chronic rhinosinusitis is accompanied by neck muscle tension or headaches associated with cervical
spine dysfunction. Other reports indicate that some patients who have not responded to conventional
medical management, including those who have undergone sinus surgery or who wish to avoid
surgery, may experience symptom relief with conservative manual therapy treatment.
While current evidence does not support chiropractic care as a first-line treatment for chronic
rhinosinusitis, manual therapies provided by doctors of chiropractic may play a supportive role as
part of a comprehensive care plan. This may be especially relevant for patients who have difficulty
managing symptoms with usual care alone. Individuals interested in this approach should speak with
their healthcare provider to determine whether a trial of chiropractic care may be appropriate for their
situation.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
Core Strengthening to Reduce Low Back Pain Risk
2 AprLow back pain is one of the most common and disabling conditions worldwide. It’s estimated that
nearly 200 million acute episodes of low back pain occur each year, of which roughly 20% persist for longer
than three months. With the aging of the global population combined with the obesity epidemic, low back pain
is expected to become an even more substantial physical health issue in the coming decades.
Because weakness in the core muscles that help stabilize the spine has been linked to up to a threetimes increased risk of new-onset low back pain, improving endurance and control in this muscle group may
help reduce one’s risk. The core muscles include the abdominals, back, and gluteal muscles. In addition to
stabilizing the spine to help stay upright, strong core muscles are important for maintaining balance through
proprioception and for supporting the wide range of motion the trunk performs—from rotation, to bending
forward, to side-bending, and backward movement. Key core-strengthening exercises include:
- Front plank: Lie face down and prop yourself up on your elbows under your shoulders. Lift your body
onto your elbows and toes (or knees for an easier version). Keep your body in a straight line from
shoulders to heels, tighten your stomach and glutes, and avoid letting your hips sag or rise. Hold 10–
30 seconds, repeat three to five times, working up to a 60-second hold. - Side plank: Lie on one side with your elbow directly under your shoulder. Lift your hips off the floor
so your body forms a straight line from shoulders to feet. Keep your core tight and don’t let your hips
roll forward or backward. For an easier version, bend your knees and lift your hips. Hold 10–25
seconds per side and repeat three to five times. - Bird dog: Start on hands and knees with hands under shoulders and knees under hips. Tighten your
stomach slightly and keep your back flat. Slowly extend one arm forward and the opposite leg
backward. Keep hips level and avoid arching your back. Hold for five to ten seconds, return to start,
then switch sides. Do eight to twelve repetitions per side. - Glute bridge: Lie on your back with knees bent and feet flat on the floor about hip-width apart.
Tighten your stomach and squeeze your glutes. Lift your hips until your shoulders, hips, and knees
form a straight line. Avoid arching your lower back. Hold three to five seconds at the top, then slowly
lower. Perform ten to fifteen repetitions for two to three sets. - Dead bug: Lie on your back with arms straight up and knees bent at 90 degrees. Tighten your stomach
gently so your lower back stays flat against the floor. Slowly lower one arm overhead and extend the
opposite leg toward the floor. Only go as far as you can without your back arching. Return to start and
switch sides. Perform eight to twelve slow, controlled repetitions per side.
Further strategies to reduce the risk of low back pain include maintaining a healthy weight; improving
workstation ergonomics; practicing good posture, especially when sitting and lifting; engaging in regular lowimpact aerobic exercise such as walking or swimming; following a balanced, minimally processed dietary
pattern (such as a Mediterranean-style diet); avoiding tobacco use; and stretching before and after physical
activity, especially the hamstrings which are often overly tight in low back pain cases. While these practices
may not completely prevent low back pain, they can improve the changes for a speedier recovery as well
reduce the risk of recurrence.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
A Practical Tool for Assessing Health and Longevity
30 MarAs we age, it is natural to become more concerned about our longevity, especially if we have
experienced health challenges or engaged in unhealthy behaviors earlier in life. One way to assess probabilistic
near-term (under five years) and long-term (10–25 years) mortality risk is to use an assessment known as the
Deficit Index, also called the Frailty Index. Essentially, the index evaluates health across many different
domains. Each item is scored as 0 (not present), 0.5 (a mild or partial problem), or 1 (a severe or fully present
problem). The individual deficit scores are added together and then divided by the total number of items
assessed (61 in this example) to produce a final index value between 0 and 1. Below are commonly included
deficit domains:
- Chronic Medical Conditions: Hypertension, diabetes mellitus, coronary artery disease, stroke or TIA,
osteoarthritis, osteoporosis, chronic lung disease, chronic kidney disease, cancer (current or past) - Activities of Daily Living (ADLs): Difficulty bathing, dressing, transferring, using the bathroom,
feeding, shopping, managing medications, managing finances, preparing meals, using transportation - Mobility & Physical Performance: Difficulty walking one block, difficulty climbing stairs, slow
walking speed, poor balance, use of cane/walker/wheelchair, fall/s within previous year - Symptoms & Somatic Complaints: Chronic pain, fatigue or low energy, shortness of breath, dizziness,
poor appetite, sleep problems, urinary incontinence - Cognitive Function: Memory complaints, difficulty concentrating, diagnosed mild cognitive
impairment, dementia, difficulty following instructions - Psychological & Emotional Health: Depressive symptoms, anxiety, low mood most days, anhedonia,
high perceived stress, poor coping skills - Sensory Impairments: Poor vision (even with correction), poor hearing, difficulty communicating due
to sensory loss - Nutrition & Body Composition: Unintentional weight loss, low BMI, sarcopenia or muscle weakness,
difficulty chewing or swallowing - Social & Environmental Factors: Living alone, social isolation, limited social support, financial strain,
low physical activity, limited access to care - Laboratory & Physiological Abnormalities: Anemia, elevated inflammatory markers, abnormal
glucose regulation, low vitamin D, reduced kidney function markers
In population studies, scores below 0.10 are considered robust and associated with low mortality risk
over the next 10–20+ years; scores of 0.10–0.15 are considered pre-frail and associated with low five-year
mortality but increased 10–20 year risk; scores of 0.15–0.25 indicate moderate frailty and a substantially
elevated 5–10 year mortality risk, with many studies showing a roughly 50–70% chance of death within the
next decade; scores of 0.25–0.40 indicate severe frailty and high near-term mortality, with up to a 50% chance
of death within ~3 years and very high five-year mortality; and scores of 0.40 or higher indicate extreme frailty
and are associated with very high 1–3 year mortality and markedly shortened survival.
Importantly, this assessment and others like it are not intended to predict exactly how many years any
one individual has left. Rather, they help visualize how multiple health factors combine to reflect overall
biological aging and vulnerability. The goal is not fatalism, but insight, so that efforts to improve strength,
nutrition, mobility, mental health, sleep, and social connection can reduce frailty, improve quality of life, and
potentially extend both lifespan and health span.
Brent Binder M.S., D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055
(717) 697-1888
Pain Relief Chiropractic 