A Weak Core May Contribute to Hip Pain

10 Dec

When people think of hip pain, they generally turn to hip-specific exercises as a self–help strategy.  However, recent evidence shows there’s a correlation between poor core stability of the trunk and injury to the lower extremities, which includes the hips.  In March 2018, Belgian researchers reviewed data from nine previously published studies with a focus on the importance of core stability and its relationship to lower extremity musculoskeletal injuries in a healthy athletic population. The investigators reported that core strength, core proprioception (balance), and neuromuscular control (coordination) of the core are directly linked to the likelihood of lower extremity injuries.

Let’s take a closer look at three specific core strengthening exercises that can be done relatively fast and are highly effective (you can view several demonstration videos on YouTube if you search for “stuart mcgill’s big-3 core exercises”).

1) The Curl-Up (abdominal strength): STEP 1 — Lie on your back, straighten your left leg, and bend your right leg, placing the right foot next to the left knee.  STEP 2 — Tuck your hands under your low back to prop up the lumbar curve (so it does not flatten out).  STEP 3 — Curl up by lifting your head, neck, and shoulders only a few inches off the floor (keep your chin tucked).  STEP 4 — Hold for 7–8 seconds (or work up to this).  STEP 5 — Slowly lower your trunk back to the ground.  Repeat five times with the right leg bent and five times with the left leg bent, while keeping the opposite leg straight.  This exercise helps reduce low back disk compression, which is significant when performing a conventional sit-up exercise.

2) The Bird-Dog (core, back, and gluts):  STEP 1 — Kneel on all-fours (hands and knees).  STEP 2 — Keeping your back flat, lift and straighten out the LEFT arm and RIGHT leg parallel to the floor. STEP 3 — To further activate the core muscles, draw a square with the arm and leg while bracing the abdominal muscles (firm up your abs, as if to brace for being punched in the stomach). STEP 4 — Return to the starting position and repeat on the opposite side (repeat STEP 3 again).

3) The Side-Bridge (obliques): STEP 1 — Lie on your side, elbow directly under your shoulder and bend your knees 90°. To increase the difficulty, keep the legs/knees straight. STEP 2 — Lift your hips off the ground so you are holding your weight with your elbow and knees (or feet). STEP 3 — Hold the “Up” position for as long as possible. STEP 4 — Repeat steps 1-3 on the opposite side.

Doctors of chiropractic are trained to evaluate the entire person from the feet up to the head to identify issues elsewhere in the body that may contribute to or even cause the patient’s chief complaint. For many patients, managing hip-related conditions may involve treatment to address issues in the core (as described in this article), the lower back, and even the feet or knees!

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

These Foods Can Help Fight Carpal Tunnel Syndrome…

6 Dec

Because inflammation along the course of the median nerve can contribute to carpal tunnel syndrome (CTS), consuming these inflammation-reducing foods may help the patient achieve their desired outcome.

Salmon and other fatty fish, including tuna and sardines, are rich in omega-3 fats called EPA and DHA, which help reduce inflammation. Supplements are commonly used as well with the recommended dose of 1000 mg of combined EPA and DHA per day, which often requires 2000-4000 mg of fish oil to get EPA and DHA to the proper 1000 mg/day level. If you take a blood thinner or are preparing for surgery, discuss this with your physician!

Walnuts are an excellent source of alpha-lipoic acid, or ALA, another omega-3 fatty acid that also reduces inflammation, though to a lesser extent compared to EPA and DHA. Other foods rich in ALA include flaxseed and chia seed.

Pineapple is rich in an enzyme called bromelain, which also reduces inflammation and aids in digestion! But again, it can thin the blood if taken in a higher concentration (from a supplement) so be aware of this.

Turmeric is another great anti-inflammatory that’s found in mustards and curry sauces. Its anti-inflammatory properties are further enhanced when combined with black pepper and ginger!

Spinach is rich in vitamin B6 (pyridoxine), which can help reduce pain.

The “good news” about getting these important benefits from whole foods rather than from supplements is that it’s virtually impossible to consume toxic levels of these nutrients. Your doctor of chiropractic can help guide you in both the nutritional management of CTS as well as the many benefits derived from manual therapies, modalities, night splints, specific exercises for CTS, ergonomic/work station modifications, and more. If diabetes, inflammatory arthritis, or other complicating conditions are present, your chiropractor can work with your medical physician to coordinate care to obtain the best results for you!

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Back Pain: Does Maintenance Care Work?

3 Dec

Non-specific low back pain (nsLBP) is one of the most common and costly healthcare problems affecting society, and it is also the leading cause of activity limitation and work absence around the world.

Following a course of treatment to reduce pain and improve function for patients with a musculoskeletal complaint—such as back pain—doctors of chiropractic commonly make recommendations to reduce the risk of a future episode (or at least minimize its severity should one occur). These recommendations may include adopting a fitness routine, dietary modifications, specific exercises, foot orthotics, and/or routine “maintenance” chiropractic adjustments, such as once a month or every six weeks.

Though further research is necessary to more clearly understand precisely how maintenance care (MC) works to reduce the risk of future episodes of back pain, researchers currently hypothesize that such treatments may improve any biomechanical or neuromuscular dysfunctions before they become symptomatic.

Studies published in both 2004 and 2011 note that patients with chronic low back pain who received maintenance care for nine months reported less pain and disability than participants who did not receiving ongoing care.

In a 2018 study that included 328 nsLBP patients, researchers found that those who received ongoing maintenance care following their initial course of treatment experienced 12.8 fewer days with LBP over the following year. Compared with patients who were advised to return for further care on an as-needed basis, the participants in the MC group only made an average of 1.7 additional chiropractic visits during the study.

The authors of this study concluded, “For selected patients with recurrent or persistent non-specific LBP who respond well to an initial course of chiropractic care, MC should be considered an option for tertiary prevention.”

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Nutrition and Exercise for Hypertension

26 Nov

Hypertension is usually a silent disease that leads to cardiovascular, cerebrovascular, and renal morbidity and mortality. This condition can seriously affect quality of life, reduce life expectancy, and place significant burdens on the healthcare system. Classic medications used to treat hypertension can involve side effects including headache, nausea, vomiting, stomach pain, constipation, diarrhea, weakness, fatigue, and erectile dysfunction. Hence, many patients with elevated blood pressure look for other means to help manage their condition with fewer, if any, side effects.

In a previous article, we discussed a 2007 study in which patients who received a specific cervical chiropractic adjustment experienced a reduction in their blood pressure that persisted for at least eight weeks. Lead author Dr. George Bakris, “This procedure has the effect of not one, but two blood pressure medications given in combination. And it seems to be adverse-event free. We saw no side effects and no problems.”

Herbal and dietary supplements have been used by patients to help manage hypertension (HT) for many years. A series of literature reviews have found the following may provide better and safer substitutes to conventional drugs: cod liver oil, garlic, coenzyme Q-10, beta glucan, lipoic acid, whole grains, potassium, magnesium, sodium, vitamin E, vitamin B6, vitamin C, polyphenol, various botanicals/herbs, and vanadium (see Table 1, https://bit.ly/2QVpcY7 ).

Regarding exercise, a 2018 research review found that aerobic exercise can reduce blood pressure in hypertensive patients by 5-7 mmHg and that dynamic resistance exercises can lower blood pressure in adults with hypertension by 2-3 mmHg—which may rival the results achieved with first-line meds for hypertension.

While exercise, improving your nutrition, and getting regular chiropractic care are all part of living a healthier lifestyle, which can result in a healthier blood pressure reading, it’s important not to discontinue taking any medications unless instructed to by your treating physician.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

A Brief Overview of Whiplash

22 Nov

Whiplash is a non-medical term that represents a large range of injuries to the neck caused by or related to a rapid, sudden movement of the neck often to and beyond the end-ranges of motion that results in injury to soft tissues and sometimes bony tissues in the neck. Cervical acceleration-deceleration (CAD) describes the mechanism of injury while whiplash associated disorders (WAD) describes the signs and symptoms of an anatomical injury.

Aside from injuries in the neck, shoulders, and back, WAD can include trauma to the brain caused the organ impacting the front and back of the inside of the skull (referred to as a coup-contra-coup injury) during the hyperextension followed by hyperflexion phases of the CAD injury. The result is a traumatic brain injury (TBI), which is commonly referred to as a concussion. Symptoms associated with TBI include forgetfulness, short-term memory loss, and “mental fog”.

One explanation for the resulting signs and symptoms associated with WAD injuries is the fact that it takes longer to voluntarily contract a muscle (about 1,000 milliseconds) vs. the time from start to finish of the whiplash process (about 300-500 ms). At about 100 ms after impact, the vehicle is accelerated forward and the seatback pushes into the spine or torso, propelling it away from the direction of the collision while the head stays stationary (due to inertia).

At 150-300 ms, the torso can “ramp up” due to the reclined angle of the seatback. Depending on the headrest position and type, the head can hyperextend over the headrest. The amount of rebound is partially affected by the “springiness” of the seatback and the amount of vehicular damage (or lack thereof), since crushing metal absorbs energy. Thus, injury can occur even when the vehicle receives little to no car due to the energy of the impact being transferred to the contents of the vehicle—including its occupants.

The whole whiplash process is over well before one can contract muscles in preparation to a crash, so it’s virtually impossible to avoid injury.

Research shows that WAD patients can experience better outcomes if they seek prompt treatment focused on restoring motion to the affected areas. Time and time again, chiropractic care has been demonstrated to not only help WAD patients get out of pain and return to their normal activities but it also achieves high scores regarding patient satisfaction.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Neck Pain – What Is Cervical Spinal Stenosis?

19 Nov

Simply put, spinal stenosis describes a narrowing at the openings of the spine. When spinal stenosis exists in the cervical spine, it’s called cervical spinal stenosis (CSS). This condition is usually the result of wear-and-tear or aging, and hence, is most common over the age of 50. However, CSS can occur at any age if a vertebra in the neck sustains a fracture.

There are two types of CSS: central and lateral CSS. Central CSS is narrowing of the central canal where the spinal cord travels and gives rise to the many pairs of nerves that exit out to the arms, trunk, and legs. Lateral stenosis is narrowing of the side openings (referred to as the lateral recess or the intervertebral foramen) through which the spinal nerves travel outward from the cord and into the left and right arms and legs.

Causes of CSS include the following: osteoarthritis (in which a narrowing of the central and/or lateral canals occurs and crowds the spinal cord and/or spinal nerves); a herniated disk (where the cushions between the vertebra crack or tear allowing the more liquid-like center to leak out and press into the cord or nerves); an injury (fracture); a tumor (growth); Paget’s disease (a condition where the bones grow abnormally large and brittle); and/or a combination of the above.

Symptoms may start out as a vague pain, numbness, and/or tingling in the innervated area(s). If a spinal nerve (lateral CSS) is affected, symptoms can present in the arms, torso, or legs. When the spinal cord itself is compressed (central CSS), symptoms can include loss of bladder or bowel control (in extreme cases); impaired balance; sciatica (pain down the back of the leg), foot drop (weakness standing on the heels), and more. A gradual loss in walking time/distance is common and stopping to sit or bend over is usually relieving (this is called “neurogenic claudication”).

The diagnosis is made by following a careful review of the patient’s history and a thorough examination, which may be aided by x-ray, MRI, and/or CT scans. Though guidelines recommend starting with non-surgical treatments, such as chiropractic care and at-home exercises, if bowel or bladder weakness is present, then surgery may be required to open the narrowed canal(s). The good news is that CSS can often be successfully managed via chiropractic treatment and other conservative options.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.
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