Is Your Foot Causing Your Knee Pain?

13 Apr

Due to bipedal locomotion (walking around on two legs), foot and ankle problems have the potential to affect EVERYTHING above the feet—even the knees!

When analyzing the way we walk (also known as our gait), we find when the heel strike takes place, the heel and foot motion causes “supination” or the rolling OUT of the ankle. As the unloaded leg begins to swing forwards, there is a quick transition to pronation where the heel and ankle roll inwards and the medial longitudinal arch (MLA) of the foot flattens and pronates NORMALLY!

During the transition from supination to pronation, the flattening of the MLA acts like a spring to propel us forwards followed by the “toe off”, the last phase, as we push off with our big toe and the cycle starts with the other leg. However, if you watch people walk from behind, you will see MANY ankles roll inwards too much. This is call “hyperpronation” and that is NOT NORMAL!

So at what point does this normal pronation become hyperpronation? The answer is NOT black and white, as there is no specific “cut-off” point but rather, a range of abnormal. Hence, we use the terms mild, moderate, and severe hyperpronation to describe the variance or the degrees of abnormality. Hyperpronation can lead to the development of bunions and foot/ankle instability that can cause and/or contribute to knee, hip, pelvis, and spinal problems—even neck and head complaints can result (the “domino effect”)!

One study looked at the incidence of hyperpronation in 50 subjects who had an anterior cruciate ligament (ACL) rupture vs. 50 without a history of knee / ACL injury. They found the ACL-injured subjects had greater pronation than the noninjured subjects suggesting that the presence of hyperpronation increases the risk of ACL injury.

Doctors of chiropractic are trained to evaluate and treat knee conditions of all kinds. Often this may include prescribing exercises or utilizing foot orthotics in an effort to restore the biomechanics of the foot, which can have positive effects not only on the knees but also further up the body.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055
Member of Chiro-Trust.org

You’re Likely to Live Decades Longer Than You Expect, So How Will You Pay for those Extra 30 Years?

10 Apr

Our basic premise is that your body is amazing. You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do. In these notes, we give you a short course in what to do so it becomes easy for you and for you to teach others. We want you to know how much control you have over both the quality and length of your life.

Recently, I talked about the possibility, maybe the probability, that if you live beyond 2023, the average age of death may exceed 120—with the quality of life you had at age 45. (And yes, you can even improve on the quality of your health at age 45. We consider that in our new book—shameless plug—but it is really good: AgeProof: Living Longer Without Running Out of Money or Breaking a Hip, which was released on February 28th, 2017).

At no other time in our history has AgeProofing been as important as it is now; that’s because we’re living longer and longer—and need more money and better health to last those extra decades (yes, decades). While this change in longevity should be exciting, the truth is that longevity comes with a price. Because we’re living longer, it’s more expensive to fund retirement. That’s true even if you’re in good shape. Traditionally, maybe we lived only a decade or so past retirement, but what happens when we live for 30 or more years after we stop earning? Surveys from financial institutions note that running out of money before running out of time is by far our biggest financial fear. One survey even found that running short of funds is a bigger fear than even death. Going the distance means we need a new set of skills, new strategies, and a new way of thinking.

The problem that many of us face is twofold. For one, we think of money and health the way we think of large-toothed forest-roaming beasts—they scare the heck out of us. Much of that fear is caused because we close our eyes, hope for the best, and are timid about confronting issues that feel as comfortable as a pair of not-quite-dry-from-the-dryer underwear. And that’s something we have to change—that is, our attitude on the topic. We have to be open and honest, and have frank conversations about subjects that can make us squirm.

Not only are money and health important issues when it comes to life satisfaction but they’re also cyclically connected—that is, how healthy you are has an effect on your bottom line, and your handling of money issues has an effect on how healthy you are. That’s because healthcare can be extremely costly (in direct ways, like the actual expenses of insurance and medical procedures, and in indirect ways, like being out of work because of health problems). Financial problems are also the biggest source of stress for Americans. Scientists have directly linked stress to a whole bevy of medical issues, including heart disease, sleep problems, weight issues, and depression.

We have found that there are eight important ways to stay well and eight important ways to stay flush, and they intersect—and your future happiness depends on them. By diving into those areas—and, more important, the science behind them—we’ve developed a new approach to help you control your life and your happiness. What we’re giving you is a new lens through which to view the choices you face, the decisions you make, the behaviors you adopt, and the goals you reach for. All drive toward the ultimate goal: AgeProofing your life by keeping your body young and your finances secure enough to go the distance (I teamed up with the Today Show’s Financial Editor Jean Chatzky—she taught me a ton about finances, which we share with you).

Jean and I found the common principles and themes for how to approach improving both your health and wealth. When you see the links, you’ll gain inside insight into how you can use the same principles to improve your health and wealth. For example, budgeting is something you may think of as something you do with money, but you can take the same approach to how you eat as well. You will also learn how to develop teams of comrades—professional and personal—who can help you face obstacles, make smart decisions, and fend off temptations.

Let me give three summaries from our new book:

1. You can’t take back time. But you can make up for lost time.

2. Don’t think of problems as dead-end streets. You always have the options to find side streets, alleys, and other routes to get you out of trouble and on the highway to healthy and happy living.

3. The thing that scares many people about the problems they’re having is that they know they might have issues that need to be dealt with, but they don’t confront them. Only when you get a full assessment of where you are can you make the changes and employ the tactics to help you catch up.

Yes, the book AgeProof: Living Longer without running out of money or breaking a hip has a safety deposit box full of information, and Jean and I are giving you the key. The AgeProof prescriptions are doable, are helpful, and make sense. I’ll try to summarize many of these for you over the coming year. We hope to help you live much younger & longer—so start preparing.

Thanks for reading. Feel free to send questions—to youdocs@gmail.com, and some of them we may know enough to answer (we’ll try to get answers for you if we do not know).

Young Dr Mike Roizen (aka, The Enforcer)

NOTE: You should NOT take this as medical advice.
This article is of the opinion of its author.
Before you do anything, please consult with your doctor.

You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week). The YOU docs have two newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz. These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.

Carpal Tunnel Syndrome… In a Nutshell

6 Apr

Here it is: carpal tunnel syndrome (CTS) in a nutshell!

WHAT: CTS is caused by an injury to the median nerve (MN) as it travels through the wrist.

WHERE: The eight small carpal bones and a ligament form a tunnel in which tendons and nerves pass through to reach the hand.

HOW: The MN gets pinched/irritated from repetitive stress.

WHY: The tunnel is tight as it includes the MN and nine rapidly moving muscle tendons!

PROGRESS: CTS usually starts slow and often progresses over weeks, months, even years.

SYMPTOMS: Pain, numbness, tingling, and/or weakness of the hand, sparing the little finger.

PROGNOSIS: CTS is easier to treat shortly after it starts, and waiting too long to seek care may lead to worse outcomes.

RISK FACTORS: 1) family history (genetics); 2) women are more likely to suffer from CTS than men; 3) age over 50; 4) manual jobs; 5) pregnancy; 6) conditions like diabetes, hypothyroid, rheumatoid arthritis (RA), osteoarthritis, autoimmune diseases (includes RA, certain types of thyroid disease), gout, kidney disease (especially dialysis patients), Down syndrome, amyloidosis, acromegaly, tumors on the median nerve; 7) medications (those that affect the immune system such as interleukin-2, possibly corticosteroids), anti-clotting drugs such as warfarin, hormone replacement, BCPs; 8) obesity; 9) smoking; 10) alcohol abuse; and 11) trauma/injuries (fractures, tendonitis).

TREATMENT: Ideally, treatment should begin as soon as possible after symptoms first start, but this RARELY occurs due its slow and gradual onset. Non-surgical care includes anti-inflammatory care (ice, anti-inflammatory nutrients—ginger, turmeric, bioflavonoids; NSAIDs like ibuprofen), wrist splinting (primarily at night), corticosteroid injections, job/ergonomic modifications, exercises (yoga, stretching, strengthening, and aerobic fitness), low level laser therapy, ice, acupuncture, and chiropractic care. Chiropractic care includes MANY of the above PLUS manual therapies applied to the neck, shoulder, arm, wrist, and hand.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055
Member of Chiro-Trust.org

What Many Back Pain Sufferers Can Do at Home

3 Apr

Low back pain (LBP) is a very common problem that affects most of us at some point in life and for some, it’s a daily issue. Through education and research, researchers have found low back-specific exercises can not only help get rid of LBP but can also prevent future exacerbations or episodes. Like brushing our teeth, low back exercises are equally important in order to maintain, preserve, and optimize function. But because there are SO MANY exercise options available, it’s hard to know which ones are best, especially for each specific person.

There are different methods for determining the right low back exercises for the patient. One of the most common is to try different exercises to determine individual tolerance, but this is not very specific, as it only determines whether or not the patient is comfortable with an exercise. Another is using physical performance tests (PPTs) that measure the strength and endurance of specific muscle groups, muscle shortness, balance, aerobic capacity, and spinal range of motion.

Physical performance tests are much more specific because they address each patient’s differences. Also, many PPTs include normative data to compare against the patient’s own performance, so repeat use of the abnormal PPTs on a monthly interval can gauge their progress (or the lack thereof), which is motivating to the patient and serves as a great outcome measure!

PPTs are typically done two to four weeks after an initial presentation or at a time when the condition is stable so as not to irritate the condition. Initially, the decision as to which exercise is best is often made by something called “directional preference” or positional bias. This simply means if a patient feels best by bending over, we initially give “flexion-biased” exercises.

Flexion-biased exercises include (partial list): pulling the knees to the chest (single then double), posterior pelvic tilts (flattening the low back into the floor), sitting and/or standing bend overs, hamstring stretches, and more. If a person’s low back feels best bending backwards, their doctor of chiropractic may give extension-biased exercises, which include (partial list): standing back bends, saggy push-ups (prone press-ups), and/or laying on pillows or a gym ball on their back, arching over the ball.

Chiropractors generally add exercises gradually once they’ve determined tolerance and will recheck to make sure the patient is doing them correctly. Studies show that spinal manipulation achieves great short-term results, but when exercise is added to the treatment plan, the patient can achieve a more satisfying long-term result. Unfortunately, other studies have shown that ONLY 4% of patients continue their exercises after pain is satisfactorily managed and they fall back into old habits of not exercising.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055
Member of Chiro-Trust.org

High-Intensity Interval Training – What Is That?

27 Mar

High-intensity interval training (HIIT) is characterized by 30-60 second bouts of high-intensity output followed by a very low-intensity exercise (like walking or slow pedaling) which allows one’s heart rate and breathing to recover before the next high-intensity segment.

Studies have shown HIIT can produce similar results as low-intensity aerobic exercise, but with significant differences in intensity, duration, and energy output. HIIT participants can experience improved maximal rate of oxygen uptake (VO2max), improved skeletal muscle capillarization, increased enzymes of fat metabolism, and improved insulin sensitivity—all of which result in better overall health-status and physical performance.

Three separate studies report that HIIT can reduce one’s body fat percentage using durations of only nine total minutes high-intensity activity per week—without controlling food intake! A 2016 study looked at even shorter weekly time durations and included both male and female participants to see what differences exist between the sexes.

The study involved 24 men (average age 38) and 17 women (average age 41) who performed HIIT three mornings a week using a cycle ergometer followed by a blood sample draw over the course of twelve weeks. Their routine consisted of a two-minute warm-up (moderate intensity) followed by four bouts of 20 seconds at maximum effort (set at 175% of the workload attained in the VO2max test) separated by two-minute recovery bouts using very low-intensity cycling (~20% VO2max).

After the three-month study, the participants experienced a lower body fat percentage (average 1%), higher rates of fatty acid oxidation (average 13%), and a greater VO2max (average 9%). Women had greater gains in their VO2max than men, while men lost more fat than the women. Keep in mind the participants only engaged in high-intensity activity a total of 240 seconds per week!

The “TAKE HOME” message is that if you don’t enjoy spending 30-60 minutes per day doing aerobic exercises, then HIIT may be something to consider, as it can produce similar (sometimes even better) results in less time.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

 

Posture and Whiplash

20 Mar

Posture assessment is a key component of the chiropractic examination, and the posture of the head and neck is especially important for a patient recovering from a whiplash injury. Forward head carriage describes a state in which the head sits more forward on the shoulders than it should. In order for the muscles in the neck and shoulders to keep the head upright, they must work harder. This added strain can increase one’s risk for neck pain and headaches, which is why retraining posture is a key component to the management of neck pain and headaches in patients with or without a history of whiplash.

Forward head carriage also increases the distance between the back of the head and the headrest in the seated position, especially when the seat is reclined. In a rear-end collision, a gap greater than a half an inch between the head rest and the back of the head increases the probability of injury due to the greater distance the head can hyperextend as it rebounds backwards into the headrest.  This makes posture correction of forward head carriage an important aspect of treatment from both a preventative and curative perspective.

So this begs the question, can forward head carriage be corrected?  The simple answer is “yes!” One study evaluated the effects of a 16-week resistance and stretching program designed to address forward head posture and protracted shoulder positioning.

Researchers conducted the study in two separate secondary schools with 130 adolescents aged 15–17 years with forward head and protracted shoulder posture. The control group participated in a regular physical education (PE) program while the experimental group attended the same PE classes with the addition of specific exercises for posture correction. The research ream measured the teens’ shoulder head posture from the side using two different validated methods and tracked symptoms using a questionnaire. The results revealed a significant improvement in the shoulder and cervical angle in the experimental group that did not occur in the control group.

The conclusion of the study strongly supports that a 16-week resistance and stretching program is effective in decreasing forward head and protracted shoulder posture in adolescents.  This would suggest that a program such as this should be strongly considered in the regular curriculum of PE courses since this is such a common problem.

Doctors of chiropractic are trained to evaluate and manage forward head posture with shoulder protraction. This can prove beneficial in both the prevention as well as management of signs and symptoms associated with a whiplash injury.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder 4909 Louise Drive, Suite 102 Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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