Common Mistake Made When Correcting Posture

Poor posture can lead to back and neck pain. Too often I see people making mistakes when trying to correct their posture. In this video, I'm going to show you a simple trick to help you get it right.

How Long Will It Take?

My colleague, Dr Jerry Kennedy, wrote this great article on a common patient question and frustration. He did a great job in answering it.

One of the most common questions that patients ask their chiropractor is, “How long will it take?” Some people ask because their #1 concern is that the chiropractor is never going to let them go. Maybe they have heard the “once you go you always have to go” myth that some people say about chiropractors. If that’s you, I have good news. It’s not true. Your chiropractor isn’t ever going to hold you hostage. That’s not the reason that most people ask that question. The majority of people who ask, “How long will it take?” are asking because they are in pain or in some way hampered, and they would like to get back to normal as soon as possible. That makes perfect sense. If patients had their way, they would get better instantly. I jokingly refer to that concept as patients wanting a “Jesus visit.” That’s when they go into their chiropractor’s office, get an adjustment, and are instantly better. Healed! Unfortunately, it doesn’t usually work that way. Sure, there is the occasional exception to the rule, but for the most part, your body takes time to heal. It’s also important to note that healing and feeling are not the same things. There are times when a medication or a treatment can help your body feel better quickly, but that doesn’t mean it has healed yet. If your pain/problem comes back as soon as the medicine wears off, your body hasn’t yet fully healed. The same is true of treatment. If your pain/problem comes back a few days after your treatment, your body hasn’t yet fully healed. That doesn’t necessarily mean the medicine/ treatment isn’t working. It could just be the difference between feeling and healing. So that brings us back to our original question, “How long will it take?” Unfortunately, there isn’t an exact answer. It depends on the problem. It depends on the person. There are a lot of factors at work. It’s an oversimplification, but I used to tell my patients that 5 factors would determine how long it would take their body to heal.

First - how old are you? That’s an easy one. Younger people heal faster than older people. The older you get, the more you realize how true that is.

Second - how bad is the problem? Not all health problems are the same degree of severity. Let’s use a sprained ankle as an example. On one end of the spectrum, you could have a minor sprain that heals up in 24 hrs. No big deal. On the other end, you could have a major sprain that requires many weeks of rest and therapy to heal. As a general rule, the more severe a health problem is the longer it takes to heal.

Third - how long have you had the problem? Just to clarify, that’s not necessarily the same thing as how long you have felt bad. It’s possible to have a health problem much longer than you have felt bad. Arthritis is a great example. Most people who have arthritis will have it for years before they ever have any pain. As a general rule, the longer you have had a health problem the longer it will take to heal.

Fourth - where is the problem? You may not know this, but different parts of the body heal at different rates. Muscles heal faster than ligaments. Ligaments heal faster than bone. Even the different joints of the body heal at different rates. An injury to your elbow is likely to heal much faster than an injury to a more complex joint like your shoulder.

Fifth - are you (the patient) willing to do your part? Healing not only takes time but it also takes participation. Sometimes rest is required. That means the patient has to be willing to slow down or stop. Sometimes nutritional changes are required. That means the patient needs to add something or remove something from their diet to help their body heal. Sometimes stretching or strengthening is required to help heal an injury. Ultimately, a patient who is willing to do their part to help their body heal will heal faster than a patient who doesn’t.

So when you ask your chiropractor the question, “How long will it take?” often you won’t get a specific answer. Don’t worry…they aren’t avoiding the question just for the sake of avoiding the question. It’s a difficult question to answer because the answer is different for every person. More often than not, chiropractors will take the information that you have given them, and use their clinical experience to give you a timeframe. It’s not set in stone. You may do better than expected and heal faster. You may do worse than expected and heal more slowly. Everyone is different. What does all this mean for you? Well, it means a couple things.

First, it’s important that you understand that healing takes time. If you expect your body to heal instantly, you may quit doing the exact things you should be doing because you aren’t willing to give them the proper amount of time.

Second, it’s important that you have open communication between you and your healthcare providers. You should be able to ask questions and express concerns. They should be able to let you know what you are doing right and what you are doing wrong. When you and your healthcare providers work together as a team, you are more likely to get positive results faster.

Lastly, it’s important that you do your part. Patients who participate in their care heal much faster than those who don’t. Stretch when it’s time to stretch. Go to your chiropractic appointment when it’s time to go to your appointment. Do your exercises when it’s time to do your exercises. Rest when it’s time to rest. The bottom line is this…everyone is different. How long it takes your body to heal is going to be different than how long it takes my body to heal. If you want to heal as quickly as possible and get back to normal, you have to be patient and you have to participate in the process. You can do it!

If you are ready to have your back pain resolved, please contact us or call 8096 6781.

Alcohol and Sleep

Ever felt sleepy after consuming alcohol? Alcohol doesn't help you to sleep, it actually sedates you. Similar to a light anaesthesia. It breaks up your sleep because it causes you to wake up many times for a short period, you just don't remember it.

It also suppresses REM sleep. This is when we dream and if we suffer from lack of REM sleep it impairs our ability to learn complex tasks. (1) Even moderate consumption of alcohol in the afternoon and evening can impair this.

Consuming alcohol before bed can affect your ability to form new memories, not only for any that day but for several days prior as well. This is from research where test subjects were given 2-3 shots of vodka (This is the equivalent to 2-3 standard glasses of wine or beer)
after learning new information. Those that drank alcohol retained the least amount of information when retested 7 days later, followed by those who drank 2-3 days after learning the new material and those who didn't drink at all remembered all of the new information. (2)

Any amount of alcohol appears to affect one's sleep quality. Sounds like a couple of alcohol free days per week is good advice.

If you have any questions regarding this or would like help with your back pain. Please contact us as our chiropractors would love to help you out.

(1) https://www.howsleepworks.com/types_rem.html

(2) 'Why We Sleep: The New Science of Sleep and Dreams', Matthew Walker

Standing Work Station Ergonomics

So, you have yourself a standing work station. They're awesome! Whilst they take a lot of strain off the discs in your lower back and muscles it also means you are burning more sugar and fats i.e. calories. We will be taking a look at the benefits of having one, how it should be set up correctly, common postural mistakes and how to correct them.

Benefits

1. It is much better for your core spinal muscles – providing you stand properly and can lower the incidence of neck and upper back pain by up to 54%. https://www.ncbi.nlm.nih.gov/pubmed/23057991
2. Reduces the risk of cancer, particularly breast and colon cancer which seem to be affected by activity. It also reduces the risk of obesity because you burn more calories which helps to prevent heart disease and metabolic syndrome.
3. It can also help to increase productivity and boost your mood.
4. Our core muscles become less active when we sit especially for long periods of time. When we stand they're much more active but only if they're strong and haven't been damaged, think use it or lose it. I won't go into how to strengthen your core as that's a whole topic of its own. The problem with this is they support all the joints in our spine and if they are weak you are more likely to injure yourself.

Set up

As with sitting down to use a computer the set-up is very important as well.

1. Desk height should allow a 90degree angle at elbows with keyboard at a comfortable distance in front of you
2. Monitor arm's length from eyes
3. Top of screen not monitor level with eyes
4. If wear bifocals, top of screen level with upper most part of near sighted section. 
5. If using two monitors, whichever monitor you use the most be directly in front of you. If you use two equally, put them together on an angle with the edges touching. 

Problems that may arise

 A picture speaks a 1000 words so have a look at the accompanying image. I caught myself a couple of times standing with my weight significantly over one leg and then also leaning on my elbow. This caused my spine to curve which creates wear and tear.

Also, watch out for rounding your shoulders and sticking your chin forward. This causes a huge increase in strain for your upper back and neck, again, causing wear and tear which eventuates in pain and arthritis.

Standing up is hard work. Partly because it takes time to get used to it but even after you have been doing it for a while your heart needs to work harder to pump the blood around your body and your muscles have a fatigue cycle so they need some rest. To help out with this, alternate between sitting and standing every 45-60 minutes.

Acquiring a standing work desk is absolutely a win for your health. Please remember to have it set up correctly and stand properly as this does wonders for your spine and body.

If you have any questions regarding this or would like help with any spine, muscle or joint pain please contact us, book online or call our North Ryde chiropractor on 8096 6781.

What This Biomechanics Professor Wishes People Knew About the Real Causes of Low Back Pain

Over half of the patients that Dr. Stuart McGill sees were injured by improper personal training. The following article debunks long-held myths to help you keep clients pain free.

As a spine biomechanics professor of over 32 years, I share with you an astonishing fact: Over half of the patients that had been referred to me for back pain were caused by personal trainers!

That is quite an indictment of the results from personal training, but make no mistake, I am the biggest supporter of trainers. Trainers, however, have the potential to be the most important determinant of a person’s lifelong health–perhaps more important than their family doctor, therapist, psychologist, or any other type of clinician. But personal trainers often misunderstand the true mechanics behind back pain.

My recent book, Back Mechanic, contains information that is culled from decades of research in various laboratories and clinics. In it, I provide guidelines to assess the cause of pain, then show the reader what to do, as well as what not to do. Part of what’s discussed are several myths that get perpetuated by the public and personal trainers alike. We dispel those myths and help create the framework for making better clinical decisions.

Here are just a handful of those myths, republished from my book with my own addendums, to make sure that you trainers change people’s lives for the better.

Let’s get started.

Myth 1: Back pain is linked to having tight hamstrings

Truth: Our research has found that in most cases, tight hamstrings are a related symptom of back issues rather than a cause. Interestingly, hamstrings often decrease in tightness as back pain subsides. That being said, when one hamstring is tighter than the other, the asymmetry has had mild influences on back pain, particularly in athletes. This book [Back Mechanic] will teach you proper movement patterns for daily activities such as tying your shoes. You will learn that even those of you with tight hamstrings are able to perform such activities while sparing your back.

From a performance perspective, many explosive-type athletes, such as jumpers, need tight hamstrings to store and recover elastic energy. Here the hamstrings are “tuned” rather than stretched (I dive more into this in Ultimate Back Fitness and Performance).

Myth 2: Lying in bed is good for back pain

Truth: In reality, lying in bed for excessive periods actually causes back pain. Let’s examine this more closely. A little known fact is that we are all actually taller first thing in the morning than we are before we go to bed at night. This comes down to our spinal disks. The disks in between each of our vertebrae are packed with very concentrated protein chains that love water. In scientific terms, this means they are “hydrophilic.” When we lie horizontally, the discs fill with fluid and gently push the vertebrae away from one another, lengthening the spine. The reason, our backs are often stiff in the morning is that the discs are so full of fluid, like water balloons ready to burst. When we get up in the morning, and our spines are once again vertical, the excess of fluid in each disc begins to seep out and an hour or two after rising from bed we have returned to our normal heights.

This natural ebb and flow is health and is what allows the discs to obtain nutrition. Problems arise, however, when the spine remains in a horizontal position for too long. While about eight hours in bed is healthy, much longer than that is not as it allows the spine to continue to swell and cause disc pain.

Limiting your time in bed can help with this, as can selecting the right mattress for your back.

Myth 3: My daily workouts at the gym will get rid of my back pain

Truth: The key is doing the right workouts that will preserve your back instead of destroying it. I see patients often perplexed by the fact that they take care of their bodies when an “unfit Joe” they know seems to get by with no back trouble at all.

The truth is that someone hitting the gym every day without spine sparing techniques during their workout, will develop cumulative trauma in their discs. Repeatedly bending your back at the gym, followed by long periods of sitting at work, chased down with poorly executed daily tasks such as getting dressed or gardening conspire together to cause the slow delamination of some of your disc fibers.

“Unfit Joe,” who sits all day, doesn’t experience the same strain on his back that a gym superstar does by aggravating their disc injuries every time they sit. In terms of pain, their spines are better off! The key is not to stop working out! The secret is in changing your default movement patterns so that you can enjoy the benefits of fitness without compromising your back.

Myth 4: Yoga and Pilates are great ways to alleviate back pain

Truth: While many doctors and therapists will suggest this type of exercise to their patients because of its “therapeutic” properties, our studies have not supported these claims and in fact have indicated the opposite. While some poses and movements may be beneficial or feel good at the time, there are components of both exercise systems that will aggravate an individual with back conditions. There is no such thing as an exercise program that is beneficial to all back pain sufferers and to broadly prescribe either yoga or pilates to a patient with undefined back pain is, in my opinion, irresponsible. Every single exercise should be justified and then modified if necessary to suit each person.

One of my major issues with Pilates is that one of its key principles is to flatten the spine and “imprint” the lower back to the floor when lying down. This deliberate effort to disrupt the spine from its neutral position and “straighten” one of its natural curves is not healthy and can trigger pain sensitivity in a person who is already sensitized.

Some people experience a false sense of relief while going through this motion because it stimulates the back’s stretch receptors. In reality, this relief is fleeting and pain symptoms typically return with a vengeance due to the stresses placed on your discs.

Another staple of the Pilates regimen is called the “Rollup.” This movement is essentially a sit-up that involves segmentally rolling through each joint of the spine. Our science has justified avoiding sit-ups as part of a routine for a healthy spine and the Rollup essentially takes a bad exercise and makes it worse.

Consider bending a slender branch back and forth–no stress develops. But repeat the bends with a thicker branch and it will crack and break due to the higher stress. This is why stronger people with thicker spines actually create delamination of their disc fibers with fewer bends than a slender-spined person.

Further, training mobility softens the matrix holding the collagen fibers together and decreases the load-bearing ability. Training strength toughens the collagen matrix reducing mobility. Thus, the adaptations are specific, which means that a person must choose between training predominantly spine mobility or spine strength with load- bearing ability. Very few people can have it both ways.

Thus the exaggerated fashion of the Pilates’ rollup puts an emphasis on moving through the spine, putting unnecessary load and strain on the discs. The real goal should be to minimize spinal movement and instead use our hips as primary centers for motion. This philosophy will allow the back pain to settle.

As we’ve already discussed, a therapeutic exercise must be recommended that correlates with the results of a detailed assessment. Many doctors mindlessly suggest Pilates, buying into the unexamined orthodoxy that says Pilates is good for the back. This needs to stop. Don’t get me wrong. There are many Pilates and Yoga instructors I have met taking my clinical courses and have expertise in matching specific exercises to specific people. These instructors are well aware of the importance of avoiding certain pain triggers and adjusting exercises to prevent the worsening of pain.

The bottom line is that if the specific components of Yoga and Pilates are selected and modified for the person doing them, they can help a back patient, but neither of these programs should ever be recommended as a “blanket cure” to all back pain sufferers.

Myth 5: Stronger muscles will cure my back pain

Truth: Therapists often begin strength training early in rehabilitation simply because strength is the easiest attribute to increase and requires very little expertise. Or, curiously they have decided to measure strength as a metric for disability–this is driven by a legal process seeking monetary settlements based on strength loss (or sometimes loss of motion).

Too many patients remain long-term patients because of their misguided efforts to train their back strength. In many cases, their training approach needs an overhaul. Think of strength in relation to the body like horsepower in relation to a car. If a souped-up 500 horsepower engine is put inside a dinky, broken down car and then raced around town at top speed, it’s only a matter of time before the mega-engine rips the frail frame and suspension to piece.

Similarly, a back patient who has developed a disproportionate amount of strength in relation to their current level of endurance can only expect further injury. We have measured this time and time again in strong back patients. Specifically, a resilient back has endurance matched to strength.

Back injuries are a result of putting a spine under load and then breaking healthy movement form. Maintaining proper movement patterns requires endurance. Therefore, we must always place endurance as a higher priority to strength when it comes to rehabilitating a patient with a spine condition. Only after the back-pained person has increased our endurance for sustaining healthy movement patterns, and in turn their stability and mobility, should they progress to more aggressive strength training.

Myth 6: Stretching is good for reducing back pain

Truth: Although stretching is considered universally beneficial for back pain sufferers, this is an old-fashioned notion that needs challenging.

There is no such thing as a stretch that is good for all patients, just as there is no such thing as a single source of pain. Each back pain case is different, and as such each stretch must be chosen very, very carefully and tailored to the individual. Too often, therapists prescribe stretches that are totally wrong for a patient often with the ultimate goal of improving mobility in the spine. For most back pain sufferers, this is the opposite of what they should be doing in order to gain control of their backs.

Physiologically, pulling your knees to your chest, or other similar stretches, trigger the “stretch reflex.” This is a neurological phenomenon that reduces pain sensitivity. This provides about 15-20 minutes of pain relief for some, making it a short-term fix. The problem is that in putting in your spin in this position, you are aggravating your discs and after you’ve experienced temporary relief, the pain will return, often worse than before. Thus begins a vicious cycle with a misinformed back patient who thinks their only solution to pain is to “stretch it out,” not realizing that this is in fact contributing to their pain. The key is to stop the cycle!

Instead of focusing your energy on stretches that bend the spine, turn instead to stabilizing and controlling the spine. Follow the self-assessment of the pain triggers shown in Back Mechanic. Modifying your daily movements to keep your spine in postures that do not trigger pain, which for most people is “neutral.” In following this path to recovery, your discs will experience less strain, your pain will subside and your mobility will return!

Essentially, when dealing with stretches with back pain, avoid those that involve pulling your knees to your chest. Your pain triggers will de-sensitize faster.

Myth 7: Having a powerful back is protective

Truth: Power is the product of velocity and force. So high power is generated when quickly bending the spine together with a forceful exertion. Generating power in the spine is highly problematic, as it increases the risk of injury. Let’s break it down. If spine movement or bending occur at a high velocity, the forces (or load) on it must be low in order to avoid injury. For example, the golf swing has high velocity but low force.

Alternatively, if the force being placed on the spine is high, then the velocity must be kept at a low level in order to maintain a low risk of injury–think the deadlift. Essentially, the risk of back injury can be controlled by keeping spine power low.

—————-

This article has been adapted from ptdc.com

All of this information can be found in my comprehensive book about back pain, Back Mechanic. Everyone needs to learn good movement for optimal health and absence of injury and disease. Well-executed motions, postures, and loads can build the body, maintain a high-level performance, and preserve pain-free enjoyment all throughout a person’s life. By contrast, little to no movement, inappropriate exercise choice, and poor programming that lacks appropriate rest and adaptation can create cumulative trauma and ill health.

If you have any questions about this article or would like help with any spine and joint issues, please either call our North Ryde chiropractor on 8096 6781, book online or contact us.

Back Your Inner Athlete

This year, Spinal Health Week 2016 runs from 23 to 29 May with the theme ‘Back Your Inner Athlete’. 
 
Every day more and more Australians experience disabling low back pain, neck pain and headaches, limiting their ability to work and engage in an active healthy life.
 
One explanation for this is the impact an increasingly sedentary lifestyle has on postural fitness. Think about all the hours you spend each day sitting at work or school, on a computer or other mobile device, watching television or playing computer games. Poor posture increases pressure on your spine which can cause low back pain, neck pain, headaches and fatigue.
 
Low back pain is a growing problem and now ranks second in Australasia and seventh in the world according to the World Health Organisation’s latest Global Burden of Disease study. Neck pain is also problematic ranking ninth in Australasia and 21st in the world.
 
If you suffer from back pain, neck pain or headaches or if poor postural fitness is impacting on your ability to live life to the fullest, visit our chiropractors at Riverside Chiropractic and Back Your Inner Athlete.
 
Chiropractic care focuses on the relationship between body structure (primarily the spine and pelvis) and function (as coordinated by the nervous system) and how this relationship can restore and maintain health.
 
Each week around 300,000 patients visit an Australian chiropractor. Chiropractic care is an increasingly common and effective treatment for back pain, neck pain and headaches eliminating the need for drugs or surgery. This means chiropractic care can also be very cost effective in comparison to other types of treatment.
 
At Riverside Chiropractic, we are encouraging our patients and the North Ryde community to begin a conversation about preventative health and well-being and adopt healthy habits.
 
Chiropractors have an important role to play in preventative health and well-being because they understand that a vital part of maintaining normal spinal function is by helping patients to make healthy lifestyle changes around nutrition, exercise and wellness. 
 
Adopting healthy habits today (such as improving postural fitness) can significantly reduce the risk of injury or pain later on and have a positive impact on your self-esteem, social relationships and even mental health.
 
Back, neck and spinal problems are also a leading cause of lost productivity in the workplace and forced early retirement. Every year forced early retirement has a traumatic effect on the hopes and prosperity of a large number of Australians.
 
We are encouraging people who haven’t been in for 6 months or more or those who have never had their back checked to com in and discover what steps you can take to improve your overall health and well-being and Back Your Inner Athlete.  Please either phone 8096 6781 or email us for an appointment today.
 
Celebrate Spinal Health Week on 23 May by downloading the CAA Back App with augmented reality feature at Back Your Inner Athlete, on the Apple App Store or Google Play.
 
Spinal Health Week 2016 is a national initiative of the Chiropractors’ Association Australia (CAA).

Microwaves: Are They Bad For Our Health?

Let’s take a look at whether microwaves are really something to be scared of.  There are 2 main points that I shall be discussing which can affect our health:

1. Does it destroy the nutrients in food
2. Are they dangerous?
 
Cooking food by any method starts to break down vitamins and other nutrients.  There are 3 factors that impact this process: time, contact with water (the most important factor) and intensity of the heat.  So, boiling food actually has the most impact on its nutrient content as they are lost in the water unless you plan to consume the cooking liquid as well.  The advantage of a microwave is that in most instances very little water is added and the cooking time is quite short. (1)
 
To help reduce the cooking time further, cover the food so that it steams as well.  According to the CSIRO, proteins, fats and carbohydrates are not greatly affected by cooking unless they have been slow cooked.  Personally, I am quite a fan of slow cooked lamb and food is to enjoy as well as nourish. (2)
 
Interestingly, cooking increases the lycopene content, which is an antioxidant, in tomatoes, it does reduce the amount of Vitamin C which is also an antioxidant. (3)  Lycopene may be beneficial in helping to reduce the risk of prostate cancer. (4)
 
Whilst eating raw food is great because the nutritional content hasn’t been compromised by cooking, it is harder to digest the nutrients.  Cooking starts to weaken the cell wall and break down proteins making them easier to digest. (5) Eating a variety of cooked and raw vegetables is probably the best way to go and summer is a great time to eat a delicious salad!

In terms of safety, if you are going to use a microwave,

then make sure you use a glass or ceramic container to reduce the likelihood of chemicals leaching out into the food.  Also, if you cover it with cling wrap make sure it doesn’t touch the food for the same reason.  Another common misbelief with microwaves is that its radiation can damage human cells, unlike X-rays which can. Microwave radiation is not energetic enough to break molecular bonds. It is considered non-ionizing radiation. Microwaves can heat water, including water in your body, and this can have biological effects. That’s why microwave ovens are shielded. The best advice is not to use a really old microwave that may not be functioning well. Also, don’t stand directly in front of the microwave when it is operating. Radiation falls off quickly with distance, so stand a metre away and any minimal radiation leakage will be harmless. (6)

1, 5, 6: http://www.sciencebasedmedicine.org/microwaves-and-nutrition/ 
2: http://www.livestrong.com/article/368262-do-microwave-ovens-destroy-food-nutrients/#page=1
3: http://pubs.acs.org/doi/abs/10.1021/jf0115589?prevSearch=rui+hai+liu&searchHistoryKey=&
4: http://cebp.aacrjournals.org/content/13/3/340.short
 
So, I hope this has shed some light on the issue as I hear a lot of people comment on how bad they are for us but really that is just a misconception.

Avoiding Back Injury Whilst Training

Back pain affects 80 percent of the population. 99 percent of cases are non-life threatening, and may be the result of :
- Muscle strain
- Joint strain 
- Disc strain

Symptoms can range from a mild ache to severe pain, not only in the back but also radiating down either one or both legs. The good news is there's a lot that can be done to help with the management of symptoms and get you back to a normal, pain free lifestyle.

Here are some tips for avoiding back injury while training:

* A strong core is the key to preventing back injuries. Ensure you engage your core muscles i.e. keep them contracted during cardio and resistance training

* Keep a neutral pelvis and lumbar spine at all times

* If you are suffering back pain, stick to exercises involving little to no low back movement and low impact cardio

* Rowing - Keep back straight, bring shoulder blades in and down with every stroke

* Horizontal/seated leg press - is to be avoided as it does not encourage core stabilizers and can cause disc injury

* Keep arm weights below shoulder level - to avoid neck strain. Also, avoid poking your chin out whilst exerting yourself

Pain is not normal; it indicates that there is a problem, pushing through it may cause extra harm. If you are experiencing pain or discomfort during or after training, come and see one of the chiropractic team at Riverside Chiropractic for a full assessment, x-rays can be taking if required and treatment provided.