Reducing Pain from Raking

Summer turning into Autumn, we come upon that time of year again when the leves start to turn and fall, blanketing our yards.  With this, comes the tedious task of raking and picking up those leaves.  Where I live, the trees are very plentiful and we end up putting out at least 20-30 bags of leaves, mulched, out for pick-up, so we usually end up pretty sore and tired afterward.  So what should we do to prevent us from becoming so sore afterward?

The following tips can help reduce or prevent pain associted with raking, such as bakc strain, neck strain, and pain in the shoulders:

• Do some strecthing for 10-15 minutes throughout your work and afterward.  Also make sure to walk around a bit to keep the blood flowing.
• Stand as straight as possible with your head up while raking and mowing (this might cause soreness by itself depending on core muscle strenght and posture)
• Avoid working in the heat when the temperature is still warm outside.  The best times to get work done is before 10am and after 6pm.
• When raking, stand with one foot forward and one foot back; make sure to switch every so often
• As always, bend at the knees to lift with your legs, and not bending at the waist to lift with your back.
• Use your whole body to push the mower and not just your arms and back.
• When starting the mower, bend at the knees and pull in one smooth motion.  Most people twist at the waist and yank which seems to be the easiest way (I do it too and I'm a chiropractor).
• Saftey first.  Wear protective gear: gloves, long pants, gloves, hat, eye and ear protection.
• Stay hydrated with water (sports drinks can have a lot of excess sugar in it and can have the opposite effect)
• Use ergonomic tools, if preferred

If everything goes well, your pain should be limited.  If you do feel pain or stiffness, use ice over the area and see your chiropractor if it doesn't improve in a few days. 

Lateral Ankle Sprain: Reducing Swelling and Bruising using Kinesiotape

About a week ago, my wife was at work and turned in such a way that she ended up rolling her ankle pretty badly.  She has had a history of rolling the same ankle to the point that if you even look at it funny, it will roll, and she would probably agree that I am not exaggerating.  She had decide that it was best not to take her shoe off until she got home and was given an ice pack about the size of a smurf to put on it in the meantime.  Being a Chiropractor and the loving husband that I am, I took a look at her ankle and saw that the area around her lateral malleolus (the bony bump on the side of your ankle) was about 2-3 times bigger compared to the other ankle.  It really looked as if she had a golf ball in her ankle.  I had her ice it with a proper sized ice pack for 20 mins at a time and had her stay off it as much as possible.  The swelling did go down a bit but not a whole lot, so I had mentioned that there was a Kinesiotape application that I could do that would help reduce the swelling and brusing that was still there. 

Lateral View

Now, I should mention that when I first met my wife, she was a little unsure about chiropractic and did not know much about it.  Five years later, she knows when something doesn't feel right and has me adjust her, including her neck, so she trusts me enough to try the Kinesiotape on her ankle (been also doing Acupuncutre on her, too).  Since I am new to kinesiotaping and have not had a whole lot of practice with it since the seminar I took in July, I knew how to cut and apply the tape, but had to refer to a manual as for the placement of the tape for a lateral ankle sprain.  It's hard to tell in the pictures how bad the swelling was and I didn't think about taking a before picture until after I had finished taping.  Normally, Kinesiotape can stay on for 3-5 days even with washing, but where I had put the ends, some of them starting peeling off when she wore shoes.  So I ended up re-taping within about 24 hours.  After a total of 48 hours with the tap and a few icings, the tape was removed to assess how her ankle was doing.  The swelling had reduced by about 3/4 and what little bruising there was had shifted some in between the lattice of tape and some settled underneath the malleolus.  This is what her ankle looked like after 48 hours with the Kinesiotape:

For more information on Kinesiotaping, you can head over to www.easterkansaschiro.com and follow the links on the Kinesiotaping page under Services. 





Chiropratic and Sport Injuries

We all know that exercise is an essential part of our overall health and well-being.  However, sports injuries can occur whether you are an avid athlete and compete/train on a reagular basis, or you are just starting up a new sport or exercise regimen.  In most cases, they can be prevented but there are few instances where an injury can occur even though you took the recommended precautions (i.e. proper technique, proper use of safety equipment that is fitted appropriately, and proper conitioning, warm-up and cool down procedures) and are in the best shape of your life.  The most common ones are Strain/sprains, tendinosis, and stress fractures. 

Strain/Sprain
Usually if there is a sports injury, it most commony involves a tear in the muscles, tendons, and ligaments.  The difference between a "strain" and a "sprain" depends upon the structure that is injured:  Strains involve muscles and tendons while sprains invovle ligaments.  The severity of the tear ranges from mild to severe.  Mild strain/sprains mean that the injury is stable with only some fibers being torn or stretched.  This grade can be easily managed conservatively with rest, ice, compression, and elevation.  A chiropractor can help out with this treatement and can start manipulating the joint once the initial inflammation has gone and the patient can tolerate it.  Some chiropractors can also do acupuncture around the sight to help easae the pain and kinesiotaping to help bring down any swelling and to help support the muscles with rehab to keep them functioning thw way they should.  Severe strain/sprains, however, means that the tear goes through, or sometimes, all of the structure, making the injury unstable.  These typically would need surgical intervention, but acupuncture can help with pre- and post-op support. 

Tendinosis
Also called Tendonitis, this injury is a commonly due to overuse or repetitive motion causing inflammation of the tendon.  The most common types are golf and tennis elbow, but can occur in any joint, especially the shoulder and knee.  Pain and swelling occurs over the tendon and get worse when motions that stress the tendon are performed.  As with sprains and strains, rest, ice, compression, and elevation is the way to treat with a combination ofchiropractic adjustments after the inflammation and swelling are gone to restore normal ROM, kinesiotaping for muscle support and re-education if needed, and acupuncture to help with pain managment and healing support. 

Stress Fractures 
Also called Fatigue fracture, this injury usually is seen with runners that unknowingly are putting an abnormal amount of stress on normal bone.  This can happen if the running distance is increased too fast or if those who aren't used to running long distances overdo it.  Shin splints also falls into this category since it is an overuse injury caused by microfractures on the front side of the shin bone.  Pain and swelling increases gradually and can get worse with activity.  Rest, ice, compression, and elevation are probably the best treatment as it will tak a little time for the bone to heal.  Acupuncture can help relieve some of the pain and support healing.

Back to School Backpack Safety

This subject is a pretty popular one around this time of year as Summer vacation winds down and kids from pre-school on up to college start prepearing for the upcoming school year.  Most of them may be purchasing a new backpack or cleaning out last year's that has sat in one spot for the past three months.  In any case, a backpack could be a potential source of back and neck pain with or without headaches, which are seen a lot, generally, in chiropractic offices. 

How is this possible?  A lot of it has to do with how the backpack is worn and how much weight is in it.  A lot of people tend to wear a backpack with only one strap over a shoulder bacuase it is more convenient or looks better.  The problem with this is that all the weight of the pack is situated to one side of the body, putting strain on the other side from leaning to compensate.  Over a short period of time, this can lead to lower and upper back pain along with pain in the shoulders and the neck.  If not addressed sooner, it can increase the rate of the development of chronic back problems later in life.  As for the weight, the amount that kids are carrying now seems to have increased since I was in school.  Even then, I felt like I was carrying a lot (I still seem to be now).  The recommendation for the amount of weight in a backpack is about 10-15% of the child's body weight.  Anymore than this can start to put stress on the child's body and posture as he/she compensates by bending forward at the waist or hips and arching the back into more of a slumped position.  Back muscles wil be stressed along with the spine since it is now being compressed in an unnatural position.   

The best way to pick up and wear a backpack is using both shoulder straps (which should be fairly wide and padded so they don't dig into the shoulders), positioned evenly in the middle of the back and not sagging down to the buttocks.  The weight should be distributed so the heaviest items are positined closer to the mid-portion of the body.  When purchasing a new backpack, buying one with a waist belt can help distribute the weight more evenly and extra padding on the back can provide more comfort and protection from objects inside trying to poke out.  Messenger bags or bags that are carried on the shoulder or accross the chest are a nice alternative to backpacks, but they can have a similar effect on the body as carrying a backpack with one strap over one shoulder.

Once school starts, parents should also encourage their kids to use their desk or locker more often in order to keep the backpack's weight on the lighter side throughout the day.  Also, less is better; have them leave behind, either at home or in the desk/locker, anything that is unnecessary such as cell phones, laptops, etc.  It is recommended, too, that they should only bring home what is needed for homework and studying each night, unless they are being slammed with assignements, tests, or are just plain procrastinating.

Lastly, regular visits to your local chiropractor can also be beneficial in prevention or treatment of back/neck/shoulder pain and/or headaches associated with backpack use or any other cause.

Meralgia Parasthetica: What is it and can Chiropractic help?

One look at the name of this condition, Meralgia Parasthetica, and you may wonder what in the world is that.  Meralgia Parasthetica is the entrapment of the lateral femoral cutaneous nerve causing numbness, tingling, and pain in the outer part of the thigh, typically in one leg only.  This nerve runs from the abdomen through the inguinal (groin) area and into the leg, providing sensory innervation to the outer thighs.  The primary cause is pressure on the tissue surrounding the nerve that can occur with constant sitting or standing, being overwieght, wearing constrictive clothing (especially around the waist), pregnancy, and/or trauma.  From personal experience, the discomfort felt with meralgia perasthetica can range from numbness without pain to a nagging, achy pain, on up to very nagging, sharp pain.

Can chiropractic help?  The answer is yes, but with help from the patient.  From a chiropractic standpoint, making sure that the low back, pelvis, and hip are in line and functioning correctly through adjustments and some soft tissue work will help, but is only part of the equation.  The other part lies with the patient.  Things that the patient can do to help may include resting if active, losing weight, wearing looser fitting clothing, keeping the pocket on the affected side empty, and exercise and stretching.

Here are some stretches and exercises that can help:

• Hip Flexor Stretches:  standing with foot of unaffected leg about 3 feet in front of you, then flex your front knee, letting your hips sag and keeping the affected leg straight (don't bend that knee), stop when feeling a gentle stretch and hold for 5 breaths, deepening the stretch slightly with each exhale
• Quadriceps Stretches:  can be done either standing or kneeling on affected leg, bring the foot of the affected leg up towards the buttocks by grasping the ankle and gently pulling, holding for a count of 5 breaths
• Sit-ups:  strengthening the abdominal muscles can help relieve the pressure on the nerve in the abdominal region;
• Lunges:  these strengthen both the hips and the quadriceps muscles

These exercises and stretches were found the livestrong.com website and is not the only source of information for Meralgia Parasthetica.  Make sure to consult with a chiropractor or your primary care physician for a definitive diagnosis and treatment plan.

Traveling? Do it As Painless as Possible

As we approach the halfway point of summer vacation season, my recent family trip to St. Pete Beach, FL serves as a reminder that traveling, whether for fun or for business, can put a lot of stress on the body.  We have all been there before...the plane lands or you make a stop for gas and a bathroom break, you go to stand up and you feel stiff and sore.  Also, by the time you get your final destination, all you want to do is grab something to eat and go to bed because you are so tired from sitting for so long.  Well, there are some thing you can do that can help lessen the stiffness and achiness of traveling (but you may still be tired depending on how the trip went and the time of travel).

Dr. Scott Bautch is a former president of the American Chiropractic Association's (ACA) Council on Occupational Health and recommneds that you treat any travel as if it were an athletic event.  Doing a brief warm up before and a cool down after can help decrease the degree of stiffness and achiness that can occur.  It also recommneded that yoru drink plenty of water afterwards as dehydration can also become a factor.  Dr. Bautch also gives the following tips that are summed up from an ACA Patient Information sheet on travel.


Traveling by Airplane

• Use rolled-up pillows or blankets to help maintain the natural curve of the spine when you sit in your seat.  One should be tucked behind your back just above the belt and the other between the neck and headrest.  If needed, folded blankets can be used to level out the part of the seat that you sit on...some of the seats may be worn a bit and the blankets will help level out your pelvis and hips when you sit.  I know this may be difficult on some flights where there is not much room to breath, let alone move, so I suggest doing the best you can to fit the individual situation.
• Check all bags that weigh more than 5-10% of your body weight.  This one is a bit trickier now with all the baggage fees but most bags that are too big to fit in the overhead bins or under the seat will have to be checked anyway.  If you can make your carry on weigh more than 30-40 pounds, then more power to you, but just be careful how you lift it up into the overhead bin.  With any carry-on luggage going into the overhead bin, make sure you are facing the bin, keeping your back straight with no rotation of the spine, head, or neck as you lift the bag into the bin.
• When stowing items under the seat, sit in the seat first, then use your hands and/or feet to gently guide the bag under the seat.  The other option, standing up and trying to shove the bag under the seat with your leg in a side sweeping motion or kicking motion, can cause muscle strain and spasms in the low back and upper thighs.
• Since you are typically sitting for a long period of time, shift your position every now and then to improve circulation and avoid leg cramps.  The key here is to keep the blood circulating in the body, especially the lower legs since the calves are a common place to develop a Deep Vein Thrombosis in those who are at high risk for them.
• Adjust the air controls so that they are not blowing right on you.  The direct flow of air can increase tension in the neck and shoulder muscles.

Traveling By Car
We are all familiar with taking rest breaks every few hours and changing your focal point to reduce eye fatigue and tension headaches.  I also think that we are good at shifting every now and then to help with circulation and discomfort, especially in the legs, shoulders, and neck.  Here are a few others:

• Adjust the seat so that you knees are slightly higher than your hips and you are as close to the steering wheel as comfortably possible.  When you place four fingers behind the back of the thigh closest to the knee, you should be able to remove them easily.  If you can't, re-adjust the seat.
• Use a back support for your low back to reduce strain and pain.  Some cars come with adjustable lumbar support in the driver's seat, but you may or may not need extra support.
• Alternate hand positions on the steering wheel from 3 and 7 o'clock to 10 and 5 o'clock to reduce hand and arm tension.  Also, periodically loosen and tighten your grip on the steering wheel to keep circulation going in your hands to reduce muscle fatigue in the arms, wrists, and hands.  A constant kung-fu grip is not good or comfortable.

All these recommendations along with getting adjusted before and after your trip can keep you traveling in as much comfort as possible for many years to come.

Diet Soda May Not Be As Helpful in your Diet As You Thought

In the news earlier this week, it was reported that some new research shows that drinking diet sodas that use artificial sweeteners instead of the regular versions are associated with weight GAIN rather than weight LOSS.  Soda manufactueres market Diet beverages as being a healthier alternative to regular sodas because the substitution of the sugar decreases the calories per serving down to zero.  However, there may be other affects that artificial sweetners, like aspartame and Splenda, have on the body that can lead to issues like an increased waist size (when compared to those who did drink diet soda frequently or at all), increased blood sugar levels, or even an increased risk of stroke (despite the need for more research on this). 

All this scrutiny of diet sodas with artificial sweetners is nothing new and actually makes some sense when you research the history of the sweetners and how they came about.  Nonetheless, people still continue to consume these diet drinks for whatever reason.  I know...I am one of them.  For me, I got so used to diet soda that regular soda feels and tastes too sweet and heavy.  Does this make complete sense?  Probably not given the potential affects of the sweetners, but I try to limit the amount I drink to one can or bottle per day.  Still doesn't make sense since it is everyday.  The key is moderation if people are to continue drinking diet soda, or all soda for that matter.  That along with proper nutrition, portion control, and exercise.

So as we head on into the Fourth of July holiday, indulge yourself a little bit and have some fun, but please be careful. 

Upper Crossed Syndrome

For all those students and people that work at a desk and in front of a computer all day, have you ever noticed that every so often you feel pain and stiffness on one side of your neck and along the top of your shoulder?  How about at the base of your head, sometimes causing a headache on one side?  Does it feel like there is something catching in your shoulder blade when you move it?  There could be several causes for any of these symptoms together or individually, but there is one in particular that is very common and can be helped with Chiropractic treatment.  It is called Upper Crossed Syndrome.  Upper crossed syndrome is a muscular imbalance that is caused primarily by poor posture of the upper body, especially the head, neck, and shoulders.  The following muscles are typically involved, forming a criss-crossed pattern:

• Upper Trapezius (Tight) - runs from the base of the back of the skull to across top of the shoulders
• Levator Scapula (Tight) - deeper than the upper trapezius, running from the upper neck to inner-top aspect of the shoulder blade
• Lower Trapezius (Weak) - runs from the top of the shoulders, down along and attaching to the spine from C-7 to T-12 vertebral levels
• Pectorals (Tight) - chest muscles that run from your breastbone to a narrow band along the inside the front upper arm just below the shoulder
• Deep Neck Flexors (Weak) - deep muscles of the sides and from of the neck that help pull the head forward and down towards the chest.

This criss-crossed imbalance causes our head to pull forward, or Anterior Head Carriage (normal is when the ear is in line with the shoulder and not in front of it), our shoulders to pull forward, up, and inward (what we call forward or anterior rolled shoulders), and the shoulder blades to roll outwards and possibly protrude outward away from the back.  All of these postural changes puts strain on the area from the base of the head down into the shoulders and the lower borders of the shoulder blades, causing decreased and altered motion of the spinal segments therein.  All this may not be apparent at first, but after awhile, it will become stiff and painful in these areas to the point that it will be hard to concentrate on work, reading, or even sleeping.  You may start to notice that you are getting headaches that are one-sided and start from the base of the head, sweeping forward to the forehead and, at times, the back of the eye.  The headache can feel like a slight pounding or throbbing, just enough to be subtle, but enough to be a nuisance.  We call these Cervicogenic headaches and usually get worse as the day goes on.

So what can be done about Upper Crossed Syndrome?  Any combination of chiropractic adjustments, exercises to fix the postural and muscular imbalances, ergonomic changes in your work or study space, and stress relief.  I find that massage therapy can also help alleviate the pain and stiffness and with stress relief (although depending on the type of massage, you may be more sore afterward).  There are also other treatments and products available to help with Upper Crossed Syndrome.  The right combination will depend on you, the patient, and the practitioner that you are seeing.  Either way, conservative care can go along way to alleviate this condition and help make up for productivity lost due to these pain patterns.

Sleep Apnea

Last week, I was officially diagnosed with Sleep apnea, something that I think I was trying to deny for awhile now until my wife suggested that I look into doing a sleep study. Lately, I have been feeling exhausted throughout the day and she said that she has noticed it since at least the beginning of the year.  I think I have been getting nudged at least once or twice per night by her, but I just figured I was snoring too loud and it was keeping her awake...except for the fact that I was on my side and normally don't sound like a chainsaw when I snore.  I know that being overwieght is part of the issue, but I didn't realized what other factors played a part in me finally agreeing to do a sleep study.

Sleep apnea is a term that is very well known and we usually associate it with people who snore very loudly.  However, I am sure that there are quite a few people that don't know that it is actually the repeated stoppage of breathing during sleep and that it often goes undiagnosed.  When these stoppages occur, the brain has to briefly arouse the person enough to get them to continue breathing.  When you add up all of these occurances, the result is non-restful sleep and the person will usually have a hard time getting up and going in the morning and making it through the day without feeling tired or exhausted.  Other common complaints that can be associated with sleep apnea include waking up with headaches, falling asleep in the car while driving or at a stop, memory problems, depression, reflux, frequent trips to the bathroom during the night, and impotence.  For children, it could be a potential cause of hyeperactivity.  If sleep apnea is not treated in a timely manner, it can lead to high blood pressure and cardiovascular disease.

"Sleep apnea is as common as diabete and affects more than 12 million American, according to the National Institutes of Health." -www.sleepapnea.org

Types of Sleep Apnea
There are 3 Types of sleep apnea: Obstructive, Central, and Mixed, with Obstructive being the most common. 

• Obstructive Sleep Apnea (OSA):  occurs when the airway becomes blocked by the collapse of the soft tissue in the back of the throat
• Central Sleep Apnea:  The airway remains unblocked but the brain does not tell the muscles to make you breath
• Mixed:  A combination of the other two types

Risk Factors
In researching a little bit more about sleep apnea when my wife suggested that I look into doing a sleep study, I found that some of these risk factors made sleep apnea a very likely diagnosis for me. Here are to risk factors for sleep apnea (not just the one's that applied to me)

• Family History of sleep apnea
• Overweight (but can affect any weight)
• Male (also female)
• Over 40 (but can affect any age)
• Large Neck
• Recessed chin
• Abnormalities in upper airway structure
• Smoking
• Drinking
• Ethnicity (African American, Asian, Mexican)

The last risk factor, ethnicity, was one that didn't occur to me until I met with the specialist.  Being of Asian descent, we typically have narrow neck and facial features that lead to airway obstruction.

Treatment Options for OSA
Treatment for sleep apnea can be as simple as positional therapy or as drasctic as surgery.  The goal of positional therapy is simply to keep you from sleeping on your back, the position most associated with sleep apnea.  Some of the products that are available to help are foam wedges to elevate the torso in more of a reclingin position, alarms that go off when you roll onto your back, but the simplest solution is to sew a tennis ball to the back of a night shirt to prevent you from rolling over on your back comfortably.  The most drastic option, surgery, is meant to widen the airway in order to prevent obstructions to occur.  There are several different procedures, each with their own effective rates, but there is the likley chance that it could have no affect or acutally worsen the apnea.  Other options include oral appliances, weight loss if that is a factor, and the avoidance of alcohol and other CNS (Central Nervous System) depressants.

The most common and most effective treatment method is Continuous Positive Airway Pressure or CPAP which is a machine that blows pressurized room air into the airway to keep it from collapsing, causing apnea.  The pressure necessary to keep the airway open varies form person to person and is dependent on the severity of the apnea.  It takes some getting used to epsecially if you are used to breathing through your mouth when sleeping.  If you open your mouth, the pressure will come out of your mouth and defeat the purpose of what the CPAP is supposed to do.  There are different types of machines and masks so proper fitting by an appropriate medical supply provider can be beneficial to comfort. 

Once again, in any case, be sure to consult with your regular doctor to figure out what options are best for you if you are ever diagnosed with sleep apnea.

Melanoma, Vitamin D, and the Summer Sun.

With Memorial Day weekend marking the start of the summer season and with the recent death of Kansas City Royals Hall of Fame pitcher Paul Splittorff due to complications from melanoma, I figured I would begin my foray into the blogging world talking about how sun exposure can be both good and bad for us.  A lot of people probably spent a good portion of this past weekend out in the sun, whether having fun at the lake or getting out and catching up on some of those outdoor chores that fell by the wayside.

The Good
Apart from getting a nice tan at some point, being out in the sun for 10-15 minutes at three times a week can fulfill the body's requirement for Vitamin D.  The sun should shine on your face, arms, legs, or back without sunblock for this amount of time, however, it is still recommended that sunblock be used if you are planning on spending any extensvice amount of time out in the sun.  Less vitamin D is made with sun exposure through cloud cover, windows, shade, and in those with darker pigmented skin. 

Why Vitamin D is Good for Us
Vitmain D is good for us because it helps with the absorption and retention of calcium and phosphorus which is needed for normal bone formation.  In childhood, these two minerals are used to make our bones.  In adulthood, they are needed to maintain them, which means the older we get, the more we may need.  Deficiencies in vitamin D can lead to a softening of the bones suchs as osteoporosis in adulthood or rickets in children.  Too much vitamin D can leach calcium from the bones and into the blood via absorption by the intestines, depositing it in the heart or lungs, leading to reduced function in those organs and causing even more serious problems in the future.   The good news is that most overdoses are from using supplements in excess and not from spending too much time in the sun.

The Bad
The unfortunate part is that too much sun exposure without adequate protection, over time, can potential lead to melanoma, the most dangerous type of skin cancer.  Of all the skin diseases, this one causes the most deaths.  We all know that people most at risk are the ones that have fair skin, blue or green eyes, and red or blond hair becuase of their increased chance of getting sunburn.  We also know that it is the ultraviolet radiation in the sun as well as tannning beds that is the cause. Melanomas can spread very rapidly and there is increased incidence as we get older.  Usually starting as flat, irregularly shaped and colored moles, they can be detected by anyone, including chiropractors.  We cannot not treat melanoma, but we can refer cases to the appropriate professional and help co-manage after treatment and if there is no advanced spread into the bones. 

So, as the heat of summer starts to ramp up, we at Eastern Kansas Chiropractic want everyone to be safe and take preacutions when it comes to your skin...minimize your time in the sun as much as possible, wear a hat and sunglasses to protect your head and eyes, wear sunscreen, and make sure you report any suspicious looking mole to your primary care doctor.