CHIROPRACTIC &
REHABILITATION CENTRE

Your leader in innovative and cutting-edge injury care, and health and wellness promotion.

MENU

HEALTH AND WELLNESS

Interested in what's new or different and exciting in the health and wellness world? Well, this page is for you! Every once in a while a new article on a timely, trendy or pertinent topic will be added to this page. Please check in with this page occasionally for a new article.

Why stretch?

Stretching should be a part of your life. Regular stretching will help with the following:

  • • Reduce muscle tightness
  • • Help coordination via easier/freer mobility
  • • Increase range of motion
  • • Reduce risk of injury
  • • Promote circulation

Stretching can be done almost any time you feel like it. The only time I discourage people from stretching is first thing in the morning before you get out of bed, (atleast walk around the house once or eat breakfast etc. before stretching in the morning).

How to Stretch

The correct way to stretch is to hold the stretch in a relaxed, sustained manner with your attention focused on the muscle being stretched. The incorrect way is to bounce up and down or stretch to the point of pain.

Hold a stretch for 15 - 30 seconds with a comfortable pulling sensation. Stretch both sides i.e. both hamstrings, both shoulders. Stretch each side 3 to 5 times. Each repetition you may find you can stretch a bit further. Breathing should be slow and rhythmical.

Recently there has been some controversy about whether to stretch or not and when to stretch.

The best research indicates during your warm up, increase your body temperature first (i.e. jog, stationary bike, jumping jacks etc.) for 5 - 10 minutes. At this point you are safe to do your stretches. Post-exercise is a good time to do a few key stretches as well. If you are interested in stretching as a lifestyle decision and not just before sports. I would suggest stretching in the mid-morning and anytime after when your body temperature and circulation are optimal.

If you are not sure or confident about what stretches to do, ask a qualified health care provider for a customized or sport-specific program. Do not guess or begin without help. If you have any questions, please feel free to contact me.

When can I go, coach?

Your best defenceman twisted her knee in the second period. It is late in the third period and she wants to play again. It is late in the basketball season and your starting centre says he can play after tearing ankle ligaments one month ago.

These are just a couple of scenarios coaches and athletes face every season. What do you do? Are there guidelines? Are there legal implications? What would another coach do?

Fortunately, this topic has been discussed, researched and studied with much thought over the years. In today’s litigious climate, coaches, players and parents should be aware of the following so that the ultimate goal, the safety of the athlete, is always remembered.

We all recognize that injuries are a common occurrence for those who exercise and compete in sports. Injuries can be either an overuse condition (i.e. tendonitis, shin splints) or a sudden, acute injury (i.e. bone fracture, torn ligament) and many injuries require restrictions and/or a change in the training/playing schedule.

Injuries cause some kind of disruption or dysfunction to the musculoskeletal system, such as bone, muscles, ligaments, joints, resulting in pain, swelling, bruising, stiffness and reduced range of motion, strength and sensation. Improvement occurs with healing. However, the tricky part is that improvement in these signs and symptoms does not necessarily confirm that the injury has completely healed.

Everyone should remember the following after an injury has occurred:

  • • PROTECT the affected area from further injury
  • • REST will help prevent further injury, decrease risk of swelling and aid in a rapid recovery
  • • ICE on the injured area decreases swelling/pain and should be used for 2 - 3 days post-injury
  • • COMPRESSION (wrapping/bracing) helps control swelling and decreases motion
  • • ELEVATION of the injured part (especially above the heart) helps decrease swelling/pain
  • • PRICE is the first thing we should all remember with injury care

The length of time an athlete is away from their sport or exercise varies according to the type and severity of injury, body part injured and other specific factors. Of course there are always exceptions, but healing usually proceeds in certain stages:

  • • 24 - 72 hours post-injury – swelling/pain decreases
  • • 7 - 14 days post-injury – range of motion increases
  • • 10 - 14 days post-injury – discolouration (bruising) subsides

Proper rehabilitation with the goal of accelerating healing, pain control, swelling reduction and increasing range of motion, strength and coordination is paramount. Attempting to return to play too early, significantly increases risk of re-injury or additional injury. Consultation with a health care provider knowledgeable in sports injury care will aid in initial treatment and determination of return to play.

Please be aware of the following guidelines for return to play as recommended by the American College of Sports Medicine:

  • • Injured body part should have full, pain-free range of motion
  • • At least 90 - 95% strength of the opposite side
  • • Some mild discomfort/stiffness/swelling during or after initial return to exercise
  • • Athlete should be able to perform specific motions and actions required for their sport before returning
  • • Consider a progressive return to activity, beginning at 50% and progressing 10 - 15% per week
  • • Consider cross-training while healing such as biking/swimming for knee/ankle injuries
  • • Ask athlete if they feel they are ready to return/ensure mental confidence

Appropriate initial care post-injury and following proper return to play guidelines will help ensure a safe and fun season.

What holds you back?

Most people will experience back pain at some point in their lives. Chances are if you are reading this article, you are an athlete or know one who has suffered from back pain. What does one do? Who does one see? How do you know when to seek care for your low back pain?

Is your back pain holding you back from optimal performance on the track?

Take this quiz and find out! Answer YES or NO to the following questions:

  • • Do you experience recurring back pain that comes and goes every month?
  • • Do you experience daily or weekly back pain?
  • • Do you miss out on sports or physical activities as a result of back pain?
  • • Do you believe there is no effective treatment for back pain?
  • • Are you concerned that treatment for back pain might not be covered by your benefits plan or provincial health plan?
  • • Have you taken a pain reliever for more than three days in a row to treat back pain?
  • • Are you worried about what a diagnosis might mean if you visit a health professional?
  • • Do you hope that your back pain will go away on its own?
  • • Are you too busy to seek treatment for your back pain?
  • • Do you just tough it out when you experience back pain?

If you answered YES to 3 or more of the questions above (or YES to the last 2 questions), you are probably avoiding dealing with back pain that is either limiting your life or athletic performance. So, if you experience back pain that restricts your activities and lasts for more than 3 or 4 days, stop holding back and visit a health professional. Current thinking suggests that a multimodal approach is the best to tackle uncomplicated back pain. A combination of specific therapeutic exercise and manual therapy, together with minimizing or eliminating the triggers of your pain are often successful in getting patients back to normal.

Read what these world class athletes had to say: Perdita Felicien, World Champion and Olympian in sprint hurdles says “As a full-time athlete, I rely on my body to make a living, so it always has to be at its best. Chiropractic care is an important part of keeping me in the best condition so I can perform at an optimal level.”

Daniel Lgali, World Champion and Olympic Gold Medalist in wrestling says “Chiropractic care has reduced my recovery time from injuries and lessened my susceptibility to injury. I would recommend a physical assessment and chiropractic maintenance to anyone who is serious about their sport.”

What is ART?

Have you ever wondered what holds yourself back from running a 4-minute 15 m race, or a 30-minute 10 km race, or throwing a shot putt 15 m, or sprinting a 100 m race in 11 seconds? Is it your lack of cardiovascular fitness or flexibility, lack of muscular strength or inconsistent training? If one of these isn’t the reason, because you train hard and consistently, sleep and eat well, what could it be?

One possibility may be the accumulative effects of training and the thousands of repetitive motions on the body. Even with the best equipment, good biomechanics and excellent training, runners and throwers are always vulnerable to cumulative trauma. It would be like a BMW car travelling across Canada. The greater the mileage, the greater the chance for wear and tear damage.

Injuries to soft tissue (ligaments, muscles, nerves, connective tissue) result in inflammation and swelling of the tissue. In response, the body forms scar tissue in an attempt to stabilize the affected area. This scar tissue restricts motion, reduces circulation, reduces nerve function and causes friction and pressure which usually produces more scar tissue and adhesions.

Effective treatment of soft tissue injuries often seen with athletes requires an alteration in tissue structure to break up cross-fiber adhesions and restoring normal function to the soft tissue. This type of treatment will significantly decrease healing time, treat the source of the injury and improve athletic performance.

Active Release Technique® (ART) is a patented, non invasive, soft-tissue treatment that breaks down scar tissue and adhesions that cause pain, stiffness, weakness, numbness and physical dysfunction.

ART® is effective for both acute and chronic (i.e. repetitive strain injuries) and for helping improve athletic performance. ART providers treat olympic athletes as well as professional (i.e. NHL, NFL, NBA, etc.) and amateur athletes.

The treatment is a hands-on procedure in which the provider (i.e. chiropractor, physiotherapist etc.) takes the tissue (i.e. muscle) from a shortened to fully elongated position. At the same time the patient is asked to move that injured body part that causes the tissue to either move with or away from the provider. This will help release the adhesions.

ART® is effective in treating injuries such as plantar fasciitis, achillies tendonitis, runner’s knee, iliotibial band syndrome, shin splints, back pain etc. ART® can also provide patients with a means to enhance their sports performance by identifying and releasing restrictions that reduce their performance. Not everyone offers ART® or is a certified provider.

Before you make an appointment with someone, be sure to ask if they offer ART® and if they are certified. Good luck and have a great, safe season!

Running shoes 101

Although proper athletic shoes may not allow you to run faster, jump higher, or score more goals, they may help you avoid discomfort or even injury. Here are some tips about what to look for in your next pair.

Proper Fit

  • • Know what type of shoe is best for your foot
  • • Buy shoes that are appropriate for foot type and training intensity, not for cosmetics
  • • Always get fitted for running shoes in the evening
  • • If you wear orthotic inserts bring them when trying on new shoes
  • • If the shoes don’t feel good in the store, don’t purchase them

Shoe Care

  • • Wear running shoes only for running/training
  • • Don’t wash running shoes in a laundry machine
  • • Don’t kick off shoes without untying them

Shoe Replacement

  • • Excessively worn down shoes may lead to injury
  • • Replace shoes every 600 - 1000km or every 6 months
  • • The outsoles are made of durable compounds and are a poor indicator of remaining shoe life

An excellent resource on running shoes and proper fit can be found at Runners World.

The best "jock" therapy

Whether you are a professional athlete, a weekend warrior or an athlete somewhere in between, you undoubtedly have suffered from some kind of “sports injury.” We have all at some point in our “athletic careers” played through pain because of a recurring injury that just did not go away! Many have tried every treatment under the sun, from medicine, creams, therapy, and supplements with little or no success.

Many athletes have learned about a relatively new form of therapy, known as Active Release Technique(ART)®, a unique, rigorous and interactive, hands-on therapy in which a practitioner applies pressure to the injured area while moving the surrounding muscles and joints through a full range of motion. In fact ART®, which is relatively unknown to the general public, is relied upon by many elite pro and amateur athletes to heal their soft tissue injuries. The NFL, NBA, NHL and MLB have contracted ART practitioners to keep players healthy and playing at their optimum level!

When trauma occurs, whether from surgery, an accident, postural distortion or repetitive strain, the body’s natural response is the formation of scar tissue. Scarring has a detrimental effect, causing tissues to adhere to themselves as well as to other related structures. Adhesions occur as a result of the cumulative injury cycle and are responsible for the vast number of sports aches and pains. The practitioner (often a chiropractor, massage therapist or physiotherapist) will use his/her hands to search the muscles for adhesions and/or dense, tight scar tissue.

At first glance, ART® might appear similar to a standard massage. A key difference is the direction of the hands-on pressure. Other kinds of deep tissue massage move in any direction. ART® lengthens the tissue in the same direction as muscle fibres naturally move. That’s what stretches the adhesions and results in accelerated healing. Being active also sets ART® apart. The patient participates in an ART® session by moving their injured body part (i.e. leg, arm) to help stretch and release muscle tension.

The best part is ART® is not designed to be an ongoing treatment or preventive tool. It is designed to heal a specific injury quick. The average recovery requires six to ten sessions and many patients feel immediate change. ART® is so different that it has been granted a medical patent. In order to become an ART® provider, each professional must complete extensive hands-on instruction and written/practical testing unparalleled by other soft tissue programs. A certified ART® provider is trained to palpate, diagnose and treat more than 300 muscular injuries and over 100 nerve entrapments. ART® therapy is successful not only for sports injuries, but also for people injured in auto accidents or at work and people who just work hard and hurt. Increasingly more insurance companies and workers compensation (WSIB) now encourage and reimburse for ART®.

If you have a soft tissue injury that just occurred or isn’t healing with your present therapy or medication, you owe it to yourself to try ART®. Ask your health care provider about ART® or better yet find a certified ART® provider in your area. The easiest way to find a certified ART® provider is to ask a friend, colleague or fellow athlete who may know of one. You could also call until you find a certified provider or go online at www.activerelease.com (however not all certified providers are listed).

The best evidence that ART® works is to read testimonials from Active Release :

Jamie Sale, Olympic Gold medallist figure skater states “when we do some ART®, I feel much looser-almost something like I have a new body. It’s for people who are in discomfort every day. I have sent my mother and cousin for ART®!” Gary Roberts, forward for Florida Panthers says “My injury left me with no chance of ever playing hockey again. Now, after being treated with ART® and a proper rehabilitation program, I have completely regained my career in hockey!”

Future of healthcare

Liquid band aids, gene therapy, limb and joint replacement surgery, hyperbaric chambers. These are just a few of the present day health care therapies… cutting-edge, innovative and effective. The future is now. Health care is undergoing a dramatic paradigm shift in the way we progress patients through care and the treatment they receive. With today’s evidence and current literature, active care is the new norm for injury care.

What is Active Care?

This term refers to the active involvement of the patient in his/her therapy. Active care is based on patient self-empowerment which encourages the patient to assist in care via three key areas: pain management, exercise and education. Essentially the patient plays an active role in the rehabilitation process under the guidance of a health care provider. I’ll give you an example of how an injury may have been handled years ago and how it may be managed in the present-day evidence-based arena. A hockey player is hit from behind into the boards and he hyperextends his lower back. The next day he suffers from intense low back pain and stiffness. After serious injury is ruled out, years ago the passive health care model would offer this athlete pain relieving medication, rest and possibly passive modalities such as ultrasound. Today the evidence suggests multimodal therapy comprising any combination of manual therapy, exercise therapy, education regarding safety, prevention and health promotion complimented with passive therapies offers the best continuum of care. You ask what is all the fuss about health care for back injuries or knee injuries or shoulder injuries because these are the type of injuries we are talking about with respect to the active care model. The statistics don’t lie; for just back pain alone:

  • • Back pain is the single greatest reason for activity limitation in those under age 45
  • • Back pain costs have increased 65% in the last 10 years
  • • Individuals with back pain have health care expenditures about 60% larger than individuals without back pain

It is very obvious, for back pain at least, that it is causing a significant impact on our health care delivery system and more cost-effective and effective treatment methods must be utilized. As previously mentioned the three key components of the active care model that will help you and our heath care system are:

  • • Pain Management – The sooner pain is managed or reduced the quicker one returns to a normal lifestyle. Effective pain management for musculoskeletal injuries include: manual therapy, anti-inflammatory medication, R.I.C.E (rest, ice, compression, elevation). Pain will improve once mobility and inflammation is improved.
  • • Exercise – Probably the most effective approach to injury recovery is to include exercise therapy such as walking, jogging, swimming, biking etc. Proper exercise will accelerate healing, increase joint mobility, reduce inflammation and improve cardiovascular fitness.
  • • Education – The starting point is focus on prevention and health promotion via the public health model. Public health is a society’s effort to protect, promote and restore health. If we could convince patient’s that an active lifestyle, smoking cessation, diet improvement and stress reduction will improve their quality of life, extend their life and reduce injury risk, our national health care costs would dramatically decrease. I feel the greatest benefit we can offer our patients and to society is to educate them about various public health initiatives

Sarnia-Lambton Resources

Sarnia-Lambton has an abundance of public health resources available for our community. As a chiropractor, a large part of my day is assessing and treating patients with low back pain, neck pain and headaches. Effective, active care will help these patients but introducing and promoting public health measures will help the bigger picture...health promotion and disease prevention. Local resources include Healthy People 2020, which challenges you to take specific steps to ensure good health and a long life. Health Canada provides an abundance of practical, useful information on various public health topics.

Sarnia-Lambton is especially aware of Ontario and Canada’s physician shortage and the resulting frustration risk and cost this creates. Delay in assessment and treatment increases the risk of further complications and delays recovery of sick or injured people. The physician shortage paired with the fact Sarnia-Lambton residents are more likely overweight and underactive relative to the Canadian population creates a tremendous risk to our health and lifestyle. One solution is education. The public and health care providers must be aware of more effective, timely treatment options and public health initiatives.

An example I see daily is the chronic low back pain patient who has suffered through many ineffective treatments and delays. The patient has waited for weeks to see their physician, days or weeks for an X-ray or an MRI. This scenario can be avoided by immediate referral (i.e. self-referral or by the first seen health care provider) to a chiropractor, who is the specialist of low back problems. This is not only supported by the research but will help free up valuable time for the over worked physician to see/treat medical conditions. There shouldn’t be any political tug of war, hurt egos, or turf protection involved, simply common sense with the best interest of the patient in mind. Ultimately, this will save health care dollars, shorten wait times and provide better, timely care.

The Future of Health Care is Now!

Musculoskeletal injuries require proper, current, timely, active care. Without this, our hospital, physicians, health care dollars and most importantly the patients will be unnecessarily stressed and overwhelmed. This spring and summer, get more active! Swim in Lake Huron. Join a golf league. Walk regularly along the Howard Watson or Bluewater Trails. You help yourself and us all when you do! However, if you get slowed down by an injury get the timely, effective care you deserve.

Sports injury-free checklist

We all want to avoid hockey injuries during the season. Hockey is a fast, aggressive contact sport and injuries are inevitable.

The following is a collection of (but not all-inclusive) guidelines to provide guidance and hopefully help reduce risk of injury to your hockey (or whatever sport you play) season:

  • • Every athlete should receive a pre-participation physical exam including a general and musculoskeletal exam
  • • Athletes should maintain year-round conditioning focussing on muscular strength and endurance, cardiovascular fitness and flexibility
  • • Maintain good nutritional practices
  • • Wear appropriate, properly fit equipment
  • • Mouth guards should be used in all collision sports, including hockey
  • • Consistently include a proper warm-up
  • • Ice should be on the bench/sidelines of every game/practice
  • • Injuries involving bones/joints should be examined/treated by a licensed health care practitioner (i.e. chiropractor, physician, physiotherapist etc.)
  • • All injuries should be evaluated ASAP
  • • All individuals involved in the athletes’ health and safety should be encouraged to maintain cooperative liaisons.

To help educate yourself, you can check out some hockey and injury prevention websites: BC Injury Research and PreventionHockey Canada and Hockey Development Centre for Ontario.

Good luck and have a fun and safe season!

Strain vs. sprain

If you have played sports long enough chances are you have sprained, tweaked, bunged up or strained something in your body. Probably the most common sports injury is a sprain to a joint.

What is a Sprain?

A sprain is an injury to a ligament such as a tear or an overstretching. A sprain, often confused with a strain, is an injury to either a muscle or a tendon.

The typical scenario for a sprain to occur is when an athlete rolls their ankle, or falls and lands on an outstretched arm or twists their knee while the foot is planted. Ankle sprains are the most common injury and sports injury and is often a source of missed games, practices and lengthy rehab. The usual signs and symptoms of an ankle sprain or any sprain for that matter include pain, swelling, bruising and reduced ability to move the joint.

In general, a Grade 1 sprain causes an overstretching of the ligament(s) with no joint instability. The person will notice minimal pain, swelling, no bruising or loss of range of motion.

Grade 2 or moderate sprain causes partial tearing of the ligament(s) and results in bruising, swelling, moderate pain, some loss of motion and there is some difficulty with full weight-bearing.

A Grade 3 or severe sprain completely tears or ruptures the ligament(s). Pain, swelling, loss of motion and bruising are severe and the person is unable to put weight on the joint.

Any sprain should be assessed by a qualified health care provider, preferably with musculoskeletal injury experience (i.e. physician, chiropractor, physiotherapist). When diagnosing the injury, the health care provider will rule out other more severe injuries (i.e. fracture) and ask the athlete how the injury happened before examining and assessing the injured site.

Treatment for a sprain begins immediately after the injury occurs and not 2 or 3 days later at the health care clinic. Treatment for a sprain has 2 stages: to reduce swelling and pain rehabilitation. Immediately after the injury, remember R.I.C.E.:

  • • Rest (depending on severity, rest is relative; you may rest for the next shift in a hockey game or for 2 weeks while riding a stationary bike instead of running while training for a 10 km race)
  • • Ice often (15 - 20 minutes several times a day)
  • • Compression with a tensor wrap around injury
  • • Elevate injured site to help decrease swelling

R.I.C.E. should occur at least until the bruising, swelling and pain is gone.

The second stage of sprain treatment is rehabilitation with a goal of restoring range of motion, function and strength to pre-injury status. This stage may begin the day of the injury or anytime after depending on severity. Rehab should consist of a variety of techniques to accelerate recovery which may include: interferential electrotherapy, ultrasound, Active Release Technique ®, customized stretching/strengthening/proprioception (balance) exercises, ice, heat, joint mobilization, cardiovascular exercises (i.e. swimming/biking) and patient education.

These modalities are very important because they help prevent stiffness, scar tissue and effectively restore normal pain-free range of motion. Everyone wants to know how long recovery will take. The most accurate and honest answer is no one knows but may take days to months depending on quality of care and patient compliance. Most sprains recover significantly enough to return to action within a few weeks.

To wrap up, one should seek attention to get their sprain looked at if:

  • • You can’t put normal weight on the injured joint
  • • It is very tender to touch, the area looks different (i.e. lumps/bumps)
  • • Unable to move joint, joint/limb buckles and/or numbness is present

The key to a quick recovery is R.I.C.E as soon as possible, proper diagnosis and rehab (including sport specific exercises) and consistent therapy. Good luck and have a great season!

Sports injury warning signs

If you play sports or lead an active lifestyle, there are some common warning signs that you may have a sports injury. Some injuries are sudden, some creep up. If you don’t pay attention to both types of injuries, they will get worse, cause more pain and cost you more!

Six sports injury warning signs to look out for include:

  • • Joint Pain – particularly at the knee, ankle, elbow, wrist
  • • Tenderness – at a specific point
  • • Swelling – obvious or mild swelling
  • • Reduced Range of Motion – a joint that moves less than normal
  • • Comparative Weakness – comparing one side to the other for weakness is often hard to determine but can be a good clue
  • • Numbness and Tingling

Never ignore these signs! If you recognize any of the above warning signs and obviously suffered an incident that may have injured something (i.e. twisted your ankle, popped your shoulder), see a health care professional ASAP that is familiar with sports injuries. The sooner you get your injury assessed and properly treated, the sooner you can get back to playing or being active!

Want to be a better athlete?

As athletes, we tend to focus on building a stronger heart (runners), legs (soccer), upper body (hockey), back (golf), but we too often neglect other areas. That’s a big mistake. A mechanical structure like our spine is only as good as its weakest link and weak core muscles can lead to injuries and sub-par athletic efforts.

Recently, core strength training, which develops the muscles of the stomach, back, hips and shoulders has become one of the most popular areas in the fitness field. More and more athletes, coaches and trainers in all sports are recognizing that core training gives you more than just washboard abs. It also improves your athletic performance and reduces your risk of injury.

Take your back area for example. When your back muscles are weak and tight, you lose mobility and flexibility. When you play a game or practice, the increased forces acting on your back will increase the risk of injury to that weakened core area, which can also lead to hamstring pulls, Achilles and knee problems. This is why, as an athlete, you need strong core muscles to keep that pesky low back functioning properly. A well-balanced core will also improve your coordination and efficiency. The end result is faster times, harder shots, higher jumps.

To improve your core, probably the most effective and cost-efficient aid is the exercise ball. The only problem is there are literally thousands of articles, books and online websites promoting their program which may not be suitable to you or your sport.

A relatively new, research-based, sport-specific program called Core Ball Training (CBT) is a deceptively effective tool that pairs the use of a unique copper-coloured ball with an online trainer. The innovative idea with this program is the exercises are right on the ball and your health care provider familiar with CBT will prescribe the appropriate exercises at the appropriate time, based on your injury or sport. This program is endorsed by the NHLPA and is one of the most exciting exercise concepts I have seen.

If you're interested in this program, or are a coach/trainer that's interested in introducing this to your team, contact us today for more information!

Do you have LBP?

Studies indicate more than 80% of people will have LBP (lower back pain) in their lifetime and 25% of adults have had LBP in the past three months! LBP is categorized into 3 subgroups:

  • • Nonspecific LBP (i.e. 85 % of patients)
  • • Back pain due to spinal conditions such as sciatica
  • • Back pain associated with another cause, such as infection or cancer

The guidelines suggest that patient education about current evidence-based information on LBP such as expected course and effective self-care options be discussed during the patient’s visits. For nonspecific LBP, if medication is chosen, it is recommended that acetaminophen or NSAID’s be used (i.e. Ibuprofen) with a review of the risk-benefit ratio discussed.
When self-care options do not help, health care providers should consider nonpharmocologic options. For acute LBP (i.e. less than one month), the only choice is spinal manipulation. For chronic or subacute LBP, choices that will help include multi-modal rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation and yoga.

What does all this mean to you, the potential patient?

The American College of Physicians has suggested that if you have acute nonspecific LBP and self-care has offered no relief, spinal manipulation (most effectively provided by a chiropractor) should be the only choice of therapy. If your LBP has been present longer than one month, your safest options with the best chance for relief include spinal manipulation, exercise therapy, multi-modal rehab (i.e. exercise ball core strengthening, cardiovascular exercises, stretching), acupuncture, massage therapy or yoga.

Today’s current chiropractor will offer/provide multimodal therapy for conditions such as LBP that includes, spinal manipulation, exercise therapy, self-care advice, lifestyle recommendations, and return-to-play guidelines.

If you or someone you know suffers from LBP, see a health care provider knowledgeable in the current guidelines. You may be surprised what the safest and most effective therapy recommended for your LBP is.

Can chiropractic help you?

Are you one of the four out of five people that suffers from low back pain (LBP)? You’ve tried everything: medication, rest, physiotherapy, praying...nothing seems to help and you are desperate for an answer and relief! Your friend or colleague at work has suggested a chiropractor and you didn’t take that advice seriously because your MD didn’t suggest one or you heard something negative about chiropractic or were scared to try it. Even though chiropractic has been around for over one hundred years, there remains a tremendous amount of misinformation about this area of health care. Here’s some honest and straight forward information about what you need to know!

What is a chiropractor?

A chiropractor is a primary health professional who can diagnose and treat musculoskeletal and nervous system disorders. A chiropractor has a minimum of seven years of post secondary education and are licensed by national and provincial regulatory boards. While chiropractors may use traditional diagnostic testing methods (i.e. X-rays), they also use a thorough patient history and specific chiropractic and orthopedic tests to diagnose your condition. Chiropractors do not prescribe medications or perform surgery. The underlying philosophy is to provide pro-active, non-invasive health care. However, chiropractors are trained to recognize when an injury/condition is outside their scope of practice and will refer patients to the appropriate medical professional if necessary.

How do you find one?

You can ask your family physician, ask people you know who go to a chiropractor, log on to the Ontario Chiropractic Association (OCA) to locate a chiropractor.

Who can benefit from chiropractic?

Some patients with the following conditions have found chiropractic to be helpful:

  • • Pain/stiffness in neck, shoulders, back, hips
  • • Certain types of headaches
  • • Sciatica
  • • Whiplash
  • • Scoliosis
  • • Sports injuries
  • • Bursitis/tendonitis
  • • Arthritis

Types of treatment

When one thinks of chiropractic, they usually think of the spinal adjustment. During the adjustment, a chiropractor will use his/her hands to apply a gentle, controlled force to a spinal joint. This maneuver often results in a “cracking” sound made by a separation of the joint surfaces – not as many people think, by “cracking joints.” This treatment is rarely uncomfortable, and the risk of complication is rare. The main purpose of the spinal adjustment is to restore proper movement to spinal joints that are restricted or not moving properly, for example because of overlying tight or spasmed muscle.

Can other types of professionals also perform adjustments?

Yes, some osteopaths, MD’s and physiotherapists will offer these techniques. However chiropractors perform 95% of all adjustments and are considered the specialists or gold standard of manual care. Be careful of physiotherapists, massage therapists or MD’s who provide spinal adjustments as part of their care. At the very least be informed and ask about their credentials, qualifications and experience. You wouldn’t go to a chiropractor for medication or surgery. You shouldn’t go to a health care provider for manual care other than a chiropractor.

Of course other treatments are offered by a chiropractor, such as manual therapy known as mobilizations; electrotherapy and ultrasound, customized stretching and strengthening programs, specialized soft tissue techniques (i.e. ART, PNF, trigger point therapy), ice/heat, lifestyle, nutrition, postural and ergonomic advice.

One of the main tenets of chiropractic treatment is to provide holistic, patent-centered care in which the chiropractor determines which combination of treatment (not always including adjustments) compliment each other and result in an accelerated recovery.

Is chiropractic effective and safe?

There is good evidence with dozens of excellent research articles over the last few years that chiropractic management produces superior results in terms of safety, effectiveness, cost-effectiveness and patient satisfaction. It has been determined that, indeed, people who use chiropractic care spend less money on other types of medical care and are actually cheaper to pay for at the end of the year than people who do not use chiropractic care (are you listening McGuinty?)

Many people are unaware of the coverage or benefits of chiropractic care. Most extended health care plans, workers compensation (WSIB), auto accident injury claims, veteran’s affairs among others cover partially or fully chiropractic treatment.

As with any treatment, non-serious side effects may occur following treatment but are usually minor and short-lived. Serious adverse events are extremely rare. I won’t even talk about the side effects of other common medical treatments such as anti-inflammatory medication, cortisone or surgery for comparable conditions! Any mature, responsible health profession must discuss the risk/benefit ratio and the pros/cons of any treatment. Insist on this when discussing treatment options with any health care provider.

Chiropractors are well positioned by virtue of their education and training to manage neuromusculoskeletal injuries. Everyone can be confident that chiropractors have the knowledge and skills to effectively provide second to none care.

So if you or someone you know suffers from back pain, headaches, etc., you not only have nothing to lose, but would most likely benefit better with chiropractic than with other forms of therapy.

Core strength

What do most NHL, NBA, MLB and NFL professional athletes have in common? 

I’ll bet you guessed either they earn a tremendous amount of money or they are in great shape. Of course you are correct if you suggested either but for the purpose of this article, they also have in common a reliance on core strengthening.

I know what many of you are thinking...what the heck is core strengthening and why is it your topic for a sports injury/fitness column? The current vogue in health care and fitness training is to focus on what is known as core stability training. Athletes (professional and weekend warriors) are interested in injury prevention and improved performance and enhancing one’s core stability, studies have shown, is a good start. Everyone from Shaq, Gary Roberts, Lance Armstrong and Tom Brady are doing it so why aren’t you. What is the core and how do you improve the core? Read on!

The body’s core muscles lie deep within the torso. They generally attach to the spine, the pelvis and the muscles that support the shoulder blades. The major core muscles include the tranverse abdominis, the deepest of the abdominal muscles, the external and internal obliques, your side muscles, the rectus abdominis, your ‘six pack’ and the erector spinae, your back muscle. These core muscles form a cylinder or tin can around our torso and when recruited or exercised properly they function as a unit to keep your body stable, balanced, protected and moving smoothly.

When the core muscles are weak or there’s an imbalance a common side effect is back pain amongst many possible problems or injuries.

The main concept of core strengthening programs involves using many muscles in a coordinated movement. Rather than isolating a specific joint as in most weight lifting, stability exercises focus on working the deep muscles of the entire torso at once. Abdominal bracing or neutral spine is the main technique used during core training. This refers to pulling your belly button in, as if you were zipping up a tight pair of jeans, but still breathing normally. Once you can do this, you are ready for core strengthening safely.

How are core exercises done?

Many aids are used to create an element of instability that one would not normally get in a floor exercise. These aids may include exercise or stability balls, often seen in chiropractic and physiotherapy clinics and fitness clubs; medicine balls, wobble boards, BOSU balls etc.

Before you quit your step or spin class or go to Walmart and buy the hottest core training DVD you should first see a health professional appropriately trained and licensed in exercise and musculoskeletal medicine such as a chiropractor, physiotherapist, rehab or family physician etc. to rule out major injuries or conditions not suitable for this type of exercise. Of course, it is highly recommended that patients work with their health care professional, including a certified personal trainer, chiropractor, physiotherapist etc. to ensure the aid (i.e. stability ball) is properly sized and that proper form and technique are learned.

Talk to an average gym rat or athlete about core training and he or she will probably name their favourite ab exercise. Talk to someone thoroughly educated on this topic and you’ll learn strength and endurance of the core muscles are important. This is important because no matter what kind of workout you do, your core has to support it. If your core is weak, you’re limiting your potential to lift, compete, run etc. by at least 20-30%! 

How do you know if your core is weak? Try these 2 tests!

  • • Test 1: Lie on a bed with your legs and hips on the bed and your upper body horizontal, off the bed for one minute. You fail if you cannot do this
  • • Test 2: Get in the plank position (only forearms and toes touching floor, body straight, face down) and have a friend place a broomstick on the middle of you back so it touches your head, upper back and tailbone. Hold until the stick loses contact with one of those points. If unable to last two minutes, you fail. If you fail either or both tests you need core work!

There are a myriad of sources of core exercise programs on the internet, in magazines, on DVD’s and in books. I strongly suggest before you begin a core exercise program, seek out knowledgeable advice from your health care professional first. Also a well-rounded approach to treating sports injuries, low back pain etc. and enhancing sports performance includes a stretching and strengthening routine, chiropractic manual therapy and lifestyle advice.

So take charge of your health and fitness, be proactive and don’t wait for time or an injury to catch up to you! Only you can help yourself, with the proper help and advice. Good luck!

Reducing inflammation

How to reduce inflammation with your diet:

  • • Consume fruits and vegetables
  • • One multi-vitamin/day
  • • Magnesium 400 to 1000 mg/day
  • • EPA/DHA 1 to 2 g/day (Omega 3 Fatty Acids)
  • • Coenzyme Q10 100 mg/day
  • • In acute inflammatory state consider anti-inflammatory proteolytic enzymes (pineapple and papaya are rich in these)

Try to cut back on high fat meats as well as dairy products. Also limit foods high on the glycemic index (potatoes, white rice, sugar, white flour).

Soccer and spring

Finally, spring is in the air! Scraping our ice-covered car windows, cocooning in our house every night, bundling up in four layers of clothes just to stay warm outside is history. With warmer temperatures arriving, a rite of passage for many of us is to get active by playing golf, tennis, jogging or gardening after sitting on the couch all winter watching CSI or Dancing with the Stars. This is a huge problem that often results in injury and more inactivity or couch-sitting.

One of the most popular fair weather sports in Canada is soccer, the most popular sport worldwide. Like any other sport or activity, no matter the age or skill level, there are tips and suggestions to be aware of to avoid or at least minimize risk of injury and a premature end to your season.

Many injuries, including soccer injuries, are generally classified as either overuse or traumatic. Overuse injuries occur over time, accumulate, causing stress to muscles, joints and soft tissues without appropriate time for healing. These injuries begin as minor, nagging aches and pains, and deteriorate into a more painful, debilitating injury if they are not treated early.

Traumatic injuries are a result of a sudden force or impact to the body and can range from very subtle to very damaging.

For soccer, the number of severe injuries is very low, but the number of general injuries is quite high. The practice injury rate in soccer is around 3-4 injuries per 100 hours of play. Game injury rate is much higher. Game injury rates per 100 hours of play for comparison, of other sports include rugby and lacrosse 3, running 1.1, basketball 1.4, tennis 0.5, walking 0.2. Rates above 0.5 are considered high. If you have played soccer, chances are you have had injury. Common soccer injuries include:

  • • Ankle Sprains – most common, is a result of stretching or tearing of ligaments surrounding the ankle
  • • Achilles Tendonitis – overuse injury resulting in inflammation of Achilles tendon (in the back of the ankle)
  • • Concussion – result of a sudden impact or blow to the head or quick movement of the head
  • • Groin Pull – strain or overstretching of the adductor (inner thigh) muscles
  • • Patellafemoral Pain Syndrome – pain under or around the patella (knee cap)
  • • Shin Splints – generalized pain in the front or side of the lower leg due to accumulative physical stresses
  • • Low Back Pain – sudden or accumulative physical stresses resulting in low back muscle and/or joint pain
  • • Knee Ligament/Cartilage Injury – usually sudden force or sudden stopping/starting or quickly changing directions causes tear or excessive stretching

Injury prevention is your best bet to minimize your risk of injury and pain. Avoiding the weekend warrior syndrome or training too often because you realized you were a couch potato all winter is important to understand. Other helpful tips include:

  • • Wear and use proper sports equipment (i.e. soccer shoes, shinguards and maybe even a mouthguard)
  • • Proper warm up
  • • Listen to your body; pain is a warning sign
  • • Train for your sport
  • • Cross-train for overall conditioning

Treatment for an acute injury (an injury that is less than one week old) should follow P.R.I.C.E.: Prevent painful movement of the injured area, Rest, Ice, Compression and Elevation. Rest will prevent further injury, Ice will stop swelling/inflammation, Compression will limit swelling and support the injured area and Elevation will reduce swelling by using gravity to reduce excessive blood flow to the injured area. P.R.I.C.E is very important to initiate as soon as possible following an injury.

Whether an injury is acute or chronic, get checked out by a health care provider experienced with sports injuries. Appropriate options include a chiropractor, physiotherapist or sports physician. Suggested criteria and principles that should be demonstrated by a chiropractor (and by extension any health care provider) when deciding who is suitable for managing athletic injuries are as follows:

  • • Minimum treatment time 15 - 20 minutes
  • • Treatment is multimodal in nature
  • • Treatment should contain active (exercises) and passive components
  • • No mandatory X-rays required for treatment
  • • No predetermined treatment schedules or prepaid contracts of care
  • • Use of medical terminology and diagnosis

When trying to select or find someone to refer to, ask questions! Good luck, have fun and play hard and safe!