MRI Study Demonstrates Lumbar Disc Herniation Heals!

backpain-1944329_1920.pngMany times in practice, a patient presents with symptoms of lumbar (low back) disc injury. They have pain into the leg, often have difficulty standing upright, and have accompanying low back pain.

This generally occurs when a disc bulge or herniation places pressure on the spinal nerves or the spinal cord. As shown in the image below, where the purple shape is pressing on the green nerve.

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Chiropractic care is a great conservative way to manage the pain and, often, it will centralize and resolve in a matter of weeks. A home exercise program is then prescribed to help prevent re-occurrence and strengthen key muscles. When symptoms do not improve with a trial of care, a referral is made to an Orthopedist for further evaluation and MRI. Sometimes surgery is warranted.

Previous studies suggested that, while it was possible to remove symptoms, disc injuries do not fully resolve- think of them like a sleeping dragon. This article, published in the New England Journal of Medicine, is a case study that describes resolution of the patient’s disc injury, documented on MRI. This is incredibly promising and supports conservative management of  lumbar disc injuries with chiropractic care and physical therapy before a surgical option is considered.

***This blog post is intended solely for informational purposes. It is always essential to consult with your own health care provider when making decisions about low back pain or leg pain. ***

 

Air Quality and Exercise

With this summer’s forest fires in full swing, Seattle has been covered in a haze of smoke for the past week. Air quality has been poor and traffic is congested. Athletes are attempting to continue to stay in shape while battling the smokey haze.

Below, I will discuss some ideas to help stay safe while continuing to exercise. However, IF YOU HAVE ANY LUNG OR CARDIOVASCULAR CONDITIONS, please speak with your Primary Care Physician before exercising to ensure that you are not putting yourself in danger.

Assess Air Quality Prior to Exercise

Check out AirNow.Gov to learn about the current recommendations regarding air quality. For example, today’s rating in Seattle is “Unsafe for Sensitive Groups”. This means that those with any lung or cardiovascular issues should remain inside as should children and older adults who are more sensitive to particulate in the air.

Make sure that you understand what your own personal status is:

Do you have asthma or another respiratory condition?

Are you sensitive to smoke?

Have you been short of breath or have your sinuses been draining?

If you answered “yes ” to any of these, please consult your PCP prior to engaging in exercise.

By looking at the map, you may want to choose to drive to an area that has a better air rating before engaging in outdoor exercise.

Exercise Intelligently

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Once you have determined that you are “OK” to exercise and have found an adequate location, listen to your body.

  • Take frequent breaks
  • Exercise at a lower intensity to take a load off your respiratory system
  • Consider using a sinus rinse to help keep your nasal passages clear
  • If you feel prematurely out of breath or as though you are working harder than normal… Make it a Gym Day and exercise in a controlled environment. (You may also consider being evaluated by your PCP)

Hopefully the winds will pick up off the Pacific and the smoke will clear- but until then stay safe and keep your personal health in mind when spending time outside. Taking a day off training is better than compromising your health.

***The information contained in the blog above is not intended as healthcare advice and is provided for general information purposes***

 

No Pain, No Gain- An Outdated Fitness Concept

No Pain, No Gain

I remember being in high school sports and repeatedly hearing people laugh and say, “No pain, no gain” as we pushed ourselves to make gains in the weight room or in the pool. We worked out to exhaustion, more focused on completing the workout or the set in the weight room than on form or perfection. Coaches said things like, “Pain is weakness leaving the body.” We got strong, sure. We gained speed. We thought we were so cool as we showed off our bruises and iced down our shoulders.

The reality, though, is that we were injuring ourselves. We were building poorly coordinated neural pathways. We were altering our biomechanics and causing overuse injuries.

 

Now that I am years out of that scenario, I often work with athletes, like myself, who are driven to excel and want to improve in their sport. One of the biggest discussions we have is surrounding this concept of “No pain. No gain.”

A workout should build you up, not break you down.

It is important to work out in a way that pushes your capacity, but does not allow for the break down of your mechanics. For example, when I assign rehab exercises in my practice, we always discuss:

  • The goals of the exercise
  • What you should feel when you perform the exercise
  • What are the “fails” of the exercise (ie: what things let you know that you have completed as many exercises as your body can handle)

It all comes down to the neural edge. This is the limit to which the brain can control the exercise and where we can actively create new pathways. Here is where we can safely make gains in our training.

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Beyond rehab, think of it like this… If you are on a run and you have decided that you will run 6 miles today. However, at 4 miles you notice that your left foot is hurting in the arch with some knee pain as well. Do you decide to continue running? -OR-  Do you listen to your body and stop your run at 4 miles? Should you continue to run, you are risking causing damage in your body that may keep you from running later in the week or season. It is important to evaluate (or to be evaluated by a professional) why the pain is present? Are your supporting or stabilizing muscles doing their jobs? Are you wearing appropriate shoes for your feet and the surface you are running on? Do you have proper nutrition?

Running through pain or working out through pain can be extremely detrimental to training, overall. It can result in overuse injuries and in neural patterning that lends itself to future injuries. Instead, it is imperative to train intelligently. Work smart. Get evaluated to be sure that you are making safe gains and discuss your training with a coach and functional movement specialist.

Let’s forget No Pain, No Gain

Let’s shift our focus in training. Let’s teach our athletes, young and old, to listen to their bodies and find their edge.  Let’s lead by example and learn to work out smart- and hard.

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***This blog is intended to provide educational content and is not for diagnostic purposes nor to provide health care advice. Please speak with your health care professional prior to changing your workout routine.***

Same Weight, Different Body- It’s time to ditch the scale and take a broader view of health!

As a Chiropractor, my health is an important part of my practice. I try to “live my brand” and do not recommend things to my clients that I would not be willing to do for myself. That being said, I am incredibly human. I have health challenges. I do not always remember to take my supplements. Sometimes, I eat dessert- in fact, I am writing this in a Starbucks where I am treating myself to a Frappuccino. Recently, thanks to Facebook and my wardrobe, I have come to the realization that my health has drastically changed over the past 1.5-2 years (for the better).

About 2 years ago, I became aware that I was not taking care of myself the way I should be. I have food allergies and sensitivities, and while I had cut quite a bit of them out of my diet, I was desperately clinging on to dairy and rice. At a Standard Process seminar, I made the decision to take my health into my own hands and address how my food sensitivities have impacted me.

2 years ago, I was battling depression, my weight, acne, sleep, and the list could go on. I was also working out regularly, had just finished my first triathlon, working on my spiritual well being, sleeping at least 7.5 hours per night, and getting adjusted regularly. Most people looked at me and called me healthy- but I was far from it.

I was faking it and hoping to make it. When each week ended, I spent the weekends in my pajamas sleeping too much and always tired. I would find myself crying over the smallest things. I was always feeling behind and having panic attacks regularly.

It was time for a change.harmony-1229886_1920

The past 2 years have been a quite a journey. I started by cleaning up my diet further- finally giving up my beloved dairy and rice. Within weeks, I was sleeping more deeply. Within months, my skin was clearer. Soon, my clothes fit better. Slowly, I was climbing out of the hole I had dug myself into during grad school and my first years in practice.

I started to really love who I am again. I started to feel like the fun and upbeat person I pretended to be for years. I scaled my workouts back to yoga, swimming, and weight training to allow my body time to heal and balance without as much repetitive stress. I budgeted time for relaxation and recreational reading.

Then, just over a year ago, my husband and I took a month and a half off to visit Europe and move out to Seattle from our first real home together in the Detroit area. The total reset that this allowed for my emotions was unreal and I truly felt in control of my emotions for the first time since puberty.

All told, this was almost a year long process.

The best part was that even moving across the country, finding a place to live, starting a new practice from scratch, dancing this dream awake, didn’t shake my cool. In the year that we have been in Seattle, I continue to be healthier, I can hike and run again, even completing my first half marathon this past June.

Looking at pictures of myself now, the change in my health really hits home. I look happy. I feel healthy. I am significantly more fit. What’s funny, though, is that pesky scale. You know the one. The bathroom scale. Over these past 2 years, it has not budged more than 5-10 pounds in either direction. In fact, during my most unhealthy years it was both at its highest and lowest weight. As I have worked to recapture my wellness and love my body, I have settled somewhere in between- even though my dress size is smaller.

Here’s the thing. And it is a big thing. Something that took me a long time to learn and something that I continue to learn each day. Health is not any one thing. Some of the people who look the healthiest are not well on the inside. Like me, they battle depression or anxiety.

Health is not merely the absence of disease or pain. Health is the constant pursuit of joy in your body and in your soul. It is ever changing. It is not measured on the scale, nor is it truly quantifiable. “Healthy” me is going to be different from “healthy” you. You can be stick thin or curvy and be healthy or unhealthy. It is important to work with health care providers that are focused on wellness and to build your tribe around you that can support your transformation. Find someone to assess you and listen to you. Health is a discussion.

My story of the past 2 years is in no way unique. But. I hope you were inspired in some way to assess your own health.

Start the conversation.

Take those first steps toward your best self.

What in the heck is Pandiculation?

This weekend, while cruising Facebook, I stumbled across a blog discussing pandiculation versus stretching. They posit that pandiculation is more effective than stretching at changing muscle length and improving flexibility. Completely fascinated, I have started learning more…

Pandiculation Defined:

Dictionary.com defines Pandiculation as a noun. “The act of stretching oneself.” It then goes on to explain that it is most commonly associated with yawning.

Interesting, but I am pretty sure that we all recognize that a yawn is a much different kind of stretch than we achieve from a toe-touch. (Are you yawning yet? Because I am.) The real question is: Why do we feel looser in our jaw, neck, and even shoulders from a yawn, when a voluntary stretch is not as effective?

Perhaps Dictionary.com’s definition is a little incomplete.

EssentialSomatics.com defines Pandiculation as:

A conscious, voluntary contraction of a muscle, followed by a slow, deliberate lengthening of that muscle and a complete relaxation

They further explain that the conscious, voluntary component of pandiculation helps to reset the way our brain perceives the length of our muscles. For the neurology, read this.

Pandiculation versus Stretch

Essentially, pandiculation changes our brain’s understanding of muscle length, acting as a sort of soft reset.

It is important to contrast this with an understanding of our basic stretch. When we stretch a muscle, as in our hamstrings with a toe touch, a reflex tells the spinal cord that is happening in the muscle. This triggers a return signal to the muscle to contract or shorten. This defeats the intention of the toe touch and can actually reduce muscle power afterward. (See the first link in this post for more details)

This seems to indicate that if we truly want to lengthen a muscle, we must control that movement and engage the brain.

Why does it matter/How to apply this

I started reading about this during my down-time at a trail marathon and 50K where I was providing post race soft tissue work for athletes. While assessing the runners, I began to notice trends in their imbalances as well as how hamstrings and glute muscles responded to even a gentle evaluation of length/tension. They tend to cramp or contract in protest! This is a perfect setting to understand that basic stretch reflex. Many of these runners would benefit from an understanding of applied Pandiculation. (Which may be my new favorite word)

One of the best human examples of pandiculation mentioned earlier was yawning. Yawning is a controlled contraction of the muscles in the lower jaw and neck followed by a gradual release.

Now, think about your cat or dog at home. Have you ever seen your feline friend get up from sleeping without that luxurious stretch that they hold and then gently release? I am pretty sure that my cats are expert pandiculaters.

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As humans, most of this is not instinctual for us as it is with our pets. However, yoga is one form of exercise that applies pandiculation to its movements. I know that I sometimes walk into a yoga class unable to touch my toes in forward bend, but after a few flows, I am so much looser and stay that way for days. A great yoga practice literally resets your brain’s perception of muscle length.

Take Home

It is hugely important to make sure that you are training your body with intention and the help of professionals! It is possible to avoid injury, increase power and endurance, and improve overall performance by learning more about your own body’s balance and imbalances. Please work with your health care provider to ensure that your workouts and your body are balanced and appropriate for you. If you are in the greater Seattle area and would like a consultation regarding your fitness, please feel free to contact us at (206)565-9691 to schedule your appointment with Dr. Samelak.

And just for fun… try saying Pandiculation three times, quickly!

 

Muscle Testing and Chiropractic- Applied Kinesiology

As a Chiropractor, one of my main techniques is Applied Kinesiology. While in Chiropractic school, I obtained my 100 hour certification in this technique. According to the International College of Applied Kinesiology (ICAK):

Applied Kinesiology (AK) is a system that evaluates structural, chemical and mental aspects of health using manual muscle testing combined with other standard methods of diagnosis… The combined terms “applied” and “kinesiology” describe the basis of this system, which is the use of manual muscle testing to evaluate body function through the dynamics of the musculoskeletal system

The basis of Applied Kinesiology is in the manual muscle test.

When working with patients, I use the muscles of the body as indicators to help me decide where there is stress in the system and what I can do to help support the nervous system and the musculoskeletal system. A manual muscle test involves isolating a specific muscle in the body- like the deltoid or the latissimus dorsi, and checking to make sure that it is “turned on” or working how it should.

This can seem mystical and magical, but all boils down to basic neurology. Can the brain find that particular muscle and tell it to do a specific task? If it can’t, why not? According to the ICAK:

Manual muscle tests evaluate the ability of the nervous system to adapt the muscle to meet the changing pressure of the examiner’s test. This requires that the examiner be trained in the anatomy, physiology, and neurology of muscle function. The action of the muscle being tested, as well as the role of synergistic muscles, must be understood. Manual muscle testing is both a science and an art. To achieve accurate results, muscle tests must be performed according to a precise testing protocol. The following factors must be carefully considered when testing muscles in clinical and research settings:

• Proper positioning so the test muscle is the prime mover

• Adequate stabilization of regional anatomy

• Observation of the manner in which the patient or subject assumes and maintains the test position

• Observation of the manner in which the patient or subject performs the test

• Consistent timing, pressure, and position

• Avoidance of preconceived impressions regarding the test outcome

• Nonpainful contacts – nonpainful execution of the test

• Contraindications due to age, debilitative disease, acute pain, and local pathology or inflammation

What all of that means is this: It is important that a practitioner using manual muscle testing (MMT) is able to be consistent, specific, and observant when evaluating the human body. By ensuring that all muscle tests that are performed follow these basic guidelines, the results of a muscle test should be clinically useful. (ie: They should help me to tell what is going on with my patient. )

For example, when there is severe low back pain, are the muscles in the pelvis and lower back properly supporting the spine? If not, why not? How can we turn them on and make sure that they are doing their job?

In 2007, a paper was published in the Journal of Chiropractic and Osteopathy that evaluates the reliability and validity of the MMT through a review of the literature. This paper found that there is significant evidence to support the clinical use of the manual muscle test in practice; however, the experience of the provider and the adherence to specific guidelines for muscle testing is important. This review suggests that muscle testing is a useful way to evaluate the neuromusculoskeletal system, but it will be important to continue studying MMT and to incorporate randomized controlled trials, if possible.

3 Summer Fitness Trends to Try This Summer

Summer weather is here! It is warm enough to spend time out of doors and move from our winter fitness routines to summer fun. Read on to learn about 3 outdoor fitness trends that provide more than physical health benefits.

Paddle Boarding

You’ve probably seen them out in the Sound or on Lake Washington. Paddle boarding season is here! This fun fitness trend provides a full-body workout. However, its benefits don’t stop there.

paddle-board-1122355_1920.jpgPaddle boarding is a great way to improve balance. If you have a history of ankle or knee injury, balance work can help to prevent future injuries by improving proprioception (the way your body finds its limbs in space). It is important to check with your health care provider before beginning balance work following injury. For more benefits of Paddle Boarding, check out this article.

Outdoor Yoga

Yoga is a fantastic way to balance the spine and support the core. It helps to normalize and optimize breathing. Many people are turning to yoga to improve mental and physical health.

A great twist on your conventional  yoga class is Outdoor Yoga. According to Yoga Journal, benefits of outdoor yoga sessions include:

  1. Replentishing Depleted Energyyoga-2176668_1920
  2. Heightened Awareness
  3. Boosted Confidence
  4. Enhanced Meditative Benefits

Whether you join an organized class or choose to do some sun salutations on the beach at Discovery Park, you can reap the benefits of an outdoor yoga session.

Cycling Club

bicycle-1869432_1920The time has come! Ditch the spin bike and hit the trails and bike paths. Seattle has so many trails and you are sure to see groups of people on the weekends. Join in. Build your cycling skills and learn to repair your own bike. (Pssst! You can make new friends while you are at it!) Working out with a group helps you to commit to your fitness. They act like accountability partners.

Get Outside and Enjoy the Summer!

It is important to spend time in the summer sun, getting fresh air, exploring nature, and making Vitamin D. Always be sure to consult with a healthcare provider prior to starting a new fitness regime. Looking for a Seattle Chiropractor? Check out the rest of our website to learn more about Seed of Life Chiropractic and Wellness, LLC and Dr. Samelak- our Chiropractic Physician.