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.

Are Flip Flops Causing Your Headaches?

It’s that time of year again! The trees are blooming, the sun is starting to make an appearance, and so is our summer footwear. This means flip flops are about to make a comeback.

flip-flops-1479699_1920One of the things that I often see rearing its ugly head with the arrival of flip flops is headaches. People who have no trouble with headaches throughout the winter and early spring suddenly get terrible headaches as soon as they don their favorite bejeweled footwear.

But what do flip flops have to do with headache?

Our bodies are amazingly interwoven and connected. Our bones are connected by ligaments. Our muscles connect to our bones to move them. Nerves and arteries form a complex system that travels around our bodies. And all of it is tied together in fascia.

Fascia is a specialized system of the body that has an appearance similar to a spider’s web or a sweater. Fascia is very densely woven, covering and interpenetrating every muscle, bone, nerve, artery and vein, as well as, all of our internal organs including the heart, lungs, brain and spinal cord. The most interesting aspect of the fascial system is that it is not just a system of separate coverings. It is actually one continuous structure that exists from head to toe without interruption. In this way you can begin to see that each part of the entire body is connected to every other part by the fascia, like the yarn in a sweater. (https://www.myofascialrelease.com/about/fascia-definition.aspx)

Once we can understand that everything in our bodies is connected to everything else, it is possible to start seeing more patterns and relationships. The book, Anatomy Trains, has broken down this system of fascia into relationships or “trains/chains” that influence our body in a myriad of ways that can cause far-reaching results. Like headaches from flip flops!

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The Posterior Chain of fascia connects the bottoms of our feet, up through the backs of our ankles and legs, along the spine, and over the top of the head.  When we wear flip flops, we generally scrunch up our toes to keep our shoes on our feet. This causes shortening and tightening of the fascia on the bottoms of our feet. Combine that with the shortening that happens from sitting at a desk for long hours and all of a sudden that posterior chain has a dramatic increase in tension. This pulls at the base of the skull and can result in severe tension headaches.

What can we do about it?!

I, personally, try and avoid flip flops in favor of sandals that have more support or require less “toe scrunching” to walk- Birkenstocks are my favorite. However, on the occasions when I do wear flip flops, it is essential to address the posterior chain. Generally, going through a yoga routine like a sun salutation can help to regulate the tension running down the spine and into the feet.

What is most important, though, is to recognize that if a few hours in flip flops causes severe headaches, it is probably time to have a movement specialist like a Chiropractor, Physical Therapist, Personal Trainer, etc. evaluate your biomechanics. This can be a sign that you have underlying imbalances in your muscles and fascia that can lead to future issues if they are not addressed. Understanding the balance within your body (and its imbalances) allows you to make educated choices regarding your physical health and function.

So if your flip flops lead to headaches, please get your body checked and assessed for correction. Headaches are not a sign of ibuprofen deficiency, but of an underlying issue. This blog discusses only one of hundreds of possible causes- it is important to speak with a healthcare professional about your individual circumstances and seek appropriate care.

Why you should STOP ignoring your feet!

wanna-see-my-footFeet are important.

They are the foundation that we stand upon.

Your feet contain 26 bones, 33 joints, and over 100 ligaments, tendons, and muscles. Not to mention nerves and blood vessels!

And yet we abuse them by wearing impractical shoes, restraining them, sitting too much, etc.

Problems with our feet involve more than just foot pain, they can impact the low back and even headaches.

Gait patterns (how we walk) are driven by the foot.

The gait cycle is broken down below, but, in essence the way that we walk is influenced by how we transfer weight from one foot to the other. It is important for us to see that the heel hits the ground first and then the bones of the foot lock together, rolling the toes down and bearing weight.

  • The gait cycle starts with a Heel Strike. The heel of the reference foot is the first place to touch the ground.
  • When the foot is flat, weight can be transferred to the referenced leg. In this part of the gait cycle, think about weight bearing, shock absorption, and moving forward.
  • Mid Stance occurs when the body is balanced and in alignment on the reference foot.
  • Just as the heel of the reference foot leaves the ground, the body is in terminal stance.
  • Toe off occurs when the great toe of the reference foot leaves the ground and begins to swing. This is the beginning of the swing phase of the gait cycle.
  • The swing phase is that part of the gait cycle during which the reference foot is not in contact with the ground and swings in the air. It constitutes about 40% of gait cycle. (wikipedia)

Feet have arches that act as springs to support our movement.

It is important to have your arches analyzed and evaluated- no matter their shape to ensure that your feet support your body. Think about it, have you ever been told you had flat feet or high arches? Take at look at the photos below and compare to your footprints in sand.

arches

Often, high arch feet are very rigid and benefit from self-mobilization. Follow the steps below to mobilize your feet. By stimulating motion in a rigid foot, you can reduce foot pain and improve your biomechanics.

  • Grasp your forefoot in both hands and perform a shearing motion between each of the toes
  • Gently tug on each of your toes
  • Using your whole palm, grasp the heel of your foot and firmly move it back and forth

Flat feet, on the other hand, generally need to be retrained to have more muscular coordination. For this, the “Short Foot” exercises tend to be very helpful.

  • Try placing a kitchen towel on the floor and using your toes to pull it toward you

OR

  • Use your toes to pick up marbles off the floor

feet-619399_1920Either way your feet should be moveable and strong. Think of watching a toddler walk barefoot. You can see their toes grasp the ground, almost like they have suction cups on their tiny toes.

In this photo, see how the toddler is pulling up on their toes? This is especially noticeable when they are first learning to walk and balance.

Perhaps, one of the  most important things to realize is how our shoes influence our feet.

Shoes are orthotics. They support our feet or force them into submission- like in high heels. High heels can do a lot of damage to our bodies- no matter how nicely they make our behinds look in skinny jeans.

feet-1840937_1920Knees: increased pressure by 26% through the knee (knees are also affected posturally as described below)

Calves: tightens/shortens the calf muscles

Achilles (Calf tendon): Shortens and risks tearing when barefoot

“Pump Bump” or Haglund’s Deformity:     bony enlargement on the back of the heel from rubbing/irritation

Posture: whole body mechanics are different with the sacrum rocked forward, increased strain through the knee, increased pressure in the lumbar spine, anterior head carriage, etc.

Ball of foot: pushes weight forward into an area that isn’t designed for it, creating metatarsalgia (the higher the heel, the more pressure through the forefoot)

Hammertoes/Hallux Valgus: from “squishing” the foot into the toebox

What does it all mean?

It is important to go barefoot sometimes! Especially in grass or sand where your muscles in the feet are forced to work.

If you are a runner or walker, get your shoes professionally fitted to be sure that they are correct for your gait and foot type.

For that matter, have your gait assessed to be sure that you are running properly and prevent future injury.

Have your Chiropractor assess your feet to ensure that they move properly and to help you decide if exercises, mobilizations, or orthotics are right for you.

 

 

 

 

Posture- Is it really important?!

Yes.

Posture is probably one of the most important things that I see in every person I come into contact with.

I check posture in every single exam and observe it before my patients get onto my table each visit.

Posture is an outward indicator of stresses within the body. It shows us where there are imbalances and chronic issues. It can predict future injuries.

Posture influences:

  • Blood Flow
  • Nerve Flow
  • Joint Function
  • Muscle Tension
  • Hormonal Balance in the Brain
  • Perceptions of Others
  • Perceptions of OURSELVES
  • Breathing
  • This list could go on forever!…

Posture really is that important.

So what is good posture anyway?

slide4

The graphics above are mainly focused on the low back, pelvis, and lower body. However, we can see how a gravity line should be able to be drawn straight down our bodies from the side to demonstrate proper posture.

If I held a piece of string with a weight on it at the height of  your ear, it should fall through the shoulder, through the hip, just behind the knee and through your ankle to the ground.

When I think about what this feels like, imagine that someone has tied a string to the crown of your head and is gently tugging upward. Your chin will tuck slightly, your spine will lengthen, shoulders are able to relax, and tailbone tucks slightly. (This is seen in the far left photo, above. The photos to the right demonstrate increased forward head posture with hands rolled forward and low back rounded.

From the front, posture is focused on horizontal lines as well. I ask myself, “Is everything level and equal from side to side?”

  • Are the eyes level or is the head tilted?
  • Can I see an equal amount of ear on each side?
  • Are the shoulders level?
  • Are the hips and pelvis level?
  • Is the spine in midline?
  • Are the hands in front or at the sides?
  • Are the shoulders rounded?

Both of the photos above demonstrate asymmetries, but note how the left side photo demonstrates rounding of the shoulders, head tilt, right sided torso shift, etc. The photo on the right has far better posture.

How can I fix my Poor Posture?

Posture can be remedied in a number of ways.

What activities are causing the poor posture and can they be changed?

Often, poor posture is a response to a chronic position that we work in, relax in, or a repetitive activity. When this is the case, I look for ways to modify the activity or improve work ergonomics.

Is there a skeletal component?

Sometimes, we have held a posture for so long that we have, literally, changed the shape of our spine in response. In these cases, it usually takes chiropractic care and rehabilitative exercises to begin to make changes in the spine- resulting in changes in posture. As a chiropractor, there are many ways that I work with the spine and joints to help stabilize and improve posture.

Homework

All of my patients leave the office with some type of homework. We are creatures of habit and our brains rewire themselves to perpetuate these habits. This means that it takes consistent movement correction to repattern the brain. Remember the phrase: Neurons that Fire Together, Wire Together. This means that we have to fire correct patterns of movement over and over again to train our brains and bodies to correct our posture.

Be diligent!

It is also immensely important to be aware of our posture in the moment. I set a timer when I am doing computer work (blogs like this, patient notes, etc). When the timer goes off, I get up and do some exercises to improve my posture. It is inevitable that when we sit at a computer, our head drifts forward, our shoulders round, and we generally sit poorly. The same stands true for watching TV, standing in lines, looking at your phone or tablet!

Overall, posture is one of the best things that we can pay attention to to know how our biomechanics (the way we move in daily life) are programmed. Take a look of the last few photos someone has taken of you (selfies don’t really work) and see if you notice any of the things I have mentioned above.

Take control of your posture and start changing your health!

As always, contact me if you would like help with meeting your health goals!

-Dr. Sharonrose Samelak, Chiropractic Physician

 

 

Sitting Too Much is Ruining Your Health (and Spine)

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How many hours do you sit each day?

How many days a week do you sit?

Do you ever sit for a period upwards of 11 hours in a day?

 

These are very important questions to ask yourself. As I sit here writing this blog, I am aware that I, myself have been sitting for the past hour researching statistics for this very article… with my posture suffering as minutes tick by.

In some sense, we all know that we shouldn’t sit too long. That prolonged sitting is detrimental to our health. What most of us don’t realize is that it is probably worse for us than we think…

According to Web MD, sitting too much is linked to worsened mental health as well as increased risk of heart disease and disability. Why? No one seems quite sure. What we do know is that the most detrimental data came from a study looking at women who sit for over 11 hours per day.

What’s worse is that it does not appear that your morning walk or jog is enough to combat your 8+ hours of sitting each day. These activities appear to be mutually exclusive. By no means should you stop your regular workout, but this does suggest that- as a society- we need to change how we function. We need to sit less and move more. Revolutionary!

Another study even suggests that sitting is harmful to our children. This study looked at sitting times of only 3 hours. It demonstrated a marked negative change in the blood flow through the arteries of the group that did not move out of chairs for a full 3 hours. However, the group that rode a bicycle (gently) for 10 minutes out of each hour had no change.

text-neck

How often do your kids sit for long periods? School has them seated for 8+ hours each day which is not even counting video game or TV time in the evenings. Our society asks kids to sit still and pay attention. We tend to squash the wiggles right out of them by the time they are in the first grade.

Maybe this is why kids are wiggly, naturally?! Maybe we are meant to move around a lot more than we do! Movement pumps our blood back to the heart through our veins. Movement causes positive changes in our cardiovascular health. Movement keeps our joints lubricated and healthy! Movement keeps us alive and healthy.

And guess what else comes along with too much sitting? Back pain!

Our spines are made with gentle curves that support our weight and absorb shock. When we sit, we often curve our spines into a C- shape, rounding the low back, hunching the shoulders, and thrusting the head forward.

We are simply  not built for this. These abnormal stresses on the spine overwork our muscles and can cause a lot of damage to our spines. They are often accompanied by low back pain and headaches!

Proper sitting, ie: sitting on the sit bones and tall through the spine, is far less detrimental to the spine and is difficult to maintain for long periods- necessitating movement.

I feel like I am sounding a bit repetitive, but movement is what we are made for. So… here are some tips to help you to improve your health, sit less, and MOVE MORE.

  • Use a standing desk– Your posture will automatically  be better and you are more likely to move about the office. It is also easy to incorporate simple exercises like heel raises, toe taps, glute squeezes, etc into your day when you are standing at work.
  • Be conscious of your posture– I sometimes place a ball between my middle back and the back of my chair. If the ball moves, I am slouching and probably need to get up and move about.
  • Set movement reminders– If you have a tendency to get locked into a task, try setting an alarm on your phone or computer that reminds you to get up and walk a bit. Remember, the study in young girls found that moving 10 minutes out of each hour made a dramatic change in their vascular condition.
  • Try sitting on an exercise ball– It is really hard to slouch on an exercise ball. Plus, your core will remain engaged and you can perform exercises like pelvic tilts while sitting at your desk.

Now, get out there and move! Remember that regular care for your spine includes an evaluation by a Doctor of Chiropractic as well as movement and good posture. Are you worried about your posture? What about your kids? Stay tuned for my next blog about posture- How to tell if you have good posture and what to do about it!

Your knee pain may not be knee pain.

One of the most valuable things I use in my chiropractic exam is functional screening, which is looking at how the body’s joints move. It gives me insight into patterns of motion that can result in pain and dysfunction. For example, the knee is particularly vulnerable to altered biomechanics in other parts of the body.

The knee is, most basically, a hinge.

Because of this, it is significantly affected by the biomechanics of the hip, pelvis, and ankle/foot. Joint restrictions and/or muscular imbalances in these areas are incredibly common from everyday activities like sitting, improper footwear, or repetetive activities. The patterns that we create in our everyday life change the way our joints move and can cause stress in joints and tissues that are farther away.

For example, when the gluteus medius muscle is weak or inhibited (not firing when or how we want it to), it does not properly compress the hip joint. This causes the thigh bone, or femur, to change its angle, resulting in increased pressure on the inner part of the knee joint. The medial/inside part of the knee is usually the first place that arthritis shows up on x-ray of the knee. Slight narrowing of the joint (inside the circle below) is the first physical indicator that the knee is under stress.

knee-xray

Clinically, knee issues show up as pain! Remember, knee pain may not be a problem with the knee!

As a chiropractor, I evaluate to see which muscles or joints are impacting the function of the knee and work with you to strengthen or stretch them appropriately. Many times it is the gluteus medius, but can also be a number of other muscles or tissues.

When it comes to aches and pains, it is important to have a professional evaluate your mechanics for you- you cannot appropriately assess yourself. Only when you know what the true problem is, can you correct it with exercises, stretches, and joint manipulation. Otherwise you can create new problems!

I am a prime example of this. When I was working on my internship to complete my Masters in Sport Science and Rehabilitation, I spent many hours each week in a PT clinic helping to evaluate patients and work with them on their exercises. Thinking that I was helping myself, I did all of the exercises with the patients. In 4 months, I had increased my knee pain, given myself plantar fascitis, and irritated my pelvic joints. Not all of those exercises were appropriate for my body and its previous sports injuries. It took being evaluated for my own movement patterns and months of diligent corrective exercises to undo what I thought was going to help me.

Understanding how your body works and starting from a basic analysis can help to diagnose problem areas and correct problems before they begin. Pain is a warning sign that something is not right within the body. Before you cover it up or dismiss your pain, get assessed and see what can be done to strengthen and support your body.

References:

SBR Sport

Dr. Dooley Noted

 

Are walkers bad for my Baby? What about other upright toys?

Quite often I have friends and patients who ask me about walkers, exersaucers, and Bumbo seats (along with a huge list of other infant toys). There is a lot of confusing information on the internet regarding these and some of it is very misleading from manufacturers. I hope that here I can clarify some of the information and give you some facts.

The place to begin is normal child development. When a baby is born, they have no curves in their spine and they have no understanding of the physical world. These things are learned and skills are earned through experience and exploration. Motor and mental development are often broken down into “milestones” which are a series of behaviors and skills that we expect children to have at different ages.

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Spinal development is completely formed through activities. Tummy time causes the little one to lift their head up, forming the cervical (neck) curve. The curve in the lumbar spine (low back) is formed when the child begins to rock and crawl. The muscles and bones of the spine develop in response to these activities and the basis of the adult spine is formed.

The same activities that help to form the curves in the spine stimulate the brain and help your child develop a sense of where they are in space (proprioception). Crawling, scooting, pulling up, walking, and tummy time help in vestibular (balance) and sensory development. Movement stimulates a circuit called the Reticular Activating System which links motion to the cerebellum and helps the brain to learn posture and balance (and a whole lot more!).

Walkers:

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Walkers are one of the most dangerous babysitters. A 2006 study looked at ER data from 1991-2001 and found 197,200 ER visits related to walkers. This study does not take into account those who saw a pediatrician, other health care practitioner, or stayed home for self-care. Walkers allow little ones to move quickly and often they can tip when they encounter the edge of a rug, door sill, or staircase.

Actual physical injuries aside, it is important to take into account the mental and motor developmental delays associated with walkers. As we mentioned above, many skills are dependent upon motion and experiencing the environment. It is easy to see how a parent may think that a walker is a great way for their little one to experience the world. However, this is a false environment. In a walker, children cannot see their feet which changes how the brain develops proprioception, children do not have to learn balance, and their future gait (walking) patterns may be affected.

In 1999, a study was performed with 109 infants where some were placed in a walker and others were allowed to play on the ground. By a landslide, the walker infants sat, crawled, and walked later than the other group. It is also important to note that the walker group also scored lower on the Bayley scales of mental and motor development.

In 2004, Canada banned baby walkers.

Upright Bouncers:

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Upright bouncers like the Jolly Jumper are very hard on the developing spine of the infant. The stress of being held prematurely in an upright position, when the bones and muscles have not developed the proper strength can damage the infant spine. Spondylolisthesis can occur in the lumbar spines of infants in these types of devices from the repetitive stresses delivered through an undeveloped spine. Spondylolisthesis occurs when the front part of the vertebra (which stacks) is separated from the posterior elements which surround the spinal cord and most often occurs at the lowest bone in the lumbar spine.

 

Exersaucers and Bumbo chairs:

These upright devices promote abnormal postures and can lead to the altered formation of the curves of the spine. For example, when an infant is placed in a Bumbo chair, their pelvis often tips backward, thrusting the ribs forward, and promoting anterior head carriage. This is a reversal of the curves we see in a normal spine- indicating that increased spinal stress is present when children sit in these positions.

While the Exersaucer is much safer (less likely to tip) than a Walker, it still promotes weight-bearing through the spine in an abnormal and premature way and should be used with caution.

What is the take home? Children need to experience their environment in order to learn. It is essential to have a lot of exploration time for our infants and little ones. The development of their brains and bodies depend upon it. As a Doctor of Chiropractic, I am committed to sharing knowledge with parents so that they can  make informed decisions regarding their children.

References:

http://consults.blogs.nytimes.com/2010/02/22/the-dangers-of-baby-walkers/?_r=0

https://www.ncbi.nlm.nih.gov/pubmed/10533994

https://www.ncbi.nlm.nih.gov/pubmed/16510623

http://articles.chicagotribune.com/2012-03-15/health/ct-met-bumbo-posture-20120315_1_physical-therapists-developmental-benefits-babies

http://pathwaystofamilywellness.org/The-Outer-Womb/maximizing-infant-development.html