It is easy to say make sure you lift correctly… but what is the correct way? Your Woodbridge, Dale City VA Chiropractor has some proper lifting tips for you. Since you are always going to be bending and lifting you might as well do it correctly.
Back pain and injuries from improper lifting techniques typically lead to three kinds of injuries to the muscles, vertebral discs, and joints. Some injuries from incorrect lifting include:
With improper lifting, you may experience a tear, rupture, or shift out of position of the soft cushions between your vertebrae, called discs. If this injury does occur, the fibrous rings surrounding the soft leathery discs can bulge and even rupture. This can cause the dislocated or ruptured disc to press against a nerve, causing pain and numbness to radiate down into you buttocks or leg.
Because of the numerous joints in your spinal column that connect all of the various bony structures, injury may occur. A joint injury can be caused by a bad lift because it causes excessive strain on your joints, irritating tissue within them, and in some cases, locking them up. As well, if you change position during a lift, you can place a lot of stress on your lower back muscles. This added stress can easily strain and injure your back, usually in the form of a small twist or tear of a single muscle or group of muscles.
An important rule to remember when lifting is to never bend from your waist and then stand upright to lift an item from the ground. Keep your back straight and crouch first by bending at the knees or hips. This all depends on where the item is that you are lifting and allows your arms and shoulder muscles to do the brunt of the lifting, rather than your back. Some simple lifting techniques include:
Make sure you have a place to put the object you are lifting.
If you need to turn while lifting the object, use your feet to pivot, not your back.
Your leg muscles should be the ones providing the power during your motion to stand erect, not your back.
Keep the object close to your body in order to maximize the use of your arms and shoulder muscles.
Keep your chest forward and bend at your hips, or knees, not your lower back.
When lifting, push your chest out, pointing forward. Avoid twisting or turning during your lift as this will cause injury.
Lead with your hips, not your shoulders and keep your shoulders in line with your hips.
Don’t lift any objects that are obviously too heavy.
On your way to work you see some one digging a hole and you think their back must be sore. Than you get to work sit at your desk and an hour in your neck is stiff and your low back aches. Oddly enough the guy digging holes is perfectly fine. Our backs were designed to move not sit. So, if you have to sit follow your Chiropractor in the Woodbridge, Dale City VA areas advice.
The first step in setting up an office chair is to establish the desired height of the individual’s desk or workstation. This decision is determined primarily by the type of work to be done and by the height of the person using the office chair. The height of the desk or workstation itself can vary greatly and will require different positioning of the office chair, or a different type of ergonomic chair altogether.
Once the workstation has been situated, then the user can adjust the office chair according to his or her physical proportions. Here are the most important guidelines – distilled into a quick checklist – to help make sure that the office chair and work area are as comfortable as possible and will cause the least amount of stress to the spine:
Elbow measure
First, begin by sitting comfortably as close as possible to your desk so that your upper arms are parallel to your spine. Rest your hands on your work surface (e.g. desktop, computer keyboard). If your elbows are not at a 90-degree angle, adjust your office chair height either up or down.
Thigh measure
Check that you can easily slide your fingers under your thigh at the leading edge of the office chair. If it is too tight, you need to prop your feet up with an adjustable footrest. If you are unusually tall and there is more than a finger width between your thigh and the chair, you need to raise the desk or work surface so that you can raise the height of your office chair.
Calf measure
With your bottom pushed against the chair back, try to pass your clenched fist between the back of your calf and the front of your office chair. If you can’t do that easily, then the office chair is too deep. You will need to adjust the backrest forward, insert a low back support (such as a lumbar support cushion, a pillow or rolled up towel), or get a new office chair.
Low back support
Your bottom should be pressed against the back of your chair, and there should be a cushion that causes your lower back to arch slightly so that you don’t slump forward or slouch down in the chair as you tire over time. This low back support in the office chair is essential to minimize the load (strain) on your back. Never slump or slouch forward in the office chair, as that places extra stress on the structures in the low back, and in particular, on the lumbar discs.
Resting eye level
Close your eyes while sitting comfortably with your head facing forward. Slowly open your eyes. Your gaze should be aimed at the center of your computer screen. If your computer screen is higher or lower than your gaze, you need to either raise or lower it to reduce strain on the upper spine.
Armrest
Adjust the armrest of the office chair so that it just slightly lifts your arms at the shoulders. Use of an armrest on your office chair is important to take some of the strain off your upper spine and shoulders, and it should make you less likely to slouch forward in your chair.
To go along with a previous post about carpal tunnel here is a very helpful stretch. Carpal tunnel injuries have become one of the biggest work-related injuries worldwide. It is also one of the most common work-related surgeries performed. Your chiropractor in the Woodbridge, Dale City VA area would like to help you avoid this injury.
The forearm and digit energizer series is a great way to manage that fatigue and pain you are feeling creep into your hands and wrists from excessive typing, gripping, or handstand walking.
This series is challenging and can place your hands into a position that they may not be comfortable being in to start, so exercise restraint on your first time. If you find your hands, wrists, or fingers are tender in any of these stretches, try first to reduce the pressure applied, and then slowly and progressively increase that pressure over time until you gain a full range of motion. We encourage you to challenge yourself with the finger flexing and neuromuscular components shown as well. You will be surprised at how much dexterity you gain from just a few round of this series, and the fatigue you feel when you first begin is expected. However, in time, when your fingers are dancing across your keyboard pain free and you suddenly are able to shuffle a deck of cards like a riverboat gambler, you will understand why we call it the energizer series!
A couple things to remember:
Complete 5-10 good reps of all the exercises shown, and take the time to slow down the movement and get a good amount of time under tension for these small endurance muscles.
Spend more time, 60-90 seconds, in the stretching ranges that are especially difficult or hard to stretch.
Shoulder pain is one of the most common non-spinal things I see as your Chiropractor in the Woodbridge, Dale City VA area. Most people notice the pain with working with their hands in front of their bodies. Another common complaint is trying to put on a jacket or reaching in the back seat of their car. There are several causes to generic shoulder pain but this is one of the most common.
Biceps Tendinitis
Biceps tendinitis is an inflammation or irritation of the upper biceps tendon. Also called the long head of the biceps tendon, this strong, cord-like structure connects the biceps muscle to the bones in the shoulder.
Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis. They can often be relieved with rest and medication. In severe cases, surgery may be needed to repair the tendon.
Anatomy
Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
Biceps tendons
The biceps tendons attach the biceps muscle to the shoulder bone.
Glenoid. The head of your upper arm bone fits into the rounded socket in your shoulder blade. This socket is called the glenoid. The glenoid is lined with soft cartilage called the labrum. This tissue helps the head of the upper arm fit into the shoulder socket.
Rotator cuff. A combination of muscles and tendons keeps your arm centered in your shoulder socket. These tissues are called the rotator cuff. They cover the head of your upper arm bone and attach it to your shoulder blade.
Biceps tendons. The biceps muscle is in the front of your upper arm. It has two tendons that attach it to bones in the shoulder. The long head attaches to the top of the shoulder socket (glenoid).
The short head of the biceps tendon attaches to a bump on the shoulder blade called the coracoid process.
Description
Biceps tendinitis is inflammation of the long head of the biceps tendon. In its early stages, the tendon becomes red and swollen. As tendinitis develops, the tendon sheath (covering) can thicken. The tendon itself often thickens or grows larger.
The tendon in these late stages is often dark red in color due to the inflammation. Occasionally, the damage to the tendon can result in a tendon tear, and then deformity of the arm (a “Popeye” bulge in the upper arm).
Biceps tendinitis usually occurs along with other shoulder problems. In most cases, there is also damage to the rotator cuff tendon. Other problems that often accompany biceps tendinitis include:
Arthritis of the shoulder joint
Tears in the glenoid labrum
Chronic shoulder instability (dislocation)
Shoulder impingement
Other diseases that cause inflammation of the shoulder joint lining
Cause
In most cases, damage to the biceps tendon is due to a lifetime of normal activities. As we age, our tendons slowly weaken with everyday wear and tear. This degeneration can be worsened by overuse — repeating the same shoulder motions again and again.
Many jobs and routine chores can cause overuse damage. Sports activities — particularly those that require repetitive overhead motion, such as swimming, tennis, and baseball — can also put people at risk for biceps tendinitis.
Repetitive overhead motion may play a part in other shoulder problems that occur with biceps tendinitis. Rotator cuff tears, osteoarthritis, and chronic shoulder instability are often caused by overuse.
Symptoms
Pain or tenderness in the front of the shoulder, which worsens with overhead lifting or activity
Pain or achiness that moves down the upper arm bone
An occasional snapping sound or sensation in the shoulder
Nonsurgical Treatment
Biceps tendinitis is typically first treated with simple methods.
Rest. The first step toward recovery is to avoid activities that cause pain.
Ice. Apply cold packs for 20 minutes at a time, several times a day, to keep swelling down. Do not apply ice directly to the skin.
Nonsteroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling.
Steroid injections. Steroids such as cortisone are very effective anti-inflammatory medicines. Injecting steroids into the tendon can relieve pain. Your doctor will use these cautiously. In rare circumstances, steroid injections can further weaken the already injured tendon, causing it to tear.
Chiropractic/Physical therapy. Specific stretching and strengthening exercises can help restore range of motion and strengthen your shoulder.
As your Chiropractor in the Woodbridge, Dale City VA area headaches are one of the main complaints I see. Lots of time the patients will also have neck pain but the two complaints are rarely connected by the patient. Neck pain can most definitely cause headaches.
Neck pain and headaches are linked more often than you would think. Most people think they have a headache and it is local to the head. Further investigation could find the cause being your neck. There are two major types of headaches: Migraines (which we all seem to know about) and cervicogenic. Most people assume a really bad headache is just a migraine. This isn’t always the case and more often than not the headache is coming from the upper neck region. This is the reason migraine medication doesn’t work on these headaches.
Getting the headaches properly diagnosed will help people properly treat them. I see tons of patients who come in with “migraines.” They explain the entire headache. It starts in the back of my neck then shoots into my head. By this point they are taking their medication but it never seems to work. Then they sit in a dark room and try and ride out the “migraine.”
Visiting Doroski Chiropractic Neurology in Woodbridge VA is a great place to start to get the headaches properly diagnosed. If that isn’t possible check out a local chiropractor who can help you properly diagnose the headache. The headache could be what is called a cervicogenic headache. Sound scary but it is treatable and generally chiropractic care is the place to begin.
By definition a cervicogenic headache is any headache which is caused by the neck. The term ‘cervicogenic’ simply refers the cervical area, which is a part of your spine located right near the base of the skull. The pain of cervicogenic headache is usually unilateral; it originates in the neck and then spreads to the oculofrontal-temporal areas of the head. The headache initially presents as intermittent episodes and then progresses to an almost continuous pain. Pain may be triggered or exacerbated by neck movement or a particular neck position; it can also be triggered by applying pressure over the ipsilateral upper part of the back of the neck or the ipsilateral occipital region. If this sounds like your headache visiting a Doroski Chiropractic Neurology in Woodbridge Virginia may help.
There are some simple things you can do at home to help prevent the headaches if you can’t get to a chiropractor.
Relaxation
Heat or cool the head and neck
Mobilizing
Postural exercise
Improve your computer work station ergonomics (see our tips on this in other blogs at doroskichiropractic.com)
Of course if the headaches are severe enough and none of your home therapies are working do not hesitate to contact your Doctor. Headaches could be a symptom of a more serious problem and your Doctor will be able to do further testing or imaging to rule out more serious conditions.
Kids and sports are always a good idea. There are so many life lessons kids can learn while playing sports. The biggest thing is trying to avoid injury. As your Chiropractor in the Woodbridge, Dale City VA area I see tons of “old” child athletes. Most complaints begin with “yea I hurt it play football, gymnastics, baseball, softball…” back when I was in high school. Kids heal so fast most can work through a lot of injuries but that isn’t always a good thing. Here are some of the ACA guidelines for child athletes.
The majority, if not all, sports are good, provided that the child prepares appropriately,” says Timothy Ray, DC, a member of the American Chiropractic Association’s Council on Sports Injuries and Physical Fitness. “Without proper preparation, playing any sport can turn into a bad experience. There are structural and physical developmental issues that need to be taken into consideration before children undertake certain sports.”
Highly competitive sports such as football, gymnastics and wrestling follow rigorous training schedules that can be potentially dangerous to an adolescent or teenager. The best advice for parents who have young athletes in the family is to help them prepare their bodies and to learn to protect themselves from sports related injuries before they happen.
“Proper warm up, stretching and strength-training exercises are essential for kids involved in sports, but many kids learn improper stretching or weight-lifting techniques, making them more susceptible to injury,” says Steve Horwitz, DC, an ACA member from Silver Spring, Md., and former member of the U.S. Summer Olympic medical team. “Parents need to work with their kids and make sure they receive the proper sports training.”
“Young athletes should begin with a slow jog as a general warm-up, followed by a sport-specific warm-up. They should then stretch all the major muscle groups,” says Dr. Horwitz. “Kids need to be instructed in appropriate exercises for each sport to prevent injuries.”
Proper nutrition and hydration are also extremely vital. “While an ordinary person may need to drink eight to 10 8-ounce glasses of water each day, athletes need to drink even more than that for proper absorption. Breakfast should be the most important meal of the day. Also, eating a healthy meal two to four hours before a practice or a game and another within one to two hours after a game or practice allows for proper replenishment and refuels the body,” adds Dr. Horwitz.
Young athletes today often think they are invincible. The following tips can help ensure your child does not miss a step when it comes to proper fitness, stretching, training and rest that the body needs to engage in sporting activities.
Encourage your child to:
Wear the proper equipment. Certain contact sports, such as football and hockey, can be dangerous if the equipment is not properly fitted. Make sure all equipment, including helmets, pads and shoes fit your child or adolescent. Talk to your child’s coach or trainer if the equipment is damaged.
Eat healthy meals. Make sure your young athlete is eating a well-balanced diet and does not skip meals. Avoid high-fat foods, such as candy bars and fast food. At home, provide fruit rather than cookies, and vegetables rather than potato chips.
Maintain a healthy weight. Certain sports, such as gymnastics, wrestling and figure skating, may require your young athlete to follow strict dietary rules. Be sure your child does not feel pressured into being too thin and that he/she understands that proper nutrition and caloric intake is needed for optimal performance and endurance.
Drink water. Hydration is a key element to optimal fitness. Teenage athletes should drink at least eight 8-ounce glasses of water a day. Younger athletes should drink five to eight 8-ounce glasses of water.
Drink milk. Make sure your child has enough calcium included in his/her diet. For children over 2 years of age, ACA recommends 1 percent or skim milk rather than whole milk. Milk is essential for healthy bones and reduces the risk of joint and muscle related injuries.
Avoid sugar-loaded, caffeinated and carbonated drinks. Sports drinks are a good source of replenishment for those kids engaged in long duration sports, such as track and field.
Follow a warm-up routine. Be sure your child or his/her coach includes a warm-up and stretching session before every practice, game or meet. A slow jog, jumping rope and/or lifting small weights reduces the risk of torn or ripped muscles. Flexibility is key when pushing to score that extra goal or make that critical play.
Take vitamins daily. A multi-vitamin and Vitamin C are good choices for the young athlete. Vitamin B and amino acids may help reduce the pain from contact sports. Thiamine can help promote healing. Also consider Vitamin A to strengthen scar tissue.
Avoid trendy supplements. Kids under the age of 18 should avoid the use of performance-enhancing supplements, such as creatine. Instead, they should ask their coach or trainer to include weekly weight training and body-conditioning sessions in their workout.
Get plenty of rest. Eight hours of sleep is ideal for the young athlete. Lack of sleep and rest can decrease performance. Sluggishness, irritability and loss of interest could indicate that your child is fatigued.
I am starting to hear from my patients in my Dale City, Woodbridge VA Chiropractic office that this is the weekend to start raking up last winters leaves. I sometimes wait a little to see if the will blow away but for those of you who are going out there here are some tips.
Just as playing football or golf can injure your body, the twisting, turning, bending, and reaching of mowing and raking can also cause injury if your body is not prepared. Like an athlete, if you leap into something without warming up or knowing how to do it, the chances of injury are greater.
What Can You Do?
The American Chiropractic Association (ACA) offers the following tips to help prevent the needless pain yard work may cause.
Do stretching exercises, without bouncing, for a total of 10 to 15 minutes spread over the course of your work. Do knee-to-chest pulls, trunk rotations, and side bends with hands above your head and fingers locked. Take a short walk to stimulate circulation. When finished with the yard work, repeat the stretching exercises.
Stand as straight as possible, and keep your head up as you rake or mow.
When it’s still warm outside, avoid the heat. If you’re a morning person, get the work done before 10 a.m. Otherwise, do your chores after 6 p.m.
Wear supportive shoes. Good foot and arch support can stop some of the strain from affecting your back.
When raking, use a “scissors” stance: right foot forward and left foot back for a few minutes, then reverse, putting your left foot forward and right foot back.
Bend at the knees, not the waist, as you pick up piles of leaves or grass from the grass catcher. Make the piles small to decrease the possibility of back strain.
When mowing, use your whole bodyweight to push the mower, rather than just your arms and back.
If your mower has a pull cord, don’t twist at the waist or yank the cord. Instead, bend at the knees and pull in one smooth motion.
Drink lots of water, wear a hat, shoes and protective glasses. And, to avoid blisters, try wearing gloves. If your equipment is loud, wear hearing protection. If you have asthma or allergies, wear a mask.
Try ergonomic tools, too. They’re engineered to protect you when used properly.
If you do feel soreness or stiffness in your back, use ice to soothe the discomfort. If there’s no improvement in two or three days, see your local doctor of chiropractic.
Wrist pain is more and more common these days. Computer work is one of the biggest causes and that includes video games. As your chiropractor in the Woodbridge, Dale City VA area I see lots of carpal tunnel complaints
CTS typically occurs in adults, with women 3 times more likely to develop it than men. The dominant hand is usually affected first, and the pain is typically severe. CTS is especially common in assembly-line workers in manufacturing, sewing, finishing, cleaning, meatpacking, and similar industries. Contrary to the conventional wisdom, according to recent research, people who perform data entry at a computer (up to 7 hours a day) are not at increased risk of developing CTS.
What Is CTS?
CTS is a problem of the median nerve, which runs from the forearm into the hand. CTS occurs when the median nerve gets compressed in the carpal tunnel—a narrow tunnel at the wrist—made up of bones and soft tissues, such as nerves, tendons, ligaments, and blood vessels. The compression may result in pain, weakness, and/or numbness in the hand and wrist, which radiates up into the forearm. CTS is the most common of the “entrapment neuropathies”—compression or trauma of the body’s nerves in the hands or feet.
What Are the Symptoms?
Burning, tingling, itching, and/or numbness in the palm of the hand and thumb, index, and middle fingers are most common. Some people with CTS say that their fingers feel useless and swollen, even though little or no swelling is apparent. Since many people sleep with flexed wrists, the symptoms often first appear while sleeping. As symptoms worsen, they may feel tingling during the day. In addition, weakened grip strength may make it difficult to form a fist or grasp small objects. Some people develop wasting of the muscles at the base of the thumb. Some are unable to distinguish hot from cold by touch.
Why Does CTS Develop?
Some people have smaller carpal tunnels than others, which makes the median nerve compression more likely. In others, CTS can develop because of an injury to the wrist that causes swelling, over-activity of the pituitary gland, hypothyroidism, diabetes, inflammatory arthritis, mechanical problems in the wrist joint, poor work ergonomics, repeated use of vibrating hand tools, and fluid retention during pregnancy or menopause.
How Is It Diagnosed?
CTS should be diagnosed and treated early. A standard physical examination of the hands, arms, shoulders, and neck can help determine if your symptoms are related to daily activities or to an underlying disorder.
Your doctor of chiropractic can use other specific tests to try to produce the symptoms of carpal tunnel syndrome. The most common are:
Pressure-provocative test. A cuff placed at the front of the carpal tunnel is inflated, followed by direct pressure on the median nerve.
Carpal compression test. Moderate pressure is applied with both thumbs directly on the carpal tunnel and underlying median nerve at the transverse carpal ligament. The test is relatively new.
Laboratory tests and x-rays can reveal diabetes, arthritis, fractures, and other common causes of wrist and hand pain. Sometimes electrodiagnostic tests, such as nerveconduction velocity testing, are used to help confirm the diagnosis. With these tests, small electrodes, placed on your skin, measure the speed at which electrical impulses travel across your wrist. CTS will slow the speed of the impulses and will point your doctor of chiropractic to this diagnosis.
What Is the CTS Treatment?
Initial therapy includes:
Resting the affected hand and wrist
Avoiding activities that may worsen symptoms
Immobilizing the wrist in a splint to avoid further damage from twisting or bending
Applying cool packs to help reduce swelling from inflammations
Some medications can help with pain control and inflammation. Studies have shown that vitamin B6 supplements may relieve CTS symptoms.
Chiropractic joint manipulation and mobilization of the wrist and hand, stretching and strengthening exercises, soft-tissue mobilization techniques, and even yoga can be helpful. Scientists are also investigating other therapies, such as acupuncture, that may help prevent and treat this disorder.
Occasionally, patients whose symptoms fail to respond to conservative care may require surgery. The surgeon releases the ligament covering the carpal tunnel. The majority of patients recover completely after treatment, and the recurrence rate is low. Proper posture and movement as instructed by your doctor of chiropractic can help prevent CTS recurrences.
How Can CTS Be Prevented?
The American Chiropractic Association recommends the following tips:
Perform on-the-job conditioning, such as stretching and light exercises.
Take frequent rest breaks.
Wear splints to help keep the wrists straight.
Use fingerless gloves to help keep the hands warm and flexible.
Use correct posture and wrist position.
To minimize workplace injuries, jobs can be rotated among workers. Employers can also develop programs in ergonomics—the process of adapting workplace conditions and job demands to workers’ physical capabilities.
The difficult question everyone who works out eventually has to ask themselves…. Is it time to get new workout shoes? I think everyone who has faced this dilemma knows that by the time you are thinking about your shoes, it is too late. I know it sucks spending another $120.00 or more on a good pair of shoes isn’t what you wanted but your back, knees and ankles will thank you. Here are some tips from your Woodbridge, Dale City VA Chiropractor on buying running/exercise shoes.
How to Select Athletic Shoes
Too many people choose fashion over function when purchasing athletic shoes, not realizing that poor-fitting shoes can lead to pain throughout the body. Because footwear plays such an important role in the function of bones and joints—especially for runners and other athletes—choosing the right shoe can help prevent pain in your back, hips, knees, and feet.
Unfortunately, there is no such thing as the very best athletic shoe—every pair of feet is different, every shoe has different features, and overall comfort is a very personal decision. For this reason, it is recommended that you first determine your foot type: normal, flat, or high-arched.
The Normal Foot
Normal feet have a normal-sized arch and will leave a wet footprint that has a flare, but shows the forefoot and heel connected by a broad band. A normal foot lands on the outside of the heel and rolls slightly inward to absorb shock.
Best shoes: Stability shoes with a slightly curved shape.
The Flat Foot
This type of foot has a low arch and leaves a print that looks like the whole sole of the foot. It usually indicates an over-pronated foot—one that strikes on the outside of the heel and rolls excessively inward (pronates). Over time, this can cause overuse injuries.
Best shoes: Motion-control shoes or high-stability shoes with firm midsoles. These shoes should be fairly resistant to twisting or bending. Stay away from highly cushioned, highly curved shoes, which lack stability features.
The High-Arched Foot
The high-arched foot leaves a print showing a very narrow band—or no band at all—between the forefoot and the heel. A curved, highly arched foot is generally supinated or under-pronated. Because the foot doesn’t pronate enough, usually it’s not an effective shock absorber.
Best shoes: Cushioned shoes with plenty of flexibility to encourage foot motion. Stay away from motion-control or stability shoes, which reduce foot mobility.
When determining your foot type, consult with your doctor of chiropractic. He or she can help determine your specific foot type, assess your gait, and then suggest the best shoe match.
Shoe Purchasing Tips
Consider the following tips before you purchase your next pair of athletic shoes:
Match the shoe to the activity. Select a shoe specific for the sport in which you will participate. Running shoes are primarily made to absorb shock as the heel strikes the ground. In contrast, tennis shoes provide more side-to-side stability. Walking shoes allow the foot to roll and push off naturally during walking, and they usually have a fairly rigid arch, a well-cushioned sole, and a stiff heel support for stability.
If possible, shop at a specialty store. It’s best to shop at a store that specializes in athletic shoes. Employees at these stores are often trained to recommend a shoe that best matches your foot type (shown above) and stride pattern.
Shop late in the day. If possible, shop for shoes at the end of the day or after a workout when your feet are generally at their largest. Wear the type of socks you usually wear during exercise, and if you use orthotic devices for postural support, make sure you wear them when trying on shoes.
Have your feet measured every time. It’s important to have the length and width of both feet measured every time you shop for shoes, since foot size often changes with age and most people have 1 foot that is larger than the other. Also, many podiatrists suggest that you measure your foot while standing in a weight bearing position because the foot elongates and flattens when you stand, affecting the measurement and the fit of the shoe.
Make sure the shoe fits correctly. Choose shoes for their fit, not by the size you’ve worn in the past. The shoe should fit with an index finger’s width between the end of the shoe and the longest toe. The toe box should have adequate room and not feel tight. The heel of your foot should fit snugly against the back of the shoe without sliding up or down as you walk or run. If possible, keep the shoe on for 10 minutes to make sure it remains comfortable.
How Long Do Shoes Last?
Once you have purchased a pair of athletic shoes, don’t run them into the ground. While estimates vary as to when the best time to replace old shoes is, most experts agree that between 300 and 500 miles is optimal. In fact, most shoes should be replaced even before they begin to show signs of moderate wear. Once shoes show wear, especially in the cushioning layer called the midsole, they also begin to lose their shock absorption. Failure to replace worn shoes is a common cause of injuries like shin splints, heel spurs, and plantar fasciitis.
Once someone recovers from their lumbar injury, they always go into prevention mode! Which is understandable since there was nothing fun for them during the injury. The most common thing people say is should I get a brace or support. Years ago, that was the thing but now it isn’t as popular. As your Chiropractor in the Woodbridge, Dale City VA area I want to share this information with you about back braces.
So let me give you some background on back braces and do they really help.
The truth is that wearing an elastic or other support around your waist to help your back may be both good and bad. And whether wearing such a back belt will prevent back problems is controversial. A new study that found workers who routinely wear these support belts while working at Wal-Mart, were just as likely to injure their backs as those who did not.(1) However, some previous studies have shown back belts to prevent injuries, such as the UCLA study conducted with Home Depot workers, which found a 1/3 decrease in back injuries due to wearing back belts.(2)
Let’s look at the scientific evidence about whether back belts might help to support the back, whether there are any risks associated with wearing them, and whether such belts should be recommended or not.
How might back belts help to support the back? They do not hold the back in, as many presume. Back belts function primarily to hold the stomach in, thus increasing intra-abdominal pressure. This has led some to refer to these belts as abdominal belts rather than as back belts. But how does increasing intra-abdominal pressure support the spine? We will briefly review the intra-abdominal balloon theory and a more modern theory.
Intra-Abdominal Balloon Mechanism
It was originally proposed by Bartelink in 1957 that increased intra-abdominal pressure would decrease the compressive load on the spine through the intra-abdominal balloon mechanism.(3) To begin with, you must think of the abdominal cavity and the abdominal organs as a squishy liquid. Then realize that the abdominal cavity becomes a closed chamber when we bear down and hold our breath, which we instinctively do when we lift heavy things. This chamber is closed on the bottom by the anal sphincter and on the top by the diaphragm. When bearing down, the abdominal contents tend to push outwards. But if we contract our deep abdominal muscles—the obliques and the transverse abdominus muscles—or we wear a thick belt, the abdominal contents are forced upwards rather than outwards.(4 p.109) This theoretically provides a decompressive effect on the lumbar spine. Since the crura of the diaphragm is attached to the first 3 lumbar vertebrae, when the diaphragm is pushed upwards, it exerts a traction force on the lower lumbar spine (L4 and L5). It was also theorized that since this balloon mechanism makes the spine more rigid, it would decrease the amount of work required of the erector muscles to prevent us from falling forwards. Kapanji estimated that this abdominal support mechanism acts to reduce compression forces on the L5/S1 disc by 30% and reduces the force required by the erector spinae muscles by 55%. (4, p.198).
But more recent scientific evidence fails to support some of these theoretical assumptions. Such recent studies reveal that an increase in intra-abdominal pressure actually results in an increase (rather than a decrease) in compressive force on the lower spine.(5,6) And there is no decrease in the amount of work required of the lower back muscles.(7) However, by stiffening the trunk, increased intra-abdominal pressure may prevent the tissues in the spine from strain or failure from buckling. Such intra-abdominal pressure may also act to reduce anterior-posterior shear loads.(8) In other words, support for the spine is provided, without reducing compression to any appreciable degree.
Belts may also help to protect the spine by limiting the range of motion that occurs when bending or twisting, though this effect is less than expected.(9,10) However, since when the spine bends more, it is more vulnerable to injury, if these belts reduce extreme bending at all, they may be beneficial.
Are there any risks associated with wearing a back belt?
The main risk associated with wearing a back belt is that during the period of wearing it, the supportive spinal muscles—the deep abdominal and back muscles—that normally support your spine will become weaker. These muscles are less active while your spine is being artificially supported by the belt. Muscles need to be consistently exercised in order to stay strong. If these muscles become weaker, when you stop wearing the belt, you may be more likely to hurt your back. And at least one study seems to suggest this. In this study, there was an increase in the number and severity of back injuries following a period of belt wearing.(11)
Another risk associated with wearing a back belt is that it causes an increase in both blood pressure and heart rate.(12) This may pose a problem for those individuals with existing cardiovascular disease or risk factors, such as hypertension.
A third risk associated with wearing a back belt is that workers may be inclined to lift heavier objects while wearing them. These belts may be giving workers a false sense of security. This could result in an increased risk of injury.
REFERENCES:
Wassell JT, Gardner LI, Landsittel DP, Johnston JJ, Johnston JM. A prospective study of back belts for prevention of back pain and injury. JAMA. 2000; 284(21): 2727-32.
McIntyre DR; Bolte KM; Pope MH. Study provides new evidence of back belts’ effectiveness. Occup Health Saf. 1996; 65(12): 39-41.
Bartelink DL, “The Role of Abdominal Pressure in Relieving Pressure on the Lumbar Intervertebral Discs,” J Bone Joint Surg, (Br) 1957, 39B: 718-725.
Kapanji, IA. The Physiology of the Joints, Vol. III.
McGill SM, Norman RW. Reassessment of the role of intra-abdominal pressure in spinal compression. Ergonomics. 1987; 30: 1565-1588.
Nachemson AL, Anderson GBJ, Schultz AB. Valsalva maneuver biomechanics. Effects on lumbar spine trunk loads of elevated intrabdominal pressures. Spine. 1986; 11: 476-479.
McGill S, Norman RW, Sharatt MT. The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics. 1990; 33:147-160.
McGill S. Abdominal belts in industry: A position paper on their assets, liabilities and use. Am Ind. Hyg. Assoc. J. 1993; 54(12): 752-754.
Lantz SA, Schultz AB. Lumbar spine orthosis wearing I. Restriction of gross body motion. Spine. 1986; 11: 834-837.
McGill SM, Sequin JP, Bennett G. Passive stiffness of the lumbar torso in flexion, extension, lateral bend and axial twist: The effect of belt wearing and breath holding. Spine. 1994; 19(19): 2190-2196.
Reddell CR, Congleton JJ, Huchinson RD, Mongomery JF. An evaluation of a weightlifting belt and back injury prevention training class for airline baggage handlers. Appl. Ergonomics. 1992; 23: 319-329.
Hunter GR, McGuirk J, Mitrano N, et al. The effects of a weight training belt on blood pressure during exercise. J Appl Sport Sci Res. 1989; 3: 13-18.
