As a chiropractor I see all sorts of health problems. My Woodbridge, Dale City VA chiropractic office takes a holistic approach to all of the problems. So most complaints start with diet. It is hard for your car to run correctly if you fill the tank with water. Well filling your body with processed food and hoping for a smooth life doesn’t make much sense either. Diet is a tough one to conquer because sometimes you just can’t eat right. Your Woodbridge, Dale City Va chiropractor says that is ok but don’t make a daily habit of it. Here are some pretty solid diet tips from the ACA.
Healthy Dietary Choices
Eat more raw foods. Cooking and canning destroys much of the nutrition in foods. With the exception of canned tomatoes, which have been shown to help prevent prostate cancer, fresh or frozen fruits and vegetables generally have more natural vitamins and minerals.
Select organically grown foods when possible, because they have lower amounts of toxic elements, such as pesticides and heavy metals.
Consume 25 to 30 grams of fiber a day. Whole-grain breads and cereals, beans, nuts and some fruits and vegetables are good sources of fiber. High-fiber diets can help prevent digestive disorders, heart disease and colon cancer.
Eat out more sparingly. Food preparation methods in restaurants often involve high amounts—and the wrong types—of fat and sugar.
Brown-bag your lunch to control your fat and sugar intake while adding nutritious fruits, vegetables and grains.
Drink plenty of water to stay hydrated. Don’t substitute coffee, tea and soft drinks for water.
Limit your intake of alcohol, and quit smoking. Drinking alcohol excessively and/or smoking hinder your body’s ability to absorb nutrients from food.
Vegetarian Diets
Research shows that a good vegetarian diet as part of a comprehensive health program can help prevent heart disease, cancer and other diseases. However, fried foods, hydrogenated fats and commercial meat substitutes may contain more sugar and fat than a meat-eater would consume. If you are considering a vegetarian diet, keep the following tips in mind:
Eat a variety of fruits, vegetables, grains and legumes to consume a wide range of nutrients.
Consume fortified foods or take supplements, such as vitamin B12, to obtain the nutrients you no longer get from animal-based products.
Children, pregnant and breast-feeding women, and people recovering from illness should consult their healthcare practitioners before eliminating animal products from their diet.
Supplements
While dietary supplements are becoming increasingly popular, they are not substitutes for foods, nor can a person sustain good health simply by taking vitamin and mineral supplements. When taken properly, however, supplements can play an important role in achieving maximum health.
Since supplements are just an added source of nutrients, consume dark green vegetables, oils, nuts and seeds, which are sources of magnesium, fatty acids and many other vitamins and minerals.
Don’t “self-prescribe.” Consult your doctor of chiropractic to determine what supplements are best for you, especially if you have symptoms such as headaches, chronic fatigue or cardiac problems.
While I sit at my desk curled forward like a pill bug ergonomics comes to mind. Why does sitting at a chair typing have to hurt so much? I can remember doing construction and feeling great but being envious of the office worker. Besides working on patients sitting in this chair doing paperwork is killing me. Type to dust off one of my old blogs about work station safety! All jokes aside using proper body mechanics can go a long way to preventing injuries. And as we age it seems like darn near anything can hurts us. As your Chiropractor in the Woodbridge, Dale City Virginia area I feel it is my duty to provide you with the ACA guidelines on ergonomics.
What Are Good Ergonomics?
According to the United States Department of Health and Human Services, ergonomics is the science of fitting workplace conditions and job demands to employee capabilities. An ergonomic assessment of the workplace critically appraises the physical work environment—followed by changes based on the assessment. Ergonomic principles are then used to make the workplace compatible with the employee, improving the employee’s safety and productivity. In other words, the easier it is to do a job, the more productive and happy the worker will be.
When considering the impact of proper ergonomics on workplace safety, three basic principles are especially important:
1- When lifting, the largest muscles in the area should perform the task. The larger the muscle or muscle group used for lifting, the lower the stress placed on smaller, more vulnerable muscles.
2- During any work activities, people should be able to comfortably assume a number of different postures and not remain in one position for an extended time. Muscles will fatigue and be more prone to injury when assuming a particular posture, especially a poor one (e.g., partially bent forward at the waist).
3- When performing tasks, it is important to keep the joints either in their neutral posture or approximately halfway into the range of motion. Working with your joints at the extremes of their ranges of motion for prolonged periods places abnormal stresses on them and can cause repetitive stress injuries.
When working at a desk, try these suggestions for greater comfort:
1- Choose a desk that is the proper height. All things on your desk should be within easy reach.
2- Your feet should be touching the floor, with the legs and body forming an angle of 90 to 110 degrees.
3- Keep your body straight with the head and neck upright and looking forward, not to the side. Do not hunch over or slouch.
4- Adjust the height of your monitor. Look forward with your head in a neutral position. Your eyes should be at the same height as the top of the monitor. Leaning your head forward can lead to headaches and neck pain.
5- When typing, keep your wrists straight, your shoulders perpendicular to the floor, and your forearms parallel to the floor.
6- When reading at your desk, use a bookstand or a paper holder to keep your eyes in the same neutral position you use to read documents on your computer monitor.
7- When talking on the phone, use a headset, when possible, especially if you talk on the phone for prolonged periods. Holding the phone between your shoulder and cheek will only lead to neck pain and headaches.
8- Stand up and stretch your legs with a short walk about every 20 to 30 minutes.
9- Take micro-breaks often, stretching your neck, arms and wrists, back, and legs. Simple stretches include neck rotations, fist clenches, arm dangles, and shoulder shrugs.
10- If your eyes concentrate on a particular object for long periods, relax your eye muscles by shifting your focus from objects that are close to you to objects that are farther away. This helps reduce eye strain.
When lifting, follow these simple suggestions:
When lifting from the floor, keep your back straightand lift with the legs. Do not bend over at the waist and lift with the muscles of the low back. Your body is more easily injured in this position. Keep the object being lifted close to your body. Keep your elbows flexed. Keep your head up and your neck straight as you lift.
When working with a computer mouse, try the following:
Don’t move the mouse with just your wrist. Use your entire arm and shoulder. Don’t rest your arm on the edge of the desk while manipulating the mouse. Hold the mouse loosely. Keep your wrist relaxed. Don’t hold it up or down; instead, hold it in a neutral (straight) position Move away from the mouse several times per hour and move your wrists, arms, and shoulders around.
We have all heard it! The secret to preventing back pain is a strong core! Sound great but what the heck is my core and how do I strengthen it! There are a bunch of different core exercises you can do and millions of gym machines and exercises videos. Some are very complex and some are very low tech but they all work. So before you invest in some videos or a gym membership your chiropractor in the Woodbridge, Dale City Virginia area has a few tips for you.
Situps/Crunch. Lie on your back on the floor or a yoga mat. Legs are straight on the floor, leg muscles tight, backs of the legs “glued” to the floor. Either do slides (sliding your hands on your legs) or cross your arms in front of you (putting your hands behind your head will pull your head up, resulting in your neck being strained). Engage your transverse abdominus to initiate the crunch/sit up. Keeping legs “glued” to the floor, come all the way up to sitting tall with a straight spine. To modify, keep knees bent, feet flat on the floor and procede as above. If you are not ready for full sit ups, do a crunch, holding your transverse abdominus in the whole time. Beginners start with 1-2 sets of 10-12 repetitions, intermediates perform 2-3 sets of 12-15 repetitions, advanced perform 3-5 sets of 15 repetitions holding a weighted medicine ball. If you are ready for a further challenge, do as many as you can. At the number you stop, mark that down somewhere so you don’t forget. Each time you exercise, increase the number of situps by increments of 3-5. Increasing the number slowly will help get your abs used to doing situps. This gives you the “six pack” and a strong core. Performing crunches on an unstable surface such as a stability ball will further challenge the core muscles.
Plank. Lie on the floor, or yoga mat, face down. Place forearms and toes on the floor, push up so only the forearms and toes remain on the floor. Tighten your hip, leg, arm, back, chest, and abdominal muscles making this a total body exercise. Keep your whole body straight from the base of the skull all the way to the heels, and keep even breathing. You’ll want to drop your hips a little bit further than shown here. After 30 seconds, relax for a few seconds. Then for another 30 seconds, lift yourself up again, but on your right side. Your right forearm and toes should be the only things touching the ground. Shoulders and hips will be stacked directly over one another. Feet can be separated or on top of one another. Hold for 30 seconds, rest, then switch to your left side. Repeat the whole cycle one to three more times. When 30 seconds is a breeze, increase the time by at least 5 seconds. The plank strengthens not only your core, but your total body,increasing core stability.
Arm sweep. Sit on the floor and slightly outstretch your legs “gluing” them to the floor, or bending the knees with feet flat. Sit tall, engaging your mid back to help you sit up straight. Stretch out your arms out the sides. Next, twist your body to the left so that you rotate and your right hand reaches for the left foot, and the left hand touches the ground behind you or is raised in the air behind you. Repeat on your right side. This results in a sweeping motion of your arms and twisting your body to engage the abdominal muscles and back muscles. Your fitness level determines the number of sets and reps you aim for. Beginners, 1-2 sets of 8-10 reps, intermediates, 2-3 sets of 12-15 reps, advanced, 3-5 sets of 15-30 reps.
Superman. Lie on the floor, or your yoga mat, face down. Reach your arms directly in front of you, reaching to the opposite wall. Straighten your legs, “gluing” your heels and inner thighs together by tightening the inner thighs and glutes. Lift your arms, chest, head, legs and feet off of the ground. At this point, only your belly and hips are touching the ground (no knees or feet). Keep holding your arms, chest, head, and legs up, engaging your low-mid back muscles and your glutes, for at least 30 seconds. Then relax. Do it again for another 30 seconds. When 30 seconds in simple, increase your time by 5 seconds or more. This exercise strengthens the back muscles that help support your spine and are necessary for a strong core.
We are coming into flu and cold season! Many patients ask if chiropractic can help with ear infections. People seem to ask about that one the most. Some we can help and some need to be referred out. Your Woodbridge, Dale City Virginia Chiropractor is a good place to start to see if conservative care can help.
Ear problems can be excruciatingly painful, especially in children. With 10 million new cases every year, ear infections (otitis media) are the most common illness affecting babies and young children and the number one reason for visits to the pediatrician—accounting for more than 35 percent of all pediatric visits.
Almost half of all children will have at least one middle ear infection before they’re a year old, and two-thirds of them will have had at least one such infection by age 3. The symptoms can include ear pain, fever, and irritability. Otitis media can be either bacterial or viral in origin, and frequently results from another illness such as a cold. For many children, it can become a chronic problem, requiring treatment year after year, and putting the child at risk of permanent hearing damage and associated speech and developmental problems.
Standard treatment for most cases of otitis media is with antibiotics, which can be effective if the culprit is bacterial (antibiotics, of course, do nothing to fight off viruses). But, according to many research studies, antibiotics are often not much more effective than the body’s own immune system. And repeated doses of antibiotics can lead to drug-resistant bacteria that scoff at the drugs, while leaving the child screaming in pain.
Frequent ear infections are also the second most common reason for surgery in children under 2 (with circumcision being the first). In severe cases—for example, when fluids from an ear infection haven’t cleared from the ear after several months, and hearing is affected—specialists sometimes prescribe myringotomy and tympanostomy, more commonly known as “ear tubes.” During the surgical procedure, a small opening is made in the eardrum to place a tube inside. The tube relieves pressure in the ear and prevents repeated fluid buildup with the continuous venting of fresh air. In most cases, the membrane pushes the tube out after a couple of months and the hole in the eardrum closes. Although the treatment is effective, it has to be repeated in some 20 to 30 percent of cases. And this kind of surgery requires general anesthesia, never a minor thing in a small child. If the infection persists even after tube placement and removal, children sometimes undergo adenoidectomy (surgical removal of the adenoids)—an option that is effective mostly through the first year after surgery.
Before yet another round of “maybe-they’ll-work-and-maybe-they-won’t” antibiotics or the drastic step of surgery, more parents are considering chiropractic to help children with chronic ear infections. Dr. Joan Fallon, a chiropractor who practices in Yonkers, New York, has published research showing that, after receiving a series of chiropractic adjustments, nearly 80 percent of the children treated were free of ear infections for at least the six-month period following their initial visits (a period that also included maintenance treatments every four to six weeks).
“Chiropractic mobilizes drainage of the ear in children, and if they can continue to drain without a buildup of fluid and subsequent infection, they build up their own antibodies and recover more quickly,” explains Dr. Fallon. She’d like to see her pilot study used as a basis for larger-scale trials of chiropractic as a therapeutic modality for otitis media.
Dr. Fallon uses primarily upper-cervical manipulation on children with otitis media, focusing particularly on the occiput, or back of the skull, and atlas, or the first vertebra in the neck. “Adjusting the occiput, in particular, will get the middle ear to drain. Depending on how chronic it’s been and on where they are in their cycle of antibiotics, children generally need to get through one bout of fluid and fight it off themselves.” That means, for the average child, between six and eight treatments. If a child’s case is acute, Dr. Fallon will check the ear every day, using a tympanogram to measure the ear and track the movement of the eardrum to make sure that it’s draining. “I’ll do adjustments every day or every other day for a couple of days if they’re acute, and then decrease frequency over time.”
Dr. Fallon, whose research garnered her the acclaim of childrearing magazines like Parenting and Baby Talk, often sees great success when she treats a child for otitis media. “Once they fight it themselves, my kids tend to do very well and stay away from ear infections completely. Unless there are environmental factors like smoking in the house, an abnormally shaped Eustachian tube, or something like that, they do very well,” she says.
“I have two large pediatric groups that refer to me on a regular basis. In the winter, when otitis is most prevalent, I see five or six new children each week from each group,” says Dr. Fallon. “It’s safe and effective and something that parents should try, certainly before inserting tubes in their children’s ears.”
Chiropractic Care Can Help…
Talk to your doctor of chiropractic about your child’s ear infections. Doctors of chiropractic are licensed and trained to diagnose and treat patients of all ages and will use a gentler type of treatment for children.
We all hear it! You need to exercise to lose weight, for your heart, for your diabetes… For the most part it is true. The first place we all need to begin is with a good quality shoe. If your feet hurt or blister it is hard to stay motivated. Unfortunately there are thousands of shoes out there and choosing one can be hard. Doroski Chiropractic Neurology in the Woodbridge, Dale City VA area has a few tips for you.
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.
Pain free neck movement is something we all expect! When it is no longer pain free we usually do something about. Thankfully chiropractic care can help with neck pain. But how about preventing it to begin with! Doroski Chiropractic Neurology in the Woodbridge, Dale City VA area has a few tips that may help you prevent neck pain.
Maintenance of the neck range of motion is easier than you would think and pretty basic but doing it daily makes a world of difference. One of the main reasons for neck pain is poor posture. So I tell all my patients to try and break up long periods of sitting at the computer. If you get up every 45 minutes or so and do some of these stretches you can help your neck a bunch.
That being said you need to start in a good neutral postion so when you do the exercises you aren’t creating another problem. Start with you neck squarely over shoulders with your shoulder relaxed at your side.
Rotations. Sitting or standing, turn your head slowly to the left and then to the right as far as you can, comfortably. Hold each stretch for 10 seconds to 30 seconds.
Shoulder circles. While standing, raise your shoulders straight up, then move them in a circle around, down and back up again. Circle in both directions.
Side stretches. While standing, stretch your neck slowly to the left trying to touch your ear to your shoulder. Repeat on the right side.
Resistance exercises. Place your right hand against your head above your ear and gently press, resisting the movement with your neck. Do the same with your left hand on the other side.
Head lifts. Lie on your back with your knees bent and feet flat on the floor. Lift and lower your head, keeping your shoulders flat on the floor. Next, lie on 1 side and lift your head toward the ceiling. Repeat this movement on your other side and while lying on your stomach. Demonstration of head lifts.
These should help you maintain a pain-free range of motion but seeing your chiropractor on a regular basis will help you maintain alignment and also decrease muscle spasms.
Low back pain is extremely common and unfortunately most of us will deal with it at some point in our lives. The good news is there are nonsurgical ways to treat it. The even better news is there are ways to prevent it! Preventing low back pain does require some work on your end but it isn’t that involved and doing a few minutes of work each day may save you lots of time and money in the end. Doroski Chiropractic Neurology in the Woodbridge, Dale City VA area has some exercises for you that may help.
Low back pain is very common and I see it all the time in my office. One of the common things I hear is something completely benign caused it. Granted we see a lot of traumatic injuries that you would assume would cause low back pain. Such as digging a hole, falling off the roof, working doing repetitive twisting or anything strenuous. People don’t generally think twice when they hurt their back doing those activities. They may wish they hadn’t but to have back pain following those things isn’t unusual. It is the injuries associated with sneezing, that big morning stretch, bending over to grab an empty dog food bowl… These are the injuries that always make the patient scratch their head. Unfortunately, it is not the event that really caused the injury. It is the 4 weeks of back stiffness that they ignored before the injury. Usually when I ask they go yea it was stiff, or yea I just had a long car ride, or I put in new baseboards BUT it was ok after that. Odds are it really wasn’t but you were just dealing with it.
When your low back is tight for a long period of time it is a ticking time bomb. The muscles are continually pulling on the pelvis and lumbar joints until that one weird movement and the entire thing falls apart. Unfortunately, this injury is harder to fix then the guy who fell off the roof, mainly because the rest of his back hasn’t had a few weeks to compensate for the low back tightness. I always stress to my patients that spending a few minutes in the morning and at the end of the day stretching their low back will make a world of difference. That and staying hydrated will help keep the muscle from tightening up.
Here are some daily stretches you can do to keep your back stretched and relaxed so the muscles function correctly.
The Deep Squat
Stand up straight with your arms folded across your chest. Place your feet shoulder-width apart and toes pointing out slightly. Squat down as far as you can, keeping your heels on the floor. As you squat ensure your weight goes into your heels and not your toes. For a full range of movement, your bum should sit down by your heels and your head should be tall and looking forward. Perform the exercise slowly when lowering down, giving yourself time to keep control and lower all the way – or as far as your range of movement will allow. Pause for a count of two at the bottom of the squat, allowing your groin area to relax. Your knees should be directed slightly outwards in alignment with your feet. Keeping your knees out, squeeze your gluteals and stand up out of the squat. Only go as far as you can without any pain. As you perform the exercise regularly you will slowly but surely be able to achieve greater flexibility. Do this for 2 sets of 10.
Knee to Chest
Lie on your back, flex your knees up and do a pelvic tilt so you press your lower back flat to the floor. Slowly and gently pull your right knee to your chest at a slight angle towards your left shoulder. Hold for 5 seconds and release back to the bent position. Then repeat with the opposite leg. Do this 10 times in alternating fashion
Downward Dog
Place your hands and feet on the floor, shoulder-width apart, knees bent and hips high. Your heels should be off the floor at this point. Relax your head and neck so you are looking towards your knees. Do a pelvic tilt so your lower back is arched and your spine is straight. Now straighten your arms and pull your shoulder blades together. Straighten your knees as well. You may lose the arch in your low back but don’t allow your lumbar spine to flex. This will require a good abdominal squeeze to maintain the lumbar arch. Hold for 30 seconds and relax. Repeat 5 times.
Spine twists
Sit down with your legs loosely crossed. Pull your back up tall and stick your chest out so that you are sitting upright with perfect posture. Fold your arms across your chest. Tighten your abs so that your pelvis is stable. Then slowly turn your head and shoulders to one side. Turn as far as you can and you will feel the stretch in the rib area. Hold the end position for a count of two and then turn across to the other side and repeat. Perform two sets of 10 repetitions each side.
Do not force any of these exercises and if you feel any discomfort stop. Keeping your low back stretched will help you prevent some low back injuries but routine chiropractic visits with these stretches can help prevent the big injuries. Of course injuries are inevitable but if your try to prevent the preventable ones you can eliminate a lot of pain from your life.
Most people when they get pain in their leg think a disc injury. This may be the case but it could also be a small muscle in your buttock making a huge pain in your leg. It is more common than you would think and there is a pretty routine fix to this problem. Doroski Chiropractic Neurology in the Woodbridge, Dale City VA area has some tips for you. Piriformis syndrome is a muscular disorder that can compress the sciatic nerve causing radicular symptoms into the buttock and along the course of the sciatic nerve.
When the piriformis muscle shortens or spasms due to trauma or overuse, it can compress or strangle the sciatic nerve beneath the muscle. Generally, conditions of this type are referred to as nerve entrapment or as entrapment .
Inactive gluteal muscles also facilitate development of the syndrome. These are important in both hip extension and in aiding the piriformis in external rotation of the femur. A major cause for inactive gluteals is unwanted reciprocal inhibition from overactive hip flexors (psoas major, iliacus, and rectus femoris). This imbalance usually occurs where the hip flexors have been trained to be too short and tight, such as when someone sits with hips flexed, as in sitting all day at work. This deprives the gluteals of activation, and the synergists to the gluteals (hamstrings, adductor magnus, and piriformis) then have to perform extra roles they have not evolved to do. Resulting hypertrophy of the piriformis then produces the typical symptoms.
Overuse injury resulting in piriformis syndrome can result from activities performed in the sitting position that involves strenuous use of the legs as in rowing/sculling and bicycling.
Runners, bicyclists and other athletes engaging in forward-moving activities are particularly susceptible to developing piriformis syndrome if they do not engage in lateral stretching and strengthening exercises. When not balanced by lateral movement of the legs, repeated forward movements can lead to disproportionately weak hip abductors and tight adductors
Another cause for piriformis syndrome is stiffness, or hypomobility, of the sacroiliac joints. The resulting compensatory changes in gait would then result in shearing of one of the origins of the piriformis, and possibly some of the gluteal muscles as well, resulting not only in piriformis malfunction but in other low back pain syndromes as well.
Piriformis syndrome can also be caused by overpronation of the foot.[citation needed] When a foot overpronates it causes the knee to turn medially, causing the piriformis to activate to prevent over-rotating the knee. This causes the piriformis to become overused and therefore tight, eventually leading to piriformis syndrome.
Being told you have scoliosis can be very alarming. Like most diagnoses the more you know about it the less scary it can be! And thanks to the internet you can get your fill of information. At Doroski Chiropractic Neurology in Woodbridge VA we stress to our patients that there are many different factors they need to consider before you start googling.
What is scoliosis?
Because we walk on 2 feet, the human nervous system constantly works through reflexes and postural control to keep our spine in a straight line from side to side. Occasionally, a lateral (sideways) curvature develops. If the curvature is larger than 10 degrees, it is called scoliosis. Curves less than 10 degrees are often just postural changes. Scoliosis can also be accompanied by lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back). In most cases, the vertebrae are also rotated.
In more than 80% of cases, the cause of scoliotic curvatures is unknown; we call this condition idiopathic scoliosis. In other cases, trauma, neurological disease, tumors, and the like are responsible. Functional scoliosis is often caused by some postural problem, muscle spasm, or leg-length inequality, which can often be addressed. Structural scoliosis does not reduce with postural maneuvers. Either type can be idiopathic or have an underlying cause.
What are the symptoms of scoliosis?
Scoliosis can significantly affect the quality of life by limiting activity, causing pain, reducing lung function, or affecting heart function. Diminished self-esteem and other psychological problems are also seen. Because scoliosis occurs most commonly during adolescence, teens with extreme spinal deviations from the norm are often teased by their peers.
Fortunately, 4 out of 5 people with scoliosis have curves of less than 20 degrees, which are usually not detectable to the untrained eye. These small curves are typically no cause for great concern, provided there are no signs of further progression. In growing children and adolescents, however, mild curvatures can worsen quite rapidly—by 10 degrees or more—in a few months. Therefore, frequent checkups are often necessary for this age group.
How is scoliosis evaluated?
Evaluation begins with a thorough history and physical examination, including postural analysis. If a scoliotic curvature is discovered, a more in-depth evaluation is needed. This might include a search for birth defects, trauma, and other factors that can cause structural curves.
Patients with substantial spinal curvatures very often require an x-ray evaluation of the spine. The procedure helps determine the location and magnitude of the scoliosis, along with an underlying cause not evident on physical examination, other associated curvatures, and the health of other organ systems that might be affected by the scoliosis. In addition, x-rays of the wrist are often performed. These films help determine the skeletal age of the person, to see if it matches an accepted standard, which helps the doctor determine the likelihood of progression. Depending on the scoliosis severity, x-rays may need to be repeated as often as every 3 to 4 months to as little as once every few years.
Other tests, including evaluation by a Scoliometer™, might also be ordered by the doctor. This device measures the size, by angle, of the rib hump associated with the scoliosis. It is non-invasive, painless, and requires no special procedures. A Scoliometer™ is best used as a guide concerning progression in a person with a known scoliosis—not as a screening device.
Is scoliosis always progressive?
Generally, it is not. In fact, the vast majority of scolioses remains mild, is not progressive, and requires little treatment, if any.
In one group of patients, however, scoliosis is often more progressive. This group is made up of young girls who have scolioses of 25 degrees or larger, but who have not yet had their first menstrual period. Girls generally grow quite quickly during the 12 months before their first period and if they have scolioses, the curvatures tend to progress rapidly. In girls who have already had their first periods, the rate of growth is slower, so their curves tend to progress more slowly.
What is the treatment for scoliosis?
There are generally three treatment options for scoliosis—careful observation, bracing, and surgery. Careful observation is the most common “treatment,” as most mild scolioses do not progress and cause few, if any, physical problems. Bracing is generally reserved for children who have not reached skeletal maturity (the time when the skeleton stops growing), and who have curves between 25 and 45 degrees. Surgery is generally used in the few cases where the curves are greater than 45 degrees and progressive, and/or when the scoliosis may affect the function of the heart, lungs, or other vital organs.
Spinal manipulation, therapeutic exercise, and electrical muscle stimulation have also been advocated in the treatment of scoliosis. None of these therapies alone has been shown to consistently reduce scoliosis or to make the curvatures worse. For patients with back pain along with the scoliosis, manipulation and exercise may be of help.
Most people with scoliosis lead normal, happy, and productive lives. Physical activity including exercise is generally well-tolerated and should be encouraged in most cases.
When you hurt your back you are willing to try anything to help! Sometimes using a back brace may not be the way to go. There are many things you need to consider when using ones and even though you have it on you need to make sure you are careful. Putting on a brace doesn’t mean you can’t hurt or re-injure your back. Doroski Chiropractic Neurology in the Woodbridge, Dale City VA area has a few things you need to consider.
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.
