Dale City VA Chiropractors

Something else for new moms to consider!

Now that you’ve had a baby and you are looking forward to the “new normal” that might also include getting back to the gym or doing more exercise.  Exercise is always a good idea but being a new mom there are other things to consider when getting back to exercise.  Your Woodbridge, Dale City VA chiropractor has some helpful tips on how to do it safely.

  1. Starting Back Slowly

As a general rule, I recommend that women do not return to postnatal or mommy and me yoga until their bleeding has stopped. If a woman gave birth via cesarean section, she needs to wait 6 weeks before rejoining class. If you push yourself too hard in the beginning, then you can actually be setting yourself back from real recovery. That of course does not mean you need to be held hostage in your house for 6 weeks. A walk can be considered a good start to your road back!

  1. Watch For Your Bleeding to Stop

Once you do embark on some heavier activities, pay attention to signs from your body. Some women find that their bleeding that had tapered down starts to get heavier again, which is a sign that the body needs more time to heal.

  1. How Is Your Pelvic Floor?

Also, if the pelvic floor is weak, putting intra-abdominal pressure (like crunches, pilates or general ab work) can put too much pressure on the pelvic floor and inhibit healing or even lead to a chance of organ prolapse. One of the first forms of exercise you can start to incorporate daily can be a kegel routine, restrengthening or even re-familiarizing yourself with your pelvic floor muscles.

  1. Repairing Diastasis

It is very common that women experience a separation of the abdominal muscles, specifically the rectus abdominals — aka the six-pack muscles. Your care provider can check this for you when you return for your six week check up. If it is severe enough, you may need to work with a physical therapist to help draw the muscles back together. So, when easing back to an abdominal workout, be mindful not to overdo it. In postnatal and mommy and me yoga, we focus more on plank pose and variations of plank instead of old fashion crunches. It is also advised not to do extremely deep twisting poses which can also inhibit the muscles from repair.

  1. Wiggly, Wobbly Joints

Relaxin, the hormone that is responsible for softening the ligaments and joints during pregnancy and childbirth, can stay in the body for up to six months postpartum. This can lead to wobbly, unstable joints and a loose pelvis. Again, just be mindful that the activity your choose is not too jerky in movement.

  1. Find All Sorts of Exercise!

You do not need to attend a scheduled class to start to return to a general fitness routine. As I mentioned earlier, walking is a great place to start: don’t discount walking as a gentle cardiovascular exercise! At one point, I was told to avoid higher impact cardio since I was healing from some pretty severe pelvic floor issues and was instructed to try swimming. Fortunately, I have been an avid swimmer for years, so it felt like a nice welcome back to exercise and rediscovering my body. The nice thing about swimming is that it is gentle on the joints and pelvic floor, and is great for strengthening the core and back muscles.

  1. Hydrate

Once you do start to ease back into your routine, please remember to hydrate well, especially if you are breastfeeding. If you are out for a stroll with your baby, put your water bottle in the cup holder as a reminder to drink often.

  1. Rest

At the end of every postnatal or mommy and me yoga class we incorporate a few restorative yoga poses and then savasana (corpse pose). Even though many new moms hear the old saying, sleep when your baby sleeps, very few (I believe) adhere to these wise words. So, including a few moments to simply relax post-workout can really help replenish you. If you are feeling rested and restored, you will have so much more to offer to those that need you.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Cheap Gatorade!

There is something I love about making things that can easily be purchased.  It usually means spending more on ingredients and coming up with a subpar version of something.  I once spent $35 on ingredients to make tonic water which costs about one dollar!  But these sports drinks are cost effective and easy to make and your Woodbridge, Dale City VA Chiropractor has a few for you to try.

 

Maple Sports Drink

This easy-to-make, maple syrup-flavored recipe is delicious and settles well because it is not acidic, says recipe developer and author Nancy Clark, RD. “When you are working out for more than an hour, enjoy this all-natural sports beverage to energize your workouts,” she says. (If you dig natural syrups, try this molasses recovery shake, too.)

 

3 3/4 cups cold water

1/4 cup pure maple syrup

1/4 teaspoon salt

 

  1. Mix all ingredients together in a 1-quart bottle.
  2. Shake well and enjoy!

 

Yield: 1 quart.

Note: Maple syrup is also a tasty alternative to energy gels. Put some in a small flask and take nips during extended exercise.

 

“Greaterade”

 

When the Golden State Warriors decided to ban commercial sports drinks and started making their own with Himalayan sea salt, Chef John of FoodWishes in San Francisco was inspired to try his own—with less sugar. “You can tweak this recipe to create your perfect formula,” he says. (This is how much sodium you really need each day.)

 

8 cups fresh cold water

3 tablespoons honey, or other sweetener to taste

1/2 teaspoon fine *Himalayan pink salt (mine was coarsely ground, so I used a rounded 1/2 teaspoon), or sea salt (or any pure salt)

3/4 teaspoon calcium magnesium powder (I used NOW Foods Cal-Mag Citrate)

pinch cayenne

3/4 cup freshly squeezed orange juice

2 lemons, juiced

2 limes, juiced

  1. Pour 1 cup of water into a large pot.
  2. Add honey, salt, calcium-magnesium powder, and cayenne.
  3. Place pot over low heat and whisk until ingredients have dissolved.
  4. Remove from heat and allow to return to room temperature.
  5. Add juices to room temperature mixture in pot.
  6. Pour in remaining 7 cups water and whisk until well blended.

 

Makes about 9 cups.

 

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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That is a lot of tomatoes!

It is coming up on harvest time!  You have some last-minute weeding and watering but it is almost time to harvest 90 tomatoes all at once.  Eat 20 and give 70 away!  But it is all in the fun of the project and your Woodbridge, Dale City VA chiropractor wants to make sure you don’t get hurt.

Gardening can be enjoyable, but it is important to stretch your muscles before reaching for your gardening tools. The back, upper legs, shoulders, and wrists are all major muscle groups affected when using your green thumb.

A warm-up and cool-down period is as important in gardening as it is for any other physical activity,” says Dr. Scott Bautch, a member of the American Chiropractic Association (ACA) Council on Occupational Health. “Performing simple stretches during these periods will help alleviate injuries, pain and stiffness.”

To make gardening as fun and enjoyable as possible, it is important to prepare your body for this type of physical activity. The following stretches will help to alleviate muscle pain after a day spent in your garden.

Garden Fitness Stretches

Before stretching for any activity, breathe in and out, slowly and rhythmically; do not bounce or jerk your body, and stretch as far and as comfortably as you can. Do not follow the “no pain, no gain” rule. Stretching should not be painful.

While sitting, stretch your leg out in front of you, knee straight, and prop your heel on a step. Then lean forward until you feel a stretch in the back of the thigh, or the hamstring muscle. Hold this position for 15 seconds. Do this once more and repeat with the other leg.

Stand up, balance yourself, and grab the front of your ankle from behind. Pull your heel towards your buttocks and hold the position for 15 seconds. Do this again and repeat with the other leg.

While standing, weave your fingers together above your head with the palms up. Lean to one side for 10 seconds, then to the other. Repeat this stretch three times.

Do the “Hug your best friend” stretch. Wrap your arms around yourself and rotate to one side, stretching as far as you can comfortably go. Hold for 10 seconds and reverse. Repeat two or three times.

Finally, be aware of your body technique, body form and correct posture while gardening. Kneel, don’t bend, and alternate your stance and movements as often as possible to keep the muscles and body balanced

After the Bulbs Are Planted

If you feel muscle aches and pains after your day in the garden, there are ways to alleviate the discomfort. Apply a cold pack on the area of pain for the first 48 hours or apply a heat pack after 48 hours, and consider seeking the services of a doctor of chiropractic in your area.

Doctors of chiropractic (DCs) practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. While best known for their expertise in treating the musculoskeletal system and their use of spinal manipulation, DCs have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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My knee hurts again…

I have had really good results with glucosamine and so have millions of others.  I relearn how good this works with my knee on a yearly basis.  Like everyone I take them religiously for about 6 months, then less and less until I forget all together.  About 2 months later I go “man my knee is sore”.  Then a month later I go “man my knee is killing me”.  Shortly after that I see the bottle sitting on my desk and start taking them and the pain goes away.  As your chiropractor in the Woodbridge, Dale City VA area I feel obligated to relay this information.

  1. Helps Improve Joint Health & Osteoarthritis

Glucosamine is one of the best supplements for supporting joint health and lowering symptoms related to degenerative disorders like osteoarthritis. Aging naturally impacts the strength and durability of our joints, normally causing cartilage loss and joint pain over time. It doesn’t improve symptoms 100 percent of the time, but compared to many other supplements like chondroitin, glucosamine consistently rank as one of the most effective for treating arthritis discomfort.

Glucosamine slows down deterioration of joints when used long-term, plus it offers other benefits that prescription painkillers cannot (such as lowering chronic inflammation and improving digestive health). The results of taking glucosamine differ from person to person, but some long-term users often report pain relief that allows them to avoid surgeries and lower or eliminate medication use.

Osteoarthritis is a disorder characterized by ongoing joint pain caused from years of accumulating pressure and friction places on joints. It’s the most common type of arthritis worldwide, effecting millions of people (especially older adults). Glucosamine is one of the top supplements I recommend as part of a natural treatment approach for managing arthritis with diet and lifestyle changes.

Osteoarthritis is a degenerative disease, so it becomes harder to move over the years as joint friction increases. Studies show that taking about 800 to 1500 milligrams of glucosamine daily can help millions of people suffering from degenerative joint diseases, preventing further damage, especially in commonly effected joints such as those in the knees and hips.  It has been shown to help offer relief from joint pain within 4–8 weeks, which might be longer than some prescriptions or over-the-counter pain killers, but it’s also a more natural and well-tolerated approach.

Glucosamine, whether used alone or in combination with other supplements like chondroitin, is not a “cure all” and guaranteed to help everyone, but major studies have found it can help many, especially those impacted most by arthritis. The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), which is considered the most comprehensive trial ever done involving glucosamine, found that the combination of glucosamine and chondroitin sulfate used for 8 weeks resulted in significant relief in the majority of study participants who had high amounts of joint pain. Many experienced improvements regarding their moderate-to-severe knee pains, although not all did (including those with milder pains).

 

  1. Improves Digestion & Eases Inflammatory Bowel Diseases

Glucosamine is a helpful supplement for improving digestive function and repairing the lining of the GI tract. It’s even been shown to be an effective leaky gut supplement, combating a condition sometimes called “intestinal permeability.” This condition involves undigested food particles and proteins (like gluten, toxins and microbes) passing into the bloodstream through tiny openings in the lining of the GI tract.

Once these particles enter the bloodstream, they often trigger inflammation or initiate or worsen immune responses in the body. These include food sensitivities, arthritis and inflammatory bowel diseases. Glucosamine supplements, or naturally glucosamine-rich bone broth, help repair damaged tissue and lower inflammation related to inflammatory bowel disease (IBD), a set of conditions that are notoriously painful and hard to treat. The supplement may also help repair the lining of the bladder and stomach and intestines.

In 2000, researchers from the University Department of Pediatric Gastroenterology at University College School of Medicine found that glucosamine was an effective, inexpensive and nontoxic supplement used for treating chronic inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis. Children affected by inflammatory bowel disease tend to have lower levels of glucosamine in the body. Interestingly, N-acetyl supplementation (GlcNAc) offered a mode of action distinct from conventional treatments, resulting in lower symptoms in 75 percent of patients.

The researchers found evidence of significant improvements in the majority of patients using glucosamine, even those who were unresponsive to other anti-inflammatory medications and antibiotics. Results showed improved integrity of the GI tract and restoration of healthy epithelial cell structures that helped stop gut permeability.

 

  1. Can Help Relieve TMJ Symptoms

TMJ (a disorder related to the temporo-manibular joint in the jaw) is common in young to middle-aged adults and characterized by frequent jaw and neck pains, headaches and trouble sleeping. TMJ affects the joint that connects the jaw to the skull and allows for the head to move up and down, or side to side, normally without pain.

As the TMJ joint becomes inflamed and worn down, pain worsens. This makes it harder to talk, eat and function normally. Studies suggest glucosamine helps ease TMJ symptoms and pain in people with arthritis that effects the jaw. The pain relief is on par with taking NSAID pain relievers can (such as ibuprofen or Advil).  Taking 500 to 1500 milligrams of glucosamine daily for several months or years may help you sleep better, chew and heal while lowering inflammation in the jaw long-term.

 

  1. Helps Alleviate Bone Pain

 

Many people with bone pain, low bone density and a history of fractures can benefit from taking glucosamine, which assists bone healing. This is especially true if they also have joint pains or a form of arthritis. Some evidence suggests that glucosamine helps preserve articular cartilage surrounding bones, decreases pain, increases physical function, and enhances activities in people with bone disorders or those who are at most at risk for bone loss (such as middle-aged and older women).

A 2013 study by the Department of Orthopedics and Traumatology at Haseki Training and Research Hospital in Turkey found that glucosamine helped speed up the time it took rats to heal from bone fractures. Those researchers found that new bone formation and osteoblast lining were significantly higher in glucosamine-treated rats compared to those in control groups. After 4 weeks of taking 230 milligrams of glucosamine sulfate daily, the rats’ connective tissue surrounding bones were more cellular and vascular, and the newly formed bones that were previously fractured were stronger compared to controls.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Get your workstation adjusted, not your back!

It seems like more and more businesses are having their workers return.  Now would be a good time to evaluate your workstation.  Having a well-adjusted workstation can help you avoid having to come in here and get adjusted.   Your Woodbridge, Dale City VA chiropractor has some tips on helping you get your workstation adjusted.

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.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

 

Maplink

Pain in the Wrist!

Carpal tunnel is a fairly common wrist/hand injury.  It is usually associated with typing but you can get it from almost any overuse of the hand and forearm.  My mom got it from knitting.  Your Woodbridge, Dale City VA Chiropractor has some information to help you avoid this common 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.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Hopefully kids sports are back!

Hopefully summer sports will be in full swing this year.  So now is the time for the young athletes to start preparing!  Your Woodbridge Dale City VA chiropractor has some tips to get them back out there without injury.

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.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Just rake it!

It is time to clean up the last of winter and get ready for summer.  Which just means mowing your lawn but it has to be done.  Your Woodbridge, Dale City VA Chiropractor has some tips to safely get that yardwork done.

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.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

To brace or not to brace….

Wearing a back brace for a low back injury isn’t always the best thing you can do for yourself.  Some times it can help and lots of times it can cause more problems.  Your Chiropractor in the Woodbridge, Dale City VA area wants to help you better understand when to use a back brace.

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.

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Maplink

It is just a sprained ankle…

People have a tendency to blow off an ankle injury.  Most of us have had them and to be honest I ignored mine until it finally stopped hurting.  As your Chiropractor in the Woodbridge, Dale City VA area I want to tell you that isn’t a good idea.  Does every ankle injury require 4 weeks of rehab… probably not but you should do something to make sure it heals with a full and pain free range of motion.

Ankle Rehabilitation Program1

As described in Human Locomotion, the following is a sample ankle sprain rehabilitation plan.

Phase 1. The patient is unable to bear weight.

  1. A) Compressive wrap with U-shaped felt balance around fibula. Change every 4 hours.
  2. B) Patient actively abducts/adducts toes for 5 seconds, repeat 10 times.
  3. C) Write out alphabet with toes, 5 times per day.
  4. D) Stationary bike, 15 minutes per day.
  5. E) Ankle rock board performed while seated (off weight-bearing), 30 circles, performed clockwise and counterclockwise 2 times per day. Perform on uninjured ankle while standing for 3 minutes. The standing rock board performed on the uninjured ankle has been shown to increase proprioception in the contralateral limb.
  6. F) Mild Grade 3 and 4 mobilization of the joints of the foot and ankle.

Phase 2. Patient can walk with minimal discomfort, and the sprained ankle has 90 percent full range of motion.

  1. A) Mobilize all stiff joints in the lower extremity and pelvis.
  2. B) Thera-Band exercises in all planes, 3 sets of 25 in each direction.
  3. C) Double-leg and then single-leg heel raises on the involved side, 3 sets of 10 reps, performed 2 times per day.
  4. D) Standing closed-eye balance, 30 seconds, 5 times per day.
  5. E) Standing single-leg ankle rock board, performed for 1 minute, 5 times per day.
  6. F) Closed kinetic chain exercises. (The sprained ankle is positioned securely on the ground while the patient pulls a resistance band forward and to the side. The patient then rotates 180° and the exercise is repeated by extending and abducting the uninvolved limb.)

Phase 3. Patient can hop on involved ankle without pain.

  1. A) Run at 80 percent full speed, avoid forefront touch down.
  2. B) Minitrampoline: 3 sets of 30 jumps forward, backward, and side to side. Begin on both legs, progress to single limb.
  3. C) Plyometrics performed on a 50cm and a 25cm box, positioned one meter apart. Jump from one box to the ground and then to the other box, landing as softly as possible. Perform 3 sets of 5 repetitions.

Resource:

Michaud, T. 2011. Human Locomotion: The Conservative Management of Gait-Related Disorders. Newton Biomechanics.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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