Month: May 2012

My Crossfit Level 1 Trainer Course & This Week’s 1-Page Health News…

I (Glenn) woke up early on Mother’s Day, emptied the dishwasher, woke the kids up to give Meredith her gift, and promptly abandoned them for Day 2 of the CrossFit Level 1 trainer’s certification course. I’m not going to lie, I felt bad about it. But in addition to that espresso machine, Meredith got herself a live-in CrossFit trainer to put her through the paces.

While I’m still fully interested in an participating in Xterra Triahtlons, there’s no denying that CrossFit is on to something: train all 10 aspects of fitness – strength, endurance, stamina, power, speed, flexibility, agility, balance, coordination, and accuracy. Using “Constantly Varied Functional Movements Done at High Intensity” is how CrossFit gets you there.

Anyway, I’m working out the details, but I’ll be doing some CrossFit classes in the near future. We’re in talks with Colorado Kettlebell Club to use their space, which is about 1 mile from our office. We’re looking at weeknights at 5 PM and 6 PM. So if you’re interested, keep an eye out for more info.

And here’s this week’s 1-Page Health News…

Mental Attitude: Dementia. The number of people globally with dementia is set to rise from its current 35.6 million, to 65 million by 2030 and 115 million by 2050. Currently, $604 billion are spent each year worldwide on treating and caring for individuals with dementia. This toll includes the provision of health and social care, as well as loss of income of the dementia patients and their caregivers, as many caregivers have to give up their jobs to look after a person with dementia. World Health Organization, April 2012

Health Alert: America’s Obesity Epidemic. The scope of the obesity epidemic in the US has been greatly underestimated. Researchers found that the Body Mass Index (BMI) substantially under-diagnoses obesity when compared to the Dual Energy X-ray Absorptiometry (DXA) scan, a direct simultaneous measure of body fat, muscle mass, and bone density. The study found 39% of Americans who are classified as overweight based on BMI are actually obese as measured by DXA. The BMI is an insensitive measure of obesity, prone to under-diagnosis, while direct fat measurements are superior because they show distribution of body fat. PLoS ONE, April 2012 Diet: How Should You Take It? For reversing damage and promoting repair to cartilage, the supplements Chondroitin Sulfate and Glucosamine have been shown to be more effective if taken together, as the mixture of the two allows them to act synergistically. Osteoarthritis Cartilage, 2006

Exercise: Caffeine & Exercise? According to a 14-week study conducted on mice, caffeine and exercise may cut the risk of developing skin cancers caused by sun exposure. Researchers found 62% fewer non-melanoma skin tumors and the size of tumors reduced by 85% in the caffeine and exercise group when compared to the control group (no caffeine, no exercise). The results of the caffeine and exercise group also exceeded the other two groups in the study (caffeine, no exercise and exercise, no caffeine). American Association for Cancer Research Annual Meeting, April 2012

Wellness/Prevention: Still Smoke? 7,000(!) chemicals and chemical compounds are present in tobacco and tobacco smoke, including 93 HPHCs (harmful and potentially harmful constituents). Food and Drug Administration, April 2012

Quote: “I look to the future because that’s where I’m spending the rest of my life.” ~ George Burns

Low Back Pain or Hip Arthritis: Which One is it? How the Active Release doctors at Denver Chiropractic Center can help you

Low back pain (LBP) can have many causes. Our job is to identify the main pain generator(s) and manage the patient accordingly. This requires a careful history, examination, and a short trial of treatment with conservative methods, like Active Release Techniques Soft Tissue Treatment.

When first presenting for care, the patient tells us about their complaint in the history portion of our evaluation. Here, we not only ask about the main reason for their appointment or, what’s bothering them now but also their past history. We also discuss old injuries such as slips and falls, sports injuries that date back to high school, motor vehicle induced injuries, as well as family history (we ask if family members have or have had low back trouble since it’s been reported that there is a genetic link identified for osteoarthritis).

We also inquire about the patient’s current activity level and how well those activates are tolerated, often using tools completed by the patient that can be scored and compared periodically during care to track the benefits of treatment. When we finally return to the primary complaint history, we ask about the location, mechanism of injury, notable changes in the course of the condition, the onset date, pain related activities that increase or decrease pain, the quality of pain, radiation patterns, severity levels (such as a 0-10 scale), and timing issues such as, worse in the mornings vs. evenings.

When patients say, “…I have low back pain,” they may point to anywhere between the lower rib cage and their hip area. In other words, everyone interprets where their low back is located differently. So, when differentiating between low back pain and hip pain, one would think that the patient would either point to their low back or their hip, right? Well, where does hip osteoarthritis usually hurt? That’s what makes it so hard! The pain location can vary and move around in the same patient anywhere in the pelvic region including the groin (which is common), to the side of the pelvis, to the buttocks, the sacrum and in the low back.

To make it even more challenging, degenerative or injured disks in the lower lumbar spine can refer pain directly into the hip area and also create localized low back pain. In fact, patients often have BOTH conditions simultaneously. Usually, during examination, we move the hip in the socket and feel for reduced motion and watch for pain patterns in certain positions. When comparing the two sides, we both can feel, “…a difference between the two.”

The osteoarthritic (OA) hip is comparably more tight and painful with rotation movements. For example, the patient is seated with their leg crossed, trying to touch their knee to their opposite shoulder. In the OA hip patient, they may only be able to get it half way there compared to the other side and often complain of groin pain. The “ultimate test” is the x-ray that reveals the loss of the joint space – the “cartilage interval” – which narrows on the OA hip side.

How often is hip OA found? In a recent article, after reviewing 2000 patient files and 1000 x-rays of patients 40 years or older, 19% (~1 out of 5) demonstrated x-ray findings of hip OA. THAT’S A LOT!  At Denver Chiropractic Center, management of hip OA includes mobilization, manipulation, stretching the muscles surrounding the hip joint with Active Release Techniques, exercise/stretch instruction, nutritional strategies and others. If/when the time comes, we will help set up a referral to the orthopedic surgeon for joint replacement, as any “quarterback” of your care should.

In our experience, using Active Release Techniques to manages the soft tissues (muscles, tendons) that are associated with the hip joint –and there are a lot of them – is the best option to both manage the pain and stiffness in the hip joint.

It all starts with the initial exam. To schedule yours (or schedule one for someone that you care about), call us at 303.300.0424.

Carpal Tunnel Syndrome- try Active Release techniques at Denver Chiropractic Center before surgery

In many cases, Carpal Tunnel Syndrome (CTS) results strictly from overuse activities though, as we have discussed previously. Other conditions such as, pregnancy, etc. can also be involved as a contributor and / or the sole cause. When these conditions are present, they must be properly treated to achieve a favorable result. However, the majority of cases are the result of a repetitive motion injury. So, the question remains: What is the role of the patient regarding activity modification during the treatment process of CTS? How important is it?

To answer this question, let’s look at a fairly common type of CTS case. The patient is female, 52 years old, moderately obese (Body Mass Index 35 where the normal is 19-25), and works for a local cookie packing company. Her job is to stand on a line where cookies are traveling down a conveyor belt after being baked and cooled. She reaches forwards with both arms and grasps the cookies, sometimes several at a time, and places them into plastic packaging which are then wrapped and finally removed from the belt and placed into boxes located at the end of the line. Each worker rotates positions every 30 minutes. A problem can occur when other workers fall behind or when there aren’t enough workers on the line, at which time the speed required to complete the job increases.

So now, let’s discuss the “pathology” behind CTS. The cause of CTS is the pinching of the median nerve inside the carpal tunnel or muscles of the forearm, located on the palm side of the wrist. The tunnel is made up of 2 rows of 4 carpal bones that form top of the tunnel while a ligament stretches across, making up the tunnel’s floor. There are 9 tendons that travel through the tunnel and “during rush hour” (or, when the worker is REALLY moving fast, trying to keep up with production), the friction created between the tendons, their sheaths (covering) and surrounding synovial lining (a lubricating membrane that covers the tendons sheaths), results in inflammation or swelling.

When this happens, there just isn’t enough room inside the tunnel for the additional swelling and everything gets compressed. The inflamed contents inside the tunnel push the median nerve (that also travels through the tunnel) against the ligament and pinched nerve symptoms occur (numbness, tingling, and loss of the grip strength). The worker notices significant problems at night when her hands interrupt her sleep and she has to shake and flick her fingers to try to get them to “wake up.” She notices that only the index to the 3rd and thumb half of the 4th finger are numb, primarily on the palm side.

At this stage, the worker often waits to see if this is just a temporary problem that will go away on its own and if not, she’ll make an appointment for a consultation, often at her family doctor (since many patients don’t realize Active Release Techniques Soft Tissue Treatments REALLY HELP this condition). In an “ideal world,” the primary care doctor first refers the patient to the ART provider for non-surgical management. Other treatment elements include the use of a night wrist splint and (one of the MOST IMPORTANT) “ergonomic management.” That means work station modifications, which may include slowing down the line, the addition 1 or 2 workers, and reducing the reach requirement by adding a “rake” that pushes the cookies towards the worker/s. Strict home instructions to allow for proper rest and managing home repetitive tasks are also very important. Between all these approaches, our office is quite successful in managing the CTS patient, but it may require a workstation analysis.

It all starts with the initial examination. Call our office at 303.300.0424 right now to schedule yours.

Our 14th Anniversary and This Week’s 1-Page Health News

Those of you who want these weekly 1-Page Health News emails sent directly to your email can go to denverback.com and fill out the little form on the upper left part of the page.

May marks another year for Denver Chiropractic Center. For those of you keeping score, that’s 14 years down, and now in our 15th year.

Last week was the busiest week we’ve ever had. Ever. And we’d like to thank you. Your trust, support and referrals are what make our existence and growth as a business possible. We look forward to being here to help you for a few more decades. Once again, thanks.

We’d also like to wish all the moms out there a Happy Mothers Day.

Here’s this week’s 1-Page Health News:

Mental Attitude: Berry Good News. Men who regularly consume foods rich in flavonoids (such as berries, apples, certain vegetables, tea and red wine) may significantly reduce their risk for developing Parkinson’s disease. Flavonoids are naturally occurring, bioactive compounds present in many plant-based foods and drinks. Neurology, April 2012

Health Alert: Stressed? The risk for coronary heart disease and stroke increases by 30% in a person whose partner has cancer. The cause is probably the negative stress to which the cancer patient’s partner is exposed. Previous studies show that stress can affect the nervous system, blood pressure, and inflammation, increasing the risk of developing coronary heart disease and stroke. Centre for Primary Healthcare Research in Malmö, April 2012

Diet: Pain Relief. The supplement Methylsulfonylmethane gave osteoarthritis patients relief from symptoms of pain and physical dysfunction. Osteoarthritis Cartilage, 2008 Exercise: Being Fit. Improving or maintaining physical fitness appears to help obese and overweight children reach a healthy weight. During a four-year study, obese and overweight girls and boys who achieved fitness were 2.5 to 5 times more likely to reach a healthy weight than those who stayed underfit. Obesity, April 2012

Active Release Techniques: Sciatica. Many people with sciatica are worried that it’s coming from a ruptured disc. While this is sometimes true, in most cases, muscles are pressuring the sciatic nerve and causing symptoms down the back of the leg. The piriformis is a likely suspect, as are the hamstrings. Using Active Release Techniques to relieve the tension in these muscles can take the pressure off of the nerve and fix the problem.

Wellness/Prevention: Obesity and Watching TV. In a study of obesity among European children, Dr. Yannis Manios, Assistant Professor at Harokopio University in Athens, writes, “We found that many countries are lacking clear guidelines on healthy eating and active play. However, there is good evidence linking sedentary behavior (like TV watching) with subsequent obesity. Obesity Reviews, March 2012 (Um, this is not brilliant work.)

Quote: “Simple diet is best; for many dishes bring many diseases; and rich sauces are worse than heaping several meats upon each other.” ~ Pliny

Whiplash: Where’s the Pain Coming From?

Whiplash commonly occurs as a result of a motor vehicle collision when, typically, there is hyper-motion in one direction followed by motion in the opposite direction in a “crack the whip” like manner.

The direction of the strike typically dictates the direction of movement of the head so in a rear end collision, the strike is from behind, whipping the head forwards and then backwards. In a side-on collision, a side-to-side motion results. Pain can occur anywhere around the neck, upper back, arms, chest and/or head, depending on the tissues that are injured.

Soft tissues including the muscles, their tendon insertions, ligaments that securely tie bone to bone, the shock absorbing disk in the front of the vertebral column, and/or the nerves that pass through the holes of the spine that innervate the arms and hands can be affected by these injuries.

The injuries associated with whiplash can lead to disruption of normal daily activity, depression and anxiety. There can be immediate symptoms or a delay in the onset and pain with its associated disability can last for days, weeks, months, or longer, depending on each case.

Last month, we discussed the grades 1, 2, and 3 or, mild, moderate, severe sprains (ligament injuries) and strains (muscle injuries). Previously, we discussed methods of prognosing the lasting effects of the injury in a reported classification system called “whiplash associated disorders” or WAD I, II, III. & IV.

Here, the differentiating feature is pain with no objective exam findings (WAD I), the presence of objective loss of motion but negative neurological findings (WADII) or, the presence of measurable neurological dysfunction (WAD III). Studies have shown that the likelihood of prolonged injury increases with each WAD grade.

A side-to-side or front-to-back mechanism of injury can result in damage to the ligaments in the back of the spine called the supra- and inter- spinous ligaments, the disk and/or nerve root that exits the spine allowing the arm and hand to sense and be strong (when it’s not pinched or damaged like in a WAD III) and/or, the bone which can compress when the force is hard enough (WAD IV).  A concussion can occur when the brain bounces against the inside of the skull.

In our opinion, after careful exam to rule out more significant injuries, and advanced soft tissue treatment system like Active Release Techniques is the best way to deal with the soft tissue injuries that result from a car accident (or bike crash, etc). By managing the scar tissue your body lays down in soft tissue injuries, we can usually improve your ranges of motion and reduce pain. While gentle (never forced) chiropractic adjustments can help as well, in our experience they are secondary to the soft tissue treatment.

To se if you’re a candidate for our care, call the office at 303.300.0424. We work with all major insurance companies and we accept Med Pay.

Denver Chiropractic Center is proud to be an authorized dealer for the A-Line foot suspension system. Do you have foot, ankle or shin pain?

A-Line foot suspension system is unlike any other insole. It is designed as a foot suspensions system, to balance the foot and let your leg align itself while you move. We are one of the few authorized A-Line dealers in Denver. We offer free fitting and reasonable prices ($100-$110) per pair, and a 30-day money back guarantee.

Foot pain can be both annoying and debilitating. Anything that affects your ability to move around and participate in sports is a problem. Several factors can contribute to foot pain, and in this article, we’ll look at one of the most common…Poor foot, ankle and knee alignment.

Many of you know that the so-called barefoot running movement became incredibly popular in the last few years. And while many of us were willing to go minimal on the shoes and experiment, most of us couldn’t hack it.

The theory seemed sensible – get rid of supportive shoes and your feet will naturally strengthen. But there was a problem- many of us had spent 30 or 40 years in supportive shoes. Or feet were like lifelong welfare recipients – the simply didn’t know how to support themselves.

So the barefoot running experiment failed a lot of people. Here’s why: The human foot does well if you’re out shoes from an early age (like from the time you start crawling). If you stay away from flat surfaces, like sidewalks, streets, floors, etc, varying terrain challenges your feet. This builds strong feet.

Strong feet have arches that function well, and exhibit good alignment between the foot, ankle, and knee. Appropriately strong ligaments and equally strong muscles support this alignment.

The correct this alignment is start with an assessment. Some people have better alignment than others. The use of a dynamic insole like the A-lines that we carry at Denver Chiropractic Center allows the foot to get some supports, while also allowing the arches of the foot to strengthen. Rigid orthotics weaken the feet and further degrade natural alignment.

Specific low-impact strengthening exercises can help as well. An example is standing on one foot while making circles with the other foot. 10 circles in each direction with the “flying” foot circling in from of and behind the working foot works well. Another great exercise is simply trying to stand on one foot for 3 minutes.

At Denver Chiropractic Center, we use Active Release Technique to address the scar tissue that develops in muscles that are overworked in poorly aligned feet. This can include muscles of the foot, shin and calf. Scar tissue further weakens muscles, making alignment worse.

If foot or ankle pain has been bothering you, we can probably help. But it all starts with the initial exam, including a foot-ankle-knee alignment check. Call us today to schedule yours. 303.300.0424. We’re here to help.

An update on Miss Keri (after the bike crash) and this week’s 1-Page Health News from your Denver Active Release Providers at Denver Chiropractic Center

Miss Keri here at the office wanted to say thanks to everyone for the concern after her “meeting” with the concrete wall while on her bike last week. Her nasty injury required a little attention from a wound care nurse to make sure it doesn’t leave a scar, but she’s on the mend. Once again thanks for your concern.

That last email about her bike crash received the highest open response of any email we’ve ever sent. And here’s this week’s 1-page health news.

Mental Attitude: Meditation. Adults with memory impairment and memory loss may benefit from mantra-based meditation (12 minutes of meditation per day for 8 weeks). Mantra-based meditation has demonstrated a positive effect on patients’ emotional responses to stress, fatigue and anxiety. Findings revealed a substantial increase in cerebral blood flow in the patients’ prefrontal, superior frontal, and superior parietal cortices, and also better cognitive function. Journal of Alternative and Complementary Medicine, March 2012

Health Alert: Diabetics And Stroke. 26 million Americans have diabetes, and more than half are younger than 65. The longer you have diabetes, the higher your risk for stroke. Compared to people without diabetes (after considering other factors such as age, smoking history, physical activity, history of heart disease, blood pressure and cholesterol), the risk of stroke increased 70% in people with diabetes for less than 5 years, 80% in people with diabetes for 5-10 years and three-fold in people with diabetes for 10 years or more. American Heart Association, March 2012

Diet: Seeing Things? Hungry people see food-related words more clearly than people who’ve just eaten. This change in vision happens at the earliest perceptual stages, before higher parts of the brain have a chance to change the messages coming from the eyes. Psychological Science, March 2012 Exercise: Good Reasons. Exercise helps to alleviate low-back pain, helps to reduce the amount of insulin required to control blood sugar levels in Type I (insulin-dependent) diabetics and improves mental alertness. Surgeon General’s Report on Physical Activity and Health, 1996

Chiropractic: Hold Your Head Up! “Head in forward posture can add up to thirty pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. Forward head posture (FHP) may result in the loss of 30% of vital lung capacity. These breath-related effects are primarily due to the loss of the cervical lordosis, which blocks the action of the hyoid muscles, especially the inferior hyoid responsible for helping lift the first rib during inhalation.” ~Rene Cailliet M.D., famous medical author and former Director of the Department of Physical Medicine and Rehabilitation at the University of Southern California

Wellness/Prevention: Avoid Absenteeism. The US is losing $226 billion per year due to employee absenteeism. A worker is less likely to take sick leave if their supervisor offers support (lightened work load or stress management training) when an employee is experiencing psychosomatic stress symptoms. The worker feels inclined to reciprocate the supportive treatment by keeping their work effort high. European Journal of Work and Organizational Psychology, January 2012

Quote: “Anything is possible. You can be told that you have a 90% chance or a 50% chance or a 1% chance, but you have to believe, and you have to fight.” ~ Lance Armstrong