May 2022 blog.

Text in part from The Joint Chiropractic (www.thejoint.com). Photo credit: Amy Dragoo for Shannon Brinkman

Riding a horse is an invigorating experience. The rider connects with an animal that holds incredible physical power. One can engage with horseback in a way that can be energizing, calming, or competitive. Regardless of how you ride, the ever-shifting weight distribution your body experiences while horseback riding can take a toll on skeletal alignment and joint health. On top of that, taking care of your horse — and possibly even getting bucked or thrown off — can lead to injury that can be reduced through chiropractic care. 

Constantly Changing Weight Distribution 

As the horse shifts from trot to canter and gallop, your body has to adjust constantly. Not only are your joints affected by the animal’s speed, but also by the ever-changing angles of the horse’s body. This can throw your skeletal structure out of alignment, and lead to injuries, either in the moment or down the road.

Injuries from Falls, Stable Upkeep, And More

While riding has its set of stressors on your structure, regularly riding and taking care of a horse can increase your risks of injury. Whether you’re cleaning out the stable or you are catapulted off a horse’s back, there are opportunities for injury. However, joint dysfunctions can lead to more dramatic accidents as the surrounding muscles can already be in pain and tensed to the point that regular injury can be exacerbated.

How Spinal Adjustments Can Help 

A preventative regime of chiropractic adjustments can lead to a healthier equestrian experience. Through the process of spinal manipulations and posture correction, riders can look toward reducing the impact of future injuries, as well as getting into a better groove with the horse’s gait. The more you’re in alignment and motion, the more control you have over moving accurately in response to your horse’s movements.

“Regular chiropractic adjustments have helped me focus on my posture in and out of the saddle.” says Brooke Massie, a St-Lazare resident and CCI4* event rider. “Making sure my body alignment is correct has been beneficial to not only myself, but also in keeping my horses straight and even in their training”, adds the 26 years old elite rider.

Nipping joint dysfunctions in the bud before it has a major effect on your riding can save you a great deal of trouble. As with all athletics, chiropractic is available to enhance performance, prevent injury, and help you heal quicker when you do, indeed, get hurt. 

Happy riding!

 

March 2022 blog.

Text from Dr Mark Jessop, chiropractor and BC Chiropractic Association.

As chiropractors one of the many techniques we use and probably the technique chiropractors are most famous for is manipulation or “chiropractic adjustment”.  Manipulation involves a quick, specific movement of a joint and is often accompanied by a popping or clicking sound.  But what causes that popping sound during manipulation? The proper technical name for this sound is joint cavitation.

Is your back out?

We are often told by patients that their back is “out” and they need me to “put it back”. Is the pop the back going back in? Modern science has now shown that this is not the case and a patient’s back is not “out.” If it was manipulation certainly would not be appropriate. So when people have back pain or neck pain and their back is manipulated what is the sound? Is it the bones cracking? Again this is not the case, although it might sound like it is.

 

So what causes that popping sound?

In a study published in Plos One, an international team of researchers led by the University of Alberta used MRI video to determine what happens inside finger joints to cause the distinctive popping sounds heard when cracking knuckles. For the first time, they observed that the cause is a cavity forming rapidly inside the joint.

In every instance, the cracking and joint separation was associated with the rapid creation of a gas-filled cavity within the synovial fluid, a super-slippery substance that lubricates the joints.

Static MRI of the hand in the resting phase before cracking (left). The same hand following cracking with the addition of a post-cracking distraction force (right). Note the dark, interarticular void (yellow arrow). Source: Dr. Greg Kawchuk.

“It’s a little bit like forming a vacuum,” said professor and lead author Greg Kawchuk, Faculty of Rehabilitation Medicine. “As the joint surfaces suddenly separate, there is no more fluid available to fill the increasing joint volume, so a cavity is created and that event is what’s associated with the sound.”

 

So what happens if there is no sound during the adjustment?

Manipulation has been shown to be effective in the treatment of many musculoskeletal issues such as back pain and neck pain. But how does it work and is the pop important?  The mechanism of how manipulation works is complex and not a case of pushing the bones back into place because they are out of line. Although it can sometimes be nice for the patient to hear the pop as it confirms something has been done, it is not essential for therapeutic benefit.

To read Dr Greg Kawchuck research paper: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0119470

 

January 2022 blog.

Source : Canadian Chiropractic Association

When it gets cold outside, we tend to spend more time indoors doing sedentary activities and it can be difficult to stay active. It’s helpful to plan ahead and set some time aside in your schedule a few days a week to make sure you’re getting the activity you need.

To have health benefits from exercise, adults need a total of 2.5 hours of activity spread across the week, in bouts of ten minutes or more. These activities need to be moderate-to-vigorous intensity aerobic activities. Moderate-intensity physical activities include brisk walking or bike riding. Generally, you know your activity is moderate-intensity if you sweat a little and breathe harder than when you’re moving about day-to-day. Vigorous-intensity activities include jogging or cross-country skiing, and you’re likely to find yourself sweating and feeling out of breath.

Here are a few tips to help keep you motivated to stay active during the winter months:

• Plan activities ahead. When activities are in your calendar, you’re less likely to forget them. Preparedness also helps set good habits.
• Find a fun local activity, like snow shoeing, skiing, skating, or cross-country skiing.  Visit Parc nature les Forestiers-de-St-Lazare!
• Dress in layers. Insulate your body. When you can keep your body warm, it’s easier to continue being active outside.
• Use your daylight hours. It’s easier to stay outside while it’s still light out. It’s easy to miss out on activities when you start them too late in the day.
• Find indoor activities at your local community centre. This could be aerobics classes, badminton, basketball, or yoga classes.
• Climb stairs. Deliberately add more steps to your day. Consider going up and down a flight in your home, the mall, or an office building more than once over the course of your regular daily activities. As little as five minutes can make a huge difference for your health.
• Visit a library to find more motivation. There are plenty of free exercise DVDs you can borrow, including dance, step, aerobics, or Pilates. You can use the return date as a deadline to pick up another one!
• Sign up for a fun run. You can often find non-competitive “fun runs” in your community that are usually between 5 and 10 kilometers. The St-Lazare Bryan Liew Race (September 11) is one of them!
• Find an activity buddy. Find someone willing to commit to being active as often as you are, and set a plan. That could be planning to meet for morning walks or afternoon workouts. Having a friend keeps you accountable.

For help on setting activity goals based on your specific musculoskeletal needs, you can always ask your chiropractor about what activities are right for you. Most importantly, stay motivated. Revisit your goals to make sure you’re still on track. Plan ahead and make sure you can envision your goal as you look ahead towards the finish line.  Here’s to staying active in the new year!

 

December 2021 blog.

Source : Canadian Chiropractic Association

During the winter months snow shovelling can be a pain, considering that each shovelful of snow weighs about six pounds. That’s a lot of repetitive lifting, and wear and tear on your back. These back health tips will ease the hassle of clearing your driveway and help keep your back in shape.

Warm-up  Before tackling any strenuous activity, a quick 10 minute warm-up such as a walk around the block will kick-start your muscles for the activity ahead and help prevent injury.

1. Don’t let snow pile up.  If the weather report calls for several days of snow, frequent shoveling will allow you to move smaller amounts of snow after each snowfall.

2. Pick the right shovel.  Use a lightweight push shovel. If you’re using a metal shovel, spray it withTeflon, so snow won’t stick to it.

3. Push, don’t throw.  Push the snow to the side rather than throwing it.This way you avoid lifting heavy shovels of snow, and abrupt twists or turns that may result in injury.

4. Bend your knees.  If you need to lift shovels of snow bend your knees, and use your leg and arm muscles to do the work, while keeping your back straight.

5. Take a break.  If you feel tired or short of breath, stop and take a break. Shake out your arms and legs to recharge.

6. Keep comfort in mind.  Layer your clothing so you can adapt to changing temperatures. If you become too warm while outdoors, simply remove a layer or two to maximize comfort. 7. Stay hydrated.  Even though it’s cold outside, your body still needs plenty of fluids. Be sure to drink lots of water or fruit juice before, during and after shoveling. Remember – if you feel thirsty, you are already dehydrated. 8. Take it slow Rest when you feel tired or short of breath. Stop shoveling if you experience sudden or prolonged joint or muscle pain. 9. Cool down After you’ve finished shoveling cool down by taking a walk and stretching out tense muscles.

 

Text from American Academy of Orthopaedic Surgeons.

Blog – November 2021

Stress fractures often develop from overuse, such as from high-impact sports like distance running, tennis, track and field, gymnastics, dance, and basketball. When muscles are overtired, they are no longer able to lessen the shock of repeated impacts. When this happens, the muscles transfer the stress to the bones. This can create small cracks or fractures. Most stress fractures occur in the weight-bearing bones of the foot and lower leg, the most common being the second and third metatarsals. Female athletes are more prone to stress fractures than their male counterparts are.

Cause

Stress fractures usually occur when you increase your high-impact activity by: frequency (how often you exercise), duration (how long you exercise) and intensity (your level of exertion).  Doing too much too soon is a common cause of stress fractures. For example, runners who are confined indoors for the winter may want to pick up where they left off at the end of the previous season. Because of the lower level of conditioning, muscles become fatigued faster. The result could be a stress fracture in the foot or ankle.

Improper sports equipment, such as shoes that are too worn or stiff, can contribute to stress fractures. A change of surface can also increase the risk.  Technique: anything that alters the mechanics of how the foot absorbs impact when it strikes the ground may increase your risk for a stress fracture.

Symptoms and diagnosis
1. Pain that develops gradually, increases with weight-bearing activity, and diminishes with rest.  2.Pain that becomes more severe and occurs during normal, daily activities.  3.Swelling on the top of the foot or the outside of the ankle.  4.Tenderness to touch at the site of the fracture.  5.Possible bruising.

Imaging tests may help your doctor confirm your diagnosis. However, stress fractures are difficult to see on X-rays until they have actually started to heal.

Treatment

1.First Aid.

If you suspect a stress fracture in your foot or ankle, stop the activity and rest. Ignoring the pain can have serious consequences. The bone may break completely. Apply an ice pack and elevate your foot above the level of your heart. Nonsteroidal anti-inflammatory medicines like ibuprofen or naproxen may help relieve pain and swelling, but may inhibit bone healing. Try not to put weight on your foot until after you see a health care provider.

2. Rest.

Take a break from the activity that caused the stress fracture. It typically takes 6 to 8 weeks for a stress fracture to heal. During that time, switch to aerobic activities that place less stress on your foot and leg. Swimming and cycling are good alternative activities.
Protective footwear, cast and crutches. To reduce stress on your foot and leg, your doctor may recommend wearing protective footwear, like a removable short-leg fracture brace shoe. In certain cases, a cast and/or crutches may be necessary. Some stress fractures can also require surgery to heal properly

Recovery and prevention

Once your stress fracture has healed and you are pain-free, you will be allowed to gradually return to activity.

Slow pace. During the early phase of rehabilitation, it will be recommended to alternate days of activity with days of rest. You should slowly increase the frequency, duration, and intensity of your exercise.

Cross-training. Varying the types of aerobic exercise you do may help you avoid repeated stress on your foot and ankle. Start any new sports activity slowly. Your health care provider may prescribe orthotics if you are an overpronator.

Maintain a healthful diet. Eat calcium and Vitamin D-rich foods to help build bone strength. Use proper sports equipment. Don’t wear old or worn running shoes. . Gradually increase time, speed, and distance; a 10% increase per week is fine. If pain or swelling returns, stop the activity. Rest for a few days. If pain continues, see your health care professional.

Blog – October 2021

Text in part from “Running Doc’s Guide”, by Dr. Lewis G. Maharam, MD.

The ankle is what I call “the great pretender” of the body, capable of ballooning threateningly after a minor sprain (tearing of ligaments – they attach bone to bone) or concealing a serious fracture behind nothing more than an unpleasant throb.  

As a sport medicine physician, I’ve called them wrong both ways, finding just minor soft tissue damage after X-rays of patients I was ready to put into a cast and finding unexpected bone chips in others who were still managing daily workouts.  It’s chancy to assume, as so many of us do, that just because what’s happening now feels like what happened last time, it is what happened last time.

Fortunately, fractures are far less common than sprains.  And if a fracture is caught early, a couple of weeks in a cast usually permits rapid healing.  Procrastinate, and the bone chip may migrate to someplace you don’t want it and will have to come out with surgery if you expect to finally be rid of the pain.  Then we’re into real convalescence.  So the rule is, know the difference.  If there is any swelling after an ankle injury, please have it X-rayed.  But first things first.

The instant you’re hurt, ask yourself, “Can I keep going?” If you can still run with the same stride, then go ahead.  But if you start compensating, or if your biomechanics change even slightly, stop.

Three grades (from American Academy of orthopaedic Surgeons)

The amount of force determines the grade of the sprain. A mild sprain is a Grade 1. A moderate sprain is a Grade 2. A severe sprain is a Grade 3.

• Grade 1 sprain (mild sprain) : slight stretching and some damage to the fibers (fibrils) of the ligament.

• Grade 2 sprain (moderate sprain) : partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.

• Grade 3 sprain (severe sprain) : complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs.

When it’s a grade 1 and most of grade 2 sprains, there is lot more you can do than the usual RICE (rest, ice, compression, elevation).  Ice is indispensable of course, 2 or 3 times a day for 15 minutes.  And then instead of RICE, try MICE, substituting motion for rest.  Sit cross-legged and pretend there is a pencil extending from you big toe.  Now pretend to trace – with your foot, not just your toe – the capital letters of the alphabet from A to Z six times a day.  This moves the ankle in every direction, bringing blood flow and more rapid healing.  With the initial injury, this will be painful and the letters small.  As you progress, the letters will get bigger and bigger.

The faster you get your ankle moving, the faster you will be back on the road, pain-free.  You may as soon as you can do so without changing your form.  Running also brings in more blood flow for rapid healing.

Run safely!

September 2021 Newsletter.

Text from “Runner’s World Magazine”, by Patrick Milroy.

Running is becoming an increasingly popular form of sport and recreation. There are more and more running events you can join.  But when you start running, don’t plan to go too far or too fast right away — doing so is the number-one cause of injury among runners.  To make sure you don’t end up with one of the most common running injury, “shinsplints”, please follow these advices from the Runner’s World Magazine.

______________________________________________________________________________________________

Shinsplints are one of the most common running injuries. They result from tired or inflexible calf muscles putting too much stress on tendons, which become strained and torn. Overpronation aggravates this problem, as can running on hard surfaces, such as concrete; and running in stiff shoes.

Beginners are the most susceptible to shinsplints for a variety of reasons, but the most common is that they’re using leg muscles that haven’t been stressed in the same way before. Another common cause of shinsplints among beginners is poor choice of running shoes or running in something other than running shoes. Runners who have started running after long layoffs are also susceptible to shinsplints because they often increase their mileage too quickly.

Symptoms
Symptoms of shinsplints include an aching, throbbing or tenderness along the inside of the shin (although it can also radiate to the outside) about halfway down or all along the shin, from the ankle to the knee. This discomfort is due to the inflammation of the tendons on the inside of the front of the lower leg. This is basically the definition of shinsplints.   Another symptom is pain when you press on the inflamed area. The pain of shinsplints is most severe at the start of a run, but can go away during a run once the muscles are loosened up (unlike a stress fracture of the shinbone, which will hurt all of the time). With tendinitis, pain will resume after the run.

The treatment

Many runners experience mild shin soreness, which usually can be tolerated. “If shinsplints hit you at the beginning of a season, a certain amount of running through it will help the body adapt,” says podiatrist David O’Brian. “But if it’s a persistent problem, you shouldn’t run through it.”  If it does persist, ice the inflamed area for 15 minutes three times a day and take aspirin or ibuprofen. Ice immediately after running. To hasten recovery, cut down on running or stop altogether. Exercises with a resistance band will help to strengthen muscles of the lower leg.  Typical recovery time is two to four weeks.

If the injury doesn’t respond to self-treatment and rest in two to four weeks, see a health professional, who may recommend custom-made orthotics to control overpronation. Ultrasound and anti-inflammatories may also be prescribed.  While recovering from shinsplints, you may want to try alternative, non-impact exercises such as swimming, pool running, walking and cycling in low gear.

An ounce of prevention…

To guard against shinsplints, stretch and strengthen the tendons and muscles in the front of the leg by using band exercises. Anchor one end of the band to a heavy object, such as the leg of a sofa. Stretch the band, then loop it around the end of your foot. Move your foot up and down and from side to side against the band’s resistance to exercise different muscle groups.

Also, make sure to wear stability shoes or motion control shoes and consider orthotics. Also replace worn-out shoes, warm up well and run on soft surfaces, and avoid overstriding, which puts more stress on shins.

June 2021 Newsletter.

Part II: Children.

Source: Exercise is Medicine^® Canada, exerciseismedicine.org/canada

Canadian kids spend an average of 7.5 hours in front of screens each day*!

That’s right, 7.5 hours. Sounds outrageous, right? If you agree, you are not alone.  In fact, the response to this statistic is often disbelief. People repeatedly wonder how it is even possible that a child could spend that much time in front of TVs, cell phones, tablets or video games every single day.  However, according to the latest research, it is possible and this is becoming the ‘new norm’ in today’s society. A society where kids as young as 10 years old have a smartphone, where the TV is used as a form of babysitting, and where the tablet has replaced an actual, real-life book.

*Source: 2009-11 CHMS, Statistics Canada.  Read more in the Active Healthy Kids Canada 2013 Report Card (pages 32 – 36).

When kids are active, their bodies can do the things they want and need them to do. Why? Because regular exercise provides these benefits: strong muscles and bones, weight control, decreased risk of developing type 2 diabetes, better sleep and a better outlook on life among others.  Healthy, physically active kids also are more likely to be academically motivated, alert, and successful. And physical competence builds self-esteem at every age.

Canadian Physical Activity Guidelines (from Exercise is Medicine Canada):

Early years : 0 – 4 years

Infants (aged less than 1 year) should be physically active several times daily – particularly through interactive floor-based play.

Toddlers (aged (1-2 years) and preschoolers (aged 3-4 years) should accumulate at least 180 minutes of physical activity at any intensity spread throughout the day, including :

1. A variety of activities in different environments;

2. Activities that develop movement skills;

2. Progression toward at least 60 minutes of energetic play by 5 years of age.

Children aged 5 – 11 years and youth aged 12 – 17 years

For health benefits, children aged 5 – 11 years as well as youth aged 12 – 17 years should accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily.  This should include:

1. Vigorous-intensity activities at least 3 days per week.

2. Activities that strengthen muscle and bone at least 3 days per week.

What about intensity?

Moderate intensity

Moderate-intensity exercise will cause children to sweat a little and breathe harder.  It is possible for a kid to have a conversation in short sentences.  On a scale relative to an individual’s personal capacity, moderate-intensity physical activity is usually 5 or 6 on a scale of 10.  Examples are bike riding, playground activities and skating.

Vigorous intensity

Vigorous-intensity exercise will cause children to sweat and be « out of breath ».  A kid can hardly have a conversation.  On a scale relative to an individual’s personal capacity, moderate-intensity physical activity is usually 7 or 8 on a scale of 10.  Examples are jogging, swimming laps, cross-country skiing and hiking on hills.

For more information, visit these internet sites: Exercise is Medicine^® Canada, exerciseismedicine.org/Canada, Participaction and http://kidshealth.org.

April 2021 Newsletter.

Source: Exercise is Medicine^® Canada, exerciseismedicine.org/canada

Spring is around the corner.  Runners and cyclists are back in our streets.  Physical activity hasundoubted health benefits.  Being active for at least 150 minutes per week can help reduce the risk of premature death, heart disease, stroke, high blood pressure, certain types of cancer, type 2 diabetes, osteoporosis, overweight and obesity and can lead to improved fitness, strength and mental health (morale and self-esteem).

How often should I exercise?

To achieve health benefits, adults should accumulate at least 150 minutes of moderate to vigorous aerobic physical activity per week, in bouts of 10 minutes or more.  It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week.  More physical activity provides greater health benefits.

What about aerobic intensity and how can I assess intensity?

Light exercise will usually not cause adults to sweat and breathe harder. 

It is easy to have a conversation at this intensity. Walking is the typical example of light exercise.

Moderate-intensity exercise will cause adults to sweat a little and breathe harder.

It is possible to have a conversation in short sentences.  On a scale relative to an individual’s personal capacity, moderate-intensity physical activity is usually 5 or 6 on a scale of 10.  Examples are brisk walking (as if you are late to get somewhere) and bike ride.

Vigorous-intensity exercise* will cause adults to sweat and be « out of breath ».  

It is difficult to have a conversation.  On a scale relative to an individual’s personal capacity, moderate-intensity physical activity is usually 7 or 8 on a scale of 10.  Examples are jogging, swimming laps, cross-country skiing and hiking on hills.

Moderate to Vigorous-intensity physical activity (MVPA)

MVPA is a combination of moderate and vigorous intensity activity.  This is what you’re aiming for to meet the guidelines!

And what about losing weight?  Improving fitness is more important than losing weight.  Low cardiovascular fitness is associated with a much higher risk of disease and death than being overweight.

Pick a time. Pick a place. Make a plan and move more!

• Join a weekday community running or walking group.
• Go for a brisk walk around the block after dinner.
• Take a zumba or other class after work.
• Bike or walk to work.
• Rake the lawn, and then offer to do the same for a neighbour.
• Train for and participate in a run or walk for charity !
• Take up a favourite sport again or try a new sport.
• Be active with the family on the weekend!

Now is the time. Walk, run, or wheel, and embrace life!

*You should see you health care professional before engaging in vigorous exercise. 

March 2021 newsletter.

Text from “Running Doc’s Guide to Healthy Running”, from Dr. Lewis G. Maharam, MD.

Piriformis syndrome is – figuratively and literally – a pain in the butt, one that does an excellent imitation of the catchall ailment called sciatica.  This Pain can also show up in the lowermost portion of the back.  Therapy is possible but tricky.  Don’t try to diagnose and treat this one yourself.

Not long ago, for example, Paul, a 45-year-old patient of mine, came to me with what he described as a dull ache in the middle of one buttock.  It hurt him to run, and the pain was especially sharp as he was going up hills or even walking up stairs.  A string of doctors had pegged it as everything from a deteriorated spinal disc to that classic medical non sequitur, low back pain.  None apparently suspected the piriformis, one of the muscles deep in the rear of the pelvis that helps turn your leg outward and that runs alongside, and occasionally surrounds, the sciatica nerve.  Like any muscle, it can be overused and go into spasm, something that can also be triggered by tight hamstrings, prolonged sittings, or anything that twists the area.  When that happens – and especially when the sciatic nerve becomes involved – the pain is dulls, constant, and, it often seems, permanent.

Diagnosis is not difficult for anyone who has seen the condition before.  One or two simple exercises with the patient on a table can pinpoint it, and trained fingers can actually feel down to and sense the spasming muscle.  But diagnosis is only the start of treatment, and therapy is far from simple, news that is always a big disappointment to experienced athletes who are accustomed to being sent home with a list of simple stretching and strengthening exercises and a follow-up appointment. 

Paul, for example, listened to me for 20 minutes while I explained why he had to do exactly as I said.  Yes, there would be stretches, but they would have to be done […] the right way.  Other therapies, […] including a specialized technique called “transverse frictional massage”, in which the massage is applied opposite the alignment of the muscle and tendon fibers; ice; ultrasound. 

I heard from him nine months later when he called to tell me how disappointed he had been with my care.  Why?  Because he still hurt.  Of course, it turns out that once he knew what was wrong with him, he’d decided to skip all that therapy stuff, get some piriformis stretches out of a book and get to work on his own.

A condition that’s commonly not correctly diagnosed in the first place, that requires otherwise intelligent athletes to follow orders like robots, and that’s all but impervious to anything but the full galaxy of therapies is as close as one can come to a sports medicine physician’s nightmare.  But if you do what you’re told, it needn’t be our nightmare, too.