Falls Prevention, part 2.

June 2020 newsletter.

Image and text: Canadian Chiropractic Association.

Taking a tumble can cause serious injury that affects your everyday life and
independence. One of the best ways you can reduce your risk of slipping, tripping and falling is to improve your strength and balance. Almost any kind of physical activity is helpful – but some activities deliver greater benefits than others.

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Strong Legs for Stability
Strengthening your leg muscles can reduce the chance of falling if you do lose your balance. Strong legs will stabilize you and can make the difference between staying on your feet and hitting the ground. While any activity that uses your legs is good, it’s important to find something you enjoy. The best exercise plan in the world won’t help if you don’t want to do it. Here are some ideas:

Brisk Walking
Walking requires no special equipment other than a pair of supportive shoes. Make an after-dinner walk part of your routine or
leave the car in the driveway and take a walk to pick up light groceries. There are many simple ways to get moving more often.

Strength Training
Exercises that target specific leg muscles can be easily done at home – there’s no need to join an expensive gym. If you enjoy
being with a group, community centres often have exercise programs for different age groups. Here’s a simple strengthening
exercise to try:

Leg extensions:
This exercise can be done while watching TV or sitting at the kitchen table.
While seated, straighten-out one leg and gently lift it off the ground to a
height that’s comfortable for you. Hold for 10 seconds if you can. Put that
leg down. Extend and lift the other leg. As your strength grows, add ankle
weights to give your legs even more of a work out.

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Boost Your Balance
Your sense of balance is what keeps you on your feet – without it you would not be able to stand upright. Poor eyesight, some medications and some health conditions can cause dizziness or other balance problems.

Strength and balance work together to keep you steady. There are many activities that contribute to maintaining and improving balance – and help build strength. Swimming is a good choice if you enjoy the water. Cycling is appropriate for people who feel comfortable on a bike. Wear protective gear such as a helmet. Tai Chi benefits balance, strength and flexibility. It also encourages mental focus, concentration and calmness. Yoga can be adapted for any age. It offers benefits similar to Tai Chi. Golf gets you walking, and using a club requires balance and coordination. Dancing is a great workout for your legs. Put on your favourite music and practise your steps in the living room.

These are just a few ideas to consider. Remember, anything that gets you on your feet and moving will help maintain strength
and balance.

What’s a Good Goal?
Aim for 20 minutes of exercise at least three days a week. Even better – build some activity into every day. Your independence
is worth it.

Ergonomics Checklist

Special newsletter.

Image and text: Direction de la santé publique de Montréal-Centre.

During the mandatory self-isolation, most people spend more time in front of screens. Teleworking has also become very common. Following this ergonomics checklist will help you staying away from musculoskeletal pain.

Falls Prevention, part 1.

March 2020 newsletter.

Image and text: Canadian Chiropractic Association.

Fall Prevention, part 1

Sources: Canadian Chiropractic Association.

Did you know that one in every three Canadians over age 65 will fall at least once in a year? Falls often have serious consequences such as hip, wrist and pelvic fractures that can have a lasting impact on your quality of life. Best Foot Forward is a public education program developed by the Canadian Chiropractic Association to address the issue of debilitating falls among older Canadians. Canada’s chiropractors are committed to reducing injury and disability from falls. A chiropractor can test your strength, steadiness and balance – and give you advice on exercise and falls prevention.

Watch your step.

Check out these tips for simple things you can do to stay safely on your feet.

  • Remove your reading glasses when you are walking. Always slip them off before you take a step.
  • Never climb on a chair or stool to reach something. Always ask for assistance.
  • If you have a pet such as a cat or dog, consider putting a bell or reflector on its collar.
  • Take your time. Invest in a cordless phone that you can keep near you. Don’t rush to answer the door.
  • Always sit down to put on or take off shoes and clothing. Place a chair or bench near the entranceway.
  • Keep hallways and stairs free of children’s toys.
  • Wear shoes or slippers with non-slip soles indoors.

Prevent Falls in the Home.  Here are some simple things you can do to make sure your home doesn’t trip you up.

 

The Bathroom

  • Use a non-slip mat inside and outside the tub or shower.
  • Install grab bars by the toilet and in the tub and shower area.
  • Purchase a non-slip bath and shower bench to get in and out safely.
  • Install a raised toilet seat to make getting on and off easier.

The Kitchen

  • Replace loose scatter mats with rugs that have rubber backing.
  • Wipe up spills immediately.
  • Keep everyday items on shelves within easy reach.
  • Make sure no extension cords cross your path.
  • Never climb on a chair or stool to reach for something. Always ask for assistance.
  • Use non-slip floor wax.
  • Add gliders to your chairs to make moving them easier when you sit down or get up from the table.

Stairways

  • Keep stairways clear of clutter that can cause you to trip.
  • Ensure there are handrails on both sides of the staircase.
  • Install non-slip strips on the edge of each step.
  • Secure loose or wrinkled carpet.
  • Ensure good lighting in stairwells.
  • Make sure you can see where you are going if you are carrying something up or down the stairs.

Outdoors

  • Keep a covered bucket of sand or salt near the doorway in winter to safely handle slippery conditions.
  • Make sure outdoor railings and stairs are sturdy and secure.
  • Keep steps and pathways clear of clutter such as yard tools, snow shovels, newspapers and wet leaves.
  • Don’t juggle parcels while trying to enter the house. Make a few trips from the car with smaller packages.

Got a headache?

February 2020 newsletter.

Sources: Ontario Chiropractic Association.

Being able to think clearly and calmly allows us to make decisions, process emotions and carry on with our day-to-day lives. That clarity can be easily destroyed with a strong headache. Many people have occasional headaches, but frequent headaches that affect your ability to sleep or get on with your day can be disabling.

Different Types of Headaches.

Common types of headaches are tension, migraine and cervicogenic headaches. Tension headaches commonly present as band-like tension around the head, whereas migraine headaches usually result in pain on one side of the head and are commonly accompanied by nausea and sensitivity to light and sound. With cervicogenic headaches the neck is the source of the problem, but the pain is perceived in one or more areas of the head and/or face.

The causes of headaches are not always well understood but a family history of headaches, neck stiffness and stress are all common factors.

Chiropractors can assess, diagnose and manage headaches. Current evidence suggests that chiropractic care, including manual therapy, can be effective in treating cervicogenic and tension headaches. Studies have also shown that chiropractic care can help decrease the intensity and frequency of migraines. The treatment options may include: 

  1. Manual therapy
  2. Soft tissue therapy
  3. Modalities including electrical stimulation, acupuncture and ultrasound
  4. Rehabilitation and posture correction
  5. Lifestyle changes and education
  6. Referral and co-management

It’s important to take headaches seriously. Consider consulting a chiropractor if you often have headaches, if you frequently take a pain reliever for your headaches, if your headache pattern changes, or if your headaches are getting worse. Seek prompt attention if your headache is sudden and severe, follows a head injury, or is accompanied by fever, stiff neck, weakness, numbness or difficulty speaking.

Special week: complimentary exam and x-rays

Make a $30 donation to Leucan and receive a complimentary opening of a file, chiropractic examination and x-rays (certain conditions apply ¹).

From February 3, 2020.  100% of the amounts collected will be donated to Leucan (not just the profit).

Limited space, contact us today to make an appointment!

Phone: 450-455-9822

email: info@drlepagechiropraticien.com

1. Average usual fee of $130. Offer valid for new patients or for re-activations of inactive files only. Offer valid for 90 days from February 3, 2020. If a treatment is made on the first visit, it is not included in the promotion and the usual fee of $50 will apply.

4 simple tricks to make the treadmill less terrible.

January 2020 newsletter.

Sources: Canadian Running Magazine.  December 3rd, 2019 by Madeleine Kelly.

It’s officially treadmill season in Canada, which means that runners across the great north are looking for ways to improve their experience on the indoor conveyor belt.

Matt Hughes is the Canadian record-holder in the steeplechase. As Hughes adjusts to the harsher Canadian winters, he’s also accepting that the treadmill is part of training like a Canuck. Hughes reached out to Twitter for advice on how to make his indoor miles more palatable and he got some great responses from many different kinds of runners.

1. Don’t look at distance

A treadmill minute can sometimes feel like an hour. Scott Olberding recommends putting a towel over the distance and time markers and binge-watching your favourite show: ‘’Put a towel over the distance / time. iPad with Netflix. When I was on the elliptical I was able to read on the iPad but haven’t tried it on the treadmill. For some reason binge watching shows is more distracting for me than music’’.

2. Wear a lighter shoe

Wearing a lighter shoe, like your lighter trainers or racing flats, can help runners avoid the clunky feeling that can come from treadmill runs.   ‘’I always wear a lighter, more performance oriented shoe. Most of the time a beefier type racing flat. That tends to help me stay away from the “Clunkiness” that sometimes comes with running in regular training shoes on the treadmill.’’ says Gary Brimmer, coach at Training Peaks.

3. Play with your speed and adjust the grade

If you’ve got a steady long run on the docket, play with your treadmill speed the same way your speed would naturally fluctuate on the road or trails.

Jamie Langley recommendations: Speed manipulation every minute or few changing it up by 0.1km.h, you can do some great progression runs like this. Or breaking it up into small chunks.

Reid Coolsaet, one of Canada’s fastest-ever marathoners, recommends that runners also adjust the grade while running to break up the workout.

4. Watch inspirational videos

Training through the winter months for a spring race can cause a runner’s interest to wane. If you’re struggling to find the motivation to hop on the treadmill, put on either a video recap from your goal race, or a race that one of your running idols crushed. This can help you find the motivation you need.

Plantar Fasciitis

December 2019 newsletter.

Sources: American Academy of Orthopaedic Surgeons & Runner’s World Magazine. Images: American Academy of Orthopaedic Surgeons.

The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot, and supports the arch of your foot. Plantar fasciitis is the most common cause of pain on the bottom of the heel. It occurs when this strong band of tissue becomes irritated and inflamed.

Causes. Plantar fasciitis can be caused by biomechanical flaws, including flat, high-arched feet and tight calves muscles; excessive pronation and being overweight. In some cases, plantar fasciitis can develop without a specific, identifiable reason. Especially for runners, sudden increases in training mileage; beginning speed or hill work; wearing worn or inappropriate running shoes; running on hard surfaces, like asphalt or concrete; or wearing high heels all day before switching into flat running shoes can overload the plantar fascia and lead to plantar fasciitis.

Symptoms.  Plantar fasciitis sufferers feel a sharp stab or deep ache in the middle of the heel or along the arch. Another sign is the morning hobble from the foot trying to heal itself in a contracted position overnight. Taking that first step causes sudden strain on the bottom of the foot. The pain can recur after long spells of sitting, but it tends to fade during a run, once the area is warmed up.

Prevention and treatment of plantar fasciitis.  Plantar fasciitis can be a nagging problem, which gets worse and more difficult to treat the longer it’s present. To prevent plantar fasciitis, run on soft surfaces, keep mileage increases to less than 10 percent per week, and visit a specialty running shop to make sure you’re wearing the proper shoes for your foot type and gait. It’s also important to stretch the plantar fascia and calves muscles.

At the first sign of soreness, massage (roll a golf ball under your foot) and apply ice (roll a frozen bottle of water under your foot, 3 to 4 times a day). What you wear on your feet when you’re not running makes a difference. Arch support is key, and walking around barefoot or in flimsy shoes can delay recovery.

Rest.  Decreasing or even stopping the activities that make the pain worse is the first step in reducing the pain. Crosstraining (doing other sports, where your feet don’t pound on hard surfaces) is a good way to stay fit during your recovery.

Stretchings.  Plantar fasciitis is aggravated by tight muscles in your feet and calves. Ask your health care provider how to stretch these structures.

Ultrasound therapy.  Ultrasounds are helpful in reducing inflammation, increasing plantar fascia extensibility and in speeding the healing process.

Supportive shoes and orthotics.  Shoes with thick soles and extra cushioning can reduce pain with standing and walking. As you step and your heel strikes the ground, a significant amount of tension is placed on the fascia, which causes microtrauma (tiny tears in the tissue). A cushioned shoe or custom orthotics reduces this tension and the microtrauma that occurs with every step. Night splints. Most people sleep with their feet pointed down. This relaxes the plantar fascia and is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep and is sometimes necessary to treat this condition.

Cortisone injections and surgery.  Cortisone is a powerful anti-inflammatory medication that can be injected into the plantar fascia to reduce inflammation and pain. However, it should be seen as a last resort solution, because multiple steroid injections can cause the plantar fascia to rupture (tear). Surgery gives usually good results. However, because it can result in chronic pain and complications, it is recommended only after all nonsurgical measures have been exhausted.

Lisfranc Injuries.

November 2019 newsletter.

Text from: Running doc’s guide to healthy running (Lewis G. Maharam).

Lisfranc foot injuries occur in the midfoot.  They’re named after French surgeon Jacques Lisfranc, who in the 1800s, as a member of Napoleon’s army, first described an injury sustained by mounted soldiers whose foot got caught in the saddle’s stirrup as they got thrown off the horse.  Nowadays, the injury happens when stepping into a pothole in the road, twisting the foot, or pushing off with force as a football lineman might do.  These injuries can be ligament sprains, dislocations of the joints between the forefoot and midfoot, or fractures of the bones in the midfoot complex. 

Anatomically, the Lisfranc joints are between the tarsometatarsal joints involving the cuneiform bone and metatarsal bones, as shown in the figure.  Only a small percentage of Lisfranc injuries are fractures or dislocations; most are sprains involving the ligaments. 

Diagnosis

After palpating the foot, twisting the midfoot and checking the pulse on the top of the foot (because the artery there can sometimes be injured, too), the health care provider will generally order standing and non-weight-bearing X-rays. 

Treatment

Treatment varies depending on whether the injury is a sprain or a fracture.  A sprain will usually be treated in a non-weight-bearing cast boot (meaning that you cannot walk on the cast and will have to use crutches) for about 6 weeks.  After removal, physical therapy and a very gradual return to sports usually take 8 to 12 weeks.  Fractures and dislocations will often require surgery.

Non surgical treatment

Rest – Rest is important to allow the inflamed ligaments to heal. Activities other than running which do not make the pain worse such as swimming or cycling should be done to maintain fitness.

Ice – Apply ice to reduce pain and inflammation. Ice should be applied for 10 to 15 minutes every hour until initial pain has gone then later 2 or 3 times a day and / or after exercise is a good idea.

Stretching and strengthening exercises – Your healthcare provider will prescribe you Stretching and strengthening exercises to enhance the healing process and prevent relapse.

Ultrasound – Use of electrotherapeutic treatment techniques such as TENS or ultrasound may help reduce pain and inflammation.

Train safely!

IT-band Syndrome.

October 2019 newsletter.

Text from: Sports Injury Clinic, The Sports Injury Clinic on the net.

Symptoms

Iliotibial band syndrome results in pain on the outside of the knee which is caused by friction of the iliotibial band on the side of the knee. It is also known as ITB syndrome.

Symptoms of ITB syndrome consist of pain on the outside of the knee, more specifically at or around the lateral epicondyle of the femur or bony bit on the outside of the knee. It comes on at a certain time into a run and gradually gets worse until often the runner has to stop. After a period of rest the pain may go only to return when running starts again. The pain is normally aggravated by running, particularly downhill. Pain may be felt when bending and straightening the knee which may be made worse by pressing in at the side of the knee over the sore part. There might be tightness in the iliotibial band which runs down the outside of the thigh.

Causes

Certain factors may make you more susceptible to developing runners knee or iliotibial band syndrome. A naturally tight or wide IT band may make someone more susceptible to this injury. Weak hip muscles, particularly the gluteus medius are also thought to be a significant factor. Over pronation or poor foot biomechanics may increase the risk of injury. If the foot rolls in or flattens, the lower leg rotates and so does the knee increasing the chance of friction on the band. Other factors include leg length difference, running on hills or on cambered roads.

Treatment

Rest – Rest is important to allow the inflamed tendon to heal. Activities other than running which do not make the pain worse such as swimming or cycling should be done to maintain fitness.

Ice – Apply ice to reduce pain and inflammation. Ice should be applied for 10 to 15 minutes every hour until initial pain has gone then later 2 or 3 times a day and / or after exercise is a good idea.

Stretching exercises – Stretching exercises for the muscles on the outside of the hip in particular are important. The tensor fascia latae muscle is the muscle at the top of the IT band and if this is tight then it can cause the band to be tight increasing the friction on the side of the knee. Using a foam roller on the IT band and gluteal muscles can help stretch the iliotibial band and remove any tight knots or lumps in the tendon.

Strengthening exercises – Improving the strength of the muscles on the outside of the hip which abduct the leg will help prevent the knee turning inwards when running or walking and therefore help reduce the friction on the ITB tendon at the knee. In particular strengthening exercises for the tensor fascia latae muscle and gluteus medius such as heel drops, clam exercise and hip abduction are important.

Ultrasound – Use of electrotherapeutic treatment techniques such as TENS or ultrasound may help reduce pain and inflammation.

Training modification – Errors in training should be identified and corrected. These can include over training or increasing running mileage too quickly. As a general rule a runner should not increase mileage by more than 10% per week. Running across a slope or camber in the road for long periods or poor foot biomechanics should be considered. Also avoid too much downhill running.

Train safely!