Chiropractic

Here Comes Fall

By PSSM Staff

THE SEPTEMBER SHUFFLE!!!

Summer is coming to a close, vacations are ending, and the kiddos will soon return to school. From pumpkin spiced everything to bonfires, hoodies, leggings and Ugg boots, you’re probably noticing all of the little reminders of the fall season popping up everywhere.  There’s plenty of hustle and bustle that comes with this time of year especially for busy parents who are trying to get their children prepared for returning to school. Here’s some helpful tips for everyone, regarding backpack safety and footwear, as they get ready to do the “September Shuffle”:

BACKPACKS

The backpack is an essential piece of the “back-to-school” puzzle. There are some good guidelines to help you pick out the appropriate backpack for your child. In terms of the fill capacity of your child’s backpack you may be tempted to buy a bag that will fit every book they may be assigned into it but try to fight that urge. Try a smaller capacity pack that still offers compartments that can be used to distribute the contents, and their weight, evenly. Your child should never wear a pack that is longer or wider than their own torso/upper body and the straps should be adjusted so that the pack is worn as close to the torso as possible. While the weight of the pack will vary day to day, they should never be carrying more than 15% of their bodyweight. So a smaller bag that will force your child to be diligent in taking the appropriate books home every day, to avoid strain of their back, is essential. You’ll also want to choose a bag that has wide, and ideally padded, straps that cover a large portion of the shoulders. The wider straps will offer more biomechanically helpful distribution of the weight. Your children should wear their packs so that they sit high on the back so the weight can be distributed evenly across the shoulders. A good guideline for this is making sure that the bottom of the pack never drops below your child’s waistline. A backpack that has a waist and/or chest strap will also help with the days when the pack is a little bit heavier. Make sure that when your child’s backpack is packed the heaviest items are situated inside the pack as close to the body as possible.

FOOTWEAR

If proper backpack ergonomics are important for your child’s spinal health proper footwear is equally so. If your house was built on a poorly constructed foundation the overall structural integrity of your house would be questionable, unsafe and prone to problems. Not having the proper footwear will eventually have the same effect on your child’s spine no matter how diligent you are in making sure they have proper backpack habits. If your child attends a school where uniforms are required, including the footwear, it may be wise to have them wear orthotics in their shoes if the mandated footwear does not offer proper arch and ankle support; which is commonly the case. Custom orthotics are best since they are made specifically for the individual’s pedal needs, but if this is not an option purchasing an appropriate pair at your local drugstore is a good start. Orthotics would be a good idea even if your child’s footwear is not mandated so it is a good option to consider no matter what the circumstance; particularly if your child is a student-athlete as well.

MISCELLANEOUS

There are some other things to consider that may be considerably helpful with your back to school journey this year. Consider a bookstand for your child for their home studying time. Not having to put the book on the desk/table will eliminate strain on the neck and upper back from looking down for hours on end while studying at home. In addition to being relatively inexpensive, book stands are small so the use of one will also free up desk space.

Limit computer and electronic device time at night. Using these items while in bed or a darkened room can cause retinal damage. Moreover, too much electronic stimulation can interfere with your child’s sleep quality. Try shutting down all computer, tablet, and cell phone use for your child at least 60 minutes prior to bed. If you’re worried about how to keep your child occupied you can try using the time to have them help you prepare their clothes or lunch or backpack for the next day.

If you’re helping your college aged kid move onto campus and that transport requires the lifting of heavy boxes remember to use proper mechanics when attempting to lift heavy weight. Bend at the knee and the hip, lowering your entire body down to the box/object, so as to use your legs for the power needed to get the heavy item off of the floor. Be sure to situate yourself as close to the load you are lifting as possible. Try to give yourself plenty of time for the commute and the move in. Many moving injuries are a result of rushing which breeds bad form and makes it easier for you to injure yourself.

Flip Flop Fever Fest

By PSSM Staff

The summer and hot weather is upon us!!! Now is the time of year that more and more folks will ditch their conventional footwear and opt for sandals and flip flops. Although many manufacturers are producing more ergonomically sound designs, the difference in support offered is enough to cause issues with many patients and their ailments; particularly foot pain. If you desire more summer friendly footwear but contend with the discomfort and pain that comes with wearing flip flops or sandals all summer long here are a few tips to aid in alleviating your foot pain this summer.

  1. Obviously you’ll want to go with the most ergonomically appropriate design for you. Whether you have flat feet, normal arches, or high arches you’ll want to take care to purchase sandals and flip flops with the most beneficial/appropriate design for your feet.
  2. If you have pretty standard sandals or flip flips that don’t have any,or many, ergonomic features you may want to opt for gel insoles that have an adhesion to help them stick to the bottom of your sandal.
  3. Stretch out your plantar fascia by propping your toes on the bottom of the wall or the bottom step, count to 10, repeat 10 times. Do this for both feet even if only one is bothering you.
  4. Use a frozen golf ball to work on any tender spots along the foot. Focus on tender spots/problem areas and hold a firm pressure (nothing that hurts you more though) on them for relief. You can also do this with a frozen water bottle to roll across the entire bottom of the foot and roll it continuously. Make sure that you have already stretched out the fascia of the bottom of the foot, as previously mentioned in step 3, BEFORE you do this and NOT AFTER.
  5. Foam roll your calves to help with muscular involvement that may be affecting your gait and causing increased foot discomfort as well. If you have tight or sore calves this will affect your gait and can contribute to putting more strain on your feet. Combined with the potential decreased support in flip flops this could make foot discomfort worse. So get rollin!!!

Posture and TMJ

By PSSM Staff

Are you suffering from Upper Cross Syndrome or TMJ Disorder and you can’t find any relief? Look no further. Performance Spine and Sports Medicine will use an integrated approach to help treat your pain so you can live your life pain free, drug free, and surgery free.

From a physical therapist’s perspective, we can evaluate the source of the TMJ pain whether it is a postural, muscular or disc issue or a combination of these. All of these sources can be addressed with a physical therapy program, and each program is individualized to the patient. Any muscular issues would be addressed with hands on manual treatment including trigger point release and jaw mobilizations. Tightness in neck musculature may also contribute to TMJ pain so this area would also be addressed if needed. Another component of TMJ therapy is neuro reeducation of the jaw muscles to improve control of jaw opening and closing. This comes with a home exercise program for patients to work on throughout the day in order to make long term changes. Lastly, we address the postural issues that often accompany TMJ pain. Treatment for postural reeducation includes ergonomic assessments, kinesiotaping, postural muscle strengthening and core work.

Chiropractic can also be a very effective nonsurgical treatment for temporomandibular joint dysfunction. The chiropractor recognizes the relationship between the spine, jaw, skull and nervous system. Evaluation and correction of structural misalignment as well as addressing the myofascial trigger points in these areas leads to better temporomandibular joint function as well as pain relief. Gentle spinal adjustments are performed to the cervical and thoracic spine to improve segmental movement and alignment. Myofascial trigger point release technique is used in the jaw, skull and spine to relieve muscle tension.

Our medical doctors would take this approach after dental issues are ruled out and the patient has exhausted other options including rehab, manipulation, stretching techniques or using a mouth guard. The medical doctor will almost always get an MRI first and then they would then do a workup including ultrasound. Usually TMJ could be one of two types of problems, a nerve problem or a joint problem. If it is a nerve issue, the doctor could use injections from cortisone to Botox and/ or try acupuncture. If it is an unstable joint, the use of regenerative injections like prolotherapy or PRP to stem cells with ultrasound guidance can be used.

Here at PSSM we have the tools to help you break this pattern. We can help you eliminate the negative compensatory factors, teach you proper functional cues to improve the condition, teach proper ergonomics for activities of daily living that are contributing to the condition, rehabilitate the weak musculature in order to stabilize you from a postural standpoint, and reestablish your body’s optimal functional capacity in the correction of these conditions.Let Performance Spine and Sports Medicine help you get better faster and stay better longer!

Where are my abs

By PSSM Staff

Core-strengthening is a common activity recommended for patients with low back issues. The reasoning for this is due to the fact that the core is the largest low back stabilizer the body naturally has. However, many patients often ask about how to train their anterior core (the abdominal muscle group) for an aesthetic benefit as well. When this conversation takes place it is discovered that most patients are making the same mistakes when it comes to core-training.

  1. “Abs are made in the kitchen.” This is a pretty cliché phrase in the fitness world but that doesn’t make it any less true. If you aren’t going to eat clean your abdominal journey is going to be that much harder. Eating a proper diet that allows your body to both regulate and balance its insulin sensitivity will give you the upper hand in managing visceral fat in the belly. Your body uses the hormone insulin to regulate your blood sugar whenever you eat or drink something. Studies have shown that there is a direct correlation between belly fat and insulin resistance. So don’t treat your stomach like a waste basket. You’re going to get out what you put in. Stop training so hard and undoing it all with reckless eating. You’ll thank yourself for the results.
  2. Déjà vu. If you’re doing the same ab workouts over and over and over, day after day after day, then you’re probably not getting the results you truly desire. The anterior core is super complex and for that reason you need to mix it up. When your muscles become acclimated to a movement that never varies, in any way shape or form, your body will strive to make itself more efficient at that movement. This translates to decreased calorie burn because your body requires less energy output as it gets more efficient at what it is performing. Constantly varying the way you train your abs will give you some extra security against this type of plateau. So have some fun, get creative, and mix it up!
  3. Quality vs. Quantity. It’s not HOW MUCH you train abs but HOW WELL. You don’t need to do a 30 minute plank or 400 sit ups every day to get results. In fact that kind of volume will likely run you into the previously mentioned issue. That much volume will really send your body scrambling to achieve maximum efficacy pretty quickly. Moreover from that, the muscle fatigue will translate to compensation quickly as well and put you at increased risk for injury; which no one wants. Then there’s more serious risks to overdoing it with quantity; such as muscle tissue breakdown creating systemic issues and causing your organs to shut down, for example rhabdomyolysis. Why risk all of that? If you are performing a high quality abdominal movement the right way 3 sets, each totaling no more than 20 reps, should do the trick just fine. Just focus on doing the right movements the right way and your results will show themselves.
  4. You may hate it and it may not be the “sexy” thing right now in terms of popularity but IT’S NECESSARY! Remember how we talked about calorie burning demand a little earlier? Well cardio is still one of the best ways to achieve that fat burn off; it just needs to be paired with your strength and ab work too. So find a way to get some quality cardio in your routine to help burn that belly down. If you’re easily bored and/or hate treadmills try an activity that is fun for you that can still safely get that heartrate up as your source of cardio.
  5. Remember to take your time. There’s no quick fix here. Results are going to come you just have to put in the work and be patient with yourself. Wanting to see it all happen “yesterday” is only going to stress you out. Higher stress levels trigger your body’s stress hormone, cortisol, causing you to hold on to belly fat. Sorry, it’s science. The other thing stressing about this will do is put you at risk of getting impatient and streamlining yourself to doing any one, or more, of the things we just talked about. So give yourself some time, do the work, work hard, BE PROUD.

School Bag

By PSSM Staff

This blog is going to address carrying a heavy schoolbag, but really the information can be carried to carrying a heavy bag in general.

Carrying a heavy schoolbag can lead to many issues in children, specifically when it comes to the musculoskeletal system. If your child tends to wear her schoolbag to one side, then the bag is putting too much pressure on one side of the body causing a tilting of the spine.

Any outside weight added to the body causes our balance to change. This means that our bodies will automatically make corrections to our posture, so we do not end up falling over. These corrections may seem to be beneficial for remaining standing, but they are not beneficial for our musculoskeletal system.

Down the center of the back is the spine. The spine consists of vertebrae, or bones stacked on top of each other; it’s here where muscles and ligaments attach to cause movement. The spine also has disks in between each bone that help provide cushioning. A heavy schoolbag puts stress on the spine and all of the bone, muscles, ligaments, tendons, and even disks!

Imagine how a heavy schoolbag can put children at risk while their bones, muscle, ligaments, and bodies are still developing.

It is beneficial to ask your child if they are having any shoulder, neck, or back pain. Ask your child if they feel numbness, tingling, or weakness in their hands.

In the long term, the child could end up with a “hump back” also known as kyphosis.

Here is what you should look out for while buying a schoolbag.

  • Buy a sturdy, bag with wide, padded shoulder straps. This will help reduce pressure on the neck and shoulder area.
  • Buy a bag with adjustable straps which can be altered as the child grows.
  • Check your child’s posture after she has put the bag on. If you notice your child leaning forward or slouching, check if the bag is too heavy or if it has been packed incorrectly.
  • Make sure your child is only carrying the items they need for school that day – remove any unnecessary books and equipment.

Tips to Prevent Injury as You Get Out and Garden

By PSSM Staff

With spring time rolling around quickly on the east coast, countless people flock outside for different activities. One of those most often performed is gardening/yardwork. People love to get those flower beds looking pretty to go with all the sunshine! However, with this increased motivation to get active comes an influx in patients in most Rehab clinics. Most often people tend to not pay attention to body mechanics, or if they do the long hours spent gardening finds the body fatiguing and falling into improper positions. We see complaints anywhere from overuse shoulder/elbow/hand injuries to knee pain from squatting/kneeling as well as neck and low back pain.

To avoid these common injuries and pitfalls, you need to gardening like exercise or a sport. You should always warm-up and not head directly from inside to out without doing so. This includes stretching the large muscle groups of both the lower and upper body in preparation for movement and to take some stress off joints during strenuous tasks (you should also stretch afterwards as well). Several other crucial strategies to remember are:

– Plan out your time, and be honest about how much time you can physically afford to perform the task. Everything will eventually get done, do not worry!
– Good body mechanics are key! When lifting remember to bend the knees, keep back straight, hold object close to body, and lift through the legs not the back.
– Avoid all twisting motions and refrain from bending forward for long periods. If you must bend forward, keep the core tight and back straight to limit stress on the low back. Sitting on a small stool is your best option.
– Alternate tasks, not needing to completely finish one before, to use different muscle groups and avoid placing repetitive stress upon the spine and extremities
– Take small breaks every 30-60 minutes to get a drink of water
– Stop before you are fatigue as this is the time when most injuries occur

If you begin to notice and pain and soreness make sure to stop and stretch, ice and rest. If the pain persists more than a few days, it is best to then consult your MD or Rehab Provider.

Tips to exercise when you are really busy

By PSSM Staff

Making sure that you find time to exercise is difficult for a lot of people especially for people with careers and children in their lives. Fortunately, there are a few ways to try and promote a healthy life style where you can raise your heart rate or get on your feet even if it is for short periods.

For example, exercise trackers like a FitBit are great ways to promote walking and standing to get steps in during a busy day. Even if you are just taking the stairs instead of the elevator this is a great way to get more walking and exercise in a normal day. Even choosing to park farther from the store to walk farther is an easy way to walk more. Have the motivation like a tracker helps people to get up a move when they normally wouldn’t and try and get more walking in than average for them.

Another way to try and get more exercise in is to get a gym membership. Gyms offer group exercise classes, private trainers and lots of machines to allow variety in training. Paying the fee for a gym membership also promotes compliance with exercise as there is more of an incentive to make up for the price. If it is hard to get to the gym a good way to get there is by going straight from work or before work Packing clothes to take allow you avoid multiple trips.

If getting a gym membership is not up your alley exercising at home is always a great option for people. Designating a work out space in your home creates a space for you to dedicate your time and effort to yourself. There are many work out videos, yoga classes etc on dvd, online or on demand that people can participate in their own home. With warmer weather going out for walks or runs is also a great way to exercise near home. Having a running or walking partner is a great way to stay active. Or taking longer walks with your dog than normal gets your moving more than you normally would.

Hopefully these tips help people stay active and healthy despite busy schedules and hectic lifestyles!

Leaky Gut

By PSSM Staff

Do you experience digestive issues such as gas, bloating, diarrhea or irritable bowel syndrome? Do you suffer from seasonal allergies or asthma? Do you have a diagnosis of chronic fatigue or fibromyalgia? Do you have food allergies or intolerances?

If so, it’s possible that you may be suffering from a condition called leaky gut.

Leaky gut sounds like an unusual diagnosis, but it is more of a term used to describe what may be happening in many individuals experiencing the above listed conditions. Leaky gut is not the ONLY cause of these conditions, so please check with your physician for an accurate diagnosis.

So what is a gut?

The gut is usually another term used to describe the intestines. Naturally, the gut is permeable to tiny molecules. This permeability allows our body to absorb vital nutrients that we need to operate from day to day. The regulation of intestinal permeability to these vital nutrients is a natural function of the cells that line the intestinal wall. Although this seems like an easy process for cells to accomplish, there are often barriers that can stop the cells from doing their jobs.

Individuals with gluten sensitivity, often have gut cells that will begin to release zonulin, a protein that can break apart tight junctions in the intestinal lining. Gluten sensitivity is not the only culprit. Infections, toxins, stress and age can also cause tight junctions to break apart. Regardless of the reason, once the tight junctions are broken, leaky gut can occur.

The tight junctions are broken. What happens next and how does this affect us?

Leaky guy allows toxins, microbes, and undigested food particles to escape through the broken junctions which in turn, permit these substances to travel through the bloodstream to the rest of your body. This usually wouldn’t be an issue, except that each body is equipped with an immune system to protect us from foreign particles in the body. The escaped particles are marked as “foreign” by the immune system. Now the immune system will attack these substances in an attempt to protect us. This immune response can present in the ways listed at the beginning of this post.

Gluten is the main cause of leaky gut. There are other foods such as dairy, sugar, and excessive alcohol, which can contribute to leaky gut as well. Non-food related infections can also cause leaky gut, these include: candida overgrowth, intestinal parasites, and small intestine bacterial overgrowth (SIBO).

Can a leaky gut be fixed?

First, you need to remove the substances that are causing the leaky gut. Next, you will need to introduce substance/food to help your body heal. It is best to see a nutritionist or your physician to figure out the substances that are affecting you.