Tag: core health

The Adjustment

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What do chiropractors do, and how can we help you?

Chiropractors are experts of the spine. We go to school for a minimum of 3 years prior to being accepted into chiropractic college. From there, we go through a rigorous doctorate degree that encompasses many of the same core classes as a medical doctor as well as other specialized classes that have to do with the musculoskeletal system and how to adjust and align the spine.

Throughout that doctorate degree, we learn the specifics of how the brain talks with, and controls your body. Such as how your body has an inhibitory reflex when you touch a burning candle. Your body is equipped with an automatic draw reflex that makes you pull your hand away from the flame without consciously withdrawing your hand. We also learn how the individual vertebra move on one and other and how altered movement of those vertebra can cause pain, dysfunction, altered biomechanics and can also lead to an increased rate of joint degeneration.

When we talk about joint dysfunction (subluxation), we look at a joint that is fixated and that does not move independently from its adjacent segment. These fixations can be caused from stress, inflammation, trauma, repetitive movements and poor posture. When we have these subluxations, they can cause increased pain in the area of restriction, refer pain to another area of the body, it can cause increased muscle tension on surrounding muscles. The increase in muscle tension can be a protective mechanism in which the muscle tightness up because the joint feels vulnerable or it can be caused from a malposition of the spinal segment itself.  Altered spine motion can also alter your biomechanics (the way your body moves).

When your body is aligned and each segment is moving within its normal range. Our bodies have balance in the sense that there is no undo stress on any particular muscle or joint. When we develop these misalignments and fixations our bodies start to compensate for the subluxation. In the area of restriction there is likely be a segment of hypermobility above or below to compensate for the restricted segment or you may start to shift your weight to one side of your body more than the other to create a sense of balance.

You see the body is very smart and will do whatever it can to continue to function as normal as possible, but this often comes at the expense of another joint or part of your body. That is where we come in, as chiropractors we correct those areas of restriction and help to get the patient moving and pain free as best we can.

Each joint in out body has receptors that have various functions that provide feedback to the brain. These mechanoreceptors provide feedback on how much stretch is in each muscle surrounding the joint, the position of the joint in space which allows us to maintain balance and be able to move in space with coordination and balance. These receptors also send pain signals when they are irritated such as when there is lack of motion in a segment or the segment is subluxated. When we assess the joint and finds the restriction we are then able to apply a high velocity low amplitude (HVLA) adjustment to the segment in the direction of malposition or fixation to realign and create motion through the joint. The adjustment also sends feedback to the brain through the mechanoreceptors that tell the surrounding muscles to relax and also inhibits the pain receptors. The final outcome of a HVLA adjustment facilitates proper motion of individual segments, relaxation of surrounding musculature, improves biomechanics and ultimately leads to a decrease in pain.

So, if you have a back, there is a good chance that chiropractic care is going to help you.

-Daniel Hounjet, Core Health Intern

 

 

Listen Up!

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Auditory Acuity of self.

I’ve been around the health and fitness industry a long time, which means I’m getting old, but it has allowed me to personally commit all the mistakes I see patients come into the clinic with.   For the purposes of this article, let’s call the health, fitness, and food industries the wellness industry. The only constant about the wellness industry is that it’s always changing.  Information evolves, trends come and go, and maybe something we thought was “healthy” turns out to be false.  Your circumstances play a significant role in how you apply the information and methods available, which like the topic itself, is in a constant state of flux.

So how do we navigate this chaos?  Start by understanding that it’s a journey.   Be ready to try various methods of self-care, nutrition, and exercise knowing that you’re going to fail and frustrate yourself with things that have worked so well for others.  You’re not everyone and you have to find what works with for you AND your circumstances with wherever you are in your life at that time.   Don’t give up, keep trying new things, keep learning, keep discovering, and push on.

Now I could write a novel covering each of these industry topics, but I want to focus on exercise for this post and more specifically listening to your body.  I have been SO bad at this the past few years and it has been costly.   Low back pain, rib pain, knee pain, shoulder pain, neck pain, waking up every day with some sort of ache or pain and continuing to mindlessly train and push my body past its limits.   This affects how comfortable I am when I work, when I do recreational activity, and when I’m spending time with my kids.

Why? Unless you’re a professional athlete, isn’t the purpose of exercise and training to better your life outside the gym?  Aren’t we supposed to train to build ourselves up not break ourselves down?   Sure, there are going to be workouts and training sessions that push you to your limits and you’re going to be sore and beat up but that should be the exception, not the rule.   I wouldn’t want to see that go away and I don’t think it has to for you to still maintain an effective fitness routine, improve and push yourself to be a better version of your current self.    Intensity and pushing the limits is a critical part of any successful training program.  However, in my opinion, depending on your circumstances (sleep, stress, nutrition, self-care, age, recovery, etc) we must pick and choose our battles.

All too often I have a patient present after starting a new training program that they’ve been going 100mph at since day 1 and their body finally hits the brakes and things start to deteriorate.   Learning to decipher when your body is telling you to slow down because of mental fatigue vs physical fatigue can be tricky.   But if you’ve gone into training 4 days in a row, maxed out your heart rate every session, lifted as heavy as possible, ran as far and as hard as possible, done zero mobility, had no body work done, ate horribly, slept poorly, then chances are that is your nervous system telling you to take it easy.  The reason this warning is so critical is as the window of fatigue widens, so does the vulnerability for injury.   When it’s broken down it sounds like common sense, but when we are in the heat of the moment surrounded by peers and coaches we tend to push it all aside and go through the motions.

One approach that I’ve really been gravitating towards lately is identifying an intended stimulus prior to working out.  Before beginning I take stock on how I’m feeling and try to match my training stimulus to that.  How recovered do I feel?  Do I have any pain or stiffness? How did I eat this week/weekend? How much did or didn’t I sleep?   If the grading on all those questions are positive, then I may attack that workout with full intensity and really push it.    If I feel like I’m falling short on a few or all those topics, then I’ll scrap what was planned and reprogram for what I can handle.   If the scaling or changes you need to make is going to significantly change the workout in a class setting, then you may need to attend an open gym or workout from home that day.  Don’t put yourself in a situation where you’re going to succumb to peer pressure and put yourself at risk for injury or burnout.  But if you can make a few small modifications and still be in your class or group setting then go for it, you’re not going to be letting anyone down!

Start practicing this week.   Take stock of your overall wellness that day or week and come up with an intended stimulus for your training.  Quality movement is going to be the foundation for longevity and nothing derails a training program faster than injury.   I’m still learning from my mistakes and I’m looking forward to continuing my journey, now with more acuity to what my 33-year-old body is telling me.

 

Yours in Health,

Dr. Crane

Prehab for Runners

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Spring Into Running

By Daniel Hounjet, Intern, Core Health

As the snow melts and weather turns people are eager to get outside and start running.Because of the climate we live in many people either choose not to run in the winter or they run indoor on a treadmill. So, for the most part individuals who start running are not taking the necessary steps to prepare their bodies for the increased strain on the body and to prevent chronic injuries that come with an increased volume of running. The most common overuse and altered mechanics injuries that seem to plague runners include low back pain, shin splints, Iliotibial band (IT) syndrome, patellofemoral pain syndrome (runners knee) and plantar fasciitis.  I will provide you with a few recommendations to help prevent some of these issues.

The snow has melted, the streets are dry, the trees are blooming and you’re ready to get your running on… But wait, what is the first thing you should do before exercising? Warm up?! You’re absolutely right. A quick 5-minute warm up will go a long way in injury prevention. When we talk about warming up, we don’t want to go and do static stretches. Instead we want to increase blood flow to the body by increasing our heartrate and go through similar motions as when we’re running. Here are a few exercises that will help warm up properly.

-Butt kickers

-High knees

-Heel walk/Toe walk

-Lunges

 

Warmup

Each exercise should be done for 20-30 feet, 1-2 times. Once we’ve gone through these exercises it’s a good idea to do 2-3 short sprints to really get your HR up. Now that you’re ready to hit the road be sure that your starting with a distance and pace that is significantly below what you ended the previous season. Our bodies are highly adaptable to stresses placed upon it, so it important for injury prevention to slowly build back up to where you where the previous season. By slowly increasing our duration and intensity we are allowing our bodies to adapt to the stresses placed on our body, from the increased strain on our joint, our tendons and even to regain our oxygen capacity.

Cool Down

Our post run recovery is just as important as our preparation and the run itself. That is why there 3 aspects should be incorporated post run. First off, we want to slowly bring out heart-rate down. It may be difficult to do with our busy lives, but having a proper cool down will prevent blood from pooling in our extremities and the unwanted potential for dizziness and or loss of consciousness. Cooling down will also help flush out the metabolite (lactic acid) build up in your legs. Try walking or even a low intensity dynamic stretch will be great to slowly bring that HR back down. Once you’ve cooled down we want to stretch and or roll (foam roller, lacrosse ball etc.) the area that worked the most during the run; calves, lumbar musculature, hip flexors and gluteus maximus and medius. Here are a few stretches to consider.

-Pigeons stretch

-Lunge stretch

-standing calf stretch

-Hamstring stretch

-Stiff leg good mornings

 

Remember that these stretches and rolling these areas are for preventative measures and may not be the right stretches if you have altered body mechanics or are injured. If you suspect you have altered mechanics, (loss of mobility of a joint, hypermobility/ instability and/or loss of motor control) a good general tip to know, if there is an underlying issue and the pain or stiffness is only on one side of the body there is likely something that isn’t working the way it should. If you think you may have a compensation or would like to be evaluated consider seeking professional advice from a chiropractor or Physical therapist.

Advances in Functional Training Excerpt

 

Refueling

Lastly, we want to ensure we are refueling and replenishing lost nutrients. If you are running long distances with a duration greater than 90 minutes at moderate intensity it’s important to replenish our glycogen stores as they will be depleted after an intense distance run. That being said a balanced refuel is essential, consider 4:2:1 ratio of carbohydrates: protein: fat. We want to consume the carbohydrates to restore glycogen levels (glycogen is the muscles energy source for sustained activity). Protein to repair any damage to the muscle due to the increased intensity and lastly fats, which will slow digestion and allow for less of a blood sugar spike post workout. We also want to replenish any fluid losses. Water and a good electrolyte drink will go a long way in minimizing stiffness and soreness. If you are running for a shorter duration under 90 minutes, you are likely not depleting your glycogen stores. Therefore, rehydration and your regular diet will suffice. Research suggests that it is a myth that we need to consume protein within an hour post exercise, and that a balanced meal prior to activity will carry you through your run and even into your recovery. https://jcdfitness.com/2016/09/should-you-eat-fat-in-your-post-workout-meal/

Posterior Chain

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Are you working your butt off… literally?

The posterior chain muscles may be the most important group of muscles when it comes to daily performance as an athlete or an average Joe. The posterior chain of muscles in the hip include the glutes, hamstrings and the posterior core/para-spinals; and they are responsible for stabilizing and moving the hip and pelvis. They are often neglected in strength training causing muscular imbalance and anterior chain dominance, which can lead to low back pain and instability. So, if you have had some sort of low back pain, you are most likely not working your butt off as much as you thought.

Importance of Posterior Chain Muscles

When your hip joint and its muscles fail to function, your lumbar spine takes over movements that it shouldn’t which can cause low back pain. The glutes are often the most affected by the lack of hip mobility, often getting inhibited or unused. Posterior chain muscles are crucial to full functioning hips. Many Crossfit movements require powerful hips, which really means a powerful posterior chain. The power positions in the Olympic weightlifting movements, deadlifts, kettlebell swings, rowing, and even the push press all generate power from your hips. Without full functioning hip muscles, these movements will lack efficiency and cause pain.

How do I know if I have a weak posterior chain?

Along with pain there are some postural signs that can be seen that can help us identify weaknesses. One of these signs are an anterior pelvic tilt or lower cross syndrome (LCS). LCS can be seen in individuals with a hyperlordotic curve in their lumbar spine, which is caused by tight/over used anterior muscles (rectus femoris, iliopsoas, and abdominals) and weak/inhibited posterior chain muscles (hamstrings, glutes).

The Fix

Just like with UCS, we want to address the short muscles first then strengthen the weak. Stretching and mobilizing the rectus femoris and hip flexors (refer to Low Back Pain post). Next, we want to strengthen the posterior chain muscles. The main movement we want to get to activate all the posterior chain muscles is the hip hinge. This can be seen in exercises like the “Good Morning”, kettlebell swings and deadlifts. The combination of the stretching and strengthening will help take some tension off the anterior muscles, make the posterior muscles fire correctly and bring full mobility back into your hip joint and stability to your low back.

-Curtis Hoang

 

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Wrist Pain: Is it my Forearm?

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Walking into a crossfit gym for the first time can trigger a wide range of emotions. Excitement, anxiety and, potentially, mild regret as you stand there watching the current class splash in pools of their own sweat and release guttural noises while throwing heavy things in the air. You’re in too deep to leave, and so you make it through your first workout, exhausted yet invigorated. This is the typical story of the crossfit rookie. Regardless of fitness level, the beginner is new to many of the programmed movements and, in turn, will be adding many stresses to their body that have never been experienced before. Not only are the movements new, but so are the body aches and pains that accompany them. Wrist pain, shoulder impingement, IT band tightness, low back & upper trap pain are a few of the most common issues seen in the beginner WOD-er. In the following paragraphs, we will aim to explain more about the trials and tribulations of each of these issues and how you, a rookie or a seasoned vet, can work to prevent and treat them.

Wrist Pain

As a crossfit athlete, you are almost guaranteed an experience with some type of wrist pain. This could range from a mild ache post-workout to an uglier, chronic pain. Unfortunately, it’s the nature of the beast as the majority of functional movements performed in the crossfit setting require repetitive or prolonged wrist extension. Pushups, ring dips, front squats, cleans, thrusters, overhead squats, handstands. The list could go on. Performing these movements under load and in a fatigued state can push the joint into hyperextension and increase the potential for ligament sprains, muscle strains and cartilage tears. These are more of the severe injuries you could encounter, and they are actually located at the wrist joint. However, the type of pain that most people experience in their wrists is actually referred pain from the forearm. If you thought the list of exercises that put the wrist into loaded extension was long, start thinking of all the times you are required to grip something during a typical 60 minute crossfit class. Yeah. Almost the entire time. Holding on to a bar, a weight, a rope, a rowing handle. Cue Popeye forearms. Even if you don’t leave the box unable to grip your blender bottle and car keys, the repetitive use of these muscles class after class, without any stretching or treatment, is enough to elicit wrist pain. For the most part, people neglect caring for their forearms not because they’re lazy, but because they don’t even realize their forearm muscles are sore until a practitioner digs into them with a thumb or soft tissue tool. It’s pretty common to think that if a joint hurts, then the problem must be there! Often, it’s not, and this is especially true with wrist pain. At least once a week, be sure to show your forearms some love in at least one of the ways listed below.

Here are some ways to keep the forearms & wrists happy:

  • Wear wrist wraps! These are a low cost way to provide support to the joint & prevent wrist hyperextension
  • Strengthen the wrists by improving grip strength. Farmer carries, pinch grip weight carries, loaded barbell holds, and timed hangs from pull-up bar are all great ways to do this.
  • Stretch & roll-out the forearm compartments with a barbell after workouts
  • Have a practitioner perform active release or instrument assisted soft tissue work on the forearms

If you can relate to any of the following statements, your wrist pain may be due to a more serious issue. You should seek out a medical provider for an exam and diagnosis.

  • Stabbing, sharp, shooting pain at the wrist or hand
  • Hearing a snap or pop, followed by pain
  • Pain that doesn’t go away regardless of treatment or position
  • Bruising at the wrist or hand
  • Weak grip holding lighter objects like a coffee cup, or inability to grip a heavier object

 

Shoulder Impingement

Crossfit is notorious for high-rep overhead movements such as push press, overhead squats and handstand pushups. This can be great for the guns, but not so great for a shoulder that isn’t being mobilized properly after class or outside of the gym. Repetitive overhead movements without preventative shoulder care can put you at risk for shoulder impingement syndrome, an issue that causes inflammation and micro-tearing of the rotator cuff muscles. The tendons in the shoulder can then be pinched under the acromion process of the scapula, causing pain and limiting range of motion. The first step in preventing this problem is to ensure you are properly warmed up and increasing the load on the shoulder at an appropriate pace. Addition of weight to movements should be done gradually, and when choosing a weight for the WOD, a load that is suitable to your skill level should be used. If you’re not sure what you should use, ask your coach. At the same time, listen to your body, and if you begin to lose proper form or if movement becomes unstable, take a quick rest before continuing. The second way to prevent shoulder pain is to take care of them after class! Stretch & use a lacrosse ball on the muscles of the upper back, pecs and arms. Tightness in any of these regions can pull the shoulder out of ideal alignment. You should also work to strengthen the muscles of the rotator cuff to create resilience. Finally, see your chiropractor at least once a month to ensure your body is moving properly and have any soft tissue issues addressed.

  • Maintaining a proper, upright posture with shoulders back when sitting or working
  • Using proper technique when lifting or performing exercises
  • Strengthening the rotator cuff and upper back muscles
  • Stretching the anterior shoulder and chest, neck and back muscles
  • Regular chiropractic visits