This month the Chiropractors’ Association of Australia is using this year’s Spinal Health Week, held between the 23rd-29th of May, to remind all Australians that they don’t have to be sporting professionals to achieve peak performance. The main message that we as a profession are focussing on is that everyone can “Back Their Inner Athlete”, by improving spinal function, reducing pain, maintaining healthy posture and taking care of one’s general health. With the Olympics around the corner, Rio will host over 10,500 athletes from 206 countries, who are currently in intensive training to perform to their optimum. This year’s Spinal Health Week’s “Back Your Inner Athlete” campaign reminds all Australians that everyone can back their own inner athlete and perform to their peak by doing simple things. The 2016 campaign also aims to help Australians understand that chiropractors are there when they need them and that patients can live better with chiropractic care, which can assist with improving overall health. Whether this is for treatment of an injury, or purely for a check-up and to maintain mobility. According to the World Health Organisation (WHO), inactivity is a global public health problem. WHO has indicated that globally around 31% of adults aged 15 and over were insufficiently active in 2008 (men 28% and women 34%). In addition approximately 3.2 million deaths each year can be attributed to insufficient physical activity’1. The WHO has attributed overall physical inactivity partly due to insufficient participation in physical activity during leisure time and an increase in sedentary behaviour during occupational and domestic activities. Likewise, an increase in the use of "passive" modes of transport has also been associated with declining physical activity levels. Through the ‘Back Your Inner Athlete’ campaign, the Chiropractors’ Association of Australia would like to support the initiative of the WHO to achieve a voluntary global physical activity increase by 10% by 2025. How can you “Back your inner athlete. Just follow these three P’s, chiropractic care can help support you to Back Your Inner Athlete , which, in conjunction with a healthy lifestyle can help activate performance. Reduce Pain – ‘Chiropractic adjustments can help to reduce spinal related pain. In the western world, 80% of the population will experience disabling low back pain during their life. Back pain can be caused by poor posture, seating issues, ligamentous injury, incorrect lifting or even lack of exercise. Neck pain is the second most [...]
Recently I found a research paper conducted by a group of physiotherapists in America which compared the effectiveness of manipulation versus mobilisation and exercise for treatment of headache amongst a group of 110 people. The primary outcome measured in this study was the patient’s headache intensity. Patients were asked to complete a questionnaire to indicate the average intensity of their headache pain on a scale of 1-10 at the beginning of the study in addition to their intensity at 1-week, 1-month, and 3-months following the initial treatment session. Secondary outcome measures included a disability questionnaire, headache frequency, headache duration, and medication intake. On the initial visit patients completed all outcome measures then received the first treatment session. Patients completed 6–8 treatment sessions of either manipulation of the upper neck and upper back, or mobilization of the same areas combined with exercises over a 4 week period. The exact areas of the spine to be treated were left to the discretion of the treating therapist and it was based on the combination of patient reports and examination. The exercises given to the second group was neck flexion exercises during treatment, and 10 minutes take home resistance exercises using a resistance band within their own tolerance. This study is the first clinical trial to directly compare the effectiveness of both neck and upper back manipulation versus mobilisation and exercise in patients with headache. The results suggest 6–8 sessions of manipulation over 4 weeks, directed mainly to both the upper neck and upper back, resulted in greater improvements in all aspects of the patients headache than the mobilisation/exercise group. This included headache intensity, disability, headache frequency, headache duration, and medication intake. Most importantly the effects of manipulation were maintained at 3 months follow-up. Additionally there were no adverse reactions to either group aside from mild discomfort either at the point of manipulation/mobilisation or post exercise, which is completely normal in clinical practice. The underlying mechanisms as to why manipulation may have resulted in greater improvements than mobilisation plus exercise is still under investigation. In addition our current thinking about how manipulation affects patients positively in clinical practice delves into neurology far more deeply than what is possible in this column. More than likely it has something to do with joint receptors being stimulated which leads to pain reduction, greater range of motion and less muscle spasm. Fortunately in clinical practice patients will vote [...]
For this month’s column I found an interesting article online about spinal pain in adolescents and its relation to computer and tablet usage. This study was performed in Brazil, a country which due to government programs has seen a great increase in computer usage throughout all schools over the last 10 years. The use of electronic devices especially in more recent years has become an important part in the lives of adolescents throughout the world, who regularly use computers to carry out academic and leisure activities. The study consisted of 961 boys and girls aged 14–19 years who answered a questionnaire regarding the use of electronic devices and painful symptoms. Specifically these questions related to pain severity, a body diagram for symptom location, and questions related to the use of computer and video games over the last 6 months. The results indicated that the presence of pain was reported by 65.1% adolescents with pain located in the following areas. Thoracolumbar spine (point between the mid and low back), 46.9%.followed by Arm 20%. Neck 18.5% Shoulder blade region (15.8%) The triggering factors for these symptoms were reported as Using a computer 31.8% Physical exercise 20.5% Electronic games 2.9% Adolescents also indicated that pain interfered with activities of daily living like Study tasks 22.8% Sleeping 18.4% Playing sports 17.6% Additionally, 29.7% of adolescents said that the presence of pain made them more nervous. Finally and most importantly 32.1% of adolescents reported that they occasionally made use of analgesics, while another 11.1% reported that they frequently used these drugs. This study is important because it indicates how computer and tablet usage affects adolescents in our modern world. This study assessed a variety of important measures regarding adolescent health. Not only did it demonstrate the percentage of adolescents in pain but also reported on important measures like pain location, triggering factors, activities of daily living and medication usage. As younger generations are exposed to more technological advancement it will be interesting to see how we as a society adapt to these changes. Even now we are realizing that we have to take measures to either assist or limit computer and tablet use in our children. Balancing how much they have to do for school and leisure and supporting them with the best ergonomics possible is a challenge we all have to deal with. Silva GR, et al. Prevalence of musculoskeletal pain in adolescents [...]
I’ve discovered over the years especially before and after a gym workout that people will commonly use a foam roller to self-massage. This apparently has benefits to the individual and seems to be a way a person will manage muscle soreness pre and post workout. I’ve always been a bit sceptical about foam rolling as I never thought it really did anything beneficial and was more akin to stretching for the lazy. So I decided to look into whether there’s been any research into foam rolling and surprisingly there was, measuring different aspects of rolling, Ill discuss a couple below. The 3 studies that I’ll focus on today studied the benefits of rolling on the range of motion of a joint. Meaning after a workout was that joint able to move more as a result of the rolling. A few things stood out. The range of motion of the joint (hip extension) immediately increased after rolling the front of the thigh (quads) however these changes were short lived. When the patient was reassessed a week later there was no observable difference. Secondly in another study when foam rolling was performed along with stretching of the quads the range of motion in the hip joint was significantly greater than both rolling and stretching alone. This wasn’t just with the hip joint, there was another study that compared ankle motion. This study found that foam rolling of the calf alone did not produce any increase in ankle range of motion at all, where calf stretching improved the motion by 6.2%. However as with the hip example above, foam rolling plus stretching increased the range of motion by 9.1%. Studies into foam rolling are still in their early days, however there is some initial evidence that if you are going to roll, it’s important to stretch as well. The extra benefits from both stretching and rolling seem to exceed that of stretching or rolling alone. Also to make a bigger difference it’s important to roll and stretch regularly. You really should stretch and roll whenever you train even if it’s only 15 minutes and you focus on a different region each time. It’ll be more effective than rolling each muscle for 30 seconds then moving on. The long‐term benefits of these interventions are still unknown plus the physiological mechanisms responsible for these interesting findings still need more investigation. As for rolling to [...]
This month I’ll turn my attention to an article I found online researching the effects of acupuncture for the treatment of stomach pain. Even though this article focused on acupuncture, the results of this study help explain why other manual methods may produce beneficial results in patients. Acupuncture has been accepted to effectively treat pain related disorders by inserting needles into specific acupuncture points. Some practitioners connect these needles to an electrical current (electroacupuncture) or manipulate them by hand by twisting or turning motions. Pain, discomfort, and a sense of bloating in the upper abdomen were frequently reported by individuals with stomach disorders. In clinical practice patients will often describe an improvement in these disorders after completing a course of acupuncture. To cut a long and complicated article short, the authors placed a small balloon inside the stomach of an anesthetised rat. They also placed a probe into a part of the spinal cord which transmits pain signals to the brain, these pain signals were measured by the probe. To recreate stomach pain the scientists inflated the balloon by a small amount to distend the stomach and measured the electrical signals passing up the spinal cord. After inflating the balloon, an acupuncture needle was inserted into the right hind limb of the rat which corresponded to the acupuncture point for the stomach. After the needle was inserted a small electrical current was activated through the needle at different frequencies. The researchers discovered that when the balloon was inflated the pain signals through the spinal cord were elevated, indicating the rat was feeling pain. When the acupuncture needle was inserted and an electrical current was passed through it, the pain signals measured in the spinal cord significantly reduced. This demonstrated that application of electroacupuncture to the rats leg improved the rats stomach pain. This is important research as it demonstrates that electroacupuncture applied to a specific acupuncture point can reduce pain from an organ. This helps us understand the mechanisms behind how acupuncture reduces a patient’s pain. It also helps understand how other manual therapies like Chiropractic and Massage techniques can improve a patients pain levels and perceived general health.
For this month’s article I was inspired by a Halloween competition we ran at the clinic. The question was how many bones are there in the adult human body. The answer is 206. Additionally there is a network of other structures that connect the bones together, this system performs a number of vital functions such as giving the body its form, assisting with bodily movements and producing new blood cells. So this got me thinking what other interesting facts I could find about our skeletal system. The skeleton of a newborn baby has approximately 270 bones, which are a mixture of bones and cartilage. Over time, these additional bones in infants fuse in a process called ossification to form larger bones, reducing the overall number of bones to 206 by adulthood. Bones come in all shapes and sizes, and are not evenly distributed throughout the body. Each hand has 27 bones, and each foot has 26, which means that together the body's two hands and feet have 106 bones, which is more than half of the bones in your entire body. The hyoid, a horseshoe-shaped bone in the throat, is the only bone in the human body not connected to another bone. The hyoid works with the larynx and tongue to help create speech, interestingly Neanderthals are the only other species to have hyoids like humans, its presence has led scientists to speculate that the Neanderthals had complex speech patterns similar to modern humans. Bones are made of active, living cells. And like other cells in your body, the cells of your bones are susceptible to tumours. Modern humans and their relatives have dealt with tumours for thousands of years. In 2013, scientists found a tumour in a Neanderthal rib bone dating back 120,000 years. It is the oldest human tumour ever discovered. Organisms with a bony skeleton, Vertebrates, account for only 2 percent of all animal species on the planet. As our skeleton is so amazing, its best to look after it as well as we can as we age, don’t wait till a minor skeletal issue becomes a more severe problem, see a local CAA NT Chiro today.
Following on from last months column about bones, this month I thought I’d discuss some interesting facts about the spine. The spinal column has 3 very important functions. It supports the body’s weight, provides flexibility for movement and protects the spinal cord and the nerve roots from damage. As babies, we are born with 33 bones in our spine (vertebrae) but as adults we end up with 26. Four fuse to make our tailbone (coccyx) and five fuse to make the back of the pelvis (sacrum). The first vertebrae in our spine is called the Atlas. Atlas is a character from Greek mythology who, after losing a fight, was turned to stone and had to carry the weight of the Earth on his shoulders. This vertebrae were given his name as it carries the entire weight of the head. Around one quarter of the spine’s length is made up of fibrocartilage, this is due to presence of the intervertebral discs, which act as shock absorbers between our vertebrae. These discs expand in the absence of gravity, so as a result astronauts returning from space may be 1.5 to 2 inches taller than when they left. Gravity’s effect on these discs is also the cause of humans shrinking between a quarter to half an inch every decade after the age of 40. It also why we are generally taller in the morning than at night because of the daily effect of gravity upon the body. Four out of five adults will experience some type of spinal pain during their lifetime. Lower back pain is the most common type of spinal pain experienced. This is because the lower spine twists and bends more than any other part of our spine, it also bears the weight of our upper body. Sometimes back pain can be caused by other ailments in the body. Pain experienced in the middle of the back, which becomes worse after eating, may be a sign you have a stomach ulcer. And if you experience an intermittent back pain that reaches your groin, it could indicate you have kidney stones.
Last month I was part of a rehabilitation panel at the Safety institute of Australia conference in Darwin. Whenever I’m involved in a return to work case one of the major aspects of the patients care that I tend to focus on is ergonomics. Ergonomics is a very important aspect of a patients return to work program particularly when that patient’s condition is caused by sedentary posture, as with office workers. From a spinal perspective when an office worker is sitting for an extended period of time it does place a great deal of stress on the patient’s spine. So much, that after many hours a day this can produce stiffness and pain in the patient’s upper back and neck. If left untreated this can also lead to headache, arm or chest pain. For many years there has been a focus on providing a worker with the best chair possible in order to support the patient’s spine. However gradually I believe we are learning that no matter how ergonomic the chair is, when we sit down for many hours a day, it still leads to spinal complaints and other health problems. As a result there have been multiple studies that are looking at the benefit of how we can reduce the length of time office workers are sitting and how much energy they are expending. There have been different attempts over the last few years but the solution that seems to be most effective is a standing desk. Meaning that a worker can choose throughout the day whether to sit or stand depending on how they are feeling or what task they are performing. This ergonomic flexibility is a very effective way of assisting a worker manage their work and ergonomic demands. We as practitioners realise that all workers have repetitive strains placed upon their bodies and a lot of the time it’s just part of the job. However there may be simple ways to minimise these strains to help the worker function more effectively. Even though we need to make sure the patient is not sent back to work too early, improving patient ergonomics can mean a patient can return to work more quickly. In addition by improving ergonomics, it should make a permanent benefit so that the worker can continue to work effectively and minimise the chance of down time in the future.
5 Common Causes of Neck Pain. Neck pain can be acute or chronic but regardless, when you're in pain, relief is the first thing on your mind. Just as important as relief, of course, is finding the cause and ensuring you avoid the behaviour that brought the pain on in the first place. Poor Posture: Leaning over a desk all day or slouching in your office chair? You're bound to develop neck pain eventually. Monitor Fixation: Staring at the computer screen for hours at a time? That's not good for your spine, it places a great deal of strain on your upper back and neck and can produce neck pain, and headache. Sleep: Ideally, we spend a third of our life sleeping, so sleep can have a dramatic effect on your health. So don’t sleep on your stomach, try sleeping on your back or your side. If you need a new pillow try a contoured Chiropractic pillow to better support your head and neck. Technology: As a culture we are increasingly spending another third of our day typing, and texting. That can be especially bad for your neck, one doctor has even coined the phrase “text neck” the neck pain that results from constant interaction with technology. Random Movements: Twisting, turning, stretching and stressing your neck too much is an easy way to cause neck pain. While the joints and muscles in the neck are strong, they can be strained and sprained like any other tissue. It's important to note that beyond these common causes, various other health issues can also contribute to or directly cause neck pain. The good news is that a chiropractor can help identify which of these or the above causes is to blame. When people suffer from neck pain most people turn to a temporary solution first: pain-relieving medication. But that's not a permanent solution, of course, and it doesn't address the cause of the pain at all. Furthermore, research suggests chiropractic spinal manipulation is better than medication for relieving neck pain1. Suffering from neck pain? Then give your doctor of chiropractic a call. They'll help you relieve your pain and determine the cause. Williams CM et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet. 2014 Jul 23. [Epub ahead of print]
Cycling completely changes the weight distribution through your muscles and spine, and also bends the spine into an unnatural position. The neck in particular must compensate so that you can see where you are going. In a poor riding position this can be quite extreme; like standing and staring up into space for hours on end; it’s no wonder neck muscles can get tired and irritated. If you are experiencing a few niggles and aches on long rides, chances are they can easily be resolved with positional adjustments, long before they become a runaway problem. Thankfully the human body is extremely versatile and with consideration for position, through correct bike sizing and set-up, cycling should be a comfortable experience. It’s fairly clear that riding position directly affects the alignment of your neck and spine, in particular, your handlebar position and set-up is crucial. Making changes to your handlebar position to prevent or correct problems can be simple as alterations in this area are easily achieved. By taking your bike in for an assessment, changes can be made to the bike quickly and relatively cheaply with an almost immediate effect. A primary concern is excessive reach to the bars, causing the neck to be permanently ‘craned’ or hyper-extended. This can be a combination of not just how far the handlebars are from the saddle, but also how low down they are. Changes can be achieved by increasing the handle bar height by placing spacers beneath the stem to lift it up or by or altering the stem angle to give you more or less rise to achieve the optimum position. Lever position is also important, even with your handlebars in the right position there is still the question of where to position the levers. Positioning the brake levers slightly higher will encourage a more upright riding position, as you will spend a considerable amount of time riding with your hands here. To learn more, including exercises you can do to further prevent neck discomfort whilst riding from a Chiropractic viewpoint, follow the link on our Facebook site to the original article this column is based on.