The Cost of Waiting

Abraham Lincoln once said, “You cannot escape the responsibility of tomorrow by evading it today.” The same is true for addressing your health concerns. Several times each day I have patients come in who tell me they have been hurting for days, weeks, months, or even years. The story is usually that they just thought it would get better on its own but it never did. Inevitably, they express their remorse at waiting to come in.

The truth is that with any injury, the body starts the healing process immediately. The concern is whether you will heal correctly. The body will compensate in whichever way it can to stabilize. If muscles are tight or ligaments are overstretched, it will alter the proper movement of joints. Such improper movement causes the nervous system to become confused and ultimately desensitized. Consequently, the body will lay down scar tissue that will promote the new and improper movement patterns which leaves the body susceptible to reinjury or to injury of surrounding tissue.

As a chiropractor, if I can help move the joints in a proper manner before inflammation and scar tissue sets in, then the healing process is a much easier ordeal. If you wait until scar tissue repair has set in when you come in to see me, the first step will be for me to tear down most of that process so the healing can start over. As with remodeling kitchens, the demolition can be ugly. The old adage of getting worse before it gets better is often in play and can lead to a few days of discomfort.

Another caveat to waiting is establishing movement patterns that can be difficult to retrain. Old habits are harder to change than simply making new ones in a fresh environment. Chronic conditions can take years to correct for this very reason. Muscles and joints have memory locked in to the nervous system. In my experience, it typically takes around three months of consistent treatment to change that memory.

Finally, with altered movement, the the body will degenerate quicker. At a joint level that means that tissues will dry up and bone spurs will form. Once a bone spur has formed, everything changes. No amount of adjusting, taking supplements, acupuncture, or whatever is going to remove that. Tissues can be rehydrated but they are never as good as they used to be. This is mortality. However, we can help slow down the degenerative process. At the end of the day, if we just improve the function it is worth it.

All conditions will change over time. The body will strive to compensate but that compensation can lead to issues down the road. If you have an injury or if dysfunction has been brewing for too long, get in! Better yet, come consistently and do your best to maintain good health and function.

 

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How Do I Know If My Chiropractic Treatments Are Helping?

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One of the most fulfilling yet difficult aspects of my career is helping people navigate their journey to better health. Healing is a process that can take a lot of time. We tend to think of that process as a straight road from disease or injury to health but that is the exception rather than the rule. Often, things feel worse before they feel better and there are always plateaus and valleys. Helping patients to have faith in the process and continue care inspite of bumps in the road is a worthy challenge.

Everyone comes into the office with disfunction. Not all disfunction is symptomatic but it all has potential to become so. Sometimes people come in with symptoms that are just starting to show but during further examination, I discover that those symptoms are just the tip of a very large disfunctional iceberg. I know that when I start chipping away at the disfuntion below the surface it is going to make those symtoms much more obvious. This can be very alarming. In addition, symptoms can change or move locations. People who are more prone to worry, often need a lot of reassurance to stay the course. There are several signs and symptoms that may cause concern but are actually indicative of progress. Most of these happen in early stages of care.

Pain will often increase with increased movement. Adjustments are designed to move joints that have been stuck or moving improperly for some time. Getting them to move again can cause pain. It is not always pleasant but it is a necessary step. As a rule, the pain should be more of an ache or soreness. Furthermore, pain can centralize and therefore increase in intensity. Centralized pain, or pain that is focalizing on the disfunctional joint, is usually more painful than a broad spread out pain. In this phenomenon, the pain is going back to where it belongs which is a very positive step. The closer your symptoms are to the structure that is actually causing the symptoms, the better the body will be at promoting healing in that area.

Symptoms often change especially when nerves are involved. If a nerve is significantly injured, the worst thing is complete numbness with zero sensation. There is actually no pain. When we lessen the irritation, the sensation is one of pins and needles and achiness. This can be followed by soreness. These symptoms will wax and wane for some time before a complete recovery.

Another change that can happen that will cause a patient mental anguish is when a symptom switches sides. We often see this is disc related injuries. This is not necessarily a bad thing either. It tells me that the disc is not completely stuck in one bulging position and can change or, even better, that it has not degenerated to the point of no return. The ability to change means it can heal.

I find it much better to not focus on symptoms but to look at movement patterns, muscle tone, and inflammation. If range of motion is improving and muscles are calming down, then progress is being made, and it is only a matter of consistency and time before symptoms start to go away for long stretches of time. When people ask if they are getting better, or complain that they are not any better, when I know they are, I usually ask them how they feel after an adjustment. More often than not, they feel significantly better but it just does not last as long as they think it should. As we get better, we also tend to forget how bad the pain was. The contrast of any pain when you have experienced little to no pain promotes the idea that one is not improving. Perspective is the key.

If you feel like chiropractic is not helping you, please take a step back and consider the big picture before you cut your care short, thus nullifying all of the hard work you and your doctor have done to help you become functional again.

 

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Even If I Want to, I Cannot Help Everyone. Neither Can Chiropractic.

The great Aristotle once wrote that “The more you know, the more you know you do not know.” For me, the more experience I gain, the more I realize my limitations. People who know me well, know that I do not lack confidence. I try not to be arrogant but I do my best to assure myself that I can be a force for good in this world. That saying, I must confess that no matter how much I may want to make everyone better, there are just some people that I cannot help.

Recently, I had a patient come in that I hadn’t seen in a couple of years. She did not come in for an adjustment. She came in to explain why I couldn’t help her. You see, back then I gave her several adjustments which provided little to no relief and then she started heading south so she discontinued care. As a doctor, that is the most helpless feeling. It is made significantly worse when there is no explanation why. In her case, she was born with a birth defect called a Chiari Malformation where the lower part of the brain drops below the skull. This can lead to a syringomelia, a pocket of fluid in the spinal cord which can be very painful and dangerous. Anyway, this was never mentioned in her MRI report from years earlier. The neuro/spine specialist that she saw some time after seeing me saw it on the MRI. This little bit of information explained everything. I am grateful she came in and shared that with me.

There will always be conditions that are too far advanced for me to help. I don’t like it, but that is the way it is. We do not always know when a condition is beyond help until after we have tried. I have had many patients with serious back pain come in and ask if I can help. As a chiropractor, I know I can adjust them. In most cases, this will help in the healing process. At the very least, it is a conservative start. Most patients get better and we can manage. Others do not. I have recommended MRI’s and surgery when it is beyond my help. For the most part, those patients have seen good results and have come back to me for care after their surgeries.

Finally, there are people who either do not really want to be helped or have unrealistic expectations of how long and what it will take to heal. Healing takes time and effort. One adjustment can make a big difference in how a patient feels but it does not mean that their injury has healed. Consistent care is tentamount to healing properly. Likewise, just because there is still pain, it does not mean that injury is not healing. Pain can be tricky and is not a very good indicator of the level of damage.

In short, I sleep at night knowing that I do my best to help others live healthier lives. There are always challenges and there will be people that despite my knowledge, skills, and determination, I cannot help. For those people, I am sorry. I feel bad for you and hope there is some one out there with the answers and approach to help you in your journey.

What Makes a Comfortable Adjustment?

When a chiropractor adjusts a person, the goal is to get joints moving properly. Because we are talking about movement, the force equation comes into play: Force = Mass x Acceleration. So, in order to adjust, a chiropractor needs mass and acceleration. If there is not enough mass, they need enough acceleration and vice versa. In general, the greater the acceleration, the more comfortable the adjustment.

There are a number of reasons a quick adjustment is preferable. Most people guard to some degree when getting adjusted. It is a natural response. Guarding only gets worse when someone tries to increase the force by increasing mass because the body is aware of the force. Along those same lines, an adjustment when someone is guarding doesn’t always move the joints thoroughly enough which leads to an unsatisfied feeling that there is still something not moving correctly. In addition, the  nerve sensors of a joint, known as the proprioceptors, need to be stimulated to get the full benefit of an adjustment. The only way to do that is with a quick movement of the joint.

Everybody is different in how they interpret comfort. Some like a firm touch others gentle. Some like to hear the cracking sound and some do not. Regardless of preference, thorough movement of joints is critical for a proper adjustment. Whether the speed is achieved through skilled hands, an adjusting tool like the Activator, or a drop table, the quicker the movement, the less mass and the less trauma on the body.

Strengtheining the Core Through Coordination

When we talk about “the core” of the body, we are typically referencing the musculature around the abdomen and low back. These muscles consist of the abdominal muscles (rectus abdomini,  internal obliques, external obliques, and transversi) and the muscles of the back (lattisimus dorsi, serratus posterior inferior muscles, erector spinae, multifidi, interspinalis muscles, lateral intertransversi muscles, quadratus lumborum, and to some degree the iliopsoas).

Strengthening the core has become a fairly popular mantra these days. Many of us are walking around with poor posture and a fair amount of dysfunction as a result of poor core stability. A weak core leaves one susceptible to a host of joint and disc injuries as well as overly tight butt and leg and muscles. In contrast, a strong core can prevent a host of back injuries.

The word strength, however, needs some clarification in the context of strengthening the core. When most people think of strengthening muscles, they picture muscles moving against  significant resistance like lifting weights or power movement against gravity or some other force. These type of exercises can actually be detrimental to the core muscle and increase the risk of injury to the spine. Coordinating the movement of all of these muscle is what is most beneficial.

I mentioned in my last article that postural muscles are slow twitch, white fiber muscles designed for endurance. They need to be strong enough to hold you up all day. Strength in this case does not come from bigger muscle fibers but from having all of the muscle firing in a controlled and proper order. For example, if you lift a box, ideally your abdominal muscle and your spinal muscle would contract at the same time to stabilize the body so the shoulder and arms and hips and leg muscles can utilize their power to lift it. What often happens is that core muscle lay dormant until a significant strain forces is to respond. So, when you lift a box, you first engage your back muscles until you are upright then, if you go past vertical, the abdominal muscles will engage. Then, they will fire back and forth while they try to find a semblance of stability.

I bring this all to your attention to encourage you to strengthen your core appropriately. Exercises that promote coordinated movement like yoga, pilates, and modified exercises from yoga can make a huge difference. It can take time to build coordination  and it takes a consistent effort. In the following videos I demonstrate four very useful exercises for coordinating core muscles and therefore, strengthening it.

Cat/Cow

Bird Dog

A Safe Crunch

Side Bridge

Concussions

While listening to sports talk radio the other day, the topic of Sidney Crosby came up. For those who don’t know, Sid the Kid has been one of the best, if not the best, player in professional hockey since he was drafted by the Pittsburgh Penguins into the NHL in 2005. He won a gold metal for Canada at the last Winter Olympics in Vancouver and the Stanley Cup in 2009. However, no one is talking about Sid’s accomplishments right now. His career is in jeopardy due to a concussion he sustained back in the 2010-2011 season that has kept him sidelined for all but a few games where he tried to come back only to have his symptoms return.

Anyone who has played hockey or any other physical sport has at least seen someone get a concussion. It doesn’t take much. Football has tried to make safer helmets and create rules that severely penalize hits to the head. Prevention is noble but if you ask anyone who has played sports, it is going to happen no matter how cautious. The more important question to me is how to treat it when it does happen. Time and avoiding another blow to the head are the recommendations these days. I think there is more we can do.

The brain, by all accounts, is a slow healer. As a pattern, tissue that has a limited or controlled blood supply is difficult to heal. Blood and brain tissue has to be controlled because blood is very toxic to nervous tissue hence the poor healing capacity. The reason blood is important in healing is because oxygen is a necessary component to healing. Oxygen is needed to burn the fuel in the form of glucose to give the cells energy to repair itself.

If more oxygen to the brain is the solution, then we have an effective remedy: hyperbaric therapy. In a hyperbaric chamber pressure is used to help oxygen saturate into the liquids of the body and can therefore easily cross the cell membrane and be used by the cell. In the brain this is especially effective because it also allows oxygen to cross the blood/brain barrier that is an extra protection for the brain and other nerves. More oxygen will allow the brain to actually heal.

Now, I realize that most people have not have ever heard of a hyperbaric chamber let alone know where to find one. Doesn’t it make sense, though, with all of the concern about concussions that we push for a treatment with a track record of success?

Thomas Chiropractic, Roseville Food Drive!

Where: Thomas Chiropractic, Roseville 720 Sunrise Ave., Suite B-104

When: Monday, March 7th until Thursday, March 17th

-Bring in non-perishable food for the Placer County Food Bank

-Receive a FREE First Visit (exam, x-rays, 1st adjustment)

-For New Patients only, please. Call 780-1370, today!

It’s a win, win, win. New, patients, bring food for the Placer County Food Bank and receive a free first visit that includes everything from the exam, x-rays (if needed), and first adjustment. This help the new patients with their health, helps feed the community, and brings joy to all involved!

Thomas Chiropractic Patient Appreciation Day!

When: Saturday, March 12th from 10:00 am until 2:00 pm

Where: Thomas Chiropractic Roseville, 720 Sunrise Ave., Suite B-104

-FREE Adjustments

-FREE Mini-massages

-Great Food

Thank you to all my loyal patients and friends who have entrusted me with their health in regards to chiropractic care. As my thanks, please join me Saturday, March 12th from 10:00 am until 2:00 pm for our semi-annual Patient Appreciation Day. Get adjusted and sign up for a mini massage. Enjoy the some great food. Everyone is invited to attend. Prospective patients can come and meet me and the staff and enjoy the festivities.

How to Safely Stretch Your Hamstrings

Tight hamstrings can cause low back dysfunction and low back dysfunction can cause tight hamstrings. Either way, they need to be stretched daily. The trick is to hold for at least 30 seconds. This video demonstrates the proper technique.