“It Was Just a Fender-Bender”

Have you ever noticed that there are really only two types of auto accidents? There is the, “My car was smashed-I am lucky to be alive-wonder if they are going to total my car-I am hurting all over,” crash. And then, there is the, “It Was Just a Fender-Bender,” accident. You may be surprised, but the Fender-Bender where you just got a little neck pain and a slight headache may actually turn out to be the much more serious accident.

Let me explain. First, the physics of a motor vehicle accident. Force= Mass x Acceleration. Simply put, how hard something hits you is a combination of how big it is times how fast it is moving. If an object is small it can still hit you with a lot of force if it is moving rapidly. The classic example of that would be a bullet. If I throw it at you it wouldn’t do too much damage but when shot… Likewise, a large object doesn’t have to be moving very quickly to hit you with a lot of force.
Now, let’s talk about car design. Most automobiles made in the last 15-20 years were designed with collisions in mind. They are engineered to preserve life in a high speed crash and to preserve damage to the vehicle in a low speed collision. In a high speed collision, the car will crumple like an accordion to absorb the force. In low speeds the car is designed to withstand such force.
In any auto accident there is a transfer of force. The stiffer the object, the less it absorbs, so it transfers to the next softest thing. The softest structure in a car is a person. So, with high impact collisions the car will absorb most of the force but in a low impact collision it is the person in the vehicle that will. As a result, people who are in a minor collision can actually have worse soft tissue damage than someone in a really bad accident.
If you are ever in an auto accident, even if it seems like no big deal, I would highly encourage you to get and examination. Otherwise, what can happen is that joints that don’t heal properly can, over time, become dysfunctional which will lead to poor health and pain. I see people daily with necks that have been through a whiplash injury. At the time of the accident there wasn’t too much pain. Months to years later, much like erosion, degenerative change takes over complicating the healing ten fold.

Once You Start Chiropractic You Can NEVER Stop! Muaw, aw, aw, aw!

In your profession is there a comment or question you get asked a lot that just sets you off? For me it is someone trying to tell me that once you start chiropractic care you can never stop. It is so ridiculous that I often respond, “I once had a patient who quit and she died the next day.”

Seriously, what do people think is going to happen? The truth is that when you go through a course of treatment your body gets used to functioning properly. Over time, as you put wear and tear on your body, things start to become dysfuncitonal. When things are dysfunctional long enough it produces symptoms. To add insult to injury, when you have been adjusted and know what it is like to feel well, it is more obvious when things are not functioning.
I usually encourage patients to do a maintenance program after their functional correction program. This program consists of getting adjsusted on a regular basis to maintain function. When you become dysfunctional enough to feel symptoms the damage is already done. The art of maintaining is keeping things functional so that you don’t feel symptoms.
With this in mind, the real question is once you start chiropractic care, why would you want to stop?

“But Doc, It Feels So Good to Crack My Own Neck!”

Everybody knows that guy that pops his own neck. You know, the guy who is sitting by you who grabs his chin and yanks it from side to side waking up your co-worker or the sleeper in church who suddenly dreams they are being shot with a machine gun. Maybe you are that guy. If you are let me pass on some good advice. STOP!

First of all, you are annoying every one around you. Second, you are doing damage to the ligaments and joint capsules of your neck. 

Here is how it happens. When you get a hankering to pop your neck it is usually because one of the 33 joints in the neck is not moving as much as it wants to, which can cause inflammation, stiffness, and a decrease in proprioception (the sensation that tells us what the joint is doing).

When you try to get that joint moving using your chin as a long lever you apply a very non-specific shearing force to the entire neck which works as a unit. Under force the the most pliable joint will move and pop. Perpetual force over a period of time will cause the joint to be hypermobile.

Because the neck functions as a unit, to compensate for the hypermobility of one joint, other joints will become fixated or hypomobile. Joints that move too much or too little are dysfunctional joints and will degenerate quicker than properly functioning joints. 

Popping your own neck also creates a viscious cycle. You pop your neck because a joint isn’t moving. The joint you pop makes it feel better because of a natural endorphine release but those joints are not the ones that need to move. In fact, the joints that need to move become less mobile because they now have to compensate for the joints that move too much because you keep moving them. Also, the good feeling you get when you pop hypermobile joints only last a short while. 

In addition, the combination of overly hypermobile and hypomobile joints in the neck make it very difficult for your chiropractor to give a specific, effective adjustment because with overstretched ligaments it is very difficult to get the right tension to adjust the proper vertebra. 

So please, do yourself, everyone around you, and your chiropractor a favor and stop turning your neck into silly putty for a 30 second high and a cool sound. 

Have We Lost Our Minds Over a Virus?

Are you buying the hype of the Swine Virus? The media is completely outdoing themselves on this one and people are panicking like Chicken Little. I just heard that in Egypt, where there are no reported case, they just slaughtered thousand of, you guessed it, swine.

Please be rational about this. First of all, thousands of people die every year from ordinary viruses. So, it makes no sense to get worked up over a new one; they are all new. Second, we have an immune system for a reason. Keep yours in good working order and you will be fine even if you are exposed. Even if the virus gets a hold of you it will probably just feel like a bad flu. Take care of yourself and your body will fight it off better than any anti-virus medication.

And, if your immune system is compromised then wash your hands frequently and avoid crowded places. But please, stop stressing over this, it will only weaken your immune system.

“Stand Up Straight!” Part II – The Neck and Shoulders


Some could argue that good posture of the neck and shoulders is vital to your health. I agree! Most of the processes of life are controlled by the brain. Information then travels down through the spinal cord or through the cranial nerves. Either way, to get to the body it has to go through the neck somewhere. If there is not an efficient path then communication suffers.

As discussed in Part I, the outer part of the ear should line up with the middle of the shoulder. This has become so rare these days that you almost never see it. If you do, often times the only reason it is lined up is because the shoulders sit forward as well. If you go deeper (like on an x-ray) you should see a nice arc with the vertebrae neatly stacked on top of each other. The arc allows for maximum tensile strength and appropriate loading of the discs, ligament and muscles.

The head weighs about as much as a bowling ball so, in order to support the head all day long the neck should be underneath it. Generally, for every degree the head goes forward of the neck, you add an additional 10% more force. This is based on the pull of gravity and angles etc. With the head carrying forward the mechanical advantage of having an arc and the lever the muscles use start to lose ground. Pretty soon ligaments get overstretched and muscles are working much harder. There is also added pressure to the front of the vertebrae and decreased pressure on the back which creates imbalance. Imbalance leads to altered function which leads to altered nervous system flow which leads not only to poor coordination but also improper communication and disease.

Additionally, as the neck goes so go the shoulders. Shoulder injuries are one of the most common injury complaints. With shoulders you already sacrifice stability for mobility so if they are resting at an even less stable location (ie. rounded forward) then wear and tear is bound to happen. Furthermore, slumped shoulders can affect lung capacity and function. The last time I checked, most of us were already bad at breathing properly and I am pretty sure that oxygen is important to the body.

So what to do? First things first, in order to effectively improve posture, you have make sure that all of the joints are moving properly and coordinated together. Adjustments are very effective for this

Second, you have to stabilize the shoulder blades. The best way to do this is to pull the blades down and back while gently lifting the chest. This will stimulate the usually dormant postural muscles of the neck and upper back and relax the muscle that are carrying most of the work but shouldn’t.

Third, getting back the curve in the neck is tricky but important. I use what is referred to as a traction wedge my office. It is not very comfortable but allowing the head to hang over and edge with a tension band is effective in reshaping the neck.

Obviously, this is a process. It is usually not that effective to just try and stand up straighter. Nevertheless, with effort, results can be visible in less than a few weeks and long lasting results in less than 3 months.

Stay tuned for Part III where we discuss posture of the low back!

Stand Up Straight (Part I)

I know you have heard this from your mother at some point in your life even if you may not have said it to your kids, yet. Posture is becoming an increasing problem. I like to call it the de-evolution of man. You know the pictures where you see the monkey turning into cro-magnon man etc. until eventually walking upright like we are supposed to. Well imagine we add one more picture where we are hunched over a computer like a monkey.

Let me get one thing straight (no pun intended) before I stand on my soap box about posture (actually, I am not standing at all; I am lying on my couch typing on my laptop), I appreciate ergonomics as much as the next guy but there is no perfect position. We were designed to move! How we move and what we do when we are moving is what is important.

Let’s start deep, shall we? The spinal column from the side should be curved. There should be a nice arc with the apex at the front of the neck, another at the back of the mid back and another at the front of the low back. The shoulder joints (ball and socket or glenohumeral if you want to be technical) should rest slightly down and point out about 20 degrees. Likewise, the hips and knees should rest at a slight angle called the “Q angle.” The feet should then rest hips width apart point straight. This is the foundation. It is structurally sound and can carry the greatest load.

If the foundation is good then everything else will follow suit. Muscles will rest at their strongest point, ligaments will have less stress, joints will maintain acceptable pressure, and the intervertebral discs will be situated such that they are fairly even from front to back in resting position.

Ligaments hold joints together and muscles dictate motion with proper signals from the nerves. The problem is that trauma can cause weakness, nerve irritation, and muscle spasm (see earlier posts) and gravity can be considered a slow moving trauma. When you consistently place a strain on the above mentioned structures with gravity things start to change for the worse.

The ultimate resting posture looks like the picture with a straight line going through the ear, the shoulder, the hip, back of the knee and ankle. Stay tuned for more specifics on proper posture of the neck and shoulders, feet and legs, and the low back and core!

The Most Pressing Issues Regarding Healthcare!

I joined a group on LinkedIn for healthcare providers who want to discuss issues regarding health. The title of my blog is essentially one of the topics that was raised. It was interesting to read that most of the people discussed the issue of reimbursement for healthcare. My response was a lot different and set up in a way that hopefully, the others ranting about money will see the forest despite the trees. Here is my response:

In my humble opinion, the problem with so called healthcare today is that it is, in fact, rarely health care. I would argue that all of our healthcare problems are because we, as a society, focus on symptoms. This is true with the cause of disease and administrative woes. Although we are making strides towards some early detection studies we as patients, providers, administrators and insurers mostly give lip service to the underlying causes of disease. Instead, as patients we rarely give a thought towards our health unless there is a symptom bad enough to warrant an appointment with a doctor. Most doctors are not interested in seeing someone who does not have significant symptoms and administrators know that there is nothing to bill if there is no diagnosis based on symptoms and less if there is no medication or procedure that can be done. Symptoms, symptoms, symptoms and not how can I climb the ladder of improved health everyday of my life.

This focus on symptoms is perpetuated by the percieved notion that someone besides the individual is in charge of healthcare. Concern for one’s health should first and foremost rest on the shoulders of the individual. When there is a sincere desire to be healthy then the rest of us are there to show the way.

Today we argue about the fact that the government does too much or too little for healthcare. In addition, we blame insurers for not covering enough and doctors for being too busy to really help. This is all wrapped up in a ridulous sense of entitlement by individuals who, for the most part, have mostly themselves and their poor choices to blame. We assume people are not going to change so we have to change everything else to accomodate them.

Granted accidents happen and ill health is not always a function of unhealthy living, but if every individual felt responsible for his/her own health then the paradaigm completely shifts 180 degrees. In this scenario people reduce risky behavior because there is true risk involved. Loss of life, lifestyle and livlidhood is potentially on the line. They seek providers whom they trust can help in a manner that is cost effective and know that proactive healthy habits are also less expensive in the long run. If the majority of people thought and acted this way they would be healthier. Doctors would educate and coach and occasionally treat individuals with disease which would significantly decrease the taxing burden they bear. Insurance rates would be reasonable because fewer people would need to utilize the extreme measures to extend life that cost so much. In this way, insurance would be utilized as it is intended, to reduce the risk of losing everything in the face of an unfortunate circumstance; not benefits that we hope to use because we paid so much for them. Finally, the government would keep the hell out of the arena in which it has no business.

Complacency in the absence of symptoms and entitlement in the presence of is the disease of what we call healthcare today. Personal and individual responsibility to improve one’s health on a daily basis is the cure.

Venting

The title is meant to be a pun. If you have ever been in a hyperbaric chamber you will get the joke. I find humor a good way to calm down my anger towards idiocy.

I posted about the hyperbaric chamber yesterday and now I am going to vent about some mis-information out there. I operate a mild pressure chamber as opposed to a high pressure chamber. I went with the mild pressure because it does everything that a high pressure chamber does but was much cheaper to purchase and operate and much much safer.

I have gotten a few calls lately and it is very clear that there are some individuals with an interest involved saying that mild hyperbaric therapy has no value. They are obviously saying it loud enough that people are scared and need to be educated.

First of all, what makes hyperbaric therapy work is in the pressure that drives ambient oxygen (the oxygen in and around the body but not in the cells) into the cells. It is not in the oxygen you breath in. In fact, breathing in pure or concentrated oxygen only improves the treatment slightly. Secondly, pressure is pressure. The old riddle what weighs more a pound of feathers or a pound of lead applies here. The answer is they are the same. It doesn’t matter whether there is a soft wall (which is not so soft when it is pressurized) or a hard wall be glass, metal, or whatever.

The only difference between a high pressure chamber and a mild pressure chamber is in the name. High pressure chambers can go up to a much higher pressure than mild pressure. Since I am mostly interested in dealing with brain and nervous system healing and repair, which research has shown to be more beneficial at lower pressure and not 100% oxygen. In fact, the clinics working with kids on the Autistic Spectrum and other brain issues only go up to about 1.3 ATA. The chamber I operate goes up that high as well.

It drives me crazy that professionals are out there preaching that if a little is good a lot is much better when the research is pretty clear. For additional information check out this link to an article written by Julie Buckley, MD.