I get asked quite frequently whether to use ice or heat on an aching joint. When in doubt, use ice but use it properly. I have outlined protocols for icing below. That is not to say that there are not times when heat is appropriate, but icing is almost always beneficial if done right, whereas heat can cause problems on a new or inflamed injury.
The rule of thumb is that if the injury is acute or new within the last 6 weeks or if it is an exacerbation of an injury, use ice. Heat is good for loosening up sore muscles and stiff joints. If you need to get things moving, heating for 20 minutes can be very therapeutic. Be careful though. If you heat an inflamed joint, it will feel better while it is on but the heat will increase the inflammation and not only cause more discomfort but also prolong your healing. As a precaution, I typically recommend using heat only if you are going to be moving around (ie. never before or during bedtime). If you are going to use heat before bed, follow it up with ice. That way you won’t wake up feeling like you were hit by a train.
Icing is not as simple as just putting something cold on you for a little while. If done properly, it can be extremely beneficial. If done improperly, it will have little to no benefit. So, here are the rules to using ice properly.
1. Cover the affected area. Not using enough ice will not drive the inflammation away enough to make it worth the pain of icing. A nice big ice pack for big areas like the back, legs, and arms is critical. Conversely, for feet and hands, an ice pack might not be good at all. I usually recommend an ice bucket if the body part fits. ***I will explain those protocols below.
2. Make sure the ice penetrates. Too often, people will put a bath towel between the ice pack and the affected area. Their excuse is usually that it is too cold. They are missing the point. It is supposed to be cold! You should only use a paper towel or thin t-shirt in between.
3. Let it go numb. If the area you are icing doesn’t get numb you really haven’t done it right. When icing you should feel it get cold which should then start to burn. (Be careful not to get an actual ice burn. On rare occasion, if the ice pack is too cold and it is up against sensitive skin it can burn the skin. This shouldn’t happen with most ice packs if you have a paper towel in-between.) After the burning feeling, the area should start to ache until it goes numb. Once it is numb, you are done!
4. Never ice longer than 20 minutes. After 20 minutes the body sends out a signal that the area is developing frostbite and will send more blood to the area. As icing helps to drive blood/inflammation away, sending more blood in is a bad thing. If after 20 minutes the area never got numb, take it off and wait 40 minutes to ice again.
5. Wait 40 minutes before you can ice again. Make sure the affected area is back to regular body temperature before you shock it again with ice.
***Ice Bucket Protocol: Use an ice bucket for ankles/feet and hands/wrists. This is by far the best way to drive out inflammation from these areas.
1. Get a bucket big enough.
2. Put as much ice in it that will cover your affected extremity.
3. Fill it with water to the same level.
4. Cover fingers or toes with a sock.
5. Immerse the extremity.
6. Keep it moving gently to keep the water immediately surrounding from warming up.
7. Ice until numb (usually around 5 minutes).
8. Repeat once the limb is back to body temperature.
1. Make sure you and the other driver are safe before getting out of the car. If you are in a busy intersection move out of harm’s way (if possible). Make sure you pull as far as you can to the side of the road.
2. Check for injuries. Most people don’t feel injured immediately after an auto accident because of the adrenaline rush. Be cautious. With every auto accident you are going to have an injury; the forces involved are just too great not to. If an ambulance comes, the EMT’s will check things out. They usually recommend you come with them. If you feel like you can drive home then tell them. If not, go. Better safe than sorry. It will be a pain to deal with the ambulance bill when it comes and your claim hasn’t been paid, but your health is worth the hassle
3. Exchange information. At minimum, you should get their name, telephone numbers, license plate and card numbers, and their insurance information. One of the more innovative things I would recommend besides writing down the above information is to take lots of pictures. Most cell phones these days have cameras. Take pictures of the accident but also take pictures of their driver’s license and insurance card.
4. Call the police. Do this just in case. Truth is, most of the time they just tell you to exchange information. It may not feel necessary to call but you never know. If you call and they can’t help you in time then call back later and file a police report. This will help protect you.
5. Inform your and the other driver’s insurance company. The quicker you get the ball rolling the easier it will be for you. There are two sides to an auto accident claim, the property damage and the bodily injury. The car they should fix quickly. Taking the time to see a doctor about the bodily injury before any decisions are made is important (will discuss next). If the accident was not your fault, you should still let your insurance company know. They can back you up if the other person is either under insured or just a pain to work with. You may also have Med-pay which is an extra writer that covers injuries regardless of who may be at fault.
6. See your chiropractor! Chances are you have some pain or discomfort. Even if you don’t have pain, get an exam. In every auto accident you are dealing with forces that cause tissue damage. Sometimes you don’t feel the problems until months later when weak scar tissue tears and starts the inflammation again. In addition, it is tough to argue with insurance companies unless you get checked out soon after the accident.
7. Ice. The protocol for icing should be 20 minutes maximum on the affected area. You want to feel the cold then burn then ache before it goes numb so only use a paper towel or thin t-shirt between your skin and the ice pack. NEVER USE HEAT after an auto accident. This will feel good while it is on but bring a lot more blood to the area and make the inflammation worse. Increased inflammation will slow down the healing process.
8. How should you pay for your care? This could be its own blog post but I will keep it short. If the accident was not your fault you shouldn’t have to pay anything out of pocket. I am happy to treat people on a lien until is settles. If it is your fault you either have to pay for it yourself or have Med-pay on your auto insurance policy. Besides Med-pay, if you are not at fault, retaining an attorney can save you a lot of hassle and stress and should help you get a little extra money for all the things you will have to deal with on your road to recovery.
9. Journal. The more information you have the better. Take note of your aches and pains, when you have to take pain meds, times when you get headaches, days/hours missed from work. One of the most important things you can document is what you cannot do anymore as a result of your injuries from the auto accident. Detail will help convince the insurance adjuster that your injuries are legitimate.
10. Get better. Healing takes time. It is a roller coaster ride that can be frustrating. Don’t stop treatment too early or it could come back and become chronic. Remember, a positive attitude goes a long way to healing.
I get asked on a daily basis which bed is the best. My honest answer is whichever bed provides the most support while allowing a comfortable night’s sleep. I also share that my best advice is to use the 90 day money back guarantee. I know that this sounds like a cheeky answer but finding the right bed can be tough. You don’t want to invest your time and money into a bed that is going to cause harm. By the same token, it can take 30 days or more to really figure out if your new bed is going to work. That saying, knowing where to begin in helpful. Here are some key points to consider:
1. Keeping the spine in neutral is the most important thing you can do. Beds that are too soft typically let your pelvis sink which can cause low back problems. Conversely, beds that are too firm will push too hard on the shoulders and hips, causing discomfort that can keep you from a well rested sleep. A good bed will help distribute the weight making it more comfortable while keeping your spine in neutral.
2. Your body type will determine what type of bed you need. The less dense a person is, the less support is needed so a soft bed can be ok. In addition, if you have large hips you may need a little more cushion to be comfortable and keep your back in neutral. Same goes for broad shoulders.
3. How you sleep makes a difference. Side sleepers typically need a little softer bed because their shoulders and hips are the major points of contact. Back sleepers should choose a more firm mattress to help support the more distributed pressure. Stomach sleepers should learn to sleep on their side or back after age 5.
After taking your body type into consideration, now you have to find the right mattress. Mattresses are very well designed these days with lots of options that can help even the playing field. This is especially true if you and your spouse have different needs. Here are your options for beds:
1. Innerspring mattresses are the most common. Spring count is the trick here. The more, typically the better the bed. A good spring mattress can work out great for you. It can also break down quickly and sag in high pressure areas.
2. Memory foam is the latest trend but a good one. Memory foam conforms to the body which is soft but provides good support. It can be an excellent choice but some do complain of feeling too hot or feeling like they feel a little trapped. These mattresses are very durable.
3. Latex mattresses are very similar to memory foam in terms of support and durability but spring back a little quicker so there isn’t that trapped feeling. They also seem to be a little better if feeling hot is a problem.
4. Air mattresses (not the kind you suffer on when you visit your family) have some major advantages. A good air bed will have several air chambers and will be adjustable. This is especially good with vastly different body types. The downside, of course, is that there is a possibility of it leaking.
5. Water beds have come a long way. In the past, I would have said avoid anything that can leak. Now, it is possible to get a good water bed that gives good support. Unfortunately, very few people will do well with a water bed and they are a much bigger hassle to return.
If you are in the market for a new mattress you should check out my friend, Christine’s blog, “From Date to Diapers.” She has a contest where she has teamed up with Sealy to give away a free mattress set. These mattresses have a great track record and lots of options to fit your needs.
The final thing to consider about a bed is that your issues might not be with your bed but with your back. If your spine isn’t functioning well, a good bed might help but chances are you just need to restore the function. Of course, I am happy to help with that, too!
It’s the last day of the year and people are starting to come up with New Year’s resolutions. I would venture to say that at least one resolution you have involves your health in some way. Let me give you 10 good reasons chiropractic should be included in your action plan.
1. Chiropractic helps control pain. Pain is a great de-motivator/distraction. When you get adjusted, you not only get an endorphine release but you also close down the nerve pathways that cause pain. This will allow you to work out with less pain.
2. Chiropractic improves joint function. Working out on joints that are not working properly can create worse problems.
3. Chiropractic improves balance. Balance is very important to good health. Getting adjusted regularly helps improve your balance. This is closely associated with proprioception which was the topic of the previous post.
4. Chiropractic will help improve your posture which will help you look and feel your best. Correcting the posture of the low back will especially help decrease the “pooch.”
5. Chiropractic improves nerve flow to the vital organs. When your organs are working properly your body will be healthier. This is especially true for the organs that deal with elimination of waste like the gut, the kidneys and the liver. When you get the gunk out you will be healthier. This is especially true after binging since Halloween.:)
6. Chiropractic improves hormone function. The thyroid gland controls metabolism and is critical to good health. In addition, balancing estrogen, testosterone, progesterone, etc. can make a huge difference in your energy.
7. Chiropractic is good for your feet. When you make that resolution to go running and your feet are killing you, we can help adjust the foot or do some soft tissue work to get you back out there.
8. Chiropractic can increase your lung capacity. When you get adjusted it allows the joints of and around the rib cage to be well lubricated and move freely. This allows proper inhalation and exhalation. Good breathing equals more oxygen which leads to more efficient cells and better health.
9. Chiropractic can help your sinuses. When you feel like you cannot breathe because the cold you caught just before Christmas just won’t go away, come in for some cranial adjusting and experience what it’s like to breathe through your nose again.
10. Chiropractic restores the body’s ability the work, heal, and function properly!
There you have it! 10 good reasons you should include chiropractic care in your goal to be healthier. See you soon!
Proprioception has to do with coordination and position sense. Try this experiment. Close your eyes and touch the tip of your nose with your fingertip. Were you able to do it? The highest number of nerve receptors that sense movement are in the neck, hands, and feet. All joints, however, have their fair share. The better these receptors work, the better the body can respond.
Let me give you an example. If a person sprains his or her ankle, they are more likely to sprain it again and again. This happens because the ligaments are weak but more importantly because with injury the proprioceptors become dull. It doesn’t have to be an injury either. Posture changes proprioceptors, as well.
The danger of having dulled proprioceptors is a much broader topic than you probably want to delve into at this time. Suffice it to say that if your proprioceptors are not working well, you leave yourself very susceptible to injury. Likewise, pain sensation travels on the same nerve fibers so pain increases as proprioception decreases and vice versa.
The trick to getting these proprioceptors to wake up? Get the joint moving. Lack of motion or improper motion scrambles the receptors. Proper stimulation through movement, improves their function. Chiropractic adjustments and activities that challenge us physically both in strength and coordination are the best ways I can think of to accomplish this goal.
It is quite the conundrum when you are trying to strengthen your core to decrease your risk of low back injury and you find that you have hurt your low back. This crunch, when done correctly, is very safe and very effective!
I was talking with a patient last week who had just come from her oncologist. To help with the side effects of chemotherapy and to help fight off the cancer cells, she has been doing hour long sessions in my hyperbaric chamber 2-3 times per week. Her energy has been remarkable during chemo. Very little fatigue. One would never know she even had cancer and was on chemo. By the way, she is in her late 70’s.
Two of the most, if not the most, important spinal stabilizing muscles of the back are the quadratus lumbori. (quadratus lumborum singular or QL). This exercise is the most difficult of the 4 stabilization exercises but is extremely beneficial.