Momentum of Healing

It is always interesting when a new patient who has never seen a chiropractor before,  and knows very little about it, asks what it will take to get better. When I explain that we are going to start off adjusting them three times a week, their eyes usually get very big and the eventual question is, “Why so often?” My answer is always the same, because you need consistency and momentum to heal.

Healing can be like climbing up a sand hill. When you first start out, the sand is the thickest and you are very prone to getting stuck or sliding back down. Likewise, if you are not concentrating on healing correctly, you can start going sideways and waste a lot of energy but not get anywhere. Heading in the right direction with enough momentum to gain traction is the only way.

Getting adjusted three times a week in the beginning of care provides the momentum necessary to progress up the sandy hill of healing. A little higher up on that hill it does not take as much energy so twice a week is sufficient to keep healing. However, stopping or slowing too much can make it difficult to get started again and complete the healing process.

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 muscles and increase the risk of injury to the spine. Coordinating the movement of all of these muscles 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 muscles 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 muscles lay dormant until a significant strain forces them 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

Photo by bruce mars on Unsplash

A Frank Discussion with Your Medical Doctor

The purpose of this blog post is in no way to belittle or degrade the medical profession. My best friend is a medical doctor and I have several friends whom I admire and respect who are medical doctors. Furthermore, I have many medical doctors who refer patients to me on a consistent basis. No, this article is for those medical doctors who refuse to educate themselves on the benefits of alternative health care. Lately I have had a few medical doctors tell our mutual patients that they should not get adjusted anymore. Every single one of them cited arthritis as the reason why they should discontinue care with me. I hope this article will educate you as a patient of such physicians and maybe even influence some of them to do some research.

First of all, arthritis is a very generic term. Medical doctors routinely use it for any ache or pain in a joint. Most of the time calling it arthritis is technically true but over simplistic. It seems to me like they use it liberally because they do not want to explain what is really going on. Arthritis means is inflammation in a joint. It can be caused by auto-immune conditions like Rheumatoid or Lupus but more often it is caused by wear and tear. This is rarely explained to a patient so I am going to.

When doctors tell you that you have arthritis, most of the time what they are saying is that they can see signs of degeneration on your x-rays. Examples of degeneration are decreased joint space, bone spurs and misalignment. Essentially, instead of seeing nicely aligned joints with smooth edges, they see jagged edges with varying degrees of misalignment. This happens over time. How quickly is determined by how dysfunctional the joint is. The more dysfunctional the quicker it degenerates. Dysfunction of a joint means it is either not moving properly or not moving at all.

In the spine, the vertebrae have discs that can degenerate. Usually, this is associated with a disc herniation or bulge. Degeneration in the spine can lead to stenosis or narrowing of the openings where the nerve roots travel. Spinal degeneration or arthritis can come in varying degrees and complications. I am very aware of the risks involved with adjusting a highly degenerative spine.

Let me repeat that. I am very aware of the risks of adjusting a spine that has arthritis or degeneration! I also know the benefits. For this reason, I am very frustrated with these MD’s who are telling my patients to stop. Do they think I am unaware of my patient’s condition? Do they believe that I have no regard for my patient’s health? To be honest, I don’t believe they consider this, at all. I see fear derived from ignorance.

The truth is that an adjustment of a degenerating joint can be very beneficial. Retraining the joints to move properly can decrease inflammation and increase the nerve flow to that area which will at the very least slow down the degenerating process. Increased function will lead to improvement to the health of the joint. Are there risks? Of course. There are risks to everything. I believe the greatest risk is doing nothing. It is certainly the most predictable risk.

Trusting in your chiropractor to know when to adjust or not is important. Communication is the key! If you have a condition and you are unsure of your chiropractors awareness of it, express your concern. On that same note, avoid taking advice from people who don’t know. They shouldn’t be making recommendations about things of which they are ignorant. That doesn’t seem to be stopping some of them. If you stopped chiropractic care because your MD told you to, but have’t discussed it with your chiropractor, its time to have a frank and open discussion with all the parties involved, OK?

Pregnancy and Chiropractic

First of all, yes, it is completely safe to receive chiropractic adjustments when you are pregnant even at 9 months. In fact, it can be very beneficial. Shoot, my wife’s OBGYN is my top referring MD. Why? Because when his patients are suffering from the ravages of pregnancy, all he can do is be a sympathetic ear or recommend Tylenol. He knows that chiropractic care is safe and can help manage his patients symptom where options are limited.

For those who are unaware, pregnancy can be really hard on a body. For the record, when we men argue that we are the tougher of the two genders, women can always trump the argument by simply mentioning pregnancy and child birth. Trust me, no man is tough enough to withstand. Add to that list the duties of motherhood and it is game, set, match. During pregnancy the fetus becomes top priority. This means that the body will compensate and adjust to keep the baby viable. Nutrients needed will be taken from whatever source available. In addition, the shape, weight, posture, and the mechanics of the body, especially the core, change and adapt for the growing baby. Combine that with the production of the hormone relaxin which softens up all of the joints to allow the baby to be birthed, and the potential for dysfunction is inevitable.

Getting chiropractic adjustments during pregnancy helps the body cope with all of those changes. When joints and ligaments become lax, the muscles tighten to compensate. This alters the mechanics. The adjustment helps restore the body’s mechanics and therefore reduces the secondary and tertiary responses like muscle spasms. Proper function will make it easier to carry and deliver the baby and will also help joints maintain coordination which positively affects the nervous system. Properly functioning nerves will promote better health, in general. A classic example of this is managing heartburn. When my wife was pregnant with our 2nd child, she had terrible heartburn. We found that adjustments were much more effective than antacids in controlling it because of the connection between the nerve roots in the midback that go to the esophagus.

Chiropractic care during pregnancy is not just effective for low back pain relief and heartburn, it is also helpful in treating tension headaches, foot pain, hip pain, mid back pain and tightness, shoulder soreness, constipation, and much more.

Keep in mind that predicting a schedule for treatment during pregnancy is impossible. The body changes too fast. Some women need chiropractic adjustments every so often and others may need an adjustment several times a week. The key is to keep things functioning as best we can and not let it get bad.

Finally, during pregnancy the body does not heal as well. If you are pregnant and experience trauma or just have a traumatic pregnancy, be patient. It will take time after the delivery to heal up properly. If you are adjusted during pregnancy and again after delivery, your healing time will improve dramatically.

It’s Not All About Pain, People!

Pardon my rant for moment and please consider what I am about to say. Pain is a symptom or an indicator. Pain is annoying. Pain can be frustrating. Pain can even be debilitating. Treating for pain, however, is a terrible way help someone get out of pain.

The origins of pain are not well understood and can be a very deep topic. That saying, from my study, most of our pain is distributed through the limbic center of the brain. The limbic system is really the emotional center of the brain. So, to me, pain is an emotional response. Ever notice that some people have a high pain threshold and others have little to none? Likewise, some cultures are very stoic about pain while others are extremely passionate. The very same stimulus can be applied but the reaction is completely different.

Don’t get me wrong. Pain is very real. I am not suggesting we write off anyone in pain with the idea that it is all in their head. What I am suggesting is that we keep pain in perspective. Bad pain does not always mean horrible damage. Likewise, some of the most serious damage to the human body can display very little pain. Furthermore, pain can be a good thing when it gives a warning that something can be harmful. Have you ever stepped on hot sand and immediately pulled away so you didn’t burn your feet? What if you were a diabetic with poor blood circulation and therefor poor feeling in your feet. Would you say that it was a good thing to burn your feet because you couldn’t feel it? Of course not!

Rather than focus on the pain of an injury, I like to focus on the rehabilitation or function. If we only treated for pain, very few people would ever recover. Rehabilitating an injury whether chronic or acute can be painful. Let me say that again, TREATMENT CAN BE PAINFUL!  Sometimes we have to break down a lot of scar tissue. This will be painful. When you are dealing with functional and physical medicine, like chiropractic, the end result is to get you functional which will eventually lead to less pain. By the way, this takes time.

Please don’t kid yourself that you can rehabilitate an injury without pain or discomfort. It is just not how the body works. Would you expect to work with a personal trainer to get in shape and never feel soreness or fatigue? Instead, focus on improving function and accept pain for what it is. In the words of the Dred Pirate Roberts aka Westley from The Princess Bride, -“Life is pain, your highness. Anyone who tells you differently is selling something.”

“It’s Never Just a Muscle!”

Back Pain

I hear it just about everyday. I don’t know how or why people think it. There is no known conspiracy about it. It may be because it is the only explanation people can think of. It drives me crazy and takes all of my energy to control my emotions when I hear, “I think it’s just a muscle.”

Let me explain why it is never just a muscle when you are talking about back and neck pain. The muscles in the back and neck are slow twitch muscle fibers. They are designed for endurance. They are not fast twitch, speed muscles. In addition, there are three layers of muscles with a ton of overlap amongst the muscles of each layer. For this reason, it is nearly impossible to tear or “pull” one of these muscle without doing damage to a much more susceptible structure first. 

The most common tissue to receive damage in the spine is the disc which can bulge, herniate, mishape, and swell when over worked or over loaded. Then there are the joints and ligaments of the spine which will sprain long before a postural muscle reaches tearing status. Finally, you have the nerve roots which if irritated even slightly will cause a muscle spasm which essentially protects the muscle. Herein lies the issue. 

When a muscle spasms it can be a lot more painful and noticeable than the underlying cause. Don’t be fooled. Muscles don’t just decide to spasm on their own. It is a protective measure. 

There can be occasions where a muscle due to overuse, usually because of postural strains, will form a knot (the technical term being a trigger point). When this happens it is commonly like asking, “which came first the chicken or the egg.” If there is a trigger point it will immediately affect the joints, discs, and nerves. There will also be a good argument that the trigger point only developed because of a lack of motion or subluxation of the joints. Either way, it is never just a muscle. 

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