A few gardening tips!

Injuries from gardening is a common presentation to the clinic. We often fine with the changes in season, people come out to garden and do too much the first time after a long break.

Orchid
One of Neil’s Orchids at Mona Vale Chiropractic Centre

 

Gardening is a lot of repetitive movements, of which if not done correctly, could lead to injury. A few tips on ensuring a comfortable gardening session:

  •  Warm up! Walk and a few stretches before you start will ensure your body is ready to start an active session
  •  Reduce the amount of twisting – Twisting places an uneven strain on the muscles and joints. Make sure you squarely face whatever you are working on, this minimises the amount of twisting that can occur.
  •  Take regular breaks! Especially if you are just starting gardening after a long time off. Frequent breaks are a great way to minimise injury and let the body rest and recover. Every 15-20 minutes with a 5-minute break in between is a good start.
  •  Keep your elbows bent when digging – this reduce the amount of strain on the forearm muscles. If they are over worked too quickly tennis elbow can occur – a form of tendinopathy.
  •  Frequently switch sides when raking those autumn leaves, keep the knees and elbows both bent and make sure your grip is relaxed. Also, using a scissor stance is the most efficient technique.
  •  Kneeling on one knee is the best position for weeding
  •  Use your hips and legs when picking up pots – stand square on bend at the hips and knees while keeping your back straight (think hinging at the hips). Keep the pot as close to your body as possible and avoid twisting while holding it.
  •  Plant pots on a table, not the ground

The most important thing to remember is to pace yourself!

Mitchell Roberts – Chiropractor 

Ice or heat?

Ice or heat? Which is better?

I am often asked by patient which is best, ice or heat for an injury. The simple answer is that it depends on the type of injury and how long it has been there for.

Firstly, let’s see what impact ice and heat can have on the bodies tissues:

Ice:

  •  Decrease blood flow to an area
  •  Decrease swelling/inflammation
  •  Generalised numbing of an area
  •  Constrict/tighten muscles

Heat:

  •  Increase blood flow to an area
  •  Relaxation of tight muscles
  •  Increased movement/mobility

As you can see, ice and heat have opposite effects.

 

When to apply ice – Immediately  and up to 72 hours after an injury has occured, with the aim to reduce the pain and swelling. The most common areas being ankle, knee, wrist and shoulder. Use ice for a period of 20 minutes every 1-2 hours

When to apply heat:

  •  Chronic injuries – longer than 12 weeks
  •  Muscle or joint stiffness/tightness
  •  Osteoarthritic joints – warms the joint up, encourages blood flow to the area before moving
  •  Before exercise – especially that early morning golf tee-off

 

When not to apply ice – Onto burns or sensitive skin. Avoid using before or during exercise, as it may reduce the flexibility of a joint/muscle

When not to apply heat – On acute inflammation (swelling, redness or hot), open wounds and avoid using if you are diabetic.

If in doubt as to which one to use, ask your chiropractor!

 

 

Mitchell Roberts – Chiropractor

Updated low back pain treatment guidelines

One of the top medical journals – The Annals of Internal Medicine, has published a paper updating the guidelines for the treatment of low back pain. The paper is titled ‘Non invasive treatments for acute, subacute and chronic low back pain: A clinical practice guideline from the American College of Physicians” February 2017. The authors of the guidelines looked at studies of non-invasive (IE not surgical) interventions for treating acute, subacute and chronic low back pain.

It should be noted that acute pain lasts less than 4 weeks, subacute lasting between 4-12 weeks and chronic being pain lasting longer than 12 weeks.

The authors concluded that the following can help as a first line treatment (before taking medications) for acute/subacute low back pain:

  •  Heat
  •  Spinal manipulation
  •  Massage
  •  Acupuncture

Medication should only be considered if there has been no improvement. Patients should discuss the possibility of taking ibuprofen or muscle relaxants with their health care professional.

For chronic low back pain (lasting more than 12 weeks), the authors concluded that the following can help as a first line treatment:

  •  Exercise
  •  Rehabilitation
  •  Spinal manipulation
  •  Acupuncture
  •  Mindfulness based stress reduction – meditation

At Mona Vale Chiropractic Centre, we can use the above recommended techniques to assist and help relieve low back pain. Also, if you are not keen on having spinal manipulation, there are many other techniques that we can use to get the results you are after.

Click on the link to read the full article: http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

Mitchell Roberts – Chiropractor 

Chiropractic could save you $000’s in surgery for your dog

Beau came to me yesterday from Blacktown.  Beau was suffering complete loss of the use of his back legs.  Bowel actions plus urination had seemingly lost control.  He had no control of the tail and was not even able to wag the tail.
He possibly suffered a fall injuring a lumbar disc it seemed to be L 4/5 .
Beau had 2 visits to the Vet.  Surgery was recommended at a cost of $8,000 .The Blacktown vet Dr Russ Dickers suggested that Beau see a Chiropractor first.
Wendy and Billy, Beau’s owners drove to MONA  Vale to have a treatment .
On exam I observed an inability to walk and a loss of bowel control.  Motion palpating of the back revealed a lumbar disc lesion at L4/5 with a subluxation.  Acupuncture was done to the lumbar spine using bladder points and adjustments to the lumbar spine L5 and the RHS Psis which was P.I.  I also used cold laser to the lumbar spine.
Wendy reported Beau slept all the way home and on arrival at home he walked into the house and was wagging his tail.  I have recommended full rest, meaning no activity, and a follow up treatment on Saturday .

Sciatica

Sciatica is a common presentation to the chiropractor. We often hear a patient saying they have a ‘pinched nerve’, but sciatica is normally not that simple as there are a number of factors that can cause it.

We will start of with some simple anatomy – The sciatic nerve arises from several segments in the lower back, in the lumbar and sacral spine, joining together to form one big nerve which travels through the hip, buttock and all the way down to the toes, branching out as it goes.

sciatic-nerve

Symptoms are often varied, although the main one is pain down the leg, with the ‘classic’ sciatica causing pain in the calf and foot. Other symptoms can include pins and needles, numbness and weakness of the muscles. Very rarely, losing function of the bowel and bladder can occur, which requires urgent medical intervention.

Causes: There are a number of causes for sciatica, here are the most common ones:

  • Disc – A herniation or rupture to a disc can cause leakage of disc contents into the spinal canal and thus place pressure on the nerve. Furthermore, inflammation associated with the injury can also irritate the nerve.
  • Bony growths – These can narrow the canal of where the nerve exits the vertebral column, reudcing the amount of space for the nerve to exit
  • Piriformis syndrome – In a small percentage of individuals, the sciatic nerve passes through the middle of the piriformis muscle (gluteal region). When it is tight it can compress the nerve
  • Joint strain – Inflammation from a joint sprain can irritate the nerve
  • Spondylolistesis – A forward slippage of the vertebra which can compress the spinal cord or exiting nerves

Sciatica causes

Diagnosis – Here at Mona Vale Chiropractic Centre we will perform a thorough history and examination involving orthopaedic and neurological testing to come to a diagnosis. If we believe you require imaging such as x-ray or MRI this can be arranged and we will refer accordingly. Communication with your GP will also occur and if we feel chiropractic treatment is not appropriate for your condition, a referral to the appropriate healthcare professional will be done.

Treatment – There are a number of different treatment options, some of the ones we use include: Adjustments and mobilisations, muscle releases, dry needling, stretching and rehabilitation exercises. The treatment will be aimed to address the cause of the sciatica through improving movement, decreasing inflammation and strengthening surrounding muscles.

What can be done in the meantime for sciatica? Keep moving is the simple answer! Avoid aggravating movements such as bending,twisting and prolonged sitting. Moving encourages blood flow through the joints and muscles to reduce the chances of the lower back from tightening up. Heat is recommended if the injury has been longer than 24 hours.

Mitchell Roberts – Chiropractor

Lumbar Supports

Lumbar supports are a great idea for the office, car or airplane for that time when you know you will be sitting for an extended period. The good thing about lumbar supports is that you can use something simple – an inflatable lumbar cushion, a small pillow or even a rolled up jacket or towel.
The best position to place the support in is not the same for each individual, as it varies due to the curvature of your spine.The aim is to lengthen the muscles/tissues of the lumbar spine and try to feel that your spine is in a neutral position. Placing it directly onto your lower back may cause too much extension through the lumbar spine, so therefore start off by trying these 2 places:

  • At the bottom of your rib cage
  • Place it just below the belt line

Play around with the position of the support and vary it throughout the day. Also don’t forget to try it on the lounge at home for when you are watching television or reading!

Mitchell Roberts – Chiropractor 

 

Our sedentary lifestyle

When we think about it, we do sit a lot. From watching TV, driving to work, to using the computer in the workplace and then using our computer at home – we sit for a very long time each day. It is estimated we sit for around 10-15 hours per day.

seats

So, just how bad is all this sitting? It has often been termed that ‘Sitting is the new smoking’. Dr James Levine from the Mayo clinic in the USA suggests that there are over 34 chronic diseases that are associated with excess sitting. These include type 2 diabetes, heart disease and even cancer.

What happens to our body during prolonged sitting? Our metabolism slows due to our cells not needing as much energy, our blood sugar levels and blood pressure both increase. When we are not moving, our muscles are not contracting. When muscles contract, it forces the sugar in our blood to be forced into the muscles to provide a fuel source for contraction. This is the reason type II diabetes occurs – our muscles are not using up the sugar in our blood stream.

How to minimise our seating:

Keep moving at work:

  • Get up and move for 10 minutes of every hour
  • Stretch your back and legs often
  • Walk over to your colleagues instead of emailing or calling
  • Use the stairs
  • Use a standing desk
  • Conduct walking meetings

Reduce the number of hours we watch TV, use tablets/laptops!

Making frequent posture changes is very important. Prolonged sitting does encourage more rounded shoulders, an increase in thoracic kyphosis (ie, hunchback) and a forward head carriage posture (head positioned in front of the shoulders). Breaks as short as 1 minute can even help with posture, you just need to change your static position!

A quick postural exercise:

Brugger’s postural exercise – Start by sitting on the edge of your chair with your arms hanging by your side, palms facing forward. Now rolls your thumbs out and back. As you do this, try and get your shoulder blades to touch each other in the middle of your spine. Add in a chin tuck, by tucking the chin straight back.

bruggers-postural-relief

 

Hold this position for roughly 10 seconds and perform 2-3 times. You can perform this exercise as many times as you want throughout the day. Also don’t forget to include this into your routine of getting up out of the chair and moving!

Mitchell Roberts – Chiropractor 

 

 

 

Hamstring strains

At Mona Vale Chiropractic Centre, we treat more than just the spine. We see and treat daily things like ankles, knees, hips, shoulder and muscle/ligament injuries.

Hamstring strains are a very common injury we see in the clinic. There are many mechanisms as to how they occur, the most common being running, jumping and sports such as rugby, tennis and soccer.

The hamstring consists of three muscles located at the back of the thigh. Its function is to extend the hip and to bend the knee.

Hamstring-Muscles
The 3 muscles of the hamstring

Muscle overload is the main cause of a strain. This happens when the muscle is stretched beyond its capacity. There are several risk factors for hamstring strains:
• Previous hamstring strain
• Muscle imbalance (Quadriceps / hamstring ratio)
• Poor conditioning
• Muscle fatigue

Management and treatment of hamstring strains varies depending on the type of strain. A type 1 strain can take 1-4 weeks to heal, while a grade 3 tear (complete tear of the muscle) can take up to 6 months to heal.

Symptoms include a sharp & intense pain at the back of the thigh, some initial swelling, possible bruising/discolouration, weakness (especially with stairs/running) and stiffness.

Initial management should follow the RICE protocol – Rest, Ice, Compression and elevation. Following, chiropractic treatment can commence which will involve stretching and strengthening of the hamstring and surrounding muscles. Specific chiropractic adjustments are also used on the lower back and pelvis. Adjustments to this area can improve the biomechanics of running/walking and also ensure that correct muscle recruitment occurs. A rehabilitation program based on best available evidence will also be provided to ensure optimum strength and flexibility is obtained allowing for a return to play.

At Mona Vale Chiropractic Centre, we use a variety of treatment options – Adjustments, myofascial release, acupuncture / dry needling, instrument assisted soft tissue mobilisation (IASTM), ultrasound, kinesiotaping and Scenar.

Mitchell Roberts – Chiropractor

Instrument assisted soft tissue mobilisation (IASTM)

Instrument assisted soft tissue mobilisation is another form of treatment we use at Mona Vale Chiropractic Centre. It is a treatment involving using a stainless steel tool, such as the Edge Mobility Tool:
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The tool allows for the diagnosis and treatment of soft tissue injuries (Muscle, ligament, tendons and fascia). The tool effectively breaks down scar tissue and adhesion’s within the soft tissues. The tool causes a micro-trauma to the tissues, resulting in a local inflammatory response. This in turn results in an increased vascular response leading to a remodeling of the collagen fibre matrix and a reduction in scar tissue.
Studies have shown an increase in range of motion, strength and a decrease in pain following IASTM treatment. (Melham, 1997)

IASTM is very effective for:

  • Neck and back pain
  • Plantar fasciitis
  • Tennis elbow (lateral epicondylalgia)
  • Shoulder pain / Rotator cuff injuries
  • Knee pain
  • Ankle Pain
  • Shin splints

References:
Melham, TJ, Sevier, TL, Malnofski,fckLRMJ, Wilson, JK, and Helfst, RH, Chronic ankle pain and fibrosis successfully treated with a new non-invasive augmented soft tissue mobilization (ASTM): A case report.fckLRMed Sci Sports Exerc.fckLR1997;fckLR30:801-804

Mitchell Roberts – Chiropractor

 

Another Year, Another Christmas

Christmas is a wonderful time of year where we can see the family, take some time off and enjoy the summer. I’m not the only one who thinks that the most wonderful thing about an Aussie Christmas is a swim on Christmas Day.

As we all know, Christmas can take a toll on our bodies, affecting our spine and nervous system. Christmas is a mixed experience of over indulging in Christmas cheer as well as lugging heavy presents around – not to mention the stress of getting everything ready for the big day. Not suprising that Christmas is a stressful period on the body in many ways. Here are a few Christmas survival tips;

If you are planning on doing lots of physical things during the holidays like renovations or taming the garden, take it easy. Listen to your body for warning signs that indicate subluxations such as strains, reduced range of motion, stiffness pain and soreness.

Remember your posture and good lifting techniques while working around the house, garden and garage (bend your knees not your spine & be careful of any combined bending/twisting action).

Anxiety, stress and depression are very common during the festive season. Take time out for you and your family and enjoy. Whether this be a holiday, hobby or just potting around. This is all good for your health and wellbeing.

Get enough sleep. Plan for some mid-day naps or early nights to help you cope with the “silly season”

Watch the alcohol intake and don’t overdo it. Alcohol will dehydrate you and is a depressant which will have negative effects of tiredness. The same thing applies to too much food. Have a salad or just fruit for a few meals each week.

Keep moving, plan for some walks, swimming and gentle exercise. If you are looking forward to the annual game of golf, tennis of a surf, remember start slowly. If you haven’t done that activity for a while take it easy and don’t over do it.

Keep your spine adjusted and subluxation free. Have a Chiropractic treatment or enjoy a massage to make sure that you are well prepared for the Christmas season.

Have a wonderful Christmas and a joyful New Year
From all of us at Mona Vale Chiropractic Centre