Understanding High Blood Pressure

blood pressure tracker

For most people one of the most stress inducing things that happens in any doctor’s office is the taking of blood pressure. You can tell yourself to relax, breathe easy and envision yourself on a beach, but the truth of the matter is you are at a doctor’s appointment for one reason or another having your health evaluated. What is the most concerning is that a lot of people aren’t exactly sure what the numbers mean or where they come from. In this article we will be going over how to understand blood pressure readings, why it matters, understanding your risks, and new research on how to lower that high blood pressure and improve quality of life.

Understanding High Blood Pressure

Blood Pressure– is a ratio of systolic over diastolic and is measured in millimeters of mercury, mmHg.

Systolic– is the top number of the ratio and is the higher of the two. It measures the pressure of the body’s arteries when the heart muscle contracts.

Diastolic– is the bottom number of the ratio and is the lower of the two. It measures the pressure of the body’s arteries between heartbeats, aka contractions, so this is when the heart muscle is relaxed.

The systolic, or top number is the more important of the two and usually slowly increases with age after 50, due to stiffness of arteries, plaque buildup etc.

Blood Pressure Chart

blood_pressure_chart_AHA

(taken from American Heart Association website heart.org)

Blood pressure should be taken at least once every two years, even if it is around normal, and more frequently if it is higher. The numbers change in a person minute to minute due to the time of day, exercise, stress, lack of sleep, posture, and the food one has eaten! If your blood pressure is higher than desired, your doctor might monitor it on a consistent basis and/or have you keep track of it frequently at home. Even if your blood pressure is normal, it is always a good idea to develop healthy lifestyle habits to help prevent high blood pressure (HBP).

High blood pressure is known as “the silent killer” because there can be no signs or symptoms of it. If untreated, consequences of HBP (but not symptoms) may include:

  • damage to the heart and coronary arteries
  • stroke
  • kidney damage
  • vision loss and damage
  • memory loss
  • fluid in the lungs
  • angina
  • peripheral artery disease

Risk factors that can contribute to hypertension, also known as high blood pressure, include:

  • family history
  • advanced age
  • lack of physical activity
  • poor diet, especially one that includes too much salt
  • being overweight or obese
  • drinking too much alcohol (binge drinking, ie 3-5 alcoholic drinks in one sitting)

Contributing factors to high blood pressure include:

  • stress
  • smoking and secondhand smoke
  • sleep apnea

Recent research from the National Institutes of Health has shown that being more aggressive in the treatment of high blood pressure, can significantly lower a person’s rate of cardiovascular disease. Until recently, it was recommended by the American Heart Association that the systolic pressure should be less than 140 mmHg for most adults to be out of the high blood pressure or hypertension category. This new research found that decreasing the systolic number to 120 mmHg and below reduces the risk of death of cardiovascular disease by 43%.

In 2013, 360,000 deaths were associated with or directly related to high blood pressure. About 80 million, or one in three American adults have HBP which puts them at a much higher risk of heart attack, stroke, kidney failure and other serious health problems.New research from Tulane University School of Public Health and Tropical Medicine, found that patients age 75 and older benefited even more from this lowering of the systolic blood pressure than the younger age group. However, one unfortunate side effect in some patients in the aggressively treated group with medication, is acute kidney failure. Even with the immediate push for a lowering of the systolic BP, experts all agree that the best way to go about it is a thorough lifestyle change and not rely on drugs alone.

Here are a few lifestyle interventions to aid in the process of lowering HBP and keeping it within the goal range of systolic 120 mmHg or below:

  • HBP Medication
  • Weight Reduction
  • Exercise (2.5 hours per week of moderate exercise: jogging, swimming, walking etc.)
  • Reduce salt intake (only 3 or 4 grams per day)
  • Eat more fruits and vegetables (4-6 servings per day)
  • Snack on dark chocolate (antioxidants in cocoa, called flavanols, can help dilate arteries)
  • Reduce alcohol intake (maximum drinks per day:one for women and two for men)
  • Meditate

The US National Institutes of Health has created what is known as the DASH diet plan (dashdiet.org) in order to lower blood pressure without medication, and also subsequently aid in weight loss. Through copious amounts of research, DASH is a strict eating plan that is rich in vegetables and fruit, low-fat and nonfat dairy products, along with beans, nuts, and seeds. The snacks and meals are balanced with both fiber filled foods (fruits and vegetables) along with food that is protein-rich and/or contain heart healthy fats (nuts, seeds, avocado, fatty fish) that aid in offsetting hunger. A decrease in high blood pressure was achieved by decreasing the amount of “empty carbs” (pasta, bread, rice, sweets, ice cream, candy etc.) consumed and replacing them with heart healthy fats and/or protein. By doing so, the diet provides more key nutrients which includes: potassium, calcium, and magnesium, which all contribute naturally to lowering blood pressure.

 

Resources:

 

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp#.Vs3IevkrLIU “No-Smoking Confidence Assessment and Tips.” Understanding Blood Pressure Readings. American HEart Association. N.p., 18 Dec. 2015. Web. 24 Feb. 2016.

 

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Why-Blood-Pressure-Matters_UCM_002051_Article.jsp#.Vs3JOvkrLIU

“Why Blood Pressure Matters.” Why Blood Pressure Matters. American Heart Association. N.p., 13 Aug. 2014. Web. 24 Feb. 2016.

 

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/Understand-Your-Risk-for-High-Blood-Pressure_UCM_002052_Article.jsp#.Vs3KGvkrLIU

“Understand Your Risk for High Blood Pressure.” Understand Your Risk for High Blood Pressure. American Heart Association, 18 Dec. 2015. Web. 02 Mar. 2016.

 

http://blog.heart.org/more-aggressive-treatment-of-high-blood-pressure-saves-lives-in-study/

“More Aggressive Treatment of High Blood Pressure Saves Lives in Study – News on Heart.org.” News on Heartorg. American Heart Association, 09 Nov. 2015. Web. 02 Mar. 2016.

 

http://www.cnn.com/2015/11/12/health/blood-pressure-control-and-hypertension/

Goldschmidt, Debra, and Carina Storrs. “High Blood Pressure Control Improving; What Else to Do.” CNN. Cable News Network, 12 Nov. 2015. Web. 24 Feb. 2016.

 

http://dashdiet.org/what_is_the_dash_diet.asp

Heller, Marla. “What Is the DASH Diet?” What Is the DASH Diet? N.p., n.d. Web. 02 Mar. 2016.

Foam Roller: Tips and Techniques

Foam Roller Tips and Techniques: Upper Back, Shoulder, and Chest

Benefits of using a foam roller is comparable to a deep tissue massage, myofascial release and myofascial trigger point therapy.Myofascial trigger points are taut bands or knots in the muscle tissue that can refer pain to other areas. Trigger points can also limit range-of-motion, inhibit muscle strength and cause muscle fatigue. Regular work can increase flexibility and performance while decreasing muscle tension and pain.

Maximize the effectiveness of the foam roller by incorporating it into your daily stretching routine. Use the roller before and after activity, and always roll before you stretch. This will help to warm up cold muscles and prepare them for deeper stretching.

Make sure you roll on soft tissue and not over joints, ligaments, or bony protrusions. Start by placing your body on a roller and slowly roll up and down the muscle. If you find a knot or tight band, hold that spot and try to feel the tissue release and soften underneath the pressure. Take deep breaths and try to keep your body relaxed as possible.

Use of the foam roller can be painful. If an area is too painful to roll, place your body on the roller for 15 seconds before moving on to the next spot. As the tissue starts to loosen up you should be able to roll with less pain.


Thoracic Spine

019Position the roller so that it’s inline with your spine, knees bent with feet flat on the floor. Make sure that it is supporting you from your tailbone all the way up to the back of your head so that you can relax everything during the exercise.

Hold this position for 15-90 seconds as long as it is comfortable and does not cause pain.

To target the the postural muscles on the right side, roll your body to the left, keeping your spine parallel to the roller, and stop on the muscles that run along the length of your spine. Hold for 15-90 seconds and allow yourself to relax. Repeat on the left side.

 Pectoralis

028Lie with your spine inline with the foam roller. Again, be sure to keep your head and hips supported on the roller. While keeping your knees bent and feet flat on the floor for balance, place your arms directly out to the side so you make a “T” with your body.

The more advanced version of this 029stretch is to have your upper arms on the floor perpendicular to your body and elbows bent at a 90 degree angle up and pointing above the head. Hold for 15-90 seconds.

 

 

 

 

Upper Back (rhomboids, middle trapezius, thoracic spine)

022Lie with the foam roller perpendicular to your body under the upper back. place your hands across your chest or behind your head with your elbows drawn in slightly toward midline- this allows for cervical spine support as well as letting your shoulder blades separate. If able, move body up and down a few inches at a time to target trigger points. Hold for 15-90 seconds as long as it is comfortable and does not cause pain.

Lateral Upper Back (latissimus dorsi, teres major)

026Lie on the left side with the foam roller perpendicular to the body and slightly below the armpit. Lean back slightly and extend the left arm out with your palm facing forward. Hold for 15-90 seconds. Repeat on right side.

To get an additional spot, try angling your body (as seen in picture 2) to assist in getting more of the teres/latissimus region

027

Mid Back (rhomboids)

024Lie with foam roller perpendicular to your body and across the shoulder blades, arms crossed on chest. Turn slight to the right about 40-45 degrees or until the roller rest between the shoulder blade and spine. Once positioned, slowly roll your body up and down an inch or two in either direction along the rhomboid. Hold for 15-90 seconds. Repeat on opposite side of body.

Stop in the office to pick up your foam roller today! (802)655-0354

Reference: Foam Roller Techniques, OPTP, 2008, Michael Fredericson, MD, Terri Lyn S. Yamamoto, PhD, Mark Fadil, CMT, p. 15, 17, 23.

 

Headaches Are a Real Pain (in the neck)?

Image

Headaches Are a Real Pain (in the neck)?

When we experience a headache, the focus tends to be on alleviating symptoms directly within the head but many times the source of the pain may actually originate in the neck.

There are 7 vertebrae that make up the neck (cervical spine) and 8 sets of nerves that exit this part of the spine.  These nerves innervate various parts of the head, neck, shoulders, arms and hands.  The uppermost spinal segments, C1-C2-C3, share nerve tracts with the cranium.  The brain lacks the ability to define the precise location of pain when coming from the neck. This is why the brain usually mistakes upper cervical spine pain as a headache.

Muscle tension can come from emotional or physical stress.  Physical stress such as spinal misalignment of the neck or sitting for long periods at a computer, gripping a telephone between the shoulder and ear or driving in heavy traffic are all activities that can lead to muscle tension, resulting in headaches.

The most common type of headache is the tension headache.  Approximately 80-90 % of the U.S. population suffers from tension headaches at some point in their lives.  The International Headache Society recognizes and classifies two types of tension headaches:  Episodic, which occur less than 15 days per month and Chronic which occur more than 15 days per month for 6 months or more.  Both types are pressing “band-like” (non-pulsating) in nature.  The pain location is bilateral at the base of the head or forehead.  The pain may cause modification of activity but is usually not incapacitating.  Causative factors include abnormal posture, muscular tightness, joint stiffness, general stress, and lack of sleep.

Head pain originating from the cervical spine is known as a cervicogenic headache.  The pain may radiate to the forehead, temple, eyes or ears and it is aggravated by neck movements of sustained postures.  A person will typically exhibit reduced neck range of motion, one-sided neck, shoulder or arm pain and tightness/contracture of neck and shoulder muscles.

Approximately 15% of the population suffers from migraines.  These can be far more debilitating than the tension-type headaches.  Many times, migraine sufferers report some sort of trigger that initiates their headache (food, drink, smell).  Consuming vasoactive foods such as coffee, alcohol, preservatives, monosodium glutamate (MSG) dialates the blood vessels within the skull resulting in headache pain.  There may be a hormonal component as more women than men are affected by migraines.  Stress, lack of sleep, missing meals or rapid changes in blood sugar can also be triggering factors.

The nature of pain is usually moderate to severe throbbing or pulsatile, one-sided and localized in the frontal, temporal and/or eye area.  80% of migraine sufferers experience nausea while 20% report visual disturbances such as hazy or shimmering light patterns in their field of vision.  Paresthesias (numbness) in the arm, hand, or face occurs in 40% of cases.  Duration is usually several hours to a day or more.

Cluster type headaches are defined by recurrent, brief (5 minutes to 3 hrs.) attacks of sudden, severe, one-sided, overall head pain, described as “excruciating, piercing and deep”.  The frequency of attacks can occur every other day up to 8 times per day.  A typical cluster lasts 2 weeks to 3 months.  Triggers include stress, relaxation, extreme temperatures, glare, allergic congestion.  Some speculated causes are hormonal influences disrupting circadian rhythm, serotonin metabolism, and histamine receptors.

Dysfunctional patterns of movement and posture affect how much tension and stress the body holds.  Chiropractic care helps to restore proper spinal alignment, joint range of motion and reduce abnormal stressors by normalizing muscle tension.

Proper breathing is essential to relaxation, blood flow and oxygen supply to the brain and body.  Headache sufferers tend to breathe more from their chest and shoulders as opposed to their diaphragm.  This leads to increased tension in the head and neck due to repeated elevation of the shoulders and upper back muscles.  Chiropractic spinal adjustments increase proper function of the spine, ribs, and hips to maximize breathing and postural control.

At our practice, we incorporate specific myofascial release and trigger point therapy which aims at reducing contracted musculature in the neck, shoulders and back, decreasing the tension on the cervical spine.  Chiropractic adjustments applied to the joints of the neck, especially in the upper cervical spine, work well for headaches of all types.   Often, the most effective treatment for headaches is the combination of both spinal manipulation and myofascial release to the involved musculature.

If you are suffering from headaches, let us help determine the cause of your pain.  Call our office today!  802-655-0354

References:

Biondi, David M. DO, The Journal of the Osteopathic Association, Cervicogenic Headache:  A Review of Diagnostic and Treatment Strategies.  http://www.jaoa.org/content/105/4_suppl/16S.full

Chapman-Smith LL.B. (Hons.), David.  September 2010 Vol. 24 No. 5:
http://www.chiro.org/LINKS/ABSTRACTS/Cervicogenic_Headache_Revisited.shtml

Cornell University http://www.biog1105-1106.org/demos/105/unit10/muscles.html, accessed 6/27/2012.

Kamhi, Lawrence M., MD, FIPP.  Neck Pain and Headaches.   Treating Cervicogenic Headaches.  http://www.spineuniverse.com/blogs/kamhi/neck-pain-headaches, submitted on March 17th, 2010.

McCrory DC , Penzien DB et al. Evidence report: Behavioral and Physical Treatments for Tension-Type and Cervicogenic Headache Des Moines, Iowa, Foundation for Chiropractic Education and Research.  2001.

Nickelston, Perry, DC, FMS, SFMA.  A Drug-Free Way to Treat Headaches:  Chiropractic CareTo Your Health, April 2012 (Vol. 06, Issue 04)

Vizniak, Nikita A.,DC, Carnes, Michael A., DC  Conditions Manual, 2004, page 8-17.

Understanding Plantar Fascitis

  Understanding Plantar Fascitis

Sore feet?  Painful arches?  Plantar Fascitis?!

Are you waking up in the morning hobbling out of bed?  Finding walking, running and doing stairs painful?  Are you trying to stay healthier, lose weight and get fit only to be frustrated by not being able to because of pain on the bottom of your feet?  You may have plantar fascitits or fasciosis.

Plantar fascitis (PF) is a condition of inflammation on the bottom of the foot, in particular the plantar fascia, which is the fascia or fibrous, connective tissue that attaches from the bottom of the heel or calcaneus to the phalanges or toes of the foot.  The PF has a protective function for the underlying muscles, blood vessels and nerves of the foot.  It also has a supportive role making up the three weight bearing arches of the foot:  the medial longitudinal arch, the lateral longitudinal arch and the transverse arch.  You may have heard the term “dropped arches”.  This is referring to failed integrity of these arches.  Dropped arches can lead to the formation of inflammation on the bottom of the foot via a stress effect or pulling of the plantar fascia.

Patient is seated.  Integrity of medial arch is seen (above).

       Patient is weight bearing.  Notice loss of medial longitudinal arch.

Patient is weight bearing.  Pronation and valgus bowing of Achilles tendon is seen (left).

PF usually presents as pain on the bottom of the foot especially near the inside edge of the bottom of the heel and along the medial or inside arch.  Commonly the pain can be worse upon getting out of bed in the morning but improves with subsequent steps.  The problem will often present more with standing on one’s feet for prolonged periods, walking for extended periods,  compressive activities or sports, such as volleyball, running, and with wearing non supportive shoes or sandals, e.g. flip flops, sandals and high heeled shoes.

Many now believe a chronic state of plantar fascitis eventually becomes plantar fasciosis, or degeneration of the plantar fascia tissue.  This most likely occurs due to an ongoing inflammation causing eventual degradation of the tissues on the bottom of the foot1.

So what causes PF?  When one studies the anatomy of the foot and posterior line of the lower leg, the attachments of both the plantar fascia to the inferior aspect of the calcaneus (heel) and the Achilles tendon (the conjoined tendon of the gastrocnemius and soleus muscles of the calf) to the superior, posterior aspect of the calcaneus – it is apparent that these two tissues/areas would influence each other.  It is no wonder that tightness in the calf muscles could then create a pulling effect on the plantar fascia below via the common bony attachment site of the calcaneus.  Commonly, runners and bikers as well as office workers who sit a lot will often have very tight calf muscles.  Dropped or failed medial longitudinal arches will obviously create an elongation and stretching of the PF.  Combine this with shoes with poor arch support and an irritation of the PF can easily develop.

Obesity has been identified as a contributing factor to the development of PF, especially of chronic heel pain 2 .  The feet are the base or the foundation of our structure, supporting our entire frame especially with weight bearing postures or standing.  Added weight to our frame will have a multiplying effect on the demand of the plantar fascia for supporting the integrity of our arches.  The more weight our arches support the more likely the PF will be tractioned and stretched.  Subsequent inflammation will likely develop in between and above the fibers of the PF connective tissue.

My primary doctor friend always used to say to me “the apple never falls far from the tree”.  I find this is the often the case with inheriting our parent’s system, organ or tissue weaknesses.  One can inherit our parent’s low arches, flat feet or overpronated feet or even their high instep or supinated feet.  If one or both of your parents have dropped arches, you may be headed for the same especially as age has its “drooping” effect on our bodies.

Finally, it is commonly believed by many different medical authorities (medical orthopedists, podiatrists, chiropractors, physical therapists, osteopaths, etc.) that overpronation and abnormal motion of the foot is the major instigator for development of plantar fascitis or fasciosis3.

Now that we understand more about the beast of plantar fascitis and its causes, what can we do to tame this beast?  Stay tuned for a follow-up  article on just this subject!

References:

1.  www.northcoastfootcareblog.com/plantar-fascia-tear.

2.  Irving DB, Cook JL, Young MA, Menz HB.  Obesity and pronated foot type may increase the risk of chronic heel pain:  a matched case-control study.  BMC Musculoskeletal Disord.  2007 May 17; 8 (1): 41.

3.  Kwong PK, Kay D, Vover RT, White MW.  Plantar Fascitis:  Mechanics and pathomechanics of treatment.  Clin Sports Med.  1988: 7: 119-26.

Link

Introducing Laser Therapy to Onion River Chiropractic

We have a new kind of therapy at Onion River Chiropractic called Laser Therapy! Laser therapy is a non-toxic and non-invasive treatment that is extremely easy to apply.  There are no side effects and almost no contra-indications to using this therapy, making it safe for most patients.  Because Laser is highly effective in reducing pain, it can be an alternative to pain relieving medications and other therapeutic modalities.  It might also reduce the need for surgery.

What is Laser Therapy?

L.A.S.E.R. (Light Amplification by Stimulated Emission of Radiation) is therapy using a high energy beam of light.  Laser beams have unique physical properties that increase the speed in which tissues heal, give relief from pain and reduce inflammation.

What conditions does it treat?

Double-blind, randomized studies have shown many conditions can be treated by Laser therapy, including:

  • Forearm tendonitis
  • Knee tendonitis
  • Shoulder tendonitis and bursitis
  • Ankle tendonitis
  • Plantar fasciitis
  • Carpal tunnel syndrome
  • Tarsal tunnel syndrome
  • Chronic neck and back pain
  • Acute neck and back pain
  • Myofascial pain syndrome
  • Muscle strains
  • Soft tissue injuries
  • Rotator cuff injuries
  • Peripheral neuropathy
  • Wound healing
  • Scar tissue adhesions

How does it work?

Laser works by emitting photons into mitochondria and cell membrane of the body’s tissue, resulting in physiological changes affecting the body’s immune and nervous systems.   These changes include:

  • An increase in cell growth, metabolism and regeneration
  • An increase in vascular activity, increasing blood flow to the injured area
  • Invoking of the anti-inflammatory response, promoting tissue healing
  • Stimulation of nerve function, resulting in increased healing of areas affected by nerve damage
  • An increase in the production of endorphins
  • Reduction in swelling and inflammation
  • Decrease in scar tissue formation from cuts, burns, and surgery

How is it applied?

There are several ways to apply L.A.S.E.R. therapy.

  • Tissue saturation- the LASER probe is placed on the skin for a short period of time, before moving it to a nearby area until the entire affected area is covered.
  • Tissue penetration- the probe is placed with firm pressure on the skin surface for a longer period of time, resulting in increased penetration of light waves to the treatment area
  • Trigger point therapy- the probe is placed on a trigger point for an extended period of time
  • Laserpuncture- Acupuncture points are stimulated with light waves, resulting in increased activity along acupuncture meridians.

References:

Kneebone WJ. (2006) Practical Applications of Low Level Laser Therapy. Practical Pain Management November/December