Take a Stand for Health

Women jumping

Take a Stand for Health

By now you may have heard the phrase “sitting is the new smoking.” Beyond being clever, the catchphrase, coined by Mayo Clinic-Arizona State University Obesity Solutions Initiative director Dr. James Levine, underscores a disturbing fact. According to Levine, we lose two hours of our lives for every hour we spend sitting. In fact, in an interview with the LA Times, Levine makes a further comparison: “Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death.”1 With the CDC’s National Health and Nutrition Examination Surveys showing that 50-70 percent of Americans sit for six or more hours each day, sitting has truly become an epidemic2.

The sitting epidemic is fueled by contemporary culture and lifestyle, particularly in the U.S. Our bodies and brains developed in response to particular environmental pressures and an active lifestyle. These days, most of us are not exposed to life-threatening scenarios on a regular basis. We exert little energy in our daily efforts to survive. Even our schools and workplaces promote the sedentary lifestyle: children are expected to sit still for hours upon end, and our workplaces have us sitting at desks, often typing away at keyboards for most of the day. Even our recreational habits have become less active: video games, instant access to movies and television shows, and virtual social environments tempt us to sit more and stand less.

The physical effects of this cultural shift are daunting. Excessive sitting has been linked to hormonal changes, increased inflammation, cardiovascular disease, diabetes, obesity, and cancer.3 From a chiropractic standpoint, sitting can distort the natural curvature of the spine, cause undue stress on nerves and ligaments, overstress muscle tissue, and compress the vertebral discs and spinal joints. As we age, too much sitting leads to disability. According to an NPR report, research out of Northwestern University found that, “For people 60 and older, each additional hour a day spent sitting increases the risk of becoming physically disabled by about 50 percent — no matter how much exercise they get.” With U.S. Census data revealing that nearly half of the population over age 65 have a disability, the impact on our aging population, their families, and their communities is significant.4

The science behind the sitting epidemic revolves around a neat acronym: NEAT. NEAT stands for non-exercise activity thermogenesis. Along with exercise activity thermogenesis, NEAT is the third component of human energy expenditure—calories burned during daily activity (basal metabolic rate, which is the energy required for basic body functions, and the energy needed to process food are the other two.) Some people have a “NEAT switch” that gets them up and moving after over-eating, while other people do not, which can lead to obesity. Surprisingly, the simple act of standing burns more calories than sitting, as noted in the table below.

Occupational Non-exercise Activity Thermogenesis (NEAT)*
Occupation type NEAT, cal/d
Chair-bound 300
Seated work (no option of moving) 700
Seated work (discretion and requirement to move) 1000
Standing work (eg, homemaker, cashier) 1400
Strenuous work (eg, farming) 2300
*Data based on a basal metabolic rate of 1,600 cal/d. Adapted from Black AE, Coward WA, Cole TJ, Prentice AM. Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements. Eur J Clin Nutr. 1996;50:72-925

So what can we do about this national health crisis? Unlike with anti-smoking campaigns, we can’t tax chairs and benches, people can’t be banned from sitting in public spaces, and we can’t enact a legal sitting age. We can, however, actively participate in our own health. As shown above, just standing makes a difference. Some workplaces and even schools are using sit-to-stand desks, which allow the user to set their workspace at a different height in order to stand. If your boss is not quite there yet, or if you’re retired, here are some simple things to do to reduce the effects of sitting.

  • Stand. It seems obvious, but, as shown above, standing burns more calories. Instead of just sitting during a lunch break, try standing for a bit, or even doing some simple stretches like bending forward and reaching for your toes to get the blood flowing. Standing a little more each day not only increases your metabolism, it also helps tone muscles, burns calories, and increases blood flow.6
  • Walk. Directly related to standing, of course, is walking. You should get up and walk around every 20-30 minutes.
  • Stretch at your desk. Shrug your shoulders up to your ears and hold that position for several seconds before releasing. Gently stretch your fingers, hands, wrists and arms by bending at the joints. Straighten your legs and point and flex your toes. These simple stretches are great for multitasking: the person on the other end of the phone will never know!
  • Do eye yoga or eye palming to stretch and moisten your eyes. Try moving your eyes in circles of varying sizes, or doing a figure eight with them. Or you can stare at the tip of your nose—and no, your face won’t freeze like that. Eye palming is simply cupping your hands over your eyes and breathing. As well as giving your eyes a break, this can make your vision clearer and reduce headaches.7
  • Use good posture. Your mother was never more correct. Good posture goes a long way to preserving the overall health of your spine and reducing stress on the nervous tissue of the spinal cord (which provides nerve input to all your muscles and internal organs.) Maintaining and supporting the natural curves of the spine is paramount to spinal health. While sitting at your desk/computer, use a lumbar and/or a thoracolumbar support cushion height along with proper workstation ergonomics (correct workstation, chair, and monitor height, proper keyboard placement, etc.).
  • Exercise, exercise, exercise. With summer coming, it’s easier to jog, swim, or hike, and there’s always the treadmill or elliptical machines at the gym. While, by definition, exercising doesn’t affect your NEAT, it does help your overall metabolism and health.

Moving around during the workday not only benefits individuals, but companies and schools as well. Research shows that productivity and focus improve if employees and students have the ability to stand or move during the day.8 According to Dr. Levine, “This is about hard-core productivity. You will make money if your workforce gets up and gets moving. Your kids will get better grades if they get up and get moving.”9 Like ergonomic keyboards, standing desks are becoming a workplace necessity.

With summer coming, we’re likely to be more active outside of work. Warm weather tends to get us out-of-doors on the weekends and inspires us to exercise more overall. But after spending the weekend on the trail, don’t forget your body during the weekday grind. Take a stand for your health by taking a stand at work.

1MacVean, Mary. “‘Get Up!’ or Lose Hours of Your Life Every Day, Scientist Says.” Los Angeles Times, July 31, 2014. http://www.latimes.com/science/sciencenow/la-sci-sn-get-up-20140731-story.html.

2“Questionnaires, Datasets, and Related Documentation.” Accessed May 11, 2017. https://wwwn.cdc.gov/nchs/nhanes/Default.aspx.

3“Sitting Disease: The New Health Epidemic.” The Chopra Center, August 14, 2014. http://www.chopra.com/articles/sitting-disease-the-new-health-epidemic.

4“Sit More, And You’re More Likely To Be Disabled After Age 60.” NPR.org. Accessed May 4, 2017. http://www.npr.org/sections/health-shots/2014/02/19/279460759/sit-more-and-youre-more-likely-to-be-disabled-after-age-60.

5Ibid.

6Just Stand “Burn Calories at Work.” http://www.juststand.org/Portals/3/literature/Burn_Calories_at_Work_Flyer.pdf Accessed May 11, 2017.

7 “Sitting Disease: The New Health Epidemic.” The Chopra Center, August 14, 2014. http://www.chopra.com/articles/sitting-disease-the-new-health-epidemic.

Upper Back, Lateral Chest, Posterior Shoulder Use of Foam Rollers – Tips and Techniques

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. For example, a trigger point in a gluteal muscle may refer pain down the leg. 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 as 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.

For Upper Back (rhomboids, middle trapezius thoracic spine):
Lie with the foam roller under your upper back. Place your hands behind your head with your elbows drawn in slightly toward midline – this allows your shoulder blades to separate. UB1

Draw your belly button in and lift your hips up off the floor using your legs for leverage. Roll up and down on the roller from your shoulders down to the bottom of your rib cage. UB2

For Lateral Chest (latissimus dorsi, teres major)
Start lying on your left side with the foam roller below your armpit and positioned perpendicular to your body. Lean back slightly and extend your left arm out with your palm facing forward.SLDR1

Using your right arm for leverage, roll the lateral upper torso along the foam roller. Repeat on the opposite side.SLDR2

Outstretch your arms placing your palms on the foam roller. Sit back on your heels. Focus on stretching forward rather than down. A stretch should be felt along the side of your upper back.SLDR3

Posterior and Lateral Shoulder (serratus anterior, posterior capsule, lateral and posterior deltoid)
Start side-lying and extend your right arm. Place the palm of your left hand on the roller. Keeping your hips stacked and torso still, push the roller out and back extending and retracting through the shoulder and shoulder blades. SLDR4

As your shoulder muscles relax, increase the range-of-motion for a greater stretch. Repeat on the opposite side.SLDR5

Stop in the office and pick up your 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.

LaserStim Cold Laser Therapy

LASER

At Onion River Chiropractic, we use LaserStim cold laser therapy with patients who suffer with pain associated with a variety of conditions:  Tendonitis (knee, ankle, forearm, shoulder, hip) bursitis, rotator cuff injuries, plantar fasciitis, carpal tunnel syndrome, tarsal tunnel syndrome, neck and back pain, muscle strains, soft tissue injuries, myofascial pain syndrome, peripheral neuropathy.  It is helpful, safe and effective for those who have artificial knees or hip replacement or other metal implants.  It is the only physiotherapy modality that can treat joint replacements as it does not cause vibratory insult or heating of the metal implant as is the case with ultrasound treatment.

Laser works by emitting photons (light energy) into the mitochondria and cell membrane of the body’s tissues.  It uses both red, visible light and infrared light which can penetrate the tissues from the surface of the skin up to a depth of 5 inches with a peak power of up to 25W. 

Physiological changes affecting the body’s immune and nervous systems 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
  • Relaxation of muscles and stimulation of nerve transmission, resulting in increased healing of areas affected by nerve damage
  • An increase in the production of endorphins, providing pain relief
  • Reduction in swelling and inflammation
  • Decrease in scar tissue formation from cuts, burns, and surgery

The diverse tissue and cell types in the body all have their own unique light absorption characteristics; that is, they will only absorb light at specific wavelengths and not at others. For example, skin layers, because of their high blood and water content, absorb red light very readily, while calcium and phosphorus absorb light of a different wavelength.  Although both red and infrared wavelengths penetrate to different depths and affect tissues differently, their therapeutic effects are similar. 

Visible red light, at a wavelength of 660nm, is beneficial in treating problems close to the surface such as acne, eczema, psoriasis, wounds, cuts, scars, trigger and acupuncture points, and is particularly effective in treating infections.  Infrared light (905nm) penetrates deeper than visible light and is effective for treating ailments of bones, joints, and deep muscle tissue.

Light therapy can:

  1. Increase vascularity (circulation) by increasing the formation of new capillaries, which are additional blood vessels that replace damaged ones. New capillaries speed up the healing process by carrying more oxygen as well as more nutrients needed for healing and they can also carry more waste products away.
  2. Stimulate the production of collagen. Collagen is the most common protein found in the body. Collagen is the essential protein used to repair damaged tissue and to replace old tissue. It is the substance that holds cells together and has a high degree of elasticity. By increasing collagen production less scar tissue is formed at the damaged site.
  3. Stimulate the release of adenosine triphosphate (ATP).  ATP is the major carrier of energy to all cells. Increases in ATP allow cells to accept nutrients faster and get rid of waste products faster by increasing the energy level in the cell. All food turns into ATP before it is utilized by the cells. ATP provides the chemical energy that drives the chemical reaction of the cell.
  4. Increase lymphatic system activity.  Edema, which is the swelling or natural splinting process of the body, has two basic components. The first is a liquid part which can be evacuated by the blood system and the second is comprised of the proteins which have to be evacuated by the lymphatic system.  Research has shown that the lymph vessel diameter and the flow of the lymph system can be increased with light.  The venous diameter and the arterial diameters can also be increased.  This means that both parts of edema (liquid and protein) can be evacuated at a much faster rate to relieve swelling.
  5. Reduce the excitability of nervous tissue. The photons of light energy enter the body as negative ions. This calls upon the body to send positive ions like calcium among others to go to the area being treated. These ions assist in firing the nerves thereby relieving pain.
  6. Increased phagocytosis, which is the process of scavenging for and ingesting dead or degenerated cells  for the purpose of clean up. This is an important part of the infection fighting process.  Destruction of the infection and clean up must occur before the healing process can take place.

We are offering a Laser treatment special promotion which includes an initial examination and 6 laser treatment sessions for $150.  This offer is not valid with any insurance, personal injury or workers compensation cases.  Scheduled appointments are required.  Valid until July 31, 2013.   Call the office today at 802-655-0354 and see how effective Laser therapy can be for you!

REFERENCES
The Photobiological Basis of Low Level Laser Radiation Therapy, Kendric C. Smith; Stanford University School of Medicine; Laser Therapy, Vol. 3, No. 1, Jan – Mar 1991

Low-Energy Laser Therapy: Controversies & Research Findings, Jeffrey R. Basford MD; Mayo Clinic; Lasers in Surgery and Medicine 9, pp. 1-5 (1989)

New Biological Phenomena Associated with Laser Radiation, M.I. Belkin & U. Schwartz; Tel-Aviv University; Health Physics, Vol. 56, No. 5, May 1989; pp. 687-690

Macrophage Responsiveness to Light Therapy, S Young PhD, P Bolton BSc, U Dyson PhD, W Harvey PhD, & C Diamantopoulos BSc; London: Lasers in Surgery and Medicine, 9; pp. 497-505 (1989)

Photobiology of Low-Power Laser Effects, Tina Karu PhD; Laser Technology Centre of Russia; Health Physics, Vol. 56, No. 5. May 89, pp. 691-704

A Review of Low Level Laser Therapy, S Kitchen MSCMCSP & C Partridge PhD; Centre for Physiotherapy Research, King’s College London Physiotherapy, Vol. 77, No. 3, March 1991

Systemic Effects of Low-Power Laser Irradiation on the Peripheral & Central Nervous System, Cutaneous Wounds & Burns, S Rochkind MD, M Rousso MD, M Nissan PhD, M Villarreal MD, L Barr-Nea PhD. & DG Rees PhD,

Low Level Laser Therapy: Current Clinical Practice In Northern Ireland, GD Baxter BSc, AJ Bet, MA,,JM AtienPhD, J Ravey PhD; Blamed Research Centre University Ulster Physiotherapy, Vol. 77, No. 3, March 1991

Low Level Laser Therapy: A Practical Introduction, T. Ohshiro & RG Caiderhead, Wiley and Sons

Bone Fracture Consolidates Faster With Low-Power Laser, MA Trelles, MD and E Mayayo, MD, Barcelona, Spain; Lasers in Surgery & Med. 7:36-45 (1987)

Wound Management with Whirlpool and Infrared Cold Laser Treatment, P Gogia; B Hurt and T Zim; AMI-Park Plaza Hospital, Houston TX, Physical Therapy, Vol. 68, No. 8, August 1988

Effects of Skin-Contact Monochromatic Infrared Irradiation on Tendonitis, Capsulitis and Myofascial Pain, T.L Thomassoi DDS, 19th Annual Scientific Meeting, American Academy of Neurological & Orthopaedic Surgeons, Aug. 27-30, 1995 Facial Pain/TMJ Centre, Denver, CO

The World on Your Shoulders (AKA Rotator Cuff Syndromes)

“The World on Your Shoulders (AKA Rotator Cuff Syndromes)” by Dr. Kelly Rybicki

The old saying “the weight of the world on your shoulders” well picturizes what it is like for someone with a shoulder issue.  The precise incidence of symptomatic rotator cuff injuries is not known.  Cadaver studies of elderly persons have estimated full-thickness tears as high as 30%.[2]   An estimated 4% of cuff ruptures develop a cuff arthropathy. Various authors report a rate of success with conservative treatment ranging from 33-90%, with longer recovery time in older patients.[3, 4, 5]   Rotator cuff injuries and tears usually do not occur in persons younger than 40 years (5-30%). The great majority is found in persons aged 55-85 years. Approximately 15% of patients with shoulder pain who are older than 70 years have rotator cuff injuries.[2]   Prevalence increases with age.[2]  Younger patients are more likely to have rotator cuff dysfunction because of overuse, subtle instability, and muscle imbalance.  Older patients tend to have chronic shoulder pain and degeneration. 

One of the most common shoulder conditions is rotator cuff syndrome.  The term “rotator cuff” actually refers to a group of muscles which stabilize and control primarily abduction, internal and external rotation of the shoulder.  Often referred to as the “SITS” muscles:  S= supraspinatus, I= infraspinatus, T= teres minor, S= subscapularis.  They attach around the upper part of the humerus or arm bone and form a “cuff” around the ball and socket of the shoulder joint.  These muscles are responsible for stability to the inherently unstable shoulder joint.

Within the category of rotator cuff problems are:  rotator cuff syndrome or rotator cuff myofascial syndrome, rotator cuff tendonitis, and rotator cuff tendon tears or frays.  Of the three, rotator cuff tendon tears are the most severe.  This is when one of the tendons of the rotator cuff muscles has become stretched, torn or severed, either due to chronic overuse, arthritic spurs at the acromioclavicular joint pushing down and fraying the supraspinatus tendon or a sporadic, traumatic event causing damage to the tendon. Unless the tendon has been completely severed, therapy or treatment such as cross friction massage, trigger point therapy, ultrasound, laser therapy or interferential current and specific shoulder strengthening exercises can usually significantly improve or heal the problem.  If the tendon has been completely torn, the only option for reasonable recovery is surgical intervention.

Rotator cuff tendonitis usually occurs due to repetitive and/or overuse of the shoulder and arm in certain positions which cause low grade strain to the muscle and specific tendons, and hence, an inflammatory process settles around the tendon in question and therefore a “tendonitis is born”.  Tendonitis of the shoulders is often very reluctant to resolve and frequently eschew even consistent therapy, partly because of our constant use of our shoulder and arm throughout the day.  Everyday tasks such as lifting a jug of milk, putting a plate up into the cupboard and sleeping at night on that side are all possible aggravators to an injured shoulder.  The best treatments again include interferential stimulation, ultrasound, laser therapy (to decrease the inflammation and promote cell regeneration), specific Active Release therapy to tightened rotator cuff muscles and cross fiber massage across the rotator cuff tendons, as well as rehabilitation exercises to strengthen the rotator cuff and surrounding parascapular/shoulder blade supportive muscles. 

Rotator cuff myofascial pain syndrome is, quite simply, a condition in which there is chronic inflammation and myofascial trigger points throughout the rotator cuff muscle especially in the belly of the muscles.  Probably one of the most common problems of the shoulder, this condition causes a progressive tightening of the rotator cuff muscles.  Symptoms include achy, burning pain in the local area of the shoulder and sometimes with referral into a specific trigger point pattern i.e. down the arm, into the shoulder blade, or into the front of the shoulder.  This condition will be negative for abnormality on x-ray and MRI and will not necessarily respond very positively initially to strengthening exercises.  Although orthopedists generally very easily diagnose shoulder pathology as osteoarthritis, rotator cuff tendon tears, etc., this condition often eludes even the very knowledgeable shoulder specialists (especially if they are not familiar with Dr. Janet Travell’s extensive research and documentation of myofascial trigger point conditions).  This condition is very successfully treated with specific myofascial release, trigger point therapy or Active Release techniques to rid the area of fibrous feeling “knots” (or trigger points) in the specific muscles.  A tell-tale signal of a rotator cuff myofascial pain syndrome is when one pushes on a big knot in a rotator cuff muscle and pain refers to another area of the body, (typical trigger point patterns of referral).  In order to successfully treat this condition a highly skilled therapist (chiropractor or massage therapist who is specifically experienced with trigger point syndromes) will be best able to resolve this condition.  Swedish type massage generally will not resolve this type of condition. 

With all of these conditions, after successfully reducing the muscular tightness and offending trigger points and reducing the inflammation in the tendons and/or muscles, shoulder stretching, rotator cuff strengthening, as well as parascapular stabilization exercises are important in full recovery.  Postural retraining and ergonomic evaluation of home and work station are often vital to prevent return of the condition.

With this information and the skill of an experienced doctor and therapist you soon may experience a greater “swing” of your shoulder and arm….”Batter up!”

References:

  1. Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: part I.       Evaluation and diagnosis. Am Fam Physician. 2008;77(4):453-460. [PubMed: 18326164]
  2. Moosmayer S, Smith HJ, Tariq R, Larmo A. Prevalence and characteristics of asymptomatic tears of the rotator cuff: an ultrasonographic and clinical study. J Bone Joint Surg Br. Feb 2009;91(2):196-200. [Medline].
  3. Ecklund KJ, Lee TQ, Tibone J, Gupta R. Rotator cuff tear arthropathy. J Am Acad Orthop Surg. Jun 2007;15(6):340-9. [Medline].
  4. Fongemie AE, Buss DD, Rolnick SJ. Management of shoulder impingement syndrome and rotator cuff tears. Am Fam Physician. Feb 15 1998;57(4):667-74, 680-2. [Medline].
  5. Hayes K, Ginn KA, Walton JR, Szomor ZL, Murrell GA. A randomised clinical trial evaluating the efficacy of physiotherapy after rotator cuff repair. Aust J Physiother. 2004;50(2):77-83. [Medline].
  6. Greiwe RM, Ahmad CS. Management of the throwing shoulder: cuff, labrum and internal impingement. Orthop Clin North Am. 2010 Jul;41(3):309-23.
  7. Matsen III FA, Fehringer EV, Lippitt SB, Wirth MA, Rockwood Jr. CA. Rotator cuff. In: Rockwood CA Jr, Matsen FA III, Wirth MA, Lippitt SB, eds. The Shoulder. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 17.
  8. Seida JC, LeBlanc C, Schouten JR, Mousavi SS, Hartling L, Vandermeer B, Tjosvold L, Sheps DM. Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med. 2010 Aug 17;153(4):246-55.