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All Posts in Category: Health Basics

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6 Steps to A Healthier Day

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6 Simple Steps to A Healthier Day:

Sit Less
We’ve all heard that sitting is the new smoking. Try to combat this by taking sitting breaks. Set yourself an alarm: each hour stand up and take a short walk, whether it’s to the bathroom, the water fountain or just a lap around your desk, your body will thank you
Move more
Even little things like taking the stairs instead of an elevator, parking your car farther away, or taking a walk around the block are beneficial for your health. Every thing counts!
Drink more water
Considering our body is made up of approximately 70% water, it’s a pretty important part of our diet. Try substituting at least one pop or sugary drink each day with water. Try carrying a container of water around with you every day so you’ll have easier access at all times.
Eat more fruits + vegetables
Start with substituting one food per day with something fresh. If your usual afternoon snack is something processed, try switching it with an apple or carrots and hummus. Another tip is to portion out your dinner plate so 50% of the contents are vegetables and the rest is split between protein and carbohydrates,
Sleep
Set a bedtime for yourself and stick to it. Allow for 6-8 hours of sleep every night. Even better, try to turn off all screens at least 30 minutes before sleeping so your body can get itself ready without that extra stimulation. Sleeping is so important for both your mind and body.
Be proactive with your pain
Combat your pain before it gets chronic. At the first sign of pain, go see your chiropractor, physiotherapist, athletic therapist, massage therapist or medical doctor. They will be able to give you treatment and active care to work on at home. The goal is to get rid of the pain quickly and teach you ways to manage things on your own. The longer pain has settled in, often, the longer it takes to go away. Don’t procrastinate seeing someone!

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Heat vs. Ice!

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I get this question too many times a day to even count. So, I thought I would spend some time laying out why I might recommend heat for one person and ice for another.

Both heat and ice are helpful tools in pain management. Although there are many theories as to why they work, the research is incomplete and there is still much that is unknown. One main theory for icing, for example, is that the reduction in temperature reduces the conductive ability of your nerve to relay information back and forth, therefore not allowing the ‘alarm signal’ of pain to be expressed as quickly. It is also understood to be helpful for inflammation as blood flow to the area is decreased. Heat, on the other hand, promotes blood flow to the area, which is helpful for healing. Heat activates certain neurotransmitters which blocks the ability for our body to perceive pain.

WHEN TO USE ICE
You have an acute injury (e.g. ankle sprain), within the first 48 hours
Inflammatory conditions (e.g. rheumatoid arthritis, ankylosing spondylitis)
Red, hot, swollen tissue

WHEN TO USE HEAT
Acute low back or neck pain
Chronic pain
Muscle stiffness

HOW TO USE ICE
Make sure the ice is covered or wrapped in a wet cloth, and not against your bare skin to protect from frostbite (I’ve done this before. It’s not fun – I promise!)
Use the 20:20:20 rule – 20 minutes on, 20 minutes off, 20 minutes on. This can be repeated several times a day

HOW TO USE HEAT
If you have sensory issues, be careful not to burn your skin
Heat can be applied much longer than ice and there’s really no guideline – just make sure you are awake and aware of the sensations you are feeling so as not to become injured

Having said all that, each person and each body is different; what works for one person might not work for someone else. So, if you love ice and find it’s super helpful for your chronic pain – GO FOR IT!

As with everything, there are precautions and contraindications to all forms of therapy. Make sure you speak with a regulated health care professional to make sure that ice and/or heat is safe for you before using it.

Author: Dr. Allie Dennis

RESOURCES:
Algafly AA, George KP. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. British Journal of Sports Medicine. 2007;41(6):365-369. doi:10.1136/bjsm.2006.031237.
Nadler SF, Weingand K, Kruse RJ. The Physiologic Basis and Clinical Applications of Cryotherapy and Thermotherapy for the Pain Practitioner. Pain Physician. 2004;7:395-9.
Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine. 2015; Early Online: 1-9.

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Do I Have a Slipped Disc?

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In short, the answer is NO – our discs don’t ‘slip’.

I often get this type of question from patients with back pain and neck pain so I wanted to take some time and explain what our intervertebral discs are, whether or not they ‘slip’ and why they may sometimes contribute to pain in our back or legs.

⦁ What is an intervertebral disc?

Our spine is made up of 33 vertebrae and the majority of them are separated by intervertebral discs. These discs are made up of two components – the outer annulus fibrosis which is composed of strong connective tissue and the inner nucleus pulposis which is a softer, gel-like material. The disc allows for increased motion in our spine and helps connect each segment together.

⦁ Do discs slip?

Nope! The connective tissue attaching those discs to our vertebrae is very strong and much too stable to cause any slippage. Some things that might occur to the discs over time includes dessication (aka dehydration), bulging, herniations, and other forms of degeneration. These are all very common and the majority of adults will have findings of these things in their spine, regardless of whether or not they are experiencing pain. In fact, it has been studied quite often that degenerative findings in the intervertebral discs have little to no correlation with pain.

⦁ Can discs cause pain?

Sometimes. The most likely reason a disc will cause pain is a disc herniation. Over time, with repetitive stresses on our back the outer annulus fibrosis can begin to tear. If it tears enough, some of the inner, gel-like nucleus pulposis can herniate out of the disc and can irritate the nerve root sitting nearby. The pain can be a result of mechanical compression or chemical irritation to the nerve, or both. This can lead to symptoms along the entire course of the nerve. For example, disc herniations in your lumbar spine, or low back, may cause symptoms down your legs.


So what does this mean for the patient with back and/or leg pain?

Majority of cases of back and leg pain due to disc herniations are self-limiting and will get better on their own. Conservative care (e.g. chiropractic, physiotherapy, massage therapy) can often help you get there faster. There are very few cases where disc herniations can lead to a medical emergency – if you are unable to urinate and/or unable to control your bowel movements, go to the emergency room. Additionally, if you have rapidly worsening neurological symptoms (e.g. weakness, loss of sensation), this also needs to be checked out urgently and more invasive approaches to care may be necessary.

Dr. Allie Dennis

**This is not intended to be a replacement for medical advice. If you are suffering from any of these symptoms, please see your healthcare provider for appropriate management**

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Garden Safely This Spring!

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Spring is here! Time to get those gardens flourishing. Gardening can be very hard work with lots of kneeling, bending, twisting, lifting and carrying. It’s important to ensure we keep our bodies and spines healthy and moving well during this increase in physical activity.

The Ontario Chiropractic Association has an excellent acronym to help us remember how to stay healthy while we’re gardening!

HEALTHY BACKS

H – Have the right tools for the task at hand.

E – Ensure you drink plenty of fluids.

A – Alternative between light and heavy jobs.

L – Lift correctly.

T – Take frequent breaks.

H – Heavy loads should be shared.

Y – Your feet should be protected with thick soled supportive shoes.


B – Before you start, warm-up your muscles.

A – Avoid muscle strain, learn the right techniques.

C – Change positions frequently.

K – Kneel to plant and weed.

S – Spinal check-ups can help keep your back healthy.


If you do injure yourself while gardening, or have questions about specific techniques (lifting, bending, etc…) please go see a regulated health professional for a proper assessment, treatment and advice specific to your body. Enjoy the sun! Looking forward to seeing those May Flowers!

Author: Dr. Allie Dennis


Source: http://www.chiropractic.on.ca/wp-content/uploads/Tips-for-a-Healthy-Back-in-the-Garden-Apr17-v2.pdf

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What is Fascia?

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Many of you may have heard of the term “fascia” before. Over the last few years, “Fascial Stretch Therapists” (F.S.T) have gained popularity in the fitness and Kinesiology fields. In fact, your Registered Massage Therapist (R.M.T) may have already thrown around the term myofascial release or even suggested incorporating fascial techniques into your hands-on sessions. It’s possible you might have even suffered from a common condition called plantar fasciitis. So, the question remains, what is fascia?

To best explain fascia, try picturing a form of netting, webbing, a sort of glue or bandage. It’s actually a dense sheet, or band, of irregular connective tissue that lines the body wall and limbs, supporting and surrounding muscle groups that perform similar functions. It is strong yet mobile. Picture a spiderweb, intricately interwoven silk threads; this intricate interwoven network runs throughout our entire bodies acting like a web, holding us together.


The appearance of fascia throughout the body can differ greatly, ranging from quite thick, mimicking muscles such as the fascia making up the plantar fascia of the foot; it can also be quite thin and broad such as the thoracolumbar fascia of the lower back. Important to note is that when fascia is tight and inflexible it can pull on other structures within the body, causing tension, pain and decreased range of motion.


Factors that can affect fascia:
⦁ Repetitive movement
⦁ Sedentary lifestyle (little to no daily movement)
⦁ Trauma including surgery or injury (ex. post C-section)
⦁ Postural imbalances
⦁ Inflammation
⦁ Pathology

The benefits of regular body work, or preventative maintenance as I like to describe to patients, is so important in maintaining the health of your muscles, tissues and fascia. Keeping these integral tissues in consideration for your fitness and overall health, and getting manual work done, the fascia will become more pliable, your range of motion will increase, you will begin to experience a decrease in pain and discomfort and it will eventually increase the flow of the lymphatic fluid. This can lead to decreased inflammation and swelling.

Regardless if you are feeling specific discomfort in a particular bodily area, preventative work can be performed. Each individual responds differently to each modality (ex. myofascial release, trigger point therapy, cupping, active release therapy, acupuncture and so on). Whether you see a Chiropractor, Physiotherapist, Acupuncturist, Registered Massage Therapist or Fascial Stretch Therapist, listen to your body!

At your next appointment ask your practitioner about fascial work or try a session with a Fascial Stretch Therapist – I’m sure you will not be disappointed!

Author: Lesley Andress R.M.T

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The DOMS

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Why does my body hurt after a workout?
You know that feeling a day or two after a really tough or new workout? The one where everything just hurts? Well that pain has a name! You might be suffering from something called DOMS (aka Delayed Onset Muscle Soreness).

What is DOMS?
DOMS is muscle pain that typically begins approximately 12-24 hours after a particularly difficult or new workout. The pain tends to peak between 24-72 hours after the offending exercise routine and can sometimes last up to 1 week!

Why does DOMS happen?
For many years it was believed that a build-up of lactic acid was the cause of this post-workout pain; however, more recently this has been proven untrue. Although there is still some controversy and unknown variables surrounding the exact mechanism of DOMS, the current general consensus is that it is related to the healing of microtears or microscopic damage to your muscle tissues that occur during eccentric contractions. Eccentric contractions are what happen when your muscle is both contracting and lengthening at the same time (for example, when bringing your arm back down in a slow controlled manner during a bicep curl, you are eccentrically contracting your bicep – keeping that contraction while bringing the muscle into a position of length).

How do I make it feel better?
Again, for this, the evidence is conflicting. Mostly, just giving your body some time to heal will help you out. This isn’t to say you should go sit on the couch and wait it out! Out of all of the poor evidence on treatment for DOMS, exercise has been found as one of the most effective methods (MOTION IS LOTION!). Instead of another gruelling workout right off the bat, try some lighter movements like a light jog, some light yoga and stretching for a few days before getting back into it. Things like ice or an Epsom salt bath might help speed things along as well but the evidence is poor on these. Make sure you are always hydrating!

Can I prevent DOMS?
While DOMS may not be entirely prevented unless you just don’t move ever (in that case, you’ll likely end up with worse problems than just some good ol’ DOMS), there are some ways to reduce the severity. When you’re starting a new exercise, make sure you progress slowly into it to give your muscles time to react to their new demands. Some evidence shows a proper warm-up and cool down might also be beneficial in prevention.

What if it isn’t DOMS?
If the pain occurs DURING the workout, if the pain persists beyond 1 week, or it is preventing you from doing your activities of daily living, then it might be something else. Make sure to seek care if things aren’t progressing the way you think they should. Of course, you always need to trust your own body and seek care if something doesn’t feel right.

Author: Dr. Allie Dennis

Resources:
Cheung K, Hume PA, Maxwell L. Delayed Onset Muscle Soreness: Treatment Strategies and Performance Factors. Sports Med. 2003; 33 (2): 145-164.
American College of Sports Medicine: https://www.acsm.org/docs/brochures/delayed-onset-muscle-soreness-(doms).pdf

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Dr. Paolo’s Morning Shake

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I love to begin each day with a hard workout session! Following that session, I need a high energy, hearty and protein filled shake in order to get may day going! Here is what I found works best for me, try it out if you like:

1. 710 mL (about a pint and a half) of cold water.

2. 1 large banana (or 1 cup of frozen unsweetened mixed berries)

3. 1 tsp of ground unsweetened cocoa pods

4. 1 tsp of ground turmeric

5. 2 cups of ground rolled unsweetened oats

6. 1 tsp of ground cinnamon

7. 2 tbsp of ground flax seed

8. 1 avocado

9. 1/2 scoop of whey protein isolate (I prefer chocolate or vanilla flavoured)

Enjoy!

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Breathing is Important!

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How important is breathing?

The short answer is…. VERY!

I know this sounds like a silly question and silly answer – of course breathing is important, without oxygen our bodies wouldn’t survive. But I’m here to explain why breathing is not only vital to living, but is important for pain management and musculoskeletal health.

The first important piece of information is to know and understand what the diaphragm is. The diaphragm is our main breathing muscle. It sits at the bottom of our rib cage and when our brain tells us to breath in, it gets the diaphragm to contract, pulling it downwards and leading to decreased pressure in our chest cavity. This change in pressure allows air from the outside to flow into our lungs with ease. When we breath out, the diaphragm relaxes, pushing the air back out of the lungs.


https://media1.britannica.com/eb-media/36/92936-004-8881E781.jpg

I assess breathing in almost every patient I have, especially those with low back and neck pain.

In patients with low back pain, there is often a large focus on core stability and core strengthening. What you may not realize, your diaphragm is really the top part of that ‘core’ that we talk about so much. By focusing on your diaphragm while breathing and allowing it to work optimally, you are training your core. There is evidence showing faulty breathing patterns in a significant number of patients with low back pain, compared to their pain free counterparts.


http://ibphysio.com.au/wp-content/uploads/2015/04/core-muscles.jpg

In patients with neck pain, there tends to be a lot of ‘chest breathers’. Instead of using their diaphragm to control breathing, these patients often use their accessory breathing muscles in the neck that really only need to be activated when we’re exercising very hard and need to have hard, rapid breathing. So again, by focusing on your diaphragm while breathing and allowing it to work optimally, you are allowing those accessory breathing muscles in the neck to have a break so they can stop taking on another muscle’s job.


http://www.physio-pedia.com/images/e/e7/949_937_muscles-of-respiration.jpg

Finally, breathing plays an important role in pain management. When we are in pain, our sympathetic nervous system turns on (i.e. fight or flight response). This tells our brain that something bad is going on and every sensation becomes amplified. When our sympathetic nervous system is amped up, we tend to use shallow, rapid breaths; this is not the most efficient way to oxygenate our tissues. By taking some time to focus on diaphragmatic breathing, and taking slow, deep breaths, we are actually able to ‘trick’ our brain and tell it that everything is okay, by turning on our parasympathetic nervous system instead (i.e. rest and digest response). This allows for a decrease in sensitivity to painful stimuli which really just means that our brain will tell us we have less pain than we did before.


https://s-media-cache-ak0.pinimg.com/736x/42/fb/98/42fb981f07b10cbb16164c8be93600d5.jpg

So in summary, BREATHE! It will help you in more ways than you even knew.


Author: Dr. Allie Dennis

Resources:
Roussel N, Nijs J, Truijen S, Vervecken L, Mottram S, Stassijns G. Altered breathing patterns during lumbopelvic motor control tests in chronic low back pain: a case-control study. European Spine Journal. 2009; 18: 1066-1073
Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine. 2004; 7(1): 34-41.
Cagnie B, Danneels L, Cools A, Dickx N, Cambier D. The influence of breathing type, expiration and cervical posture on the performance of cranio-cervical flexion test in healthy subjects. Manual Therapy. 2008; 13(3): 232-238.
Jerath R, Edry JW, Barnes VA, Ferath V. Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical Hypotheses. 2006; 67(3): 566-71.

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Injury With Spring Cleaning

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Spring has sprung! Currently, with all the available time at home, I know lots of people will be doing that deep spring cleaning. With any activity that you haven’t done in a while, it’s important to make sure you’re keeping excellent form and using spine-sparing techniques in an attempt to avoid injury. Here are some tips to keep you feeling good while you’re busy cleaning out that garage and vacuuming in places you forgot existed!

TAKE BREAKS
Our bodies aren’t made to go from 0 to 100 with no preparation. Many of us tend to be less active in the winter and then want to immediately jump back into our previous level of activity. It’s important that you know your body’s limits and even start out on the cautious side. Every 30 minutes, stop, stretch, take a rest, drink some water and make sure your body is ready to continue the task before moving on.

KEEP A NEUTRAL SPINE
Cleaning that bathtub? It’s important to make sure we maintain the natural curve we have in our low back when bending/reaching over. The longer you stay in a flexed position through your lumbar spine, the more susceptible your back is to pain and discomfort.

LIFT WELL
Cleaning out those old boxes from the garage? Make sure you only lift what you can handle. As above, maintain that neutral spine. Bend from your knees and hips, not your back. Keep the load close to your body to have the centre of gravity stay as close to you as possible.

GET DIRECTLY BEHIND THAT MOP OR VACUUM
It’s easy to want to do some crazy twists and turns getting into those nooks and crannies with your mop or vacuum but in order to keep your back, neck and shoulders feeling good and comfortable, being directly behind the cleaning tool is the best. Keep your hips forward and square and position yourself in a slight lunge to keep your back from aching!

If you have any other questions about keeping your body safe and comfortable during spring cleaning, you can contact Dr. Allie Dennis at the Sports Specialist Rehab Centre!


Author: Dr. Allie Dennis

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Body Saving Tips for Sitting at a Computer All Day

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Are you a desk worker like the majority of people in our modern society? Does your back or neck get sore when you’ve been stuck in your chair all day typing away? During these unprecedented times, are you spending increasing amounts of time at your desk in front of a screen? These tips are for you! Let’s get you feeling more comfortable so you’re happier at that desk.

⦁ The top of your computer screen should be at forehead level and the top of the words at eye level. This keeps your head in a straight and upright position without extra strain on your spine.
⦁ If you use a phone a lot at work, headsets are the best way to prevent neck and shoulder irritation. Cradling the phone in your neck repetitively will start to create soreness and pain.
⦁ Your keyboard should be roughly at elbow height, assuming your shoulders are down and elbows are sitting at 90 degrees. Make sure your wrists aren’t sitting in too much extension. As in the photo above, it can help to have a wrist pad to bring the wrists into a little bit of flexion.
⦁ Your feet should be flat on the ground. If they are unable to reach and be flat after adjusting your chair to the height of your desk and computer, you can put a foot rest underneath to help you out.
⦁ Your new favourite number is 90! We want your joints to be resting comfortably in a 90-degree position – ankles, knees, hips and elbows should all be at roughly 90 degrees while you are sitting.
⦁ Ideally, you will be sitting all the way to the back of the chair and have some sort of support to maintain the natural curve we all have in our lumbar spine. It is great if your upper back can be resting against the chair as well.

As important as the above tips are, the most important tip is to MOVE! MOTION IS LOTION. The above position should be your ‘reset’ position but ideally we aren’t staying in any one position for more than 10 minutes at a time. Go ahead and slouch, cross your legs, lean to one side – as long as you stay there for under 10 minutes these so-called ‘bad’ positions don’t bother me. If you can, get up once an hour and walk around the office, grab a cup of water, go to the bathroom, just get out of that seat.

Author: Dr. Allie Dennis

**Please note that this is for educational purposes only and not intended as specific medical advice. If you have any questions or concerns make sure to consult one of our knowledgeable health practitioners at the Sports Specialist Rehab Centre.

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