Chiropractic Maintenance

In today's Blog post, I would like to discuss the importance of Chiropractic Maintenance or continued regular chiropractic care. Most of you visit my practice when you are in pain after a injury. Many feel better after an adjustment or two, but in reality the body takes longer to heal beyond the initial improvement phase. The ligaments and muscles that support the spine are still healing even after you no longer feel the pain.


Maintenance is about preventing the initial complaint from resurfacing and then to prevent new ones occurring.

During your initial appointment, I only begin to address the problem and initiate healing of the soft tissue around the spine. It is only through continued maintenance that we complete the healing process which leads to lasting recovery.  I use a specific diagnostic technique so that when you come to see me for a maintenance session I can evaluate problems before they become symptomatic, that way I am working to  improve your health and prevent the return of the original condition.

With regular visits I am able to correct small problems before they become serious. It should be noted that pain only occurs once tissue damage has taken place. During your maintenance session I make sure your spine is staying in its proper position and alignment and I make sure your muscles and nerves are functioning correctly.

Everyday life situations like sitting for long periods of time, emotional stress, poor posture which we are all accustomed to, puts pressure on your spine. Regular maintenance keeps your spine healthy. A healthy spine leads to more energy and enhances your overall health.

If you would like to book an appointment for your maintenance session, or discuss a plan dependent on your activity and stressors,

please contact me and I will gladly assist.

Dr Matthew Walters

Part 2- A more in-depth look at reading X-Rays

In the last blog article I explained the various reasons we use X-Rays as tools for evaluation as well as the basic outline on what we look for when looking at your X-rays. In this particular blog article I want to explain what we can determine from a chiropractic point of view from films.

What is more interesting from a Chiropractic Evaluation is the specific position of each vertebra.
When a vertebra is out of position it shifts and tilts FORWARDS a small amount, this needs to be corrected with a specific adjustment. From the forward position it can tilt sideways as well so that these vertebra can initiate sideways curves or scoliosis and a set of compensations that lead to muscle tension and further injury.

Using films to explain the concept.

Lateral view:

In this lateral view,  the last lumbar vertebra (L5) and the next up (L4) tilt and shift forward. We still need to stand upright so they cause  L3 and L2 to hyper-extend and this causes an  increase in the lumbar lordosis.

The sacrum also extends backwards due to the change in orientation of L5. Due to the hyper-extended position of L2,  the thoracic spine Vertebrae need to flex forwards until they tilt and collapse forwards eventually leading to wedging of the vertebral bodies.

                                                                                                                                                              

The forward view:

The vertical lines show the curve that is initiated at L5 with L4 following it.
The lateral lines show how the pelvis has compensated and how a change in leg length would be caused.

What are they feeling?
These injuries should have been caused by some sort of trauma, postural or an accident. If the spine is going left the muscles would be strained and painful on the right from trying to hold the body up.
The change in direction from left to right at L3/4 would cause Joint pain on the right from the compression of that joint. Disc compression at L3/4, the rounded surface of the bottom of the L3 vertebral body shows this as the disc has been pressing upwards due to the hyper extend position.  The shadows of the Iliopsoas muscles indicates muscle tension and a forwards pull on the spine that would cause the gluteal muscles to deactivate, the hip muscles would have to take over and become fatigued and sore over time.
Based on the spine position this person should have chronic muscle tension and hip pain with acute flare ups of central low back pain and hip pain with exertion.

How to fix it?
Lifting the L5 and then L4 Vertebrae and correcting the Pelvic position would make the muscles function better and correction of the pelvic position would facilitate this further.
The improved positions of the lower vertebrae would remove the need for the upper compensations.
The thoracic spine vertebrae that have tilted forwards can then be corrected and specific rehabilitation can be done teach the correct muscles to work at the correct time.

If you have a set of x-rays that you would like to discuss or if you have any questions regarding this article please give me a call to discuss that.

How I read X-Rays

The next series of articles will be about reading  X-rays. These are the basics and the follow up will be more in-depth. X-rays are a quick and easy tool for me to be able to get a good idea of what is going on in the spine. You may want to refer to my article on anatomy for a better idea about the structures being described.

 

There are specific criteria for Spinal X-ray/ Diagnostic evaluation: They are as follows:

• Traumatic injuries especially those with a dangerous mechanism of injury, fracture risks with low bone density, 

• Neurological signs and symptoms such as radicular pain or muscle weakness

• Persons who don't progress and heal as expected are also sent for diagnostic imaging. 

The classic way to read a spinal X-ray is to look at the ABCD, that is the Alignment, quality of the Bone, the Cartilage and joints and the Dense soft tissue.  I'll show a few X-rays and comment on them to show what can be seen. 

 

As a basic evaluation:

 

Alignment: 

Are the vertebrae stacked neatly on top of each other?

Is there a curvature or scoliosis?

Bone

The quality of the bone, fractures, bony outgrows and signs of injury are examined.

Cartilage and Joints

Are the joints symmetrical, are they close together indicating a loss of disc height or a loss or cartilage, are there signs of arthritis or stenosis?

Dense Soft Tissue

Spamming Muscles can become visible, thickening of ligaments, metastatic tissue, visceral spaces, signs of bleeding show up on X-ray. 

The follow up article I will be giving more of a chiropractic evaluation and discussing these films with you.

If you have a set of films you would like to discuss or if you have any questions regarding this article, please give me a call or leave a comment.

Boost your Immune System with Chiropractic Care

As we are approaching winter, I thought it would be fitting to write an article on how chiropractic can help you boost your immune system and how regular adjustments can reduce your chance of becoming ill or if already ill ,it can assist with healing you much faster .  Here is a quick breakdown of how this works.

Your nervous system works together with your immune system to create optimal responses for the body to adapt and heal appropriately. When your spine goes out of alignment and stresses the nervous system, it causes compression and irritation of the nerve pathways that lead to a poorly coordinated immune response. This affects the organ systems of your body and in turn leads to an altered measure of immune function and increased susceptibility to a variety of diseases.  Your nervous system controls all of your organs including that of your lymphatic system that produce that body immune response.

A two year study was conducted at the University of Lund, in Sweden by Ronald Pero, Ph.D.  He is an internationally respected cancer researcher who demonstrated the positive affects of Chiropractic care on the immune system by studying 96 people who had received ongoing chiropractic treatment. He looked at their overall health and immune indictors and found that regardless of age they had a 200% increase in their immune system development and function.  These studies suggest that chiropractic treatment can influence the B&T lymphocytes, NK Cell numbers(Natural Killer Cells), anti-body levels as well as your Beta-Endorphin levels, leading to a better immune response and viruses and bacteria being destroyed.

Analyzing your spine for irritation and correcting it with specific adjustments reduces stress on the nervous system, optimizes the immune response and reduces the chance of you getting sick.

How to get better

I believe the fundamental stages required to get better and overcome an injury are: correction, rehabilitation, maintenance and resistance.

There's a lot to be gained from following the steps and making sure that healing has occurred and chance of  re-injury is limited:

Correction:

Correction entails moving the joints and vertebra back to the most ideal position. To allow a vertebra to move the muscles automatically change their tension, stiff muscles begin to relax and movement patterns begin to change.

If appropriate correction does not occur we can examine to find out why not.

Rehabilitation:

All spines degenerate over time; if it were possible to transplant a perfect spine how long would it take before it started looking like the former?

Traumatic injures and our habits cause stresses on our spines and affect their position and structure.

A previously injured spine is more likely to resume habits that may cause further damage.

Rehabilitation means changing our habits for the better to prevent re injury.

Sitting, sleeping, standing, exercising, our movement patterns and the way we time our muscle contractions whilst moving, how things work when we're stressed or off balance.

Most of the time simple Ergonomic changes may be implemented and have very favorable outcomes. Learning a new exercise or technique can teach your body to function better and prevent reinjury can have long term benefits.

The typical example is a mom who's had a C/section, cutting through the abdominal muscles forces the body to use other muscles to try and stabilize the spine the habit of using the wrong muscles is retained. It takes a 5 minute exercise to feel the abdominal muscles work again. If this is maintained it boomers the new habit.

These changes can be tested and monitored as improvement occurs.

Maintenance:

How well the corrective and rehabilitative steps have gone determines the required maintenance one may require to prevent a relapse of a condition. If a you have a desk job and you hunch over a laptop all day the likely hood of full recovery is limited without ergonomic improvement and postural improvement, once posture is improved what schedule is required to maintain it before it deteriorates again and symptoms reoccur.

We can test this with functional orthopedic tests and exercises that require specific muscle recruitment. Improvement and Prognosis can be measured and scheduling can be done accordingly.

Resistance.

In sports such as tennis  and golf it's often said that to make real gains in ones ability you need to make your weaknesses strengths, if your volleys or short game are weaknesses work at them until they're an asset to your game. Why not apply the same logic to an injury; if your core muscles are weak don't just rehab them until they work continue until they become an integral part of your functioning.

There's and endless number of exercises that can challenge your balance and stability, range of motion and control, the challenge can be fun and again measurable outcomes can be rewarding.

If you'd like any help with Correction, Rehabilitation, Maintenance or Resistance please don't hesitate to give me a call.

Description of Exercises

These Rehabilitation exercises aim to create stability initially and then test and exercise it with varying amounts of stability and a motion. Once basic exercises and movements are mastered more complex movement patterns can be attempted. Eventually even when stressed the Abdominal Muscles and Glutes work to stabilize instead of sudden Back and Hip Flexor (Iliopsoas) contraction which causes injury.
Chiropractic care Corrects the position of the joints and controls muscle tension. Movement patterns and Rehabilitative exercises help to prevent further or future injuries. Maintenance care follows and should test and examine the boundaries of ones fitness so that you know when you're likely to injure yourself and can take action before getting sore.



1. Abdominal Activation whilst Breathing

• Are you able to breath and Maintain Abdominal contraction?

• Place one hand on your abdominal muscles and the other in the small of your back and focus on maintaining your abdominal contraction whilst changing your breathing pattern.
• You should maintain Abdominal contraction during all exercises irrispective of your breath... this teaches you to maintain stability even whilst tired. 
• Exercise 7 can be done as a precursor to learn the initial activation or the Abdominals.

 

2. Lunges and quadriceps stretches

• Stretches the Iliopsoas and Quad muscles the antagonists to the Gluteal Muscles.

• Hold for at least a minute on each side

 

3. Bosu ball stability exercises. Standing Balance Exercise

• Learn to create a functional connection between the trunk and pelvis and stabilize the body.

• This can be done with eyes open and closed, on both and then one foot and on various unstable surfaces such as sponges or bosu to increase the difficulty.

 

4. Planks/ bridges

• Lift your Pelvis and hold the position

• Maintain Abdominal and Gluteal Contraction

• When comfortable with maintaining the position on two feet; lift a foot by straightening the knee and keep the position without allowing the opposite hip to drop, To do this you need to use your stabilizers.

• Keep your Pelvis in position whilst changing legs. How Stable can you make the transition?

• A sponge under the feet or back can make the exercise more challenging later on
  

5. Opposite extensions/ superman’s/ kick-backs

• Hold Pelvis Still with Abs and Glutes.

• Start with one arm and the one leg and do opposite leg and arm only when technique is correct.

 

6. Lunge with rotation

 

• Lunge first with good posture and arms forward.
• Make sure your knee stays in front of your hip inline with the foot and doesn't buckle inwards, if you are unable to maintain the knee position don't progress to rotations.
• Rotate to the open side first. progress to the closed side when the open side is mastered. Maintain posture and trunk control with your Abdominal and Gluteal Muscles.
• If Technique fails stop!

 

7. Abdominal specific crunches

•  Lie on your back with your feet on an exercise ball, bend your knees and press downwards on to the ball.
•  If the pressure on the ball changes start again. This is more important than the Crunch!!! If your Glutes are working you eliminate your Iliopsoas from contracting, this makes it specific because you cant bend from the waist.
• Hold Abs tight and use them to do a small Crunch; the idea is to isolate and teach you how to contract your Abs.
• Can do rotations to each side to activate the Oblique Muscles too.

All Exercises should be done with the correct technique and should not cause any pain!
There are no set number of reps or sets, technique is what determines how many to do. A difficult exercise should not be attempted unless you're able to master the basic variant.
Should you require further explanation, supervision, or would like to discuss these exercises please don't hesitate to contact me.
Chiropractic Adjustments correct the position of the joints to make these exercises more comfortable and prevent injury (Correction/Rehabilitation/Maintenance).
 

Rehab of Low Back Pain; Steps, Goals and Exercises

Steps for lower back rehab: 1. Abdominal bracing 2. Hip flexor stretches/ releases 3. Stability exercises 4. Static postural muscle exercises 5. Gluteus muscle strengthening 6. Dynamic stability exercises 7. Abdominal crunches (without hip flexor activity) Goals: 1. Begin activating the abdominals 2. Decrease the forward pull of the hip flexors     (Iliopsoas) 3. + 4. Strengthen and test the appropriate            muscle groups in the correct posture. 5. Change amount of forward tilt of the pelvis by     activating the abdominals and gluteal stabilizers 6. Decrease the amount of required spinal     extensor activity (injury to posterior joints) 7. Decrease excessive lumbar curvature Exercises: 1. Static abdominal activation with breathing     exercises 2. Lunges and quadriceps stretches 3. Bosu ball stability exercises 4. Planks/ bridges 5. Opposite extensions/ superman’s/ kick-backs 6. Lunge with rotation 7. Abdominal specific crunches (activate the glutei while doing crunches)  Consult a qualified practitioner or trainer before embarking on a new training or rehab program.