Chiropractic care is not promoted enough as an option to people suffering pain or injuries. Many patients I see say things like "I wish I knew to see you sooner" or "I can't believe I waited so long". Unfortunately our profession is shrouded in many myths, and there are some out there not practicing under an Evidence-Based paradigm. I would like to help bring a spotlight on the positive benefits of care (and what the research says), and ways in which chiropractors can help! Here's a great article on what to expect during your first visit, from the CCA:
Here's a great infographic from Precision Nutrition to help guide you in exercising while pregnant. If you experience back pain during pregnancy, remember that chiropractic care is safe and recommended. Connect with a Webster trained chiro, like myself ; )
Believe it or not, your feet can be a factor in the development of chronic low back pain. Your feet act as a very important foundation for your body, and can dictate how you adapt to stresses and changes in activity. Your feet strike the ground and propel you forwards, and faulty foot biomechanics can result in pain and dysfunction in other joints and structures in the body. If you think of your body as a kinetic chain from the ground up, your weight-bearing feet and ankles function as shock absorbers for the whole body. If your feet are not working effectively at this job, the shock and stress makes its way up the biomechanical chain in your body. This concept often gets lost in translation, and people do not always understand the missing link between the feet and the back.
The most common offending foot dysfunction leading to back pain and other issues is over-pronation, or the inward rolling/dropping of the arches. As the foot over-pronates, the feet become flat and therefore absorb less shock when you walk or run. The rest of your body is then forced to compensate for faulty foot mechanics; your pelvis may slightly drop, your knees may rotate, and you may develop a slight lean. Over time, this adaptation may lead to the development of pain in other areas of the body such as in the back, neck, knees, hips, Achilles tendon, and plantar fascia. In one study, it was found that women with flat feet are almost 50% more likely to develop low back pain.
When faulty foot mechanics are a factor in low back pain, one way to approach is to consider supporting your foot as you walk or run. When I see patients with chronic back or hip pain that are not responding to treatment and exercise recommendations, I often look to the feet as a possible solution. Using foot orthotics to support your feet can help you with foot pain, and they can change the way your whole body moves and adapts.
Orthotics have been shown to be beneficial for low back pain in a number of studies on groups exposed to higher levels of foot stress (such as in runners, military recruits, and golfers). The idea behind using orthotics for back pain- as your feet are better supported, your body becomes more balanced as you stand and walk. Eliminating imbalances in your feet will cause a ripple effect up the biomechanical chain in your body. Studies show that people suffering from chronic or re-occurring low back pain tend to respond very well to custom orthotics within 6 weeks of wearing them. So if you have been suffering from low back pain which continues even after a course of conservative care/exercise, consider taking a look to your feet as another part of the puzzle.
In my practice, one of the most common issues I get asked about is sciatica. So what actually is sciatica anyways? Sciatica is a term used to refer to pain which radiates along the sciatic nerve. Sciatic nerve pain is a symptom of an underlying musculoskeletal problem.
The sciatic nerve is the largest single nerve in our body. It begins from your lower lumbar region (L3), and travels through the buttock region, down the back of your thigh before it branches below the knee. When it becomes irritated, you may experience leg pain/tingling/numbness, lower limb weakness, burning or ‘electrical’ sensations down the back of your leg from the buttock to the ankle.
The length of the sciatic nerve, and the fact that it originates from the low back, makes it susceptible to irritation from a number of different sources. Most commonly, sciatic nerve issues result from lumbar disc injury or herniation, degenerative disc disease, spinal stenosis, and low back muscle strains. Additionally, it can arise from piriformis syndrome, as the nerve passes through the muscles in the buttock region. Pregnancy and sacroiliac joint issues can also lead to sciatic nerve pain. Some may find the pain is made worse with sitting, and sometimes the pain may not travel beyond the buttock.
Treatment for sciatic nerve pain is individualized for each patient, due to the fact that the pain may come from one of many sources. If you encounter sciatic nerve pain, you should work with your chiropractor to determine the cause of your pain, and the best course of treatment. Exercise and activity are important steps you can take towards improving your symptoms. Staying active will keep your muscles conditioned, and will encourage movement in the spine resulting in an improved flow of nutrients to your ligaments and joints. You should avoid high impact activities, and continue with your regular tasks and light exercise. Contrary to common belief, bed rest is not appropriate and may lead to your symptoms being prolonged or worsened. Bed rest is only appropriate in rare cases -if your pain is so severe you cannot move- and should be limited to only a day or two.
Some of the common recommendations I make to patients include walking, gentle strengthening of core muscles, stretching of target muscles, low impact aerobics, and nerve flossing. It is important to seek out advice on which activities would help your specific cause of sciatic nerve pain, as the wrong exercises may in fact worsen your symptoms. Chiropractic care helps to decrease your symptoms, and your chiropractor can provide advice on how to prevent future sciatic nerve pain from reoccurring. For most, symptoms of sciatica should resolve with appropriate conservative treatment.
There is almost nothing more enjoyable this time of year than spending a warm afternoon outside perfecting the garden. Gardening provides an excellent outlet for stress relief, and it also allows us to gain some of the much needed vitamin D we have all been lacking over the long and harsh winter. It is really common for gardening to be a source of aches and pains for many people, although many don’t realize this until it’s too late! With a little bit of planning, it is possible to avoid the aches and pains that we see pop up with gardening and yard work. Here are five tips to help you get started:
1. Prepare your work area
Before you jump right into your gardening tasks, consider where you will be working and what you might need to make the job easier. If you are planting in containers, consider placing them up on a higher surface, level with your waist to avoid crouching or reaching. Bring your equipment close by so that you can avoid awkward positions or prolonged hunching. When planting flower beds, many people stoop over in awkward positions for sustained periods of time, which in turn can lead to a sore back. Plan where you will sit and what you will be doing ahead of time.
2. Prepare your body
Believe it or not, your body needs a warm up to prepare for some of the new and sustained movements you will be doing as you garden. Make sure to warm up your sides, thighs, hamstrings, wrists, back, and arms. As you take breaks, stretch out your forearms to avoid tightness later on.
3. Practice mindful awareness of your work positions
It’s really easy to get caught up in digging and planting sections of your garden, and before long you’ve spent over an hour in a very awkward position. To avoid this, plan a good variety in tasks- consider alternating heavy and light tasks throughout the day. Listen closely to your body, and if you start to ache, consider switching what you are doing. Changing hands to reduce strain is a good option. Aches are generally a sign that the body needs to change its position.
4. Take breaks and replenish
Pace yourself when gardening to build in planned breaks. Some people do this by carrying around a timer while others pace themselves according to tasks (“2 more bunches of geraniums before I stop”). A good starting point is to consider taking a posture break every 20 minutes, the way you would at work. Plan to rehydrate during your breaks, and remember to re-apply sunscreen if you need to as well. Light stretching and active ranges of movement help to keep away potential aches and pains.
5. Be aware of how you lift heavy loads
If you must lift something heavy and awkward, such as a bag of soil or mulch, be mindful of how to lift properly to avoid injury. Keep the load close to your body, bend your knees and keep your low back neutral (avoid bending from the waist). Consider breaking heavy loads into smaller more manageable loads –your back will thank you later!
After your fun filled gardening day is over, remember to lightly stretch to avoid any lingering tightness. If you experience pain that lasts more than a couple of days, call your chiropractor for a check-up. Have fun out there, and remember to plan ahead to avoid those pesky strains!
After such a long harsh Canadian winter, signs of spring are finally all around us – green peeking through the grass, buds on the trees, and happy glowing pregnant moms to be! As a Webster trained chiropractor, I work with many pregnant women and often get asked questions about how to reduce the risk of back pain during pregnancy. Remaining active and healthy during and after pregnancy is one key way to keep your back aligned, and fortunately with High Park so close by, there are a number of community led groups who meet and exercise in the park.
The last trimester of pregnancy can be a very exciting and anxious time, and is unfortunately also when low back pain is most likely to make an appearance. It has been estimated that 50% of all pregnant women experience back pain during their pregnancy, however only 21% seek consultations with their physician or chiropractor (1). Back pain during pregnancy arises from mechanical, hormonal, and circulatory changes in the body. As your body works to adjust to the changes in your mechanics and a shift in your centre of gravity, your muscles and ligaments can work overtime to keep everything moving in proper alignment.
With the hormone Relaxin increasing in the body, ligaments and joints have greater laxity, and as a result can become much more sensitive to strain and dysfunction. The most common region to feel pain is in the sacroiliac joint area of the pelvis, which can lead to low back pain, hip, buttock, and sciatic nerve pain. Misalignment of the joints of the pelvis can result in tighter surrounding ligaments, tendons and muscles, and can also restrict your baby’s living quarters. There are things that you can do to manage your low back pain, for a more comfortable pregnancy, and gentle exercise is an important piece of the puzzle.
Chiropractors, particularly those of us who are trained in Webster Technique, can work alongside you to help you move with ease through all stages of pregnancy and post-partum. The Webster Technique, is a specific biomechanical analysis and chiropractic treatment protocol, which aims to assess the areas of dysfunction in your pelvis, with the goal of improving function, decreasing pain, and creating a more aligned and comfortable environment for the baby.
Chiropractic is safe and effective throughout pregnancy, and can bring some great relief from pain and discomfort. As health and wellness professionals, chiropractors can also recommend customized and safe exercises and help you return to normal biomechanics during and after pregnancy. Keeping your core strong will help support your spine at any stage in life, but most importantly during pregnancy. Your glute muscles also are important in keeping your pelvis stabilized and moving well. There are great benefits to participating in gentle exercise such as swimming, yoga, and other low-impact exercise. If you prefer the group atmosphere, consider one of the many awesome local groups out there, such as those on Meet-up! It’s important of course to discuss which options might work best for you with a healthcare provider.
Further reading: 1.Borggren CL. Pregnancy and chiropractic: a narrative review of the literature. Journal of Chiropractic Medicine. 2007;6(2):70-74.
Taking care of your back is an important factor in maintaining an active and healthy lifestyle. Your back and its related structures (muscles, nerves, joints, and ligaments) work hard every day to keep you upright and moving through your daily activities. Unfortunately, statistics show that almost 80% of Canadians will suffer from low back pain throughout their lives. Low back pain can originate from a number of different structures, and may manifest immediately following an injury or it may be delayed by a day or two. Posture can play an important role in how your body responds to certain movements, and poor posture and weak core stability can pre-dispose you to a greater risk of injury and pain.
So what exactly is low back pain, and what causes it? Lower back pain can result from a number of causes, including: muscle strain, restrictions in the movement of the spinal joints or pelvis, irritations of the joints in the spine, irritated spinal nerves, disc injuries, and sprains. Sometimes, something as simple as sleeping on your stomach or shovelling the driveway can lead to low back pain. Injury to the low back may also irritate the longest nerve in the body called the sciatic nerve, which runs from the low back down the back of the thigh where it eventually branches below the knee to the foot. Symptoms of sciatic nerve irritation include burning and tingling along the back of the thigh, and weakness of the leg and foot muscles.
The key to limiting your potential for low back pain is prevention! Maintaining an active lifestyle will help to keep your muscles and joints moving in your low back. Strengthening your core muscles will also enable your back to move in a well supported and balanced way. Activities like yoga, swimming, and walking are very beneficial, and simple moves at home to keep your core and legs strong will help reduce your risk for low back pain. Encourage yourself to take breaks from sitting, and avoid movements which decrease the natural curve of your low back. A little effort throughout the day can go a long way towards improving your posture and reducing your risk of developing low back pain. For short periods of low back pain, you should avoid bed-rest (keep moving!), and use ice to help decrease the pain and inflammation.
If you do experience low back pain that lasts longer than a couple of days, consult with a chiropractor for an assessment. We will assess your ranges of motion, and examine your back to determine the cause of your pain. For those who may benefit from chiropractic care, conservative treatment of the low back may include: soft tissue therapy, spinal manipulation or mobilization, rehabilitative exercises, electrotherapy or laser, and acupuncture. Chiropractors are highly educated about back pain, and will work alongside you and your family healthcare team to get you feeling your best. We also work to educate patients on the reasons why they developed the low back pain, and ways in which they can self-manage to decrease the risk of re-injury.