Monday, October 10, 2011

Life vs. Ergonomics: Part 1

Part 1 of 2

Most patients—most people—know little about spine-related ergonomics:

  • Some sit hunched in place over a keyboard or in front of a computer screen for hours—and they can’t figure out why they have headaches and tight shoulders.

  • Some watch TV from the soft family sofa with backs flexed into a loose “C” shape—and they don’t understand why their backs hurt.

  • Some torque the body while lifting heavy items—which can easily lead to pain and a chiropractic visit.

And the list goes on. The doctors we spoke with generally believe that a home exercise program should also have an ergonomics teaching component. Scott Bautch, DC, DACBOH, says it’s extremely important to get people to be “posturally friendly,” adding, “The closer the body is to neutral, the better the joint function. The farther you get from neutral, the more detrimental it is.”

Whole-Body Involvement
The chiropractic profession, says Dr. Aspegren, has led the idea of whole-body involvement for years—even when the injury is supposedly to a discrete part of the body. “That’s where much of medicine is transitioning now—going away from the pathoanatomical model, where we just look at the area that’s hurt—just that little area, such as a disc injury and that’s all—to more of the biopsychosocial model, which is a much more widely focused, much more broadly scoped technique. With some of the techniques that are coming out, like Graston, the research is showing how the fascia connects throughout the whole body, and how this affects multiple areas. This is very important, particularly when working with athletes.”

Dr. Aspegren says he is a great proponent of aerobic exercise. “For the most part,” he says, “it’s been shown that aerobic activity is one of the foundational forms of exercise for our injured patients. The literature points out that it is helpful in the profusion of blood into the injured area. That helps to dissipate inflammatory by-products, such as enzymes that exude from the disc, for instance. Aerobic exercise can be used to regulate pH levels that sometimes plummet with a disc pathology. If we can get blood into the region of an intervertebral disc that in the adult is avascular, by-products of inflammation are flushed out and nutrients are diffused inward.”

Dr. Bautch agrees that aerobic exercise can be valuable during the acute phase—within patient tolerance. He says even Clarence Gonstead had patients walk after their adjustments. And he points out that Dr. Gonstead had an Olympic-sized pool built so patients would get moving even if they had to be supported in part by water.

Part 2: The Aging Body, Challenges and Solutions for Compliance and Building Patient Motivation

By Carol Marleigh Kline, MA, JACA Online Editor
Chiropractic Home Exercise Programs—Ergonomics & Compliance (Part II)
J Amer Chiropr Assoc 2006 May;43(4):2-6

No comments: