Monday, October 31, 2011
“My InMotions were far superior to other insoles. I needed orthotics that could take the beating.”
Foot Levelers’ individually designed Stabilizing Orthotics support all three arches in the foot, leading the industry with its patented Gait Cycle System®. The InMotion® provides shock protection, energizes performance and results in quicker recovery. Celliant® stimulates blood flow and increases tissue oxygen levels. Dri-release® helps remove moisture four times faster and silver helps control odor and bacteria.
Optimal Family Chiropractic uses Foot Levelers technology. We have the ability to screen our patients for foot imbalances to ensure that they receive the best possible care.
Monday, October 24, 2011
By now, most people have heard of BlackBerry thumb. Recently, there has been talk of a new repetitive strain injury called “cell-phone elbow.” As technology advances, allowing us to do more tasks on smaller equipment, our bodies often pay the cost. With a growing potential for injuries from tools we rely on, it’s a good time to educate your patients about what they can do to minimize their risk.
Addressing Cell-Phone Elbow
Dr. Peter Evans, director of the Hand and Upper Extremity Center at Cleveland Clinic, recently coined the term “cell-phone elbow” to describe the paresthesias, pain and weakness some people experience from excessive phone use. These symptoms can progress to atrophy, weakness and clawing of the ulnar digits, affecting daily living tasks, as well as typing and writing.
Cell-phone elbow is not a new diagnosis but simply a new name for cubital tunnel syndrome. The two biggest controllable risk factors for cubital tunnel syndrome are prolonged flexion of the elbow at greater than 90 degrees and pressure placed directly on the ulnar nerve as it passes around the underside of the elbow. With technology allowing for full Internet access, social networking and entertainment to be performed from cell phones, more people spend greater time using them. The more time spent staring at that little screen, the longer people keep their elbows bent, which diminishes blood flow to the nerve and results in injury. Compounding the problem is resting on the flexed elbow when using the cell phone at a desk or in a car, which leads to direct nerve compression, in addition to elbow flexion.
Doctors of chiropractic can play a key role in educating patients about the risks of excessive time holding a phone to the ear and looking at a screen. If your patients experience overuse symptoms, it is also important to help them analyze the other activities they do that may contribute to the problem. Sleeping with the elbows bent and habitually crossing the arms, as well as working on a surface that is too high, pinch the nerve and should be addressed.
To eliminate prolonged elbow bending, remind patients to use headsets, which free the hands to take notes or type, eliminating the need to pinch the phone between the ear and shoulder. Simply showing patients what happens to the vertebrae and nerves in this extreme side-bent position is often enough motivation to get them to begin using a headset.
Avoiding Posture Pitfalls
The popularity of texting, combined with the increasing amount of time spent in front of a computer, will very likely contribute to worsening posture. Teens and young adults are particularly at risk. Many people find it challenging to maintain their posture in everyday tasks. When you add staring intently at a small screen for long periods, it is easy to fall into a slouched, head-forward position.
Teach your patients to sit upright with the head over the shoulders while using the phone. If the PDA is to be used for lengthy typing, see if an external keyboard can be used. Resting the forearms on a pillow while texting or typing will also help minimize neck tension by allowing the upper traps to relax. Cue patients to look down with the eyes and gently tuck the chin to maintain a healthier posture.
In addition, make sure the screen is easy to read. Straining to see what is on the screen leads to jutting the chin forward, shifting work from the spine to the muscles to hold the head up. Avoiding use of PDAs while in bright sunlight can help.
While they describe conditions known before recent advances in technology, terms such as “BlackBerry thumb,” “Wii-itis” and “cell-phone elbow” don’t simply give new names to old problems. If these new terms help the public begin to recognize how everyday tasks can place them at risk for injury, maybe our patients will take ownership of their own health, instead of passively expecting others to “fix it.” Our role is to help them move in that direction.
By Chris Sorrells, OTR, CHT, CEAS. Chris Sorrells is the president of www.ErgonomicsSimplified.com, a free online resource for health professionals. He can be reached at Chris@ErgonomicsSimplified.com.
Monday, October 17, 2011
The Aging Body
We know that muscle loss is a huge problem with aging,” says Dr. Bautch, “so we want to be careful with that.” While people who have been exercising aggressively all their lives may be able to continue exercising, aging tends to make people more sedentary. “Our bodies don’t like great changes, so if I get more sedentary and then go out and play softball or football on weekends, the chances of injury become tremendous. We decondition faster as we get older than we recondition.
Compliance: Challenges and Solutions
As doctors of chiropractic know, most patients are compliant as long as pain is the driver. After the worst of the pain subsides, they tend to want to start living like they did before injury slowed them down. To offset this very human desire, doctors need to look at numerous factors involved in helping a patient get better—and stay better.
Dr. Bautch says that when it comes to prescribing a home exercise program, quality cannot be the only criterion.
“I prefer to teach the exercises to my patients so they can gain a kinesthetic feel for them," says Dr. Morris. I prefer to teach the exercises to my patients so they can gain a kinesthetic feel for them. I include errors that patients routinely fall into. If I feel there is a risk that the patient will perform the exercise incorrectly, which is common, I teach him or her to perform it both correctly and incorrectly so the difference between the two can be appreciated. I never allow patients to perform an exercise at home unless they have mastered it in the office, which includes doing it correctly and incorrectly. The percentage of my patients who returned and performed their exercises wrong dramatically diminished after I initiated this strategy.”
Building Patient Motivation: Tips from the Field
- Dr. Christensen says it’s important not to overload patients with exercises since that will lead to noncompliance. He also asks the patient to agree to perform daily exercise with a regular time set aside. Keeping a journal that records repetitions and sets may also be helpful, he adds.
- Dr. Kurtz says that clear goals or benchmarks to reach for and someone to hold patients accountable so they will continue to do their prescribed exercises are valuable motivators.
- “If the doctor looks very fit and looks like he exercises, patients are more apt to perform their exercises.” Dr. Aspegren also looks for patient red flags that may indicate problems ahead, such as smoking, obesity, a blue-collar background, or basic lack of motivation.” When such patients are identified, he says, “We try to spend a little more time with them. We make sure we emphasize the importance of performing their exercises to reduce the need for care and to help reduce the relapse rate that permeates many musculoskeletal-type injuries.”
- Dr. Bautch says because it takes 21 days to develop a habit, he reminds his patients of what they should be doing every time they talk.
- Dr. Morris puts his own twist on compliance. “One of the keys to motivating patients to perform their exercises is to find out what they have lost that they are passionate about. I have found that by listening to my patients and letting them explain their concerns, their fears, their frustrations, and their desires, we generally find reasonable rehabilitation strategies together that comfortably motivate them to continue.”
Chiropractic Home Exercise Programs—Ergonomics & Compliance (Part II)
J Amer Chiropr Assoc 2006 May;43(4):2-6
Monday, October 10, 2011
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.”
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.”
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
Monday, October 3, 2011
Modern technology such as smart phones and texting is bringing people together in new ways…but it also has the potential to take a toll on our bodies and our health.
This year for National Chiropractic Health Month (NCHM), the American Chiropractic Association (ACA) asks chiropractic patients and the public the question, “Are you TechnoHealthy?”
As experts in ergonomics, doctors of chiropractic can help their patients use technology safely, avoiding unnecessary injury and strain, or treat the aches and pains that may already exist. Being TechnoHealthy also means knowing when to unplug and reconnect with the world around you through exercise and other wellness activities.
ACA encourages doctors of chiropractic nationwide to participate in National Chiropractic Health Month this year and help tackle a serious public health problem today: the overuse and misuse of technology.
The American Chiropractic Association (ACA), based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of ethics and patient care, contributing to the health and well-being of millions of chiropractic patients.