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Exercise Snacks

Exercise Snacks

 

On busy days, setting aside a large chunk of time to work out can feel unrealistic — even impossible. But new research suggests that a few short bursts of activity spread throughout the day could still improve aerobic fitness.

Dr. Martin Gibala, a professor at McMaster University and senior author of the study, and his team have been researching the benefits of short exercise bursts for more than a decade. But these types of studies often take place in lab settings using stationary bikes.

"We've been increasingly interested in translating this out of the lab and making this more practical and accessible to people," he said. "We thought, well, stair climbing is a great way to apply this. Many of us work in an office tower or live in apartment complexes, so stairs are readily available."

The researchers recruited 24 college students who were healthy but inactive, reporting less than one hour of structured exercise per week.

Half of the students were randomly assigned to a control group, while the other half took on a six-week regimen of exercise "snacks," or short bursts of physical activity.

This latter group performed three exercise snacks per day, three days out of the week. For each snack, they vigorously climbed stairs for 20 seconds.

Each bout of stair climbing was separated by one to four hours of recovery time. The snacks were also preceded by a short warmup (10 jumping jacks, 10 squats, and five lunges on each side) and followed by a one-minute walking cooldown.

"The practical analogy would be, people come into work in the morning and bound up a few flights of stairs. They do that again on a break or a lunch and they do it again before they leave for the day," Gibala said.

 

Before and after the experiment, the participants underwent a test to measure their cardiorespiratory fitness. "[The test] reflects the ability of the heart, the blood vessels, and the lungs to deliver oxygen through the body, Gibala said. “We measure that using something called a maximal aerobic capacity test, or a VO2max test. That involves exercising on a bike at progressively higher workload ... until you're not able to go anymore. It provides a very accurate measure of the body's peak ability to use oxygen."

 

This measure of fitness is also important to health, Gibala added, because it's closely related to the risk of developing certain chronic illnesses like heart disease and type 2 diabetes.

After the six-week exercise snack regimen, the stair climbers had improved their VO2max by about 5%, compared to the control group that stayed inactive.

"The size of the effect was small, but nonetheless we saw a measurable improvement," Gibala said.

He added that this very small experiment was a "proof of concept" study, and in the future, the researchers have plans to study exercise snacks in larger, longer-lasting studies with more diverse groups of participants. They also plan to look at how these bursts of movement might affect different markers of health, like blood pressure and blood sugar control.

For now, though, the takeaway message is simple.

"We're not at all suggesting that people should only do a minute of exercise or this is all you need," Gibala said. "Really it's a reminder to people that small bouts of activity can be effective. They add up over time. Exercise doesn't mean you have to change into spandex and go to the gym. It can be something as easy as stair climbing."

Adapted from https://www.thisisinsider.com/short-workout-improve-fitness-exercise-snacks-2019-1

*Related reading* :'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance.” 2014.
https://well.blogs.nytimes.com/2014/05/14/exercise-snacks-to-control-blood-sugar/

Scans in Asymptomatic People

Scans

People tend to think that if a scan shows something, then there will likely be symptoms or pain as well. In reality, that is often not the case. This pictures shows (as the title suggests) abnormalities found on scans for people who had ZERO symptoms.

 

*All credit to Lee Darren H for the infographic as posted on the British Journal of Sports Medicine Facebook Page.

Things To Start Doing Now to Master Your Pain

10 Things To Start Doing Now to Master Your Pain (Part 2)

 

Remember that the first five were in last weeks blog, these 10 principles may seem simple in some ways, but they are the basis for approaching

pain—and in essence, life—in a healthier way. There will be times when they are difficult, but they are the things that are under your power and control.

 

Keep Moving

Continue to move and explore ways that make moving possible. Some clinicians still tell patients to not move if it hurts. This is not usually helpful as it tends to make patients believe that hurt means harm. It is well-known that a lack of movement can lead to deconditioning, depression, and worsening pain (and other medical issues). In fact, your body can become more sensitive and less tolerant of activity the more you avoid some discomfort. Well-informed clinicians can help you discover ways to modify your activity in a healthy way to minimize deconditioning. Avoiding movement is rarely indicated unless you have had a recent trauma or surgery. Keep moving by pacing yourself with just enough to challenge you but not so much that it sets you back for days. As you now know, your body can adapt.

 

Be Patient

When you hurt, there is a human tendency to just want it to go away without giving your body the necessary time and space to restore and calm down on its own. One way that some people can become impatient is starting opioids (strong painkillers). These drugs suddenly become the “go-to” from that point on for many people. Unfortunately, opioids can increase your sensitivity to pain and decrease your motivation over time in addition to the concerns of severe constipation, impaired breathing, and depressed immune and hormonal systems.

 

Don’t Focus on the Diagnosis

Avoid labelling yourself. Well-intentioned clinicians will give you a diagnosis that may only describe your pain symptom but not give you the “why.” Some diagnoses may appear to be threatening or unchangeable which does not help you feel hopeful of change. This can lead to more fear and an increase in pain. In fact, diagnoses can also be wrong. Even if they are correct, the question is always, “What can YOU do to help yourself in spite of that diagnosis?”

 

Live Your Life

Continue to live your life and fill it with the things that bring you joy, which will ultimately decrease stress, anxiety, fear, and pain. It is not always easy early on in the journey, but smiling, connection, and social support are critical components to ease suffering and pain. Focusing on any pain in life will only magnify it. Chronic pain can cut us off from the things we love, which is why it’s all the more important to fight to keep those things in our lives . You truly have the power to change your pain.

 

Educate Yourself

Continue to educate yourself about pain throughout your life journey, and find pain experts who can help guide you when you are struggling to do it on your own. The world of pain continues to evolve and so will you. You have been born into an amazingly adaptable human body. Continue to remain active in doing things for yourself versus relying solely on the medical system to do things to you. We all need a little help every once in a while, but the power of what you can change with education is unlimited.

Again, please remember this article is intended to provide educational information. It is for informational purposes only and should not be construed as medical advice.

Dr. Melissa Cady, D.O., the "Challenge Doctor," is an osteopathic physician certified in anesthesiology and pain medicine by the American Board of Anesthesiology. She often writes about and presents on various health and pain-related topics. Dr. Cady is the founder of PAIN OUT LOUD, an online community of pain challengers and pain professionals. She’s also the author of PAINDEMIC: A Practical and Holistic Look at Chronic Pain, the Medical System, and the ant iPAIN Lifestyle.

 

Things To Start Doing Now to Master Your Pain

10 Things To Start Doing Now to Master Your Pain (Part 1)

 

These 10 principles may seem simple in some ways, but they are the basis for approaching

pain—and in essence, life—in a healthier way. There will be times when they are difficult, but they are the things that are under your power and control.

 

Rule Out Your Biggest Fears

If you are experiencing pain, and you suspect it may be life-threatening or relentlessly progressive, then immediately seek medical help to rule out any emergencies or life-threatening conditions. Isolated pain without other concerning symptoms such as severe leg or arm impairments, fevers, significant weight loss, and/or changes in other body systems is rarely serious. Assuage your concerns by doing your due diligence to address potential urgent matters.

 

Be Aware

Your body’s natural pain response is intended to protect you. Therefore, pay attention to ensure that there is no obvious threat to you. Sudden, acute pain can help us flee dangerous situations. Pain itself is constructed by many inputs, including fear, physical sensations, stress, depression, social isolation, lifestyle patterns, etc. Pain that persists with no serious survival or health concerns can fester in a way that can isolate you from many things in your life. Ironically, merely fixating on the pain or suffering can magnify pain. Noticing what makes your pain better or worse can help you or someone who is trying to help you understand your pain better. However, being aware that there are many inputs that can influence your pain is important to understand so that you can explore those things that improve your pain experience.

Breathe

Deep breathing enables you to counteract the sympathetic nervous system (fight-or-flight) with the parasympathetic system (rest and digest). Practice some slow, deep breathing to calm down your nervous system. This skill can be used at any time for the rest of your life. Your nervous system can go on high alert or be hypervigilant for various reasons, and it is not always due to physical threats, but the power of breath can soothe your system. There are many scientific reasons that this is a commonly used practice during childbirth.

Master you Mind

Once you have ruled out any emergencies or life-threatening conditions, then your next step is to practice mastering your mind’s interpretation of pain. Are you still anxious despite the fact that there is no evidence that you have a life-threatening condition? Are you uncomfortable with not knowing the pain’s cause? Identify the feelings and concerns you are experiencing. They will be guiding the types of choices that you will make for addressing your pain. It is important to understand how you are interpreting your pain. If you are incredibly fearful, then many of the decisions that are chosen in haste may not always be the best solution or may not be addressing the root cause of your pain.

Remember “Hurt Does Not Always Mean Harm”

Although there are times that harm can lead to hurt, hurt does not always mean harm. Information that is sent to the brain and interpreted as pain does not mean that you are injured or hurt. In fact, it can mean many things including you may not have been moving enough, not been moving well, been moving something too much, or other parts of your life can be causing your nervous system to be extremely sensitive. The body is incredibly resilient, healing, and adaptable. Sometimes the body sends information to our brain because the body/brain needs us to change what we are doing and/or is overly sensitive due to stress, poor diet, lack of sleep, toxins, or other inflammatory states. Just remember that pain does not mean you will injure yourself unless you have extreme conditions like severe osteoporosis.

Dr. Melissa Cady, D.O., the "Challenge Doctor," is an osteopathic physician certified in anesthesiology and pain medicine by the American Board of Anesthesiology. She often writes about and presents on various health and pain-related topics. Dr. Cady is the founder of PAIN OUT LOUD, an online community of pain challengers and pain professionals. She’s also the author of PAINDEMIC: A Practical and Holistic Look at Chronic Pain, the Medical System, and the ant iPAIN Lifestyle.

Low Back Pain Beliefs

Low Back Pain Beliefs

In 2014, a study by Darlow et al was published in BMJ Open. The study looked at beliefs of back pain in New Zealand citizens above the age of eighteen years of age.

602 valid responses were received. Although not all of them had back pain at that moment (27%, which is still a substantial amount), 87% had experienced it at least once in their lives

34 questions were asked. Some of the significant responses were:

  • 60% think the risk of exercise outweigh the benefit.
  • 69% think they should “take it easy”.
  • 59% think that any pain with activity should be avoided in the future.
  • 35% think the main treatment is bedrest.
  • 94% think lifting without bending their knees is not safe for their back.

Negative views were prevalent, in particular, the need to protect the back to prevent injury.

People with current back pain had more negative overall scores, particularly related to back pain prognosis.

Participants also showed uncertainty about links between pain and injury and appropriate physical activity levels during an episode of back pain.

Respondents had more POSITIVE views about activity if they had consulted a HEALTH PROFESSIONAL about back pain, which illustrates the power of EDUCATION in back pain recovery.

TAKE HOME MESSAGE: Your BELIEFS can strongly influence your back PAIN and your RECOVERY, both positively and negatively

It is important to remember that MOST people experience back pain at least once in their lives, and MOST people recover just fine

Your back is strong and resilient Treat it that way

Darlow B., Perry M., Stanley J., et al, A cross-sectional survey of attitudes and beliefs about back pain in New Zealand, BMJ Open 2014
 

Lumbar Spinal Stenosis

Degenerative lumbar spinal stenosis, is a leading cause of pain, disability and loss of independence in older adults.  Lumbar spinal stenosis refers to a focal narrowing of the central canal and / or lateral foramina of the spine usually identified by imaging.  It is interesting to note narrowing of the spinal canals alone with clinical information is not meaningful as 30% of patients over 55 years have narrowing (stenosis) but no symptoms.

Neurogenic claudication is the term used to describe the clinical syndrome caused by lumbar spinal stenosis.  It is characterized by buttock, leg pain, heaviness, numbness, tingling or weakness brought on by walking and standing and relieved by sitting and bending forward.

There are many causes of narrowing of the spinal canals and these include; congenital variations, spondylolisthesis, some bone diseases and a previous spinal surgery. However, the most common cause is degenerative arthritis.

Degenerative or osteoarthritis is a wear and tear type of arthritis that we all get to some degree when we age.  This kind of arthritis results in a thinning and bulging of the intervertebral discs and a thickening of the facet joints and internal spinal ligaments.

Degenerative spinal changes lead to a decrease in the area of the spinal canals and potential compression to the spinal nerves that travel to the lower extremities.  The narrowed spinal canals also restrict blow flow to the spinal nerves with needs oxygen to function. This leads to neuro-ischemia and hypoxia to the nerves which results in leg pain and impacts the ability to walk.

Interestingly, patients who have difficulty walking due to lumbar spinal stenosis have greater limitations than those patients with hip or knee arthritis and even congestive heart failure or chronic obstructive lung disease.  This leads to a sedentary lifestyle and a progressive decline in health status.  As such lumbar spinal stenosis is chronic disease that can deteriorate with age. Given the aging population this condition is now associated with a large increase in health care resources.

What does a patient history with lumbar spinal stenosis look like?

Patients will typically describe leg symptoms as numbness, tingling, pins and needles, weakness or heaviness in the buttock, back of the thigh and lower leg that can impact their ability to walk.  Back pain is not always present.

Using a shopping trolley or walker relieves symptoms, and some patients report a difficulty in balance which is due to the nerve compression in the lower legs.

What are the treatment options?

Degenerative lumbar spinal stenosis is the most common reason of spinal surgery in individuals over 65 years, however overall this is a small number of individuals.  Patients who have leg dominant rather than back dominant symptoms tend to do better after surgery, many patients note the benefits of surgery tend to diminish over time.

The vast majority of patients receive non- surgical care including: physiotherapy, chiropractic, acupuncture, massage, medications and epidural injections.  Anti-inflammatory medication and injections tend to be less effective as the symptoms are not due to inflammation.

The ability to reduce symptoms of degenerative spinal stenosis by changing spinal posture / structural alignment and /or increasing blood flow to the spinal nerve provides potential mechanisms for interventions to improve symptoms and walking ability.  Dr Carlo Ammendolia and his team from the Mount Sinai Hospital have designed and implemented a six-week self-management program training program, a Boot Camp – which like any boot camp is very physical and tough, however, the goal is to provide patients with the knowledge, skills self-confidence and physical capacity to manage their symptoms and maximize their function on their own.  Ailsa is trained in this program.  The program is delivered one on one over six weeks and during this period a step by step home exercise program is designed and tailored to the individual with the goal of being maintained for life.  This change of lifestyle approach has been studied by the University of Toronto in a clinical trial which demonstrated excellent short and long term results.  Remember “Motion is lotion”.

For more information go to www.spinemobility.com

Pass Overs

The 'Pass Over' is a great exercise for anyone but particularly those working at a desk all day, your shoulders can become tight from being in the same position for hours and this provides an effective way of loosening them up. It helps to warm up and stretch the muscles in your shoulders, arms, and back. Your hamstrings also get a nice stretch with this one. 

Check out the video below for a demonstration.

https://www.facebook.com/CityCentreChiro/videos/1697773220259423/

Hip Hinges

The 'Hip Hinge' is not an exercise to increase strength or build flexibility, it is an exercise to activate our hips to flex. When bending over to lift up a box, change a baby or brush your teeth, a common error to make is to bend your lower back instead of your hips.

This exercise is demonstrated in the clip below.

https://www.facebook.com/CityCentreChiro/videos/1697772190259526/

Wall Angels

One of the best and simplest exercises that can be used to correct poor posture from sitting is called the 'Wall Angel'. This exercise will fire up your core, activate your bum muscles, help extend your thoracic, stretch your chest and activate your lower traps.

Our friend Luke from Reactivate Function gives a demonstration of the exercise in the video below.

https://www.facebook.com/CityCentreChiro/videos/1697735450263200/

Men's Health for Movember

 

 

  1. Make man time

Stay connected. Your mates are important and spending time with them is good for you. Catch up regularly, check in and make time.
 

  1. Have open conversations

You don’t need to be an expert and you don’t have to be the sole solution, but being there for someone, listening and giving your time can be life-saving.
 

  1. Know the numbers

At 50, talk to your doctor about prostate cancer and whether it’s right for you to have a PSA test. If you are of African of Caribbean descent or have a father or brother with prostate cancer, you should be having this conversation at 45. Know your numbers, know your risk, talk to your doctor.
 

  1. Know thy nuts. Simple

Get to know what’s normal for your testicles. Give them a check regularly and go to the doctor if something doesn’t feel right.
 

  1. Move, more

Add more activity to your day. Do more of what makes you feel good.

  • Take a walking meeting
  • Park further away from the station
  • Get off the bus a stop or two earlier
  • Cycle to work instead of driving

From the Movember Foundation website please visit au.movember.com for more information.

View older posts »

Exercise Snacks

Exercise Snacks

 

On busy days, setting aside a large chunk of time to work out can feel unrealistic — even impossible. But new research suggests that a few short bursts of activity spread throughout the day could still improve aerobic fitness.

Dr. Martin Gibala, a professor at McMaster University and senior author of the study, and his team have been researching the benefits of short exercise bursts for more than a decade. But these types of studies often take place in lab settings using stationary bikes.

"We've been increasingly interested in translating this out of the lab and making this more practical and accessible to people," he said. "We thought, well, stair climbing is a great way to apply this. Many of us work in an office tower or live in apartment complexes, so stairs are readily available."

The researchers recruited 24 college students who were healthy but inactive, reporting less than one hour of structured exercise per week.

Half of the students were randomly assigned to a control group, while the other half took on a six-week regimen of exercise "snacks," or short bursts of physical activity.

This latter group performed three exercise snacks per day, three days out of the week. For each snack, they vigorously climbed stairs for 20 seconds.

Each bout of stair climbing was separated by one to four hours of recovery time. The snacks were also preceded by a short warmup (10 jumping jacks, 10 squats, and five lunges on each side) and followed by a one-minute walking cooldown.

"The practical analogy would be, people come into work in the morning and bound up a few flights of stairs. They do that again on a break or a lunch and they do it again before they leave for the day," Gibala said.

 

Before and after the experiment, the participants underwent a test to measure their cardiorespiratory fitness. "[The test] reflects the ability of the heart, the blood vessels, and the lungs to deliver oxygen through the body, Gibala said. “We measure that using something called a maximal aerobic capacity test, or a VO2max test. That involves exercising on a bike at progressively higher workload ... until you're not able to go anymore. It provides a very accurate measure of the body's peak ability to use oxygen."

 

This measure of fitness is also important to health, Gibala added, because it's closely related to the risk of developing certain chronic illnesses like heart disease and type 2 diabetes.

After the six-week exercise snack regimen, the stair climbers had improved their VO2max by about 5%, compared to the control group that stayed inactive.

"The size of the effect was small, but nonetheless we saw a measurable improvement," Gibala said.

He added that this very small experiment was a "proof of concept" study, and in the future, the researchers have plans to study exercise snacks in larger, longer-lasting studies with more diverse groups of participants. They also plan to look at how these bursts of movement might affect different markers of health, like blood pressure and blood sugar control.

For now, though, the takeaway message is simple.

"We're not at all suggesting that people should only do a minute of exercise or this is all you need," Gibala said. "Really it's a reminder to people that small bouts of activity can be effective. They add up over time. Exercise doesn't mean you have to change into spandex and go to the gym. It can be something as easy as stair climbing."

Adapted from https://www.thisisinsider.com/short-workout-improve-fitness-exercise-snacks-2019-1

*Related reading* :'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance.” 2014.
https://well.blogs.nytimes.com/2014/05/14/exercise-snacks-to-control-blood-sugar/

Scans in Asymptomatic People

Scans

People tend to think that if a scan shows something, then there will likely be symptoms or pain as well. In reality, that is often not the case. This pictures shows (as the title suggests) abnormalities found on scans for people who had ZERO symptoms.

 

*All credit to Lee Darren H for the infographic as posted on the British Journal of Sports Medicine Facebook Page.

Things To Start Doing Now to Master Your Pain

10 Things To Start Doing Now to Master Your Pain (Part 2)

 

Remember that the first five were in last weeks blog, these 10 principles may seem simple in some ways, but they are the basis for approaching

pain—and in essence, life—in a healthier way. There will be times when they are difficult, but they are the things that are under your power and control.

 

Keep Moving

Continue to move and explore ways that make moving possible. Some clinicians still tell patients to not move if it hurts. This is not usually helpful as it tends to make patients believe that hurt means harm. It is well-known that a lack of movement can lead to deconditioning, depression, and worsening pain (and other medical issues). In fact, your body can become more sensitive and less tolerant of activity the more you avoid some discomfort. Well-informed clinicians can help you discover ways to modify your activity in a healthy way to minimize deconditioning. Avoiding movement is rarely indicated unless you have had a recent trauma or surgery. Keep moving by pacing yourself with just enough to challenge you but not so much that it sets you back for days. As you now know, your body can adapt.

 

Be Patient

When you hurt, there is a human tendency to just want it to go away without giving your body the necessary time and space to restore and calm down on its own. One way that some people can become impatient is starting opioids (strong painkillers). These drugs suddenly become the “go-to” from that point on for many people. Unfortunately, opioids can increase your sensitivity to pain and decrease your motivation over time in addition to the concerns of severe constipation, impaired breathing, and depressed immune and hormonal systems.

 

Don’t Focus on the Diagnosis

Avoid labelling yourself. Well-intentioned clinicians will give you a diagnosis that may only describe your pain symptom but not give you the “why.” Some diagnoses may appear to be threatening or unchangeable which does not help you feel hopeful of change. This can lead to more fear and an increase in pain. In fact, diagnoses can also be wrong. Even if they are correct, the question is always, “What can YOU do to help yourself in spite of that diagnosis?”

 

Live Your Life

Continue to live your life and fill it with the things that bring you joy, which will ultimately decrease stress, anxiety, fear, and pain. It is not always easy early on in the journey, but smiling, connection, and social support are critical components to ease suffering and pain. Focusing on any pain in life will only magnify it. Chronic pain can cut us off from the things we love, which is why it’s all the more important to fight to keep those things in our lives . You truly have the power to change your pain.

 

Educate Yourself

Continue to educate yourself about pain throughout your life journey, and find pain experts who can help guide you when you are struggling to do it on your own. The world of pain continues to evolve and so will you. You have been born into an amazingly adaptable human body. Continue to remain active in doing things for yourself versus relying solely on the medical system to do things to you. We all need a little help every once in a while, but the power of what you can change with education is unlimited.

Again, please remember this article is intended to provide educational information. It is for informational purposes only and should not be construed as medical advice.

Dr. Melissa Cady, D.O., the "Challenge Doctor," is an osteopathic physician certified in anesthesiology and pain medicine by the American Board of Anesthesiology. She often writes about and presents on various health and pain-related topics. Dr. Cady is the founder of PAIN OUT LOUD, an online community of pain challengers and pain professionals. She’s also the author of PAINDEMIC: A Practical and Holistic Look at Chronic Pain, the Medical System, and the ant iPAIN Lifestyle.

 

Things To Start Doing Now to Master Your Pain

10 Things To Start Doing Now to Master Your Pain (Part 1)

 

These 10 principles may seem simple in some ways, but they are the basis for approaching

pain—and in essence, life—in a healthier way. There will be times when they are difficult, but they are the things that are under your power and control.

 

Rule Out Your Biggest Fears

If you are experiencing pain, and you suspect it may be life-threatening or relentlessly progressive, then immediately seek medical help to rule out any emergencies or life-threatening conditions. Isolated pain without other concerning symptoms such as severe leg or arm impairments, fevers, significant weight loss, and/or changes in other body systems is rarely serious. Assuage your concerns by doing your due diligence to address potential urgent matters.

 

Be Aware

Your body’s natural pain response is intended to protect you. Therefore, pay attention to ensure that there is no obvious threat to you. Sudden, acute pain can help us flee dangerous situations. Pain itself is constructed by many inputs, including fear, physical sensations, stress, depression, social isolation, lifestyle patterns, etc. Pain that persists with no serious survival or health concerns can fester in a way that can isolate you from many things in your life. Ironically, merely fixating on the pain or suffering can magnify pain. Noticing what makes your pain better or worse can help you or someone who is trying to help you understand your pain better. However, being aware that there are many inputs that can influence your pain is important to understand so that you can explore those things that improve your pain experience.

Breathe

Deep breathing enables you to counteract the sympathetic nervous system (fight-or-flight) with the parasympathetic system (rest and digest). Practice some slow, deep breathing to calm down your nervous system. This skill can be used at any time for the rest of your life. Your nervous system can go on high alert or be hypervigilant for various reasons, and it is not always due to physical threats, but the power of breath can soothe your system. There are many scientific reasons that this is a commonly used practice during childbirth.

Master you Mind

Once you have ruled out any emergencies or life-threatening conditions, then your next step is to practice mastering your mind’s interpretation of pain. Are you still anxious despite the fact that there is no evidence that you have a life-threatening condition? Are you uncomfortable with not knowing the pain’s cause? Identify the feelings and concerns you are experiencing. They will be guiding the types of choices that you will make for addressing your pain. It is important to understand how you are interpreting your pain. If you are incredibly fearful, then many of the decisions that are chosen in haste may not always be the best solution or may not be addressing the root cause of your pain.

Remember “Hurt Does Not Always Mean Harm”

Although there are times that harm can lead to hurt, hurt does not always mean harm. Information that is sent to the brain and interpreted as pain does not mean that you are injured or hurt. In fact, it can mean many things including you may not have been moving enough, not been moving well, been moving something too much, or other parts of your life can be causing your nervous system to be extremely sensitive. The body is incredibly resilient, healing, and adaptable. Sometimes the body sends information to our brain because the body/brain needs us to change what we are doing and/or is overly sensitive due to stress, poor diet, lack of sleep, toxins, or other inflammatory states. Just remember that pain does not mean you will injure yourself unless you have extreme conditions like severe osteoporosis.

Dr. Melissa Cady, D.O., the "Challenge Doctor," is an osteopathic physician certified in anesthesiology and pain medicine by the American Board of Anesthesiology. She often writes about and presents on various health and pain-related topics. Dr. Cady is the founder of PAIN OUT LOUD, an online community of pain challengers and pain professionals. She’s also the author of PAINDEMIC: A Practical and Holistic Look at Chronic Pain, the Medical System, and the ant iPAIN Lifestyle.

Low Back Pain Beliefs

Low Back Pain Beliefs

In 2014, a study by Darlow et al was published in BMJ Open. The study looked at beliefs of back pain in New Zealand citizens above the age of eighteen years of age.

602 valid responses were received. Although not all of them had back pain at that moment (27%, which is still a substantial amount), 87% had experienced it at least once in their lives

34 questions were asked. Some of the significant responses were:

  • 60% think the risk of exercise outweigh the benefit.
  • 69% think they should “take it easy”.
  • 59% think that any pain with activity should be avoided in the future.
  • 35% think the main treatment is bedrest.
  • 94% think lifting without bending their knees is not safe for their back.

Negative views were prevalent, in particular, the need to protect the back to prevent injury.

People with current back pain had more negative overall scores, particularly related to back pain prognosis.

Participants also showed uncertainty about links between pain and injury and appropriate physical activity levels during an episode of back pain.

Respondents had more POSITIVE views about activity if they had consulted a HEALTH PROFESSIONAL about back pain, which illustrates the power of EDUCATION in back pain recovery.

TAKE HOME MESSAGE: Your BELIEFS can strongly influence your back PAIN and your RECOVERY, both positively and negatively

It is important to remember that MOST people experience back pain at least once in their lives, and MOST people recover just fine

Your back is strong and resilient Treat it that way

Darlow B., Perry M., Stanley J., et al, A cross-sectional survey of attitudes and beliefs about back pain in New Zealand, BMJ Open 2014
 

Lumbar Spinal Stenosis

Degenerative lumbar spinal stenosis, is a leading cause of pain, disability and loss of independence in older adults.  Lumbar spinal stenosis refers to a focal narrowing of the central canal and / or lateral foramina of the spine usually identified by imaging.  It is interesting to note narrowing of the spinal canals alone with clinical information is not meaningful as 30% of patients over 55 years have narrowing (stenosis) but no symptoms.

Neurogenic claudication is the term used to describe the clinical syndrome caused by lumbar spinal stenosis.  It is characterized by buttock, leg pain, heaviness, numbness, tingling or weakness brought on by walking and standing and relieved by sitting and bending forward.

There are many causes of narrowing of the spinal canals and these include; congenital variations, spondylolisthesis, some bone diseases and a previous spinal surgery. However, the most common cause is degenerative arthritis.

Degenerative or osteoarthritis is a wear and tear type of arthritis that we all get to some degree when we age.  This kind of arthritis results in a thinning and bulging of the intervertebral discs and a thickening of the facet joints and internal spinal ligaments.

Degenerative spinal changes lead to a decrease in the area of the spinal canals and potential compression to the spinal nerves that travel to the lower extremities.  The narrowed spinal canals also restrict blow flow to the spinal nerves with needs oxygen to function. This leads to neuro-ischemia and hypoxia to the nerves which results in leg pain and impacts the ability to walk.

Interestingly, patients who have difficulty walking due to lumbar spinal stenosis have greater limitations than those patients with hip or knee arthritis and even congestive heart failure or chronic obstructive lung disease.  This leads to a sedentary lifestyle and a progressive decline in health status.  As such lumbar spinal stenosis is chronic disease that can deteriorate with age. Given the aging population this condition is now associated with a large increase in health care resources.

What does a patient history with lumbar spinal stenosis look like?

Patients will typically describe leg symptoms as numbness, tingling, pins and needles, weakness or heaviness in the buttock, back of the thigh and lower leg that can impact their ability to walk.  Back pain is not always present.

Using a shopping trolley or walker relieves symptoms, and some patients report a difficulty in balance which is due to the nerve compression in the lower legs.

What are the treatment options?

Degenerative lumbar spinal stenosis is the most common reason of spinal surgery in individuals over 65 years, however overall this is a small number of individuals.  Patients who have leg dominant rather than back dominant symptoms tend to do better after surgery, many patients note the benefits of surgery tend to diminish over time.

The vast majority of patients receive non- surgical care including: physiotherapy, chiropractic, acupuncture, massage, medications and epidural injections.  Anti-inflammatory medication and injections tend to be less effective as the symptoms are not due to inflammation.

The ability to reduce symptoms of degenerative spinal stenosis by changing spinal posture / structural alignment and /or increasing blood flow to the spinal nerve provides potential mechanisms for interventions to improve symptoms and walking ability.  Dr Carlo Ammendolia and his team from the Mount Sinai Hospital have designed and implemented a six-week self-management program training program, a Boot Camp – which like any boot camp is very physical and tough, however, the goal is to provide patients with the knowledge, skills self-confidence and physical capacity to manage their symptoms and maximize their function on their own.  Ailsa is trained in this program.  The program is delivered one on one over six weeks and during this period a step by step home exercise program is designed and tailored to the individual with the goal of being maintained for life.  This change of lifestyle approach has been studied by the University of Toronto in a clinical trial which demonstrated excellent short and long term results.  Remember “Motion is lotion”.

For more information go to www.spinemobility.com

Pass Overs

The 'Pass Over' is a great exercise for anyone but particularly those working at a desk all day, your shoulders can become tight from being in the same position for hours and this provides an effective way of loosening them up. It helps to warm up and stretch the muscles in your shoulders, arms, and back. Your hamstrings also get a nice stretch with this one. 

Check out the video below for a demonstration.

https://www.facebook.com/CityCentreChiro/videos/1697773220259423/

Hip Hinges

The 'Hip Hinge' is not an exercise to increase strength or build flexibility, it is an exercise to activate our hips to flex. When bending over to lift up a box, change a baby or brush your teeth, a common error to make is to bend your lower back instead of your hips.

This exercise is demonstrated in the clip below.

https://www.facebook.com/CityCentreChiro/videos/1697772190259526/

Wall Angels

One of the best and simplest exercises that can be used to correct poor posture from sitting is called the 'Wall Angel'. This exercise will fire up your core, activate your bum muscles, help extend your thoracic, stretch your chest and activate your lower traps.

Our friend Luke from Reactivate Function gives a demonstration of the exercise in the video below.

https://www.facebook.com/CityCentreChiro/videos/1697735450263200/

Men's Health for Movember

 

 

  1. Make man time

Stay connected. Your mates are important and spending time with them is good for you. Catch up regularly, check in and make time.
 

  1. Have open conversations

You don’t need to be an expert and you don’t have to be the sole solution, but being there for someone, listening and giving your time can be life-saving.
 

  1. Know the numbers

At 50, talk to your doctor about prostate cancer and whether it’s right for you to have a PSA test. If you are of African of Caribbean descent or have a father or brother with prostate cancer, you should be having this conversation at 45. Know your numbers, know your risk, talk to your doctor.
 

  1. Know thy nuts. Simple

Get to know what’s normal for your testicles. Give them a check regularly and go to the doctor if something doesn’t feel right.
 

  1. Move, more

Add more activity to your day. Do more of what makes you feel good.

  • Take a walking meeting
  • Park further away from the station
  • Get off the bus a stop or two earlier
  • Cycle to work instead of driving

From the Movember Foundation website please visit au.movember.com for more information.

View older posts »

Exercise Snacks

Exercise Snacks

 

On busy days, setting aside a large chunk of time to work out can feel unrealistic — even impossible. But new research suggests that a few short bursts of activity spread throughout the day could still improve aerobic fitness.

Dr. Martin Gibala, a professor at McMaster University and senior author of the study, and his team have been researching the benefits of short exercise bursts for more than a decade. But these types of studies often take place in lab settings using stationary bikes.

"We've been increasingly interested in translating this out of the lab and making this more practical and accessible to people," he said. "We thought, well, stair climbing is a great way to apply this. Many of us work in an office tower or live in apartment complexes, so stairs are readily available."

The researchers recruited 24 college students who were healthy but inactive, reporting less than one hour of structured exercise per week.

Half of the students were randomly assigned to a control group, while the other half took on a six-week regimen of exercise "snacks," or short bursts of physical activity.

This latter group performed three exercise snacks per day, three days out of the week. For each snack, they vigorously climbed stairs for 20 seconds.

Each bout of stair climbing was separated by one to four hours of recovery time. The snacks were also preceded by a short warmup (10 jumping jacks, 10 squats, and five lunges on each side) and followed by a one-minute walking cooldown.

"The practical analogy would be, people come into work in the morning and bound up a few flights of stairs. They do that again on a break or a lunch and they do it again before they leave for the day," Gibala said.

 

Before and after the experiment, the participants underwent a test to measure their cardiorespiratory fitness. "[The test] reflects the ability of the heart, the blood vessels, and the lungs to deliver oxygen through the body, Gibala said. “We measure that using something called a maximal aerobic capacity test, or a VO2max test. That involves exercising on a bike at progressively higher workload ... until you're not able to go anymore. It provides a very accurate measure of the body's peak ability to use oxygen."

 

This measure of fitness is also important to health, Gibala added, because it's closely related to the risk of developing certain chronic illnesses like heart disease and type 2 diabetes.

After the six-week exercise snack regimen, the stair climbers had improved their VO2max by about 5%, compared to the control group that stayed inactive.

"The size of the effect was small, but nonetheless we saw a measurable improvement," Gibala said.

He added that this very small experiment was a "proof of concept" study, and in the future, the researchers have plans to study exercise snacks in larger, longer-lasting studies with more diverse groups of participants. They also plan to look at how these bursts of movement might affect different markers of health, like blood pressure and blood sugar control.

For now, though, the takeaway message is simple.

"We're not at all suggesting that people should only do a minute of exercise or this is all you need," Gibala said. "Really it's a reminder to people that small bouts of activity can be effective. They add up over time. Exercise doesn't mean you have to change into spandex and go to the gym. It can be something as easy as stair climbing."

Adapted from https://www.thisisinsider.com/short-workout-improve-fitness-exercise-snacks-2019-1

*Related reading* :'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance.” 2014.
https://well.blogs.nytimes.com/2014/05/14/exercise-snacks-to-control-blood-sugar/

Scans in Asymptomatic People

Scans

People tend to think that if a scan shows something, then there will likely be symptoms or pain as well. In reality, that is often not the case. This pictures shows (as the title suggests) abnormalities found on scans for people who had ZERO symptoms.

 

*All credit to Lee Darren H for the infographic as posted on the British Journal of Sports Medicine Facebook Page.

Things To Start Doing Now to Master Your Pain

10 Things To Start Doing Now to Master Your Pain (Part 2)

 

Remember that the first five were in last weeks blog, these 10 principles may seem simple in some ways, but they are the basis for approaching

pain—and in essence, life—in a healthier way. There will be times when they are difficult, but they are the things that are under your power and control.

 

Keep Moving

Continue to move and explore ways that make moving possible. Some clinicians still tell patients to not move if it hurts. This is not usually helpful as it tends to make patients believe that hurt means harm. It is well-known that a lack of movement can lead to deconditioning, depression, and worsening pain (and other medical issues). In fact, your body can become more sensitive and less tolerant of activity the more you avoid some discomfort. Well-informed clinicians can help you discover ways to modify your activity in a healthy way to minimize deconditioning. Avoiding movement is rarely indicated unless you have had a recent trauma or surgery. Keep moving by pacing yourself with just enough to challenge you but not so much that it sets you back for days. As you now know, your body can adapt.

 

Be Patient

When you hurt, there is a human tendency to just want it to go away without giving your body the necessary time and space to restore and calm down on its own. One way that some people can become impatient is starting opioids (strong painkillers). These drugs suddenly become the “go-to” from that point on for many people. Unfortunately, opioids can increase your sensitivity to pain and decrease your motivation over time in addition to the concerns of severe constipation, impaired breathing, and depressed immune and hormonal systems.

 

Don’t Focus on the Diagnosis

Avoid labelling yourself. Well-intentioned clinicians will give you a diagnosis that may only describe your pain symptom but not give you the “why.” Some diagnoses may appear to be threatening or unchangeable which does not help you feel hopeful of change. This can lead to more fear and an increase in pain. In fact, diagnoses can also be wrong. Even if they are correct, the question is always, “What can YOU do to help yourself in spite of that diagnosis?”

 

Live Your Life

Continue to live your life and fill it with the things that bring you joy, which will ultimately decrease stress, anxiety, fear, and pain. It is not always easy early on in the journey, but smiling, connection, and social support are critical components to ease suffering and pain. Focusing on any pain in life will only magnify it. Chronic pain can cut us off from the things we love, which is why it’s all the more important to fight to keep those things in our lives . You truly have the power to change your pain.

 

Educate Yourself

Continue to educate yourself about pain throughout your life journey, and find pain experts who can help guide you when you are struggling to do it on your own. The world of pain continues to evolve and so will you. You have been born into an amazingly adaptable human body. Continue to remain active in doing things for yourself versus relying solely on the medical system to do things to you. We all need a little help every once in a while, but the power of what you can change with education is unlimited.

Again, please remember this article is intended to provide educational information. It is for informational purposes only and should not be construed as medical advice.

Dr. Melissa Cady, D.O., the "Challenge Doctor," is an osteopathic physician certified in anesthesiology and pain medicine by the American Board of Anesthesiology. She often writes about and presents on various health and pain-related topics. Dr. Cady is the founder of PAIN OUT LOUD, an online community of pain challengers and pain professionals. She’s also the author of PAINDEMIC: A Practical and Holistic Look at Chronic Pain, the Medical System, and the ant iPAIN Lifestyle.

 

Things To Start Doing Now to Master Your Pain

10 Things To Start Doing Now to Master Your Pain (Part 1)

 

These 10 principles may seem simple in some ways, but they are the basis for approaching

pain—and in essence, life—in a healthier way. There will be times when they are difficult, but they are the things that are under your power and control.

 

Rule Out Your Biggest Fears

If you are experiencing pain, and you suspect it may be life-threatening or relentlessly progressive, then immediately seek medical help to rule out any emergencies or life-threatening conditions. Isolated pain without other concerning symptoms such as severe leg or arm impairments, fevers, significant weight loss, and/or changes in other body systems is rarely serious. Assuage your concerns by doing your due diligence to address potential urgent matters.

 

Be Aware

Your body’s natural pain response is intended to protect you. Therefore, pay attention to ensure that there is no obvious threat to you. Sudden, acute pain can help us flee dangerous situations. Pain itself is constructed by many inputs, including fear, physical sensations, stress, depression, social isolation, lifestyle patterns, etc. Pain that persists with no serious survival or health concerns can fester in a way that can isolate you from many things in your life. Ironically, merely fixating on the pain or suffering can magnify pain. Noticing what makes your pain better or worse can help you or someone who is trying to help you understand your pain better. However, being aware that there are many inputs that can influence your pain is important to understand so that you can explore those things that improve your pain experience.

Breathe

Deep breathing enables you to counteract the sympathetic nervous system (fight-or-flight) with the parasympathetic system (rest and digest). Practice some slow, deep breathing to calm down your nervous system. This skill can be used at any time for the rest of your life. Your nervous system can go on high alert or be hypervigilant for various reasons, and it is not always due to physical threats, but the power of breath can soothe your system. There are many scientific reasons that this is a commonly used practice during childbirth.

Master you Mind

Once you have ruled out any emergencies or life-threatening conditions, then your next step is to practice mastering your mind’s interpretation of pain. Are you still anxious despite the fact that there is no evidence that you have a life-threatening condition? Are you uncomfortable with not knowing the pain’s cause? Identify the feelings and concerns you are experiencing. They will be guiding the types of choices that you will make for addressing your pain. It is important to understand how you are interpreting your pain. If you are incredibly fearful, then many of the decisions that are chosen in haste may not always be the best solution or may not be addressing the root cause of your pain.

Remember “Hurt Does Not Always Mean Harm”

Although there are times that harm can lead to hurt, hurt does not always mean harm. Information that is sent to the brain and interpreted as pain does not mean that you are injured or hurt. In fact, it can mean many things including you may not have been moving enough, not been moving well, been moving something too much, or other parts of your life can be causing your nervous system to be extremely sensitive. The body is incredibly resilient, healing, and adaptable. Sometimes the body sends information to our brain because the body/brain needs us to change what we are doing and/or is overly sensitive due to stress, poor diet, lack of sleep, toxins, or other inflammatory states. Just remember that pain does not mean you will injure yourself unless you have extreme conditions like severe osteoporosis.

Dr. Melissa Cady, D.O., the "Challenge Doctor," is an osteopathic physician certified in anesthesiology and pain medicine by the American Board of Anesthesiology. She often writes about and presents on various health and pain-related topics. Dr. Cady is the founder of PAIN OUT LOUD, an online community of pain challengers and pain professionals. She’s also the author of PAINDEMIC: A Practical and Holistic Look at Chronic Pain, the Medical System, and the ant iPAIN Lifestyle.

Low Back Pain Beliefs

Low Back Pain Beliefs

In 2014, a study by Darlow et al was published in BMJ Open. The study looked at beliefs of back pain in New Zealand citizens above the age of eighteen years of age.

602 valid responses were received. Although not all of them had back pain at that moment (27%, which is still a substantial amount), 87% had experienced it at least once in their lives

34 questions were asked. Some of the significant responses were:

  • 60% think the risk of exercise outweigh the benefit.
  • 69% think they should “take it easy”.
  • 59% think that any pain with activity should be avoided in the future.
  • 35% think the main treatment is bedrest.
  • 94% think lifting without bending their knees is not safe for their back.

Negative views were prevalent, in particular, the need to protect the back to prevent injury.

People with current back pain had more negative overall scores, particularly related to back pain prognosis.

Participants also showed uncertainty about links between pain and injury and appropriate physical activity levels during an episode of back pain.

Respondents had more POSITIVE views about activity if they had consulted a HEALTH PROFESSIONAL about back pain, which illustrates the power of EDUCATION in back pain recovery.

TAKE HOME MESSAGE: Your BELIEFS can strongly influence your back PAIN and your RECOVERY, both positively and negatively

It is important to remember that MOST people experience back pain at least once in their lives, and MOST people recover just fine

Your back is strong and resilient Treat it that way

Darlow B., Perry M., Stanley J., et al, A cross-sectional survey of attitudes and beliefs about back pain in New Zealand, BMJ Open 2014
 

Lumbar Spinal Stenosis

Degenerative lumbar spinal stenosis, is a leading cause of pain, disability and loss of independence in older adults.  Lumbar spinal stenosis refers to a focal narrowing of the central canal and / or lateral foramina of the spine usually identified by imaging.  It is interesting to note narrowing of the spinal canals alone with clinical information is not meaningful as 30% of patients over 55 years have narrowing (stenosis) but no symptoms.

Neurogenic claudication is the term used to describe the clinical syndrome caused by lumbar spinal stenosis.  It is characterized by buttock, leg pain, heaviness, numbness, tingling or weakness brought on by walking and standing and relieved by sitting and bending forward.

There are many causes of narrowing of the spinal canals and these include; congenital variations, spondylolisthesis, some bone diseases and a previous spinal surgery. However, the most common cause is degenerative arthritis.

Degenerative or osteoarthritis is a wear and tear type of arthritis that we all get to some degree when we age.  This kind of arthritis results in a thinning and bulging of the intervertebral discs and a thickening of the facet joints and internal spinal ligaments.

Degenerative spinal changes lead to a decrease in the area of the spinal canals and potential compression to the spinal nerves that travel to the lower extremities.  The narrowed spinal canals also restrict blow flow to the spinal nerves with needs oxygen to function. This leads to neuro-ischemia and hypoxia to the nerves which results in leg pain and impacts the ability to walk.

Interestingly, patients who have difficulty walking due to lumbar spinal stenosis have greater limitations than those patients with hip or knee arthritis and even congestive heart failure or chronic obstructive lung disease.  This leads to a sedentary lifestyle and a progressive decline in health status.  As such lumbar spinal stenosis is chronic disease that can deteriorate with age. Given the aging population this condition is now associated with a large increase in health care resources.

What does a patient history with lumbar spinal stenosis look like?

Patients will typically describe leg symptoms as numbness, tingling, pins and needles, weakness or heaviness in the buttock, back of the thigh and lower leg that can impact their ability to walk.  Back pain is not always present.

Using a shopping trolley or walker relieves symptoms, and some patients report a difficulty in balance which is due to the nerve compression in the lower legs.

What are the treatment options?

Degenerative lumbar spinal stenosis is the most common reason of spinal surgery in individuals over 65 years, however overall this is a small number of individuals.  Patients who have leg dominant rather than back dominant symptoms tend to do better after surgery, many patients note the benefits of surgery tend to diminish over time.

The vast majority of patients receive non- surgical care including: physiotherapy, chiropractic, acupuncture, massage, medications and epidural injections.  Anti-inflammatory medication and injections tend to be less effective as the symptoms are not due to inflammation.

The ability to reduce symptoms of degenerative spinal stenosis by changing spinal posture / structural alignment and /or increasing blood flow to the spinal nerve provides potential mechanisms for interventions to improve symptoms and walking ability.  Dr Carlo Ammendolia and his team from the Mount Sinai Hospital have designed and implemented a six-week self-management program training program, a Boot Camp – which like any boot camp is very physical and tough, however, the goal is to provide patients with the knowledge, skills self-confidence and physical capacity to manage their symptoms and maximize their function on their own.  Ailsa is trained in this program.  The program is delivered one on one over six weeks and during this period a step by step home exercise program is designed and tailored to the individual with the goal of being maintained for life.  This change of lifestyle approach has been studied by the University of Toronto in a clinical trial which demonstrated excellent short and long term results.  Remember “Motion is lotion”.

For more information go to www.spinemobility.com

Pass Overs

The 'Pass Over' is a great exercise for anyone but particularly those working at a desk all day, your shoulders can become tight from being in the same position for hours and this provides an effective way of loosening them up. It helps to warm up and stretch the muscles in your shoulders, arms, and back. Your hamstrings also get a nice stretch with this one. 

Check out the video below for a demonstration.

https://www.facebook.com/CityCentreChiro/videos/1697773220259423/

Hip Hinges

The 'Hip Hinge' is not an exercise to increase strength or build flexibility, it is an exercise to activate our hips to flex. When bending over to lift up a box, change a baby or brush your teeth, a common error to make is to bend your lower back instead of your hips.

This exercise is demonstrated in the clip below.

https://www.facebook.com/CityCentreChiro/videos/1697772190259526/

Wall Angels

One of the best and simplest exercises that can be used to correct poor posture from sitting is called the 'Wall Angel'. This exercise will fire up your core, activate your bum muscles, help extend your thoracic, stretch your chest and activate your lower traps.

Our friend Luke from Reactivate Function gives a demonstration of the exercise in the video below.

https://www.facebook.com/CityCentreChiro/videos/1697735450263200/

Men's Health for Movember

 

 

  1. Make man time

Stay connected. Your mates are important and spending time with them is good for you. Catch up regularly, check in and make time.
 

  1. Have open conversations

You don’t need to be an expert and you don’t have to be the sole solution, but being there for someone, listening and giving your time can be life-saving.
 

  1. Know the numbers

At 50, talk to your doctor about prostate cancer and whether it’s right for you to have a PSA test. If you are of African of Caribbean descent or have a father or brother with prostate cancer, you should be having this conversation at 45. Know your numbers, know your risk, talk to your doctor.
 

  1. Know thy nuts. Simple

Get to know what’s normal for your testicles. Give them a check regularly and go to the doctor if something doesn’t feel right.
 

  1. Move, more

Add more activity to your day. Do more of what makes you feel good.

  • Take a walking meeting
  • Park further away from the station
  • Get off the bus a stop or two earlier
  • Cycle to work instead of driving

From the Movember Foundation website please visit au.movember.com for more information.

View older posts »

Centre News Blog

Exercise Snacks

Exercise Snacks

 

On busy days, setting aside a large chunk of time to work out can feel unrealistic — even impossible. But new research suggests that a few short bursts of activity spread throughout the day could still improve aerobic fitness.

Dr. Martin Gibala, a professor at McMaster University and senior author of the study, and his team have been researching the benefits of short exercise bursts for more than a decade. But these types of studies often take place in lab settings using stationary bikes.

"We've been increasingly interested in translating this out of the lab and making this more practical and accessible to people," he said. "We thought, well, stair climbing is a great way to apply this. Many of us work in an office tower or live in apartment complexes, so stairs are readily available."

The researchers recruited 24 college students who were healthy but inactive, reporting less than one hour of structured exercise per week.

Half of the students were randomly assigned to a control group, while the other half took on a six-week regimen of exercise "snacks," or short bursts of physical activity.

This latter group performed three exercise snacks per day, three days out of the week. For each snack, they vigorously climbed stairs for 20 seconds.

Each bout of stair climbing was separated by one to four hours of recovery time. The snacks were also preceded by a short warmup (10 jumping jacks, 10 squats, and five lunges on each side) and followed by a one-minute walking cooldown.

"The practical analogy would be, people come into work in the morning and bound up a few flights of stairs. They do that again on a break or a lunch and they do it again before they leave for the day," Gibala said.

 

Before and after the experiment, the participants underwent a test to measure their cardiorespiratory fitness. "[The test] reflects the ability of the heart, the blood vessels, and the lungs to deliver oxygen through the body, Gibala said. “We measure that using something called a maximal aerobic capacity test, or a VO2max test. That involves exercising on a bike at progressively higher workload ... until you're not able to go anymore. It provides a very accurate measure of the body's peak ability to use oxygen."

 

This measure of fitness is also important to health, Gibala added, because it's closely related to the risk of developing certain chronic illnesses like heart disease and type 2 diabetes.

After the six-week exercise snack regimen, the stair climbers had improved their VO2max by about 5%, compared to the control group that stayed inactive.

"The size of the effect was small, but nonetheless we saw a measurable improvement," Gibala said.

He added that this very small experiment was a "proof of concept" study, and in the future, the researchers have plans to study exercise snacks in larger, longer-lasting studies with more diverse groups of participants. They also plan to look at how these bursts of movement might affect different markers of health, like blood pressure and blood sugar control.

For now, though, the takeaway message is simple.

"We're not at all suggesting that people should only do a minute of exercise or this is all you need," Gibala said. "Really it's a reminder to people that small bouts of activity can be effective. They add up over time. Exercise doesn't mean you have to change into spandex and go to the gym. It can be something as easy as stair climbing."

Adapted from https://www.thisisinsider.com/short-workout-improve-fitness-exercise-snacks-2019-1

*Related reading* :'Exercise snacks' before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance.” 2014.
https://well.blogs.nytimes.com/2014/05/14/exercise-snacks-to-control-blood-sugar/

Scans in Asymptomatic People

Scans

People tend to think that if a scan shows something, then there will likely be symptoms or pain as well. In reality, that is often not the case. This pictures shows (as the title suggests) abnormalities found on scans for people who had ZERO symptoms.

 

*All credit to Lee Darren H for the infographic as posted on the British Journal of Sports Medicine Facebook Page.

Things To Start Doing Now to Master Your Pain

10 Things To Start Doing Now to Master Your Pain (Part 2)

 

Remember that the first five were in last weeks blog, these 10 principles may seem simple in some ways, but they are the basis for approaching

pain—and in essence, life—in a healthier way. There will be times when they are difficult, but they are the things that are under your power and control.

 

Keep Moving

Continue to move and explore ways that make moving possible. Some clinicians still tell patients to not move if it hurts. This is not usually helpful as it tends to make patients believe that hurt means harm. It is well-known that a lack of movement can lead to deconditioning, depression, and worsening pain (and other medical issues). In fact, your body can become more sensitive and less tolerant of activity the more you avoid some discomfort. Well-informed clinicians can help you discover ways to modify your activity in a healthy way to minimize deconditioning. Avoiding movement is rarely indicated unless you have had a recent trauma or surgery. Keep moving by pacing yourself with just enough to challenge you but not so much that it sets you back for days. As you now know, your body can adapt.

 

Be Patient

When you hurt, there is a human tendency to just want it to go away without giving your body the necessary time and space to restore and calm down on its own. One way that some people can become impatient is starting opioids (strong painkillers). These drugs suddenly become the “go-to” from that point on for many people. Unfortunately, opioids can increase your sensitivity to pain and decrease your motivation over time in addition to the concerns of severe constipation, impaired breathing, and depressed immune and hormonal systems.

 

Don’t Focus on the Diagnosis

Avoid labelling yourself. Well-intentioned clinicians will give you a diagnosis that may only describe your pain symptom but not give you the “why.” Some diagnoses may appear to be threatening or unchangeable which does not help you feel hopeful of change. This can lead to more fear and an increase in pain. In fact, diagnoses can also be wrong. Even if they are correct, the question is always, “What can YOU do to help yourself in spite of that diagnosis?”

 

Live Your Life

Continue to live your life and fill it with the things that bring you joy, which will ultimately decrease stress, anxiety, fear, and pain. It is not always easy early on in the journey, but smiling, connection, and social support are critical components to ease suffering and pain. Focusing on any pain in life will only magnify it. Chronic pain can cut us off from the things we love, which is why it’s all the more important to fight to keep those things in our lives . You truly have the power to change your pain.

 

Educate Yourself

Continue to educate yourself about pain throughout your life journey, and find pain experts who can help guide you when you are struggling to do it on your own. The world of pain continues to evolve and so will you. You have been born into an amazingly adaptable human body. Continue to remain active in doing things for yourself versus relying solely on the medical system to do things to you. We all need a little help every once in a while, but the power of what you can change with education is unlimited.

Again, please remember this article is intended to provide educational information. It is for informational purposes only and should not be construed as medical advice.

Dr. Melissa Cady, D.O., the "Challenge Doctor," is an osteopathic physician certified in anesthesiology and pain medicine by the American Board of Anesthesiology. She often writes about and presents on various health and pain-related topics. Dr. Cady is the founder of PAIN OUT LOUD, an online community of pain challengers and pain professionals. She’s also the author of PAINDEMIC: A Practical and Holistic Look at Chronic Pain, the Medical System, and the ant iPAIN Lifestyle.

 

Things To Start Doing Now to Master Your Pain

10 Things To Start Doing Now to Master Your Pain (Part 1)

 

These 10 principles may seem simple in some ways, but they are the basis for approaching

pain—and in essence, life—in a healthier way. There will be times when they are difficult, but they are the things that are under your power and control.

 

Rule Out Your Biggest Fears

If you are experiencing pain, and you suspect it may be life-threatening or relentlessly progressive, then immediately seek medical help to rule out any emergencies or life-threatening conditions. Isolated pain without other concerning symptoms such as severe leg or arm impairments, fevers, significant weight loss, and/or changes in other body systems is rarely serious. Assuage your concerns by doing your due diligence to address potential urgent matters.

 

Be Aware

Your body’s natural pain response is intended to protect you. Therefore, pay attention to ensure that there is no obvious threat to you. Sudden, acute pain can help us flee dangerous situations. Pain itself is constructed by many inputs, including fear, physical sensations, stress, depression, social isolation, lifestyle patterns, etc. Pain that persists with no serious survival or health concerns can fester in a way that can isolate you from many things in your life. Ironically, merely fixating on the pain or suffering can magnify pain. Noticing what makes your pain better or worse can help you or someone who is trying to help you understand your pain better. However, being aware that there are many inputs that can influence your pain is important to understand so that you can explore those things that improve your pain experience.

Breathe

Deep breathing enables you to counteract the sympathetic nervous system (fight-or-flight) with the parasympathetic system (rest and digest). Practice some slow, deep breathing to calm down your nervous system. This skill can be used at any time for the rest of your life. Your nervous system can go on high alert or be hypervigilant for various reasons, and it is not always due to physical threats, but the power of breath can soothe your system. There are many scientific reasons that this is a commonly used practice during childbirth.

Master you Mind

Once you have ruled out any emergencies or life-threatening conditions, then your next step is to practice mastering your mind’s interpretation of pain. Are you still anxious despite the fact that there is no evidence that you have a life-threatening condition? Are you uncomfortable with not knowing the pain’s cause? Identify the feelings and concerns you are experiencing. They will be guiding the types of choices that you will make for addressing your pain. It is important to understand how you are interpreting your pain. If you are incredibly fearful, then many of the decisions that are chosen in haste may not always be the best solution or may not be addressing the root cause of your pain.

Remember “Hurt Does Not Always Mean Harm”

Although there are times that harm can lead to hurt, hurt does not always mean harm. Information that is sent to the brain and interpreted as pain does not mean that you are injured or hurt. In fact, it can mean many things including you may not have been moving enough, not been moving well, been moving something too much, or other parts of your life can be causing your nervous system to be extremely sensitive. The body is incredibly resilient, healing, and adaptable. Sometimes the body sends information to our brain because the body/brain needs us to change what we are doing and/or is overly sensitive due to stress, poor diet, lack of sleep, toxins, or other inflammatory states. Just remember that pain does not mean you will injure yourself unless you have extreme conditions like severe osteoporosis.

Dr. Melissa Cady, D.O., the "Challenge Doctor," is an osteopathic physician certified in anesthesiology and pain medicine by the American Board of Anesthesiology. She often writes about and presents on various health and pain-related topics. Dr. Cady is the founder of PAIN OUT LOUD, an online community of pain challengers and pain professionals. She’s also the author of PAINDEMIC: A Practical and Holistic Look at Chronic Pain, the Medical System, and the ant iPAIN Lifestyle.

Low Back Pain Beliefs

Low Back Pain Beliefs

In 2014, a study by Darlow et al was published in BMJ Open. The study looked at beliefs of back pain in New Zealand citizens above the age of eighteen years of age.

602 valid responses were received. Although not all of them had back pain at that moment (27%, which is still a substantial amount), 87% had experienced it at least once in their lives

34 questions were asked. Some of the significant responses were:

  • 60% think the risk of exercise outweigh the benefit.
  • 69% think they should “take it easy”.
  • 59% think that any pain with activity should be avoided in the future.
  • 35% think the main treatment is bedrest.
  • 94% think lifting without bending their knees is not safe for their back.

Negative views were prevalent, in particular, the need to protect the back to prevent injury.

People with current back pain had more negative overall scores, particularly related to back pain prognosis.

Participants also showed uncertainty about links between pain and injury and appropriate physical activity levels during an episode of back pain.

Respondents had more POSITIVE views about activity if they had consulted a HEALTH PROFESSIONAL about back pain, which illustrates the power of EDUCATION in back pain recovery.

TAKE HOME MESSAGE: Your BELIEFS can strongly influence your back PAIN and your RECOVERY, both positively and negatively

It is important to remember that MOST people experience back pain at least once in their lives, and MOST people recover just fine

Your back is strong and resilient Treat it that way

Darlow B., Perry M., Stanley J., et al, A cross-sectional survey of attitudes and beliefs about back pain in New Zealand, BMJ Open 2014
 

Lumbar Spinal Stenosis

Degenerative lumbar spinal stenosis, is a leading cause of pain, disability and loss of independence in older adults.  Lumbar spinal stenosis refers to a focal narrowing of the central canal and / or lateral foramina of the spine usually identified by imaging.  It is interesting to note narrowing of the spinal canals alone with clinical information is not meaningful as 30% of patients over 55 years have narrowing (stenosis) but no symptoms.

Neurogenic claudication is the term used to describe the clinical syndrome caused by lumbar spinal stenosis.  It is characterized by buttock, leg pain, heaviness, numbness, tingling or weakness brought on by walking and standing and relieved by sitting and bending forward.

There are many causes of narrowing of the spinal canals and these include; congenital variations, spondylolisthesis, some bone diseases and a previous spinal surgery. However, the most common cause is degenerative arthritis.

Degenerative or osteoarthritis is a wear and tear type of arthritis that we all get to some degree when we age.  This kind of arthritis results in a thinning and bulging of the intervertebral discs and a thickening of the facet joints and internal spinal ligaments.

Degenerative spinal changes lead to a decrease in the area of the spinal canals and potential compression to the spinal nerves that travel to the lower extremities.  The narrowed spinal canals also restrict blow flow to the spinal nerves with needs oxygen to function. This leads to neuro-ischemia and hypoxia to the nerves which results in leg pain and impacts the ability to walk.

Interestingly, patients who have difficulty walking due to lumbar spinal stenosis have greater limitations than those patients with hip or knee arthritis and even congestive heart failure or chronic obstructive lung disease.  This leads to a sedentary lifestyle and a progressive decline in health status.  As such lumbar spinal stenosis is chronic disease that can deteriorate with age. Given the aging population this condition is now associated with a large increase in health care resources.

What does a patient history with lumbar spinal stenosis look like?

Patients will typically describe leg symptoms as numbness, tingling, pins and needles, weakness or heaviness in the buttock, back of the thigh and lower leg that can impact their ability to walk.  Back pain is not always present.

Using a shopping trolley or walker relieves symptoms, and some patients report a difficulty in balance which is due to the nerve compression in the lower legs.

What are the treatment options?

Degenerative lumbar spinal stenosis is the most common reason of spinal surgery in individuals over 65 years, however overall this is a small number of individuals.  Patients who have leg dominant rather than back dominant symptoms tend to do better after surgery, many patients note the benefits of surgery tend to diminish over time.

The vast majority of patients receive non- surgical care including: physiotherapy, chiropractic, acupuncture, massage, medications and epidural injections.  Anti-inflammatory medication and injections tend to be less effective as the symptoms are not due to inflammation.

The ability to reduce symptoms of degenerative spinal stenosis by changing spinal posture / structural alignment and /or increasing blood flow to the spinal nerve provides potential mechanisms for interventions to improve symptoms and walking ability.  Dr Carlo Ammendolia and his team from the Mount Sinai Hospital have designed and implemented a six-week self-management program training program, a Boot Camp – which like any boot camp is very physical and tough, however, the goal is to provide patients with the knowledge, skills self-confidence and physical capacity to manage their symptoms and maximize their function on their own.  Ailsa is trained in this program.  The program is delivered one on one over six weeks and during this period a step by step home exercise program is designed and tailored to the individual with the goal of being maintained for life.  This change of lifestyle approach has been studied by the University of Toronto in a clinical trial which demonstrated excellent short and long term results.  Remember “Motion is lotion”.

For more information go to www.spinemobility.com

Pass Overs

The 'Pass Over' is a great exercise for anyone but particularly those working at a desk all day, your shoulders can become tight from being in the same position for hours and this provides an effective way of loosening them up. It helps to warm up and stretch the muscles in your shoulders, arms, and back. Your hamstrings also get a nice stretch with this one. 

Check out the video below for a demonstration.

https://www.facebook.com/CityCentreChiro/videos/1697773220259423/

Hip Hinges

The 'Hip Hinge' is not an exercise to increase strength or build flexibility, it is an exercise to activate our hips to flex. When bending over to lift up a box, change a baby or brush your teeth, a common error to make is to bend your lower back instead of your hips.

This exercise is demonstrated in the clip below.

https://www.facebook.com/CityCentreChiro/videos/1697772190259526/

Wall Angels

One of the best and simplest exercises that can be used to correct poor posture from sitting is called the 'Wall Angel'. This exercise will fire up your core, activate your bum muscles, help extend your thoracic, stretch your chest and activate your lower traps.

Our friend Luke from Reactivate Function gives a demonstration of the exercise in the video below.

https://www.facebook.com/CityCentreChiro/videos/1697735450263200/

Men's Health for Movember

 

 

  1. Make man time

Stay connected. Your mates are important and spending time with them is good for you. Catch up regularly, check in and make time.
 

  1. Have open conversations

You don’t need to be an expert and you don’t have to be the sole solution, but being there for someone, listening and giving your time can be life-saving.
 

  1. Know the numbers

At 50, talk to your doctor about prostate cancer and whether it’s right for you to have a PSA test. If you are of African of Caribbean descent or have a father or brother with prostate cancer, you should be having this conversation at 45. Know your numbers, know your risk, talk to your doctor.
 

  1. Know thy nuts. Simple

Get to know what’s normal for your testicles. Give them a check regularly and go to the doctor if something doesn’t feel right.
 

  1. Move, more

Add more activity to your day. Do more of what makes you feel good.

  • Take a walking meeting
  • Park further away from the station
  • Get off the bus a stop or two earlier
  • Cycle to work instead of driving

From the Movember Foundation website please visit au.movember.com for more information.

#Loveyourspine

Taking place on October 16 each year, World Spine Day has become a focus in raising awareness of back pain and other spinal issues. With health professionals, exercise and rehabilitation experts, public health advocates, schoolchildren and patients all taking part, #LoveYourSpine will be celebrated on every continent.

#LoveYourSpine will highlight the importance of spinal health and wellbeing. Promotion of physical activity, good posture, responsible lifting and healthy working conditions will all feature as people are encouraged to look after their spines and stay active.

With an estimated one billion people worldwide suffering from back pain, it affects all age groups, from children to the elderly. It is the biggest single cause of disability on the planet, with one in four adults estimated to suffer from back pain during their lives. Prevention is therefore key and this year’s World Spine Day will be encouraging people to take steps to be kind to their spines.

Movement is medicine, especially for most back and neck pain. Whether you dance, walk, stretch, swim, play, or just wriggle, show your body that you #LoveYourSpine. For more information visit www.worldspineday.org.

Your Second Core

For years, our core muscles have been the focus of workout attention. For those who have failed to find them, these are the muscles that wrap around our middles like a corset and, through workouts aimed at engaging even the most deeply embedded of them, we have been promised better posture, flatter stomachs and more supple movement. Now there is a new core workout and what’s surprising is that the core muscles being targeted are not to be found in your trunk, but in your feet.

Improving foot core stability is the latest fitness target among those preoccupied with avoiding rounded shoulders, back pain and falls prevention.

Our feet comprise four layers of muscle and soft tissue, there are muscles at the top and bottom of the foot that help to lock it into place and keep us upright, in short the foot’s core supports the body.

A strong, healthy foot has a moderately high arch, no over­pronation — rolling inwards — and some natural spreading of the toes. In a paper published three years ago in the British Journal of Sports Medicine, a team of Harvard researchers define the central core of the foot as the range of muscles intertwining to maintain this raised arch, providing us with the stability needed to hold us in good posture or to support even the most basic movement patterns, such as walking.

In evolutionary terms, the foot developed in response to the ­demands placed on it as humans walked and ran. Its intricate musculature connects to muscles in the ankle, lower leg, back and abdomen.

When we are doing something as simple as standing up, it is the feet that act as a solid base, when we walk or run, it is the muscles in the feet that provide the ability to push off and move forward. Like any other muscle, when the foot’s core is underused it becomes weak and unable to function as it should.

As the Harvard researchers put it, our “foundation becomes ­unstable and malaligned” and the result, at the very least, can be foot-related repetitive strain and chronic pain. With diminished strength, the foot arch can drop or collapse, potentially leading to strain of the plantar ­fascia — the thick, supportive band of tissue that runs across the bottom of your foot and connects to your heel. That can trigger pronation of the ankle and ­unusual forces being placed on the knee joint. Over time, a weak foot core can be implicated in ­reduced walking efficiency and range of movement, or worse. It can lead to problematic things like chronic plantar fasciitis, tendon dysfunction and even osteoarthritis.

Despite their strong connection with performance enhancement, injury and falls prevention, our feet remain the last body part we think of working at the gym. There are no classes to strengthen the foot core muscles, no foot equivalent of the pilates reformer and they are rarely included in conventional rehab programs. So what should we do? A daily regimen of ‘exercises’ is key.

The researchers suggest, perhaps the simplest thing we should all do is barefoot walking. Simply, walking around the house and the yard (or perhaps the beach) can be used as a tool to strengthen the foot core in those who are not suffering existing pain. Also try to pick something up with your toes, socks or a towel, then try something like marbles. You could also try simple moves such as writing the alphabet with your toes.

In Nature’s Scientific Reports journal in February, it was suggested that the shoes we wear often do nothing to help foot strength. Wearing supportive or restrictive footwear ­reduces the role of the foot muscles. That includes not only high heels, which force the feet into an unstable position and put pressure on the plantar fascia tissue, but overconstructed trainers and insoles that give so much support for the foot arch that the muscles have little work to do to keep it raised.

However, if you already have flat foot or overpronation or other afflictions that cause foot pain, stick to your shoes or insoles or whatever helps you minimise that pain. But if you don’t have any of those problems, you should try easing your way into using less structured shoes. Based on data from a few different studies, there is now a cautious suggestion that minimalist shoes those with no in-built arch support and sandals are ideal in helping to maintain a strong, healthy foot.

As for a as your brain is concerned your feet are an enormously rich source of movement information (proprioception)  which ensures our body and spine remain stable whilst we are conducting all the tasks of daily living. Your brain and neural networks like variety, the more you can stimulate the nerves in your feet and ankles, the better. Strengthening specific small muscles of the foot and ankle can play a huge role in performance enhancement and injury prevention.  Because the toe and arch muscles provide stability during the pushoff phase while walking, jumping, and running, weakness in these muscles may lead to a variety of injuries including plantar fasciitis, stress fractures, bunions, and Achilles tendinitis. Remember maintaining strong toes is especially important as we age, because older adults have toe strength declines of more than 35%, and the resultant toe weakness correlates strongly with an increased risk of fall.

Treating Lower Back Aches Without Drugs and Surgery by 'Rethinking Pain'

You're worn down by intermittent back pain. It's an unpredictable beast. It can come on so strongly you cannot walk, or sit.

At least you think you can't (but read on).

In desperation, you consider surgery — but this is not always a good move.

The evidence of benefit from surgery is weak at best, as a recent Lancet series on lower back pain found.

Despite this, plenty of people are still going under the knife. Lumbar spine surgery rates are doubling roughly every 10 years, according to University of NSW professor of orthopaedic surgery Ian Harris.

And, he said, the operations are getting more complex, and therefore more risky.

"What we are seeing is an increase in complex surgery over simple surgery, in particular fusions, in particular multilevel fusions."

There are however, cheaper, more effective ways to deal with back pain. We asked the experts what works — and what doesn't.

 

Get Moving

Yes, even if it hurts. Once you have the all clear from a doctor or physiotherapist, you are safe to move.

Developments in neuroscience indicate that the brain creates pain as a mechanism to protect us.

In the case of chronic pain, the pain system gets more sensitive. Our body learns pain — and so we feel it more acutely.

When it comes to chronic pain, the brain is being overly cautious. Pain is increased by fear of re-injury and a whole host of other factors. And so, over time, our body creates a bigger than necessary pain buffer zone.

But you can still move — and exercise — within that pain buffer zone, without causing tissue damage, according to University of South Australia professor of clinical neurosciences Lorimer Moseley, who is at the forefront of Australia's world-leading brain and pain research.

"If we can appreciate that pain is a protective device, not a measure of tissue damage, if we can communicate that to people, then we change the game," Professor Moseley said.

When people realise they are safe to move, they can start to get better, he said.

Associate Professor Mark Hancock, a physiotherapist researching lower back pain at Macquarie University, agrees.

"If people stop moving they get weaker and stiffer and it often causes more harm. Moving into a little bit of pain is appropriate," he said.

Move how?

There's a plethora of activities promising to be good for backs, from Pilates to the Alexander Technique, to half a dozen forms of yoga.

Associate Professor Hancock said although there is no strong evidence that one type of exercise is superior to another, most exercise is beneficial.

"There is no evidence that any specific exercise is dangerous if done appropriately or by people who are ready for it," he said.

But if after an acute onset of back pain there is not improvement over two weeks, perhaps seek advice from a physiotherapist.

"A good clinician will help find the most appropriate exercise for the person," he said.

"If muscles are weak around the spine then it's strength exercise."

If there are coordination or movement problems, it could be a different exercise.

A patient's preferences are important, too. There's no point taking up swimming if you don't like water.

And movement has an added bonus. Most back pain is recurrent, but exercise has an important preventative role.

"It's a good news story," Associate Professor Hancock said.

"There's evidence that exercise reduces the rate of recurrence by 50 per cent. That's a good reduction. Not a lot of medical treatments are that effective."

US journalist and author of Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, Cathryn Jakobson Ramin, said her own back has responded to some fairly simple intervention.

Now 61, she had suffered back pain since the age of 16, but these days is mostly free of it.

"What I discovered is I had a very weak upper body," she said.

"I had a lot of fear, which was taking its toll. I'd had enough pain that I was afraid to do anything that might cause more. I realised I had gluteal amnesia. My butt had fallen asleep.

"Once I began to do the exercises that recruited those muscles, and recruited all the pelvic muscles, things got better and they got better fast."

Scans & X-Rays

Seeing an image of your spine has to help explain the cause of the pain, doesn't it?

No, not usually, according to Associate Professor Hancock, who was one of the 30 international authors who worked on the Lancet back pain series.

He and his co-authors found widespread overuse of imaging for back pain.

The reason a picture of a bulged disc, for example, doesn't tell the whole story, is that everyone's spines change over time — and two people can have exactly the same imaging findings, but one of them will feel no pain at all.

Associate Professor Hancock acknowledges doctors are under pressure from patients who want to see what's going on in their spine.

But he said scans for simple lower back pain should not be subsidised by our health system, as they are costing far too much, with questionable usefulness.

Cortisone Injections

Often offered as the panacea, the use of cortisone injections has "doubled, perhaps tripled, over a short period of time", Associate Professor Hancock said.

They have become a very common intervention for people with sciatica.

The Lancet researchers pulled together all the available literature on the injections — and again, there was little justification for cortisone injections.

"The best estimate we have from previous studies is that corticosteroid injections reduce sciatica (leg pain associated with back pain) by only five points on a 100-point scale compared to placebo in the short term, with no long term benefit," Associate Professor Hancock said.

"So it's a very small difference."

 

No surgery … ever?

"You can never consider surgery as your best option for ordinary low back pain. because an intact spine is always better than a surgically altered spine," said Ms Ramin, who is adamant on this point.

For her book, Ms Ramin researched what she calls the "back pain industry", and its many surgical trends over the decades.

Problems emerged with each, and new techniques would take their place, but rarely with adequate evidence, she said.

There are exceptions where spinal surgery may be warranted — for trauma, tumour, or neurological deficit from instability or displacement of the vertebrae.

But Professor Harris — an orthopaedic surgeon himself, who wrote the book Surgery, The Ultimate Placebo — agrees that for most back pain, surgery is not the answer.

"For patients with typical degenerative changes in the spine and chronic low back pain without a significant neurological problem, I would not advise spine surgery in any situation," he said.

"It is expensive and increases the risk of harm and there is no high-level evidence of a benefit."

In the workers' compensation system, the impact is dire, he said.

"We have previously shown that the results of this surgery in this group of patients is poor, with only 3 per cent returning to pre-injury duties and about 89 per cent still taking major narcotics for pain relief at 24 months post-surgery," Professor Harris said.

"The cost to the workers compensation system for this surgery is about $100,000 per procedure."

 

Stay off the drugs

Back pain is the main reason people use opioids over a long period of time, according to the Lancet authors.

However, the addictive harm of opioids has been well documented.

Associate Professor Hancock said a short stint on anti-inflammatories may be helpful.

"The important thing is not taking meds for a long period," he said.

"If a short period of anti-inflammatories helps get the person moving, then that's appropriate."

With opioids, it's a different story.

"But with opioids we know that even very short periods of use increase the risk of dependence. Try to avoid them in almost all cases," he said.

 

Rethink your pain

Sometimes the very language we use to describe pain — "feels like a knife" and "there's something burning in there" — contributes to the experience of pain. Drug advertising urges us to fight pain, attack it, and see it as an enemy.

Instead, the Pain Revolution movement, led by Professor Moseley, wants people to understand what the science indicates — that pain is a friend that protects our tissues when they need to heal.

But it can get over-protective, because the brain is responding to all kinds of influences.

Professor Moseley said being aware of that has many benefits. The change of outlook — letting go of the fear — allows people to gradually increase what movement they can do. We need to retrain our pain system — body and brain.

As well, varied and new experiences, of sight, smell, touch and creativity may reorient neural pathways and be helpful.

 

Find the right clinician

How do you make sure you're on the path outlined above? It might not be easy, but try to find a GP, physiotherapist or chiropractor who is across the current evidence.

There's a strong view among pain researchers that not nearly enough is taught in medical school, or in other clinical courses, about the complexity of pain and the potential to influence it.

And when it comes to the lower back, many practitioners are not keeping up with the guidelines, Associate Professor Hancock said. The old days of ordering bed rest are long gone, yet some clinicians still advise rest.

"If the clinician is recommending MRIs, investigations and injections, that should be a red flag to you," Associate Professor Hancock said.

"If a clinician says see me three or four times a week for hot packs and massage, that's also not good evidence-based care. It's passive. You're not taking responsibility.

"The focus should be on you being given the skills and knowledge to self-manage in safe and simple ways."

 

Retrieved from http://www.abc.net.au/news/health/2018-06-11/treating-lower-back-pain-without-drugs-and-surgery/9850798

12 Tips for Taking Care of your Spine

  1. Posture!

Get vigilant, catch yourself in the act of slouching and commit to straightening up. We’ve written all about the benefits of good posture before, but it’s worth repeating. Maintaining good posture is the #1 thing you can do to protect your spine, moment to moment.

Here’s an easy way to think about it: keep your ear, shoulder and hip lined up neatly.

 

  1. Keep movin’ movin’ movin’

According to the World Health Organisation (WHO), ‘Approximately 3.2 million deaths each year are attributable to insufficient physical activity’. Human bodies need to move; there’s no denying it. But it’s not just a matter of life and death – your spine also suffers due to lack of activity. Regular movement – daily walking, safe, enjoyable sports, strength and flexibility – keeps you limber. It decreases inflammation, supports healthy lymphatic flow and function, keeps muscles and ligaments strong and the spine supported plus reduces pain and stiffness.

 

Need help to get moving? Chat to us next time you’re in clinic. We can help you put one foot in front of the other in a way that works for you.

 

  1. Mind that text neck!

What’s text neck, you ask? Looking down at your mobile phone or device and putting the weight of a bowling ball on your upper spine. This leads to pain, stiffness and ultimately – damage.

 

Our advice? Bring your device up to eye level, draw your chin back and take regular breaks from those ubiquitous screens.

 

  1. Bags.

Use a handbag? Carry a briefcase? Kids lugging big, heavy backpacks to school? Take a moment to investigate. Are these lopsided and cumbersome bags causing problems? Unsupportive bags + one-sided weight + heavy contents = sad spine! Ask us in clinic for advice and back-friendly recommendations.

 

  1. Dream of good posture.

How do you sleep? Chiropractors generally recommend sleeping on your back or side as opposed to your stomach. It’s also a good idea to invest in a quality mattress – firm but supportive – and for perfect spinal/pelvic alignment you can also pop a pillow between your knees overnight.

 

  1. Ditch the cigarettes.

By now, we’re collectively well-versed in the dangers of smoking. The same rules apply for the spine. Smoking promotes inflammation, dehydration, free-radical damage, depletes vitamins, minerals and oxygen to the tissues.

 

  1. Whole body wellness isn’t just for hippies.

Besides the obvious: sitting up straight, standing tall, not lifting and twisting, nutrition also plays a vital role in spinal health. A wholesome diet high in fresh, seasonal, colourful produce and low in inflammatory fast food, bad fats and refined sugar will support your entire body – back included. The right foods nourish and heal; decreasing inflammation, pain and the risk of disease.

 

What does this look like? There are no strict rules, but you can’t go wrong with oodles of veggies and fruit, non-processed meats and seafood (if you eat it), whole dairy (if you’re not allergic), nuts, seeds and a slice of soul food thrown in occasionally. If it comes in a packet, leave it on the shelf.

 

  1. Be brave, be gentle.

This tip is for anyone already suffering pain, injury or loss of function. When you’re in chronic pain, sometimes you become fearful of any movement at all. However, there’s a point at which you need to be a little brave, a touch proactive and a lot gentle. With the help of your Chiropractic practitioner, you can start incorporating beneficial movement that won’t hinder your progress – in fact, it’ll set you on the road to recovery.

 

  1. Get creative in your cubicle

Did you know that Australian office workers spend up to 70% of their day sitting? That’s a whole lot of hours folded up, inactive. To prevent the risks associated with being sedentary, it’s time to think outside the box (or, cubicle).

  • make sure management has invested time (and money) in ergonomic furniture
  • for every 30 minutes spent sitting, get up and move around for 1-2
  • maintain good seated posture
  • consider a standing desk (but make sure you ask us for advice, first! There’s a right and wrong way to go about it).
  • try ‘walking meetings’ instead of seated chats in the boardroom

 

  1. Make like an apple and core.

And by that we mean: build a strong one. Research shows that decreased core-stability muscle endurance is predictive of low back pain. Work with a qualified personal trainer or ask us for specific exercises that will help strengthen and set that rock-solid middle.

 

  1. Say hello to your spine.

Then ask: how are you? By listening to what your spine’s trying to tell you, you can learn a lot about it’s health and function. If any movement or exercise causes you pain, it’s best to stop (and book in for a check-up). Basic but effective advice.

 

  1. Pay it forward.

The best way to nurture the next generation of spines?  Educate your kids. The habits we cultivate as children stick with us for life: encourage your little ones to stay healthy, active and properly aligned.

 

Retrieved from https://www.spinecarechiropractic.com.au/back-back-12-top-tips-spinal-health/

22 Facts about the Brain

  1. Déjà vu (French for “already seen”) has never been fully explained, though some scientists believe that a neurological glitch causes an experience to be registered in the memory before reaching consciousness.
  2. While Einstein’s brain weighed 1,230 grams, which is within normal human range, the brain had no parietal operculum in either hemisphere and had an enlarged Sylvan fissure. Certain parts of his brain also had more glial cells in relation to neurons.
  3. The brain takes the longest of any organ to develop and goes through more changes than any other organ.
  4. The human brain weighs approximately 3.0 pounds. Human skin (all three layers) weighs approximately 20 pounds, intestines 7.5 pounds (large intestine: 4.0 lbs., small intestine: 3.5 lbs.), lungs 5 pounds (2.5 lbs. each), the liver 3.2 pounds, and the heart 0.6 pounds.
  5. What appears as random bursts of light when people hit their heads is actually caused by a jolt to the brain cells responsible for vision. Stars most often appear following a blow to the back of the head because that is the location of the visual cortex.
  6. Eyeballs are a direct physical extension of the brain.
  7. While awake, a human brain can generate enough energy to power a light bulb (between 10-23 watts).
  8. Adults have between 125-150 ml of cerebrospinal fluid. An infant has 50 ml. The total volume of cerebrospinal fluid is replaced three to four times per day with a rate of production of .35 ml/min, or 500 ml/day.
  9. The human brain does not stop maturing until a person's late 40s. The prefrontal cortex, the part of the brain that makes us human, develops in early childhood, is rearranged in late adolescence, and keeps developing for decades afterwards.
  10. The first description of the anatomy of the brain is found in the 1700 B.C. Edwin Smith Surgical Papyrus, but it most likely contains information that was much older, perhaps from a thousand years earlier. In the document, ancient Egyptian doctors describe 26 different head injuries and treatments, wrinkles and fluids in the brain, its outer wrapping, and even the fluid inside it.
  11. A human brain is 75% water and has the consistency of tofu or gelatin.
  12. In 1862, Paul Broca determined the location of the speech center in the brain when he dissected the brain of a man who could only say “Tan! Tan!” and discovered that the left side of his brain had been eaten away by disease. The section of the brain responsible for speech was named “Broca” in honor of his research.
  13. Eduard Hitzig (1839-1907) and Gustav (1838-1927) Fritsch discovered that the right side of the brain controls the left side of the body and vice versa.
  14. President John F. Kennedy’s sister, Rosemary, was given a lobotomy for her mild retardation. A famous actress named Frances Farmer was given a lobotomy to make her easier to get along with, even though she may not have been mentally insane. Howard Dully discovered late in life that he had been lobotomized in 1960 at the age of 12 by Walter Freeman—simply because, it appears, his stepmother didn’t like him but she convinced Freeman something was wrong with the boy.
  15. Scientists claim that the most complicated and mysterious thing in the universe is the human brain. Scientists know more about stars exploding billions of light years away than they know about the brain.
  16. During the first few weeks of life, a babbling baby utters almost every sound of every known language. Later, the ability to make some sounds vanishes, which is a case of neural pruning.
  17. The brain does not have any pain receptors and, consequently, cannot feel pain.
  18. Wearing a helmet can reduce the risk of brain injury by as much as 80%.
  19. The human brain has around 100,000 miles of blood vessels.
  20. The human brain consists of 60% fat, making it one of the fattiest organs in the body.
  21. Humans have more brain cells at the age of two than at any other time of their lives.
  22. The sense of smell connects to the part of the brain that also controls emotions and memories. This is why smells often evoke strong memories.

Retrieved from ://www.factretriever.com/human-brain-facts

How Your Body Reacts to Exercise: A Timeline

What happens to your body within the first 10 minutes of starting a new exercise program?

As soon as you start exercising your body will respond by stimulating and inhibiting physiological processes that will allow you to exercise more efficiently. For example, your cardio-respiratory system increases its activity above what it would be at rest, whereas the digestive system slows right down.

Within the first ten minutes your heart rate increases meaning there is an increased supply of blood to the brain, making you more alert, blocking pain signals and then the body will use different energy systems depending on the duration and intensity of the exercise.

 

What happens after one hour of exercising?

The body doesn’t like to waste energy, so it is always trying to work as efficiently as possible and return to a state of balance. ‘Cardio’ and ‘weight training’ are different, so the body will respond differently. For example, the body’s preferred energy system for that activity and prioritising blood supply to the muscles that are most active.

 

What happens an hour after you finish exercising?

The body will try to return to its resting state as quickly as possible, the fitter you are the better your body is at doing this.

Generally, everything that was elevated during the exercise will now slow down, whilst everything that was slowed during exercise will speed up.

Interestingly, during this process there is typically an over-reaching effect, whereby the body doesn’t just go back to “normal” pre-exercise levels, but it actually overcompensates.

For example, during exercise, blood pressure is elevated as a result of increases in both the heart’s activity and resistance within the blood vessels, however, after exercise people can experience “post-exercise hypotension”.

This is when your blood pressure actually goes lower then than your normal resting levels and is something accredited exercise physiologists will sometimes take advantage of when prescribing exercise for someone with cardiovascular disease. *do not attempt this without seeking advice from an appropriately qualified health professional*

 

What happens a day after commencing an exercise program?

When you exercise your muscles experience micro-trauma and can result in “delayed-onset muscle soreness” or “DOMS” for short. Experiencing muscle soreness after exercise is normal and luckily isn’t something that occurs after every session.

Once your body becomes accustomed to that type of exercise, the delayed soreness is often minimal.

A common question I get is whether people should exercise through DOMS? I generally recommend that as long as your movement is not compromised then exercising is OK.

 

What happens three days after commencing an exercise program?

Exercising can result in a prolonged increase in your metabolic rate for up to 72 hours post-exercise. One study has shown that after 45 minutes of vigorous cycling, participants experienced an approximately 40% rise in their metabolic rate for 14 hours post-exercise.

What happens one week after commencing an exercise program?

You start to experience both physiological and mental changes.

On a cellular level mitochondria—mini power plants that produce energy—multiply, meaning that your body can produce more energy.

People are also likely to experience improvements in their self-confidence and reductions in symptoms of depression.

 

What happens two weeks after commencing an exercise program?

Between two and four weeks of regular exercise you will start to see measurable improvements in your strength and fitness. If weight loss is a goal and your exercise program is being complemented by healthy eating then you may start to see desirable changes in your weight.

 

What happens four weeks after commencing an exercise program?

The benefits of regular exercise are so profound and often personal that it would be impossible to identify all the effects.

People can expect to see improvements in their physical health, mental health, social health and financial health. Exercise has been shown to improve productivity, reduce sick days and reduce out-of-pocket health system expenses for those already living with chronic conditions, such as Type 2 Diabetes.

Essentially, you will be happier, healthier and have a new lease on life.

 

Retrieved from http://exerciseright.com.au/body-reacts-to-exercise/

For a Better Night’s Sleep, You’ve Really Got to Work on Your Core (Temperature)

The role of temperature has gained attention since a study published last year found that core body temperature, which tends to fluctuate by a few degrees over the course of the day, needs to drop to help initiate sleep.

Setting the thermostat to around 18C is good for sleep, studies have found. Research has also found that room temperatures as low as 16C are best when people pile on the blankets.

Temperature is a big point of debate for couples. Women tend to raise the thermostat while men want to lower it. While researchers haven’t focused on such differences, many companies have with products from mattress that promise zoned temperatures to apps that let you control heating.

“People tend to set their ambient house or bedroom temperature a little higher than is actually optimal for sleep,” says Matthew Walker, a professor of neuroscience and psychology at the University of California, Berkeley.

The body’s core temperature needs to drop by about two to three degrees to initiate sleep, Walker says. “If our core temperature is too high, the brain cannot easily make the switch from being awake to being asleep, or create the best quality sleep.”

Core body temperature is the temperature of our heat-producing core, which is the brain and ­abdominal cavity. As the ambient temperature drops, so too does our core temperature. It usually reaches the lowest level in the early morning hours, before awakening.

When treating insomnia patients, sleep experts will often ask about room temperature and advise ­patients who set their thermostat to about 21C to drop it, Walker says. For people who live in hot climates and don’t have air-conditioning he recommends minimal bed clothes, a light bed cover and open windows.

Flinders University clinical psychologist Michael Gradisar says that during sleep, people’s bodies naturally try to lose heat from the hands and feet. Put on socks if your feet are too cold, he suggests. And if you’re too hot, try sticking your hands and feet out from under the covers.

A study published in October in the journal Current Biology that examined sleep patterns of pre-industrial societies found temperature played a critical role. The 94-person study suggested “the daily cycle of temperature change, largely eliminated from modern sleep environments, may be a ­potent natural regulator of sleep” says researcher Jerry Siegel, a professor of psychiatry at University of California, Los Angeles. The study looked at three groups living in tropical, natural environments.

Siegel says none of the study participants went to sleep near sunset or woke up at sunrise. On average they fell asleep three hours and two minutes after sunset and woke up before sunrise. They slept about one more hour in the winter than in summer.

After gathering temperature information, Siegel realised the sleep period in the Hadza people of Tanzania occurred during the coldest part of the night. In follow-up studies involving groups in Namibia and Bolivia, he found the participants consistently woke up when the early morning temperature stopped falling.

“Temperature may have a much greater role in helping promote normal sleep than we previously thought,” says John Peever, a professor in the department of cell and systems biology at the University of Toronto. He says specific brain cells located in a region called the hypothalamus sense temperature changes to control sleep.

In a 2008 study in the journal Brain, a group of researchers in the Netherlands put 24 people in a thermosuit that allowed them to manipulate temperature by running water through the veins of the suit. They found that a 0.4C increase in skin temperature — which allows the body to release more heat — led to fewer wake-ups and more slow-wave, or deep, sleep.

“By dialling down the temperature of the body (core), the participants in the experiment fell asleep quicker, and they also obtain significantly deeper quality of sleep,” says Walker, who wasn’t involved in the study.

Other experiments that varied the ambient temperature — decreasing it early in the night and increasing it in the morning — have shown similar benefits for improving and maintaining sleep.

Taking a hot bath before bed has a similar effect.

The hot water brings the circulating blood to the surface of the body, which is one of the quickest ways to drop core body temperature.

“When you get out of the bath you cool down more quickly, which is what the body wants to do at bed time,” says James Horne, a neuroscience professor at Loughborough University in England. His research has found that young, healthy people have about 10 per cent more slow wave sleep when they take a warm bath before bedtime.

He says soaking in water that is about 39C for 30 minutes in the early evening will improve sleep. A shower won’t have the same effect.

 

Retrieved from https://www.theaustralian.com.au/life/health-wellbeing/for-a-better-nights-sleep-youve-got-to-really-work-on-that-core-temperature/news-story/34fa8c4fa2a795d0cc447cabc24d9606

Functional Exercise

What is Functional Exercise?

These exercises can be modified to suit both beginner and advanced exercise routines and are great for weight loss! They are fun, complex and can you challenge you both in and out of the gym.

Put simply, functional exercise is any movement that mimics activities that we do every day. They are exercises which involve the movement of multiple joints or body parts. Nowadays, this definition has been stretched to incorporate movements which we don’t necessarily conduct every day.

Functional exercise requires multiple muscles to be used, in which we see the upper, lower and abdominal muscle working together, in comparison to a single muscle unit. As with all fitness modalities, functional exercise has its place in the world of health and fitness but it doesn’t rule out the other modes of fitness.

Benefits of Functional Exercises

  • Improves your everyday movements i.e. squats, step ups, lifting – improvement in general day to day moveability.
  • Increases flexibility and coordination.
  • Improves posture and balance.
  • Increases abdominal strength and whole-body stability.
  • Enhances athletic performance.
  • Suitable for people of all ages.
  • Burns more calories due to more muscle movements.
  • Ability to improve multiple fitness principles; speed, strength, power, cardiovascular fitness, muscle, endurance and flexibility.

 Things to Consider

  • Practice and time is required to be able to perform the movements correctly.
  • Some movements require a certain amount of flexibility, strength and mobility before performing them.
  • Advanced exercises can increase the risk of injury.

 

EXAMPLE: BODY WEIGHT SQUATS

The squat is the most frequently used movement in our everyday lives and it is crucial to include this exercise in your workout routine. It is a great exercise to develop the lower body, improve athletic performance and a simple way to assess for any muscle imbalances or weaknesses.

Technique execution:

  1. Stand with feet shoulder width apart and toes pointing slowly out
  2. Lower yourself by pushing back your hips as if you’re taking a seat.
  3. As you are lowering yourself push your knees out slightly and stop when your hips are in line with your knees. If you have good flexibility, you may lower your hips below your knees. Keep an upright posture, your chest up and your shoulder blades pinned together.
  4. Lift yourself up by pushing through your heels and bringing your hips forward to return to the standing upright position.

 

There is a significant amount of functional exercises that can be performed both inside and outside of the gym. They can be used at a beginner level right through to advanced where we see the involvements of other exercise equipment. Be sure to include some of these movements in your exercise routines to reap the benefits of performing functional exercises, and remember to be creative when performing them... there are no limits!

 

http://exerciseright.com.au/functional-exercise-how-functional-are-you/

 

The well founded evidence for exercise as medicine in treating both musculoskeletal disorders and chronic pain has continued to overwhelm in the past couple of years. In the US an extraordinary amount of clinics have opened up that take patients through rehabilitation programs where exercise is part of your treatment. Unfortunately our inner city location prevents us from having space for facilities to practice these exercises in this clinic, for this reason we have been referring patients to functional movement therapist Luke Armstrong. Luke works with clients for about 6 weeks and in that times he gives you the understanding and skills to be able to complete the exercises by yourself. We have all been to Luke’s to try it out and found the experience extremely helpful.

Victoria Health on Chiropractic

What is chiropractic?

The word ‘chiropractic’ comes from the Greek words cheir (meaning ‘hand’) and praktikos (meaning ‘done’) – namely, done by hand. Chiropractors are primary contact practitioners (which means they can see patients without a referral from a GP).

 

They focus on treating the spine by using their hands to examine and treat health conditions related to the bones, muscles and joints (musculoskeletal problems). Chiropractors are trained to recommend exercises to treat and rehabilitate health conditions related to the bones, muscles and joints, as well as to provide nutritional, dietary and lifestyle advice. 

 

They use a broad range of methods to diagnose musculoskeletal problems, including hands-on clinical examination, and diagnostic imaging such as x-rays or MRIs. These and other diagnostic methods are used to determine when chiropractic treatment is appropriate. 

 

If chiropractic care is not appropriate, or if your health condition needs to be co-managed with other health care professionals, your chiropractor will refer you to the appropriate health care provider.

 

In many cases, such as lower back pain, chiropractic care may be a person’s primary method of treatment. For some medical conditions, chiropractic services may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition.

You do not need a referral to see a chiropractor unless you are seeking treatment through Veterans’ Affairs or the Medicare Chronic Disease Management program.

 

When to consider chiropractic care

Painful joint and back problems can be caused by work, accidents, sports injuries, household chores, and even the stress of daily living. 

 

Chiropractic care may help if you are experiencing aching joints or muscle pain that is affecting your ability to get through the day, or preventing you from doing your favourite activities. It can also help maintain healthy spine and joint function, even if you do not have painful symptoms.

 

People commonly visit a chiropractor for help with: back pain, neck pain, headache, whiplash, strains and sprains from daily activities, overuse injuries, work and sports-related injuries, arthritis and restricted movement in the back, shoulders, neck or limbs.

 

Referrals for chiropractic care

You do not need a referral to see a chiropractor unless you are seeking treatment under Medicare’s Chronic Disease Management program through the Department of Veterans’ Affairs.

 

Chiropractic treatments 

Common chiropractic treatments include a range of different techniques, such as: 

  • spinal manipulation, sometimes called an adjustment – using the hands to apply controlled force to a joint of the spine
  • mobilisation – gentle movement of the joint to increase its range of motion
  • exercises
  • reassurance
  • application of heat or ice
  • stretching
  • soft tissue techniques – such as massage
  • activity modification – suggesting how to make changes to your day-to-day activities to alleviate discomfort and enable recovery
  • lifestyle advice – such as healthy eating and physical activity advice
  • physiologic therapeutics – such as use of ultrasound, laser or TENS
  • orthotics – shoe inserts that help support the feet and improve posture and alignment
  • drop piece table technique – the use of a specially designed table to help mobilise a joint in a controlled way
  • treatment of other joints, including feet, ankles, shoulders, wrists, elbows.

 

Your chiropractor will discuss these with you as part of a shared decision-making process. 

 

Spinal manipulation

One of the most common and well known therapeutic procedures performed by chiropractors is spinal manipulation (sometimes referred to as a ‘chiropractic adjustment’, although this technique is also used by osteopaths and physiotherapists). The purpose of spinal manipulation is to restore joint mobility by manually applying a controlled force into joints that have become restricted in their movement as a result of a tissue injury. 
 
Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function. 

Manipulation or adjustment of the affected joint and tissues restores mobility, thereby alleviating pain and muscle tightness, allowing tissues to heal.


Spinal manipulation is very safe when performed by a trained, registered practitioner, although some people may experience mild soreness or discomfort following treatment. This usually resolves within 12 to 48 hours. Your chiropractor will discuss this with you prior to any intervention in a process called informed consent.

What is chiropractic?

The word ‘chiropractic’ comes from the Greek words cheir (meaning ‘hand’) and praktikos (meaning ‘done’) – namely, done by hand. Chiropractors are primary contact practitioners (which means they can see patients without a referral from a GP).

 

They focus on treating the spine by using their hands to examine and treat health conditions related to the bones, muscles and joints (musculoskeletal problems). Chiropractors are trained to recommend exercises to treat and rehabilitate health conditions related to the bones, muscles and joints, as well as to provide nutritional, dietary and lifestyle advice. 

 

They use a broad range of methods to diagnose musculoskeletal problems, including hands-on clinical examination, and diagnostic imaging such as x-rays or MRIs. These and other diagnostic methods are used to determine when chiropractic treatment is appropriate. 

 

If chiropractic care is not appropriate, or if your health condition needs to be co-managed with other health care professionals, your chiropractor will refer you to the appropriate health care provider.

 

In many cases, such as lower back pain, chiropractic care may be a person’s primary method of treatment. For some medical conditions, chiropractic services may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition.

You do not need a referral to see a chiropractor unless you are seeking treatment through Veterans’ Affairs or the Medicare Chronic Disease Management program.

 

When to consider chiropractic care

Painful joint and back problems can be caused by work, accidents, sports injuries, household chores, and even the stress of daily living. 

 

Chiropractic care may help if you are experiencing aching joints or muscle pain that is affecting your ability to get through the day, or preventing you from doing your favourite activities. It can also help maintain healthy spine and joint function, even if you do not have painful symptoms.

 

People commonly visit a chiropractor for help with: back pain, neck pain, headache, whiplash, strains and sprains from daily activities, overuse injuries, work and sports-related injuries, arthritis and restricted movement in the back, shoulders, neck or limbs.

 

Referrals for chiropractic care

You do not need a referral to see a chiropractor unless you are seeking treatment under Medicare’s Chronic Disease Management program through the Department of Veterans’ Affairs.

 

Chiropractic treatments 

Common chiropractic treatments include a range of different techniques, such as: 

  • spinal manipulation, sometimes called an adjustment – using the hands to apply controlled force to a joint of the spine
  • mobilisation – gentle movement of the joint to increase its range of motion
  • exercises
  • reassurance
  • application of heat or ice
  • stretching
  • soft tissue techniques – such as massage
  • activity modification – suggesting how to make changes to your day-to-day activities to alleviate discomfort and enable recovery
  • lifestyle advice – such as healthy eating and physical activity advice
  • physiologic therapeutics – such as use of ultrasound, laser or TENS
  • orthotics – shoe inserts that help support the feet and improve posture and alignment
  • drop piece table technique – the use of a specially designed table to help mobilise a joint in a controlled way
  • treatment of other joints, including feet, ankles, shoulders, wrists, elbows.

 

Your chiropractor will discuss these with you as part of a shared decision-making process. 

 

Spinal manipulation

One of the most common and well known therapeutic procedures performed by chiropractors is spinal manipulation (sometimes referred to as a ‘chiropractic adjustment’, although this technique is also used by osteopaths and physiotherapists). The purpose of spinal manipulation is to restore joint mobility by manually applying a controlled force into joints that have become restricted in their movement as a result of a tissue injury. 
 
Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function. 

Manipulation or adjustment of the affected joint and tissues restores mobility, thereby alleviating pain and muscle tightness, allowing tissues to heal.


Spinal manipulation is very safe when performed by a trained, registered practitioner, although some people may experience mild soreness or discomfort following treatment. This usually resolves within 12 to 48 hours. Your chiropractor will discuss this with you prior to any intervention in a process called informed consent.

Retrieved from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chiropractic

Dr Graeme Massager Information

Massage can be an extremely useful and beneficial form of therapy. If it were not for cost, time and availability issues most practitioners would probably have their patients receive more. If not for those issues again patients could make far better usage of massage for general health and well-being. Supplementary home massage, where patients use our massagers at home under professional advice removes these restrictions making a huge number of benefits possible.

The basics

  • Relax the part to be massaged
  • Try and position the part to be massaged to be horizontal. By doing this you do not have to support the weight of the machine, and the weight helps apply pressure
  • Allow the massager to finish penetrating one and massaging one spot before moving to the next

The Massager Contact
To get the maximum penetration the head of the massager should sit flat on the part to be massaged. At moderate speeds the weight of the machine should be enough to maintain contact. However, as speed increases the massager head will have a tendency to patter (bounce up and down). When this happens either slow the machine down or apply a moderate amount of pressure until the head stops pattering.

Duration
Judgement should develop with usage. As a starting point try:

  • A moderate speed
  • 30 seconds for a moderate trigger point (60 for chronic deep trigger points such as those in the glutes)
  • There may be multiple trigger points in an area, each needing an application of massage

Also, our massagers are sealed units which keep out moisture and dust but keep in heat. Please allow to completely cool after 15 minutes of use.

Professional Advice
We consider our massagers to be serious pieces of equipment designed to provide a genuine therapeutic benefit. We desire that users be safe and get the maximum benefit, that means usage under professional advice. This is especially important if used on an injury or pain syndrome. Such conditions require a proper diagnosis and treatment plan. Because of this all of our marketing material and massager instructions have a strong message instructing to obtain professional advice. We only supply wholesale quantities to those we believe can provide such advice.

Research and Professional Acceptance of Home Massage
To our knowledge when we started building massagers for home use this was not widely prescribed. Some of the reasons were summed up by a study done in the UK (McDonagh, 2005). They found that practitioners did not support home massage for the following reasons:

  • The manufacturers of massagers for consumer use were more focused on looks than function
  • The instructions provided with such machines were poor, and
  • Practitioners preferred to do it themselves

These are the issues we have been trying to address. Gradually among health care professionals things are changing.

Ailsa invested in one of these almost two years ago to use on her patients and we now have them in stock on the request of the patients. Dr Graeme is an Australian who came up with this product and has always been very helpful and friendly to us. He provides a lot of information that he is happy for us to share with our patients. If you would like a brochure or demonstration please feel free to ask.

For more information visit http://www.drgraeme.com/

Here’s something completely different for low back pain

It’s a question that has challenged generations of patients and their doctors. The answer has changed over the years. When I was in medical school in the early 1980s, bedrest for a week or more was often recommended for severe back pain. This sometimes included hospital admission. Then, research demonstrated that prolonged bedrest was actually a bad idea. It was no better (and often worse) than taking it easy for a day or two followed by slowly increasing activity, including stretching and strengthening the back.

Medications, including pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants were a standard part of the initial treatment of back pain. But, recommendations released in February 2017 urge doctors to change their approach to back pain once again.

Didn’t I just hear that NSAIDs don’t work well for back pain?
You did. A recent study found that NSAIDs did not work well for back pain. But, new recommendations take that conclusion even further: it may be best to avoid medications altogether — at least at the start.

The American College of Physicians has just come out with new guidelines for the treatment of low back pain based on a review of more than 150 studies. The big news? Medications tend to have only temporary and modest benefits, so it makes sense to try something other than a pill. The specifics depend on the type and duration of back pain.

For new low back pain (lasting less than 12 weeks), try:

  • heat
  • massage
  • acupuncture
  • spinal manipulation, as with chiropractic care.

If these don’t work, NSAIDs or a muscle relaxant are reasonable options. But given their potential to cause side effects and their modest benefit, they aren’t the first choice.

For chronic low back pain (lasting 12 weeks or more), try:

  • exercise (including stretching, improving balance, and strengthening core muscles)
  • physical therapy
  • acupuncture
  • mindfulness-based programs intended to cope with or reduce stress.

Other approaches, such as tai chi, yoga, or progressive relaxation techniques may also be helpful.

If these don’t work, treatment with NSAIDs, tramadol, or duloxetine is worth consideration. However, opioids should be considered only if other measures have failed and only after a thorough review of potential benefits and risks with your doctor.

It’s important to emphasize these suggestions are for low back pain that might begin after an unusually strenuous workout or shoveling snow. It’s not for serious causes of back pain such as a major injury, cancer, infection, or fractures (see “red flag” symptoms below).

What if the pain continues?
If pain persists despite these non-medication and medication-based treatments, your doctor may want to consider additional tests (such as MRI) or treatments. Remember, each person’s situation is a little different, and even medications that don’t work well on average, may work well for you.

You could see this coming?
It’s been known for years that the vast majority of low back pain goes away on its own, regardless of treatment. So, the challenge has been to find something that safely eases symptoms while waiting for improvement.

How do I know it’s nothing serious?
You don’t. But, you should be reassured that the numbers are with you. Ninety-nine percent or more of people with low back pain do not have a serious cause. But to help make sure your back isn’t in that small sliver of dangerous causes, doctors use the “red flag” questions:

  • Have you ever been diagnosed with cancer?
  • Have you experienced unexplained or unintentional weight loss?
  • Do you have an abnormal immune system (due to disease or medications)?
  • Do you use intravenous drugs?
  • Have you had a fever recently?
  • Have you had significant injury to your back recently?
  • Have you had bladder or bowel incontinence?

These questions and a physical examination are intended to identify factors that would increase the chances that your back pain is due to infection, tumor, or other serious cause.

So, what?
These new guidelines endorse an approach to treating a common ailment that only a few years ago would have seemed outrageous. The remedies recommended are not brand new; but discouraging medication use as an initial step is a big departure from prior recommendations. An email alert I received just after these guidelines were published included the headline: “Take two yoga classes and call me next month?” It may not be such a bad idea!

Medical practice rarely changes right away, and these guidelines may have relatively little impact in the short run. But I would not be surprised if non-pharmacological treatment of back pain becomes the norm over time. Many of my patients already seek out these treatments regardless of whether I recommend them. After all, the “usual” medications for low back pain are not all that effective and often cause trouble. It’s time we recognize that there are other, better ways to help.

https://healthharvard.edu/blog/heres-something-completely-different-for-low-back-pain-

A Lifetime of Adventure

In recent conversations with their colleagues Ailsa and Doug have discovered that there is just one degree of separation between them and Elon Musk. The connection comes from their colleague Scott Haldeman, he is the Chairman of the Research Council for the World Federation of Chiropractic and is currently a professor at the University of California – both Ailsa and Doug attend conferences where he speaks. The article below  explains the interesting connection.

It was 1989 when Mark Teulon first met his 17-year-old cousin.

The boy came all the way from South Africa to stay at Teulon’s farm near Waldeck, a village east of Swift Current. He spent a mere six weeks on the farm, but it was enough to give Teulon the impression that he was a little sharper than your average teenager.

“He was a pretty smart guy,” says Teulon. “We had that figured out pretty quick.”

His cousin, who celebrated his 18th birthday on the farm, was Elon Musk.

Yes, that Elon Musk.

Musk is now an inventor, engineer and entrepreneur who has revolutionized several high-tech industries. He is the CEO and product architect of electric car manufacturer Tesla, as well as the founder, CEO and CTO of SpaceX, one of the leading private aerospace companies. His most recent business venture, Neuralink, intends to create devices that can be implanted in the brain, allowing humans to interface directly with computer software.

Musk’s face and name have become inseparable from discussions on the future of technology. He’s seen as an authority on subjects that once resided in the realm of science fiction, such as artificial intelligence or colonizing other planets.

But before Musk was thinking of how to send people to Mars or plug our brains into computers, he was doing chores at Teulon’s grain farm while waiting for his mother Maye to arrive in Canada.

Musk’s time in Saskatchewan was brief, but his family’s roots in the province go much deeper. Looking at his grandfather’s story of political intrigue and international adventure, it’s enough to make one wonder if the family has a genetic predisposition for ambition.

Musk’s grandfather, Joshua N. Haldeman, moved with his family to Herbert in southwest Saskatchewan from Pequot, Minn., in 1906 when he was four years old.

Haldeman’s time in Saskatchewan was far from boring. He joined forces with a new political movement called Technocracy, which was temporarily outlawed. He worked to establish the country’s first chiropractic association and school, and waged a public health campaign against Coca-Cola.

Haldeman was born on Nov. 25, 1902 to John Elon Haldeman and his wife Almeda Jane at a log cabin in Pequot. Almeda studied chiropractic care in Minneapolis, and after the family moved to Saskatchewan, she became Canada’s first known chiropractor. Her son would eventually follow in her footsteps.

In fact, more than just choosing the career path of a chiropractor, Joshua Haldeman was pivotal in building organizations and legislation to cement the profession in Canada.

As Scott described it, his father built up the profession “from zero.” Haldeman is credited with drafting a chiropractic law to provide legal protection, which was approved by the Saskatchewan government in 1943.

Haldeman also participated in the creation of the Dominion of Canadian Chiropractors (DCCC), the precursor of the Canadian Chiropractic Association. While with the organization, he was involved with planning the creation of the country’s first chiropractic college, which opened in Toronto in 1945.

In fitting with his independent spirit, Haldeman didn’t align himself with a mainstream Canadian party. Between 1936 and 1941, he became involved in Technocracy, and eventually became the leader of the Canadian branch of the party.

Technocracy is a political philosophy that advocates government by skill, rather than by opinion. The government is designed to use science and technology to distribute services to citizens, instead of relying on human opinions or traditions. The movement was temporarily banned by the Canadian government out of fear that its members planned to overthrow the government by force.

Haldeman defied the ban by placing an ad in the Leader-Post that featured a statement by the Technocratic party’s Canadian branch. An essay Scott wrote on his father years later says he faced three charges as a result of the ad.

After the Second World War, Haldeman became dissatisfied with Canadian politics, believing the country was becoming too socialist. However, Scott thinks the main reason his father decided to move the family to South Africa was his thirst for adventure.

Haldeman packed up his family, a single engine airplane and his Cadillac, and boarded a freighter for a 30-day journey to Cape Town.

The Haldeman’s adventures in South Africa sound like something from an Indiana Jones film. The family made an annual trek into the uncharted wilderness in search of the Lost City of the Kalahari desert. The legend involves a theory that the ruins of a long-forgotten city exist somewhere in the desert.

“I can remember being on top of the truck and a rifle across my legs, and when a deer came up I would have to hit it, or we ate sardines that night,” recalls Scott.

The family made a total of 16 expeditions into what is now modern-day Botswana.

“In those days there was nothing there,” says Scott. “We’d go into the bush for a month and just camp. There’d be nobody. I mean, we’d just bush bash for a month.”

Haldeman’s other adventures in South Africa included becoming, at one point, the country’s pistol shooting champion, with Winnifred winning the women’s pistol championship. The couple competed in The Cape to Algiers motor rally, which spanned more than 12,000 miles, and tied for first place.

Scott says the race was then considered “the most strenuous motor rally the world.”

In 1954, the couple embarked on a 30,000-mile, round-trip flight in Haldeman’s single-engine aircraft up the coast over Africa, over parts of Asia, and across the sea to Australia.

A sense of adventure and dreaming big appears to run in the family. Nowhere is that currently more evident than in the latest generation with Elon Musk, who has set bold goals for the future of space travel and Mars colonization.

An adventurer, a world-renowned doctor and a titan of technology. There could be something in the family’s genes that breeds this success, or maybe it goes back to the way Haldeman brought up his children.

“Dad always said there’s nothing a Haldeman can’t do,” says Scott. “Give them tremendous freedom to do whatever they want.”

Adapted from http://leaderpost.com/feature/elon-muck-inherited-a-lifetime-of-adventure-from-his-sask-family

Mobile Phones are changing our Skeleton and Turning Us into Hunchbacks

Children as young as six are developing hunched backs and text neck syndrome from using their mobile phones. And experts warn they are at risk of degenerative spinal disease, chronic headaches, osteoarthritis and reduced mobility as a result.

A survey by the Chiropractors’ Association of NSW shows Chiropractors are seeing up to 20 patients a week suffering chronic neck pain, headaches, poor posture and repetitive strain injuries in the wrist and hands from texting.

There has been a 47 per cent increase in neck problems in the last three years and President of the CAANSW, Dr John de Voy says nearly half the patients treated were teenagers.

Research shows people are being drawn to their phones over 200 times a day to email, tweet, check Facebook and post on Instagram, he says.

“I’ve treated a six year old boy and an 11 year old who had chronic shoulder and neck pain, he said felt like a headache in his neck,” Dr de Voy said.

“I’ve been a chiropractor for 35 years and I’ve never seen as many neck problems as I am now,” he said.

Physiotherapy Association Australia spokesman David Hall says text neck is also a growing problem for physiotherapists.

“It’s an epidemic,” he says. “We are definitely seeing an increase in young adults coming to physiotherapists if they have done lots of study and have an office job and lots of mobile phone use and poor posture,” he says.

“It’s an early version of what can develop into a hunchback,” he says.

The proportion of patients seeing a physiotherapist for help with text neck has grown from one in four to over one in three, he says.

The neck and back problems are a decade in the making and caused by poor posture, he says.

People who wait too long to get help run the risk of having their body sculpted into and rounded, hunchback position, he says.

Regular stretching and strengthening is required and every half-hour it is necessary to get up from a sitting position and walk and vary your posture, he says.

Paula Cunningham, says her 13 year old daughter Bridget is seeing a chiropractor every fortnight to treat text neck.

“She’s using her phone and the computer five hours a day for schoolwork and I can’t limit it because it’s school work,” she says.

“We got her into treatment because my husband and I noticed she had a growth spurt and was hunched over like a little old lady and I was concerned,” Ms Cunningham said.

Text neck occurs when people bend forwards to look at their phone.

Research has found the head which normally weighs around 4-5 kilograms can weigh as much as 26 kgs when flexed forward to 60 degrees.

Even a tilt of only 15 degrees doubles the weight of the head to more than nine kilograms.

The design of the mobile phones and tablets and the way they are used can also cause hand strain.

Physiotherapist David Hall provides the following advice about the healthy use of mobile phones

  1. Choose a phone that is the shape and size that feels comfortable for your hands and is a good match for the size of your hands — protective covers can both help and potentially sabotage this so select them appropriately too.
  1. Vary your position when looking at your device — move between reclined, sitting and standing.
  1. Place your device on a bench / tray / support as much as possible to reduce load on the arms.
  1. Text two handed — this allows the wrists and fingers to be held in a more neutral position.

http:heraldsun.com.au/technology/smartphones/mobile-phones-are-changing-our-skeleton-and-turning-us-into-hunchbacks/

Managing a First or Acute Episode of Low Back Pain

What is low back pain?

Low back pain is very common. So common, in fact, that most (80%) Australian adults will experience at least one episode of low back pain during their lifetime. Although often very painful, most low back pain is not caused by a serious problem and will resolve with some simple care. Physical activity is an important part of that care.

Occasionally, however, low back pain can be caused by serious disease or damage to the tissues of the back. You should seek advice from a health care practitioner as soon as possible if your back pain:

  • occurs after a traumatic event, such as a car accident or a fall;
  • wakes you during the night;
  • does not reduce or change, no matter how you move or change position;
  • accompanies numbness, tingling, or ‘pins and needles’ in your bottom, legs or feet;
  • or accompanies changes to your bowel or bladder control.

 

How do I manage my low back pain?

If you simply have low back pain without any other issues, then your pain is likely to be ‘uncomplicated low back pain’ that will resolve. Perhaps surprisingly, staying as physically active as possible helps you manage your low back pain. You might also want to apply a heat wrap. Finally, try not to worry too much about your uncomplicated low back pain. This is particularly important because thinking the worst apparently increases the pain; with the worry (called ‘catastrophising’) eventually becoming a bigger problem than the pain itself.

 

How should I stay active?

Exercise is great medicine for low back pain. You can choose from many options of exercise, with no specific type being the best. Just stay as active as you can, allowing for the restrictions in movement that may come with pain. Staying active means different things to different people: think for a moment what staying active means for you. If you enjoy gardening, then staying active may mean pottering in your garden, even if heavy jobs such as digging or pruning are too much for you. If you run marathons, staying active may mean continuing training but reducing the distances you run each week.

If you do not exercise regularly, an episode of low back pain may be your prompt to start. Walking, swimming and cycling allow people with low back pain to become active and stay active. Some forms of dancing, yoga and tai chi are popular too. People with low back pain usually do not compete, work for medals or train hard in these activities. They use these leisure activities for therapy, and to experience the joy and pleasure of movement.

 

What are the benefits of exercise?

Exercise is a powerful tool for moderating strong emotions, such as anxiety and depression. In fact, participating in enjoyable physical activities keeps you connected, happier and more focused on the important things in life. Also, while you are in pain, staying active prevents loss of physical fitness, muscle strength and cardiorespiratory function (e.g. deconditioning). Staying active therefore helps you ensure that other aspects of your health do not decline too — being in pain is quite enough!

 

What happens as I start to recover?

When you had severe low back pain, you were using exercise to stay active and to stop yourself from getting worse. Now you want to get better and stay that way. As your low back pain reduces, you can increase your program of preferred exercise to include ‘graduated training’ and specific exercises that increase your range of spinal movement and strengthen the trunk and abdominal muscles. There is moderate evidence that doing exercise at this post-back pain stage can help stop another episode of low back pain.

Graduated training: To keep physically improving, your exercise program must become increasingly more difficult; this is called graduated training. For example if you stayed active by walking, to gain further health benefits you now need to walk further or faster, walk up hills, or carry extra weights. Accredited exercise physiologists can help you plan a suitable graduated training program in your preferred form of exercise.

Increasing your range of motion: Your spine and the surrounding muscles are designed for movement. As your low back pain subsides, add some stretching and reaching exercises that increase the amount that you move your back. This is an ideal time to begin some tai chi, yoga, stretching or dancing if you have not done so already.

Strengthening: Muscle strength, particularly in the small muscles that stabilise the lower back, does not return automatically when low back pain eases. To regain this strength, you may need to do some specific strengthening exercises, with graduated difficulty to progressively increase strength. An accredited health professional or sports trainer can help you plan an exercise program to strengthen your low back. It is important you seek assistance with planning exercise if you have had multiple episodes.

Adapted from http://exerciseismedicine.com.au/wp-content/uploads/2016/11/2014-Low-Back-Pain-FULL.pdf

Cramps, Spasms, Tremors & Twitches

Sometimes muscles contract when they shouldn’t. Sometimes it’s merely weird and annoying, and sometimes it’s painful or even crippling. Although common and often unnerving, odd muscle contractions are rarely medically worrisome. There are several major types of unwanted contractions:

  • Exercise-induced cramps are intense, painful contractions that usually strike when fatigued and/or overheated. They are most common in the legs, especially the calves and hamstrings, more rarely the quadriceps. Fatigue and heat are major factors, but not dehydration and electrolyte shortage — that’s a myth.
  • Night cramps are a lot like exercise-induced cramps… but without the exercise! They are associated with fatigue from exercise during the day, but have many other possible causes, ranging from drug side effects to disease to iron deficiency. They mostly affect the calves and thighs, but foot arch cramps are much more prevalent with night cramps than exercise-induced cramps.
  • “Spasms”, as in “back spasms” are not actually a thing: it’s an informal, non-specific term often used to “explain” musculoskeletal pain.
  • Spasticity is like slow-motion cramping, usually caused by neurological diseases: a combination of jumpy reflexes and very tight muscles causing awkward and stiff movement and partial paralysis in severe cases. A good clinical example of spasticity is the “multiple sclerosis hug,” a painful, suffocating spasticity of the trunk muscles that often feels like a tight band around the ribcage.
  • Fasciculations (twitches) are small, brief, repetitive contractions. They occur in healthy people all the time — eyelid twitching (blepharospasm) is especially common — usually in isolated episodes like a case of the hiccoughs, sometimes dragging on longer (I had a twitching muscle in my shoulder for eight months in 2014). There are pathological causes as well; if it occurs too much with no pathological explanation, it’s “benign” fasciculation syndrome, but it can be severe in some unlucky people.
  • Tremors are a huge category of involuntary muscle activity, ranging the trivial to the disastrous, from teeth chattering in the cold to the wobbles of Parkinson’s Disease. Essential tremor is the largest subcategory and most common of all movement disorders, including lots of harmless episodes in healthy people (often stress induced). Tremors are usually classified as occurring either at rest or when trying to use the muscle.
  • Myokymia is fatigue-induced muscle rippling and quivering, which occurs in healthy people occasionally, and pathologically in people with a bad CAV3 gene (“rippling muscle disease”).
  • Clonus is rhythmic, muscular contractions and relaxations often seen with spasticity, usually in cases of stroke or spinal cord injury.
  • Trigger points (muscle “knots”) are a hypothetical mini-cramp: a small area of muscle tissue that is abnormally contracted, causing a sensitive spot in the muscle associated with aching and stiffness. However, this model of them is speculative, and the pain and sensitivity may have nothing to do with muscle contraction. 

Twitching and Tremors Rarely Indicate a Serious Problem

Nearly all twitches and tremors are harmless and will never be explained. They are classic “non-specific” symptom with endless possible causes, like fatigue or malaise. Unlike most other non-specific symptoms, they seem specific, and so they twitches and tremors tend to freak people out. But they rarely indicate any serious pathology, and are commonly caused by:

  1. Obvious things like stress, anxiety, fatigue, excessive caffeine and “other” stimulants
  2. Increases in neuromuscular irritability, which occur with many relatively minor pathologies, possibly so minor that there aren’t even any other symptoms, and you’ll just have to chalk it up to …
  3. The weirdness of biology

This is not to say that tremors and twitches are never a symptom of something more serious, of course. But in the absence of other worrisome signs and symptoms, the odds are overwhelmingly in your favour.

Speculation: our motor control systems are a bit delicate, and smooth, precise management of our muscles is the result of a miraculous balancing act that’s fairly easy to throw a little off kilter. And yet there are so many amazing checks and balances that it’s much harder to throw them off a lot. This may be why unwanted contractions are so common and yet usually meaningless.

https://www.painscience.com/articles/cramps-spasms-twitches-tremors.php

What can I do about tension headaches?

 

There is quite a lot that you can do yourself to get relief from tension headaches.

Relaxation — They are called “tension” headaches for a reason! Stress relief and relaxation is often the magic bullet with chronic headaches. Most tension headaches can be traced to mental and emotional overexertion and exhaustion, or sitting too long in front of a computer (or both). Obviously, rest helps a headache. But consider the less obvious: headaches should not happen regularly, and you should consider them an important communication from your body if they are. A returning headache could be your body saying to you, “Whatever you are doing, knock it off.” Consider changing your lifestyle: less stress, less computer, whatever it takes. Chronic headaches aren’t just annoying — they are proof that you are doing something your body really does not appreciate.

Heat or cool the head and neck — Heating or cooling can really help with tension headaches, but you have to be careful which one you choose. Ordinarily, spasmed or chronically tight muscles need heat — but in the case of headaches, heat can sometimes contribute to a very uncomfortable flushed or congested feeling that just makes it worse. Use your instincts. What will work in the case of a headache is whatever feels soothing. If cool washcloths feel soothing, use that. If steaming washcloths sound better to you, use those instead. It may vary from one time to the next. Sometimes alternating back and forth feels great. Experiment with temperature and location. Don’t forget to include your neck, face and jaw muscles, which are a very important part of the tension equation with all headaches.

Specific exercise (stretching, mobilizing, and strengthening)— Exercise is amazingly potent medicine for many musculoskeletal conditions, but attempts to prove a benefit for headaches specifically have been unimpressive. We do know from a really nice 2007 experiment that determined, long-term strengthening of the neck is an effective self-treatment strategy for neck pain. If so, there’s a good chance it will work for headaches as well, which is what another study showed (from the same lab, three years later). They also showed that stretching alone was less effective than more dynamic and vigorous exercises for strength and endurance.

I recommend a long-term, patient exercise program, targetting not just the neck muscles but also the jaw muscles because of their frequent involvement in headaches. Skip ordinary stretching (unless you just enjoy it), and begin with lots of pain-free range of motion and mobilizations. Progress to endurance exercises, and then finally strength training. Although you will probably need to be disciplined and patient, strength training is remarkably efficient.

General exercise is a no-brainer treatment option for all stubborn painful problems, but it’s probably extra worthwhile for tension headaches because (1) it’s so good at improving mood and sleep, both of which are probably particularly important factors in most cases of chronic tension headaches; and (2) if you have a little migraine mixed in with your tension headaches, as many probably do, then fitness is even more relevant, in theory.

Bioenergetic breathing exercises — Headaches are often involve psychological factors, and so vigorous breathing exercises — an easy way of blowing off steam and shifting mental state — tend to be helpful for headaches. Note that breathing for headaches can be as challenging as it is rewarding: they may feel worse before they get better, but that is part of the process.

https://www.painscience.com/articles/tension-headache.php

Scoliosis Awareness Month

What is Scoliosis?

Scoliosis is a progressive, lateral curvature of the spine. When viewed from the side, the spine should have curves. But when viewed from the front, the spine should be straight.

The most commonly found type of scoliosis is called “adolescent idiopathic scoliosis”. Idiopathic means “of unknown origin. Research however into the cause of scoliosis seems to suggest that there is often a genetic factor which affects the control of the growth of the spine.

Scoliosis can affect both children and adults. In children it can be a more serious condition because it can rapidly progress as the child grows.

Scoliosis is usually first seen in children between the ages of 11 and 15. However, it can occur in younger children aged 3 to 10 years (juvenile scoliosis) and in babies (infantile scoliosis). Scoliosis can also occur in adults with no previous history, due to spinal degeneration and advancing age. This is called (De Novo scoliosis).

The effects of scoliosis include: poor posture, shoulder humping, muscle weakness, and pain. In rare cases scoliosis can lead to heart and lung problems.

If scoliosis is detected and treated early, patients can avoid these symptoms in many cases. If left untreated, scoliosis can sometimes require surgery. In surgical cases, the bones of the spine are sometimes fused together and metal rods are inserted to try to straighten the spine. If the correct approach is used early enough, bracing is an effective treatment for halting the progression of scoliosis curves and reducing the need for surgery.

In adults pain and poor posture are the most common complaints. Sometimes ongoing progression can also be an issue. Often regularly prescribed treatments for the pain associated with adult scoliosis do not help. Fortunately new treatments such as the adult brace and intensive exercise rehabilitation offers these patients new hope.

 

Frequently Asked Questions

I have been diagnosed with scoliosis and told to 'wait and see'. What should I do?
If you are concerned about the diagnosis given to you, or the recommendation of treatment you should seek a second opinion from a scoliosis clinician.

What is the best treatment for scoliosis?
The treatment recommended for scoliosis will vary with the individual patient. Their individual situation, the severity and location of the curve, their age and potential for further growth will all contribute to finding the right treatment for them.

If I have scoliosis, will my children have it?
Scoliosis is considered a partially genetic condition. With this in mind, it is important to have children screened regularly if you have a family history of scoliosis especially during their growth spurts (10 to 15 years old).

Why didn't we recognise the scoliosis sooner?
Scoliosis curves can worsen very quickly particularly during pre-adolescence. You may not have taken your child to see your doctor at this time of growth.

Can exercise fix my scoliosis?
There is no scientifically-proven exercise therapy that will reduce a scoliosis or prevent a curve from progressing. However there are special exercise and rehabilitation programs which have been designed to address the scoliosis curve and these have shown to be very effective in certain cases.

http://www.scolicare.com

The Human Brain: Anatomy and Function

 

The brain directs our body’s internal functions. It also integrates sensory impulses and information to form perceptions, thoughts, and memories. The brain gives us self-awareness and the ability to speak and move in the world. Its four major regions make this possible: The cerebrum, with its cerebral cortex, gives us conscious control of our actions. The diencephalon mediates sensations, manages emotions, and commands whole internal systems. The cerebellum adjusts body movements, speech coordination, and balance, while the brain stem relays signals from the spinal cord and directs basic internal functions and reflexes.

1. The Seat of Consciousness: High Intellectual Functions Occur in the Cerebrum

The cerebrum is the largest brain structure and part of the forebrain (or prosencephalon). Its prominent outer portion, the cerebral cortex, not only processes sensory and motor information but enables consciousness, our ability to consider ourselves and the outside world. It is what most people think of when they hear the term “grey matter.” The cortex tissue consists mainly of neuron cell bodies, and its folds and fissures (known as gyri and sulci) give the cerebrum its trademark rumpled surface. The cerebral cortex has a left and a right hemisphere. Each hemisphere can be divided into four lobes: the frontal lobe, temporal lobe, occipital lobe, and parietal lobe. The lobes are functional segments. They specialize in various areas of thought and memory, of planning and decision making, and of speech and sense perception.

2. The Cerebellum Fine-Tunes Body Movements and Maintains Balance

The cerebellum is the second largest part of the brain. It sits below the posterior (occipital) lobes of the cerebrum and behind the brain stem, as part of the hindbrain. Like the cerebrum, the cerebellum has left and right hemispheres. A middle region, the vermis, connects them. Within the interior tissue rises a central white stem, called the arbor vitae because it spreads branches and sub-branches through the hemispheres. The primary function of the cerebellum is to maintain posture and balance. When we jump to the side, reach forward, or turn suddenly, it subconsciously evaluates each movement. The cerebellum then sends signals to the cerebrum, indicating muscle movements that will adjust our position to keep us steady.

3. The Brain Stem Relays Signals Between the Brain and Spinal Cord and Manages Basic Involuntary Functions

The brain stem connects the spinal cord to the higher-thinking centers of the brain. It consists of three structures: the medulla oblongata, the pons, and the midbrain. The medulla oblongata is continuous with the spinal cord and connects to the pons above. Both the medulla and the pons are considered part of the hindbrain. The midbrain, or mesencephalon, connects the pons to the diencephalon and forebrain. Besides relaying sensory and motor signals, the structures of the brain stem direct involuntary functions. The pons helps control breathing rhythms. The medulla handles respiration, digestion, and circulation, and reflexes such as swallowing, coughing, and sneezing. The midbrain contributes to motor control, vision, and hearing, as well as vision- and hearing-related reflexes.

 

4. A Sorting Station: The Thalamus Mediates Sensory Data and Relays Signals to the Conscious Brain

The diencephalon is a region of the forebrain, connected to both the midbrain (part of the brain stem) and the cerebrum. The thalamus forms most of the diencephalon. It consists of two symmetrical egg-shaped masses, with neurons that radiate out through the cerebral cortex. Sensory data floods into the thalamus from the brain stem, along with emotional, visceral, and other information from different areas of the brain. The thalamus relays these messages to the appropriate areas of the cerebral cortex. It determines which signals require conscious awareness, and which should be available for learning and memory.

5. The Hypothalamus Manages Sensory Impulses, Controls Emotions, and Regulates Internal Functions

The hypothalamus is part of the diencephalon, a region of the forebrain that connects to the midbrain and the cerebrum. The hypothalamus helps to process sensory impulses of smell, taste, and vision. It manages emotions such as pain and pleasure, aggression and amusement. The hypothalamus is also our visceral control center, regulating the endocrine system and internal functions that sustain the body day to day. It translates nervous system signals into activating or inhibiting hormones that it sends to the pituitary gland. These hormones can activate or inhibit the release of pituitary hormones that target specific glands and tissues in the body. Meanwhile, the hypothalamus manages the autonomic nervous system, devoted to involuntary internal functions. It signals sleep cycles and other circadian rhythms, regulates food consumption, and monitors and adjusts body chemistry and temperature.

http://learn.visiblebody.com/nervous/brain

The Long and the Short of It: The Five Types of Bones

 

The human skeleton has a number of functions, such as protection and supporting weight. Different types of bones have differing shapes related to their particular function.

So, what are the different types of bones? How are they categorized?

There are five types of bones in the skeleton: flat, long, short, irregular, and sesamoid.

Let’s go through each type and see examples.

1. Flat Bones Protect Internal Organs

There are flat bones in the skull (occipital, parietal, frontal, nasal, lacrimal, and vomer), the thoracic cage (sternum and ribs), and the pelvis (ilium, ischium, and pubis). The function of flat bones is to protect internal organs such as the brain, heart, and pelvic organs. Flat bones are somewhat flattened, and can provide protection, like a shield; flat bones can also provide large areas of attachment for

muscles.

2. Long Bones Support Weight and Facilitate Movement

The long bones, longer than they are wide, include the femur (the longest bone in the body) as well as relatively small bones in the fingers. Long bones function to support the weight of the body and facilitate movement. Long bones are mostly located in the appendicular skeleton and include bones in the lower limbs (the tibia, fibula, femur, metatarsals, and phalanges) and bones in the upper limbs (the humerus, radius, ulna, metacarpals, and phalanges).

3. Short Bones Are Cube-shaped

Short bones are about as long as they are wide. Located in the wrist and ankle joints, short bones provide stability and some movement. The carpals in the wrist (scaphoid, lunate, triquetral, hamate, pisiform, capitate, trapezoid, and trapezium) and the tarsals in the ankles (calcaneus, talus, navicular, cuboid, lateral cuneiform, intermediate cuneiform, and medial cuneiform) are examples of short bones.

4. Irregular Bones Have Complex Shapes

Irregular bones vary in shape and structure and therefore do not fit into any other category (flat, short, long, or sesamoid). They often have a fairly complex shape, which helps protect internal organs. For example, the vertebrae, irregular bones of the vertebral column, protect the spinal cord. The irregular bones of the pelvis (pubis, ilium, and ischium) protect organs in the pelvic cavity.

5. Sesamoid Bones Reinforce Tendons

Sesamoid bones are bones embedded in tendons. These small, round bones are commonly found in the tendons of the hands, knees, and feet. Sesamoid bones function to protect tendons from stress and wear. The patella, commonly referred to as the kneecap, is an example of a sesamoid bone.

http://learn.visiblebody.com/skeleton/types-of-bones

Skeletal System Pathologies: Common Disorders and Conditions

 

The skeletal system, which includes bones, ligaments, and cartilage, gives structure to the body. The pathologies described below can occur when stress and aging affect the skeletal system.

1. Sciatica Can Result from Disc Herniation

The lumbar spine bears the weight and stress of the body. As a result, disc herniation can occur, which affects spinal nerves. The sciatic nerve, which starts at the lower back and travels down the back of the leg, is often affected. When a disc herniates, it can pinch the nerve. This is a common cause of sciatica. Sciatica typically affects one side of the body, with mild to severe pain, muscle weakness, or numbness felt anywhere along the nerve pathway.

 

2. Cartilage Degenerating Over Time May Lead to Cervical Spondylosis

As people age, bones and cartilage that make up the back and neck region submit to wear and tear. Cervical spondylosis is a type of osteoarthritis that affects the intervertebral joints of the neck region. The cartilage of intervertebral discs and the cartilage that lines the joint-facing bodies of vertebrae can degenerate over time. This pressure causes compression, leading to bulging discs. To stabilize the spine, bone spurs called osteophytes often grow from the vertebrae. These changes cause pain and stiffness.

 

3. Plantar Fasciitis Can Result from Repeated Foot Strain

The plantar fascia is a thick band of connective tissue that runs along the bottom of the foot, connecting the heel bone to the toes. Activities such as running or dancing can repeatedly pound the feet on hard surfaces or put too much tension on the plantar fascia. This repeated strain can result in microtears of the ligament, which lead to irritation, inflammation, and pain called plantar fasciitis.

 

4. Wear and Aging Can Cause Osteoarthritis of the Hip

With age and use, the articular cartilage in the hip joint can degenerate. The tissue becomes frayed and rough, exposing the bone surfaces beneath, making movement painful. This condition is diagnosed as osteoarthritis, also known as degenerative arthritis or degenerative joint disease. Degeneration of the articular cartilage and osteoarthritis are caused most often by wear and aging. A previous injury to the hip joint, bone deformities, or stress from repetitive physical activities may also cause or increase the likelihood of this condition. Other associated risk factors include obesity and a family history of osteoarthritis. Symptoms include stiffness, pain, and tenderness. Bone spurs may also form around the joint, causing further pain.

 

 5. A Sharp Knee Movement Can Lead to an ACL Tear

The knee joint contains bones, muscles, and ligaments that flex, rotate, and pivot during normal range of motion. A knee sprain can occur when a jump or sharp pivot twists or hyperextends the joint. The force can damage or tear one or more knee ligaments, such as the anterior cruciate ligament, which connects the end of the femur (thigh bone) to the top of the tibia (shin bone). ACL injuries commonly occur during sports activities.

http://www.newhealthguide.org/Skeletal-System-Diseases.html

Did you know that there is a specific word that defines the act of stretching and yawning concurrently?

 

Pandiculation ‎(plural pandiculations)

A stretching and stiffening of the trunk and extremities, as when fatigued and drowsy or on waking, often accompanied by yawning.

http://essentialsomatics.com/hanna-somatics-articles-case-studies/pandiculation-safe-alternative-stretching

Why Do You Stretch After Sleeping?

 

Every morning when you wake up, instinct takes over, and you feel compelled to stretch out your body. Why do we do this? Aside from feeling good, it actually does help to wake you up. Stretching works to increase flexibility and range of motion in the muscles and joints. It also improves circulation and relieves tension.

Muscle Flexibility

After a long, restful sleep you often find yourself waking up with stiff, tight muscles. This is usually caused by lying in the same position for an extended amount of time. Upon waking, you often stretch out the kinks in your neck, back and legs, maybe even subconsciously, leaving you feeling better. When your muscles are flexible, it makes getting out of bed easier, along with performing everyday tasks.

Joint Flexibility

The main causes of morning stiffness are lack of daily physical activity, being overweight, poor diet, not sleeping properly, and a cold or damp environment, according to the Healthy Back Institute. Stretching in the morning helps improve the range of motion in the joints, as well as stiffness that often accompanies being inactive or overweight. Decreased flexibility in the joints may increase your likelihood of developing arthritis or having poor balance, which could result in injury.

Improved Circulation

Stretching in the morning dramatically improves blood circulation. A quick stretch upon waking can energize you to get out of bed. The heart rate is slowest just before rising, so when you stretch, your blood starts moving faster and circulating to the muscles in the extremities. Proper circulation helps you move and function throughout the day.

Stress Relief

Stretching helps you relieve stress and tension. Sometimes it is hard to get out of bed in the morning, especially when you know that you have a stressful day ahead. Taking a few minutes first thing in the morning to stretch will help relieve some tension and allow you to face the day more positively. To get the most out of your stretches, hold each stretch for 30 seconds to give your muscles time to lengthen, then relax and breathe normally.

http://www.livestrong.com/article/355285-why-do-you-stretch-after-sleeping/

 

5 Awesome Ligaments

How much do you enjoy moving? A lot, I bet. While many attribute our ability to move to the muscular system, it actually goes a little deeper than that! Your skeletal system is a rigid organ (yep, it’s living tissue!) that, without your awesome ligaments, wouldn't be able to move normally!

Ligaments are fibrous swathes of connective tissue that connect bones and help prevent your joints from flapping around willy-nilly. They also help to hold organs in place.

5. Linea alba

I love the linea alba. Do you know why? Because it’s exactly what its namesake says it is—a white line. The linea alba is a thin stretch of connective tissue that runs between the xiphoid process of the sternum and the pubic symphysis of the pelvic girdle. It also acts to divide the two rectus abdominis muscles.

 4. Pubocervical fascia

Stretched across the pelvic cavity is the pubocervical fascia, which connect the cervix to the pelvic walls and posteriorly blend with the perineal membrane. Think of the pubocervical fascia as a sort of hammock for the uterus and bladder.

 3. Flexor retinaculum

The flexor retinaculum and I have a complicated relationship. On the one hand (ha!), it helps to keep the flexor tendons together; on the other, it’s to blame for my increasingly rough ride through the carpal tunnel.

The flexor retinaculum is an arch of tough, fibrous tissue attached to the pisiform, hamate, trapezium, and scaphoid, and—with the carpal bones—forms a tunnel through which the flexor tendons of the hand and median nerve pass. Carpal tunnel syndrome occurs when one of the tendons becomes inflamed; since the retinaculum is so tough, there’s not enough stretch in it to accommodate the swollen tendon, so the tendon presses against the median nerve, resulting in numbness and/or pain.

 

2. Nuchal ligament

You know what’s awesome about the nuchal ligament? If you look at it laterally, it looks like a shark fin (yes, I’m one of those people who watches “Shark Week” religiously).

The nuchal ligament extends from the external occipital protuberance and median nuchal line to the spinous process of the seventh cervical vertebra. It stabilizes the head and neck, as muscles that would otherwise attach to the spinous processes of the vertebrae instead attach to the nuchal ligament.

 1. All the ligaments of the skull

How could I pick just one ligament in the skull when all of them are so important? The ligaments of the skull comprise the ligaments that surround the temporomandibular joint, reinforcing the area where the cranium articulates with the mandible. The temporomandibular joint is a synovial joint and allows not only for flexion and extension, but also small movements of rotation and gliding.

The main “hinge” of the joint is the sphenomandibular ligament—a flat, thin band that connects the spina angularis of the sphenoid to the lingual of the mandibular foramen. The other ligaments connect the mandible to various bones of the skull. 

(from the Visible Body Blog)

Chiropractic Australia president Rod Bonello responds to RACGP.

"The RACGP stands accused of an “injustice” against patients after it urged GPs to stop referrals to chiropractors.
On Wednesday, the college said GPs should “seriously reconsider any support for chiropractic involvement” in the care of patients, saying the evidence base for chiropractic was little better than placebo.
The statement – which effectively ostracises chiropractors from mainstream healthcare — also includes a demand that the Federal Government strip Medicare funding for chiropractic treatment.
But Professor Rod Bonello, president of Chiropractic Australia, said the statement was over the top.

“It’s entirely reasonable to be very frustrated with the behaviour of individual practitioners who do the wrong thing, but to recommend that doctors do not refer to chiropractors is an inappropriate response.” Professor Bonello said he did not support interventions such as that shown in the recent YouTube video of a popular Melbourne chiropractor manipulating the spine of a four-day old infant. “I can understand that from a conservative medical perspective, that would be seen as outrageous. If all chiropractors behaved in that manner, then the RACGP would be right," he said.

“But they’ve done an injustice to the doctors’ patients by denying them the opportunity of chiropractic care when it is indicated.”
Medicare funding for chiropractic care via GP chronic disease management items is worth around $16 million a year. Last year, there were 700 GP referrals to chiropractors for children under the age of five.

While some doctors have called for a ban on paediatric chiropractic care, Professor Bonello said that spinal conditions in children like scoliosis or torticollis could benefit from chiropractic care, but that such interventions were not common.
“The thing with paediatric care is that the research lags far behind, more than it does for other groups. It’s very difficult to get ethics approval for research on children generally.”
But he said it was “disingenuous” to suggest conventional medical practice was always evidence-based in comparison.
He pointed to estimates that up to a third of commonly accepted medical practice did not have strong research behind it. “That doesn’t mean its wrong," Professor Bonello said. "It simply means that research lags being practice; it always has. “The evidence certainly favours chiropractic management of acute lower back pain, but if a practitioner wants to offer a treatment that is not strongly validated, then the practitioner needs to let the patient know. "And that’s the same for anyone practising healthcare.”
Professor Bonello said that Chiropractic Australia has not yet formed an official response to the RACGP statement, but that the basis on which the organisation was founded was to “help reform the chiropractic profession”.
Australian Doctor is seeking a response from the Chiropractors Association of Australia.

Functions of the Blood: 8 Facts about Blood

The heart pumps blood through a vast network of arteries and veins. Blood is a living fluid. It transports oxygen and other essential substances throughout the body, fights sickness, and performs other vital functions. Below are 8 important facts about blood.

1. Blood Is Fluid Connective Tissue

Blood is composed of 55% plasma and 45% “formed elements,” including red blood cells, white blood cells, and platelets. Because of these living cells suspended in the plasma, blood is considered a fluid connective tissue (not a fluid). It is the only fluid tissue in the body.

2. Blood Provides the Body's Cells with Oxygen and Removes Carbon Dioxide

Blood absorbs oxygen from air in the lungs. It transports the oxygen to cells throughout the body, and it removes waste carbon dioxide from the cells. In the lungs, the carbon dioxide moves from the blood to the air and is exhaled.

3. Blood Transports Nutrients and Hormones

Blood plays a large role in digestion and endocrine system functions. Digested nutrients are absorbed into the bloodstream through capillaries in the villi that line the small intestine. These nutrients include glucose, amino acids, vitamins, minerals, and fatty acids. Blood also transports some hormones secreted by endocrine system glands to target organs and tissues.

4. Blood Regulates Body Temperature

Blood absorbs and distributes heat throughout the body. It helps to maintain homeostasis through the release or conservation of warmth. Blood vessels expand and contract when they react to outside organisms, such as bacteria, and to internal hormone and chemical changes. These actions move blood and heat closer to or farther from the skin surface, where heat is lost.

 5. Platelets Clot Blood at Sites of Injury

When a blood vessel tears, platelets and plasma proteins work together to stop blood loss. Platelets, also called thrombocytes, clump and form a plug in the damaged area. The proteins form threads called fibrins to complete the platelet plug, or clot.

6. Blood Brings Waste Products to the Kidneys and Liver

Blood transports waste substances to the organs that remove and process them for elimination. Blood flows into the kidneys through the renal arteries and out through the renal veins. The kidneys filter substances such as urea, uric acid, and creatinine out of the blood plasma and into the ureters. The liver also removes toxins from blood. During digestion, it cleans blood that has been enriched with vitamins before sending it back out to the rest of the body.

7. Red Blood Cells Are the Most Numerous Living Cells in Blood

Blood is 55% plasma and 45% formed elements. Red blood cells, also called erythrocytes, make up most of that 45%. Their primary function is to transport oxygen from the lungs to the cells of the body. Red blood cells are disc-shaped. They are flexible and bioconcave—flat and round with depressed centers.

8. White Blood Cells Protect the Body from Pathogens

White blood cells, also called leukocytes, are the disease-fighting components of blood. They account for just 1% of circulating blood but multiply during infection or inflammation. There are five types of white blood cells: neutrophils, eosinophils, basophils, lymphocytes, and monocytes. Neutrophils are the most abundant, comprising 60% to 70% of all white blood cells.

http://learn.visiblebody.com/circulatory/circulatory-functions-of-the-blood

Muscle Contractions: How Neurotransmitters And Chemical Reactions Move Muscles And Bones

 

How do the bones of the human skeleton move? Skeletal muscles contract and relax to mechanically move the body. Messages from the nervous system cause these muscle contractions. The whole process is called the mechanism of muscle contraction and it can be summarized in three steps:

(1) A message travels from the nervous system to the muscular system, triggering chemical reactions.

(2) The chemical reactions lead to the muscle fibers reorganizing themselves in a way that shortens the muscle--that’s the contraction.

(3) When the nervous system signal is no longer present, the chemical process reverses, and the muscle fibers rearrange again and the muscle relaxes. 1. A Muscle Contraction Is Triggered When an Action Potential Travels Along the Nerves to the Muscles

Muscle contraction begins when the nervous system generates a signal. The signal, an impulse called an action potential, travels through a type of nerve cell called a motor neuron. The neuromuscular junction is the name of the place where the motor neuron reaches a muscle cell. Skeletal muscle tissue is composed of cells called muscle fibers. When the nervous system signal reaches the neuromuscular junction a chemical message is released by the motor neuron. The chemical message, a neurotransmitter called acetylcholine, binds to receptors on the outside of the muscle fiber. That starts a chemical reaction within the muscle.

2. Acetylcholine Is Released and Binds to Receptors on the Muscle Membrane

 

A multistep molecular process within the muscle fiber begins when acetylcholine binds to receptors on the muscle fiber membrane. The proteins inside muscle fibers are organized into long chains that can interact with each other, reorganizing to shorten and relax. When acetylcholine reaches receptors on the membranes of muscle fibers, membrane channels open and the process that contracts a relaxed muscle fibers begins:

  • Open channels allow an influx of sodium ions into the cytoplasm of the muscle fiber.
  • The sodium influx also sends a message within the muscle fiber to trigger the release of stored calcium ions.
  • The calcium ions diffuse into the muscle fiber.
  • The relationship between the chains of proteins within the muscle cells changes, leading to the contraction.

 

3. Muscle Fibers Relax When the Nervous System Signal Is No Longer Present

 

When the stimulation of the motor neuron providing the impulse to the muscle fibers stops, the chemical reaction that causes the rearrangement of the muscle fibers' proteins is stopped. This reverses the chemical processes in the muscle fibers and the muscle relaxes.

 http://learn.visiblebody.com/muscular/muscle-contractions

Five Cool Facts about the Middle and Inner Ear

 

Do you hear what I hear? It’s the sound of some awesome anatomy truthiness coming atcha! The middle and inner ear are kind of overlooked in the cool anatomical structures department, so I decided to honor some of the awesome things inside that head of yours.

1. The smallest bone in the body resides in the middle ear.

The stapes, also known as the stirrup, is one of the auditory ossicles, consisting of a head, neck, two crura, and base. It looks sort of like a wishbone, or, well, a stirrup! Sound waves strike the eardrum and the vibrations travel into the middle ear. When these vibrations reach the stapes, it pushes the membrane of the oval window, building pressure waves in the cochlea, and this begins a process that generates nerve impulses.

2. The smallest muscle in the body is also in the middle ear.

The stapedius muscle attaches to the stapes. It stabilizes the bone and dampens large vibrations to protect the oval window from loud noises.

 3. The ear is not just for detecting sound.

The semicircular canals of the vestibule of the inner ear are responsible for balance. They provide sensory input for equilibrium by detecting acceleration or deceleration. Each canal ends in an ampulla; these ampullae contain fluid that moves when the head does. The movement of the fluid causes hair cells to bend, which generates nerve impulses.

 4. The ear drum actually looks like a drum.

he ear drum is a thin, oval-shaped membrane that separates the external auditory canal from the middle ear. Sound waves strike the ear drum, creating vibrations that travel to the auditory ossicles. It's very easy to perforate the ear drum, which is why you shouldn't stick cotton swabs in your ears.

 5. You have a pressure equalizer in your head.

Do your ears sometimes “pop” when you yawn? This is actually the Eustachian tube opening, stabilizing pressure in the middle ear with outside air pressure. The Eustachian tube is a channel that links the cavity of the middle ear with the nasopharynx

http://info.visiblebody.com/bid/323583/Five-Cool-Facts-about-the-Middle-and-Inner-Ear

 

My previous Chiropractor didn’t do that?

 

Like all health professionals we get stuck in our opinions as to the cause of dysfunction and what best approach to take when treating.  Most experienced practitioners understand that things change over time and we learn that not all our patients appear to respond equally to the same stimulus or treatment.  Why would it matter what treatment you use? Surely it works the same way every time.

Treatment choices are numerous and confusing but thankfully science and research has given us clues as to why they might all be effective.  Physically based treatments involve applying a force to certain body structures.  Some of these structures (particularly the spine and neck) are the most sensitive structures to movement (especially rapid movement) and many of the issues we see involve to some degree a weakening or lack of responsiveness of the brain-muscle system which keeps us upright and oriented and any reintroduction of normal movement will potentially help.  It also appears that small rapid movements send a bigger 'signal' to the brain.  Slow muscle stretch for example sends a signal without a sharp high peak in electrical activity.  In effect the brain can be re sensitised to joint sensation using a variety of movement and sensation based approaches.  The clinical challenge is to determine what 'variety' will help which individual.

Chiropractic In The Media.

 

 Some of you may have seen the recent media attention regarding chiropractic, all chiropractors registered in Australia need to adhere to the codes and guidelines set out by the legislation, some registrants unfortunately do not behave appropriately.  Below is the policy statement from one of the professional associations which outlines the provision of “wellness” care.

 

“Chiropractic Australia is a professional organisation that advocates quality, safe and ethical chiropractic care within the framework of evidence based practice. As such Chiropractic Australia endorses the Australian Government’s Primary Healthcare Strategy which promotes the concept of wellness and disease prevention. Chiropractic “wellness” care, often referred to as “maintenance care”, has been accepted by many chiropractors as an integral part of chiropractic practice (1-6). A recent study on clinical practices of chiropractors in Victoria (7) reported that 39 per 100 patient visits were related to maintenance or wellness care. However, while the two terms “wellness” and “maintenance” have often been used interchangeably, particularly within the chiropractic profession, for the purposes of this Policy Statement they have distinct meanings. Maintenance care has been described as treatment provided to preserve a condition without additional functional improvement of the patient’s health outcome. (8) Wellness care is a patient-centred process, which emphasises the development of health promotion and disease prevention. (9) Wellness care provided by chiropractors that incorporates advice on smoking cessation, good nutrition, weight control, physical activity and other lifestyle changes is strongly supported by high quality research evidence. (10)

 

However, where wellness care consists solely of periodic spinal analysis and spinal manipulation for the correction of asymptomatic spinal “subluxations” this kind of approach is not supported by Chiropractic Australia. Further, the use of periodic and long term spinal manipulation as part of a maintenance or wellness approach for the prevention, delay or reversal of spinal degenerative disease is also not sufficiently validated and is also not supported by Chiropractic Australia. (11). However, there is evidence that suggests periodic spinal manipulation may be of benefit in the ongoing treatment of spinal problems such as chronic low back pain (12,13) but there is little evidence as yet supporting the use of spinal manipulation in other aspects of disease prevention or health promotion. (14)

 

As primary health care practitioners, chiropractors are well placed to play an important role in wellness promotion and disease prevention, in areas such as physical activity, nutrition, mental health and other lifestyle considerations. It is inadvisable to provide treatments lacking evidence of safety and effectiveness when other available treatment options have been demonstrated to be beneficial. However, where a patient has unsuccessfully been treated by standard methods it may be reasonable to trial a more experimental alternative. In cases where patients elect to undergo treatments which have not been fully validated they should be informed of the lack of scientific evidence supporting the proposed treatment and provided with a balanced view of the clinical justification for such treatment. (16,17)

 

For more information and for a complete list of references please refer to: http://chiropracticaustralia.org.au/wp-content/uploads/2015/07/Wellness-Care-Policy.pdf

Prevent Back Pain, Orthotics Are Out, Exercise Is In

 

Lower back pain is an almost universal if unwelcome experience. About 80 percent of those of us in the Western world can expect to suffer from disruptive lower back pain at some point in our lives. But if we begin and stick with the right type of exercise program, we might avoid a recurrence, according to a comprehensive new scientific review of back pain prevention. Lower back pain develops for many reasons, including lifestyle, genetics, ergonomics, sports injuries, snow shovelling or just bad luck. Most often, in fact, the underlying cause is unknown. For most people, a first episode of back pain will go away within a week or so. However, back pain recurs with distressing frequency. By most estimates about 75 percent of people who have had one debilitating episode of lower back pain will have another within a year. These repeated bouts can set off what doctors and researchers call a “spiral of decline,” in which someone takes to his or her couch because of the pain; this inactivity weakens muscles and joints; the person’s now-feebler back and core become less able to sustain the same level of activity as before and succumb when he or she tries to return to normal life, leading to more pain and more inactivity; and the spiral accelerates. This scenario obviously makes preventing back pain, especially in someone who already has undergone at least one episode, extremely desirable. But until now, few studies have systematically examined what really works against repeated back pain and what doesn’t.

So for the new review, which was published in JAMA Internal Medicine, researchers affiliated with the George Institute for Global Health at the University of Sydney in Australia and other institutions set out to gather and analyse as many relevant studies as possible.

There were surprising few high-quality studies, meaning those that had randomized participants to be treated or not. But after scouring through more than 6,000 studies about back-pain prevention, the researchers settled on 23 that they felt to be methodologically robust. These studies had examined, in total, more than 30,000 participants with back pain. The prevention techniques under review included education about lifestyle changes, shoe orthotics, back belts, various types of exercise programs and exercise programs that also included some type of education about back-pain prevention.

For the purposes of the review, a successful prevention program was one that had kept someone from reporting another bout of back pain within a year or longer or that had staved off lost work time due to back problems.

Such success, as it turned out, was discouragingly limited. Educational efforts by themselves showed essentially zero ability to prevent a recurrence of back pain, the researchers found. Back belts and orthotics likewise were almost completely ineffective, leaving people who employed either of those methods very prone to experiencing more back pain within a year.

But exercise programs, either with or without additional educational elements, proved to be potent preventatives, the researchers found.

In fact, “the size of the protective effect” from exercise “was quite large,” said Chris Maher, a professor at the George Institute, who oversaw the new review. “Exercise combined with education reduced the risk of an episode of low back pain in the next year by 45 percent. In other words, it almost halved the risk.” Interestingly, the type of exercise program didn’t matter. In some of the experiments that Dr Maher and his colleagues reviewed, the regimens focused solely on strengthening the core and back muscles. In others, the training was more general, combining aerobic conditioning with strength and balance training. Most asked participants to complete two or three supervised sessions every week, typically for about two months, although some lasted longer. A few included education programs as well.

The end result was that if someone with a history of back pain exercised in a regular way, he or she was considerably less likely to be felled by more back pain within a year.

However, the protective effects typically wore off after that, with recurrences rising after 12 months, probably because many of the people who’d been involved in the studies stopped exercising, Dr Maher said, and their back problems returned. So based on the currently available evidence, he said, it’s still impossible to know whether exercise improves back health in the long-term, or if one type of exercise program is measurably better than others. He and his colleagues hope to mount studies comparing different routines head-to-head and follow people for several years.

But for now, he says, “of all the options currently available to prevent back pain, exercise is really the only one with any evidence that it works.”

 

http://well.blogs.nytimes.com/2016/01/27/to-prevent-back-pain-orthotics-are-out-exercise-is-in/?smid=fb-nytimes&smtyp=cur

http://www.abc.net.au/news/2016-01-15/goal-setting-failure-and-new-year-resolutions/7090482

You are probably going to fail. Well, not fail exactly, but it's unlikely you will achieve your goal in the way you envisage.

This may not sound very encouraging. It's vital you understand this when you decide to make a change to your life, like when you've made a new year's resolution.

But it does not mean you won't achieve your goal. There is good news - we know a lot about change and how to make it stick.

When you understand a bit more about the stages of change, and where you are up to, you are much more likely to reach your goals.

In the last several decades researchers have studied people going through the change process and have found certain things improve a person's chances of successfully making changes.

Initially this research focused on how people progress through change when giving up "bad habits", such as cigarettes, drugs or alcohol.

More recently positive psychology researchers identified techniques that could support each one of us to be our best possible selves. One of the most important things we've learnt from this research is that "relapse" is a part of the process, particularly the first time we try to make a change.

For example, evidence shows on average people attempt to give up smoking seven to ten times before they are able to. This may all sound fairly academic, but it's worth understanding the change process and the stages you pass through on your journey, because doing the wrong things at the wrong stage means you're less likely to succeed and more likely to give up.

Stages of change

Imagine your goal is to get fit. Let's see how you might move through the stages of change.

Pre-contemplation: If you're at this stage you're not really thinking about making changes to your fitness.

In fact, you're pretty certain that you don't need to worry about exercise. You wish your family and friends, who tell you need to get up off the couch and do something active, would just chill out.

Contemplation: You think you'd benefit from regular exercise and trying to get fitter, but you just don't know how you are going to squeeze it in with all the other things you have to do.

Also, there are so many confusing messages about what type of exercise you need to be doing.

At this stage you might want to focus on the reasons for change rather than the reasons not to change. Now is a good time to identify your personal values and work out how to link those to more specific goals. An easy place to start is a list of the pros and cons of getting fit.

Preparation: Now you know you are ready to get fit. You don't need any more convincing, but you do need a plan.

Make a genuine commitment to being a fitter and healthier person and focus on how good you'll feel when you are.

Don't rush into deciding exactly how you're going to get fit. Now is a good time to keep a log of your daily fitness-related activities - include things like walking to the shops, taking the dog for a walk or a stroll on the beach.

Action: So you've been getting up for a walk three mornings a week and taking some gym classes. Great work. Keep busy and focused on action and activity.

Use both short-term and long-term goals, and keep track of your progress using a journal or checklist.

At this stage you may want to set yourself more demanding goals, maybe you can register for a fun run or invest a gym membership (if you think that would be helpful) or find someone to buddy-up with.

Avoid complacency and reward and congratulate yourself at regular intervals.

Maintenance: You've been getting regularly exercise for about six months. Recognise that maintaining the fitness you've got is a long-term, ongoing process, but it is easier than starting all over again from scratch.

Now you can set yourself more demanding goals. Think about taking yourself to the next level. So if you've done your fun run, why not sign up for a half marathon. Enjoy your success and build on it.

Relapse: Life got in the way and it's been a while since you were able to do any exercise. That's OK, relapsing into old behaviours is normal.

Learn from your past mistakes. Recognise what went wrong and get back into action as soon as possible.

You haven't been running for a week, or even a month. That's OK, put on your shoes and head out for one this afternoon. This is also the time to think about the things that were working well (the Saturday morning runs with friends) and get this back on track.

So the big question is - are you really ready for change?

You may believe you're ready, research suggests you may be only contemplating change, which is only the second stage of the process and at this stage you'll still be weighing up the pros and cons of change.

http://www.abc.net.au/news/2016-01-15/goal-setting-failure-and-new-year-resolutions/7090482

Why Does a Circle have 360 Degrees?

 

Have you ever thought about how it’s kind of weird that a circle has 360 degrees? At first thought, it seems like a rather random number to have chosen—why not 100, or 500, or 720 degrees? Was it really a random choice? Or was there actually some good reason that 360 was chosen to be the number of divisions in a circle?

The When and Where of 360 Degrees

As you probably know, these days we humans like to divide a circle up into 360 pie-shaped wedges. Each of these wedges contains an angle at its vertex, and we say that the size of this angle is 1 degree. As you also probably know, degrees aren’t the only way we can measure angles. Angles are also measured in radians and sometimes (very rarely), they are even measured in obscure military units called gradians (which is why a lot of calculators have “deg rad grad” buttons on them).

While we don’t know exactly why the 360 degree convention was chosen (more on that in a minute), we do know approximately when and where it all started. At least we know that it came to be a long, long time ago—as in 4 or 5 thousand years ago with the Babylonians, the Greeks, and perhaps other even more ancient groups.

Reason #1: The Length of the Year

Even if you have absolutely no idea right at this instant why there are 360 degrees in a circle, I bet that if you stop and think for a few minutes you can figure out one possibility. If after those few minutes you’re still not sure, think about where else you’ve seen a number that’s close to 360 in your life. And if you’re still stuck after that, think about the Sun … the Earth … orbits … and calendars.

Got it?

The Earth takes one year to orbit the Sun. And a year is just a little more than 365 days. That means that the Earth rotates on its axis a little more than 365 times every year. And it means that every day the Sun appears to move about 1/365 of the way along a huge circle projected onto the sky that extends all the way around the Earth (called the ecliptic). If you lived a few millennia ago and didn’t have modern instruments to accurately record the positions of objects in the sky, you might conclude that the Sun moves about 1/360 of the way along this circle every day, which is exactly what ancient astronomers did. And they then made a leap and decided to divide this circle on the sky—and all circles—into 360 even parts so that the Sun would move through 1 part per day. Each of these parts was dubbed 1 degree, thus giving us the idea that a circle contains 360 degrees. And given that the ancient Babylonian and Persian calendars were both based upon 360-day years, it seems likely that this simple astronomical observation is the reason a circle contains 360 degrees.

Reason #2: Babylonians and Base-60 Numbers

Because there are other reasonable ideas out there as to the origin of the 360 degree convention. As we saw earlier, the Babylonians used a 360 day calendar. And, as it turns out, the Babylonians also used a base-60 number system (called the sexagesimal system). Just as we use 10 different symbols to represent numbers in our base 10 decimal system, the ancient Babylonians used 60 symbols to represent numbers.

Well, 60 x 6 = 360. This means that 360 is a nice even multiple of the number base in the Babylonian system (which would have had the same aesthetic value to their brains that a nice even multiple of 10 has to ours). But there’s more to it than that. The Babylonians knew about equilateral triangles. And they knew that if you arranged 6 of these equilateral triangles in a certain way with the edge of one aligned on top of the edge of the next, the last one would end up meeting back up with the first. In other words, the total angle formed by 6 of these equilateral triangles would be the same as the angle around a circle. Given the Babylonian usage of 60 as their number base, they decided that each of the angles of an equilateral triangle would be 60 degrees. And thus, when you multiply these 60 degrees by the 6 equilateral triangles that combine to create a sort of circle, you get 6 x 60 = 360 degrees. And thus, 360 degrees in a circle.

So, there’s that.

http://www.quickanddirtytips.com/education/math/why-does-a-circle-have-360-degrees#sthash.QaORuU9i.VtnWUHXo.dpuf

Why Different Painkillers are only effective for certain types of pain

 
Adapted from the Conversation
 
Whether it’s your head, tooth or back, when you’re in pain, it’s hard to think about anything else. If it’s not too strong, some can ride it out. But in many cases, the pain just gets worse and won’t go away until you take something.
Medicines that kill pain are called analgesics and they vary in how they work. No single painkiller can relieve all types of pain. Those that work for mild pain usually have little effect on severe pain unless combined with a stronger painkiller.
If you want to effectively control your pain, you will need to match your medication to its type and severity.
Nociceptive pain
Nociceptive pain is caused by damage to body tissue. If the pain is mild, such as a headache or a sprained ankle, commonly used over-the-counter painkillers are effective. These include tablets containing paracetamol (Panadol), aspirin, or non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).
Paracetamol helps to dampen pain signals to the brain. NSAIDs inhibit the activity of the enzymes that lead to pain, inflammation and fever being produced in the body. Combination tablets, which have a small dose of codeine plus paracetamol, aspirin or ibuprofen, can be used to treat moderate pain. In Australia, you can buy these kinds of painkillers only in a pharmacy. Those sold over the counter have brand names such as Panadeine, Aspalgin and Nurofen Plus.
The government recently announced it will make any medication containing codeine available only with a prescription from mid-2016.
It is important to remember the maximum adult dosage for paracetamol is four grams (eight tablets) per day. Taking more than the recommended dose can cause damage to your liver.
Painkillers typically prescribed by a doctor to relieve acute to moderate pain are codeine together with paracetamol tablets (Panadeine Forte) and tramadol tablets, which are opioid pain killers.
The severe pain you experience following a broken bone or an operation usually needs strong painkillers that your doctor would prescribe. This may be morphine given as a tablet or by injection.
Morphine-like medicines relieve pain by interacting with specific proteins called opioid receptors, which are located in the brain, spinal cord and other parts of the body. These opioid receptors are the same ones the body’s own natural pain-killer molecules, called endorphins, use.
Neuropathic pain
Neuropathic pain is pain caused by damage to the nerves. Painkillers such as morphine, NSAIDs and paracetamol that are effective for the relief of nociceptive and inflammatory pain conditions are not effective for the relief of neuropathic pain.
This is because the underlying mechanisms that cause neuropathic pain following nerve injury are different from those that induce nociceptive and acute inflammatory pain.
Medications originally developed to treat depression and epilepsy are recommended as first-line treatments for the relief of neuropathic pain.
Antidepressants alleviate neuropathic pain by boosting the body’s own pain-fighting pathways. This includes boosting signalling in the brain which inhibits pain-signalling at the level of the spinal cord. The detailed mechanisms by which anti-epileptic drugs alleviate neuropathic pain are diverse but the net effect is to dampen pain signals.
Migraine pain
Migraine is a particularly debilitating type of pain. It is often accompanied by nausea, vomiting and sensitivity to light and sound. It can last for a few hours or several days. Migraine affects about 12% of Australians. Some experience auras such as flashing lights or changes in smell perception, which can serve as early warning signs the migraine is coming.
If painkillers such as paracetamol, aspirin, ibuprofen or ergotamine (made specifically to relieve migraine by narrowing blood vessels in the brain) are taken at the onset of the aura, the migraine can often be stopped or its severity reduced. For those suffering a severe migraine attack, prescription medications known as triptans can be effective treatments by reversing the brain blood vessel dilation.
Chronic inflammatory pain
Chronic pain affects up to one in five adults. One of the most common is pain from osteoarthritis, the most common type of arthritis.
Osteoarthritis pain is a chronic inflammatory pain caused by arthritic joint disease, typically in the knee or hip. As the joint cartilage and underlying bone break down, the joint becomes inflamed and this triggers the pain. The first-line painkiller for osteoarthritis pain is paracetamol.
For people with more severe pain, NSAIDs such as naproxen may be more effective. But chronic use of these is associated with an increased risk of side effects, especially bleeding and ulceration of the stomach lining. Less commonly, morphine or strong morphine-like analgesics are prescribed.
Cancer pain
Most cancer pain is caused by the tumour pressing on bones, nerves or other organs in your body. Pain can also be caused by the cancer treatment such as chemotherapy or radiotherapy. Oral morphine-like analgesics taken regularly, often in combination with paracetamol, are prescribed for moderate to severe chronic cancer pain.
Although drowsiness usually occurs at the start of treatment or after a dosage increase, this typically reduces after a couple of weeks. Anti-nausea and laxative agents are given at the beginning of treatment to minimise the side effects of nausea, vomiting and constipation. Nausea usually lasts no more than two to three weeks.
However, as constipation persists, it is very important that laxative use is maintained. For cancer pain involving nerve impingement, your doctor will add a prescription painkiller for neuropathic pain.
 
Court finds Nurofen made misleading Specific Pain claims
Media release from ACCC
In proceedings commenced by the Australian Competition and Consumer Commission, the Federal Court has found that Reckitt Benckiser (Australia) Pty Ltd (Reckitt Benckiser) engaged in misleading conduct in contravention of the Australian Consumer Law by representing that its Nurofen Specific Pain products were each formulated to treat a specific type of pain, when the products are identical.
The Nurofen Specific Pain product range consists of Nurofen Back Pain, Nurofen Period Pain, Nurofen Migraine Pain and Nurofen Tension Headache.
 
The court found that Reckitt Benckiser made misleading representations on the packaging of each Nurofen Specific Pain product, and on its website www.nurofen.com.au(link is external), that each product:
• was formulated to treat a particular type of pain; and
• solely or specifically treated a particular type of pain.
In fact, each product contains the same active ingredient, ibuprofen lysine 342mg, and is no more effective at treating the type of pain described on its packaging than any of the other Nurofen Specific Pain products.
Reckitt Benckiser admitted that it had engaged in the contravening conduct and consented to the orders made by the Court.
“The ACCC took these proceedings because it was concerned that consumers may have purchased these products in the belief that they specifically treated a certain type of pain, based on the representations on the packaging, when this was not the case,” ACCC Chairman Rod Sims said.
“Truth in advertising and consumer issues in the health and medical sectors are priority areas for the ACCC, to ensure that consumers are given accurate information when making their purchasing decisions.”
“Any representations which are difficult for a consumer to test will face greater scrutiny from the ACCC,” Mr Sims said.
“The retail price of the Nurofen Specific Pain Products was significantly higher than that of other comparable analgesic products which also act as general pain relievers. Price sampling conducted by the ACCC before the proceedings were commenced indicated that the  Nurofen Specific Pain products were being sold at retail prices almost double that of Nurofen’s standard ibuprofen products and the general pain relief products of its competitors.”
The Court ordered that Reckitt Benckiser remove the Nurofen Specific Pain products from retail shelves within 3 months. The court has also ordered that Reckitt Benckiser publish website and newspaper corrective notices, implement a consumer protection compliance program, and pay the ACCC’s costs.
The ACCC has agreed an interim packaging arrangement with Reckitt Benckiser for use following the removal of these products. This will clearly disclose to consumers that the products are equally effective for other forms of pain.
A hearing on penalty will be held on a date to be fixed by the Court.

Amazing facts about your body

1 SUPERSIZED MOLECULES

Practically everything we experience is made up of molecules. These vary in size from simple pairs of atoms, like an oxygen molecule, to complex organic structures. But the biggest molecule in nature resides in your body. It is chromosome 1. A normal human cell has 23 pairs of chromosomes in its nucleus, each a single, very long, molecule of DNA. Chromosome 1 is the biggest, containing around 10bn atoms, to pack in the amount of information that is encoded in the molecule.

2 ATOM COUNT

It is hard to grasp just how small the atoms that make up your body are until you take a look at the sheer number of them. An adult is made up of around 7,000,000,000,000,000,000,000,000,000 (7 octillion) atoms.

3 ATOMIC COLLAPSE

The atoms that make up your body are mostly empty space, so despite there being so many of them, without that space you would compress into a tiny volume. The nucleus that makes up the vast bulk of the matter in an atom is so much smaller than the whole structure that it is comparable to the size of a fly in a cathedral. If you lost all your empty atomic space, your body would fit into a cube less than 1/500th of a centimetre on each side. Neutron stars are made up of matter that has undergone exactly this kind of compression. In a single cubic centimetre of neutron star material there are around 100m tons of matter. An entire neutron star, heavier than our sun, occupies a sphere that is roughly the size across of the Tasmanina.

4 ELECTROMAGNETIC REPULSION

The atoms that make up matter never touch each other. The closer they get, the more repulsion there is between the electrical charges on their component parts. It's like trying to bring two intensely powerful magnets together, north pole to north pole. This even applies when objects appear to be in contact. When you sit on a chair, you don't touch it. You float a tiny distance above, suspended by the repulsion between atoms. This electromagnetic force is vastly stronger than the force of gravity – around a billion billion times stronger. You can demonstrate the relative strength by holding a fridge magnet near a fridge and letting go. The electromagnetic force from the tiny magnet overwhelms the gravitational attraction of the whole Earth.

5 STARDUST TO STARDUST

Every atom in your body is billions of years old. Hydrogen, the most common element in the universe and a major feature of your body, was produced in the big bang 13.7bn years ago. Heavier atoms such as carbon and oxygen were forged in stars between 7bn and 12bn years ago, and blasted across space when the stars exploded. Some of these explosions were so powerful that they also produced the elements heavier than iron, which stars can't construct. This means that the components of your body are truly ancient: you are stardust.

6 THE QUANTUM BODY

One of the mysteries of science is how something as apparently solid and straightforward as your body can be made of strangely behaving quantum particles such as atoms and their constituents. If you ask most people to draw a picture of one of the atoms in their bodies, they will produce something like a miniature solar system, with a nucleus as the sun and electrons whizzing round like planets. This was, indeed, an early model of the atom, but it was realised that such atoms would collapse in an instant. This is because electrons have an electrical charge and accelerating a charged particle, which is necessary to keep it in orbit, would make it give off energy in the form of light, leaving the electron spiralling into the nucleus. In reality, electrons are confined to specific orbits, as if they ran on rails. They can't exist anywhere between these orbits but have to make a "quantum leap" from one to another. What's more, as quantum particles, electrons exist as a collection of probabilities rather than at specific locations, so a better picture is to show the electrons as a set of fuzzy shells around the nucleus.

http://www.theguardian.com/science/2013/jan/27/20-human-body-facts-science

The Power of Placebo

 

What if each of us could make the symptoms of an illness disappear? Cast a spell so powerful it would actually rid us of pain, help us walk, or breathe better? For centuries placebos have been thought of as fake medicine involving trickery and deceit, but Brain Magic: The Power of Placebo pulls back the curtains on the proof that placebos can have powerful – and real – effects on our mind and body.

New research is proving that everything from sugar pills, to saline injections, to sham surgery, can have real healing power. Placebos won’t shrink tumours or cure diabetes, but they can be effective in subjective conditions – where self-appraisal plays a role. And, as we’ll discover in Brain Magic, neuroscience is revealing how our bodies’ response to treatment is heavily influenced by our expectations, prior experiences, our beliefs, and the social cues that surround us.

All kinds of myths regarding placebos are being shattered. One long-held belief is that placebos only work if the patient is deceived into thinking he or she is getting real medication. But in Brain Magic we travel to Boston where we meet Linda, a patient who experienced relief from the symptoms of a painful medical condition, even though she knew she was taking sugar pills. 

The other great myth is that placebos only work on people who are gullible. But whether we respond to a placebo might well be written into our DNA, and have nothing to do with our vulnerabilities. In Brain Magic: The Power of Placebo we’ll meet patients of all ages, with a range of conditions, who have all benefited from placebos.

As we dig deep into the magic power of placebos, we step on to esteemed university campuses across North America where researchers continue to uncover new, and potentially therapeutic, applications of the placebo effect. They are giving an exciting new legitimacy to what was once thought to be “all in the head.”

12 Known Benefits of Apple Cider Vinegar

 

This article leads on from the Gut Reaction article that was included in the September newsletter. The consensus shows that the reason vinegar could be a medicine because it contains acetate.

1. Improved Digestion

Drinking apple cider vinegar in water can help to naturally improve your digestion. Take a tablespoon of ACV in a big glass of water around 15 minutes before a meal to stimulate digestive juices for better breakdown of your food. It’s important to use raw, unpasteurized apple cider vinegar with the mother for this and all of the other health benefits listed below.

Filtered and pasteurized vinegars will not have this and lack the enzymes and other nutritional properties in raw ACV that have such a positive effect on the digestive process. Real apple cider vinegar contains valuable minerals and trace elements, LDL cholesterol lowering pectin, fat burning acetic acid, anti-viral malic acid, live enzymes, amino acids and many other beneficial nutrients. When you drink apple cider vinegar regularly, ideally before each main meal, your digestion improves and you naturally begin assimilating more from your food. This can also reduce hunger and help with losing weight. More on this ahead.

2. Heartburn, Intestinal Problems and Constipation

Regular apple cider vinegar in water is believed to help correct low stomach acid conditions that leads to heartburn. Importantly, straight ACV is very strong and likely to be too powerful for heartburn sufferers, and especially those with ulcers, so make sure you dilute it well. Apple pectin fiber, found in the mother of raw and unfiltered apple cider vinegar, soothes the entire gastrointestinal tract, helping to prevent stomach cramps, bloating and gas. Apple cider vinegar can also be useful as a mild laxative to stimulate peristalsis in cases of occasional constipation. It should not have this effect if your bowel movements are already regular.

3. Prevent Candida and Normalize Intestinal Bacteria

ACV is full of beneficial acids which are believed to help improve the make up of your intestinal flora. These include acetic acid and malic acid, which have antibacterial, antimicrobial and anti-fungal properties and can help control the spread of the candida fungus in your intestines, a common debilitating problem with many people’s high sugar diets.

4. Strengthen Your Immune System

Your intestinal flora are a big part of your body’s immune system. It makes sense then that improving the conditions for the growth of friendly bacteria with apple cider vinegar can help improve your overall immunity.

The malic acid in ACV is also a strong antiviral, perhaps one of the reasons people often say they experience fewer colds when they take apple cider vinegar in water daily. Additionally, raw and unfiltered apple cider vinegar is said to benefit your lymphatic system by helping to cleanse lymph nodes and break up mucus in the body. Over time this can relieve sinus congestion, reduce colds and alleviate allergies.

5. Regulate Blood Sugar and Aid in Diabetes

Apple cider vinegar is full of acetic acid which appears to slow down the digestion of simple carbohydrates, thus regulating blood sugar levels from the brief highs and longer lows of a high carb diet. The anti-glycemic effect of ACV has been proven in several studies, including this one that concluded, “vinegar can significantly improve post-prandial insulin and sensitivity in insulin resistant subjects…thus, vinegar may possess physiological effects similar to acarbose or metformin (anti-diabetic drugs). Further investigations to examine the efficacy of vinegar as an antidiabetic therapy are warranted.”

6. High Blood Pressure

Some animal studies have shown that apple cider vinegar may lower high blood pressure and there are many reports in online forums of using it for this purpose. It’s possible that ACV increases nitric oxide production that helps relax blood vessels, or it may just have a generally beneficial effect on your cardiovascular system that, over time, naturally results in a lowering of high blood pressure.

7. Detoxification

Apple cider vinegar is a popular ingredient in detoxification protocols with good reason. Aside from all the other body cleansing benefits already listed, drinking diluted raw and unfiltered apple cider vinegar is believed to help detoxify and cleanse your liver. One tablespoon of ACV in a large glass of water before each meal is often recommended as an effective dosage for daily detoxification. Some detoxifying methods may use larger doses, though it’s best to build up to these over time.

8. Weight Loss

Apple cider vinegar’s acetic acid has been shown in studies to suppress the accumulation of body fat and liver lipids. Its pectin content is also thought to slightly reduce your body’s ability to absorb fat.

When you have an apple cider vinegar drink before a meal, as well as improving digestion, it will usually reduce your hunger levels as well, which can only be beneficial for losing weight. Once again, 1 tablespoon in a large glass of water before each meal is the recommended dosage. Raw ACV may well aid weight loss, but it would be better thought of as part of a larger body fat reduction plan. In all I’ve read on the subject, I believe the most effective first step is to reduce grain-based carbohydrates and eat more, not less, of the right type of foods.

9. Bad Breath

The natural acids in real apple cider vinegar, like acetic and malic acid, can reduce the bacteria in your mouth that cause bad breath. Using apple cider vinegar for halitosis, you would make it a bit stronger than when drinking it. Add one tablespoon to a third of a cup of water and gargle it for around 20 seconds to minimize bad breath.

10. Skin Benefits

Apple cider vinegar balances your skin’s pH levels and has long been recommended as a skin tonic. It can also help treat dermatological conditions like acne, especially when used both internally and externally regularly.

11. Leg Cramps and Restless Leg Syndrome

Sipping on an apple cider vinegar drink can increase low potassium levels in your body, a suspect in night-time leg cramps and restless leg syndrome.

12. Stamina and Energy

Improved stamina and energy are harder to measure subjectively, but raw, unpasteurized apple cider vinegar has long been considered a general health tonic and more energy and greater stamina are commonly reported when drinking it.

This may be a combination of all the other health benefits of ACV already listed. Or it could be due to the powerful alkalizing effect it has on your body when you drink apple cider vinegar daily. Despite being acidic outside the body, ACV, like lemon water, is recognized as a premier alkalizing drink, which reduces acidosis in the body and has been reported to aid in recovering from a wide range of health conditions and diseases.

www.collective-evolution.com/2014/06/02/12-reasons-why-apple-cider-vinegar-will-revolutionize-your-health/

blog post

Eat like you love yourself

Move like you love yourself

Speak like you love yourself

Act like you love yourself

-        Tara Stiles

We know neuroscientists are a fun group, so it didn’t surprise us that there are so many great jokes out there. Here’s a collection of our favorites.

 

What is a sleeping brain’s favorite musical group (rock band)? REM.

 

What does a brain do when it sees a friend across the street? It gives a brain wave.

What do neurons use to talk to each other? A cellular phone.

 

What did the stimulus do to the neuron after they got married? Carried it over the threshold.

 

If some of Fred Flintstone’s neurotransmitters could talk, what would they say? “GABA-daba-doo!”

 

Why does the spinal cord belong in the brass section of an orchestra? Because it has dorsal and ventral horns.

 

What do you call a skull without 1 billion neurons? A no-brainer.

 

What happens when a neurotransmitter falls in love with a receptor? You get a binding relationship.

 

What do you call a group of brains who form a signing group? A glia club.

 

What does a neuroscientist order at a bar? A spiked drink.

blog post

 

Alzheimer’s is the most common form of dementia, affecting some 36 million worldwide, with an estimated annual cost of approximately $600 million. The greatest risk factor for Alzheimer’s is age, with the likelihood of developing the disease doubling about every five years after the age of 65. The number of people who suffer from the disease is therefore predicted to triple by the year 2050.

With the threat of this epidemic looming on the horizon – not to mention the promise of huge profits – drug companies have invested huge amounts of time and money into research and development of treatments that can slow progression of the disease or stop it in its tracks. But so far they have failed, with the vast majority of drugs that showed potential in animal studies proving to be ineffective when tested in humans.

While effective treatments may still be a long way off, other research suggests that a number of lifestyle factors may reduce your risk of developing Alzheimer’s or delay the onset of the disease:

1. Exercise your body: What’s good for your heart is good for your brain, and so maintaining good cardiovascular health is essential for a healthy brain. The single, most important thing to do to keep your heart healthy is to stop smoking. Another is to exercise regularly; this not only reduces your risk of heart disease and diabetes, but also reduces your risk of suffering a stroke, as well as boosting your mood and self-esteem.

2. Exercise your brain: Your brain is like a muscle that needs to be flexed regularly to stay in good working order. Although the jury’s still outon whether expensive brain training programs are of any benefit to overall brain health, there is some evidence that keeping your brain active by reading, doing puzzles, or learning a new language or musical instrument could delay the onset of Alzheimer’s disease and other forms of dementia.

3. Stay in schoolEducation has a neuroprotective effect. There’s now good evidence that the more highly educated a person is, the lower their risk of developing Alzheimer’s, and the better they’ll be able to cope with the disease when it does develop. Similarly, the more educated a person is, the better they will recover after a stroke or other brain injury.

4. Maintain a balanced diet: You’ve probably read about something about fish being good “brain food,” because they are enriched in omega oils, but in fact, the evidence so far is conflicting and inconclusive. Nobody doubts the benefits of maintaining a healthy, balanced diet, however – like exercising regularly, it prevents excessive weight gain and is important for good cardiovascular health. And although it’s still not clear whether it’s worth spending your money on fish oil supplements, there’s good evidence that adhering to a Mediterranean diet can lower the rate of age-related cognitive decline and reduce Alzheimer’s risk.

5. Get motivated: Like education, having purpose in life, or being driven towards achieving a specific goal, also has a neuroprotective effect. We still don’t know exactly why this may be. What does seem clear, however, is that it’s never too late to go back to school or learn a new skill, and that motivating oneself to do so can be beneficial for your brain.

6. Sleep wellSleep disturbances are linked to Alzheimer’s disease and other neurodegenerative conditions, as well to neuropsychiatric disorders such as anxiety, stress, and depression. In most of these conditions, sleep disturbances seem to arise decades before other symptoms, and may be the earliest behavioural manifestation of them. All the evidence suggests that the relationship is bidirectional – that is, poor sleep patterns may lead to pathological brain changes, which in turn may exacerbate sleep disturbances.

The very latest research, published earlier this month in the journa lNeurology, shows that poor sleep quality in people over 60 years of age is associated with widespread increased brain shrinkage. Thus, maintaining good sleep hygiene throughout life thus seems to be essential for slowing or preventing the brain changes associated with Alzheimer’s and a wide range of other conditions.

Alzheimer’s is an extremely complex disease that clearly involves a combination of environmental and genetic factors. While each of the factors listed above has been shown to influence Alzheimer’s risk, many of the observed effects are quite subtle. It may be the case that combinations of these factors have a cumulative effect on reducing Alzheimer’s risk, but this remains to be seen, as much of the research into these so-called modifiable risk factors is still in its infancy.

Adapted from http://www.theguardian.com/science/neurophilosophy/2014/sep/22/the-neuroprotective-lifestyle

The History of Vitamin C

 

The history of vitamin C goes back to the Discovery voyages of the 15th to 17th century when sailors went to sea for a long period of time-- weeks, and sometimes months. And after a while, disease would develop, or symptoms will appear among the crew, a symptom that today we know as scurvy. What happened is that the gums would start bleeding. They would get blotches over the skin. And actually, there is a description of the time of someone observing what happened when people developed this particular condition that became known as scurvy. "Legs became--swollen and puffed up while the sinews contracted and turned coal-black and, in some cases, all blotched with drops of purplish blood. Gums were so decayed that the flesh peeled off down to the roots of the teeth while the latter almost all fell out-- By February out of our group of 110 there were not ten left in good health--already eight were dead, and over fifty more were given up for lost. “The first indication that scurvy could be caused by a nutritional deficiency came about when Jacques Cartier actually landed on what was to become New France. Most of his crew suffered from scurvy, not knowing what caused the problem. Fortunately, the natives recognized the symptoms--they recognized the causes of the symptom. They realized that actually, they had a treatment for that. They approached Jacques Cartier and they suggested to him that he makes a brew made out of pine needle. And today, we know that pine needle actually is a rich source of vitamin C that can fight off scurvy. So for instance, if you're stuck in northern Canada, and you notice the first symptoms of scurvy, look around, pick up some pine needles, make yourself a brew, and this should be helpful. Now actually, vitamin C-- ascorbic acid-- is present in a number of other foods. It is also present in cabbage, and again, this could be of use. And on long trips, eventually it was realized that one could take cabbage--or sauerkraut, and use this to prevent the symptoms of scurvy. The first person to recognize that in fact, scurvy could be prevented through proper nutrition was a British surgeon by the name of James Lind. And actually, it is said that James Lind was the first one to carry a clinical trial. What he did, he gave to sailors suffering from scurvy different food, or a different potion, to see if it could make a difference. Some were given the food, some the potion-- some were not. And what they did is that they noticed that among all the different food and potion, there was one that was really important. And that one was lime. They found that lime contained some sort of nutrient that prevented scurvy. And actually, initially it was believed that it was not so much the food itself, but the acidity of the food that was helpful in preventing scurvy. So as a result, initially the British sailors were made to drink--to take-- diluted sulfuric acid, also known as oil of vitriol, to prevent scurvy. But eventually it was realized that it was the lime that was important. So on their long voyages, British sailors would take lime juice with them. And they had two ways of preventing the lime juice from oxidation. One way was to mix it together with brandy, with alcohol. And the other way, actually, was to keep it in a barrel and cover the top of the barrel with oil so that the oil would prevent air from getting into contact with the juice, with the lime juice. Now if you look at this particular slide, you'll notice that the second method, the one that involves putting it in a barrel with oil on top was used rather than the one where the juice was mixed with brandy. You know, these gentlemen were not too happy. Well, following this, it was decided that on the long voyages, all the British sailors had to drink one ounce, or to have one ounce of lime juice per day. And this became known, and this is the reason why there's a nickname associated with these British sailors, and that is limey. Now, it took a long time to determine  what the substance in lime juice was that actually did prevent this disease. It was only in 1927 when Albert Szent-Gyorgyi isolated the active ingredient in lime juice and citrus fruit and cabbage and the like, and found out that active ingredient was what we know today as vitamin C, ascorbic acid. And it is 10 years later in 1937 that Albert Szent-Gyorgyi, a Hungarian chemist, got the Nobel Prize actually for his identification of vitamin C as the substance that prevented scurvy. Adapted from edx talks on the History of Vitamins https://www.edx.org/ 

 

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