How to set up your car seat

If you spend a lot of time in your car then this post is for you…and let’s face it, if you're reading this you most likely live in Melbourne, so there is a good chance you DO spend too large a portion of your life driving, sorry, I mean, in traffic.

If reading this whole post isn't really for you, then feel free to skip down to the end where I will summarise how to set yourself up in your care in a checklist.

 Note how her head is sitting comfortably above her shoulders? Ideally shed have 2 hands on the wheel also…

Note how her head is sitting comfortably above her shoulders? Ideally shed have 2 hands on the wheel also…

What is the issue?

As a society, we appear to give a lot of attention to ergonomics for when we are setting up an office work station, or using a computer, but thats often where our attention to the issue ends.

We are guilty of it too!

If you follow this blog you will know that we have recently posted about how best to set up your computer or your laptop, we have talked about ways to avoid text neck when using your smart phone or tablet. We have even discussed how to sit and the importance of limiting how long we sit for, yet all of those are predominantly centred around screen time, or when you are in an office.

The reality is, the office, be it at work or at home is only a PART of how we spend every day. Important as good ergonomics are during these times, we need to remember that improved spinal health, being mindful of our posture and maintaining high levels of function are 24/7 activities.

We are the result of what we do the most.

To be more precise, our body will get better at whatever we ask it to do the most, so it is important to ask yourself regularly throughout the day:

“What am I asking my body to do right now?”

This is why we often tell our clients that the most important thing they can do for themselves throughout the work day is to get up out of their chair and move around.

One place where getting up and moving around is not really an option however is when we are in the car.

Kieran, I will not be getting a beaded car seat cover so don’t even mention it.

Fair point. I wouldn't want one either. I am far too car proud for that.

Most of my clients will probably already know that I am into cars and that I love driving.

I am fortunate enough that my commute is very short, so much so that I mostly get the opportunity to walk or ride my bike to the practice. I do however get to spend a lot of time in the car though, as I enjoy driving almost everywhere else and spend most of my weekends heading out of the city to go camping, hiking or traveling to visit family in Bendigo.

One thing I don’t like about driving though, is how easy it can be to make myself very sore if I haven't set the car up properly.

A poor driving position can lead to (among other things):

  • Low back pain,

  • headaches,

  • sore shoulders,

  • pins and needles in your legs or arms,

  • fatigue,

  • Sciatic pain and most dangerous of all,

  • an inability to control your car properly.

Setting your car up is easy

Fortunately we live in a world where other people have done most of the hard work for us and your car is no exception.

Car companies have employed a literal team of people to make your car so that it is able to get you to YOUR ideal driving position, however most of us rarely use all of the functions they have bent hundreds of hours developing.

It doesn’t matter whether you drive something fun and sporty, or purely as a taxi you use to ferry your children, the following suggestions should be able to apply to nearly every car you drive.

Step 1: Seat height and distance

When it comes to how high you sit in the car, too much of anything is a bad thing. Too high and you have to bend down to see out of the window clearly, too low and you will struggle to see everything you have to avoid.

You want to be a comfortable height to be able to see everything easily over the steering wheel without extra effort. Seems like a no brainer I know but you do wee some weird things out there.

Distance from the pedals is important too. You never want to be reaching for the pedals…obviously but you don't want to have your knees too bent either.

If you are too close, you have to actively position your feet for too long leading to hip issues. On top of this, if your knee is close to or is resting on the dash board, then your leg bones will have to act like an air bag to slow you down in an accident…which is less than ideal if you're the kind of person that enjoys having legs.

Ideally, the best distance from the seat to the pedals would mean that in a manual car, your knee should be *almost* straight but not quite when you press the clutch in all the way. About a 5 degree knee bend in that position should be it.

In an auto, the same rule applies for you to be able to leave your foot on the foot rest (look for it, you most likely have one to the left of the brake pedal) but if you don't have one, you should have that same 5 degree knee bend when your foot rests on the firewall (thats the carpet behind the pedals).

This should also mean that when you take your left hand off the steering wheel it should be able to rest comfortably on the gear stick without having to reach for it, allowing your shoulders to remain relaxed.

Step 2: Steering wheel position

Have the steering wheel at a distance where you can relax your hands onto the 10 and 2 positions on the wheel without leaning forward and having to round your shoulders, keeping a relaxed bend in your elbows.

This means you have the most control of the wheel without having to grip onto it, strain your shoulders or your low back to reach for it.

Another easy way to know if its in a good spot, is when you rest your wrists onto the top of the steering wheel, it should sit *just* at your wrists.

Move it to a height where your hands can sit at 10 and 2 roughly in front of your shoulders, you don't want to have to go reaching up or down to find the steering wheel.

Most cars now have an electric steering wheel movement, but if not, its easy to unclip the handles on the steering column and play around with its position, moving it up and down or forward and back. Take your time with its one, when you get it right, you’ll know.

Step 3: Head position

If you have done the other two right then this should already be set, but just make sure your head isn't having to lean forward too far and is relaxed over the top of your shoulders.

If it is leaning forward, readjust your steering wheel closer to you.

Watch out for car seats that push your head forward. Bad posture is so common that engineers in some car companies have started building their seats to have the head rests moving forward to meet where they assume people with poor postures heads will be.

This forces you into a bad position and over time will GIVE you forward head posture. Personally I have not been able to buy certain cars because of this, and I know it has meant Martin has had to choose a different brand when replacing one of his.

You also shouldn’t need to rest your head back on the head rest.

The name is deceptive, you should have active control of your head, it shouldn't have to be pushed back into the head rest. Its the name of a safety feature in a crash, not a suggested use.

Step 4: Lumbar support

If your car has inbuilt lumbar support, don't be afraid to use it. When you find the right spot for you, you will be amazed that you ever drove without it.

If need be, you can always buy a lumbar support pillow to use when you are driving for long periods or on longer road trips.

Step 5: Never drive with something in your back pocket.

Thats right men who keep a wallet in your back pocket when you're driving, I am talking to you. I don’t care how long you have done it for, it causes an unevenness under you that WILL eventually lead to back pain and even sciatica in some cases.

The same goes for mobile phones. They seem small but even on a short trip they make a difference to how you have to sit. I don’t care HOW short the drive is.

Again, it seems obvious but people do it.

Step 6: Take breaks regularly.

Especially if you are driving a distance. They don't only stop you from feeling fatigued, they allow your body to wake up as well, and they don’t even have to take long! Even a 2-5 minute walk can do the trick.

As promised, here is the checklist:

Step 1: Height and distance

Seat at a height where you can see everything without straining to have your eyes above the wheel or below the sun visors.

Sit at a distance where your foot can relax at the back of the foot well with your knee bent slightly to around 5 degrees.

Step 2: Steering wheel

Bring it close enough to have a slight bend in your elbows when your hands are at 10 and 2, you should be able to rest your wrists on the top of the wheel without reaching for it with your shoulders.

Step 3: Head position

Like sitting at a computer, above your shoulders, not poking forward at the steering wheel.

Step 4: Lumbar support

Play around with it until it feels good for extended periods. This might take some experimenting. If you need to, buy a support cushion.

Step 5: Nothing in your back pockets.

Step 6: Take breaks.

If you have any questions or concerns, would like to chat about how to set up your car please contact us at Align, we would love to help you.

However, if you're happy with your car set up but would like to chat about cars specifically, please feel free to talk to me about it…don’t bother talking about them with Martin…they aren't really his thing.

Kieran

The most important step to choosing the right pillow

If you are one of the many people who are not sure where to start when selecting a pillow then please watch our quick video on what we think is THE most important step when making your choice. 

Let's face it, there are too many options for pillows out there. There are so many materials, shapes, and seemingly random options for you to choose and the hardest part for a lot of our clients is that nearly all of them seem incredibly expensive! 

Choosing the right pillow for you is very important but it shouldn't be something you lose sleep over. 

At Align we believe that there is one simple factor that you need to consider above all else before settling on a new pillow.

If you have any further questions after you have watched the video about choosing a pillow or how best to approach sleep to manage your issues (be it posture, neck pain, low back pain or headaches), please do not hesitate to contact us at Align. We have a select range of pillows on hand at any time that are available to you even if you have never been in before. 

Knowing how important sleep is to our community, we are always happy to offer a complimentary pillow fitting for you so that you can be confident that you are making the right choice. 

Watch our video below to hear what advice Drs Martin and Kieran start with for anyone who is considering an updated pillow. If you'd prefer not to watch, the clip has been transcribed below. 

Hi, Martin Harvey from Align Chiropractic here. 

One of the most common questions that we get asked in practice is: “What sort of pillow should I be sleeping with?”

We have people coming in who have entire collections of pillows, made out of everything from feathers, through to the latest space-age materials, and they wonder: 

“Why can't I find a pillow that’s comfortable for me?” 

The first thing that we always want to make sure is that the pillow is the right size and the right fit for you. 

Obviously some people are different sizes and there are also people who choose or are most comfortable in, different sleeping positions. 

Make sure you check out our “which sleeping positions should you be using” video as well, but if you’re somebody who predominantly sleeps on your side, then you're going to need a larger pillow. 

In side sleeping, the idea of the pillow would be to take up a significant amount of the space between your shoulder and your neck, so that it’s supporting your neck. 

If it is not, when you’re sleeping on your side and it's too low, your pillow is going to force you to tip over quite a bit that way, and at the same time if it's too big for you, it's going to tend to tip you the other way. 

If you're somebody who mainly sleeps on your back, then wanting to keep your head fairly balanced over your shoulder, you’re not going to want to big a pillow because a really big pillow is going to tend to force you forward quite a bit.

To that end, the type of pillow that typically is the best compromise if you're one of the many people who sleep a bit in both is a contoured pillow. 

The contour allows the thicker part of your head when you're lying on your back to be in the contour and it also supports your neck without forcing you too far forward. 

This is a low-profile pillow and this would be for somebody who primarily sleeps on their back or they're a smaller person who sleeps on their side.

If you're a bigger person who's a side sleeper, then you're going to want to go to a larger, higher profile pillow. 

You can see here that it's much thicker than the other pillow, again it's the same basic structure. 

So there you have it, a simple way of getting a bit of an idea of which pillow you should be using. 

The most important first thing is that it's less about the material that it’s made from these ones are made out of latex which is a really comfortable and durable material but the most important thing is to make sure you get the right size based on how big you are, as well as your preferred sleeping position.

Sleeping position: How should you sleep to avoid neck pain?

This post is for people wondering about the best position to sleep in, especially if they suffer from neck pain, upper back pain, neck tightness or forward head posture. 

How should you sleep to avoid neck pain?

We frequently get asked 'what the best position to sleep in?'.

Although this question has many answers depending on the specific needs of the person, we wanted to address what we see as one of the most common sources of issues for our clients, and that is to focus on head and neck position. 

The aim is to take the pressure off the structures supporting your head, as well as allowing your body to be as comfortable as possible throughout the night. 

We hope that you can get some insights from this short video to help your body work with you in your efforts to alleviate neck pain etc as well as improve your posture for the whole third of your life you are SUPPOSED to spend asleep.

As with all our videos, this one has been transcribed below.

Be sure to check back on this page next week when Martin explains how best to choose a pillow.

If you have further questions about making the most of your sleeping position, please do not hesitate to get in contact with us. 

Never underestimate the importance of good quality night of sleep!

 

Hi, it’s Martin and Kieran from Align Chiropractic and one of the most common questions that we get asked every day in practice is: “what position should I be sleeping in?” 

What I want to go over today is (in our opinion) the two best positions that we want to be in when we're asleep, and it's really very similar to what we're looking for when we're looking at your posture when you are standing up. 

What should your sleeping posture look like?

If we have a look at Kieran’s posture, what we're really looking for when we look at somebody’s posture from the front is when we look at head posture, does the head line up coming in the middle of their chest we don't want to see posture that's tipped over this way or twist it around or whatever. 

When we translate that to sleeping position, we’re trying to set up a sleeping pose so that our posture is in that ‘ideal’ position. 

Kieran, if you can turn side on, we want to see the same thing, because our bodies are in three dimensions we’re also looking to make sure that our posture is lined up from the side so that this big weight about our head is balanced over the big weight of our chest so we're looking for our ear over our shoulder to balance up, so again if we translate standing posture to lying down posture, that’s what we're looking for there. 

Sleeping on your back

So, what I’ll get you to do now Kieran, if you can lie down on your back for me and if we look at posture from the side here, we've got the right position here, lying on our back we've got a pillow set up properly.

What we're really looking for is that same thing where we've got that ear kind of balancing up over the shoulder. 

What about side sleepers?

Now if we can now turn into our side posture, what we're really looking for here again is, if we're looking at the middle of the face we're wanting that to be almost a straight line. 

We don't want it this pillow was too low, then it would allow his head to tip… well that's way over to the side but similarly if we had a higher, pillow it's going to lift that up too high. 

So we're looking for a straight line there, we want that lining up, kind of at the middle of the chest so that again, we’re keeping that perfect posture while we’re spending the seven and a half to eight hours in this position while we're in bed this way. 

I hope that video is useful gives you a bit of an idea that the two best positions for you to sleep in are either on your back or on your side, because it's really important to make sure that your spinal posture is in a great position while you're asleep.

 

Simple exercises for people with neck pain

If you have neck pain, tight shoulders or headaches that come from your neck then I suggest you watch the video below.  

In the video I run you though some very simple movement exercises to keep you mobile, try and get your neck moving again and hopefully help make you more comfortable as you go through your day. 

I have tried to keep them very quick and easy so that you can incorporate them into your day simply and without having to make it too obvious that you're doing them.

If you are concerned about your neck pain or you have any questions, or if you experience discomfort doing them, then please do not hesitate to get in contact with us. 

As always, the video has been transcribed below, but I recommend you watch to get a demonstration...and to see me in my solo video debut. Enjoy. 

 

Hi I'm Kieran from Align Chiropractic. I just wanted to run you through a quick exercise for getting your neck moving.

Now if you're somebody that suffers from neck pain, a tight neck or headaches that feel like they come from your neck then this video is for you. 

One of the main group of exercises that we recommend for our clients regularly are to get their neck moving again. 

It's really important that your neck range of motion is even to both sides, it should be pain free and it shouldn't feel too tight one side compared to the other. 

The important thing to remember when doing these exercises is don't push through a pain barrier or push to the extremes of your motion. 

What we are wanting to do is get to the point of restriction and just relax into that position. 

So its very simple to do; first of all we're looking at rotation. 

Turning your head to one side holding it at that point of restriction for three seconds come back to the middle then turning the other side. 

You're looking for it to be even on both sides and pain-free, hold for three seconds, back to the middle. 

Next we go straight to side, lateral flexion for three seconds, back to the middle and then to the right-hand side for three seconds and finally, back to the middle again.

Remember, it’s three seconds on each side and you cycle through all four of those five positions 5 times to keep things moving.

If you are finding a lot of restriction or are particularly uncomfortable on one side more than the other, that can be an indication of a more significant underlying imbalance.

If you are feeling that or have any concerns about how your body is moving,  I'd recommend that you get on to us and let's figure out what's happening for you.

Neck pain and forward head posture. 

If you are experiencing neck pain and it feels as if it is related to your posture, and you want to start to get on top of the problem then this post is for you. 

Shoulders always tight? Started to notice that you're chin pokes forward further than it used to?

As I have said in previous posts, neck pain is one of the most common reasons that people start to see us at Align. While there are many causes of neck pain one of the most likely reasons is poor posture. Specifically what is known as Forward Head Posture (which I call FHP below occasionally) 

Forward head posture is when, as the name suggests, your head starts to move forward from its correct position, poking your chin out over your chest. 

For many of you reading this post online, you know this posture as the one that your parents were always nagging you about when they would tell you to “stand up straight!” but you always thought it was an annoying waste of time. 

I’m sorry to tell you, this is just one of those times when your parents were right. I know…so lame. 

 Not all of our client's have blurred faces but many of them do have FHP. In this photo, you can see a client's progress from where her head started on the left, to where she is headed now.   She still has some way to go, however we can tell that she is headed in the right direction.   *Individual results may vary.

Not all of our client's have blurred faces but many of them do have FHP. In this photo, you can see a client's progress from where her head started on the left, to where she is headed now. 

She still has some way to go, however we can tell that she is headed in the right direction. 

*Individual results may vary.

Why should I care? 

Issues that can arise from FHP include (but are not limited to): 

  • Neck pain,
  • Tight and restricted neck movement,
  • Headaches, 
  • Arm and shoulder pain, 
  • Tingling in the arms and hands, 
  • Issues with your jaw, 
  • Sinus issues, 
  • Increased kyphosis (hump in upper back), 
  • Low back pain, 
  • Degenerative joint disease in your neck and mid back.

Ok…that seems like plenty of problems…but doesn't it happen to everyone? Isn’t it normal?

FHP is VERY common yes, but it isn't “normal”.

The thing is, forward head posture has not always been as prevalent as it is today. 

Throughout history, the people who suffered from FHP have tended to be only those to have spent to have spent a lot of time being sedentary. 

In the past (and I don’t mean ancient times, I am talking literally only in the last 40 years) as a society in the western world, we have become less active and spend more time at desks and in front of computers especially. 

As a result, more commonly our heads are starting to drift forward as we spend time at a screen, or commuting and this is starting to have lasting effects. 

In my personal experience as a chiropractor, I have begun to see more children visiting for postural related issues, and even begun to see degenerative changes on teenager’s neck X-rays regularly that when I was at university I was told to begin to expect when people were in their 30s! 

Perhaps the best example of this change in demographics though comes in reference to that hump in the upper back I mentioned earlier. 

Our mid back, called our thoracic spine is meant to have a natural forward curve (which is known as a kyphosis). FHP causes extra strain and pull on this area and over a long period of time, this leads to an increase in this forward curve, causing a bump in our upper back. 

When I was studying, we learned that this issue was called a “Dowager’s Hump”. You see, traditionally, FHP lasting for a long period was something the medical profession associated almost exclusively with old ladies. 

Society ladies to be specific, being the most common members of the community who were expected (wrongly, obviously thats sexist) to be sedentary (think Maggie Smith’s character in Downton Abbey).

This condition as the name suggests was quite exclusive, normally expected in ladies who were old enough to have outlived their husbands. Hence, it was named for the dowagers who exhibited it. 

Flash forward to today and it has a new name beginning to appear in medical research literature. So new in fact that I had never heard of it until doing some research about this post. 

I won’t bore you with the details but see if you can guess which age group are the most likely sufferers are. The new name? iHunch.

Think of how bad you feel when you spend a day with your head leant in at a screen. 

Now think of the posture you find yourself in, or you see in children on a smartphone of tablet. We usually have it so far down, our head isn’t forward, it’s straight out flat!

How does FHP actually cause neck pain etc? 

Always remember, our body gets better at anything you ask it to do, but it is also always looking to do it using the smallest amount of energy possible.

It is virtually impossible to spend your whole day sitting and keep perfect posture so if we keep insisting that we spend multiple hours a day sitting in front of a screen, over time our body starts to change and the reason is simple. Weight. 

Just like you can’t hold a heavy barbell up all day every day, our body fatigues from our sitting position and eventually drops into a rounded back and head forward position, and this is where the trouble starts. 

Our heads are heavy. We have a heavy brain and a thick skull to protect it. Some of us more so than others. 

You know how when you hold something out in front of you and it feels heavier than it does when you bring it in close to your body? Our head works the same way. 

In fact, for every 2.5cm our head sits forward from it’s ideal position, our shoulders and neck have to deal with an extra 4.5kg. 

To illustrate, 4.5kg is roughly the weight of a number 10 bowling ball. All day, every day, being held by your neck and your upper back. 

How far forward is your head when you look at your phone? Or your tablet device?

Is it any wonder then why it gives us neck pain etc? 

So what can I do about it?

Plenty, and its never too early nor too late to make changes. 

Firstly, re-asses your sitting posture, watch our videos on the best way to set up your desk top and laptop computers for ergonomics. 

Next, look at our post about “Text Neck”.

Thirdly, get help. You want to know what your exact situation is and what you need to do specifically. 

You don’t want to spend months attempting to change your posture and accidentally be focusing on the wrong type of exercises for you, wasting time or even making your situation worse. 

You’ll see in this post a picture of FHP taken on a device that we use to assess our client’s posture. We LOVE this as it gives us specifics of where your major issues lie, and even gives us a weight of how much your head effectively weighs for your upper back to hold onto, versus how much it ACTUALLY weighs. 

This allows us to know in real time if our care plan is moving you in the correct direction and make individual amendments for you where necessary. 

*Please note, there are other underlying conditions that may cause alterations in posture that should not be left un-diagnosed, especially if they are rapid in onset and/or progression, or if they are present in younger people. 

If you have concerns about your posture, or the posture of those close to you, please get in contact   with us at Align.

What to expect when you visit us with Neck Pain

This post is for anyone with neck pain wondering what to expect as part of your initial assessment with us at Align. 

Neck pain is one of the most common issues people will come to visit us for. We are chiropractors after all. 

The goal of your first visit with us is to determine not only the likely cause of your neck pain, but the best course of action moving forward for you as well. 

If you have been watching the other videos about initial visits that we have posted recently, you will notice there is a certain level of commonality between the different assessments.

This is by design.

The video outlines the common elements to our cervical assessment. 

We want our examination process to be accessible to people with various levels of pain, injury or disability, and at the same time give us enough scope to individualise our assessment on an individual basis.  

There is a transcript of the video below. Although why WOULDN'T you want to see it filmed live?

 

 

 

 

 

Hi, Martin from Align Chiropractic and Kieran...also from Align Chiropractic. This video is just going to give you a little bit of an idea of what to expect if you're coming to see us and you're concerned with having neck pain.

The first thing we're going to do, Kieran if you’ll pretend that you’re the person with neck pain is make sure that you get to tell me all that you need to tell me about your neck pain. 

Certainly I have some questions about when it started, what makes it better, what makes it worse etc, and for a lot of people it's really important for us to understand what is it that their neck pain is making it harder for them to do, or stopping them from doing that they need to get back to.  

It’s really important that you get to tell all about neck pain so that we know what's going on. 

Step two: Palpation

When we're assessing somebody who's come to see us with neck pain is a palpatory exam. A plapatory exam is where we use gentle pressure to assess what is happening in your neck, are there areas where the joints are restricted in their ability to move? Are there areas where there's tenderness or discomfort? Are there areas where there's increased muscle tension?

Once we've assessed the neck, often, because the spine is one

integrated system it's all part of one whole system, we extend our palpatory examination through the rest of the spine. 

Sometimes we will also assess other related areas such as your shoulders or your jaw. 

Step 3: Show us your moves

When we are assessing somebody who's come to see us with neck pain is to assess how they bend, move and twist. 

Often when you have neck issues that will affect how far you can go one way compared to the other. The way we measure that is we use inclinometry, which is where we use an accurate measuring tool to see how far you can bend to the left comfortably and then compare the left side to how far you can move to the right. Simple as that.

Step 4: Assess Alignment

When we're assessing somebody who's come to see us complaining of neck pain is that we have a look to see if there’s any alteration in alignment of their spine. 

The way that we do this is we can use specialised software to take a photo of the person and then digitising that photo to see if there’s any misalignment or alteration in their posture. 

The software works by taking a photo and it uses the iPad to make sure that we have a photo that is absolutely vertical. 

The software then places our grid around exactly where straight up and down is and then we can compare landmarks on your body to measure against. 

Your body's landmarks should also be aligned so we can then see exactly how straight up and down or symmetrical your posture is.

 

 

Neck Pain

Neck pain is a common condition that most of us will suffer from at some point in our lives. 

It can arise for a whole host of reasons but if you have ever suffered from neck pain, you know that even mild neck pain can feel like  it is taking over your life! It can make it harder for you to sleep, work, exercise and enjoy time with your friends and family.

The most common causes of neck pain  are day to day movements and postural stresses and  neck pain is rarely the sign of a more serious condition.

 In case you aren't sure where neck pain is, here is a stock photo to indicate what a pain in the neck neck pain is. In this instance, pain is indicated by redness.

In case you aren't sure where neck pain is, here is a stock photo to indicate what a pain in the neck neck pain is. In this instance, pain is indicated by redness.

Neck pain can often refer to areas such as your shoulders, arms and upper back, as well as being a cause of headaches.  

Common causes of neck pain include:

  •         Poor posture (the way your body is positioned when standing or sitting)
  •         Sleeping in an awkward position.
  •         Upper back and neck muscle tension.
  •         Injury such as a muscle strain.
  •         Whiplash. 
  •         Prolonged sitting, especially when using a desktop or laptop computer.
  •         Arthritis.
  •         Degenerative changes in bones of the neck as a part of the ageing process or previous injury.

You will notice a common theme to the list above and that is; all of them appear relatively trivial when compared to the impact that neck pain has on our lives.

In fact, for a lot of our clients suffering from neck pain, that adds to the frustration. It doesn't matter if the pain is mild or severe, recent or decades old, most frequently, our clients will say that it just doesn't add up. “Why they are in so much discomfort? Why won’t the pain just go away by itself? Why does it keep coming back?”

How can something so mundane cause so much pain?

In these situations it is highly likely that there is an underlying imbalance of function that meant that their body was ‘on edge’. There was a build up of tension in an area of their spine and that mundane event was just the straw that broke the camels back (for the want of a better term).

Does it make sense to you that if your spine is functioning well that a trivial stress would be enough to make your neck hurt? If your range of motion was symmetrical, your muscles, ligaments and tendons were relaxed, elastic and strong  does it make sense that it would suddenly start to hurt you? 

Of course it doesn’t. 

An underlying imbalance of function is most likely why you notice neck pain that comes out of no where, or won’t calm down, or keeps coming back. 

This is why our initial assessment of someone with neck pain looks for two things:

  1. What is the cause pain and how do we get it to calm down as quickly as possible? 
  2. Is there an underlying imbalance and if so, what can you do to address it to minimise the chances of it coming back?

There are also more serious causes of neck pain that, although much more rare, we need to screen for. 

The more serious causes of neck pain are issues like fracture, disc prolapse compressing on nerves, cancer or meningitis.

We have designed our assessment to be able to determine if your neck pain arises from an issue that we can start to address immediately, requires referring for further testing (such as X-rays or MRI etc.) or if you require immediate referral for medical assessment. 

So how do I know if I need to see you or go to the Emergency Department?

If you are experiencing intense neck pain after a severe head or neck injury, have lost vision due to an accident, are having difficulty swallowing, have lost or severely altered bowel and/or bladder function or your neck pain is linked to intense fever, we advise that you visit your ED as soon as is possible to make sure that you aren’t suffering from more serious conditions. 

If you have any questions or concerns about neck pain, please do not hesitate to get in contact with us at Align.

What to expect when you visit us with Back Pain

This post is for anyone who has back pain and wants to know what to expect if they were to come and see us at Align.

Lets face it...as chiropractors, back pain really is our thing. You might have already guessed but along with neck pain and headaches, back pain makes up a large number of the people who come to visit us initially.

Unsurprisingly therefore, it is important for us to be able to efficiently find out what is happening in these cases and be able to determine their best course of action to move forward. 

The video below outlines very generally what to expect when you first come to see us. 

I use the term 'generally' as obviously, each person is different and so are their injuries, so we treat every client individually depending on their presentation. 

Sometimes back pain sufferers might require a neurological examination, for others we might require X-rays and for some, we may not be the first place they should be at all! 

We take pride in our initial examination's ability to individually assess back pain sufferers quickly and effectively to determine their needs and best course of action.

This video outlines the common elements of our exam.

For those who don't enjoy seeing Martin run an assessment on the Best Looking Chiropractor in Melbourne*, there is a transcript beneath the clip. 

*Not a real competition or title.

 

Hi, Martin and Kieran from Align Chiropractic and this is a short video to tell you what to expect if you're going to come and see us because you are concerned about back pain.

Step one: History

To be begin, we need for you to tell us all about your back pain; 

-what have you been feeling? 

-what makes it better? 

-when did it start? 

-what makes it worse? 

However mostly we want to understand is; what does the pain mean to you? 

For a lot of people, the pain is only a part of the problem. 

A big part of it is the impact that it's having on your life. What are the things that the pain is stopping you from doing that you love to do or need to do in your life? 

Step one then is for us to get a really good understanding all the ramifications.

Step two: Palpation

Next when you come to see us complaining of back pain, is a palpatory assessment. What we’re looking for with that assessment are areas where the joints are restricted in the motion.

When they are out of balance, they are not able to move the same left and right. 

We also want to see if there are areas where there's increased muscle tension and/or the presence of tenderness.

We are looking for the areas where things are just not working how they should. 

Once we've done that palpatory assessment of the area that is giving you problems, we will often also extend the examination beyond that area of pain because your spine is linked with the way the whole body works and so we will often then extend up into assessing how your neck is working or in other related areas.

Step Three: Assess Alignment

the next step when we are assessing somebody who has come to see us with back pain is we assess the alignment of their spine.

Posture is the window for us to be able to assess alignment.

To do this, we use specialised software where we can take a photo from the side and from the front. 

We then digitise those photos and then analyse them to see if there are indications of misalignment in the spine.

The way the software works is that we first take a photo and it uses the iPad to make sure that we have a photo that is absolutely vertical. 

The software then places a grid around exactly where straight up and down is and then we can compare landmarks on you that should also be aligned to see exactly how straight up and down or symmetrical your posture is.

4 Steps to Assess people with Headaches

If you or someone you know suffers from headaches than this post is for you. 

Below is a video Martin and I made about the steps we take when assessing a client who visits us at Align suffering from headaches. 

There are many different types of headache and not all of them respond to chiropractic care. This is why we go through our 4 step process to determine 

  1. What type of headache you are suffering from,
  2. Are you in the right place and we the right people to help you,
  3. What steps do you need to take to get on top of your headaches.

If you are concerned about your headaches or just sick of dealing with them, contact us at Align and lets find out how to get you on track. 

The video is 3 minutes but for those of you who prefer to read, there is a transcript below the clip. 

 

Hi, Martin here and Kieran from Align Chiropractic and this is a short video to let you know what to expect if you were to come and see us because you've got concerns about your headaches. 

Step One:

The first thing when you have headaches, is you want to make sure that you get the opportunity to tell us all about what's been happening with you. 

There are a lot of different types of headaches and so we're going to be asking you some really specific questions about the type of headache you have, where in your head you get it, the sort of things that make it better or worse and also the things that your headaches are making it harder for you to do in your life. 

This is because while headaches are one part of the problem for, a lot of people the most important thing is to be able to get back to doing the things that they either love to do or need to do in their life. 

So step one we're going to be asking some questions and giving you an opportunity to tell us all about your headaches. 

Step two

When we're assessing somebody who's come to see us with headaches, is to do a palpatory examination. 

A palpatory exam is where we use gentle touch, gentle pressure to assess areas where joints might be restricted in their motion or muscles might have tightened up or there might be areas where there's tenderness that can be part of the trigger for head pain. 

We will also often extend beyond that area, once we’ve got an assessment of the neck and upper back to other related areas so we might be feeling out through the shoulders, palpating the jaw or palpating down through the lower back and rest of the spine. 

Step Three

When we are assessing somebody who has come to see us for headaches is we look at how their spine bends and moves and twists. 

Often when there are imbalances or problems in the way the neck is working it will affect how far you can bend to the left compared to the right. the way that we assess that is to use a process called Inclinometry, which is where we use a precise instrument, called an inclinometer to measure exactly how far you go to the left compared to the right. 

So we can assess all the way, comfortable range of motion one way and then see if going the other way is more restricted. 

Step Four: 

When we are assessing somebody who has come to see us complaining of headaches, is we assess the alignment of their spine. 

Posture is the window that we can use to assess how their how well aligned their spine is and we use specialised software to take a digital photo of them from the front and the side we then digitise that to see if there's any significant alteration in their alignment. 

The way the software works is we first of all take a photo and it uses the iPad to make sure that we have a photo that is absolutely the software then places our grid around exactly where straight up and down is and then we can compare landmarks on you that should also be aligned to see exactly how straight up and down or symmetrical your posture is.

How to set up your desk if you use a desktop computer in 4 steps

This is a post for people who want to know how to set up their desktop to work on or for longer periods of time in the office or at home.

It is especially good for people worried about or who suffer from tension headaches, neck or low back pain, high or sore shoulders, or other postural issues such as forward head posture.

In the video, Martin (once again using Kieran as an ergonomics model extraordinaire) talks us through the correct ergonomics of how to set up our desktop as a workstation.

Please enjoy the quick video. 

For your convenience, the ergonomics demo has been transcribed below.

Hi, Martin and Kieran and we are here to give you a quick instructional video on how to set up your desktop computer so that it puts you in the best position to look after your precious spine and nervous system that you have, given that we are spending so much of our day working on computers.  

We have got a separate video that shows you how to set up for a laptop. There are some similarities but there are a couple of really key differences when you’re setting up for a desktop, so we'll run through everything here as well. 

Just like with the laptop setup, key thing is we're gonna start from the bottom up.  

Step 1: Seat height and foot position

First thing is, Kieran has his feet absolutely flat on the floor, he’s not crossing his legs which would create a twisting torsion through your lower back then cause tension to build up through the day. 

Next, we set the height of the chair. If you have a gas lift chair, you want the height of a chair so that your hip is either at the same level as his knee, so we've got a horizontal line, or so that the hip is slightly higher than your knee because that allows him to maintain a really good lower back position. 

If you sit with your hips lower than your knees it's really easy of get into a rounded posture, causing horrible loading up of tension in your lower back. 

Step 2: Position your arms, elbows, keyboard and mouse

So once we've got that position we then want to make sure that the height is still okay for his elbow position. 

What we really want is as close to possible as a 90 degree angle at the elbow so that you can have relaxed shoulders while your hands are on the keyboard. 

What we don't want is to be sitting too high, so that you have to reach down or too low, so that you’re scrunching shoulders up to get your fingers onto the keyboard. 

That height looks pretty good.

Then what we want to do is to zoom in or out, so that we've got a nice relaxed position here. 

If Kieran was too far back he'd be reaching and then having to use all those shoulder muscles to hold his hands on the keyboard. 

What we want is that so that his arms are nice and relaxed by his side while he's using the keyboard. 

The same rule applies to the mouse.

A lot of people may have the keyboard set up right but then end up having the mouse right across the desk where it’s causing a peep of pressure through their shoulder that feeds back up into your neck and causes all sorts of problems. 

So once we've got that set up, this is where it's a bit different to the laptop setup. 

3. Screen Position

With a desktop, the screen can be moved to two different positions depending on how often you needing to look at your keyboard. 

If you touch type or you're doing a lot of data entry where you're very rarely looking down at the keyboard, then you really want the screen to be a bit higher than we've got it here. In that case, the landmark that I always use is the absolute dead center of the screen.

If you are the type of person who needs to look down at the keys periodically you don't want the screen too high, otherwise you make yourself dizzy going up and down. 

So the compromise in this instance is to have the centre of the screen at about chin level and that way you're never looking too far up, and you're just working in this range. 

If you're the sort of person who can touch type and you don’t really need to look at your keys, then you can go up higher which has the advantage of having a posture where your head is more balanced over your shoulders. 

What we have here is a set up that is good for Kieran if he can touch type. 

If he doesn't often need to look down at the keys he can spend all of his time just looking straight ahead at the screen. 

So for this setup, what we've done is put a couple of books underneath the screen here, to raise it up, allowing us to have the centre of the screen at the point where it's hitting here, in-between the lip level or the tip of his nose.

That's a really comfortable posture for him to be able to look at the screen and have his head posture really nicely balanced over the shoulder, meaning a nice relaxed position through here. 

When you're in that position, you are not building up so much tension on your neck and shoulders etc. by looking down all the time. 

Remember, this setup is only for people who can touch type but it's a really optimal position that'll mean that he feels nice and comfortable for hours and hours of work. 

Step 4: As always, take micro breaks

Micro breaks are discussed in the Laptop video here.

I hope you found this video helpful please feel free to shoot us a message and let us know what you think.

How to set up your desk when you use a laptop in 4 steps

This is a post for people who frequently use a laptop to work on or for longer periods of time. It is especially good for people worried about or who suffer from tension headaches, neck or low back pain, high or sore shoulders, or other postural issues such as forward head posture.

In the video, Martin (using Kieran as the perfect ergonomics model) talks us through the correct ergonomics of how to set up our laptops as a workstation.

Please enjoy the quick video, for your convenience, the ergonomics demo has been transcribed below. 

This video will show you what you need to do to set up your desk when you are using a laptop.

Hi, this is Martin and Kieran from Align Chiropractic, we're here today to give you a quick video that will answer one of the most commonly asked questions that we get in the practice every day.

How should you have your desk set up so that you can look after your spine and your posture when you're spending time at your computer?

The first example we're going to do today is how to set it up for a laptop. Laptops are always a little bit more of a compromise than a desktop because you can't separate the screen but we’re going to go through how you can set it up so that your posture is in as close to the optimal position as possible. 

Step 1: Seat Height

The first point that we want to address is make sure, we can't see this but just take my word for it, Kieran's feet are flat on the floor. 

So we don't want crossed legs because it’s going to create twisting and torsion through our pelvis and lower back and create tension there. 

We want to make sure that the height of the chair, if you've got a gas lift chair, is up high enough so that your hip is either level with your knee so that we've got a straight line there, or you want the hips slightly higher than the knees.

What you don't want, because it's going to create a real curve in your back is knees higher than hips. 

So first point; set up the gas lift so that you're at that height. 

Step 2: Keyboard and arm position

we also want to have when we've got a hand on the keyboard there we want to make sure that we have pretty close to a 90 degree angle here. 

The main thing you don't want to have is to have the keyboard a lot lower, so this is particularly important for shorter people. 

If you have the chair too low then you're in a position where you start having to bunch up and create a lot of tension in your shoulders to be able to keep your hands on the keyboard. 

We want the set up so that we have hands easily on the keyboard with elbows roughly at about that 90 degrees or slightly more open. 

So we want to move our chair in or out so that with our hands comfortably on the keys we've got our hip and shoulder lined up because what we're really wanting to do here is have the big weight of the chest balanced over our hip.

What we don't want to be is so far back that we start to do this kind of thing, where there's a lot more tension on both the lower back and shoulders. Similarly, we don't want to be leaning all the way forward because it's going to tire out our back. 

Step 3: How do you manage the screen position?

So, a nice comfortable position of the chair, then this is the bit where we always have the little bit of a compromise with the laptop where we want to get your head balanced over your shoulder, but if you're looking down at a screen on a laptop, then that's always going to be a little bit tricky. 

The idea with the laptop is, make sure that you realise that you're always going to have a little bit of your head posture forward rather than balance the weight of your head over your shoulder so it’s really important to take micro breaks. 

Step 4: Micro Breaks

There are programs you can get that will remind you every 20-25 minutes to just stop for a minute, relax your arms way aside have a little micro break, turn your head all the way to the left, all the way around to the right, just drop your shoulders up and down a little bit and then you can get back to work.

So there it is, a couple of key points that you can use to set up your desk or your laptop in the optimal position, thanks.

 

9 tips for more comfortable travel

If you’re traveling and have back pain or you're concerned about making sure you're still comfortable once you actually REACH your destination, this post is aimed at you. 

For Kieran and Martin’s 9 tips to prevent back pain, neck pain and headaches when flying, skip to the bottom this post. 

For more back ground and some extra info about looking after yourself when you travel, please read on. 

With the school holidays upon us, a number of our clients are planning to get away with the family for what we hope will be a fun and relaxing time for them all. With that in mind, we wanted to share a few tips on traveling in comfort to maximise how great you get to feel no matter where the destination. 

 Like I said...gloating. This was on my first day in Tokyo at Shibuya crossing, the busiest intersection in the world.

Like I said...gloating. This was on my first day in Tokyo at Shibuya crossing, the busiest intersection in the world.

Anyone who follows me on Instagram was made very aware in the last few weeks that I went away for a few days… and lets be honest, isn't gloating really all insta is about? 

My point is, if you looked at someone’s travel photos, you see beautiful views, drinking in glamorous locations and sometimes food (I don't really show food as I am too busy eating it) but there is a side to travel that you’ll never see on people’s insta profiles. 

You never see the multiple times that you have to lift and shift luggage, the waiting in lines, the lack of opportunity to exercise and of course, the dreaded aeroplane seats and accompanying lack of leg room with its *ALMOST* enough to be comfortable but not quite level of recline. 

I was contemplating this when I realised that even though it was only a quick trip and a relatively short flight, my girlfriend who has no injury and no major history of back pain and is quite fit and active, had me bring my activator along so that I could adjust her if need be while we were traveling. 

Originally I was jealous because I would have LOVED to have travelled with my own private chiropractor. 

Then I remembered that most of Align’s clients feel the same. 

I cant tell you how many times people in the practice who are about to fly have joked “can I just take you with me to have you on call for the whole trip?”

Yet no matter how many times I have said “yes, pay for my flights and Ill see you at the airport.” no one ever takes me up on it. 

What I mean by all this is, it doesn't matter if you're headed away for a holiday or work, long or short haul flying, everyone knows what it feels like on the other side of travel and wishes they could somehow avoid it. 

The fact is, even though we are keen, even though we might have a person willing to be your travel chiropractor, for most of us (my girlfriend excluded) it is just not practical to bring one, nor does it seem possible to avoid the physical pitfalls of travel. 

This even appears to be true for people I see who don't have to travel in the same class that I do, those fortunate enough to have seats that recline MUCH further and have access to vastly superior champagne. 

It appears that our bodies just aren't built to be inactive for extended periods then immediately lift weights from above head height and repeatedly walk, stand in line, sit again, lift and twist until FINALLY we are at our destination. Who’d have thought? 

Who are you to tell me how to fly?

For both Martin and myself, our interest in comfortable plane travel goes beyond seeing clients every week who are flying all over the world.

 Me at Harajuku...not looking like a tourist at all. As you can see, NOT suffering a post flight migraine, the reason in flight health is so important. 

Me at Harajuku...not looking like a tourist at all. As you can see, NOT suffering a post flight migraine, the reason in flight health is so important. 

As a lot of you are probably already aware, Martin regularly runs seminars and workshops on chiropractic education here in Australia, but what you might NOT know, is that he is actually a highly sought after speaker internationally as well. In just the last few years Martin has spoken in the USA, Argentina, New Zealand, the UK, Ireland, Holland and Spain and what always amazes me is how short his turn around times will usually be. 

For instance, for his most recent speaking engagement in Scotland, Martin left the practice slightly early on a Thursday evening, flew to Edinburgh for a seminar and was back in Melbourne again Tuesday evening to start practice at 7am Wednesday morning. As someone 18 years his junior (I had to fit that in somewhere) it always astounds me how much energy he still has on the other side of those trips! 

For my part, I began taking more than just a professional interest in healthier travel when as I got into my later 20’s, international flights started to trigger migraines. 

Think of how fun you find airports and customs, and now imagine doing it with burred vision, an inability to deal with noise and a headache seemingly splitting your head in two from the back of your neck to just behind your eye. 

Obviously, I was keen to avoid repeating this fate and so, in recent years have adjusted (pardon the pun) my travel habits to accommodate. 

Well get on with it Kieran, what am I meant to do?? 

Kieran and Martin present:

9 tips to prevent back pain, neck pain and headaches when flying

1. Seating position

For tips about ideal degrees of seat back position, read my post on sitting here.

Don’t forget, that tiny pillow we are given on a plane that seems useless is a great substitute for short term lumbar support or to go under your legs if the seat cushion is pressing in behind your knees.

Another rule of seating position is to mix it up! Your back hates being still for too long and your circulation NEEDS us to change position. You wouldn’t fly to London without moving your ankles toes and feet to avoid DVT and you should think of your low back the same way. 

There are at least 4 seating positions available to you no matter what class you travel in, upright, reclined, upright with lumbar support, reclined with lumbar support. Keep changing between these 4 options to allow your low back the chance for at least SOME movement. 

2. Neck Pillows

No one can actively hold their head up while properly being asleep, as is characterised by the nodding and catching movement we do continually when sitting on planes. 

I have a number of clients who return from flights (many people literally call us to come in on their way home from the airport!) with symptoms that are like mild whiplash. Tight neck muscles, headaches, pins and needles in their arms and restricted neck range of motion are just a few of the symptoms we regularly see after flying and a lot of these could have been avoided if they had been able to properly relax their necks while attempting to sit upright. 

Believe me, I know how lame neck pillows look but there better/less daggy options out there and for me, a neck pillow has changed my life for when I arrive and the quality of my sleep. 

If you are limited for space or forget one, a towel from your carry on or the blanket the airline gives you can be used in a pinch. 

3. Hydration

Staying hydrated tends to be hard everyday in real life, and can seem especially hard when you have to ask someone else for water all the time, but for avoiding headaches, migraines, quality of sleep and relaxing your muscles it is essential. 

The air in the plane tends to dry us out so you should always try to keep your water intake up. Some people travel with a small amount of high quality salt to put a sprinkle in their water to try retain fluid so that drinking doesn't mean too many trips to the bathroom but be careful not to go too far with that. 

The most boring suggestion I have is to limit/don’t drink alcohol while flying. Alcohol inhibits the realise of Anti Diuretic Hormone (or ADH) from our brain, making us need to use the toilet more frequently leading to further dehydration, its one of the main reasons we get hangovers! For further proof of this phenomenon see: “You on a Sunday morning prior to having children”.

4. Sleep

Get as much as you can at the right time. Obviously we need to acclimatise our body to wherever we are traveling to, so if this is in a vastly different time zone, try to sleep like you are already. there.

Neck pillows (as discussed above), eye masks and good quality ear plugs are essential.

The rise in affordable noise cancelling ear plugs has been a God send, but Martin and myself recommend ‘in ear’ earplugs/headphones as larger over the ear ones can make it harder to get your head in a good position for sleeping. 

5. Don't just sit there

Get up and move an annoying amount. Do not care what other people in the cabin think about you getting up and moving about the cabin. 

Obviously this is recommended for avoiding DVT but has the added benefit of stretching and moving the soft tissues of your body. 

My personal tip is to try do some discrete glut activation while you are up. Your gluten are you main pelvic stabilisers and your Glut Max is your largest muscle as its meant to be used for all your lifting, you need it to get your bag down from the overhead lockers and taking luggage off the carousel. 

Remember, you aren't trying to be good at flying, you're actually wanting to enjoy yourself at the other end! 

6. Travel light

The lighter your bags and the less bulky and awkward they are to move around, the easier it will be on your body, no matter how strong you think you are.

7. Prepare early so that you're rested

I cannot tell you how many times I have had to adjust people who have injured themselves PRIOR to leaving for a holiday because getting ready to leave has meant a lot of extra stress in and of itself!

Wry necks, disk issues and headaches are just a few of the issues we see that can be exacerbated or even caused by stress, so do everything you can to be ready early for wheels up - including at work. How often do you stress out about having to get things ready at work so that you can get away? Start looking after yourself in the weeks leading up to your departure and from day one you'll actually feel like you're on holiday. 

8. Meditation

Let’s face it, travel can be stressful. Delays, anxiety about making a connecting flight and of course, your fellow passengers can be an ordeal. 

It can pay to have a good meditation app or relaxing music (as I have said in a previous post I am an Enya man, but there are a few types of music more relaxing than others. For more tips on distressing that post can be found here) can make you more chilled while you fly, leading to a better rested version of you once you get out of the plane on the other end. 

9. Have a brilliant time

You deserve to enjoy your holiday. If you have been putting these tips into practice, you'll be maximising your chances of having the trip you have planned, not one marred by injury. 

Don’t worry! If you find yourself in a spot of bother while you are away, shoot us an email, you'd be surprised just how many places we will be able to fond someone great to get you back on track while you are away. 

If you have any questions about these tips or any suggestions of things I have missed, please feel free to contact us at Align. 

Have a safe and healthy school holiday!

 

 

 

6 tips for better sleep - Waking up to being asleep (Part 2)

This article is about why sleep is important, what happens to us if we don't get enough sleep and 6 tips to improve your sleep. 

If you are just after the 6 tips, skip to near the end of the post. 

If you haven't read part 1 of this post, please read it here.

This is a continuation of my discussion of an interview on the Joe Rogan Experience podcast with British neuroscientist Matthew Walker. 

(To listen to the podcast, click here)

 Man with some serious sleep issues...namely, he is not even trying to lie down...I'm not even sure what his plan is. 

Man with some serious sleep issues...namely, he is not even trying to lie down...I'm not even sure what his plan is. 

In the first post I focused mainly on how and why the information about the importance of sleep really spoke to me as an element of my life that I needed to address, but in this post I wanted to outline other elements of the interview, specifically, I wanted to talk more about the actual health issues associated with skipping a few hours of sleep. 

What do you mean when you talk about ‘sleep’?

In the interview, Matthew Walker classifies sleep as being between 7-9 hours of good quality sleep that contains appropriate time spent in each of 4 stages of sleep. 

Although all 4 stages of sleep are essential to the quality of your sleep, I wont get into the nitty gritty of how sleep works specifically here, because thats really a few massive posts all on their own, and like you, we only really have time to just hit the high notes here, so yes, I am GROSSLY oversimplifying the whole system here, but here is a general run down. 

Stages 1 and 2 are your “set up” stages of sleep, they are the period where your body begins to turn off your monitoring systems and relax, changing your heart rate and breathing to eventually get into deeper levels. This is also the stage where you can have a power nap as long as you don't doze for more than 20 minutes.

Stages 3 and 4 are where you get down into deeper levels of sleep. In Stage 3, your brain waves become very long and slow and become much less responsive and harder to wake up, while your brain “paralyzes” your body in a type of muscular incarceration so that during stage 4, otherwise known as REM (Rapid Eye Movement) sleep, you don't get up and start acting out your dreams…it sounds scary at first but its a handy survival mechanism. You have probably experienced this lock down first hand if you have ever suddenly felt awake at night time but been unable to move your body.  

Stages 3 and 4 are where most body replenishment occurs. This type of sleep is excellent for cardiovascular health, metabolism, and most importantly, removal of waste products that accumulate in your brain throughout the day. 

OK, get on with it - what health issues does it cause? 

Short answer? Heaps. Almost everything in fact. According to Matthew, the shorter you sleep, the shorter your life. Fewer hours of sleep predicts all cause mortality. Put simply, you’ll be dead sooner and the quality of your life will be worse.

Kieran, I want more detail than that…

Fair enough.

In the podcast, Matthew talks about the research he has done for his book “Why we sleep” and summarises a few of the more…well lets face it, scary side effects of a lack of sleep. 

Some of the issues are more functional than others.

As mentioned in the previous blog, fewer than 6 hours of sleep leads to a decrease of physical endurance and function of 30% due to lactic acid build up as well as the bodies ability to expire our breath, but anything below 7 hours has been shown to impair us, with decreases in our peak muscle strength, peak running speed and our vertical jump. 

Coupled with this fact is that according to Matthew, it has been shown that sleep and frequency of injury has a linear relationship, stating that 9 hours of sleep Vs 5 hours of sleep leads to a 60% increase in the probability of injury.

Another more functional element to sleep is that it has been shown to improve learning performance (in rats at least) by 20-30% as it is thought to be the time when our brain strengthens its connections when learning something new. 

Have you ever been trying to learn something new or studying and come to a point where you are just stuck so you give up for the night? 

If your anything like me, I know that you found that the next morning it just clicked. You were able to get through the whole song you were learning, the language came to you, or you could remember the whole quote correctly. 

It appears that the brain literally prunes away the unnecessary elements of the pathways and streamlines your new skill. 

This next one really spoke to me also, as someone who has always carried more weight than is strictly necessary, and frequently had a yo-yoing relationship with weight gain and loss, I was surprised to learn that sleep doesn't just help you lose weight, it actually helps you keep it away! 

Lack of sleep decreases the body’s levels of a hormone called Leptin, who causes the sensation of satiation (aka - feeling full). At the same time, the hormone Gremlin (the guy responsible for NOT feeling full, and making you hungry), is ramped up. 

It has been shown that people who sleep between 5-6 hours a night will eat 200-300 MORE calories a day, equalling roughly 70,000 calories a year, leading to 10-15 pounds (or 4.5-6.8kgs) of obese mass a year. 

Worse, you eat more of the WRONG THINGS, going for heavy hitting carbs and heavy processed food, while simultaneously staying away from leafy greens etc. 

Matthew claims that if the rise in obesity in last 70 years, is plotted on same graph as amount of sleep in society on average, the lines go in equal opposite directions.

So just to clarify…on average, if you slept more than 7 hours a night, you would eat fewer calories, crave better quality food and with no extra effort or will power necissary, you would have to manage up to 7kgs of fat FEWER, each year. 

Do you know any other “magic” weight loss solution that can offer all that with zero negative side effects and at zero cost?

And now, as promised…the scary stuff.

Insufficient sleep according to the podcast, degrades our DNA, specifically it has a negative effect on immune response genes, decreasing their reproduction. At the same time, we get increased chronic inflammation, increased stress response leading to cardiovascular disease and an increase in the expression of genes related to the promotion of tumour growth.

I shouldn't really need to go on about those points but I will. 

Matthew claims that this is most exemplified by people who do shift work. Night shift workers suffer from higher rates of obesity, diabetes and cancers, most notably bowel, prostate and breast cancer. 

This is apparently so prevalent he states, that the World Health Organisation now classifies night shift work as possible carcinogen in and of itself as 4 hours of sleep even for just one night, causes a remarkable state of immune deficiency, a significant drop in anti cancer cells in our immune system.

But wait, there’s more!

Sleep deprivation affects your sex hormones too, in fact, Men who sleep 5-6 hours a night will have testosterone levels 10 years their senior, a critical element of health, strength, muscular performance etc, in short, it ages you a DECADE.

Consider how you are when you're deprived of sleep; reduced alertness, impulsive, lack of ability to concentrate, difficulties with learning and memory.

Why could this be? What do you think happens to your brain when you are like this for weeks, months or even YEARS on end? 

While we are awake our brain builds up toxicity, especially a protein called ‘Beta Amyloid’. You may have hear of this protein before as it is the main mechanism in the  development of Alzheimer’s Disease. When we sleep properly, the process of sleep wipes our brain, reducing build up of Beta Amyloid.

Insufficient sleep across lifespan now appears to be one of THE most significant lifestyle factors in determining whether or not you will develop Alzheimer’s disease.

Simply put: wakefulness causes low level brain damage and sleep offers reparatory function.

Matthew offered two real life examples that are suggestive of these findings too. Love them or hate them, Margaret Thatcher and Ronald Reagan have arguably had a huge effect on our world today. They were both known as having strong wills with sharp minds. They were both also famous for getting around 4-5 hours of sleep a night. They both died with Alzheimer’s. 

This anecdotal evidence is hardly proof of the research but it raises a few questions about the concept, two people with very active minds and social lives (two factors previously thought to be predictive of the disease) got it anyway.

But Kieran, I’m one of those people who doesn’t need that much sleep…so I’m all good right? 

Wrong. 

Well…at least its a safe bet that you're wrong anyway. 

If you had read Part 1 of this post (seriously, why are you this far in if you haven’t?) you’ll remember that Matthew’s research has shown that people are completely incapable of determining how much they are affected by sleep deprivation. 

I was was of you, I was convinced of my own ability to get things done when I was working off lower levels of sleep, but it turns out, like you, I am completely unqualified to make that assessment. 

Negative effects of your lack of sleep can ONLY be assessed by external sources and measurements. 

“I’ve heard some people just don't need that much though. I bet I’m one of them.” 

Again, you're only partially correct. 

Although studies show us that there is a population of humans that can function as normal from just 5 hours of sleep, but those same genetic studies show that is a group of less than 1% of the population. 

In fact, you're MORE likely to be struck by lightening in your life time than to be one of those people, so you should probably assume that you aren't one of them. 

So…what can I do then? 

Get to sleep. Seriously, its as simple and as difficult as that. 

The minimum you should aim for is 7 hours! 7-9 hours appears to be our sweet spot as humans. 

6 ways to improve sleep:

  1. Regularity; go to bed at same time.
  2. Decrease light; Try away from screens for at least an hour before bed or at LEAST have your screens on night mode. 
  3. Halve the number of lights on in your home in an evening. Apparently, if you are in an environment with no lights at all, we fall asleep 2 hours earlier. 
  4. Keep it cool, brain decreases temp by 2-3 deg fahrenheit to initiate sleep. always easier to sleep in a room thats too cold rather than too hot. We fall asleep faster and deeper in cold. 
  5. Wear fewer clothes to bed. Again, its a heat thing.  
  6. Try to have warm feet and hands. It helps keep your brain cool as it stakes blood away from your core. You could also try having a hot bath or shower before bed, it brings blood to the surface then your core body temp plummets when you get out of the water and you're more ready to sleep. The reverse is true for waking up, studies have shown that its the rise in temperature in the morning not just the light that wakes you.

This is not an exhaustive list of things you can do to try improve your chances of going to sleep but I like them because they are the classic set you always read. If you have any other tips about sleep we’d love to hear them.

If you have any questions about how your body is working, sleep related or not, always feel free to contact us at Align to discuss your health issues. Its literally what we are here for. 

I am going to leave you with a few more things to think about. 

Sedation is NOT the same as normal sleep, pills and alcohol might help you nod off but they do not allow you to go through the full normal stages of sleep and so you will miss out on a lot of it’s benefits. Be sure to discuss your inability to sleep with a health practitioner about improving your sleep hygiene as Matthew Walker states in the podcast that sedatives are an absolute last resort.

Sleep is NOT like a bank, you cant accumulate debt during the week and then make it up on the weekend. As humans we've never developed the ability to create a safety net to overcome a lack of sleep as we are the ONLY species that deliberately deprive themselves of sleep for no apparent reason.

Remember too that every day in Australia there are car accidents that are linked to sleeplessness. Drowsy driving is apparently worse statistically than drinking or drugs. In fact according the Matthew Walker, being awake for more than 20 hours makes your brain act like it is over the legal blood alcohol limit for drink driving. 

Lastly NO ONE tells you to stay awake on a problem. “Sleep on it” so that you can have a fresh perspective is a suggestion with no cultural boundaries. 

Accumulated wisdom for centuries has promoted sleep as a way of better tackling your problems, getting things done and improving your life…do we really think that is no longer true just because television is so much better now?  

Text Neck

This post is a slight change of pace for us, rather than reading about what is on my mind this week, for the first time we invite you to WATCH it instead. 

Leading into Spinal Health Week with a theme of “chiro can help”, Martin and I thought we would make a very quick video about the dangers of “text neck”. 

Please watch me make my video debut as we discuss the importance of this simple but very under appreciated element of daily life. 

For those of you not inclined to enjoy a video format, I will summarise below. 

Text neck is that happens to us when we spend too much time with our head in our phones. Look out your window right now (or just as likely if you're reading this on your smart phone or tablet, think about your own posture) and you are bound to see people leaning their head right forward into the screens of their devices. 

Craning our head forward towards a device causes our posture to follow. Eventually our head stays forward and our shoulders roll forward to follow it. 

This poor posture does not only affect adults, unfortunately it is now very common to see this position in children as they can spend even more time on devices than some adults! 

This head forward posture can lead to number of conditions that we see in practice every day, such as headaches, neck pain, migraine, shoulder pain, tight shoulders or a dowagers hump, just to name a few.

There are several exercises we regularly recommend in practice to clients that we identify need to work on this posture but for this video we wanted to keep it simple. 

Stop, being, in, that, position. 

It is as simple and as difficult as that. Stop training your body to only be good at putting your head forward. 

The solution we offer in the video is to merely hold your phone up higher so it’s in front of your face. Bring the device to you, not you to it!

I know it sounds too simplistic or even glib but we are being sincere, make yourself aware of your posture and what position you are training your body to be in, try to stop staring at screens as often as you can, and if you find yourself looking down at your screen, as yourself, why is it in my lap and not up in front of my face?

Waking up to being Asleep (Part 1)

It's not often that new information scares the hell out of me. It's even less often that that information comes in podcast form. 

I enjoy a podcast about a serial killer more than the next guy but a few weeks ago, Martin sent me a podcast that literally changed how I live my life every day. 

I would say that it's kept me up at night but to be honest, it has done the exact opposite. Its made me fear being awake!

Let me explain my back ground to you a little bit...

I. Don't. Sleep.

There I said it. Since the age of 16, I can honestly say, it would be unusual for me to have slept for 6 hours or more. 

It wasn't because I was like Ronald Reagan, Margaret Thatcher or Winston Churchill, where I feel like any more than 4 hours of sleep was a waste of time. Nor was it because I thought that sleeping less proved that I was tough or even that I wasn't tired. 

 Two people doing something most of us actively avoid...creepily being taken by a 3rd person in their bedroom while they aren't awake?

Two people doing something most of us actively avoid...creepily being taken by a 3rd person in their bedroom while they aren't awake?

I don't say it to boast. I don't say it to sound cool, the reality is, I just didn't go to bed. 

I can honestly say, that for a 15 year period of my life I got into a routine where I was sleeping for just over 5 to 5 and a half hours on average. I was known amongst my friends as "always being awake" or "just doesn't need to sleep". 

Yet for the whole time, even though I knew I SHOULD sleep more, but I was always able to perform how I thought I should. I did well enough in year 12 to get into the course I wanted to and then I finished a bachelor and even a masters of Chiropractic. I even graduated both of them "with Distinction" from RMIT (for even more #notsohumblebrags about me click here or follow my instagram). 

The point is, why did I need to get to bed earlier if I was able to do everything anyway? 

Then came...The Podcast.

So what is the deal with this podcast? 

Martin and I will frequently talk about new things we have learnt, new articles we have read, research we come across and like the true nerds we are, podcasts we are listening to. 

Martin knows well the ridiculous approach I have had to sleep and thought with the information shared by author of the book 'Why we sleep' and Professor of Neuroscience and Psychology Matthew Walker, that this podcast might be relevant for me. 

Relevant is an understatement. 

In the 2 hours this podcast goes for, I had my eyes opened to how I was looking at getting some shut eye. 

It showed me that how I organised an entire 3rd of my life, a feature on which I arranged my whole day, predicated a large part of my persona, as well as how I thought my body worked and impacted every second of my waking life, wasn't just wrong, it was dangerous. 

I strongly urge you to listen to the interview I have linked below, however if you think you haven't got 2 hours to listen to it, I will attempt to summarise the elements that most impacted me.

 

 

Firstly, understand that although I knew academically that sleep was good for me, I was convinced that I was just one of those people who didn't need as much sleep as everyone else. I didn't think that made me special, I just genuinely believed that lack of sleep obviously didn't affect me as much as it seemed to affect everyone else. 

After all, I never had to say "no" to anything because I was too tired, even though I felt it. I just thought that "everyone is tired" or "being tired is normal". What I know now is that being tired is COMMON, but it isn't NORMAL, and that makes a huge difference. 

Nowadays as a society we seem do deify being busy, getting things done, "you can sleep when you're dead", and that is where I see this post fitting into our Spinal Health Week theme of the month of May. I want to challenge you to recognise where it is that you're taking on too much, sacrificing yourself and your own health in the service of a deadline or those around us. Remember, you cannot give from an empty cup!

This obsession with never being unplugged, with getting things done, and especially, with not going to bed till late hasn't always been the case. 

It has taken millions of years to develop into homo sapiens. Homo sapiens came into anatomical being at least 315,000 years ago, with our modern behavioural and mental capacities being at least 60-80 thousand years old. 

We have had a reliable and controllable ability to erase the night using electric light for - give or take - 150 years. Since that time, humans have become the first and only known species to actively and persistently forgo sleep.

No other species will choose any activity over sleep outside of a survival situation. For us, far from being a survival situation, it means, to stay up and watch Netflix, scroll Instagram, or generally to just get a few jobs done without anyone interrupting us. 

Think about that...why is it that WE choose to avoid rest, when no other mammal will do this naturally? 

So what? Who cares if I choose to stay up and watch Stranger things even if other animals don't? 

I hear you, thats exactly what I thought, and I wasn't alone in thinking like that, according to Matthew Walker, 1 out of every 2 people are sleep deprived, and almost 1/3 of those people are sleep deprived on 6 hours sleep or less.

 So how much sleep are we meant to get?

According to Professor Walker, as humans we need between 7 and 9 hours of good QUALITY sleep for our body to operate the way it is intended to.

Thats not just physical time in bed, 

Quality in this sense refers to our biological imperative to get through all of the stages of sleep for an appropriate amount of time, in order for our brain to recharge. 

So...what happens when we don't get enough sleep?

Here is where things get scary.

This was originally intended to be a single post but I realised once I started writing there was too much to go through to cover in a single post. As a result, I have saved a lot of the more specific information about sleep for the next post.

I know, what a jerk, just get you started and then leave you hanging! 

I want this first instalment to get you thinking about how many hours you spend sleeping and if you are honest, what sort of quality do you believe you actually achieve?

In the next post, I will outline in greater detail what happens to our body while we are sleeping as well as discuss what happens to us when we try to cheat our body and brain out of it.

Most importantly, I will suggest a few different techniques you could employ to try get to sleep easier. 

For now though, I want to leave you  with the main point raised in the podcast that I can't keep from popping into my head.

When we sleep for fewer than 7 hours, our performance, both physically and mentally dimities by 10%. 

When the hours we sleep are fewer than 6, our performance is decreased by 30%. 

30%.

That means that for a 15 year period, my ability to work, to remember, to drive, to study or even enjoy downtime with my friends and family was down by 10-30%. 

Equally as scary, the research suggests that people who are sleep deprived are actually incapable of measuring the negative effects of lack of sleep on themselves. It's like knowing your exact blood alcohol while drinking (a comparison that will become more relevant in Part 2 of this post). We know we have been drinking but have no actual way to know if we are .05 or not until its measured externally. 

Imagine the compound interest of life lost over 15 years of being 30% less of yourself. I am certain I would likely still be at Align, and I know I would still be a chiropractor, but who knows how much further I would be in my career, how much more I could have given to my clients or how much more I could have enjoyed those years? 

Who would you be if you had 30% more of you to give every day to yourself or your loved ones?

I know this is a pretty esoteric finish to a health post but isn't that the whole reason we want to be healthy in the first place? 

In the 2 weeks I have been getting a minimum of 7 hours of sleep a day, I have already started noticing changes to what I can do and how well I can do it and how clearly I can plan it. 

So if you are like me and you're chronically sleep deprived, how important to you is it that you get 30% more you out of every day?  

Can Chiro Help? Discover how chiropractic can help improve your quality of life

I doubt that you already know it, but Spinal Health Week 2018 is the 21st - 27th of May.

Spinal Health Week is about two things.

The first is that there exists a lot of confusion about what chiropractic can help with, and so it is an awareness campaign designed to illustrate exactly who we see in our practices every day.

The second? In our practice, Spinal Health Week is a time every year we we ask our community to focus on how they are looking after their spine, but not just talking about being adjusted or doing rehab exercise. We want to challenge people to look at how their spinal health affects their lives as a whole, not just focus on whether they are in pain or not.

As a result, Align Chiropractic is encouraging you to make small lifestyle changes to improve their spinal health and wellbeing.

In Australia, there are 3.7 million people with back problems. Thats JUST back problems. That doesn't even take into account headaches, migraine, nerve pain, sciatica, shoulder pain, ankle sprain or the whole host of other conditions that people regularly see their chiropractor for.  

So what REALLY causes back pain and other issues that chiropractors see?

In some cases, the cause of back pain can be difficult to avoid (such as in the case of an accident or injury) however, everyday habits can be a big determining factor in how well our spines may handle stress.

This year, Align will be asking our community to focus on everyday habits which can be harmful to the health of our spines and encourage small, practical steps for the better.

What is the point in only making small changes to my lifestyle?

Part of our challenge to our community is to recognise the importance of each tiny effort. Health is like exercise, you can’t get fit every day, but each time you get out there and run, or make it to the gym, you make that incremental step towards a better version of you. 

There is no point trying to make many, or even just one MASSIVE change to your life from today onwards. If it is too big a leap from your daily routine then it becomes too hard to continue with and so inevitably you drop it.

Much like a new diet, its unsustainable to decide that you'll only ever eat grapefruit for every meal from now onwards in an effort to lose weight, instead the most impact comes from deciding what elements aren't ideal and take steps to make change that are realistic and most importantly SUSTAINABLE. 

For this reason, we will never suggest our clients do a 180 and completely change their lives, rather we prefer to help you in identifying a 5-10 degree change in course that when followed over the next few decades helps you end up in a much better place than your old path was leading.

Never underestimate the power of simple lifestyle adjustments can have on your quality of life long term.

Adjustments such as;

  • being mindful of your posture, 
  • being more active, 
  • taking breaks from mobile devices, 
  • a focus on sleep as well as a larger focus on sleep and, 
  • incorporating stretching into your daily routine

It is important to take preventative measures when it comes to spinal health and if you are already experiencing pain, it is not advisable to ignore it.

Over the next few posts I am going to attempt to address some of these concepts I have listed above so keep popping back over the next few weeks, however if you have any more specific questions on how you can approach your spinal health, please do not hesitate to contact us at Align. 

Kieran

 

 A happy life preserver because asking for help shouldn't be scary.  Also, truth be told, other stock images related to 'help' were a bit lame, not cute like this guy...and as well I thought this picture was funny because he has a shadow underneath him. Why? He is meant to be in the ocean...the shadow implies a light source above his head and that there is a floor underneath him, as if this is a photograph taken on a flat back ground rather than in water...even though its a cartoon. I'm not sure what is going on there. Anyway, if we can help you in at all, or if your are keen to know if we are the right people to help you, please get in contact.

A happy life preserver because asking for help shouldn't be scary.

Also, truth be told, other stock images related to 'help' were a bit lame, not cute like this guy...and as well I thought this picture was funny because he has a shadow underneath him. Why? He is meant to be in the ocean...the shadow implies a light source above his head and that there is a floor underneath him, as if this is a photograph taken on a flat back ground rather than in water...even though its a cartoon. I'm not sure what is going on there. Anyway, if we can help you in at all, or if your are keen to know if we are the right people to help you, please get in contact.

Ice Ice Maybe?

Before I get into this, I need to clear up two things.

1. When I use the term 'Ice' or say, 'use ice' I am of course ONLY referring to frozen water. Whatever you do, DO NOT take those terms out of context.

2. let's just get it out of the way:

An obvious yet somehow necessary gag to put at the top of a discussion on anti-inflammatory protocol

There, now that this blog has a soundtrack, we can get started. 

Should I use ice or heat?

As Chiropractors, we get asked this a lot. There appears to be a lot of confusion out there about what you should use, when and why, and that confusion is not just limited to the general public! 

There is a lot of debate and conflicting info about ice vs. heat amongst different health care professions and even between practitioners within the SAME profession, so it is little wonder that when people are injured, they aren't sure what to try. 

In this post I will attempt to explain a bit of the ins and outs of the issue, as well as some of the  the common sticking points in the discussion and ultimately, try to give a summary of the basic approach you could try, based on the best and most current research I am able to get my hands on. 

So, if you are the type of person who just wants to get a few tips WITHOUT having to go through the rest of it (and to be honest, I don't blame you if you do), then please feel free to skip down to the bottom of this post where I will summarise the main info in bullet point form. 

However, if you're like me and you're kind of into the back ground of things, then please read on. 

So why would I use ice or heat anyway?

Full disclosure...this will not be an exhaustive explanation of how inflammation works because that would be WAY too much info to put in this blog and to be honest I really couldn't do the topic justice with my explanation anyway (however, if you would really like to geek out and marvel at just how incredible the human body is, and get a much more complete picture of what is happening at a cellular level in detail, I suggest you check out a video called "Basic Inflammatory Response". Be warned though, videos like this are only the start of a fascinating rabbit warren so be sure to have a clear afternoon for all the other info you'll want to follow it up with).

To EXTREMELY oversimplify the situation: 

  1. You injure yourself
  2. Your body detects the injury
  3. Chemical signals are released to signal to your body to begin healing and cleaning the injury up.
  4. The chemicals also cause more healing factors in your blood to come to the area/slow down in the blood stream at the site of injury and help to clean up/heal
  5. The resulting 'inflammatory Soup' causes redness, swelling and alterations of movement at the affected site as well as activation of nerves that carry information about the damage to your brain where it is registered as being painful.

As stated above, this is a very simplified version of events that skips many steps in the process but I feel gives you an idea of the situation. 

The most important take home message though? The body is very smart and so it does all this to HELP you, so we want to allow healing to occur as much as possible without hindering the healing process too much.

The reason then that we employ heat or ice is to limit the levels of swelling and discomfort you have to experience, while allowing all these steps to occur and let you live your life while your body gets on with the task at hand. The cooling or heating of tissues is used to constrict or dilate blood vessels in order to modulate the inflammation to inhibit or help the healing factors to arrive at and move on from the site of injury.

Heat and ice have the added bonus of having relatively few side effects compared to their pharmaceutical counterparts, something I find clients are generally very keen to avoid having to take where possible.

Kieran, you haven't answered the question yet, do I use heat or ice? 

That depends on the injury. 

Generally speaking, we use ice for acute injuries (i.e. injury that has only occurred in roughly the last 48 hours) and heat for more chronic injuries (i.e injuries arising more than 2 weeks ago). 

In yet another simplification, we use different modalities because in the early stages of injury, the inflammatory soup is different to one that has been around for a longer period of time. In the gap between 2 days and 2 weeks, you can use ice or heat, or ice AND heat. 

You can however have a chronic injury that you exacerbate, in which case you might need to act like its a new injury and switch back from heat to using ice on it again. 

By now I am sure you can see why so many people can become confused as to what they should do. Don't worry, Ill still give that summary below. 

Does it matter where the injury is? 

No, that shouldn't be a factor.

In the past, some health professions have prescribed ice for acute inflammation for everywhere on the body EXCEPT the spine. For some reason they appeared to have forgotten that the spine is made up of joints, ligaments, tensions, muscles, blood vessels that have the same characteristics as other areas of the body. 

So, in cases of acute injury and pain in the neck and/or back, you should still use ice like you would on a knee. 

Some important points to remember...

As I have said, this is not an exhaustive discussion of this topic, and there is still a lot of argument among researches and practitioners as to the best practice for ice or heat (just type ice vs heat into Google and you'll get a sense of what I am talking about) I am just attempting to summarise what I have discovered from the best sources of research information I can find, as well as my experience with clients with acute and chronic injury in practice. 

Other important points to remember are:

  • It appears that crushed ice in a bag is more effective than traditional cooling packs
  • Do not return to activity immediately after using ice
  • Don't use ice for more than 20 minutes of constant contact/ 
  • If you have any questions or concerns about your injury, contact your health practitioner immediately.
  • If either of the approaches make you feel worse, stop using them immediately and contact us to discuss your options. 

In Summary:

  • Ice for acute injury (roughly under 48 hours old).
  • Use ice for 10 minutes on, 10 minutes off, repeat as often as you like.
  • Heat for more chronic issues (especially for injuries over 2 weeks old)
  • You can alternate heat and ice for 10 minutes of one, 10 minutes of the other 
  • There is no hard and fast rule, these are tools designed to make you more comfortable so let your body be your guide. 
  • I would still recommend avoiding heat for acute inflammation.
  • Do not just put up with pain or even just hope for the best with an injury, the earlier you act the better your prognosis. 
  • Call us at Align to have a chat about your injury and discuss how to get back on track. 

If you're the type of person who would like to know where the information I have talked about here came from, please feel free to contact me at the practice at any stage and I will send you through the details of the research articles I have used, 

I will be keeping my eye out for newer, more definitive research and promise to update this post if anything new comes to light.

If you have any other questions or concerns, please do not hesitate to get in contact. 

Kieran

 

What is the best way to sit?

"How should I be sitting?"

We often get asked this by our clients and on the surface it sounds like a pretty simple and straight forward question but when you think about it, its a much broader subject than it first appears. 

If you subscribe to the theory that the researchers at QI are correct about pretty much everything (and let's face it, who doesn't?) then this video will explain to you a little about the *ideal* way to sit, but what do they mean by the BEST way to sit?

For instance, it could be argued that what you are sitting FOR might actually dictate how you could best attempt to sit. Then again, there are some people who argue that we shouldn't be sitting for more than just short periods at all! 

In this post I wanted to discuss a few different types of sitting and when you might want to use them.

But Kieran, what do you mean by different types of sitting?

I'm glad you asked! there are a few different ways in which we position our bodies when we sit and each has its own set of pros and cons. 

In the video above, they make reference to sitting with an angle between your low back and your hips of roughly 30 degrees. They don't specify this in the video but sitting with an angle like that refers to research for the best sitting position to ease pressure on your lower lumbar vertebrae and disks, hopefully reducing the risk of low back pain or injury including disk bulges. 

When I was studying biomechanics as part of my Bachelor of Applied Science (Chiropractic) at RMIT, (back then, the course was an undergraduate degree and a Masters by course work instead of the 5 year Bachelor degree Chiropractors currently undertake...also Youtube was only 1 year old...thats not relevant to that last point other than it gives you an indication of how old I must be) we learned that the ideal angle to sit was indeed NOT sitting up straight but between 100-110 degrees. Definitely within the ball park of what this episode of QI suggests.

So why are we always trying to sit up straight?

It seems strange doesn't it that despite scientific evidence to the contrary, that we should still be obsessed with sitting up straight. 

I can't find any rational reasoning for this but I posit that it's due to our societal awareness of posture in reference to our shoulders and head forward positions, rather than any awareness of our spinal health at large. 

Well then...which is it? Posture or low back health?

To be completely honest, I do not believe that there is one answer to this question. 

Firstly, if you know you have, or at risk of a low back injury, then it is reasonable for you to, as much as possible while sitting, attempt to have an appropriate angle of between 10 and 30 degrees beyond sitting up straight. I would also add, if you have or believe you are at risk of a low back injury, please contact us at Align Chiropractic to see what ELSE you can do to get on track beyond remembering how to sit. 

Secondly, if you don't have a specific reason or concern in reference to your low back, then as stated earlier, perhaps it is best to remember the context in which you find yourself sitting. 

If you are going to be at a computer for most of the day, then a focus on correct sitting posture. 

A couple of quick reminders are:

  • Key board - Positioned more directly in front of you, so you aren't reaching for it or turning your     wrists to get the correct angle.
  • Screen - Directly in front of you,at a height where your eyes are aimed directly in the middle just about the centre of the screen.
  • Chair - Adjusted to a height where your feet can easily touch the floor with your hips at or just past 90 degrees to your torso.
  • Mouse - Just to the side of the keyboard, easy to reach in a way that keeps your arm bent, not reaching for it.
  • Alignment - Sitting up straight, don't slouch and don't let your head and shoulders slump forward. 

Always remember to keep what you need to use IN FRONT OF YOU in an easy position to use.

Computers and equipment was designed to fit US, not the other way around!

Your other best line of defence is to try utilise a standing desk for at least some part of the day!

However, the above video raises an interesting point, If sitting more casually, i.e. watching a movie etc, then sitting up straight as if you are using a computer doesn't really feel like it makes much sense. Lets face it, it doesn't matter who you are, no one can sit up straight for extended periods of time. 

It makes sense to do it while working, where we can get up from the desk to stretch, get water or to stop our body from fatiguing, but if you're planning to sit and enjoy Casino Royal, re watch the Back to the future trilogy or binge The Sinner, then you can hardly annoy everyone you're watching with and interrupt the show with incessant stretching. 

This is where finding that 10 to 30 degree angle for your low back really comes to the fore.

Similarly while driving, I do not expect you to stop every 20-40 minutes on your daily commute for a walk, so keep that position in mind when you set up your car seat (I will post about correct driving position in the near future, but as a general rule, give yourself that slight angle, position the steering wheel so you aren't leaning forward to reach for it and make sure your head isn't being pushed forward by the headrest).

Another question we get asked frequently is should you sit on a gym ball instead? 

My answer is always the same...if your living room or office aesthetics suit the presence of a gym ball as a permanent piece of furniture, then perhaps posture and sitting is NOT the biggest issue you are currently experiencing. 

More seriously though, in my experience, sitting on a gym ball doesn't provide you with a better sitting technique for an extended period. Like anything, our body will fatigue if we ask it to hold a more rigid position for a long time and eventually we all end up slumping. Personally, I believe that a gym ball can actually help you to slump your shoulders forward as it offers you no form of support to relax into a better position. 

If you DO insist on sitting long term on gym ball, always be mindful of when your head slumps forward and your low back has started to curve in the opposite direction. 

Yep, just like any product sold on late night infomercials, the sad reality is, sitting on a gym ball will NOT automatically give you abs. 

The same can be said of ergonomic chairs or those kneeling 'chairs', not only are they usually more of an eyesore than you would hope them to be, they are really about trying to make the most of a crummy situation. They will try place you in a better posture but without adjusting your position, mindfulness of your body and remembering to get up and move frequently, your body will always try to reduce energy expenditure and slack off as soon as you aren't looking. 

So what SHOULD I be sitting on?

For a hint at the type of chairs we at Align DO actually like people to sit in, look at the furniture in our practice. 

The Eames chairs we have in the practice weren't just chosen for how beautiful they are, or how well they stand up to being sat on by hundreds of people, they also allow you to be comfortable in a relatively good position for a reasonable period of time. 

At the end of the day, there really is no substitute for body awareness. 

Listen to your body. Stand up when you need to stand up, move when you have to move, and re-position yourself when your body tells you it needs re-positioning. 

To discuss the best ways to combat bad posture, exercises to improve your ability to sit better, or discuss your concerns about your posture, contact us at Align on (03) 9696 1057, or bring it up during your next visit so that we can discuss your issues specifically and tailor an approach to your and your needs. 

School is Back so Back Pack chat is Back

Back to school time...

Yep, I'm sorry to ruin your child's holidays but we knew this day was coming eventually. 

Although to be honest, this blog shouldn't really just about going BACK to school. For some reason we only talk about back packs when we are about to commence a new school year, but really we need to focus on them the whole year through. 

No matter how old the school bag or how old your children are, back packs represent one of the most common physical stressors that children will face in our society. Research suggests that back packs should not be heavier than 10-15% of the body weight of the child carrying it, yet how many times have you picked up your child's bag and thought it would be uncomfortable for YOU to wear?

As a matter of fact, an international study printed in Spine found that 79.1% of children find their backpacks are heavy, and 46.1% complained that their bags caused back pain.

This is made worse by the fact that in the same study, it was discovered that even though nearly half of the students had back pain, 33% of all of the students were still wearing their back packs too low!

If you want an idea of what happens to posture and spines when you wear a back pack incorrectly, see the photos of our amazing practice model Nicholas below. Nicholas has great posture and is more active than an average boy of his age. (On top of that, he is hilarious and an absolute gun for being a part of this post!) As you can see, none of that matters when he wears his bag incorrectly.

 Nicholas shows us what happens when your back pack is too low, note that his head is forward, his shoulders are rolled and his low back has increased curve. 

Nicholas shows us what happens when your back pack is too low, note that his head is forward, his shoulders are rolled and his low back has increased curve. 

The reality is, this overloading and incorrect loading of your child's spine may be putting them at risk of longer term spinal damage.

Add that to the time spent sitting or looking at the screen of a phone or iPad and....well I don't need to tell you what this means for posture. 

IMG_3264.jpg
IMG_3265.jpg

I have already discussed the issues with poor posture earlier in this blog, (for a look at a more in depth discussion about posture, read the post here) but in summary, poor posture is bad, and the longer it's left unmanaged the worse things get.

So what should you do?

At Align we are concerned about the future of younger generation's health and posture, which is why Martin and I will be providing free back pack assessments to ensure that your child starts the year off with their best foot forward. 

It is always fascinating to see how a small adjustment to a child's backpack can have far reaching effects. 

If you would like to book a Back Pack assessment for your children, please do not hesitate to contact us on 9696 1057.

Ankle Sprain 2: Standing on your own two feet

A few posts back, I said I would outline some important points you want to be thinking about if you have an acute ankle sprain, as well as what you can do if you already ARE someone with a "bad ankle". 

Even if this isn't your first rodeo when it comes to ankle sprain, I would encourage you to read this post as every time you injure your ankle will little different from the last!

The first place to start when it comes to ankle injury is just how serious is it? 

So what can go wrong?

We all know its sore, and we have all seen a puffed up and inflamed ankle, but what exactly is going on when you injure it? 

By far, the most likely mechanism of injury in an ankle is rolling outwards or "over the top" of your ankle. This direction of movement accounts for the Anterior Talofibular Ligament (literally meaning, the ligament at the front that connects your ankle bone of your foot, or Talus, to the bone that runs on the outside of your lower leg making that bump on the outside of your ankle, your fibula) being the most commonly injured tissue in an ankle sprain injury.

In my opinion, it is this injury to ligaments that causes ongoing issues in regard to ankle sprain, as ankles can take 12- 24 MONTHS to heal completely (depending on the severity of injury) and most people don't continue their specific rehab for long after the ankle is no longer in pain, which is usually much faster than this. This lack of correct rehab leads to other issues longer term. 

What else can be injured?

Beyond the Anterior talofibular ligament, other sites on injury can include the ankle cartilage or even in more extreme cases, fracture of the fibular or the foot itself!

When do you need to X-ray?

There are various factors to take into consideration when determining if you need an X-Ray of your injury.

Some are best assessed by a health care professional such as exactly where it is sore, what type of pain do you have, as well as the exact mechanism of the injury. 

As a general rule though, if you have injured your ankle and you are trying to decide if you should go to the emergency department, the best thing to ask yourself, according to the Ottawa rules for determining need for X-ray is this:

- Could I weight bear immediately after the injury occurred?

and 

Can I walk at least 4 steps now?

If either of these are a yes, it is likely a radiograph will be warranted and I would recommend either contacting your health practitioner and letting them know, or visiting the emergency room immediately.

But if there is no fracture, what else can go wrong?

As discussed above and in a previous post, a major issue can be the damage to relevant ligaments, but there is yet another structure that can be affected by intense or repeated ankle sprain, and thats cartilage. 

The cartilage in your ankle is special in that it possesses healing and regenerative properties that are better than many other areas of your body, to account for extra stress in such a mobile weight bearing joint. Yet, even this area can be permanently damaged. 

Due to the healing, the ankle is an unlikely region to suffer from arthritis as a primary issue, but is one of the MOST likely joints in the body to develop arthritis in response to an injury as secondary symptom. Another reason that ongoing and thorough management and rehab is paramount to insult to the ankle!

When can I be back on it and how much can I do?

This is the most important question in getting you  (for want of a better term), back on your feet. The main area of focus is OPTIMAL LOADING. Not too much too soon injuring you further, and not too little so as to hamper your recovery. 

This is best assessed in person with your health care practitioner. 

If you have any concerns about your ankle, or you re not sure who you SHOULD be seeing about your injury, please do not hesitate to contact us at Align, we would love to help you be back up and running as soon as possible.

 

 Image of ankles doing what they are MEANT to do, take you confidently wherever you would like to go.

Image of ankles doing what they are MEANT to do, take you confidently wherever you would like to go.