Viewing entries tagged
back pain

Back to school pART 1: Are your kids set up to succeed?

If your children are headed back to school later this month then read on, this post is for you even though it’s about them.

It’s time we talked behind your kid’s back. Literally.

Being a chiropractor I might sound biased, but now is the perfect time to set your child up for success at school this year and make sure that their bodies look after them throughout.

Over the space of two posts about getting ready to be back at school, I want to challenge you to think a little differently about how you send your little one (and let’s face it, they are always your little one even when they aren’t physically so little any more) off to commence their school year.

Back Packs

In the video below, the Australian Chiropractors Association have spoken to a number of parents about their thoughts and experiences with how their children are affected by their back packs.

I think it’s an important reminder that, especially when they are young, our children’s spines are still developing, so the stress and strain that we put upon them physically can literally play a role in how their body works for the rest of their life.

The rest of this post might seem familiar to a few of you, and that’s because it is a slight edit of our back to school post from last year. The reason it remains largely unchanged is that the information is still accurate, the message still relevant, and our commitment to you through free back pack fitting for your children is ongoing.

So what happens when back packs aren’t right?

An ill fitting, incorrectly worn or over weight back pack can be a precursor to spinal issues and even exacerbate existing problems.

in fact, 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?

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.

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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. 

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I have previously discussed the issues with poor posture at other times 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.

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

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.

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!

 

 

 

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. 

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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.

Coccyx pain, its a literal pain in the...well...you know where.

If you don't already know what I'm talking about its fair to say that this post isn't for you. 

If you have experienced Coccyx Pain (aka coccydinia), then you already know just how painful and potentially debilitating it can be. It can stop you from exercising, driving, walking or for some clients I have seen, even from being able to work! 

So what is a coccyx?

A coccyx (pronounced COX-SIX) is the proper name for what we usually refer to as our "tail bone" and is small bit on the end of our sacrum. It *kind of* looks like a little tail, but in reality is that little curved forward bit you see on the pelvis of a skeleton. 

Why does the tail bone get it's own blog post?

The tail bone has its own post because it's small and seems so insignificant, which in my opinion, has meant that it has never had much coverage. This has lead to many people suffering, frequently needlessly, with a condition that leaves them feeling powerless when chiropractic can potentially help them.

 

If its so small then what is it's issue?

Some people are more likely to suffer from coccyx pain than others for anatomical reasons such as degenerative change in the area, the presence or absence of vertebral disks, scoliosis, or even the shape or angle of the coccyx itself. As well, lifestyle reasons like being overweight, recently pregnant or from extended periods sitting can also contribute to the likelihood of suffering from coccydinnia.

By far the most likely reason to suffer from coccyx pain is from direct trauma like a fall onto your buttocks, which is why as chiropractors, we don't find videos like this funny at all.

Most unfairly however, just by being a woman you are anatomically 4-5 times more likely to suffer from coccyx pain as a result. 

(On a personal note, it was a fall off a swing set onto my coccyx when I was 4 or 5 that was the reason I started seeing a chiropractor in the first place...so it is fair to say it's a pretty powerful injury for me, however not everyone's experience is so positive)

An artists impression of me about to injure my coccyx

An artists impression of me about to injure my coccyx

So what can be done?

Firstly, you want to try if possible to get to the bottom of WHY your coccyx is painful in the first place.

We take time to assess you more globally, to see what other factors can be affecting your coccyx and your healing. As well, we have to determine exactly what area or tissues actually are inflamed, causing your pain. Is it the bone itself? The disks? The ligaments attached to it?

One of the other factors that might need to be taken into account is, does this client need to have X-Rays taken to get to the bottom (no pun intended) of this issue?

Most importantly, we need to know, how can you be helped and is chiropractic the right thing to get this person back on track?

If you think you or someone close to you might be having issues with coccyx pain, please call us at Align so we can see if we can't have you sittin' pretty.

 

In a slump...Is it time to stand tall and stop your mum from nagging you?

Good Posture...I know, I can feel how bored you are already. I don't blame you. Can you even count how many times you have been nit picked about slouching? 

And why the hell should you care right? I mean, who cares that you slump a little? Plus, its so hard to stop doing! You try so hard to be upright when you first get to your computer but sure enough, 2 hours later you find yourself leaning into the screen of your computer with your shoulders hanging from your ears and a back hunch that would make Mr. Burns envious. 

A man displaying woeful posture...in need of nagging

A man displaying woeful posture...in need of nagging

As a Chiropractor, 2 things happen often in my life. 

The first is that at almost every time I am introduced to a person or group, most people instinctively straighten their backs and sit or stand taller, as if they all instinctively know that 'Good Posture' is important (even if we don't know why) and that its something we only think about when prompted to (even though we know deep down that our posture isn't great in the first place)

The second is that poor posture is one of the leading causes the issues that we see in our practice every day!  

Low back, neck pain, jaw pain, shoulder injury, predisposition to spinal degeneration, carpal tunnel type symptoms, migraines and tension headaches are some of the most common symptoms we see day in and day out and it doesn't take much Googling to find that a lot of these problems are either caused by, or at the least made worse by, poor posture. 

So, how does having bad posture lead to these issues? 

The answer is actually really simple and its actually a major part of understanding what we do as chiropractors:

Nervous system feedback and the body’s position in space

"The deeper layers of muscle are concerned with ‘sensing’ our position in space and relaying this information to the brain. If this function is taken over by muscles... (As a result) the brain gets an incomplete picture. The brain assumes that the body needs to be propped up to counteract the effects of gravity, so it triggers further muscle contraction. This adds to the general fatigue and pain felt by the person with poor posture." - The Victorian Government's better health website 

The issues with poor posture appear to go beyond just the physical mechanics as well! 

If I told you to imitate a person who is stressed out, anxious or depressed, I bet you would tighten and slightly raise your shoulders, pushing your head forward and making you shorter. Sound familiar? 

Some authors discuss that consistently being in this position might actually lead to deepened depression, increases in perceived stress, circulation issues, as well as negatively affecting digestion, breathing mechanics and the we way we are perceived by ourselves and others!

So what can we do about it? Well I'm here to tell you that dealing with posture is both simple AND challenging. 

Simple in that there are very basic ways that we can start to work on and improve how our body holds itself, yet challenging in that as Australian's, we are sitting or lying down for an average of 23 hours and 47 minutes, so we have a lot practice at bad posture to try and work against!

Over the space of a few more blog posts, I am hoping to talk you through some strategies to start tackling this problem, but until then, if you have any questions, or if yourself or someone close to you needs help getting out of their slump, please do not hesitate to contact us at Align on (03) 9696 1057.

 

Kieran 

 

Are you Sitting too much?

Maybe you've heard the new catch phrase, "Sitting is the new smoking"? 
Have you wondered why that is?  Are you curious as to how prolonged periods of sitting is causing you harm?  How sitting decreases brain activity, can cause back pain, shoulder pain and neck pain? How sitting can decrease fat metabolism, contribute to metabolic diseases, heart disease, depression and even some cancers?
For a simple explanation, watch this 5min Ted Ed talk (perhaps do it standing!) and learn what impact sitting is having on your posture and health.
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If you're curious, you can even take this survey and calculate just how much sitting you are doing each day, the results may shock you!
Here's a few strategies you may use to get off your butt;
1. If you work in an office at a desk, perhaps get into the habit of taking phone calls standing up
2. Set an alarm for every 30mins to get up out of your chair and do a few stretches
3. If you commute to work via Public Transport, you could choose to stand instead of sit
4. There are great options for standing work stations - check this one out
5. Walk to work, or at least park further away from the office.  This serves two purposes, increases your exercise for the day AND reduces sitting time in the car
6. If you're into computer games, try playing them standing up, instead of sitting!  It may surprise you to know that standing actually increases brain activity and reactivity.  So standing may help you get to that next level.