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neck pain

HOW TO TRAIN WHEN YOU HAVE A NECK INJURY FOR THE CROSSFIT, F45 AND HIIT ATHLETE.

If you love your HIIT, and you know who you are…I’m talking to you, CrossFitters, F45 junkies or you’re a boxer etc, we know that getting back to exercise is likely your number 1 priority! Watch the video or read below to get our tips on getting you back on track as soon as possible.

As we said in our last post on back pain, taking time out of training is boring and can seriously impact on the gains that you have made. When you have become addicted (in the healthiest possible way) to getting the most out of your body, training with intensity and seeing the huge improvements in your health and injuries take on an altogether more frustrating element the can affect your body and even your mental state as well.

The reality is, the better you allow your body to heal, the quicker you can be back to 100% and the less likely you are to have recurring injury, and the rehab is going to take some effort on your part, so what CAN you do to get back into it at full speed?

The first thing to work on is recognising that just like gains you have made, THERE ARE NO SHORT CUTS in healing your injury.

Sadly we cannot immediately heal injuries without letting your tissues repair themselves, but you CAN work smarter to reinforce healing, strengthen what you can strengthen, and make sure that you’re healing things properly to minimise risk of recurrence.

In the video below, Martin outlines some of our possible recommendations for managing neck pain while still keeping up your training.

For those of you who enjoy reading the video is transcribed below.

As always, if you have any concerns, neck issues, be they old or new, or just want to get the most out of your training, we are here for you so don’t hesitate to get in touch!

Hi guys Martin here from Align Chiropractic and what I wanted to talk to you about today is something that we see super commonly, which is people that we're taking care of who have are getting neck pain or other issues with their neck where they are also really keen on their cross fit, their f45 their boxing or other forms of high intensity training. 

The main question they ask us is:

“Do I have to stop doing my training for the injury to get better?”

What I want to talk through with you today are the things that you can do while you're managing an injury so that you're not making it any worse and you can keep the gains that you've made from the training so that you can keep the metabolic conditioning, you can keep losing weight and you can maintain muscle by keeping training even while you’re working through the process with us of sorting out the neck issue. 

First of all, we're going to get you to shift focus. So, neck issues are often exacerbated by upper body exercises and things that are super dynamic so people with neck issues can often find doing sit-ups are really uncomfortable because it strain you can strain your neck a little bit. 

Similarly they might find that pushing weight overhead is uncomfortable because of the position that your neck goes into.

So what we suggest you do is move to some exercises or rather, substitute exercises that are super comfortable. 

Often they are lower body exercises, so you can do air squats or you can do squats where you're holding a dumbbell or a kettlebell. 

You also can do lunges, in fact you can can do almost all of the lower body exercises. 

You may find that while performing more dynamic stuff that there can be a little bit of a jarring. So in that instance we're talking skipping or box jumps, Also running for instance might not be comfortable, so we're going to suggest that you substitute by maybe doing things on an exercise bike or do things where on a rower where you can make sure that you're keeping a more controlled cadence, but most importantly, you're looking after the alignment of your spine by making sure your head is nicely above your shoulder rather than coming forward. 

What we can do upper body wise when we're managing a neck injury: often horizontal things, such as horizontal pushups.

Pushups can be okay so long as you’re keeping your posture really neutral. 

Horizontal pulling like ring rows can be comfortable even though perhaps exercises like pull-ups might not be because of that neck extension that is commonly involved with it.

So key here then is focus on the lower body, get rid of really dynamic movements, like things that have jarring in them and substitute for things that eliminate the overhead stuff in particular. 

The second phase once we have been working with people and we are getting some improvement in the way that their neck is working but they're not a hundred percent, then we're going to start adding in some things that are a little bit more dynamic but are a little bit more forgiving on your neck. 

As we’re reintroducing things we might go “you’re not ready for box jumps yet but you can do step ups” for instance, or “you're not ready for skipping but you can do single leg hops as an exercise”

The key thing to remember here if you're training with a neck injury is first of all you just want to wind things back, shift focus and you can get a lot of benefit in working on lower body stuff then as things start to recover we will reintroduce things but in a modified form that reduces how much jarring and how much movement of your neck is required. 

The important thing to remember is, you can keep training through almost all injuries, the most critical thing though is to think through and get advice on what the things you need to avoid and what really clever substitutions you can put in place.

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.

 

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.

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 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.

 

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?

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. 

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