A Weak Core May Contribute to Hip Pain

When people think of hip pain, they generally turn to hip-specific exercises as a self–help strategy.  However, recent evidence shows there’s a correlation between poor core stability of the trunk and injury to the lower extremities, which includes the hips.  In March 2018, Belgian researchers reviewed data from nine previously published studies with a focus on the importance of core stability and its relationship to lower extremity musculoskeletal injuries in a healthy athletic population. The investigators reported that core strength, core proprioception (balance), and neuromuscular control (coordination) of the core are directly linked to the likelihood of lower extremity injuries.  

Let’s take a closer look at three specific core strengthening exercises that can be done relatively fast and are highly effective (you can view several demonstration videos on YouTube if you search for “stuart mcgill’s big-3 core exercises”).

1) The Curl-Up (abdominal strength): STEP 1 — Lie on your back, straighten your left leg, and bend your right leg, placing the right foot next to the left knee.  STEP 2 — Tuck your hands under your low back to prop up the lumbar curve (so it does not flatten out).  STEP 3 — Curl up by lifting your head, neck, and shoulders only a few inches off the floor (keep your chin tucked).  STEP 4 — Hold for 7–8 seconds (or work up to this).  STEP 5 — Slowly lower your trunk back to the ground.  Repeat five times with the right leg bent and five times with the left leg bent, while keeping the opposite leg straight.  This exercise helps reduce low back disk compression, which is significant when performing a conventional sit-up exercise.

 2) The Bird-Dog (core, back, and gluts):  STEP 1 — Kneel on all-fours (hands and knees).  STEP 2 — Keeping your back flat, lift and straighten out the LEFT arm and RIGHT leg parallel to the floor. STEP 3 — To further activate the core muscles, draw a square with the arm and leg while bracing the abdominal muscles (firm up your abs, as if to brace for being punched in the stomach). STEP 4 — Return to the starting position and repeat on the opposite side (repeat STEP 3 again). 

3) The Side-Bridge (obliques): STEP 1 — Lie on your side, elbow directly under your shoulder and bend your knees 90°. To increase the difficulty, keep the legs/knees straight. STEP 2 — Lift your hips off the ground so you are holding your weight with your elbow and knees (or feet). STEP 3 — Hold the “Up” position for as long as possible. STEP 4 — Repeat steps 1-3 on the opposite side. 

Doctors of chiropractic are trained to evaluate the entire person from the feet up to the head to identify issues elsewhere in the body that may contribute to or even cause the patient’s chief complaint. For many patients, managing hip-related conditions may involve treatment to address issues in the core (as described in this post), the lower back, and even the feet or knees!

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Great Exercises for Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is caused when the median nerve is compressed as it passes through the tight bony carpal tunnel at the wrist. The condition can result in pain, numbness, tingling, and weakness in the hand, and it can affect one’s ability to carry out everyday life and work tasks. Here are a few GREAT exercises for CTS that require no equipment and can be done anytime and anywhere:

Calm slim model standing in tree pose in bright room

PRAYER: Place your hands in a “prayer” position. Touch the palm-side finger pads together and slowly push the palms into one another while keeping the elbows up as much as possible as you feel a strong stretch in the hands, fingers, and palm-side of the forearms.

SHAKE: Shake your hands for 10-15 seconds as if you just washed them and you’re trying to air dry them off.

WRIST FLEXION STRETCH: Hold your arm out in front of you with the elbow straight, palm facing down. With the opposite hand, bend the wrist as far downward as possible so the fingers point to the ground. This will produce a strong stretch in the muscles located in the back or top of the forearm. Repeat five to ten ties holding each stretch for 15–20 seconds (as tolerated).

These exercises can be repeated multiple times a day, as often as once per hour. It is often very helpful to set a timer on your cell phone to remind you to take a stretch break. A “good pain” (stretch) is considered safe while sharp or radiating pain may be potentially harmful. However, if you experience sharp, lancinating, or radiating pain, then stop or modify the exercise.

Frequently, CTS involves more than just the wrist, and exercises that target the neck, shoulder, and elbow can often hasten recovery. This is especially true when there is “double crush syndrome” where the median nerve is entrapped in more than one location such as the neck, shoulder, elbow, or forearm (as well as the wrist).

Chiropractic management of CTS can include manipulation and mobilization of the hand, wrist, forearm, elbow, shoulder, and neck. Muscle release techniques are often employed as well as the use of physical therapy modalities such as laser, electric stimulation, ultrasound, and others. The use of night splints to keep the wrist straight when sleeping is a “standard” used by most healthcare providers. Co-management with primary care may be appropriate if diabetes, inflammatory arthritis, or other complicating conditions are present

The Red Flags of Low Back Pain

Treatment guidelines published around the world note that ruling out “red flags” is a healthcare provider’s number one responsibility, which is in line with the decree exhorted by all healthcare professionals when first entering practice to do no harm. When detected, red flags prompt a doctor to stop and immediately send the patient to the appropriate healthcare provider or emergency department to avoid a catastrophic outcome, which may include death.how-to-tell-if-your-back-pain-is-serious

The four main red flags cited for low back pain include: cancer, fracture, cauda equine syndrome, and infection. In 1992, Dr. Richard Deyo reported that the patient’s history is more important for identifying red flags than a routine physical exam, especially in the early stages of these conditions. This is partially why new patients need to fill out so much paperwork on their initial visit. These are the factors that suggest red flags when it comes to low back pain:

Cancer: a past history of cancer, unexplained weight loss, failure to improve with a month of therapy, no relief with bed rest, and duration of pain over one month. However, when the combination of age over 50 years, past history of cancer, unexplained weight loss, and failure to improve with one month of therapy exists, the sensitivity or “true-positive” reaches 100%—in other words, IT IS CANCER until proven otherwise!

Cauda equine syndrome: acute onset of urinary retention or overflow incontinence, loss of anal sphincter tone or fecal incontinence, “saddle” anesthesia, and global or progressive motor weakness in the lower limbs.

Infection: prolonged use of corticosteroids (such as organ transplant recipients); intravenous drug use; urinary tract, respiratory tract, or other infection; and immunosuppressant medication and/or condition.

Spinal fracture: history of significant trauma at any age; minor trauma in persons over 50 years of age; patient over 70 years of age with a history of osteoporosis (with or without trauma); and prolonged use of corticosteroids. A checklist that includes these important historical questions can be easily applied in any practice, which is highly recommended.

All healthcare providers—including chiropractors—managing patients in a primary care setting are obligated to rule out red flags in order to ensure patient safely when rendering treatment for LBP. The good news is that most cases of low back pain aren’t caused by these red flags and respond well to conservative chiropractic care!

Low Back Pain: What Can I Do for It?

Back-Pain-PNG-FileLow back pain (LBP) is the second most common reason for doctor visits in the United States and it is a condition that most of us will at some point in our lives. Last month, we reviewed the wide acceptance of spinal manipulation as the treatment of choice for both acute and chronic LBP. This month, let’s take a look at what you can do outside the doctor’s office to self-manage acute and chronic low back pain.

One of the best self-management protocols for LBP is exercise that targets the lower back. It appears that the optimal time to engage in exercises for the lower back is during the work day since doing so may help alleviate some of the overuse and repetitive strain contributing to one’s LBP. Let’s focus on exercises you can perform from either a sitting or standing position during short work breaks…

RULES: Perform slowly to a full/firm stretch without pain; take three slow deep breaths for each; only do exercises that “fit” your job and time limits—this might be only one every fifteen minutes; make it work!

SITTING EXERCISES: 1) Sitting Forward Bends – bend forward and reach for the floor (as far as reasonably tolerated). 2) Sitting trunk rotations – twist slowly left, then right. 3) Cross Leg Stretch – cross one leg over the other; grasp and pull the crossed leg knee to the opposite shoulder while arching the back to its maximum until a firm stretch is felt in the buttocks.

STANDING EXERCISES: 1) Hamstring Stretch – place one foot on an elevated surface (like a chair seat, foot stool, or guard rail); perform an anterior pelvic tilt by arching your low back until you feel a firm stretch in the hamstrings. Switch sides and repeat. 2) Groin Stretch – do exactly the same steps as the hamstring stretch but this time, rotate your trunk to the side of the standing leg (away from the stretched leg) until you feel the stretch in the inner thigh or groin muscles. 3) Backward Bends – place your fists behind your low back and slowly bend backwards to a maximum tolerated point.

These “portable” exercises can be performed frequently throughout the work day, whenever you can spare 30-60 seconds. The most important point is to do these exercises on a regular basis. It may help keep your LBP from worsening during your workday.

What Type of Doctor Should You See For Acute or Chronic Back Pain?

Have you ever considered which type of doctor is best suited to treat back pain?

Since there are so many treatment options available today, it is quite challenging to make this decision without a little help.

To facilitate, a study looking at this very question compared the effectiveness between medical and chiropractic intervention.

 

Over a four-year time frame, researchers followed 2,780 low back pain patients who were treated using conventional approaches by both MDs (Medical Doctors) and DCs (Doctors of Chiropractic).

Chiropractic treatments included spinal manipulation, physical therapy, an exercise plan, and self-care education.

Medical therapies included prescription drugs, an exercise plan, self-care advice, and about 25% of the patients received physical therapy.

The study focused on present pain severity and functional disability (activity interference) measured by questionnaires mailed to the patients.

The authors of the study reported that chiropractic was favored over medical treatment in the following areas:

  • pain relief in the first 12 months (more evident in the chronic patients);
  • when LBP pain radiated below the knee (more evident in the chronic patients);
  • chronic LBP patients with no leg pain (during the first 3 months)

Similar trends favoring chiropractic were observed in regards to disability but they were of smaller magnitude.

All patient groups saw significant improvement in both pain and disability over the four-year study period.

Acute patients saw the greatest degree of improvement with many achieving symptom relief after three months of care.

This study also found early intervention reduced chronic pain and, at year three, those acute LBP patients who received early intervention reported fewer days of LBP than those who waited longer for treatment.

While both MD and DC treatment approaches helped, it’s quite clear from the information reported that chiropractic should be utilized first.

These findings support the importance of early intervention by chiropractic physicians and make the most sense for those of you struggling with the question of who to see for your LBP.

Ending Pain and Staying Healthy Is a Surprisingly Small Thing…

Here’s something interesting. Do you know how much money American Airlines saved in 1987 by eliminating ONE olive from each salad they served in first class?

You’ll never guess.Single-olive

$40,000!

Amazing, isn’t it? And if you translate that amount to today’s dollars—it would be a lot more!

You want to know what else is interesting and quite amazing? If you do, listen to this: It is estimated that 75% of Americans are chronically dehydrated, which basically means three quarters of the country does not drink anywhere near enough H20.

And check this out—it is also estimated that in 37% of Americans, the thirst mechanism is so weak it is often mistaken for hunger. And even mild dehydration can slow down your metabolism by as much as 3%. And there’s more…

One glass of water shut down midnight hunger pangs for almost 100% of the dieters in a University of Washington study. But that’s not all! Lack of water is the number one trigger for daytime fatigue. A mere 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen.

As a quick aside related to computers—in 2006 one in eight people showed signs of being addicted to the Internet! Can you imagine? (And that was before smartphones and social media really hit the scene.)jyh63rhks5g3na9dsnhu-1-800x445

BACK TO WATER… SOME ESTIMATES SAY DRINKING FIVE GLASSES A DAY CAN DECREASE THE RISK OF COLON CANCER BY 45%, SLASH BREAST CANCER BY 79%, AND DECREASE YOUR CHANCES OF GETTING BLADDER CANCER BY 50%.

So what’s the point of all these interesting facts? Is all this just to get you to drink more water? Hardly…

Listen… although it’s obvious you should be drinking plenty of water—the REAL take home message here is: small things done consistently over a long period of time can have a major impact on your health and life.

Let’s face it. One olive is not a big thing. But removing just one from the in-flight salad meant $40,000 over the course of a year. Just five glasses of water a day might save you from one of those deadly conditions listed above.

And here’s something else you may find important: regular Chiropractic care may have a BIG impact on your life. How, you ask? If you came to us in pain and we helped you… it might stop your original condition from coming back. And not only that—just one visit per month may help you live a healthier, more pain-free life… in many ways.

Those olives and glasses of water add up and have a huge impact over time. So do Chiropractic treatments, even though they may be tough to actually measure.

Here’s one more interesting fact if you’d like to lose weight: Banging your head against the wall burns 150 calories an hour! Yeah… you’re right… there’s probably a better way… 🙂