The importance of the diaphram

Who knows what your Diaphragm muscle is?  Where and what it does?  So that we are all on the same page, its the muscle separating the intestines from the lungs.  a thin sheet of muscle attached at the bottom of the ribs that is designed to be the primary muscle for respiration.  On inhale it pushes down into the belly and on exhalation is pulls back up into the chest forcing the air from the lungs.  You know what else it does...... CORE STABILITY!! If you are not a belly breather, most of us are not, One of the biggest and best core muscles isn't being utilized which will eventually lead to core instability and low back or pelvic dysfunction.  So how do you work that particular muscle, I know I've never seen a "diaphragm" station in the gym!! Breath, yes, just breath! Lay flat on the floor with your legs elevated and just breath in and out of the stomach.  On a side note, if you have a problem with acid reflux, this may help with that as well.  The cardiac sphincter, meant to prevent acid backflowing into the esophagus is connected to the diaphragm.  If the diaphragm is weak would it not make sense the cardiac sphincter could be weak as well?  So if you get the diaphragm working right you could in turn stifle your acid reflux.  

Regional Interdependence

    Ever hear of Regional Interdependence? Its a newly emerging concept in the health field. Its the idea that the regions of the body (upper and lower extremities) should be able to move and function independent of other extremities. Example: Hip extension should only require stabilization of the core and activation of the lower extremity. When I have a patient perform prone extension while palpating the cervical spine and can feel the neck muscles contracting it tells me there's a lack of regional interdependence. To be more specific, it tells me the core isn't stabile, not to be confused with weak, theres a big difference between the two. So how is it achieved, regional interdependence, that is? The first step is a proper exam and movement assessment, second is to identify the causes, third is intervention (adjustments, soft tissue work etc.) and finally exercises to reinforce the work done by the healthcare professional. All of these things we specialize at Power Chiropractic. So if you're interested in fixing any long standing aches and pains feel free to make an appointment today @ athletepowers.com

A few thoughts on running......

   After this last weekend, covering for the Shoes and Brews 4th annual Soul Mates 5k, something occurred to me:  running isn't for the faint of heart.  This may cause a few of you to chuckle to yourself but perhaps you should try it sometime, for longer than a couple weeks or miles!

   My above statement is designed to help you understand its not about intensity, necessarily.  More so, its about the amount of force that can go into the body, which can be substantially increased if done without proper preparation!  Preparation?  Yes, Preparation!  If you're the type that thinks you can just throw on a pair of runners from the value store and hit the pavement for a couple miles and be just fine, you are poorly mistaken!  If done without proper preparation, running can be very taxing on the lower extremity and back!  So how does one prepare?  I thought you'd never ask!  

   Here's a quick list of things to consider:

1. Make sure your physically fit for running.  A quick adjustment from your trusty chiro can ensure the lower extremity is functioning properly to prevent injury.  Coupled with a quick physical wouldn't hurt, making sure there's nothing internal that may result in a coronary attck in the middle of your run

2. Equipment check.  Not all shoes are created equal!  If you're gonna take this thing seriously you should know there are good shoes and bad shoes to be running in.  The bargain bin runners are not for running!  Shoes breakdown.  If you're running distance you should be changing out you runners every 3-5 months, 6 years is WAY too long!  Get fitted by people who know their stuff, Shoes and Brews is a good locally owned and operated shop near main street.

3.  Start small.  Don't go out trying to run 10 miles your first day.  Its unrealistic and you'll most likely be so sore it may take a few weeks before you're able to run again.  Depending on your ability, start with 1-2 miles and as you get your lungs and legs back start bumping the mileage up after a few weeks.

4.  Hydration.  At altitude hydration is HUGE.  Most people don't understand what hydration is!  The guys you see walking around with gallon jugs of water may be cliche but I'm pretty sure they don't get cramps or heat stroke very often!  Coffee, soda and alcohol all cause dehydration, more so than you think, so if you have any of that stuff you need to offset it with extra water that day.

5.  Set goals and keep track.  Depending on why you are running (weight loss, increase activity, cross training, etc) you should have goals to keep you on track.  Using a heart rate monitor isn't a bad idea either.  The Polar models are great at tracking you calories, heart rate, time etc..  

6.  Get a workout buddy.  It's amazing how effective having a workout buddy can be!  Someone to hold you accountable for your workouts.  Someone with similar goals that you can, essentially, race towards against.  I know I love a good competition!

7.  Break up the monotony with a little cross training.  If all you do is run the same distance at the same intensity every day your body will plateau and your progress will cease.  Change it up weekly.  Run a couple days and hit the bike, the pool, the rower the basketball court for a pickup game once or twice a week.  The change will keep you mentally engaged making it more enjoyable and in turn more long term!  Nobody likes doing the same darn thing everyday for 30+ years, or do you!? haha

8.  Listen to your body.  If at any time you start feeling light headed, dizzy, nauseous or pain that ordinarily isn't there don't be scared to stop.  Better safe than sorry.  You're not an international athlete so theres no reason to push too hard.  Be smart and be safe

I hope all this has been helpful.  If you feel I've left anything off feel free to let me know and I'd be happy to add it.  Best of luck with your running and feel free to stop in for an adjustment anytime.

Cheers

The importance of balance.....

    Just wanted to share a thought from a conversation I had with a colleague yesterday. We were discussing patient care and progression through pain and we started talking about home care instructions.
    Its important to realize that when you, as a patient, experience pain, its more than likely that your lifestyle is the biggest variable in the equation! To put it another way, the things you do on a daily basis are the reason you are in pain/dysfunction. All the negatives and the positives combined are resulting in pain. Which, in a way, is saying you are living an unbalanced life. 
You might ask "what do you mean unbalanced?" Thats easy! It could be a number of things leading to the imbalance. It could be your work, diet, family, stress, workouts, hobbies, relationship, etc.. Ever hear the saying "all things in moderation" or any number of variations? It couldn't be more true when looking at life. Most anything can be a positive in life as long as you don't overdo it. 
      So with that in mind when a patient comes in with back pain its not only my job to treat the specific pain at the moment, its also my job to identify the imbalances in their life that may be contributing to their current dysfunction. I can add positives, treatment and exercises, but if I don't identify and eliminate negatives, bad posture or bad diet, the cycle of dysfunction continues. 
     So the key to balance is eliminating negatives. Adding positives, home exercises etc., won't do it alone. Without identifying negatives and removing them your routine is just muddying the waters of progress. It kind of reminds me of the definition of insanity: repeating the same action expecting different results. If you want change you have to make change! I can acquire all the licenses and certifications in the world and they can only do so much for you. The real improvement comes when you make the decision to put in the work!

Movement: the key to health!

   For all of you out there that don't feel great on a daily basis and don't know why, kids aside!  For you that don't feel as young and spry as you did 10 year ago or even a few years ago.  For those of you who have noticed a spare tire shaping up around your hips.  This is for you!

     Movement is as close to a fountain of youth as any of us will find!  There is no miracle pill, no treatment, no diet that will lose the weight or get you out of pain faster than just getting out and moving!  Our bodies are designed to be constantly moving.  Think back 500 or 1,000 years ago and imagine how unsuccessful the human race would be if we lived as we do now, sitting most of the day.  You don't have to be a brain surgeon to recognize the obvious answer here.  You might suggest we live longer now than back then and you'd be correct.  The average life span, depending of the time your referencing, has nearly doubled in most societies.  Unfortunately what that number fails to consider is quality of life.  First world amenities aside, we are living longer but breaking down faster.  Whats the point of living 150 years if you're confined to a bed for 80 of those years!?  No thanks!  

     So, what to do?  Simple, ANYTHING!!  Now depending on your current level of physical fitness there are many different entry level activities that you can enjoy both physically, psychologically and socially.  These days the new fad to introduce many people is the Fit Bit, counting steps in a day.  I'll take it if it gets you started if gets you on the road to movement and its something you can do pain free.  However, for many people this is both the start and finish lines.  They never progress past walking.  My problem lies in the fact that walking isn't good enough, its entry level and never REALLY challenges the cardiovascular and musculoskeletal systems like other exercises/activities can and do. 

      Now, I am speaking to those of you that are able bodied and quite capable of progressing but choose not to.  Why??  Why do you stop here?  Is it a lack of understanding, are you lazy, not enough time, are you uninspired?  If you don't understand what you need to do, thats cool, ask someone!  There are too many gyms and trainers around to use this excuse.  They make their living to inform you on how to exercise properly.  Lazy??  Heck, we're all lazy from time to time!  I'll challenge you to make excuses TO workout instead of making excuses to stay on the couch or in bed!  If time is your limiting factor, easy!  Work smarter and harder!  Be efficient with your workout by ramping the intensity.  In the gym setting, instead of doing 30 minutes of cardio then 6-10 exercises spending 10 minutes at each station do them at the same time!  Make a circuit of your workout where you go from one exercise to the next with little to no rest in between each set.  You can easily condense a 90 minute workout into 30 minutes and still get all the work in!  If you're the one that starts running to get in shape and can't make it more than 2 weeks before you fall out of the habit.  Sounds like you need to find something that you enjoy more.  A field sport perhaps: soccer, rugby, ultimate frisbee are all great workouts.  For the colder months there are just many options: martial arts, Cross fit, racquetball, basketball etc.. If you don't enjoy what you're doing for fitness it'll never last!  You gotta find things you enjoy, that challenge you both physically and mentally!  For those who are less mobile or just not at the level of running or weight training, cool, we all have a different starting point.  AS long as you're willing thats all that matters.  For you, theres plenty to do as well: Yoga, swimming, the stationary bike, elliptical machine are a few examples.  

    Now, a very important part many people overlook is health measures.  Yeah, you might have been a phenomenal high school athlete but if that was 20 years ago, you aren't him/her anymore!  Things change and they don't change for the better.  If you haven't even thought of hitting the gym in 20 years its not like riding a bike, you could hurt yourself and then your movement plan just got shelved for 4-6 weeks if not longer.  Be smart and get checked out by your Primary care physician to make sure you're not gonna have a coronary in the first 10 minutes.  Get a functional movement screen so you know where you are physically and can be made aware of any biomechanical restrictions that could lead to injury and if you're already in pain (shoulder, low back, knee, ankle etc.) you need a Selective Functional Movement assessment to correct existing biomechanical deficits, both of which are done in the office. 

    At the end of the day you need to be moving to keep living and it needs to be more than a few weeks at a time. It should be a part of life, not just something you do when you have time.  I understand we all have things going, other priorities but when it comes to your health, your life, many of those "things" can and should wait.  If your efficient and can plan properly there is always 30-45 minutes to spare for a little time to get the heart rate up!  Just make sure you do it safely and smart!

    

Have you ever asked WHY it hurts when you move?

    Now when I ask the WHY, I don't expect to hear answers like "arthritis, bad ankles or old injury".  These are not the "WHY", they are simply contributing factors.  I'm looking for "whys"!  You USED to be active.  You USED to be pain free.  You USED to be able to touch your toes.  You USED to be able to roll over with minimal effort.  Now?  Not so much, yeah? I know what I'm capable of doing and have a good understanding why, but then again thats my job.  Do you know why you can't touch your toes? I'll be willing to bet it can be isolated to 3 possibilities: Tissue, Joint or Motor control!

   In the Selective Functional Movement assessment there are 3 possible explanations (aside from anatomical variations, congenital or acquired) and they are as follows: 1. Stability Motor Control Dysfunction (SMCD).  2.  Joint Mobility Dysfunction (JMD).  3.  Tissue Extensibility Dysfunction (TED).  With any dysfunction, usually indicated by the presence of pain, there will be either a stability or mobility dysfunction and in some cases both can be present.  So what are these 3 categories, allow me to explain.

    The Stability motor control is the neurological side of things where the brain has forgotten how stabilize a joint during active motion while in a weight bearing position.  In the scenario where a patient can't touch the toes while standing but can do it while sitting on the ground, it tells me there is something wrong the brains understanding of stability somewhere in the posterior chain.  At which point we would issue motor control exercises to rewire the connection (so to speak) for the brain and retest for improved stability.

    The Joint mobility Dysfunction (JMD) is much simpler in nature.  It is very simply what it sounds like.  It's what we use to label a joint that cannot physically move, active or passsively, with in the normal anatomically accepted ranges of motion.  At this point the joint is "stuck" or "subluxated" and is in need of mobilization or chiropractic adjustment to reintroduce the proper motion in the joint.  A good example would be when a patient is unable to touch their chin to their chest in either a vertical or horizontal position, actively or passively.  

   The Tissue Extensibility Dysfunction (TED) is similar to the JMD in that they are both mobility issues.  Obviously they differ in the nature of the mobility restriction, but they can be equally troublesome.  In this case the active/passive ranges of motion in weight bearing and non weight bearing are are restricted.  The difference is noted in the passive range of motion when the end point of the joint is a soft "bouncy" feel to it, while theJMD has a "hard" stop to the motion that is finite in nature.  For the patient, the TED illicits a "stretch" in the hamstrings (back of the leg) when touching the toes and the JMD would be pain in a joint when being pushed to end range.

     If you are in pain, annoying or debilitating, you have dysfunction and all the aspirin, advil, TENS units, copper wraps, kiniesiotape, pain pills etc. are gonna fix it!  The only way to fix it is proper assessment, diagnosis and treatment will get you started in the right direction.  after that its up top you to put in the work.  Improving dysfunction is not a passive activity.  You can't just sit there while the doctor or physio does they're magic to make you whole again, we all saw how well that worked for Humpty Dumpty!!  As a responsible physician I can only tell you what is wrong and provide a little guidance, but you have to put in the effort to make it work!!  So let's get you feeling better together and see where it takes us!! look forward to seeing you in the office!  

Cheers

Selective Functional Movement Assessment

Selective Functional Movement Assessment

The goal of every athlete should be to improve on your limitations. The SFMA can be a very useful tool for athletes and non athletes alike.

The goal of every athlete should be to improve on your limitations. The SFMA can be a very useful tool for athletes and non athletes alike.

    Known as the SFMA, you may be more familiar with its predecessor the Functional Movement Screen (FMS).  If not familiar and you're an aspiring athlete then you should!    The SFMA is a series of movement used to evaluate an individuals basic functional movements providing a road map to their pain or eventual dysfunction.  

    One of the biggest problems with todays healthcare, as a whole, is the tendency of physicians to "chase the symptoms" or treat pain.  For many people this is great!  They go to the doctor in pain and get pain pills, massage, adjustments or any other number of palliative treatments.  They essentially are getting pampered and lets be honest, who does like getting pampered!?  The problem is that none of this provides long term relief.  When you chase the symptoms/pain you are ignoring the problem!  Don't get me wrong, on occasion the pain and dysfunction are one in the same, especially in a scenario where there is a direct trauma to the area.  However, when dealing with chronic pain, like like back pain, to isolate treatment to just the low back you are ignoring the problem.  

AS you can see, the FMS and the SFMA have a few similar movements in common.  Very simple, yet when proper form is reinforced can be very difficult for most people.

AS you can see, the FMS and the SFMA have a few similar movements in common.  Very simple, yet when proper form is reinforced can be very difficult for most people.

       First the FMS. The FMS is a series of 7 functional movements designed to screen athletes for movement deficiencies.  The idea is use this tool to predict the likelihood of injury with activity.  These movements are not complicated yet most people are unable to perform these basic motions adequately.  The FMS is usually implemented with pre-participatory screenings for personal trainers, gyms and team sports.  The screen is not designed to be diagnostic in nature.  It is simply a pass or fail test that tells the coach, trainer or instructor whether or not the athlete should be attempting the activities upcoming.

These are the basic movements to the SFMA.  From here more joint specific movements are used to diagnose the dysfunction at a micro level.

These are the basic movements to the SFMA.  From here more joint specific movements are used to diagnose the dysfunction at a micro level.

     Now the SFMA is a much more diagnostic set of movements.  There are a couple movements that they share but where the FMS stops at pass or fail the SFMA takes the fail and asks "why".  Once movement limitation or dysfunction is identified further tests are implemented to differentiate between mobility or stability problems.  In the SFMA there are 3 different types of dyfunction: Joint Mobility dysfunction (JMD), Tissue Extensibility Dysfunction (TED) or Stability Motor Control Dysfunction (SMCD).  Once these are identified in either the joint or the spine rehab protocols are in place to correct said dysfunction.  Exercises are designed to either create stability or mobility in the appropriate joints where the SFMA indicates.  The best part...... Pain is not a requisite for these tests to elicit positive indicators.  The SFMA can indicate dysfunction both before and after pain is present!  As a matter of fact, for those of you who feel as though are in tip top shape I'd challenge you to make it through the SFMA without any dysfunctional movement indicators.

      So, In the event you're in the market to prevent/remedy dysfunction, pain and/or injury the SFMA is something that would be useful to you.  Regardless of your level of competition (Olympics, high school, college or recreational) or sport (baseball, rugby, ultimate, swimming etc.) the SFMA is an invaluable tool for preventing injury by identifying faulty movement patterns before they cause pain.  

Core instability...... The six pack problem

Core instability...... The six pack problem

Although this is what we are conditioned to aim for with physical fitness, its not actually good long term.

Although this is what we are conditioned to aim for with physical fitness, its not actually good long term.

      A quick thought about what most people know as "core stability". How many of you out there are familiar with the constant battle between form and function? To put it another, simpler way: Looks versus functionality! AHHHHH, yes!! Pretty sure EVERYBODY is familiar with this one! Girls, those high heels you LOVE to wear out on a hot date but almost invariably end the night carrying them instead of wearing them...... Yes they LOOK amazing, but it doesn't take long to find out they aren't very functional! Guys, Those big trucks we like to drive sure look nice until you do the math on the petrol bill! So heres another one I think is very commonly overlooked when it comes to exercising and core training.
     

Competitive weightlifters are a great example of stable core.  Instead of that "hour glass" figure they are more like a rigid cylinder the same diameter top to bottom.  This shape is the most functional in terms of a stable core and there low back and extremities.

Competitive weightlifters are a great example of stable core.  Instead of that "hour glass" figure they are more like a rigid cylinder the same diameter top to bottom.  This shape is the most functional in terms of a stable core and there low back and extremities.

So according to all the magazines a strong core would look something like a six pack with that nice little "V" starting at the waist line going down into the groin area. Yes, it is very appealing to the eye and considered a good look by most. The reality: it's just "window dressing" and from the functional rehab standpoint indicates core INSTABILITY! This look indicates that you do a great job working your rectus abdominus muscles (the 6-pack muscles) and an even better job ignoring the rest of your abdominals! If your wondering what this actually means; you're only working 2 of the 8 abdominal muscles (4 on each side). It doesn't take an engineer to recognize the eventual problems when only 25% of the stabilizers are used to support a structure! Now don't take that to mean that everybody that has a six pack is gonna get hurt, rather when you DO experience some sort of pain/dysfunction a possible explanation is that due to core instability everything else (arms and legs) are unstable as well. After all, all movement starts must start with a solid anchor and for the human body the core is the anchor for our extremities.
If there are any questions I encourage you to make an appointment (multiple options) so we can discuss any concerns you may have.

Low Back Pain: The Psoas muscle

Low Back Pain: The Psoas muscle

The above a good illustration of how the psoas attaches to the spine and femur.

The above a good illustration of how the psoas attaches to the spine and femur.

  Most everybody at some point will experience low back pain.  If you're lucky its short term and very mild!  Unfortunately, this is not the case for most of us and for a small percentage of us we will experience life long, debilitating low back pain!  In almost every case it could have been prevented with a little foresight and hard work.  For those with low back pain caused by a major trauma (car crash etc.) this article may not provide much insight but it may help you understand a little more about your pain and suffering.

The crunch is a good exercise that isolates the rectus abdominals without engaging the psoas, as long as the shoulder blades remain on the floor, with trunk flexion.

The crunch is a good exercise that isolates the rectus abdominals without engaging the psoas, as long as the shoulder blades remain on the floor, with trunk flexion.

   What is the psoas!?  The psoas muscle's primary job is to perform hip flexion.  Its attachments are as follows:  the proximal attachment is at the anterior aspect of the lumbar spine, it then runs down through the pelvis and attaches to the lesser trochanter of the femur (inner thigh).  So what is hip flexion?  To put it simply, anytime your knee gets closer to you chest or head, hip flexion is occuring.  Examples include: sitting, running, walking, sit ups (not crunches) and leg raises.

As you can see here the full sit up requires hip flexion which requires psoas contraction.  So if you're doing a lot of sit ups and your back keeps hurting you might reconsider how you train the core.

As you can see here the full sit up requires hip flexion which requires psoas contraction.  So if you're doing a lot of sit ups and your back keeps hurting you might reconsider how you train the core.

    Ok, so what does this have to do with back pain?  Possibly nothing but theres just as much chance that its a direct contributor to your daily discomfort.  When you consider our lifestyles include a lot of sitting (daily commute and desk jobs) and bad posture it makes sense that the psoas can become shortened and when it becomes shortened it pulls at its attachments on either end.  How does it become shortened?  Muscle memory or habit!  I'm sure most everybody is familiar with muscle memory, but in case not:  Muscle memory: the ability to reproduce a particular movement without conscious thought, acquired as a result of frequent repetition of that movement.  So to equate that definition to our current topic, When you sit around (at your desk or in traffic) for 8-12 hours/day (30-50% of your day) the psoas becomes conditioned to remain in a contracted state.  So know when you go to lengthen it by standing, it resists and does what it can to remain in that shortened position.  When it does that the majority of the pulls goes into the lumbar spine resulting in constant lumbar spine extension.  So what does this mean?  Well for one, when you're in constant lumbar extension the posterior elements of the vertebra are compressed and two your spine is in a less than optimal weight bearing position when in extension.  The spine is designed to be its strongest in neutral, allowing for short term stability when in flexion or extension.  Prolonged hyper lordosis (exaggeration of the natural lordotic curve of the lumbar spine) can lead to permanent changes in the structure of the vertebral bodies as well as ruptured intervertebral discs (think spinal sciatica) at which point your intermittent low back pain is now chronic if not permanent.

This is good form in stretching the psoas. Note how the trunk is vertical and in a neutral position, pushing through the pelvis. 

This is good form in stretching the psoas. Note how the trunk is vertical and in a neutral position, pushing through the pelvis. 

    So how do I prevent this?  Easy, a little hard work never hurt anybody, right!?  It starts with being conscious of your posture and making sure to stay balanced.  Don't sit too long at your desk, get up and move around.  Our bodies aren't designed to sit all day, so keep moving.  Stretch the psoas.  The hurdler stretch many of us know from youth soccer is a good one.  Make sure to push through the hips and not through the chest.  If you're extending your back to get a stretch you'll feel it in the quads and miss the boat.  When done properly you should feel the stretch in the groin.  Massage can be helpful with right LMT.  Chiropractic care is a big part of it.  In most cases the psoas is just a small part of a bigger picture and proper diagnosis is necessary to formulate an effective care plan, which should include adjustments, soft tissue work and exercises designed to correct any muscle imbalances.  

This would be an incorrect stretch.  He is pushing his chest forward while extending the lumbar spine.  you will feel a stretch doing this, just not where you want!

This would be an incorrect stretch.  He is pushing his chest forward while extending the lumbar spine.  you will feel a stretch doing this, just not where you want!

   At the end of the day its up to you to do something if you're in pain.  Pushing the pain out of your pain will only result in 2 things: 1. more pain and 2.  Longer recovery period.  So I highly recommend anybody with anybody with back pain or any pain for that matter, take the initiative and let a professional get them on the right track to wellness.  We aren't getting any younger people!  As always, If you have any questions feel free to schedule a free 15 minute consult or a new patient visit form the website and I'll be happy to see what we can do together. 

Joint stability Part II

In the previous article I talked about the dynamic joint stabilizers.  Part 2 is focusing on the static stabilizers or ligaments and joint capsules.  The static stabilizers are designed form a hard barrier limiting joint range of motion, much like a rope tethering a ship to the dock.  There is play in these ligaments but once the tensile threshold is exceeded they will fail and allow the joint to exceed normal anatomical limits.  Once this occurs the joint is no longer stable and more times than not surgery is required to reestablish a base of stability.  The Anterior Cruciate Ligament is a good example that happens quite often.  Once ruptured most athlete's season is over for surgery and subsequent rehab for 9-12 months depending on the nature of their competition or extent of injury.  The important part of surgery that many people overlook is the need for proper rehab both before and after surgery.  As discussed in part 1, the dynamic stabilizers are the real safeguards to joint control and in order to make a full recovery and prevent repeat injury the dynamic stabilizers are the ones to focus on.  In the case of a non-contact ACL injury there is an imbalance in the hamstrings and quadriceps that causes the ACL rupture.  So once the rupture occurs, surgery is performed and rehab begins if careful attention is not paid to correcting previous aberrant muscle activation, balancing the quadriceps and hamstrings properly, the same injury will occur later on.  

Tensegrity and the body

Tensegrity and the body

The Kurilpa Bridge (Brisbane, Aus.) is the largest Tensegrity bridge in the world.

Plank:  What you oughta know....

Plank: What you oughta know....

Although the plank can be a very beneficial exercise, for lumbar spine stability, when done with incorrect position or for too long it can be a cause of low back pain.

Joint stability Part I: Dynamic stabilizers.

Joint stability Part I: Dynamic stabilizers.

300px-Muscles_Rotator_Cuff.jpg

      Have you ever had a stiff joint?  A stiff knee, perhaps a stiff or painful shoulder!?  If you've ever played rugby, thats a strong YES!  For most everyone else I'm sure it may not be so exact but most of you have experienced joint pain, not directly caused by injury.  By that I mean something like back pain, most everyone knows about back pain.  As the 2nd most common cause of disability in America, either you or someone you know knows about back pain!  So you might be thinking "how does back pain have anything to do with Dynamic stabilizers"?  Well thats the easy part, but first we need to establish a little foundation .

The anterior view of the shoulder, the pectoralis muscles are a big source of forward shoulder carriage, usually associated with spending extended time at a computer or any occupation involving sitting.

The anterior view of the shoulder, the pectoralis muscles are a big source of forward shoulder carriage, usually associated with spending extended time at a computer or any occupation involving sitting.

     Dynamic stabilizers:  What are dynamic stabilizers (DS)?  DS are muscle crossing the joint responsible for keeping the opposing surfaces of the joint in alignment for proper joint mechanics.  These muscles provide guidance through ranges of motion so that the joint can move with stability.  A good example is in the shoulder with the rotator cuff.  The rotator cuff consists of The following muscles: Supraspinatus, Infraspinatus, Teres Minor and Subscapularis.  Together these muscles work together with coordinated and graded contractions in an effort to ensure the head of the humerous, moves as designed, with in the Glenoid fossa of the scapula.  In the event any of these muscles are injured the dynamic stability of the shoulder is compromised and the subsequent motion is altered which invariably results in pain in the joint or, as the doctors like to say, arthritis ("arthro"- joint + "itis"-pain = joint pain).  This relates to the low back on a more complex level in that rather than 4 muscles responsible for stability the low back relies on 28-30 to work together.  not only that but the low back isn't just one joint, it's a series of vertebra stacked on the pelvis which can be very complicated.  

This is the posterior view of the shoulder showing the retractors, elevators and depressors.  The Rhomboids are of particular interest in that they are usually problematic when one experiences bad posture.

This is the posterior view of the shoulder showing the retractors, elevators and depressors.  The Rhomboids are of particular interest in that they are usually problematic when one experiences bad posture.

    Its important to understand that not all muscles that cross a joint are responsible for joint stability.  In the case of the shoulder we have numerous muscles that move the joint that aren't designed to stabilize the joint itself.  To expound on that thought, you have the 4 muscles of the rotator cuff that are the dynamic stabilizers then you have Pec major/minor that are the projectors (forward movement), Rhomboids are the retractors (think about pinching your shoulder together), Upper Trapezius are the elevators and Latissimus dorsi are the depressors of the shoulder.  None of these muscles are responsible for stabilizing the Glenohumoral joint, better known as the shoulder.

As you can see the knee is a much simpler joint with only a few muscles.  The quadriceps and hamstrings do the majority of the dynamic stability in the knee. 

As you can see the knee is a much simpler joint with only a few muscles.  The quadriceps and hamstrings do the majority of the dynamic stability in the knee. 

   So to help you understand your shoulder pain, as well as other joint pain, here's a general explanation of what happens to cause joint pain.  One of the most common situations is where an injury occurs to the joint involving the dynamic stabilizers.  From there the joint becomes unstable, the brain recognizes this instability and attempts to stabilize motion by recruiting one or more other muscles to do so.  The problem, joint pain, comes in at some point after when this compensatory mechanism fails and the joint is longer functional due to the overall instability.  You see, not every muscles is created equally, therefore its not a simple matter of "next man up" when injury occurs.  Every muscles has a specific job or function to perform and when its recruited to do another's job it does it poorly.  It'd be like having your starting QB getting injured during a game and having the punter take his place, yeah he can throw the ball around but does he know the plays or even where to go..... No, He doesn't have a clue!  

    This information is important after an injury, when a joint hurts and/or when rehabbing after surgery.  If you don't get the right muscles stabilizing the joint prior/during movement it will be painful and eventually fail again later on down the line.  

Stability v. Mobility

Stability v. Mobility

Joints in the body are designed for stability and mobility.  If you wanted to further classify them you could sort them by design of stability or mobility based on what they are most likely to become deficient in.  For example: The knee usually fails in stability prior to mobility and the hip becomes immobile prior to unstable and so on.

Plantar Fasciitis PART DEUX:

Plantar Fasciitis PART DEUX:

foot anatomy.jpeg

So last week we touched on what Plantar Fasciitis, what causes it and a few things you can do to alleviate it. This week we continue with palliative measures for short and longterm care and prevention.

braces like this won't help long term.  The muscles need to be retrained to prevent plantar fasciitis from returning.

braces like this won't help long term.  The muscles need to be retrained to prevent plantar fasciitis from returning.

Have you ever had your foot adjusted? Yeah, I said it. Why not? If a chiropractor can adjust a joint in the spine why cant he adjust a joint(s) in the foot!? If you consider there’s 28 bones in the foot responsible for the majority of the shock absorption when you walk, jog, run or jump; it makes sense. The foot is the #1 shock absorber in the body. If the bones/joints don't move like designed it becomes a rigid club, talking to you heel walkers out there, passing that shock/energy up the kinetic chain into the knees, hips and low back. This can explain why you may have low back, knee or hip pain as well? Chiropractors adjust more than just the spine. As a matter of fact, we’ve been instructed in numerous techniques that addresses every joint in the body, including the feet. Though not all do, some in our profession focus on other parts of the anatomy, but thats a conversation for another day. From my perspective, as a chiropractor, if you're having any sort of lower extremity problems you need to have your feet looked at to ensure the bones are articulating properly. Without proper motion in the foot your ceiling for improvement is limited.

Another form of passive, short term relief.  To simply treat the symptoms means your ignoring the problem!  

Another form of passive, short term relief.  To simply treat the symptoms means your ignoring the problem!  

Next, inserts for your shoes. This approach addresses the overpronation of the foot by giving it a hard barrier to keep it in a more natural position during the last part of the plant phase. Overpronation causes excessive stretch and forces to be placed on the plantar fascia which over time causes plantar fascitis. You can start by trying the foot station at your local pharmacy. These inserts are very generic, unlike you! But its a starting point and if it works then it was a cheap easy fix. If not, don’t be surprised if it doesn’t, you may look into getting fitted for a pair from a health care professional. You should be aware there are numerous options and not all are created equally, nor do all of them need to cost $300-500!! In the world of inserts there are heel lifts and full length inserts. On top of that there are arch supports for supination and over pronation designed to provide your foot gentle guidance into a more neutral/natural position during the plant stage of your stride. How do you know which one to use? Thats were the eye of a trained health care professional comes in. Proper analysis and testing is required to identify pathological movement patterns. FMS and SFMA are two reputable systems used to identify contributing factors. Even then its not always clear cut. Most times it takes a series of adjustments to both the foot and the insert based on your feedback/progress. You start simple, a small insert to start and as the body normalizes you increase the lift until symptomatology is minimized or even resolved. The one problem with this approach, its a passive fix. Its the equivalent of a brace, its not requiring the body to actively correct the muscle deficiency. Its simply a gentle reminder. Corrective exercises should be issued to aid the support.

At the end of the day, regardless of your unique scenario in which causes this dysfunction, you have to take responsibility for taking care of yourself. You essentially got yourself here and only you can get yourself out of it. And for those who think they are too busy to make time, This issue will only get worse and before you know it you will have all the time in the world to rehab when you are no longer able to bear it and cant work! Whats that our parents used to say: "an ounce of prevention is worth a pound of cure". More true than we could have ever known.

A little about me.....

A little about me.....

Dr.Mark-Aylor-Longmont-Chiropractor.jpg

   To think all this time I've been here, 6 months at the end of this month, and not once have I thought to introduce myself properly to my fans (figure of speech).  Yeah, the website has a little blurb on my past but it doesn't really tell you much.  So allow me this time to give a little more explanation.  

   First and foremost I am a chiropractor.  Chiropractors adjust subluxations above all else.  No matter what you as the patient come in with, my first priority is to correct any subluxations present in the spine or extremities.  

   "What is a subluxation" you ask?  In the chiropractic world the subluxation is what we base our profession.  Put simply a subluxation is a misalignment of a joint, very small in nature, which results in nerve interference.  Which can manifest as pain, altered sensation, muscle weakness and many other forms of dysfunction.  In my world, to be a chiropractor and NOT adjust subluxations constitutes subpar care to you the patient.  In saying that, it is also a disservice to the patient if ALL I do is adjust.  The current level of information available on the body and how the musculoskeletal system operates there needs to be more done with soft tissue and neurology.

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   Soft tissue isn't just a massage but more in depth in terms of recognizing muscle imbalances and kinetic chain dysfunction.  The Functional Movement Assessment is a good tool to identify functional capacity of each patien, which can be utilized by personal trainers as well as health care professionals.  The Selective Functional Movement Assessment is a more focused tool utilized specifically by health care professional to pinpoint functional instability and provide exercises designed to correct and improve patient functionality and stability.

   Neurology is much simpler than it sounds.  Where the soft tissue side of things my require difficult exercises in awkward positions the neurology side of things involves generally effortless movements that can be boring and tedious but rarely involve sweating or heavy breathing.  

   When treating athletes committed to a high level of competition its imperative all 3 aspects are considered in order to achieve the desired results as well as keeping them healthy and back to play following an injury.  As a former Athlete I love taking an athlete and showing them there weaknesses, that they were unaware of, and giving them the tools to fix it and seeing how they're performance increases when they do what I prescribe!  goodness knows I've been done that way a number of times in school.

Dr.Mark-Aylor-Chiropractor-near-me.jpg

   So how do I adjust? how is it different from the guy down the street? What makes me better?  First of all, I am a large man that if I'm not paying attention could easily hurt a patient with too much thrust on any given adjustment.  I am extremely conscious of this When adjusting which is why I go the extra mile to ensure my adjustment is more forceful than absolutely necessary.  My analysis is a mixture of muscle testing, palpation and range of motion findings.  I use these objective measures in a effort to be as specific as possible when adjusting and to help the patient understand what I'm trying to accomplish with my adjustment.  For example:  when the patient fails a muscle test, I adjust, then retest the same muscle test and they now pass it demonstrates that I'm not there to simply make things go pop in hopes they make things better.  And an added benefit to that approach is that if I fail to generate that trademark "pop" and I retest and the patient passes then I've gotten the job done.  More "popping" doesn't necessarily mean better care!! And if you're not a fan of having your neck "cracked" I've got an alternative, minimal force instrument assisted method of getting the job done just the same.  

   I also have a very good handle on extremity adjusting: hands, elbows, shoulders, hips, knees and feet: I can take care of them all!  If you're current chiropractor isn't adjusting at your feet and you just can't seem to get rid of that back or hip pain, maybe he should or perhaps let see what I can do!

   At the end of the day my focus is to get you back to 100% sooner rather than later, generally inside 4-6 visits.  And if I cant figure it out in a couple weeks I'll send you to someone who can!  Thats my promise to you as a doctor, to get you the care you need!  

A little about Kiniesiotape......

A little about Kiniesiotape......

K-tape can be found in numerous colors and patterns.  My favorite is Rock Tape's blu/pink argyle!

K-tape can be found in numerous colors and patterns.  My favorite is Rock Tape's blu/pink argyle!

   So what do you know about kiniesiotape (K-tape)?  A little, a lot or nothing at all?  Have you even ever heard of it? Have you ever used it; at home or with a trainer/chiropractor etc.? If yes, what do you know about it?  Was the purpose explained or did they just slap it on you and send you on your way?  For those of you interested in understanding this new tape you seem to see on everyone these days, this is for you!  

     First and foremost it's important that you understand K-tape is not a cure-all.  It doesn't fix anything or replace proper assessment and corrective treatment.  It's designed to augment treatment.  If you have plantar fascitis and the tape makes the foot feel better, great! but if you thats all you're doing for the plantar fascitis you're doing yourself a disservice.  It's presence on the skin is simply making the brain aware of that body part, if nothing else.  as a result of lifestyle certain parts or muscles can be forgotten by the brain.  Applying K-tape over a patch a skin is a nuerosensory reminder or "cue" for the brain to activate that muscle.  Fortunately this isn't the limit of its power.

   Pain mitigation:  K-tape reduces nociception, a fancy word for pain, to the brain which works two fold:  A. Nobody likes being in pain and reducing pain is always a good thing. B. Pain causes altered motor patterns so by reducing pain signals movement patterns are normalized.  How you ask?  Well, theres a theory called "The Gate Control Theory of Pain" that can help.  The sensory nerves responsible for pain are of the faster transmitting nerves in the body.  Luckily the nerves for touch are faster so when you bump your elbow and start rubbing it to feel better those signals are getting to the spinal chord faster and override the pain signals.  K-tape does the same for pain anywhere its placed, being on the skin its constantly stimulating those light touch receptors which are then bombarding the brain with information that overrides the pain signals.

Notice in the image to the left the increased subcutaneous space with the rippling of the skin caused by K-tape.

Notice in the image to the left the increased subcutaneous space with the rippling of the skin caused by K-tape.

   Decompression:  K-tape provides decompression of the skin, or fascia, overlying muscle.  Many times, due to numerous reasons like dehydration or injury, the muscle and fascia can become adhesed making the normal glide during movement difficult.  The stretch of K-tape, when applied correctly, creates ripple or convolutions in the skin.  Side note: K-tape comes, on the reel before you take the paper off, with 15% stretch built in.  So when you just slap it on without tension it will naturally recoil the skin creating wrinkles in the skin.  These wrinkles are the skin being lifted up from the muscles creating a subcutaneous space allowing for better movement between the skin and muscles as they contract.  

a diagram demonstrating how s=kin is represented in the brain.   

a diagram demonstrating how s=kin is represented in the brain.   

    Neural stimulation:  The skin is the largest organ in the body, heavily innervated with sensory neurons for tactile stimulation (touch, pressure, pain, heat etc.).  The brain and the skin are from the same developmental tissue which results in a strong connection.  The sense of touch can cause numerous reactions, some good and some bad.  Ever known someone that doesn't like being touched?  Ever considered why?  Its possibly because its too much stimulation.  their brain and skin are so closely wired that just being touched sends them into sensory overload.  The application of K-tape stimulates sensory receptors and creates awareness in the brain, through touch.  This neural stimulation results in improved joint position sense, joint stability, muscle activation and body awareness.  Now as stated before, this isn't the fix, its just an intervention.

This type of taping is a good example of whats called "tactile cueing" where the tape is a constant remainder to activate muscle for increased stability.

This type of taping is a good example of whats called "tactile cueing" where the tape is a constant remainder to activate muscle for increased stability.

       To sum it all up and put all these parts together:  Proper application of K-tape improves function by decreasing fascial tension on muscles, increases sensory stimulation to the brain reducing pain sensation which results in increased muscle activity and joint stability during movement.  K-tape can be used for all these or just one.  Patients having recently experienced a traumatic event are more in need of taping than increased motion so I'll use it just to reduce pain and worry about the other stuff later.  Sporting events is where we see it utilized most often.  the important thing to understand is that what you see on the athletes is supportive in nature.  Like ankle taping, the athletes don't walk around with that tape on all the time, just for the event.  Hopefully this has been helpful in understanding the use and benefits of kiniesiotaping.  If for some reason you have any questions, comments or concerns please don't hesitate to reach out, thats what I'm here for!

Mark Aylor D.C.

Thoughts on TMJ disorder.

Thoughts on TMJ disorder.

TMJ pain can be alleviated with simple, noninvasive, adjustments in just a few adjustments.

The importance of your home exercises.....

The importance of your home exercises.....

The Straighten Up America campaign is one of the more successful efforts to correct bad posture.  Its comprised of a series of exercises done daily for a few minutes anytime during the day to balance the muscle of the torso, front to back.