Monday, April 29, 2013

Proper Ergonomics - A Key to Pain and Injury Prevention

The majority of my pain and injury cases that I see at the office are people who sit at a desk most of their day and/or do several hours of driving during a day or week.  There are different reasons why that is, but I also see very common things among most people that are an easy fix if you take inventory of your ergonomics, posture and alignment. 

Take a look around your work and home environment.  When you are sitting at your computer, is your monitor directly in front of you, or off to the side?  Sit at your computer:  Are you looking at the monitor straight ahead of you, or do you have to turn or cock your head to look at the screen?  Make sure that your monitor is directly in front of your face so that you are looking at it straight on without the need to move your neck.  Also, make sure it is at a height that does not require you to look up or down.

When you type, read the computer screen or read out of a book, where is your head positioned?  Is it stacked on top of your shoulders or are you leaning forward?  The majority of neck injuries that I see are as a result of a head forward posture.  Our heads are the same weight as a bowling ball.  When you stick your head out forward, the weight of that bowling ball (your head) is creating stress on your spine.  The head should be positioned on top of the shoulders with your ear in alignment with your shoulders.  Obviously, you can't tell on yourself whether or not the ears are perfectly lined up, but you get my point about what to aim for.  One exercise to help you figure out where your head is, is to put your thumb on the notch in between your collar bones and your index finger under your chin.  That is how straight your head needs to be in order to not induce injury causing stress.

When you are working the computer, the mouse or are stressed in general, where are your shoulders?  Are relaxed or are you wearing them like earrings?  Most of us like our shoulder earrings :)  Well, not really.  Taking a deep breath is one way of getting those shoulders to relax without having to think about it.  Also, when working the mouse, remember to keep that shoulder relaxed.  I have seen a lot of injuries just from working the mouse.  Also, are your shoulders blades stacked directly on your back, or are your shoulders rolled forward?  Shoulders generally roll forward when our neck is in that head forward posture.  The shoulders should be relaxed, not up to your ears and shoulders blades stacked directly on your back.  Letting them roll forward is a common cause of upper back pain because your chest muscles become tight and your upper back muscles become overstretched.

Sunday, April 21, 2013

Massage Therapy, Physical Therapy and/or Chiropractic - How do you know what you need!

I am going to talk about some of the difference between massage therapy, physical therapy and chiropractic.  This is for information purposes only and not to be taken as advice.  The first of course knowing which treatments you need is a referral from your primary care physician.  My experiences with each is this:  I was in a 2 year physical therapist assistant program for a year and a half before changing over to massage therapy.  My knowledge of chiropractic is what I have learned from my own research.

Chiropractors adjust the bones and joints to correct alignment and reduce pain.  There are many styles of chiropractic out there.  Everyone knows about the high thrusting style of manipulation.  What many people don't know, is that's not the only style out there.  Every chiropractor adjusts differently, just like no two PTs or LMTs are the same.  There are gentle styles of chiropractic available as well that do not involve high thrusting manipulation.

Physical therapy is of course, therapeutic exercises.  Physical therapy can also sometimes involve the use of heat, ice, electrical stimulation, ultrasound and manual manipulations.  No two PTs are the same, so this is in general.  Some PTs believe in some things and not others.

Massage therapy.  There are really two tiers of massage therapists.  Those who only offer relaxation and spa services and those you specialize in soft tissue manual therapy for pain relief and postural correction.  Some therapists offer relaxation and pain relief services.

So, how do you know what you need in addition to the recommendation of your doctor.  Everyone should do their own research about their health before embarking.  Here are some general guidelines to keep in mind.  This is stuff I have learned over the years through research, as well as what has worked and hasn't worked in my own chronic pain from repetitive stress injuries.  Many postural and alignment problems can be soft tissue related.  When muscle becomes tight, it pulls the joints out of proper alignment and impinges on nerves.  When not treated properly and right away, permanent damage can result.  If you're going to get your bones adjusted, make sure the problem isn't tight muscle first.  Set the foundation of your house before you build it.  Many chiropractors will tell you this too.  They refer their patients out for massage therapy for this very reason.  Now, let's talk about when to seek therapeutic exercise.  What I learned about any massage or manual therapy techniques while studying physical therapy consisted of one 3 hour lab.  I spent an entire quarter in massage school learning how to give a basic relaxation massage and another quarter learning how to do manual therapy for pain relief and postural correction.  I also learned while studying massage that exercising muscle that is already tight, makes it tighter and weaker.  I also noticed this to be true in my own experience.  When considering exercise for the relief of pain and other problems, make sure that the problem isn't tight muscle.  This was not taught to me while studying physical therapy. 

Now, how to pick the right chiropractor, PT or LMT.  I would say do your own homework and ask for referrals.  No two health care providers provide the same treatments.  Sometimes it can also be trial and error.  Sometimes you need more than one treatment to decide.  I have seen people make their decisions based on who takes their insurance and who doesn't.  I have seen a lot of client dissatisfaction happen as a result of this.  Cash or insurance, pick who can help.  Whomever can help you is going to get you well faster and save you the most money.

Sunday, April 7, 2013

Bunions, Calluses and Plantar Fasciitis, On My!

Did you know that many of the problems that we have in our body start at the feet?  Pain and postural problems start at our feet.  We live in a shoe wearing society.  Wearing shoes prevents the small muscles inside of our feet from doing their job.  When picking out a pair of shoes, the flatter, the better.  Also, make sure that your toes have plenty of room to spread.  Not having enough room to spread the toes is one of the mechanical reasons for bunions.  High heeled shoes force your posture to overcompensate.  Stand on your tip toes for a minute and observe how your posture compensates in order for you to stand upright without falling forward.  Your spine is unable to stay in proper alignment on your tip toes.  Another thing to observe when standing and walking is your foot alignment.  Stand up and look down at your feet and see where they naturally want to be planted.  Are they straight forward, or are they off to the side.  If they are off to the side, that is common among most of the population.  Straight forward is proper alignment.  What does this have to do with anything?  Well, a lot.  One of the most common reasons for chronic pain is misalignment.  When your foot is off to the side instead of straight forward, that effects the alignment of your hips.  It is also another mechanical reason for bunions and calluses.  Your entire hip has to turn in order for your feet to be turned.  If turning your feet forward is easier said than done and makes you unable to keep your balance, don't despair.  It took years for you to get to that point, so the problem will not go away over night.  Part of retraining our body means retraining our brain.  Our body has what is called proprioception. Proprioception is how your body feels in space.  When I realized I was turning my right foot outwardly, that felt normal to me.  When I made the effort to keep it straight, I constantly had to look down to make sure that I wasn't pigeon toed because my brain and propioception were trained to think that having my foot outward was normal.  I was not pigeon toed at all, it just felt like it.  The only thing that I could do about it was to remain consciously aware until I had my brain and proprioception trained to the new normal.  The reason I went through the effort to do this is because I have right hip problems and a right bunion starting.  I am all about prevention.  I once saw a woman who came to see me because she had left foot pain.  Her podiatrist told her surgery was inevitable.  She told me that she felt like it was coming from her hips and she could feel some compensation going on that was causing her foot pain.  I looked at her posture and knew that the problem was not coming from her foot.  I worked in her pelvic area to correct the alignment problem that I noticed was going on.  As I was working on her, she could feel what I was doing radiating to her foot that hurt.  After I worked on her, I gave her information about a biomechanist, Katy Bowman, who specializes in feet.  She bought Katy's book, starting doing the exercises in her book and taking the advice from her book.  When she came in to see me again for something else, she told me that she was able to tell her podiatrist that she no longer has any pain.  Everyone's source of pain is different, so this is just one person's experience.

As always, I am ending this post with some self help information.  The book that I mentioned in the post is called, "Every Woman's Guide to Foot Pain Relief - The New Science of Healthy Feet" by Katy Bowman.  Katy's book can be bought on Amazon or her website.  Katy also has two websites: http://www.restorativeexercise.com/ and https://www.alignedandwell.com/