Spinal & Sports Care Clinic

Cut Your Healing Time in Half by Applying Ice and Receiving Chiropractic Care Immediately After an Injury.

By Dr. Steve Shirley

It is common this time of year to get questions on which is more appropriate after an injury, heat or ice. With the cold weather, nearly everyone will reach for the heating pad first after slipping on the ice or shoveling snow. While heat may often feel better at the moment, it usually isn’t nearly as affective as using ice. With an acute injury, there is usually some degree of inflammation involved and ice is a natural anti-inflammatory and pain killer. It is just not as fun as using a hot pack and it is difficult to consider using ice on your body when it is 4 deg. outside!
The general rule is “when in doubt, use ice.” The recommendation for how long varies all over the place but generally icing 15-20 minutes every hour for the first 2-3 hours is a good rule. Also, never put ice or an ice pack directly on your skin. I have seen several people give themselves frost-bite from doing so!
On the other hand, heat is a natural muscle relaxer and for mild muscle injuries can be quite beneficial. Several studies have shown that heat patches, which you can wear for hours at a time, can be of great benefit. Heat can, however, irritate an inflamed muscle or joint and make it worse.
So, how do you know which is best then? My rule of thumb is: “If you have sharp or burning pain or pain that is greater than 5/10 on the pain scale, USE ICE. If you have
mild to moderate pain that is achy, USE HEAT.” Also, never sleep with a hot pad all night.
Another common question I get is, “How soon should I come in for treatment after I hurt myself.” This is particularly concerning if you have a severe amount of pain. Our research with whiplash here in the clinic has repeatedly shown that those who seek treatment the soonest have a faster recovery time. What many patients don’t realize is that we have many treatment tools at our disposal and will typically use gentle procedures during the early acute phase of injury. Mobilization, stretching and gentle traction are usually much more effective than manual adjustments at this point in recovery.
Clinical research on acute back pain supports the idea that an early return to normal activities speeds up recovery. However, if it hurts too much to do any activity then early treatment to reduce the initial pain is essential. Otherwise, you get more “stoved up” because you are avoiding movement or moving too fast. This further irritates your nerves resulting in even more muscle spasm.
So the next time you hurt yourself, reach for the ice pack first – you can always switch to heat if it doesn’t seem to help. Secondly, if you really dinged yourself up, don’t wait so long to come in. It is easier to fix right away and usually go away faster with early treatment. An old chiropractic teacher used to say the five most dangerous words he heard in practice were,” Maybe it will just go away!” There is good wisdom, don’t you think!

Conservative Approaches to Managing Fibromyalgia

Dr. Sadie Rausenberger, DC

I wake up in the morning feeling unrested, but pull myself out of bed for yet another day of living in constant pain with most movements.  I am feeling very frustrated because I had to turn down an invitation to go hiking with a friend.  I just know it’s going to cause a flare up.    This repetitive pain and tenderness all over my body has made me just not want to do anything, and also led me to be depressed, feeling sad, and almost like my brain is foggy…..when will this ever end????????

Does this sound like you or someone you know?  The above paragraph is a day in the life of a person with Fibromyalgia Syndrome (FMS).  The National Fibromyalgia Research Association defines Fibromyalgia (FM) as a complex, chronic condition of widespread muscular pain and fatigue. Research shows that about 2 percent of all adults in the US have fibromyalgia (3.5 percent of women, 0.5 percent of men). In total numbers, that means that more than 6 million, and possibly as many as 11 million Americans meet the criteria for fibromyalgia. It affects women more than men in an approximate ratio of 9:1.¹

• Pain and always feeling tired may keep FMS sufferers from their chosen profession, daily activities, and leisurely activities or exercise they enjoy.
• Symptoms are commonly seen between 20-55 years of age.
• Fibromyalgia pain continues throughout a person’s lifetime.

Fibromyalgia is a chronic rheumatic syndrome characterized by widespread pain, fatigue, and low energy.  It affects millions of Americans, mostly women, and can be both physically and emotionally draining. Fortunately, there are treatment options available to help reduce the pain of fibromyalgia and it’s related conditions without the use of drugs.

Living with FM can become much more manageable once you start seeing a health care practitioner who focuses on all aspects of the condition and the symptoms it creates.  There are several areas to consider when trying to manage FM.    The most important areas include nervous system function, sleep, diet, and exercise therapy.

The innate intelligence your body harbors is the key to getting better.  Gentle, low force chiropractic procedures reduce pressure on nerves which enables proper function of the nervous system.  Once the brain and nervous system start feeling the restoration of the nerve impulses, your body can function at it’s maximum potential.

Treatment can help to improve range of motion, reduce aches and pains, and relieve muscle spasm.  Recent studies have shown that adjusting any fixated part of the spine may reduce the irritability of trigger points in muscles innervated by that part of the spine.

Exercise and strength training has been proven to reduce the diffuse pain of FM and also improve sleep patterns/quality.  A study done by the Department of Nutrition, Food and Exercises Sciences Program at Florida State University concluded that in women with FM, they had improved strength with resistance.  Also, when chiropractic treatment was added, patients had decreased drop out rates to the strength training program and were able to do their normal daily activities with less pain.³

Individualized exercise programs can help alleviate the pain associated with the syndrome.  Exercise has proven to be one of the most natural treatments for FM because it helps the body to produce more serotonin and adrenaline, which are both natural pain relievers.  Studies have shown that increased resistance training, cardiovascular exercise, and regular stretching can help reduce the diffuse pain of FM.

Specific lifestyle changes and nutritional supplementation can improve energy, sleep, and help to manage stress.  Simple approaches include the use of vitamin supplements to combat stress, replace deficiencies, and support the immune system.  Nutritional therapy can also be helpful in counteracting stress, ridding the body of toxins, and restoring nutrients which have been malabsorbed by the body. These changes will also help to naturally reduce pain, inflammation, and help to promote healing.

Massage therapy can reduce the pain, stiffness, and tender points caused by fibromyalgia syndrome. Massage therapy enhances the production of certain pain blockers, including endorphins, serotonin, and norepinephrine. These hormones work to counteract pain signals conducted by the brain, and this would explain why massage offers such dramatic pain relief.  A published study showed fibromyalgia sufferers reported a 38% decrease in pain symptoms after receiving just ten, 30 minute massage sessions. They also reported they slept for longer periods at a time and were disturbed less by sleep disorders.

There are many different approaches to managing Fibromyalgia.  A combination of lifestyle changes, chiropractic care, specific exercises therapy, and massage therapy can help to alleviate symptoms associated with Fibromyalgia.  If you have, or know of someone who is suffering from this disease, please contact our office for a consultation.

¹National Fibromyalgia Research Foundation. www.nfra.net

²Cailliet R. Pain: Mechanisms and Management. Philadelphia: F. A. Davis; 1993.

³Pub Med. J Altern Complement Med.  2009 Mar; 15(3):321-8.

Having a Heart to Heart – With your Heart

By Steven Shirley DC CCSP

The facts were in and it wasn’t pretty.  I decided to weigh myself shortly after the holidays and the scale told me what my increasingly snug Dockers had told me months earlier.  I was becoming a fat boy again.  As a strapping Irish-Scot lad with the physique of a caber-tosser, I knew years ago that svelte was out of the question.  My body was suitable for being a linebacker or perhaps leading the charge at Normandy.  Looking like a marathoner was always out of the question.  But I’m sure my heart was pissed at me.

Regular cardio sessions and sensible eating keep things pretty well in check until last year when a terrible thing happened – I blew out my knee.   Nothing seemed to work and finally after hearing enough corny jokes from my physical therapist I relented and got surgery.  Unfortunately for me, the one to two month recovery stretched to six months before I could get back on my work out routine. By then the pounds had come back by the dozen.

In reflection, a number of things happened worth considering.  While I continued to stand all day working as a chiropractor, the pain could be quite debilitating; thus wine consumption skyrocketed.  Comfort food became my good friend to assuage my bruised “superman” male ego.  Yummy but high in fat.  Oh boy, what a bad combination.  And since I had less energy from less exercise, caffeine consumption went up.  Now getting a good nights rest was diminished, which increased cravings in the afternoon.

So two months ago I stood looking in the mirror at the now sad state of affairs known as my body.   Yeah, I was a “big guy” but this was out of hand.   Maybe I should change the name of the clinic from Spinal and Sports Care to Fat Boy Chiropractic.  I know there is certainly a market for that!

Excuses aside, standing looking in the mirror was my day of reckoning and things were going to change. Step one was to cut out the crap in my diet that I knew was terrible for me.  So long Meat Lover’s pizza and Cougar Gold on Triscuits, hello fruits and vegetables.  I then started back at the gym three days a week and I had one guiding principal – steady as she goes Scotty!  The last thing I needed was a new injury and as a somewhat fading 51 year old I increased my workouts incrementally. No problems.

After one month my weight was down 5 pounds and my energy level was coming back.  I could also do 20-30 minutes of cardio at a moderately brisk pace and feel good when I finished – Cool!  But I knew I still needed to drop another 20 pounds and I wanted faster results.   Time to change strategies.  It was time for a jumpstart.

A jumpstart is a common strategy in weight loss where you start with a fairly strict dietary routine for 2-4 weeks.  It really does work as it forces you to carefully consider what you eat and also gives you some immediate weight loss.  When you can actually tell that the pounds are coming off, you really get motivated to push harder to whip your body into shape.

So a month ago I started the Purification & Weight Loss Jumpstart program our nutritional therapist Kathi (and my wife) was doing in the clinic.   The big advantage I knew with this program was that it was not only good for weight loss but was good at flushing toxins and rejuvenating the liver (poor guy).  How could I go wrong with that?    It was tough at first but it truly is easier if you have support from your spouse or partner.   A bunch of us in the office did it together and the social support was crucial when a kind patient would drop off a plate of homemade cookies at the office. (Ok, so I did eat one!). But the other key was moderation and not being a food nazi about it.  I cut my coffee consumption from 4-5 cups a day to two small cups so that I could still think straight.  I also started eating a mid-morning and mid-afternoon snack, which helped level my blood sugar and reduce my big meals at lunch and dinner because I was no longer famished.  Wine consumption was reduced 90% for 3 weeks as we celebrated at the two week mark with a nice bottle of wine.

So here I am today, down another 15 pounds with only 5 to go.  Cardio is now up to a minimum of 45 minutes and I have returned to moderate coffee and wine consumption.  My energy level is remarkable.  I have found I am sleeping sounder.  I also require about an hour a night less sleep.

I can still wrestle a bear if needed, but at least now I have a chance of outrunning him!  I am convinced that anyone can do what I am doing and I am challenging all of my patients to do the same.  If you can beat my 3 week weight loss as a percentage of body weight through our cleanse program or any other means, I will buy you a half hour massage!  If you are interested, call Kathi at 922-0303 to arrange your initial weigh in.

Join me and have a heart to heart with your heart!

TRX, Wii Injuries and Getting in Shape

By Steven Shirley DC, CCSP

Now that the holiday season is long gone, many people have gotten back on their exercise routines as the attempt to get the Christmas cheer off their beltline.  Unfortunately for some of our patients at the Spinal and Sports Care Clinic we are seeing a rash of injuries from people using new exercise routines such as the TRX, Cross-Fit and even the Wii.  In fact, one patient the other day could barely raise their arm after playing Wii tennis for 3 hours non-stop.  When I asked her what she was thinking, she said,” I wasn’t going to let my damn 13 year old kid beat me!”

There is no doubt that varying your workout routine is good sense as it is more fun to do and cross trains different muscles groups.  However, common sense and moderation are still the guiding rules, especially if you are returning to exercise from a hiatus.  In the case of TRX, where you are suspended partially from the ground using straps, the exercise is simply too advanced for the average Joe or Jill.  We have even seen disc injuries using these new-fangled approaches.  A key tip is this: if it was developed by a Navy Seal, it is probably not appropriate for a 52 year old grandma with chronic low back pain!

So whether you are whipping on your teenager using the Wii (or at least trying!) or are back lifting weights, remember that slow and steady wins the race. Remember to integrate stretching into your workout routine and to never push through sharp or burning pain.  If you feel a “twinge” of pain your body is telling you something is wrong.  Either reduce your intensity or quite the specific activity you are doing.  There is nothing wrong with taking a break every once in awhile or so to gather your wits and do a little stretching to avoid self-inflicted pain.

Vit. D and Seasonal Affective Disorder

By Kathi Shirley

Seasonal Affective Disorder (SAD) is a situational mood disorder  brought on by dercreasing daylight in the winter months.  Recent studies suggest that Vitamin D defeciency can contribute to SAD, especially in the northern latitudes.

Recommended dosage for Vitamin D supplementation is 1000 to 2000 IU per day.  (Try our Biotics Bio D Emulsion or Bio D Forte liquid forms!)

Other treatments for SAD include: Getting outside everyday; Exercise; Light Therapy; Keep a Regular schedule for waking and going to sleep; Eat foods in season that are whole and minimally processed; Choose whole grains and complex carbohydrates (avoid refined carbs and sugars); Supplement with high quality Omega 3 oils, vitamins and minerals.

Major Vitamin D Functions

- Supports key mineral absorbtion and metabolism (especially calcium and phosphorus in bones)

- Regulates normal cell differentiation and proliferation (e.g. prevention of cancer)

- Promotes insulin sensitivity and blood sugar regulation

- Regulates over 200 genes through binding to Vitamin D receptors throughout the body