Wednesday, August 21, 2013

Is Your Cell Phone A Pain in The Neck?


A picture is worth a thousand words.   We hunch over our smart phones more than they deserve.  I took this picture in Bart, because as a chiropractor I am appalled at what I see every day.   These gentleman's heads  are literally falling out and ahead of their bodies as a result of their phones.  Research shows  that the average head weights 10lb.  For every inch  the head is held forward the strain in the neck increases 10 fold.   Therefore the  two gentlemen are caring at least 40lb, if we estimate that their heads are 4 inches forward, which is a gross understatement.   
Forward head posture is the leading cause of neck and upper back sprain and strain, stiffness, headaches, joint deformity, straightening of the cervical curve, muscle spasm, pinched nerves, carpal tunnel, radiating pain, tingling and numbness into the fingers, early degeneration of the joints of the neck and back and disc problems,  just to name a few.  These symptoms are seen in young adults as early as 14 years old.  There isn't a simple cure, but there is a way to reverse the anterior head posture over time with changing habits, increased awareness, chiropractic adjustments and exercise. 
This is what you can do: 1)  Limit your cell phone use to specific time during the day.  Talk to your friends do not text them. 2) Call your chiropractor and get evaluated for the effects of the forward head posture on your spine,  joints and muscles.  X-rays may be necessary in some cases, depending on the joint dysfunction the chiropractor finds through the orthopedic and neurological examination.  Get adjusted first before you start stretching and exercising.  The function of the joints needs to be restored first, or you will be causing more undue stress and strain.  Stretching of already over stretched muscles is not the way to go.  Stretch the chest and anterior shoulders, not the neck.   Strengthen the upper back and posterior neck and shoulder muscles.  3) Your chiropractor can prescribe a special traction equipment to help restore the curvature at your home safely.   Along with the right exercises and increased awareness you will regain the normal function and posture in your body.

The chiropractors at Chiro-Health are trained posture experts, practicing for over 11 years.  For more information please go to www.chirohealthsf.com.  Phone and office consultations are free and encouraged.  It is your future, be there healthy, we can only help along the way.

Wednesday, August 7, 2013

Is Sitting the New Smoking?



As chiropractors in the Downtown/Financial District of San Francisco, we see the effects of sitting every day. Conditions include chronic headaches, low back pain, muscle spasms, stiff neck, hip pain, knee pain, degenerative disc disease in people as early as their 20's among other things. Many patients ask us why they have these pains and degenerative changes, since they are so young and otherwise healthy. Although they may not have the symptoms, most have on thing in common: 90% are sitting 6-12 hours a day.

Recently, Anup Kanodia, a physician and researcher at Ohio State University, Wexner Medical Center said, "Sitting is the new smoking".  According to an Australian study published in October 2012 in the British Journal of Sports Medicine, every hour of sitting, cuts about 22 minutes of the person's life, while it is estimated that smokers shorten their lives by about 11 minutes per cigarette.

No one wants to grow old with low back pain.  As chiropractors our goal is help you get out of pain, but more importantly to stay without pain, with better function, so that you can age as healthy as you possibly can be.  I have a 32 year old patient, who I love quoting: " I am here because I want to be the healthiest senior citizen I can possibly be."

Here is a look at how sitting affects us, as we sit for extended periods of time the posterior muscles in the low back, middle back, neck and pelvis become elongated, weak, inhibited, and underused. The hip and neck flexors on the other hand become short and taut. We mostly feel the muscle's response to sitting in the form of muscle spasms or tension, but the problem is far beyond the muscle. Prolonged slumped postures cause micro sprains and strains to the joints of the back and neck over prolonged periods of time. This leads to lose of neutral curvatures in the lumbar spine and the cervical spine, deformation of  ligaments that are elongated in the back and shortened in the front, disc compression, disc thinning, disc bulges, pain radiating to the arms or legs, or disc tears. The body overreacts to this damage and starts producing increased muscle tone, which feels like spasm, tension, knots in the muscles.  Naturally because it feels like spasm we start stretching the muscles instead of what we need to do, strengthen them.

So next time, you experience a spasm in the lower back, stiffness in the neck, sensitivity to certain movements or unexpected movements especially in the morning,  pain after sitting and standing,  or pain from sitting, standing, lifting or carrying, take into consideration that it may not just be a muscle spasm, and most likely a weakened disc that is likely to suffer further if not treated as such.  

Our chiropractors specialize in posture evaluation, muscle testing to identify front to back and left to right muscle imbalances.We are experts in differential diagnosis meaning we do all the orthopedic tests to help us differentiate a simple muscle spasm from, joint sprain/ strain and dysfunction , from disc protrusion or bulge.  We combine chiropractic, massage, physical therapy on the same visit to address all the structures involved: muscles, joints, nerves and discs.  For more information about this article and to contact Dr. Mazgaloff go to www.chirohealthsf.com.


Friday, June 7, 2013

Yoga, The Nervous System, and The Spine


At the request of some of our yoga students I am writing an entry about the nervous system, how it relates to the curves of the spine, and how we can affect it through conscious exercises such as yoga. 

Nerves are bands of fibrous tissue that carry messages throughout our bodies. They are much like the wiring in a computer. They are just as real and palpable as blood vessels, muscles, and organs. Because nerves are a physical structure they can be affected by tight muscles, injuries, and unhealthy posture. Nerve roots are the part of a nerve that exits the spinal cord between two vertebra before it travels out to the rest of the body. They are the place where the two parts of our nervous system communicate.

A compressed nerve root refers to an actual squeezing of the nerve as it comes out from between two vertebra on its way to the rest of the body. If you squeeze a hose that has water running through it the water flow will be impeded and pressure will build up. The same thing happens in our nerves where the nerve is the hose and the water is the impulses that carry messages back and forth between the brain and the body.

Our central nervous system (CNS) is comprised of the brain and spinal cord. Our peripheral nervous system (PNS) is comprised of all the nerves that run throughout the rest of our bodies. These two nervous systems communicate with one another via the nerve roots mentioned previously.

There are two branches within the peripheral nervous system. They are the Sympathetic branch and the Parasympathetic branch. Each of the branches holds an opposite function and our body is constantly adjusting how much each branch is activated. 

The sympathetic branch is responsible for the 'fight or flight' response. This system is activated in times of stress and danger and leads to adrenaline being released, heart and breath rates to quicken, the pupils to dilate, and blood flow to increase. The parasympathetic branch is responsible for the 'rest and digest' response. This system is activated in times of low stress. It leads to blood moving to the organs, the heart and breath rates to slow down, and an overall sense of relaxation and restfulness.

Problems occur when one of the branches is overly stimulated for an extended period of time. Because of our culture, jobs, and life structure, Americans tend towards having their Sympathetic branch chronically stimulated. This leads to health issues such as anxiety, chronic stress, weight gain, tight muscles, headache, low immune system function, difficulty sleeping, and high blood pressure among others. In order to balance this a two-part solution must take place. The first is to lower the function of the Sympathetic branch and the second is to stimulate more activity of the Parasympathetic branch.

There are many ways we can affect the branches of the peripheral nervous system. Because the peripheral nervous system starts in the spine at the junction between the vertebrae we can affect it by adjusting the spine. Chiropractic care is an example of how this approach can be employed. 

Alternatively we can send signals from other areas of the body back to the roots of the nerves to tell the body to calm down. Acupuncture is a good example of this method. Because there are different approaches it is important to make use of the different healthcare modalities available to us and integrate them together to receive the most effective care.

We can also engage our bodies and nervous systems on our own without the assistance of someone else. This is an important approach to take as well because it empowers us in our bodies and in our lives. It makes receiving other treatments more effective, longer lasting, and ultimately puts us at a place of power in our own lives. Yoga is a way of using this approach to health.

Before we talk about specific yoga alignment let's take a closer look at the spine. The human spine is comprised of roughly thirty two bones. There are four curves in the spine. Two of them are concave and two of them are convex. Bones are connected to other bones by ligaments and to muscles by tendons. Between all the layers of muscle there are additional layers of connective tissue that hold everything together. Misalignments in the body can be due to bones, muscles, or connective tissue. The spinal cord runs through the center of the bones of the spine and, along with the nerve roots, are affected in shape and functionality by the posture of the spine.

Many systems of yoga and other exercise use alignment based on old research that showed that accentuating the natural curves in the spine lead to injuries in the spine and nerves whereas making the back flat, tucking everything under, and taking the curves out of the spine lead to greater stability. 

There are several problems with these studies. The first is that since these studies have been accepted and used as the basis for healthy alignment in our body no one has researched other possible alternatives. For over sixty years we've accepted that those studies discovered everything we needed to find about proper alignment in the spine. Secondly, the studies looked at overarching the lower back. What they didn't look at was the method in which the back was arched. Simply put, the back can be arched either by collapsing into it and compressing the vertebrae or by engaging the muscles of the legs to create a deep but spacious curve in the low back that matches the spine's natural alignment. Lastly, the studies all looked at arched backs where the last thoracic vertebrae (T12) in the middle of the spine poked out. None of the studies looked at alignment where T12 moved in and up, which only happens when the spine is arched through muscular engagement.

When the curves are taken out of the spine it causes the nerve roots to become compressed and sends signals to the brain that the Sympathetic branch needs to be activated. When the natural curves are put back in the spine it signals the brain to activate the Parasympathetic nervous system.

Our Sympathetic activation is exacerbated by the large amount of time that people spend sitting at desks. Sitting this way leads to several problems. It takes the natural curve out of the low back, it takes the natural curve out of the neck and when the chin is lowered it pulls on all the muscles in the jaw, neck, and upper shoulders, and, finally it tightens our hips and groins which also stimulates the Sympathetic branch. This also causes the bones of the legs and arms to be pushed forward out of their sockets. 

Tucking under requires the engagement of the butt muscles from the top of the butt to the bottom of it. This engages the muscles from the insertion to the origin. We engage every other muscle in our body in the opposite way - from the origin to the insertion. Why would it be that one of the strongest muscles in our body should be the only one that should be engaged opposite from all the other muscles? In the new system of alignment the butt muscles are engaged from the origin to the insertion (bottom to top) which naturally creates a deep spacious curve in the lower back as a result.

If an exercise class is using an old system of alignment it is basically creating the same posture we end up in sitting at desks and in cars. We end up creating the same problems we're trying to fix. The new system of alignment reverses these tendencies and reintroduces the natural curves back into the spine. Some basics of the new system of alignment I use in my teaching are:

1) Make the legs strong
2) Use this strength to create a spacious, deep arch in the low back until T12 moves in and up
3) Allow the upper back to soften and the ribs to move towards the ground
4) Look up and make the curve in the neck match the lower back
5) Extend the whole body in both directions from T12


Here is another way of looking at it:


When an animal is afraid or upset they round their lower back and neck, and tuck their tail between their legs. This is the same action of "tucking the tailbone" under that we have all been instructed to do in the past. This is an example of what animals do when they are in Sympathetic dominance. Another example is a cat arching its back when it hisses at something.






 





When an animal is relaxed and at ease and has just woken up from a nap it takes a nice big stretch as seen here. The lower back is rounded, the groins are soft, the hips are pressing back, and the chin is lifted to create a curve in the neck.







Here are more photo comparisons:





In the first set of photos we can see the difference between the old and new styles of alignment. The bottom picture shows a rounded spine, rounded neck (though usually the rounding is even more severe), and and overall look of unease. The top photo shows strong legs creating a natural arch in the lower back and the chin lifted to create a matching curve in the neck. The shoulders are lifted and the ribside is extended.













The second set of photos shows the new alignment and how it matches with the way animals align their bodies in a stretch. In the top photo I could have even more bend in my knees so as to lengthen the spine and extend the hips back more. Notice how overall the arches of the spine and alignment of the shoulders and hips match up.







 

The new system of alignment activates the Parasympathetic nervous system while at the same time strengthening and toning the body. Because the spine is naturally curved the nerve roots have the least amount of pressure put on them when the spine is in its natural alignment. By putting the spine in this alignment and then using our muscles to lengthen the curves it creates space between the vertebrae which takes pressure off the nerve roots, thus sending a message to the brain to activate the parasympathetic nervous system. Less obstruction and compression on the nerves creates feelings of ease and restfulness.

When the natural curves of the spine are supported by clear engagement of the muscles and healthy alignment of the limbs there is more than enough stability to support the curves. Old systems of alignment try to take the curves out of the spine because it is believed that the hyper-mobility of the lower back and neck are too unstable and easily injured. This assessment is only true if there is no muscular engagement supporting the arches in these parts of the spine. 

Finally, when we allow the ribcage to descend towards the ground we allow gravity to gently pull on all the connective tissue surrounding our internal organs. When we surrender in this way it further activates the Parasympathetic branch. This isn't to say that the abdominal muscles aren't engaged. They are, but instead of contracting and shortening them we engage them while they stay long and extended. 

These are some basics of the way our nervous system works in conjunction with our anatomy and alignment. There are many different systems of exercise and alignment available and it's good to explore many different ones in a safe way so that you can become more empowered in your own body. Following, I've included more pictures for comparison.

~Joshuah Ciafardone, L.Ac


The new method of alignment is from the Sridaiva system of yoga developed by Desi Springer and John Friend.

Wednesday, May 15, 2013

Shoe or No Shoe?


    

    Whether you're an avid runner or not, it is likely that you have seen someone wearing Vibram toe shoes. One of if not the biggest debate within running communities is whether it is better to run with a classic running shoe or one with barefoot. Legitimate arguments exist for both sides of the debate.
    Barefoot running advocates point out that humans ran and walked without shoes for millions of years, arguing that going barefoot is natural for humans and can reverse injuries caused by modern running techniques while preventing future problems. But those against barefoot running like to remind us that asphalt and concrete didn't always exist and that there were very few 50 or 60 year old running millions of years ago.
    A study led by Harvard professor Daniel Lieberman suggest that runners who don't wear shoes have a significantly different foot strike that minimizes structural impact compared to those who wear shoes. Barefoot runners tend to point their toes when landing, putting the impact at the middle or front of the foot instead of on the heel making the runner less prone to repetitive stress injuries. This foot strike pattern was also shown to be more economical because runners use less energy to run the same distance as runners using traditional shoes and striking on the heel.
    On the other hand a trial published in the journal Medicine &Science in Sports & Exercise raises question whether barefoot running actually develops a different set of running injuries. Runners were given pre and post MRI studies of their feet. The MRI images showed that over half of them had developed increased bone-marrow edema in the tarsals and metatarsal bones.
    One helpful point to take from this is that not everyone who makes the switch to barefoot technology will end up with injuries. However anyone planning on doing so needs to be extremely cautious during the transition period. It is important to allow foot and calf muscles to adapt. Whether you plan on running with barefoot minimalist shoes or completely barefoot using a mid range cushioned shoe initially can be a good transition. When it comes to injury prevention and running efficiency, it's much more important how you run than what you run in. Heel strikers will sustain more impact injuries than those who allow their arches to act as natural shock absorbers. The most efficient and least injury-prone runners shorten their stride, land on the forefoot and keep the running motion smooth, light and flowing.
    At Chiro-Health we have years of experience working with runners of all skill levels. Whether you have more question on barefoot running, or want a gait analysis to determine which type of running shoe is ideal for we are here to help. You can reach us by phone at (415) 546-1461 or shoot us an e-mail at frontdesk@chirohealthsf.com .
 
References: http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56486

Tuesday, April 16, 2013

Stress: How to Not Let It Affect You


Our lives are full of stressful situations. Whether you were trying to beat that April 15th tax deadline or didn't and now have to request an extension, chances are you were stressed out. Stress is recognized as the #1 proxy killer disease today. The American Medical Association has noted that stress is the basic cause of more than 60% of all human illness and disease. Below is a diagram showing you how stress can affect your body and some insightful stress facts that many people are unaware of. Don't let stress take over your life and ask us how we can help you out with Chiropractic care. 


                                                                                                                             
                          ( http://www.heartmath.com/infographics/how-stress-effects-the-body.html)

Fact #1 Your body doesn't care if it's a big stress or a little one. Regardless of the significance, stress affects the body in predictable ways.If these reactions are left unchecked we age prematurely, our cognitive function is impaired, our energy is drained and we are robbed of our effectiveness and clarity.

Fact #2 Stress can make people do stupid things. Stress causes what brain researchers call "cortical inhibition". This means that stress inhibits a part of your brain and you can't function at your best. 

Fact #3 People can become numb to their stress. Physiologically we may be under stress, but mentally numb to it because we've grown accustomed to it. Although they may be small these stresses can accumulate and we may not realize how much they're impairing our mental and emotional clarity and overall health. This may show up as a bad decision, overreaction or an unwanted diagnosis at the doctor's office. 

Fact #4 We can control how we respond to stress. 

Fact#5 The best strategy is to control stress in the moment. Don't hold stress all the day and wait until after work to go to yoga or the gym to relief stress. By this time our bodies have already initiated the stress response and it is our overall health that suffers. 


                                                                                                                           

Thursday, April 11, 2013

Movements of Nature in Chinese Medicine - Spring Time Part I

"I sit with my back against an old oak tree,
The wind blows, grass lifts around me,
The tree remains steady,
The wind pushes me forward,
My eyes tear with the rising impulse,

Spring bursts forth,
It is full of life,
Vision clear,
See the plan,
 
What do you see,
What do you judge,
What is the plan,
Shout to the world,"


In Chinese thought there are many ways of describing the world around us and our experience of it. One of them is the model of the Five Elements, or Five Phases. I prefer the term Five Phases because it denotes movements of energy over periods of time as opposed to static building blocks of reality. The Chinese phases are Wood, Fire, Earth, Metal, and Water. In a previous post I described some of the qualities of Fire as it relates to the Heart organ-meridian system. In this post we will explore the season of Spring which is associated with Wood.

Wood Correspondences (in Chinese Five Phase Theory)
Emotion
Anger
Yin Organ
Liver
Yang Organ
Gallbladder
Sense Organ
Eyes
Body Part
Tendons
Body Fluid
Tears
Sense
Sight
Taste
Sour
Life
Birth
Season
Spring
Color
Blue-green
Virtue
Judgment/Discernment
Direction
East
Climate
Windy
Movement
Upwards, Outwards

Spring is a time of birth and renewal. It is the seed growing upwards and breaking ground. There is an energy of bursting forth and moving upwards. The Yang Qi becomes dominant, bursting out of Yin which has been dominant in Autumn and Winter. The light begins to return, the days become longer, and the temperature begins to warm. The state of expansive potential associated with Winter shifts into the state of manifested potential. The full realization of potential won't happen until the Summer. There is still a quality of the unknown present in Spring.

Spring can be a difficult time for people because of all the change and movement happening. After the deep contemplation of Winter it can be a jarring shift to move into Spring. The movement happening in nature can stir up Wind - both metaphorically and literally. Things might seem like they're a little out of control and overwhelming. People will experience allergies, frustration, and a sense of being disoriented. All these things are normal and by knowing what's happening in nature we can learn to adjust to the changing seasons more easily, helping any physical symptoms to become less severe. 

The Liver likes things to be consistent and organized. The Liver is associated with vision on all levels (i.e. physical, having foresight for future projects, opportunities, etc.). Because Spring is a time of change the Liver can become irritated. It may be unable to see what will happen in the future because the potential of Winter is still being shaped into what it will become. It is analogous to the feeling that occurs whiel driving behind a large truck and being unable to see the road ahead of you. 

Spring invites us to learn to move with the currents of nature, to be okay with the unknown as it is happening. Winter is more a time of deep contemplation where we learn to sit with mystery and the unknown in a state of darkness, quiet, and stillness. Spring is a time of driving 90 mph on a winding road that we are unfamiliar with. In the Winter we use the time to discern what no longer serves us and Spring is when we get rid of it all (Spring cleaning). This process can leave us feeling raw, vulnerable, and a little rough around the edges.

Finding things in our life that we know will be consistent is helpful during Spring. Having an anchor to hold onto while things are shifting and being let go of helps us feel secure in the process. It makes change and growth more comfortable. 

We want to put ourselves at the eye of the storm where there is stillness as opposed to being on the periphery where the tornado is blowing strong and we might get hit with a flying cow. Focusing on the positive qualities that change and growth will bring into our lives will help us allow it to happen with less resistance. Asking where we want to go, where we see ourselves going, and why we want to get there will help the journey be more enjoyable. Spring and Autumn are all about the journey. Winter and Summer are more related to the destination. They are the rest in the light and dark. Spring and Autumn are navigating the old rickety bridge between two mountains.

Self-Care Tips for Spring
  • Be asleep or in bed resting between 11 am and 3 am. This is the period where the Qi is strongest in the Liver and Gladder. It allows them to carry out their functions of judgment, discernment, vision, and refurbishment. Less sleep starting earlier will always be more beneficial than more sleep starting later.
  • Contemplate or journal about visions, dreams, what you want to let go of, what you want to bring in to your life, and how those changes will help you be more content in life.
  • Dietary support for the liver requires to things: healthy proteins that allow the liver to function properly and sour/bitter foods. A great combination is a green apple, a little lemon juice, cilantro, and dandelion greens. Be careful not to overdo cold, raw, bitter foods because they can negatively impact digestion. If you notice coldness, loose stools, cramping pain, or fatigue, it means you're probably overdoing it.
  • Be smart about detoxes, cleanses, and fasts. The liver requires energy to work properly. Juicing removes all the fiber from the fruit or vegetable which means the body absorbs all the sugar very quickly. This leads to dangerous spiking of blood sugar levels and is taxing on the pancreas. Juice fasting may be helpful in serious situations but should not be self prescribed and done with the guidance of a trained healthcare professional. For most people having a healthy, consistent diet, taking care of yourself, and getting adequate sleep is going to allow your body and life to detoxify most effectively.
  • Create consistency in your life to help the liver in this time of change. Go to bed at the same time. Wake up at the same time. Eat at the same time. Create things your body knows it can rely on. Create a feeling of safety in your life.
  • Be okay with feeling off balance and a little confused during this period. You will get through it and you will be better for it afterward.
This week we explored the energetic movement of Spring in nature and our bodies. We looked at how associations with Spring show up both literally and metaphorically in our lives and bodies. Next week we will look at the biomedical physiology of how the liver detoxifies our bodies as well as talk more about allergies and how Chinese medicine helps with them. Questions are always welcome.

~Joshuah Ciafardone, L.Ac