“Doc, what does an adjustment do?”
I have been asked this a thousand times, so I am going to give you, the would-be patient, a quick low down on joint manipulation.
First, much like medicine, nutrition and chemistry have been with us for thousands of years, so has joint manipulation. For example, the ancient Chinese used it to correct for pain and inflammation. As humans are wont to do, if something works we keep doing it.
And we perfect it.
Over the millennia we have scientifically understood and improved spinal manipulation. Modern day chiropractic is not the chiro of one hundred — or even twenty — years ago.
“What is a joint manipulation?”
Easy answer: unlocking a locked joint.
When we suffer an injury — either a sudden injury, or a slow, over use injury — the sophisticated neuro-muscular system will use postural and structural muscles to lock a joint down. Preventing full and free motion.
Unfortunately, the body tends to over do this response. As a result, other nearby joints suffer as well and the problem can grow. For an easy demonstration try walking around without bending one of your knees. You will be forced to change how the whole body chain works in order to compensate for one single locked joint.
Likewise, when a spinal region is locked down, the problem affects secondary regions, making pain and dysfunction grow. A practitioner identifies the affected region and delivers an accurate and quick (but gentle) manipulation to make the joint move through its full range. By sneaking up on your body, your brain doesn’t have the chance to prevent this motion. And this proves to your Central Nervous System (CNS) that the motion is not only possible, but safe and pain free. This retrains your neural pathways and removes the “lock down.”
It can take a few visits to properly retrain the brain, but it is highly effective. And in some conditions (e.g.: facet imbrication) it can even be accomplished in a single visit.
Manipulation also breaks down scar tissue in joint capsules and surrounding soft tissue. Further enabling proper, fluid motion. For a real look at our manipulation practice, click the video below:
“How many people need manipulation?”
Most people will encounter an issue in their life time that will greatly benefit from joint manipulation.
Headaches: According to the American Headache Association, tension-type headaches are, by far, the most common form of headaches. They can be as debilitating — and even more so — than standard migraines. Fortunately, most tension-type headaches are due to tension and restriction in the neck region of the spine. As a result, manipulation is an integral part of treatment for this ailment.
Low back pain: One in four North Americans will suffer a bout of lower back pain in their life time. And low back pain is the most common cause of worker’s disability for those under the age of 45.
Several government studies over the past few decades have shown joint manipulation to be superior to surgery, injections and prescription medication for treatment of low back pain. The Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released a 1994 study stating that joint manipulation was a safe, inexpensive treatment that was more effective than standard medical approaches. It was not done by a chiropractic association but by a government assembled panel that included 23 diverse specialists comprised of medical doctors, chiropractic doctors, nurses, experts in spinal research, physical therapists, an occupational therapist, a psychologist, and a consumer protection rep.
The Ontario Ministry of Health (government) commissioned study is the largest standing study on low back pain treatment. Dubbed the “MANGA Report” it made the bold statement of recommending chiropractors as the first line of care ahead of medical doctors!
Several other studies have been done, nearly all of which have come to the same conclusion: for certain injuries, manipulation is the least expensive and most effective treatment.
Now, that being said, not all ailments require manipulation. For these other injuries and pain conditions we use a variety of physiotherapy techniques as well as exercise-based solutions and soft tissue treatments. You need your practitioner to think outside the box and apply the treatment best suited for your problem.
If you’ve tried everything else but have yet to have joint manipulation, please give us a call. And we can discuss whether or not an adjustment would be beneficial for your condition:
To see the wide ranging services we provide, click on the image below for our YouTube Channel:
A fence at the top of the hill instead of an ambulance at the bottom of it.
This is the major difference in philosophy between patients who continue to abuse their bodies and only seek care in high discomfort situations and those patients who want to stay as far away from a break down as possible. Continue reading
As a former wrestler and commercial fisherman, and now a forty-something jiu jitsu competitor and weight lifter I have had many opportunities to wreck my body. Somehow I avoided injuries that could side line me for more than a couple weeks for the past 10 years. Except for moderate to minor rib cage and ligamentous injuries, I have been pushing my body fairly hard despite my age and the much younger age of my competitors and training partners. Continue reading
**Do not start this program without first being examined and prescribed a beginner program. This is NOT a beginner program.
Stabilizing the knee via exercises is an important injury prevention technique that most people do not incorporate enough into their routine. Many sports place strain on the knee and therefore can cause injury. You cannot strengthen ligaments or joint cartilage. It simply is what it is. However you can strengthen tendons and muscles and improve flexibility and co-ordination. There is no better injury prevention for the knee than a 2 to 3 times per week stability program.
Here are the goals with knee stability programs:
Increased flexibility of:
1. Hips (internal, external rotation)
4. Inner thigh muscles
Increased co-ordination of:
3. Hip & knee movements
Increased strength of:
1. inner thighs
2. hip muscles
We cannot ignore any aspect of the leg structure, from the core down to the ankles, as they all have an impact on the efficacy of knee movement. Please do these exercises after a proper warm up (e.g.: 5 minutes on the eliptical).
1. Foam Airplanes
– stand on foam board (without shoes)
– arms out in “T” formation (do not let arms drop throughout exercise)
– lift one leg off
– keeping chest over hips (straight back), bend one “wing tip” down to ground by moving hips NOT arms
– then reverse movement and bring other “wing tip” towards ground
2 sets of 8 on both sides
2. Balance & Pass Medicine Ball
– balance on an exercise ball with your knees (feet OFF ground)
– stand erect, chest over hips, arms out, one hand holding med ball
– pass ball back and forth (see video below)
2 sets of 10 passes (5 to each hand)
3. Face-the-wall Squats
– face wall, feet wide apart
– have chair behind you to catch you if you fall
– toes turned outward 45 degrees and toes one inch from the wall
– pull chest “back” by pinching shoulder blades together and keeping ears over shoulders (head back)
– hands between your legs (finger tips against wall)
– squat down as low as possible while maintaining proper technique
2 sets of 15
4. Hamstring “pops” on exercise ball
– lay on back, feet on ball
– arms at your sides, palms down for support
– lift buttocks off floor and lift on leg up in air
– simultaneously roll the ball towards your buttocks and elevate the leg towards ceiling (see video below)
2 sets of 8 each leg
5. One-legged Quarter Squat with Ball and Foam Board
– pin ball between wall and buttocks (NOT low back)
– place both feet on foam board (NO shoes)
– chest out, arms out (do NOT lean forward)
– lift one leg in the air
– drop into a controlled, quarter squat (NO further, too much pressure on PCL)
– press back up and repeat (see video below)
– make sure foam pad is far enough away so that at bottom of quarter squat your knee is not shifting forward
2 sets of 8 each leg
6. Hip Circles
– Lie on your side.
– Bend bottom knee.
– Point toe of top leg.
– “Draw” as large a circle as you can by moving leg in a circle.
– Go as far UP and BACK as possible.
– reach forward lay forearm flat on ground to keep pelvis from leaning back during exercise
Do 2 sets of 10 on each side
7. Single Leg Pot Stirs on Exercise Ball
– lay on ground
– one leg on ball
– lift pelvis slightly off floor
– palms down on floor for support
– “stir the pot” with foot on ball
2 sets of 8 “stirs” for each leg
Patients often ask me “when should I come back to see you?”
This is a difficult question to answer. In order to help patients self evaluate for their needs of future care, I have developed the following flow chart. Feel free to use it for your own purpose.
please review this Pain Sensation Chart before using the flow chart.
Many patients who have pain in the hip will immediately claim “I have sciatica!” Often this is not the case. This blog entry will help you differentiate between hip pain and true sciatica.
The sciatic nerve is made up of the peripheral nerves L4, L5, S1, S2 and S3. Somewhere near the buttocks these 5 nerves combine into one “hose” of nerves and we call this bundle the Sciatic Nerve.
The sciatic nerve then weaves its way through the muscles of the back of the hip (buttocks region) in order to run down the leg. One of the big muscles that can put pressure on the sciatic is the piriformis muscle. Although any muscle can irritate the sciatic, it is typically the piriformis. This is why pressure on the sciatic nerve is sometimes confused with piriformis syndrome, a condition in which the piriformis is injured or strained and emits posterior hip pain but does not necessarily impact the sciatic nerve. Buttocks or hip pain without pain going down below the knee region is not sciatica.
Interestingly, the sciatic nerve often has two branches before combining into a single branch below the buttock and one or both of these branches can run over, under or through the pififormis muscle. Either way a tight piriformis will pressure the sciatic nerve and cause symptoms all the way down the leg because that is exactly where all these nerves end up.
A single nerve — such as L4 — only “feels” a small section of skin sensation down your leg, so if you are pinching the L4 nerve, only the stripe of skin innervated by L4 will be numb, in pain or give a burning sensation. But because the sciatic nerve contains several nerves combined into one large bundle, the skin region affected by sciatic nerve pressure covers larger areas of skin (sometimes most areas) than a single nerve would. So, often, most of the leg is affected and undergoes changes in region and sensation.
So, if you can check off the following, you may be suffering from sciatica.
1. pain in the back of the hip (buttocks)
2. pain, numbness or burning sensation travelling farther down than the knee region
3. pain, numbness or burning sensation that covers a large area of skin (e.g.: both sides of calves/foot/thigh)
If you suspect you are indeed suffering from this condition the clinician you visit for confirmation and treatment should apply the following:
1. active release to the hip muscles to break down scar tissue and loosen the muscle(s) off the sciatic
2. PNF stretching of the posterior hip muscles to loosen the muscle(s) off the sciatic
3. teach you proper lifting/sitting ergonomics to keep the hip muscles from tightening up again.
4. prescribe home exercises and therapies to keep the hip muscles from re-aggravating the sciatic nerve.
Best of luck!
As men pass the age of 40 their natural testosterone production is well in decline. As our testosterone decreases our estrogen increases. Continue reading
Please click below and download our FREE one month rehabilitation calendar. This is to help you keep yourself on track to perform the customized rehabilitation exercises that will get you better. Best of luck!
click: REHAB CALENDAR-1vf7ww5
As we get older it is easy to tell ourselves to “slow down” and “act our age.” In some ways there is wisdom in these statements. However, many forty-plus year-olds take this mantra too far. They stop playing their favourite sports because they do not want to take undue risks. Social circles can also take a hit as we become very career and family focused. Our worlds get smaller and smaller. In a sense people in their forties begin to prepare themselves for death decades ahead of time. You may think this is a dramatic way of describing the natural process of aging but hear me out.
I understand that we have to be aware of the changes our bodies go through as we age. And hitting your forties does mean some things have changed. At 36 years of age I tore my inner calf muscle doing 42 inch box jumps. Now, I had warmed up and stretched and had slowly worked my way up to these over a period of years. But still, my muscle ripped. This would not have happened at 26. So I decided to omit highly ballistic exercises to forego anything worse happening. I adjusted to my age. Yet I still lifted very heavy weights. I also began to practice jiu jitsu. Having wrestled in school and university, grappling came natural to me and jiu jitsu is slower paced than freestyle wrestling. So even though I “slowed down” I didn’t downgrade my efforts or time spent pursuing fitness, I simply shifted my activity to something more intelligent. In May of 2017 I even competed in the highest profile jiu jitsu tournament in British Columbia. At age 42 I entered the 30 year-old division and won first place. The weight cutting and training camp was difficult and competing against athletes 10 years younger was daunting. But I took the challenge and succeeded. You don’t have to have that lofty of a goal, but it does highlight what is possible.
MMA fighter Randy Couture won the light heavyweight title at age 40 and defended his belt against a 28 year old challenger. He also won the heavyweight UFC title at 44 years of age against a much larger 32 year old opponent. Finally Randy retired at age 47 from professional MMA. Remember that long time NHL hockey player Chris Chelios played until he was 48 and even in his mid forties the Red Wings fitness coach said he was as fit as the 30 year-olds on the team! Jaromir Jagr is still playing NHL hockey at 46 and two years ago was one of the team leaders in points at 44 years old. At least two Olympian medalists during the 2016 Games in Brazil were in their forties. All this to say that you don’t have to hang up your hobbies just because you are in your forties. If you treat your body correctly, you can stretch your athletic prime farther than you think.
Now, let’s say athletics are not your thing, you can push your intellect instead. After finishing university in my twenties, I continued to read copiously. Instead of being “done with all that learning stuff” I put my skills to use in a more varied manner.
I read history, philosophy, science and religious texts. No longer being bound by tests and heavy class schedules, I was free to expand my mind. Even though our learning speed decreases after your twenties, the ability to make accurate decisions continues to rise until your late 60’s and usually is maintained for years afterwards if you use your brain. So instead of being done with learning, I was only beginning. And I continue to devour knowledge. One of the most common traps once our careers are established is to simply entertain ourselves during our down time. Instead, I choose to educate myself. “Use it or lose it” is a catch phrase for a reason. Continued mental challenges keeps your brain young.
I continue to challenge myself in the business field as well. I am planning on shifting my work to focus on both sports medicine (working with a professional team) and eventually to hold an academic position part time then full time. The continual shape shifting of my goals in all areas of life keeps me feeling, acting and thinking young.
As a father of four kids, I am also challenged in terms of energy and time. But I have taken this challenge head on and have reaped the rewards. Many people in their forties are really winding down and foregoing many activities and goals they could still do. But the body follows the mind. If you have decided to stop challenging yourself you will slowly convince your brain and body to get old quicker than it needs to.
Why would anyone ever do that?