Posts Tagged ‘osteopath’

Viewer question: Cracking your own back….

Tuesday, December 28th, 2010

I received this question on my Facebook fan page.

I have a question about hyper mobility, and or releasing pent up gasses between vertebrae. In other words, I creek and crack a lot after 40 years of skiing, and swimming, and biking, and throwing myself off cliffs and cracking ribs, you know, that sort of thing. Should I ask it on your blog? When I do “crack” my neck, or lower back by stretching, it feels fantastic! I am in no pain, unless I sleep wrong, and this releases it. What is this?
-Adam

FIrst, I should begin by saying, that if the ‘crack’ does not induce pain, it is probably not doing you any harm. My grandmother used to tell me that cracking my knuckles would cause arthritis, and in spite of this, I did it anyway (sorry Grandma.) When I was in medical school, I started to wonder if this was true, and after exhaustive research employing a whole host of medical student lackies, I can state that there is no evidence that cracking your knuckles (or your back) will cause you arthritis.

Now, there have been informal studies that have shown that when you crack your own back, that you are usually unable to ‘self-correct’ the segment of your spine which actually needs to be moved- you are cracking the ones above or below it. It may provide you some relief, but ultimately it may not fix your underlying problem and you may find yourself in the same discomfort an hour, a day, or a week later. Having the correct segments adjusted by your Osteopath or Chirppractor may give you longer lasting and ultimately more satisfying results.

As for the release of pent up gasses- yes, there is a school of thought that believes that the sound you hear when you have your spine corrected is actually the shifting of nitrogen bubbles within the joint. After further research (and more lackies) I have found that there is no conclusive evidence about what that crack may actually be. As an aside, in my own practice, i do relatively little ‘cracking’ of the spine as my approach is based more on gentle mobilization. You would not believe how often I hear sounds of disappointment when patients realize they are not going to hear that loud ‘CRACK’ when I adjust them- they have come to associate that sound with relief.

I hope this answers your question. Thanks for visiting the blog.

-Andy

And once again, the stately grounds of Chez What are blanketed with snow.

B.T.T.o.D: For the bodyworkers and therapists out there- Change the height of your table!

Thursday, May 20th, 2010

My mentor was a the Yoda of Osteopathic medicine, and to his detriment, was also a gentleman. I say this not because it is a bad thing to be a gentleman, but because he was too good a guy to ask the nurses and OR staff to stand on steps when he did surgery. Instead at 6 foot 4 inches, he would lower the table, and do surgery hunched over to accommodate them. The result was that he spent the later part of his life shaped like a question mark.

If you are an Osteopathic Physician, Chiropractor, Massage Therapist, or other type of body work specialist- purchase an adjustable height table (well worth the investment), and vary the height throughout your work day. Certainly there is a range of height appropriate for the patient you have on your table, but by moving it around, you will prevent yourself from structural compromise over time.

Stop back tomorrow for tips on making commuting a back friendly endeavor!

-AndyL1010348

Your are wasting your money going to your Chiropractor, Osteopath, Physical Therapist, etc…

Monday, February 22nd, 2010

I knew this tagline would get someone’s attention. I am not above being a little provocative if it will help me to make a point. So now that you are here, let me tell you a short story, which I was reminded of when editing this weeks ‘The One Thing’….

I was seeing a 32 year old mother of 3 for her back pain- let’s call her ‘Sue’- and after seeing her weekly for about 8 weeks, I managed to get her essentially pain free. We discussed her workout regimen, some home exercises I wanted her to do, some ergonomic things she could do around the house, and a few other things before I sent her home.

When I get someone to the point they are feeling pretty good, my goal is to see them for occasional maintenance, perhaps every 6-9 months- with the option of them coming in sooner if they ever had an exacerbation. I never got into the whole ‘I need to see you every week for the rest of your life’ thing (the exception being some of the professional athletes I work with who put themselves in harms way pretty regularly.) I booked Sue for six months, and she was so happy for her relief.

I came into my office one morning about 3 weeks later, and there was Sue- looking none-too-happy with me.

I asked Sue what brought her in. She had full return of her pain, and was incredibly frustrated by her setback. I didn’t want to discuss this in the waiting room, and scare off other patients, so we went back into the treatment room.

Had she fallen, been injured, over did it in the gym?  No- none of the above- her pain was back and she was pissed.

She got up on my treatment table and I began to palpate her spine. Lo and behold, her spine was right back where we had started. It was as though I had done nothing at all. It was at this point, I pursued a different line of questions….

Had Sue taken any of the ergonomic suggestions we discussed for her house? No.

Had Sue been doing any of the specific exercises I had prescribed to help keep her back moving? No.

Had Sue changed her child care situation to involve her husband a little more, so she wouldn’t be the only one picking them up? Nope.

Basically, she left my office the previous visit feeling great- did none of the things we discussed to help maintain her wellness, and was really annoyed when her pain came back.

Here’s the bottom line: If you are going to a Chiropractor, Osteopath  -or anyone else who does manual medicine or body work- you are wasting your time and money if you don’t address the lifestyle issues which caused your back pain in the first place. Back pain is not just a structural  thing. I talk about the pain triad with many of my patients- that is the essential 3 things which I feel contribute to back pain. They are as follows:

Structural issues: These are what they sound like- problems associated with basic structure and function. These things can usually be measured or imaged with x-rays or MRIs, and they can usually be fixed with manual medicine, therapy, and addressing underlying ergonomic concerns.

Psychological Amplifier: This is the part of your mind which gets frustrated or annoyed with the effect back pain has on your life, and can actually make it worse.

The Learned Neurological Response: This is the part of your central nervous system which controls modification of your normal body mechanics in order to find less painful ways of functioning following an injury or compromise, and sometimes has a difficult time resetting once the structural cause of pain has been addressed.

Almost all of my patients have each of these factors contributing to their discomfort- perhaps to different degrees, but they are all there.

For you to really control your back pain, rather than having it control you- you need to look into each of the components of your back & neck pain, otherwise you will forever be at the mercy of physicians and therapists to find relief from your discomfort- and throwing money out the window. Really- give this some thought the next time you experience an exacerbation. Take your practitioners suggestions and information- and use them!! This is the only way you will find lasting relief.

Best,

Andy

One week to the Philadelphia Flower Show- Spring is four weeks away!

One week to the Philadelphia Flower Show- Spring is four weeks away!

Back pain odds & ends- the Olympics, Chiropractors & Osteopaths wasting your money treating your back pain, viewer fitness updates…

Sunday, February 21st, 2010

Following the Olympics:

I subscribe to google alerts for different stories relating to back and neck pain. This week, I have read about a hundred stories about olympic athletes and their back and neck injuries. If I hear one more interviewer ask the question ‘why do you think so many olympic athletes are having injuries?’ I will blow a cork! Aren’t there better questions they could ask? How about questions about their love lives? What kind of car are they drivin’?

Olympic and professional athletes are training at a much higher level than most of us ever will. Now, I know you are saying to yourself  ”Aren’t they in peak condition? Shouldn’t they have less injuries?” Well, sure they are in peak condition- but if you look,  pretty much all competitive sports (save for maybe curling?) have become ‘extreme sports.’ The overall stats for lifting, jumping, running, endurance- most metrics used to rank athletic performance- have all jumped by leaps and bounds. There are records from Olympic games earlier in the 20th century, where commentators essentially declared that we were approaching the limits of human performance. WOW- how wrong they were! Virtually every major record has been beaten in the past 2 sets of Olympic games. The technology to make us all faster, stronger, better nourished for endurance, and with better performance psychology has advanced so far- but in the end we are all limited by the laws of physiology, and ultimately gravity. As you reach the higher echelons of performance, you are more likely to be injured, regardless of conditioning. Now that being said- the Olympic athletes have access to training and knowledge to help minimize their likelihood of injury- but there is only so much you can do.

Sports Illustrated photo from the Olympics- One of the few photos you will find here I didn't take myself. Please don't rat me out...

Chiropractors, Osteopaths, Physical Therapists, and all the rest- are all a waste of your money!

You may have read my ‘coming Monday’ post earlier in the week. I suppose the search engines latched onto the tag line- because I have gotten a ream of hate mail, primarily from Chiropractors and Physical Therapist. ‘How dare you call my work a waste of money- I help a hundred people a week with their back pain!’

Have you ever been on this blog before? If you read back a few posts and see what I am about you will know that I am not here to bash anybody. How about reading the post first? I am not calling any body a quack- and I am certainly not about to tout my work as any better than yours- wait and give it a read.

Fitness  Challenge Update

People must have thought I dropped the ball on the fitness challenge until they read the post yesterday. Thanks for the updates some of you sent in. I am so glad you are choosing to do this along with me, and hope we can all talk at the beginning of 2011 about how we met the challenge, and lived up to our New Years Resolutions!

Have a great remainder of your weekend.

Andy

B.T.T.o.D: For practitioners: Change the height of your treatment table regularly.

Thursday, February 18th, 2010

This one is geared largely towards Osteopaths, Chiropractors, Physical Therapists, Massage Therapists, etc…

Throughout your day, vary the height of your treatment table- not only to accommodate the size of your patients/clients, but also to keep your spine from getting acclimated to one position. There are many older practitioners out there with severe kyphosis due to the limited movement of their treatment tables- take advantage of the tools you have available, and change the height of your table throughout the day.

Best,

Andy

I-Technique 14-Sacral Circle 2

Your Chiropractor/ Osteopath/ Physical Therapist is wasting your money!

Wednesday, February 17th, 2010

Please check in Monday to find out how visiting your favorite physician or therapist is a waste of your hard earned money.

In the mean time, I hope you will find my series on back pain informative- Please share any surgical experiences you have had here on BackWords. Your thoughts and contributions help to keep the blog interesting.

Be well!

-Andy

current headshot

B.T.T.o.D: Remaining adequately hydrated will help to reduce your back pain.

Thursday, January 14th, 2010

Again, this may sound like an obvious one- but remarkably, most people do not drink enough fluids throughout their day. Keep in mind, DIET SODAS DO NOT COUNT. The adage about 8 glasses of water a day is a good one, and may have the added benefit of controlling your appetite if that has been an issue for you. Also, be sure to take in fluids which will replace your electrolytes- juices are a great place to start, provided you don’t overdo it as they are typically high in sugars.

Hydration will help to flush out toxins from your tissues, and deliver needed electrolytes to your muscle tissue, preventing fatigue and injury.

Best,

Andy

Great Physical Relaxation Techniques, by contributing author, Donna Kirschner, PhD

Wednesday, January 13th, 2010

Donna uses many relaxation techniques to help the couples she works with in her natural childbirth classes, to deal with the pain of labor and delivery. I asked Donna to outline how the technique works, and how it applies to the couples-based approach of Back Together:

One of the most effective techniques that we offer laboring couples, the tension/relaxation body scan, can be a great way to promote relaxation under any circumstance. You can work this technique as a couple or alone.  It works any time of day and some people find it especially helpful to promote sleep.  I often used it on my daughters if they’re a little antsy at bedtime.  When you work on it as a couple, you have the added benefit of the partner learning what tension and relaxation actually feel like in each of the muscle groups.  I will refer to the person experiencing the relaxation as the “subject” and the person guiding the technique as the “partner.” My husband and I have found that this type of technique is great for helping with back discomfort.

This technique works best when lying down, but can work anywhere in a pinch.

Have the subject lie down in a comfortable position.  Beginning with the forehead as them to tense up the muscle group.  Then say something like, “This is tension.  This is what we want to eliminate.”  Then ask the subject to relax and affirm that action with, “This is relaxation.  This is what we want.”  Next, take  the subject through the following body areas, using the same procedure of tension/relaxation and the same script:  Have them: scrunch up and then relax their nose and cheeks, clench and then relax their jaw, tense and relax their neck, shoulders, upper arms, lower arms, hands, chest, stomach, groin, buttocks, thighs, calves, feet and toes.  When you have completed this body scan, have them tense and relax their full bodies.  Remind them that they are in a state of physical relaxation and that this is good.

Many people find that it helps if the partner touches each of these areas.  This helps both because it physically guides the subject and because it teaches the partner what tension and relaxation feel like in the subject’s body areas.

You may find over time that you can alter the script a bit, making it your own.  The key is to work together to promote a sense of relaxation for both of you.  I also urge you to reverse the roles every once in a while.  This benefits both the partner, who then gets to receive the relaxation and both partners by promoting a sense of empathy.  Have fun with this and happy relaxing!


Thanks Donna.

This is just one relaxation ‘script’- I found a website which outlines a whole bunch, and while they are kind of crunchy, they do seem helpful. Take a look here.

It sounds like telling someone to relax would be an obvious help for pain conditions, but you would be surprised how few people take the initiative to give themselves the gift of a few minutes of relaxation a day. Keep in mind that physical relaxation and mental relaxation can both have positive benefits and that some activities can relax both the body and mind. One thing I do is try to set aside a small portion of every day to play the piano, and both my body and mind are acutely aware of the days when I don’t find the time.

The magnificent Black Forrest Steinway.

The magnificent Black Forrest Steinway.