Half Full or Half Empty Matters to Your Health

How you view the world and your place in it affects the quality of your health!  Google optimism and this is how it is defined:  hopefulness and confidence about the future or the successful outcome of something.  Do the same for pessimism and this is what you get: a tendency to see the worst aspect of things or believe that the worst will happen; a lack of hope or confidence in the future

So, are you an optimist or pessimist?  Do you look for the good or the bad in people and situations?  Do you see a silver lining when things aren’t going your way? Do you see the glass as half full or half empty?

If are an optimist you are more likely to have better health, fewer colds, and a lower chance of getting cancer and heart disease.  Study after study has demonstrated that quality of your mental and physical health is better if you are an optimist.

The most recent study was published last month (12/2016) in the American Journal of Epidemiology. It showed a positive relationship between optimism and mortality in more than 70,000 women over a 6 year period.  The optimistic women in this group were 29% less likely to die of any cause!

There are several objective questionnaires that can determine if you are an optimist or pessimist.  You can find them on-line, but I think most people already know what they are.

Both in my personal and professional life I am an optimist and stay as positive as possible.  I am also a realist in that I know conditions I can treat successfully and what I can’t.  Those patients that I can’t help get referred to the correct provider.

I had a learning experience a few years ago when my optimism may have worked again me.  A patient who did not follow my treatment recommendations contacted me.  He stated when I told him he had arthritis in his spine I did not take it seriously and that is why he did not follow through with his treatment plan.  Reflecting back, I think I explained the situation correctly but took it as a learning experience.  Arthritis is degeneration of the spine.  I call it rust. It is not a normal part of aging and is caused by long term dysfunction in the spine.  It needs to be treated correctly and aggressively.  My mistake was that I told him that if we treated his arthritis and he went through my recommended treatment plan, his pain would be relieved, his function would improve and more importantly we could slow down, or even arrest the progression of his spinal arthritis. What I didn’t do, and what he needed to hear from me was that arthritis is a serious diagnosis.

Looking back, I did tell him arthritis was serious, but in a positive way.    Having spinal arthritis is not good news, but it is doesn’t mean you are doomed.  What I should have done, and do now, is tell my patients that arthritis is serious, but 30+ years of clinical experience have given me the confidence to say that if treated correctly arthritis does not have to be debilitating.   I now show before and after x-rays of patients who followed my advice and those who didn’t.  Prior patients who followed through on my recommendations had no progression in their arthritis, and those who did not and returned 5+ years later all showed a progression in their degeneration.   The patients who followed my recommendations and in spite of having arthritis are active and enjoying life!  .  It means you need to treat spinal arthritis correctly and then afterwards maintain that correction like oiling a rusty hinge, or wearing a retainer after your braces come off.

Maybe I was too positive, or maybe this patient was too pessimistic.  I don’t know.  Now I ask questions during my consultations to see if a patient leans more to being an optimist or pessimist and give my explanations accordingly.  I always discuss the seriousness of the diagnosis and offer hope with a detailed recommendation to get them out of pain and on with life.

So what are you, an optimist or pessimist?  If you want to live a long, healthy life, being an optimist improves your odds.   If you are a pessimist how do you become an optimist?

I can tell you all the things you heard before and you dismissed including: avoid other pessimists;  count your blessing; be positive; forgive others; smile more and frown less; exercise regularly; eat healthy and to stop blaming others.  Which are proven strategies to be more optimistic.

My favorite method is to write down 3 things every day that you are grateful for.  Try it!  It’s a New Year!  Start a new habit.  It can take less than a minute to do. Look at the brighter side of life! If you want to live a long healthy life, being more optimistic has been proven to make you healthier!

I wish all of my patients and friends a Healthy New Year!  At Performance Health Center we are committed to getting and keeping you healthy in a positive, supportive and caring atmosphere!

Continue with Sunscreen into the Fall Months

Happy September!  September in New England usually has amazingly nice weather; cooler nights and warm and sunny days with lower humidity- which makes outdoor activities even more pleasant.  Just remember even though the days are starting to get shorter and the temperature is starting to drop somewhat you still need protection from the sun.  The President of The Skin Cancer Foundation Dr. Perry Robins warns us… “It’s not just the sunburns that usually occur during the summer or on summer vacations that are associated with skin cancer, it is all of your lifetime sun exposure that adds to your risk of skin cancer.”

Remember that clouds filter out the light from the sun, but not the UV rays from the sun. Ultraviolet A and B (UVA and UVB) light are the cancer causing wavelengths. UVA is present year round, at all times of day, and is unaffected by a cloudy day.


Most of us are exposed to large amounts of UVA throughout our lifetime. UVA rays account for up to 95 percent of the UV radiation reaching the Earth’s surface. Although they are less intense than UVB, UVA rays are 30 to 50 times more prevalent. They are present with relatively equal intensity during all daylight hours throughout the year, and can penetrate clouds and glass.

UVA, which penetrates the skin more deeply than UVB, has long been known to play a major part in skin aging and wrinkling (photoaging), but until recently scientists believed it did not cause significant damage in areas of the epidermis (outermost skin layer) where most skin cancers occur. Studies over the past two decades, however, show that UVA damages skin cells called keratinocytes in the basal layer of the epidermis, where most skin cancers occur. (Basal and squamous cells are types of keratinocytes.) UVA contributes to and may even initiate the development of skin cancers.

UVA is the dominant tanning ray, and we now know that tanning, whether outdoors or in a salon, cause cumulative damage over time. A tan results from injury to the skin’s DNA; the skin darkens in an imperfect attempt to prevent further DNA damage. These imperfections, or mutations, can lead to skin cancer.

Tanning booths primarily emit UVA. The high-pressure sunlamps used in tanning salons emit doses of UVA as much as 12 times that of the sun. Not surprisingly, people who use tanning salons are 2.5 times more likely to develop squamous cell carcinoma, and 1.5 times more likely to develop basal cell carcinoma. According to recent research, first exposure to tanning beds in youth increases melanoma risk by 75 percent.


UVB, the chief cause of skin reddening and sunburn, tends to damage the skin’s more superficial epidermal layers. It plays a key role in the development of skin cancer and a contributory role in tanning and photo aging. Its intensity varies by season, location, and time of day. The most significant amount of UVB hits the U.S. between 10 AM and 4 PM from April to October. However, UVB rays can burn and damage your skin year-round, especially at high altitudes and on reflective surfaces such as snow or ice, which bounce back up to 80 percent of the rays so that they hit the skin twice. UVB rays do not significantly penetrate glass.

Preventative Measures:

Seek the shade, especially between 10 AM and 4 PM.

Do not burn.  Avoid tanning and UV tanning booths.

Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.

Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day.

For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB)

sunscreen with an SPF of 30 or higher. Apply 1 ounce of sunscreen to your entire body

30 minutes before going outside. Reapply every two hours, or immediately after

swimming or excessive sweating.  Keep newborns out of the sun. Sunscreens should be

used on babies over the age of six months. Examine your skin head-to-toe every month.

See your physician every year for a professional skin exam.

I definitely recommend that you do get outside and enjoy the great fall weather New England has to offer, just do not forget to continue to use your sunscreen.

If you have any questions about this Blog, or about your health in general, please feel free to contact me at:  drtomball@performancehealthcenter.com

A Split Second & the Road to Recovery, Part 4

I had my 10 week post-surgical orthopedic consult with Dr. McKeon & Jason (his PA) on June 22.  The conclusion is that the rehabilitation of my ACL allograph is going very well, probably ahead of schedule.  I was given the green light to play golf, ( though I hit a bucket of balls the day before).  I was also given permission to start running.  I’m not a runner, per say, and prefer chasing tennis balls.  I did my 1st run over the July 4th weekend.  It was a walk/run and my knee felt great during and after!  I will be gradually building up speed and distance which is the best way to build up my Vastus Medialis Oblique muscle (VMO), which was the 1st to atrophy after my injury.

Special thanks to my PT, Steve Crowell of Rebound Physical Therapy who has pushed me and gotten me to this point.  There seems to be at least 2 ACL Rehab patient’s in the office whenever I have an appointment, though at my last appointment there were 4.  I remember how at my 1st few appointments I was inspired by seeing how patients a few months ahead of me were doing.  Now I am able to inspire the others since I was furthest along.

I continue to do my daily exercises which are progressively more challenging. One of the reasons this Blog and newsletter are late is because my whole life these days are revolving around my rehab exercises.  It takes up a lot of my time, but it needs to be done if I want to resume the active lifestyle I had before my injury, and I do!

A big part of my rehab is cycling.  In the beginning of June I got the ok to cycle outside.  Inside cycling allowed me to watch more TV and Netflix then I have in the last decade but am now caught up too many movies & series.  Being outside is much nicer.  My preference is mountain biking, but I’m not ready to hit the single track trails I enjoy.  Surprisingly I am enjoying the cycling I am doing.  I’ve been exploring all the wonderful bike paths in the area including the Wellesley Aqueduct and both banks of the Charles River.  We live in beautiful area and it is nice to explore many of the communities that make up Greater Boston Proper.  I look forward to getting back into the woods, but until then look forward to exploring more bike paths.

This August I will be getting Biodex testing on my leg.  Biodex provides a high-tech evaluation of my muscle strengths and imbalances which will help drive my rehabilitation exercises.  Dr. McKeon also encouraged a stem cell injection to stimulate and promote healing.  He is finding it to be very beneficial to post-surgical rehab and is building a suite in his clinic dedicated to stem cells.  I’ll keep you posted.

Please enjoy your summers, get outside as much as possible, be active and remember to stretch before and after your activities!

The Health Benefits of Being Thankful

I am writing this month’s Blog two days after Thanksgiving- that time of year where many people begin thinking about everything they have to be thankful for. Although it’s nice to count your blessings on Thanksgiving, being thankful throughout the year could have tremendous benefits on your quality of life.  I am intrigued by the physiological changes that occur in our bodies, when we tap into the cognitive and emotional expressions of gratitude.

More and more researchers are finding that gratitude doesn’t just make you feel like a better person, it’s actually good for your health.

“Clinical trials indicate that the practice of gratitude can have dramatic and lasting effects in a person’s life,” says Robert A. Emmons, professor of psychology at UC Davis. “It can lower blood pressure, improve immune function and facilitate more efficient sleep.”

One recent study from the University of California San Diego’s School of Medicine found that people who were more grateful actually had better heart health, specifically less inflammation and healthier heart rhythms.

“Gratitude works because, as a way of perceiving and interpreting life, it recruits other positive emotions that have direct physical benefits, most likely through the immune system or endocrine system.”

Research shows that when we think about what we appreciate, the parasympathetic or calming part of the nervous system is triggered and that can have protective benefits on the body, including decreasing cortisol levels and perhaps increasing oxytocin – the bonding hormone involved in relationships that make us feel so good.

Perhaps you have a hard time expressing your thankfulness, not to worry as experts say gratitude is something you can learn.

Medical contributor Dr. David Agus explained the findings of a study in which one group of people were asked to write down what they were thankful for every week, while others wrote about their hassles and a third group wrote about neutral topics. “At the end of 10 weeks, the people who had gratitude, who wrote down the gratitude, actually had better self-esteem and they felt better about themselves and their lives. So it works. All of us can improve by just writing down what we care about.”

In fact, gratitude may be one of the most overlooked tools that we all have access to every day. Cultivating gratitude doesn’t cost any money and it certainly doesn’t take much time, but the benefits are enormous.

Be happy for who you are and what you currently have, and smile- when you do this your whole body changes, you release endorphins and not only do you feel better, you function better as well.

So smile and be thankful, and share your smile and thankfulness with others… it will benefit both of you at the same time.

If you have any questions about this blog or your health in general, please feel free to contact me at:  drtomball@performancehealthcenter.com

Prolonged Sitting is Hazardous to Your Health!

Recent research has linked sitting for long periods of time with a number of health concerns, including obesity and “metabolic syndrome” — which is a combination of several conditions that includes high blood pressure, high blood sugar, high cholesterol, and excess body fat around the waist. Too much sitting is also linked to an increased risk of death from cardiovascular disease and cancer.

One study compared adults who spent less than two hours a day in front of the TV or other screen-based entertainment with those who logged more than four hours a day of recreational screen time. Those with greater screen time had:  A nearly 50 % increased risk of death from any cause, and about a 125% increased risk of events associated with cardiovascular disease, such as chest pain or heart attack.

Sitting in front of the TV isn’t the only concern. Any extended sitting, such as behind a desk at work or driving your car can be detrimental. These detrimental effects are not easily offset by spending a few hours a week at the gym or otherwise engaged in moderate or vigorous activity a few times per week.

The solution seems to be less sitting and more moving overall. You might start by simply standing rather than sitting whenever you have the chance, and remember to take frequent breaks from your sitting position.  Do yourself a favor and get up and walk around every 20-30 minutes.

The impact of movement, even leisurely movement, can be profound. For starters, you’ll burn more calories. This might lead to weight loss and increased energy. Even better, the muscle activity needed for standing and other movements seems to trigger important processes related to the breakdown of sugars and fats within the body. When you sit for long periods of time, these processes stall and your health risks increase. When you’re standing or actively moving these processes are kicked back into action.

Decreased Brain Function:

When we are active our body pumps blood and oxygen to the brain which releases several brain and mood enhancing chemicals.  When we are sedentary for prolonged periods everything slows down including brain function.

Strained Neck:

If most of your sitting is at your desk, craning your head forward toward your keyboard or worse yet craning your head down to text, you are putting excess strain on the muscles, ligaments and tendons in your neck.  This will aggravate your cervical vertebrae and can cause pain and vertebral misalignments.

Sore Upper Back and Shoulders;

Forward head posture also affects the upper back and shoulder muscles as well, which can also lead to pain and muscle imbalances.

Inflexible Back:

Repeated bouts of prolonged sitting can lead to an inflexible spine, which in turn can leave you susceptible to spinal injury when doing ordinary things like tying your shoes.  Regular movement keeps our spines healthy as the movement of the vertebrae allows the soft discs between them to expand and contract like sponges which in turn pumps blood and nutrients into the discs to keep them healthy.  Prolonged sitting leads to collagen hardening and lack of sponginess in the discs, and research shows that people who frequently sit for long periods are at a much greater risk for herniated discs.

Weak Abdominals:

Slumping in your chair not only strains your back, but it also leads to weak abdominals.  When we stand or move our abdominal muscles are engaged, but they are essentially dormant when we slump forward in a chair.  In order to stand or to sit up straight you need to counteract gravity and engage your abdominal muscles.

Tight Hips:

Prolonged sitting can directly affect the mobility of your hips.  The sitting position puts your deep hip flexors (Psoas) in a shortened state, and these deep hip flexors actually attach to your lumbar spine.  Tight hip flexors can cause low back pain and very tight hips, and tight hip flexors will significantly shorten your stride length.

Poor Circulation:

Prolonged sitting can also decrease your circulation and cause blood to pool in your legs.  This can lead to varicose veins, swollen ankles and make you more susceptible to dangerous blood clots called deep vein thrombosis.


Soft Bones:

To maintain good bone density we need to do daily weight bearing activity, and prolonged sitting and/or lack of activity is directly related to an increased incidence of early osteoporosis.


So what can you do?


If you do need to sit for your work, try sitting on a stability ball or a backless chair that requires you to engage your core muscles.  If you do prolonged driving or you are “stuck at your desk” for prolonged periods of time, make sure to take regular breaks to get up to stretch and walk around on a regular basis.  Ask your employer to install an adjustable work station so you can alternate between standing and sitting.  Let them know that this will improve your productivity.

Stretch on a regular basis.

Physiologists have determined that we lose our strength and flexibility much faster than our endurance, and flexibility is the easiest to maintain as we age, it just takes a little time and effort to stretch daily.



When sitting, remember to maintain good posture: Your ear, shoulder, elbow and hip should all be aligned.  When you stand make sure to maintain good standing posture as well.

If you have questions on how you can improve your posture please feel free to contact me at:  drtomball@performanchealthcenter.com

Or better yet- attend my next Postural Restoration Workshop to be held from 6:30- 7:30 pm on Tuesday October 27, 2015.

Is Your Wallet Causing You Pain???

How many of you are still walking around, or better yet sitting, with the good ol’ “George Costanza” wallet in your back pocket?  I bet many of you are  In all honestly, it doesn’t matter if the wallet is thick or thin, keeping it in one’s back pocket can definitely be the cause, or partial cause, of low back pain or sciatic symptoms.

Though made more popularly known by a “Seinfeld” episode on TV in the 90’s, there is published information on this topic as far back as 1966, in The New England Journal of Medicine.  This condition has become more and more common over the years.  I have seen dozens of patients in my office over the past 8 years in regards to having some generalized chronic low back pain come on, or various “sciatic” symptoms arise due to carrying and sitting on a wallet for prolonged periods of time.

In regards to sciatic pain caused by a wallet being sat on, the object presses on the piriformis muscle that lies underneath the gluteal (butt) muscle.  The sciatic nerve usually runs underneath the piriformis muscle.  Pressing on the muscle structure irritates the muscle over time and cause inflammation to and around the area.  This causes pressure to be put on the sciatic nerve (which runs down the back of the leg), then gradually provoking sciatic symptoms.

Some patients present with localized or generalized low back pain in regards to sitting on their wallet as well.  Over time, this being a gradual onset usually, the wallet causes one side of the person’s hip to be elevated.  This puts more pressure on one side of the low back then the other, usually causing localized and achy low back pain on one side verses the other.

Wallets are not the only culprits here, but everyone should get the idea/point here.  If you are someone that does carry their wallet in their back pocket, I strongly urge you to stop, and if you are someone that may be experiencing pain or symptoms from this, please contact your chiropractor in regards to proper care and treatment protocols.  As always, you can contact any of the 3 doctors at Performance Health Center to help guide you in the right direction, www.performancehealthcenter.com.

What Does Kinesio® Tape Do Again…?

We have been using Kinesio-Tape at Performance Health Center for years help treat musculoskeletal conditions, and have had great success in doing so.  In fact, I am wearing some right now as I type this month’s article.  I was doing a trail run the other day, mostly likely from the uneven terrain, and strained my calf.

However, no matter how many patients I tape, or how many different conditions I tape for, and how well I explain what the tape does, I am always being asked the same question, “What does that tape do again?”

Kinesio-Tape was developed over 45 years ago by a Japanese chiropractor who was looking for a way to keep his hands on his patients after they left his office. In 1988, Kinesio-Tape was accepted and used by Japanese Olympic and professional athletes.  Following that, the tape started spreading across the world.  It was really the colorful tape patterns being displayed on the Olympic beach volleyball players at the 2008 Summer Olympics that really increased the popularity of the Kinesio-Tape.

Kinesio-Tape is a stretchy cotton elastic strip.  The tape is thin, mimicking the skin’s pliability and thickness.  There is an acrylic adhesive on the under side of the tape to help it adhere to the skin.  The tape therefore does not restrict or constrict one’s movement, and prevents the tape from slipping.  The tape provides dynamic support, helps protect muscles and joints, and allows for safe and functional range of motion of the taped muscles and joints.  The Kinesio-Tape supports the part of the body being taped, helps to provide pain relief, and control the parts affected by muscle inhibition.  The tape can provide tactile feedback through the skin to help with proprioception as well.
When treating a large variety of musculoskeletal injuries and conditions that are inflammatory, the characteristics of Kinesio-Tape are very important.  Because of its adhesive abilities, this increases the tape’s therapeutic value.  The tape can be left on for several days, and is able to provide therapeutic benefits throughout the day.  This can help to increase the ability for a traumatized area to heal by helping to decrease inflammation.  To do this the tape provides a “passive” lift to the skin due to the elastic properties of the tape and how it is applied.  Creating a “lift” to the skin and moving it away from the inflamed tissue allows the lymphatic and venous systems to drain more efficiently, helping swollen or bruised tissues to heal quicker.  This is also thought to be helpful to remove excess build up of lactic acid post exercise to help decrease the onset of delayed onset muscle soreness (DOMS).  The tape can also be worn during exercise, and can hold up through showering/bathing, and swimming.

I hope this simple but more detailed explanation helps everyone understand will a little more ease what Kinesio-Tape’s actual therapeutic value is.  We are not just putting it on our patients and athletes because it “looks cool”.  We tape of all kinds of injuries and conditions. We also carry all four colors of the Kinesio Gold Standard Tape (which is the tape I prefer and recommended properly by the Kinesio-Taping Association) in our office (blue, pink, black, beige).  We have over many self-application videos on the Self-Care section of our Website- https://www.performancehealthcenter.com/kinesio-taping-self-application/   As always, we are here to offer our insight and recommendations, and to tape you professionally as needed.



5 Dangerous Words

“Maybe it will go away”.  I hear these words almost every day I am in the office working with my patients as it relates to the pain syndrome(s) that brought them to seek my services.  There is usually a time frame around these words.  Some people wait a week, some a month and at times years before seeking treatment .  They all hoped the pain would go away.  Sometimes it does, like the stubbed toe, the scrape and the road-rash or burn.  At times people do feel better, but the reality is they just got used to the pain.

Pain is your body’s way of telling you something is wrong.  Quick, appropriate attention is what your body is looking for.  Pain is the like the idiot light on your car telling you that something is wrong.  If you reach under the dashboard and cut the wires and keep driving, the signal is no longer there, but the cause of the problem remains.  Ignore the signal long enough and your minor repair becomes a major overhaul.

Your body is the same way.  Our minds have been brainwashed by drug advertisers that if you have pain, you need to take medication.  There is a whole smorgasbord of pain relieving options out there from the over the counter pain meds, to the very strong and addicting opiates which have gotten too much press these days.

We have been lead to believe that these pain medications actually relieve pain.  A new study published in the British Medical Journal in March 2015 asked this very question about Acetaminophen.  There are over 600 Medications on the market containing Acetaminophen, most commonly known in the US as Tylenol.  To set the stage, 27 billion does of acetaminophen are taken in the US annually, and as a consequence there are 78,000 Emergency Room Visits resulting in 33,000 hospitalizations every year

The objective of the study was “to investigate the efficacy and safety of paracetamol (acetaminophen) in the management of spinal pain and osteoarthritis of the hip or knee.”

The results of the study as it relates to neck and back pain found, “there was ‘high quality’ evidence that paracetamol is ineffective for reducing pain intensity and disability or improving quality of life.  For hip and knee osteoarthritis there was ‘high quality’ evidence that paracetamol provides a significant, although not clinically important, effect on pain and disability in the short term.”

The results also found, “ ‘high quality’ evidence showed that patients taking paracetamol are nearly four times more likely to have abnormal results on liver function test, but the clinical importance of this effect is uncertain.”

Non-Steroidal Anti-Inflammatories  NSAIDs) also have their risks as well.  There is well published but not well publicized evidence that there is a short term benefit in pain relief, but a long term detriment of increased scaring to damaged muscle.  That is not to mention the effect of most medications to the kidney, liver and digestive track.

When you have pain, don’t mask it with medication.  Yes, there are times that the pain is so bad you may need pain medication so you can manage.  There are more effective ways of relieving pain without the side-effects of pain medication.  They include rest and ice.  You can’t have pain without inflammation.  Ice is the safest analgesic, or pain reliever known.  It is cheap and effective and can be localized to the source.

If icing, resting and avoiding painful movements do not reduce the pain that is a great time to call us.  At Performance Health Center we are experts at getting people out of pain and back to their lives.  The 1st objective is to find out what is causing your pain.  Is it joint, nerve, muscle, tendon, or something more pathological?  We know what we can treat and when to refer.  We have techniques, to accelerate the healing process of injured tissue.   Treatment may include manipulation, Active Release Technique ®, Kinesio® Taping, Electric Muscle Stimulation and traction.  Injury prevention is also a big focus of our practice.

We can also recommend nature pain-relievers and anti-inflammatories which have no side effects.  My favorite is Inflavinoid from Metagenics, which is made of Turmeric, Ginger and Boswella, which reduce inflammation and offer pain relief without any side-effects at all!

So if you, or someone you know has been saying those 5 dangerous words, ”maybe it will go away,” for too long, please give us a call and we’ll do our best to get you back on your feet and on with your life as quickly as possible so you can enjoy summer!



Got Back Pain…?

Having recently “tweaked” my own back this weekend while helping a friend move some furniture, I was reminded how easy it is to strain your back even with the best intentions of using good ergonomics etc…  This had me thinking that this would be a good time to write about some basic facts and myths about back care. Low back pain is the single leading cause of disability world wide, this is according to the Global Burden of Disease 2010.  Another fact; back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper respiratory infections. Most cases of back pain are mechanical and are not caused by serious conditions such as fractures, infection, arthritis or cancer.

The back is a complicated structure of 33 bones, 135 joints, and hundreds of ligaments and muscles that attach to these bones and joints. You can easily strain some of these muscles, or easily sprain some of these ligaments, and/or irritate some of these joints, all of which can lead to back pain.

While falls, accidents, or sports injuries can cause back pain, sometimes it is the simplest of movements—for example, picking up a towel off the floor— that can lead to painful results. We also know that poor posture, obesity, and psychological stress can also cause or complicate back pain.

I realize that many people do their own “self search” on treatments for back pain, but please be aware that there are many myths still floating around out there.

A Few Back Pain Myths Debunked:

1). Myth: “You Need Bed Rest”- Truth: Bed rest for longer than a day may actually prolong your recovery.  It is best to keep moving as much as possible.

2). Myth: “You need a narcotic or other strong medication to manage your back pain.”  Truth: Long term narcotic usage can create dependency that is harder to overcome than the back pain itself. These ‘stronger medications’ have many unhealthy side affects; even Ibuprofen (taken in excess) can cause stomach ulcers. There are many natural herbal supplements that also help with pain without these unwanted side effects.  We carry a large variety of Metagenics supplements here at Performance Health Center, and the Kaprex and Inflavonoid are excellent for pain relief.

3). Myth: “Disc degeneration means a lifetime of low back pain”. Truth: Many people have moderate to severe disc degeneration, yet they manage to be mostly pain free through Chiropractic treatments combined with the appropriate exercises. Disc degeneration and spinal arthritis are not a normal part of aging, it shows that you have either injured or abused your spine over a period of time. This could be from a major injury (Macro-trauma), or from years of poor posture and/or restricted motion (Micro-trauma).  Regular Chiropractic treatments can prevent your arthritis from advancing, and it often allows people even with severe arthritis to be able to continue doing all the activities they want to do.

A Federal Government Plug for Chiropractic Care:

The Agency for Health Care Policy and Research- a federal government research organization- recommended that low back pain sufferers choose the most conservative care first, and it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.  Chiropractic spinal manipulation is safe and effective treatment for spine pain.

Reference: (Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.)

Here are Some Tips to Help Prevent Back Pain:

Avoid prolonged inactivity or bed rest.

Maintain a healthy diet and maintain a healthy weight.

Remain active- under the supervision of your doctor of chiropractic.

Work to obtain and maintain proper posture.

Always use good ergonomics when lifting.

Lift with your legs, keep the object close to your body, and do not twist when lifting

Make sure your car seat and workstation are ergonomically correct.

Always warm up, stretch, and foam roll before any of your intense physical activities.

Obtain and maintain good “Core Strength”.

Even if you do all these things… you may still have some occasional back pain, since we occasionally ask our spines to do some things it is not designed to do.  So if you, or someone you know has back pain… for what ever reason… whether it is from driving all day, or trying to lift a heavy bulky object, we are here to help speed your healing process, and get you pain free and active ASAP!

I will be teaching another “Core Conditioning” Workshop Tuesday July 28th from 6:30-7:30 pm.  Please sign up at the front desk, or call (508) 655-9008 to reserve your spot in the workshop.

If you have any questions about this blog or your health in general, please feel free to contact me at: drtomball@performancehealthcenter.com


What is Good Posture, and Why is it so Important?

Posture ranks right up at the top of the list when you are talking about good health. It is as important as eating right, exercising, and getting a good night’s sleep.

Posture refers to the body’s alignment and positioning with respect to the ever-present force of gravity. Whether we are standing, sitting or lying down gravity exerts a force on our joints, ligaments and muscles. Good posture allows the force of gravity to be distributed evenly through our body so no one structure is overstressed.

When an architect designs a building they have to take these same laws of gravity and weight distribution into account, and like a building with a poor foundation a body with poor posture is less resistant to the strains and stresses we experience over the months, years and decades of life.   Poor posture can eventually lead to pain and premature wear and tear on the ligaments, tendons and joints of our spines.

Poor Posture can cause the following:

Limited range of motion – muscles can be permanently shortened or stretched when a slumped-over position becomes your normal position. Muscles and ligaments that have been shortened or stretched no longer function as they should.

Increased discomfort and pain – poor posture can often cause back pain, as well as headaches and pain in the shoulders, arms, and hands as a result of a forward-head position. Rounded shoulders and a forward head position can also trigger neck pain at the base of your skull where the neck and upper back muscles attach.

Pain in the jaw – a forward-head position can lead to jaw pain. This kind of pain known as TMJ, was once considered only a dental problem. Today we know that TMJ pain may also be caused or aggravated by poor posture.

Decreased Lung Capacity – poor posture can decrease lung capacity by as much as 30%.  Try taking in as deep a breath as possible with your shoulders rolled way forward and your head slumped forward, then try it again with your shoulders back and down, and head back over your shoulders. Amazing difference isn’t it?

Low Back Pain – is one of the most common consequences of bad posture. For people over 35, low back pain is often interpreted as a sure sign of age, although it may be related to years of poor posture.

Nerve interference – your spine is the basis of your posture. If your posture is poor, your spine can be misaligned. Spinal misalignments may cause interference in nerve function.

Improper bowel function – even this important bodily function may be affected by poor posture.  While poor posture compresses the digestive system, proper alignment gives abdominal organs enough space that food and excretions can flow optimally through the gastrointestinal tract.  Without the ability to expand properly, the gastrointestinal track becomes constricted, which can lead to gas, constipation and even acid reflux.

Standing Posture

When we look at someone’s posture we first look at the alignment of the weight bearing joints. Ideally from a back view the spine should have no lateral curvature and the legs should be symmetrical without unnecessary angulations at the knees or ankles. From a side view the spine should form a smooth S-shaped curve, bisected by an imaginary plumb line dropped from the apex of the head through the center of gravity of the body. This same plumb line should pass through the middle of the shoulder, the center of the hip joint and ankle joint and slightly behind the knee joint. With this ideal alignment the body weight is balanced over the spine and lower extremity joints requiring minimum muscular effort. This alignment also evenly distributes pressure on the intervertebral discs and avoids excessive stress on the ligaments of the spine.

How to Improve your Standing Posture 
When standing – keep your shoulders back and down, with abdominal muscles engaged to prevent hyperlordosis or excess curvature of your lumbar spine. If you must stand in one place all day occasionally rest one foot on a stool or take breaks to get off your feet for a while.

Sitting Posture

The sitting position is where most of us get into trouble with poor postural habits. This is especially true when driving or using a computer. As we focus on the activity in front of us we tend to protrude the head and neck forward. Because the body follows the head, the thoracic and lumbar spine tends to round forward as well. When this occurs, the weight of the head and upper body is no longer balanced over the spinal column but instead must be supported by increased muscular energy and placing spinal ligaments on stretch. Over time this leads to fatigue and eventually even pain in the neck and upper back. Shoulders rounded forward which occurs for example when your car seat is too far away from the steering wheel further contributes to this pattern of imbalance. Ideally then, the S-shaped curvature of the spine that is characteristic of good standing posture should be maintained in sitting as well.

How to Improve your Sitting Posture

If you work long hours at a desk and have the option, use a chair that’s ergonomically designed for proper support and designed for your height and weight. If this is not an option, try using a small pillow for lumbar support. Align your back with the back of the office chair. This will help you avoid slouching or leaning forward, which you may find yourself doing after sitting too long at your desk. As with standing posture, be sure to keep your neck, back, and heels in alignment. Keep both feet on the ground or footrest (if your legs don’t reach all the way to the ground). Adjust your chair and your position so that your arms are flexed, not straight out. Aim for roughly a 75- to 90-degree angle at the elbows.

Take Standing Breaks

Even if you’re using perfect posture while sitting in the best chair in the world, it’s important to occasionally stand up and stretch or walk around. Your body was not designed to sit all day, and recent studies from the University of Sydney have found that “prolonged sitting is a risk factor for all-cause mortality, independent of physical activity.” So keep moving throughout he day!

Sitting and standing with proper postural alignment will allow you to work more efficiently with less fatigue and strain on your body’s ligaments and muscles. Being aware of good posture is the first step to breaking old poor postural habits and reducing stress and strain on your spine. By putting this knowledge into practice you can prevent the structural anatomical changes that can develop if poor posture is left uncorrected for many years.

When sleeping – sleep on your side with your knees bent and head supported by a pillow, to make your head level with your spine. If you sleep on your back, avoid using thick pillows under your head. Use a small pillow under your neck instead. Avoid sleeping on your stomach.

When lifting – let your legs do the work in order to prevent injury to your low back. Stand close to the object, squat down, bend the knees while keeping your back straight and slowly lift the load by straightening your legs as you stand up. Carry the object close to your body.

If you follow these practices, but still feel discomfort and pain related to specific activities, feel free to make an appointment for a postural assessment, and for some individualized exercises that you can do at home to improve your posture.

I will be teaching a “Postural Restoration” Workshop on Tuesday June 23rd from 6:30-7:30 PM.  Sign up at the front desk or call (508) 655-9008 to reserve your spot in the workshop.

If you have any questions about this Blog or about your health in general you can reach me at:  drtomball@performancehealthcenter.com