What Can You Learn From the Tour de France?

Ever since taking a class in graduate school titled “Comparative Anatomy and Physiology” where we compared humans to other mammals, I realized that we humans are actually one of the slowest of all mammals. Try racing a dog, horse or rabbit, you name it, over a short distance and you will lose time after time. Make the race a long-distance affair and you will beat them all.  Humans have the capacity to do amazing endurance events.  One of the reasons is our ability to sweat all over our bodies making it very efficient at cooling. So, why even bother to try to go fast when we can go long!?!

I have always been intrigued by endurance events and have participated in them over the past 25+ years.  I am writing this blog on the final day of the Tour de France which is arguably the hardest endurance event in the world. Cyclists race, on average, over 100 miles per day for essentially 20 straight days. I thought I would share some of the fascinating facts of the Tour de France and some health lessons that we can learn from this amazing event.

Cycling is one of the best forms of exercise allowing you to really work your cardiovascular system for long periods of time without a lot of impact. Lance Armstrong was quoted as saying that the bicycle is the best piece of exercise equipment ever made.  There is one down side to this though, and one lesson we can all learn from the Tour. Cycling, as great of an exercise as it is, does not help promote bone density – in fact, the average Tour de France cyclist loses bone density throughout the 3-week race. This is due to the fact that the Tour cyclists are essentially non-weight bearing for 3 weeks! They are taught to stay off their feet during every waking moment before and after their race stages. Exercising at extremely intense levels for 5-6 hours for 20 days straight will cause the body to start to catabolize – including muscle and even calcium stores. So, for those of you who do cycling as your primary exercise make sure to add some weight bearing exercise(s) to your routine. One suggestion is weight training – which is a great way to help maintain your muscle mass and maintain your bone density.

A lot of cutting-edge nutritional strategies have been developed by studying the demands of Tour de France cyclists. The average cyclist consumes 7,500 calories per day during the Tour. That is a feat in itself, or should I say feast! Hydration and electrolyte balance are critical and a lot of the sports drinks we all use today have been developed with the Tour de France in mind.

All 180+ cyclists that race in the Tour get daily body work done including Active Release Techniques and Chiropractic adjustments. Lance Armstrong was quoted as saying the most important person on his staff during the Tour de France, as far as keeping the team healthy, was the team Chiropractor.

And as promised some fascinating facts from the Tour:

It may come as a huge surprise, but once upon a time the Tour de France used to be just a bunch of cigarette-smoking, booze-guzzling men riding their bikes on unpaved roads through the French Alps.

The Tour de France Was Originally A Sales Gimick! (Then vs now). In November of 1902, Geo Lefevre, a journalist from the newspaper L’Auto had an idea to boost circulation of the newspaper. The idea was the Tour de France. Two months later in January of 1903, the very first Tour de France was had but the circumstances and details were very different than what they are today. There were only 6 fairly flat stages over the course of 18 days vs. the 21 rather mountainous stages over 23 days of today. There were 60 entrants in the 1903 race vs. the nearly 200 entrants of 2014. 39 riders, roughly 60% of the 60 entrants of the first Tour de France of 1903 did NOT complete the race while only 18% of riders of the nearly 200 entrants completed the race of 2014.

As a result of the Tour de France, not only did Geo Lefevre succeed at boosting circulation of the newspaper, he created a cycling event that would go on to become one of the biggest racing events in the world of sports altogether. That original paper was printed on yellow paper- hence the leader was to wear a yellow jersey, something that they still do today.

The route of the course, and the total distance of the Tour de France changes every year, however the 21 competing teams of 9 riders from around the world can expect to cycle over 2000 miles (3,500 kilometers), up and down many hills and on routes that alternate between clockwise and counter clockwise circuits of France. In the original 1903 tour, the length was 2,428 kilometers.

The average Tour de France rider burns between 7,000-8,000 calories per day. That’s a whopping 123,900 calories over the course of the 21-day race – 123,900! That’s the calorie equivalent of eating 1,625 apples, or 872 slices of cheese pizza from Pizza Hut, or 252 McDonalds double cheeseburgers, or 619 original glazed Krispy Kreme doughnuts! Over the course of the roughly 3,500 kilometers Tour de France; a cyclist will sweat about 1.5 liters per hour totaling 130 liters (32 gallons) for the entire race.

In the 1920’s it was not uncommon for cyclists to share cigarettes while riding. Believe it or not, it was believed that smoking would help “open the lungs” before big climbs.   Now that is crazy!

So, another Tour de France has been completed providing millions of spectators a magnificent event to watch and learn from. Can’t wait until next year’s Tour starts!Tour

If you have any questions about this blog or your health in general or you just want to talk about the Tour you can reach me at drtomball@performancehealthcenter.com

 

Ice Therapy AKA Cryotherapy

Happy summer! We wait all year for these sunny days with long daylight hours. Keep enjoying the HOT weather folks!

This month I want to talk about “Ice therapy” or in medical terms, it is called “cryotherapy.”  You can’t have pain without inflammation. Ice numbs the pain and “shrinks” the inflammation.  It is the natural alternative to Ibuprofen.

What is inflammation?

Inflammation is similar to infection. In both, we are dealing with an area of the body that is warm to the touch, red, swollen and painful. The only difference is that infection has a bacterial component called pus, inflammation does not.

Inflammation is the result of an area in your body that is in distress. For example, too much constant pressure on your low back from sitting all day at your desk. Quick, sudden trauma such as a fall, or slow repetitive trauma such as bending over to pick something up, over and over again. Inflammation creates pain, and pain is the body’s way of protecting you, by letting you know something is wrong. It also stops you from moving, so you don’t get hurt further.

Icing is a “spot treatment” only to be used on the area of concern. Taking an ice cold shower is not the same effect.

So, HOW do you ice?

Let’s use your low back in this example. Say you’re “sore” from sitting all day at your desk. Whenever icing, ALWAYS use an ice pack that is SOFT when frozen. Never use the rock hard ones that belong in coolers. If you ever need a good one, we sell them here at our office for $10.

  1. Lay the ice pack on a blanket on the floor, or on your bed. Never on the couch, couches are not designed to be supportive and you’ll just sink into it.
  2. Take 2 warm/damp paper towels with all the water squeezed out, and lay them ON TOP of the ice pack. They make contact with your skin, not the ice pack. Otherwise you’re just freezing the skin, the towels allow the cold to penetrate to the muscles.
  3. Now lay on your back, on top of the towels. Wherever the soreness is, let it be “front row and center” on the ice.
  4. Have something under your knees so they are bent. Ex. Pillow, foam roller or rolled up blanket under knees, or even feet up on a chair. This takes pressure off your low back. It also flattens your back, so there is more contact between you and the ice.

Contraindications to using Ice:

Open wounds. Skin damage. History of frostbite. Raynaud’s disease. Blood pressure problems involving vasoconstriction.

Indications to using Ice:

Reduced pain. Reduced swelling. Numbs the pain naturally. Natural anti-inflammatory treatment.

Ice is a great way to manage pain. You’re not going to feel better, until the inflammation is down and the pain is reduced. This therapy is a very beneficial addition to your treatment during the healing process.

It’s just one of many treatments that we can incorporate on your road to recovery here with us, at Performance Health Center.

For more information, please contact me at:  drel-turkmani@performancehealthcenter.com

 

 

Stages of Injury and Recovery

As a Doctor of Chiropractic it is my job to help patients move and function better, and to help them recover from injuries they may be dealing with. There is more than just the physical healing that occurs with an injury. These injuries do not have to be life threatening, maybe just enough to prevent you for doing the things you love to do or maybe even prevent you from doing your normal activities of daily living. One thing that you might also want to consider when you have suffered an injury, is whether or not you might be able to get compensation for it (particularly if it wasn’t your fault). If this is something that you are interested in looking into further, the you could check out someone like this indiana personal injury lawyer. Don’t forget though, that although getting the compensation that you deserve for your injury is a good idea, the most important thing to think about is recovering yourself. There is also the psychological aspect of getting injured- which is what I wanted to focus on in this Blog. When we lose someone we love or even a family pet, we usually go through the 5 stages of grief, well that also happens (to a lesser degree) when we lose our ability to do the things we love to do. I wanted to highlight those 5 stages here in respect to getting injured to help lead you towards recovery. It doesn’t matter if you are a professional athlete or just someone who likes to work in their garden, when what we love to do is taken away from us, we often go through these 5 stages of injury and recovery.

Denial

When you first experience the shock of an injury, you immediately begin an internal dialogue in which you try to convince yourself that it’s not that bad. You probably try to run, lift or garden just like you normally do, a typical form of denial that often makes matters worse. Another common thought is that the injury will ease off in a couple of days. If you continue to do your activity of choice you may aggravate the injury. In extreme cases, some people pretend there is no injury.

Anger

Often fueled by thoughts like “Why me?” or “Why now?” you direct anger at yourself for a mistake that caused the injury, or at someone else you think is responsible. Perhaps you got hurt cleaning your gutters, or working in your garden, or an athlete gets hurt during a critical part of the season. It’s natural to feel angry. You might even direct it at family and friends, because they might not understand the sense of loss you have when you can’t do your favorite activities.

Bargaining

In a sense, this is an extension of denial. You accept the injury and endure the pain, but you try to ignore it or overcome it by adapting your activities to avoid the injured area. This usually leads to your body getting out of balance by overcompensating for the injury. Bargaining with your body by overcompensating may actually make the injury worse.

Depression

Grieving over your enforced time off from your favorite activities can lead to a form of depression, at least certainly a distinct sadness. You might feel like the entire season is lost, or that rehab will never get you back to 100%, or, worst case, that you will never finish that project in the yard or never completely recover.

Acceptance

For rehabilitation to be effective, this is the stage you need to get to. The preceding stages are completely natural and understandable. Recognize them for what they are. Just saying that you have to “pull yourself together” is a form of denial. Work through that and other stages by talking to friends, therapists and family. They can help get you to the point of acceptance. If you achieve acceptance early, you can start working on your rehab right away, even while you are going through the other stages.

Getting to a Positive Attitude

Taking positive action will get you to acceptance sooner. No matter how difficult it is, a positive attitude is your best strategy on the road to recovery. Understanding the natural stages you are going through is the first step. No one escapes unscathed from at least some of the stages; they cannot be avoided. Getting back on track takes a dedicated attitude and a commitment to excellence.

If you are dealing with any kind of injury that is keeping you from your favorite activities, please come in for an appointment here at Performance Health Center and we will do our best to get you back to doing the things you love to do. Your body and your mind will thank you for it.

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

An Interesting Take on “R.A.”, aka- Rheumatoid Arthritis!

I was just visiting at home over this past Thanksgiving break, helping out, and doing Active Release Techniques®  (ART) on the hands of my highly active grandmother of 85 years young, and chatting about her issues with Rheumatoid Arthritis, commonly called, “R.A.”.  For those of you who are not aware, R.A. is an autoimmune condition.  Unfortunately the immune system goes after and attacks its own tissues, and in regards to this condition, the joints.  The immune system recognizes the cells and tissue as an invader, and is constantly attacking certain joints of the body more then others.  In the long run this ends of triggering chronic inflammation in the body, which equals pain surrounding the joints usually.

The most common form of “standard medical treatment”, our nemesis, is prednisone, BOO…  In the short run this drug can definitely reduce pain, but acts more like a bandage.  There are also many bad side affects in regards to using prednisone for the long run as well.  Many of those side affects have been made very well aware of to the general public over the past few years, including weakening the immune system.

What if we were to think outside of the box for a little bit?  Just bare with me here… Don’t you think it would be a good idea to understand where this autoimmune condition is coming from?  Can you even guess?  What are the more advanced and validated medical researchers these days saying where many, if not most conditions are coming from?  The gut, obviously!  With all of the research out there now on R.A., it is showing a huge connection between the two.

Many of you may be familiar with “Leaky Gut Syndrome”, and if you are not, it is a condition in the digestive tract where these tiny holes are created.  Factors such as poor diet and poor environmental conditions cause these little holes where the intestines are supposed to be so tightly bound together.  Bad bacteria then can freely travel and enter into the bloodstream, not good!   There are paragraphs in much greater detail about “Leaky Gut”, but this part isn’t to bore you, or more realistically, overwhelm you.  Bottom line, these factors weaken the immune system, and this is what can also lead to a multitude of food sensitivities that everyone is now talking about, and everyone now seems to have.

In regards to the use of prednisone to treat R.A., this drug also weakens the immune system as stated above.  This drug may help control the level of pain, but doesn’t it really now seem counter intuitive to use?

I was discussing with my grandmother about eating a “whole foods” diet, and trying to stay away from processed food, which she does for the most part.  How do you think she has made it this far and remained in such amazing shape?  I was also talking to her about common food sensitivities that many people seem to have; gluten, dairy, and refined sugar!  Trying to remove these things from your diet is a huge key factor in regards to any inflammatory condition, autoimmune or not.

In regards to taking supplements, there are a few natural products that could be of great help as well.  Taking a high strain good quality probiotic (everyone and their mom should be taking this) to help increase good bacteria levels in the gut, and taking ~5,000mg of L-glutamine daily to help with healing your gut lining.  Taking in more good quality fats, like a fish oil, to help decrease inflammation through out the entire body.  Some other supplements worth mentioning and taking if contending with R.A. would be high potency curcumin, MSM, and glucosamine sulphate.

I know this a lot of information, and unfortunately there is no “quick and easy fix” when dealing with an autoimmune condition such as R.A.  That is why people are so quick to turn to prednisone for pain relief.  Unfortunately, much of the population is not well educated in regards to what an autoimmune disease is, and what terrible side affects drugs such as prednisone can have on the body.  I feel it is my job as a chiropractor to help educate my patients to the best of my ability so we can all lead a healthier and happier life.

In closing and as a side note, if you are dealing with R.A., chiropractic treatment and ART® have proven to help provide a lot of relief when dealing with chronic inflammation and pain surrounding the joints.  The goal is also to remain active.  Joints are meant to move, so KEEP MOVING!  Should you have any questions, always feel free to email me at drv@performancehealthcenter.com .  Happiest and healthiest of holidays to you all, cheers!

Stay Safe During Hot Weather Exercise

If you are a regular reader of these blogs you know that I definitely advocate exercising on a regular basis, but when the summer months turn really hot and humid, you need to be careful to avoid heat related illnesses like heat stroke or heat exhaustion.

Whether you’re running, playing tennis, working in your yard or garden, or going for a power walk, please be careful when the temperature rises. Even in your home, you should take measures to ensure the home is nice and cool. You might want to check out Allen Kelly & Company, Inc. if you need an air conditioning facility.

Exercising in hot weather puts extra stress on your body. If you don’t take care when exercising in the heat, you risk serious illness. Both the exercise itself and the air temperature and humidity can increase your core body temperature.

To help cool itself, your body sends more blood to circulate through your skin. This leaves less blood for your muscles, which in turn increases your heart rate. If the humidity also is high, your body faces added stress because sweat doesn’t readily evaporate from your skin. That pushes your body temperature even higher.

Under normal conditions, your skin, blood vessels and perspiration level adjust to the heat. But these natural cooling systems may fail if you’re exposed to high temperatures and humidity for too long, you sweat heavily, and you don’t drink enough fluids.

The result may be a heat-related illness. Heat-related illnesses occur along a spectrum, starting out mild but worsening if left untreated. Heat illnesses include:

  • Heat cramps.Heat cramps, sometimes called exercise-associated muscle cramps, are painful muscle contractions that can occur with exercise. Affected muscles may feel firm to the touch. You may feel muscle pain or spasms. Your body temperature may be normal.
  • Heat syncope and exercise-associated collapseHeat syncope is a feeling of lightheadedness or fainting caused by high temperatures, often occurring after standing for a long period of time or standing quickly after sitting for a long period of time. Exercise-associated collapse is feeling lightheaded or fainting immediately after exercising, and it can occur especially if you immediately stop running and stand still after a race or a long run.
  • Heat exhaustion.With heat exhaustion, your body temperature rises as high as 104° F, and you may experience nausea, vomiting, weakness, headache, fainting, sweating and cold, clammy skin. If left untreated, heat exhaustion can lead to heatstroke.
  • Heatstroke is a life-threatening emergency condition that occurs when your body temperature is greater than 104° F. Your skin may be dry from lack of sweat, or it may be moist.

You may develop confusion, irritability, headache, heart rhythm problems, dizziness, fainting, nausea, vomiting, visual problems and fatigue. You need immediate medical attention to prevent brain damage, organ failure or even death.

During hot-weather exercise, watch for signs and symptoms of heat-related illness. If you ignore these symptoms, your condition can worsen, resulting in a medical emergency.

WARNING SIGNS:

  • Muscle cramps
  • Nausea or vomiting
  • Weakness
  • Fatigue
  • Headache
  • Excessive sweating
  • Dizziness or lightheadedness
  • Confusion
  • Irritability
  • Low blood pressure
  • Increased heart rate
  • Visual problems

If you develop any of these symptoms, you must lower your body temperature and get hydrated right away. Stop exercising immediately and get out of the heat. If possible, have someone stay with you who can help monitor your condition.

Measuring core body temperature with a rectal thermometer is essential to accurately determine the degree of heat injury. An oral, ear or forehead thermometer doesn’t provide an accurate temperature reading for this purpose. In cases of heatstroke, due to confusion and mental status changes, you won’t be able to treat yourself and you’ll require emergency medical care. The most effective way of rapid cooling is immersion of your body in a cold- or ice-water tub.

In cases of heat exhaustion, remove extra clothing or sports equipment. Make sure you are around people who can help you and assist in your care. If possible, fan your body or wet down your body with cool water.

You may place cool, wet towels or ice packs on your neck, forehead and under your arms, spray yourself with water from a hose or shower, or sit in a tub filled with cold water. Drink fluids such as water or a sports drink. If you don’t feel better within about 20 minutes, seek emergency medical care.

IF YOU HAVE SIGNS OF HEAT STROKE- SEEK MEDICAL TREATMENT RIGHT AWAY

If your core temperature is less than 104° F, but it doesn’t come down quickly, you’ll also need urgent medical attention. In some cases, you may need fluids through intravenous (IV) tubes if you’re not able to drink fluids, or not able to drink enough fluids.

Get cleared by your doctor before you return to exercise if you’ve had heatstroke. Your doctor will likely recommend that you wait to return to exercise or sports until you’re not experiencing symptoms. If you’ve had a heatstroke, you may require many weeks before you are able to exercise at a high level. Once your doctor clears you for exercise, you may begin to exercise for short periods of time and gradually exercise for longer periods as you adjust to the heat.

When you exercise in hot weather, keep these precautions in mind:

  • Watch the temperature.Pay attention to weather forecasts and heat alerts. Know what the temperature is expected to be for the duration of your planned outdoor activity. In running events, there are “flag” warnings that correspond to the degree of heat and humidity. For example, a yellow flag requires careful monitoring, and races are canceled in black flag conditions.
  • Get acclimated.If you’re used to exercising indoors or in cooler weather, take it easy at first when you exercise in the heat. It can take at least one to two weeks to adapt to the heat. As your body adapts to the heat over time, gradually increase the length and intensity of your workouts.
  • Know your fitness level.If you’re unfit or new to exercise, be extra cautious when working out in the heat. Your body may have a lower tolerance to the heat. Reduce your exercise intensity and take frequent breaks.
  • Drink plenty of fluids.Dehydration is a key factor in heat illness. Help your body sweat and cool down by staying well-hydrated with water. Don’t wait until you’re thirsty to drink fluids. If you plan to exercise intensely, consider a sports drink instead of water. Sports drinks can replace the sodium, chloride and potassium you lose through sweating. Avoid alcoholic drinks because they can actually promote fluid loss.
  • Dress appropriately.Lightweight, loose fitting clothing helps sweat evaporate and keeps you cooler. Avoid dark colors, which can absorb heat. If possible, wear a light-colored, wide-brimmed hat.
  • Avoid midday sun.Exercise in the morning or evening, when it’s likely to be cooler outdoors. If possible, exercise in shady areas, or do a water workout in a pool.
  • Wear sunscreen.A sunburn decreases your body’s ability to cool itself and increases the risk of skin cancer.
  • Have a backup plan.If you’re concerned about the heat or humidity, stay indoors. Work out at the gym, walk laps inside the mall or climb stairs inside an air-conditioned building.
  • Understand your medical risks.Certain medical conditions or medications can increase your risk of a heat-related illness. If you plan to exercise in the heat, talk to your doctor about precautions.
  • Choose and alternative form of exercise. If you are a runner – maybe try cycling as you create your own cooling effect by moving air over your body – or maybe give swimming a go – but beware of swimming laps in a hot (> 84° F) pool – as you can quickly overheat swimming in water that warm.

I do recommend that you continue to exercise on a regular basis even through this hot month of August, just be smart about it by following these recommendations.

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

 

Fall Sports Season Is Here, BELIEVE IT OR NOT!!! Dynamic Stretching, the “Pre-workout”

I wouldn’t be doing my job at Performance Heatlh Center, if I wasn’t trying to educate all my athletes how to prevent injury and showing up to my office “all banged up”.  I know I have touched on this before, but I cannot stress the importance of stretching, and when training, dynamic stretching!

If you look up Wikipedia’s definition of dynamic stretching, this is what comes up, “Dynamic stretching is a form of stretching beneficial in sports utilizing momentum from form, and the momentum from static-active stretching strength, in an effort to propel the muscle into an extended range of motion not exceeding one’s static passive stretching ability”.

Performing dynamic stretches in a “pre-workout” or warmup are a series of active stretches will help move the muscles through their range of motion, help improve range of motion surrounding the joints, help elevate core body temperature, and help to stimulate the nervous system so it is better prepared for activity.

Dynamic stretching primes the muscle to be ready to contract and relax, just as they would need to be ready to function during a sprint, run or jumping motion etc.  Being dynamic stretching is an active movement, it helps to prevent over-stretching, which can also fatigue the muscles.  Fatiguing the muscles prior to a workout can provoke injury or unfavorable symptoms to the area.  That is one of the main reasons coaching have gotten away from prescribing static stretching before a workout.  In fact, many coaches suggest athletes do a dynamic warm up every day to help keep muscles limber and ready to move at all times.

Dynamic stretching also helps to mentally prepare the athlete before the workout or competition.  Static stretching can be more relaxing, and while there is definitely a place for it, static stretching can almost trick one’s body into relaxation mode and make it more difficult to transition to “competitor” or “beast mode”.

Dynamic stretches target major muscle groups when warming up.  For example, when running, dynamic stretches target hamstrings, quads, glutes, hip flexors and calves to help prime these areas for movement.  Usually a couple of minutes of light jogging is recommended first to get the blood flowing before getting into a 5-10 minutes of dynamic stretching.  Walking butt kicks (heel to butt), knee hugs (walking knee the chest), walking toe touches, walking lunges with an overhead reach, glute bridges, heel and toe walks, are just a handful of great dynamic stretches to get one warmed up and the muscle groups prepared for the intensity of the workout that follows.   It really is something so easy to work into a warm up, and would most likely replace a more static routine one is doing, so it would not add much time on to one’s routine either.    Some of you reading this may find that you are already doing some type of dynamic stretching prior to a workout without even knowing it, which is great!  Gold stars for you!

Should anyone reading this little article have any questions in regarding dynamic stretching and incorporating this into their pre-workout routine coming into the fall sports season, please feel free to contact me at: drv@performanacehealthcenter.com

The Concussion Muscle

Concussions are awful. There are close to 4 million sports related concussions in the U.S. every year. Your brain gets shaken up like an egg inside its shell. The skull doesn’t crack but the brain gets rattle around. You might lose consciousness, balance, ability to talk, have a headache and the world appears fuzzy. You go through concussion protocol testing and spend anywhere from a few days to weeks resting.
Slowly you start to feel better and eventually get on with life. 15% of concussion suffers have lingering effects which last beyond 3 months which is labeled “post-concussion syndrome. Persistent symptoms include inability to concentrate, memory issues, fatigue, dizziness, irritability, anxiousness, insomnia, blurry vision, noise and light sensitivity, and headache.

A recent study from the American Journal of Neuroradiology (AJNR) tried to determine if there was correlation between the suboccipital muscles and recovery time from post-concussion syndrome. The suboccipital muscles connect the upper neck vertebrae to the back part of the skull called the occiput. There are seven (7) muscles that make up the suboccipital muscles. An MRI of sixty-four consecutive patients with post-concussion syndrome was performed and symptoms were tested using standard concussion protocols.

Of the seven (7) suboccipital muscles only one (1) muscle’s cross-sectional diameter proved to have a direct association with post-concussion symptoms. That muscle is the Rectus Capitus Posterior Minor. (RCPMinor). There was a direct correlation with the RCPMinor and “greater symptom severity, longer recovery time, poor verbal memory performance and headache”. None of the other suboccipital muscles had a direct correlation.
What is so special about the RCPMinor muscles that it effects the recovery time ofpost-concussion syndrome? The RCPMinor is the only suboccipital muscle that has a ligament bridge that connects to the dura mater of your spinal cord right where your brain and spinal cord join. The dura mater is the outer protective membrane of the spinal cord. The theory is that the RCPMinor tugs on the spinal cord covering contributing to post-concussion symptoms.

I am only aware of one soft tissue technique that can isolate, evaluate and treat the RCPMinor muscle. That technique is called Active Release Techniques® or (ART). ART is patented and consists of over 500 specific protocols which differentiate, isolate, evaluate and treat the individual muscles in the body. The goal of ART is to release adhesions or scar tissue in muscles, ligament and nerve pathways in the body, in essence the soft tissues of the body. ART is cutting edge and is becoming the gold standard in treating soft tissue injuries. ART is done by hand. In order to become certified in ART you need to go through a certification course. Certification needs to be renewed every year. There are only 40 +/- certified ART providers in Massachusetts.

In the suboccipital region it is possible to isolate and evaluate the RCPMinor muscle using ART. If the RCPMinor is found to be short & tight, a specific tension is applied to the muscle which can normalize the tone and function. I have been an ART provider for 20 years. I have helped many patients suffering from whiplash injuries, headaches and post-concussion symptoms. Even before this study was published I have found that clinically the RCPMinor is a key muscle to treat to resolving post-concussion symptoms. As a side note, if you are suffering from whiplash injuries due to a car accident then it might be a good idea to get a lawyer involved, particularly if the accident wasn’t your fault. A lot of law firms will have a contact us page and this will help you to find the best lawyer for you and your case.

It’s not important to remember the name of the Rectus Capitus Posterior Minor muscle, but it is important to know that ART is one technique that is very effective in finding, evaluating and treating this muscle. If you, a family member or friend has been frustrated due to post-concussion syndrome, chronic headaches or whiplash injury, please get evaluated by an ART certified provider.
To find a certified ART provider anywhere in the world clink this link: http://activerelease.com/find-a-provider.asp

If you would like more information please contact me at: drbradweiss@performancehealthcenter.com

It’s Summer and I’m Back on the Courts!

For several months in a row last spring I wrote about my experiences post-knee surgery and the grueling rehab process I was going through.  It’s hard to believe that is now 15 months post-surgery.  The good news is that I am back doing all the activities I was able to do prior to my ACL tear and surgical replacement!

I’ve never had a serious injury before and never had to be a committed and compliant patient.  I worked hard and followed the advice of the skilled professional that I put my trust in.  I was able to ski by mid- winter and since the spring have been playing tennis several times a week.  My knee is strong and pain-free.  I have no limitations.  At times I do get swelling, but regular icing keeps it to a minimum (and feels good on these hot summer days we are experiencing).  I know I am not 100% rehabbed, but am getting closer every day!

This has been a learning experience on many levels.  Most importantly, I have a much better appreciation for the trust and confidence my patients put in me.  It is not easy being compliant with appointments and the homework I prescribe to get out of pain and optimizing function.  Between family and work responsibilities we all have busy lives.  Squeezing in one more appointment is not always easy.  I always remind my patients that it is not easy and there is never the right time to do this, but if they do the work now, they will be glad they did short term, and more importantly long term.

George Burns when he turned 90 said, “If I knew I was going to live this long I would have taken better care of myself”.  I want all my patients to say when they turn 90, “I knew I was going to live this long so I took great care of myself”.   Of course there are bumps in the road, like my knee injury, and when that happens extra care is needed.  That’s how I live my life and I hope I inspire my patients to do the same.

Now that the hard part of my rehab is over, I will continue with my “extra” exercises to make sure my knee serves me well for the many years I plan to work as a chiropractor and play hard.  Many thanks go to my team of professionals who helped me get to this place.  Dr. Brian McKeon has been my go to orthopedist for 14+ years.  I’ve always told my patients when I made a referral, if it was me, Dr. McKeon is who I would go to.  When it was me that is exactly what I did.  Steve Crowell and his amazing team of physical therapists at Rebound Physical Therapy got me moving.  Rebound Physical Therapy is my “outsourced” physical therapy department and they always make me look good when I refer my patients there.  Drs. VanNederynen and Ball, were instrumental in keeping me functional and relieved the physical stress I was putting on my body from walking funny- 1st with crutches, then with my brace, and then from limp that lasted longer than I expected.  Bernadette, Performance Health Center’s amazing massage therapist accelerated my healing with incredible massages and cupping.  Lastly, Anita Luck, my Functional Movement Therapist, has taught me how to use my body in 3-D so my body can handle the demands I put on it, even when the unexpected happens.

I have and will continue to refer my patients to these exceptional providers I have now experienced firsthand, and have even more confidence in them than ever.

I hope you all have an enjoyable, safe and healthy summer!  Now get out there and have fun!

Brad Weiss, D.C.

drbradweiss@performancehealthcenter.com

You Got Some Nerve!

The truth is you have a lot of nerve!

  • There are more nerves in your body than stars in the Milky Way.
  • The human brain alone consists of about 100 billion neurons. If all these neurons were lined up it would for a 600 mile long line.
  • The nervous system transmits impulses at 100 meters per second, or 224 miles per hour
  • There are 43 different pairs of nerve which connect the nervous system to every part of your body. 12 pairs exit in your brain and 31 pairs are connected to your spinal cord..

The longest nerve in the body is the sciatic nerve.  It is made up of nerve roots from 5 levels of your low back and sacrum (L4-S3) and ends at the tip of your toes.  The sciatic nerve is about the size of your thumb as it passes through your buttocks.  The sciatic nerve travels in the spaces between the large muscles in your leg (often with the arteries and veins).  Sciatica is the term used when the sciatic nerve gets irritated and causes pain that radiates down the leg.  We treat sciatica successfully every day in our office.

The sciatic nerve can get entrapped anywhere from where the nerves exit the spine to the toes.  When a nerve loses its ability to glide, or move, within it pathway the function of the nerve can be corrupted.  There are areas where the sciatic nerve is more frequently entrapped.  One is the tarsal tunnel.  You’ve heard of carpal tunnel. The tarsal tunnel is in the foot, just below and behind the inside of your ankle bone (or medial malleolus).  Another common entrapment site is the piriformis muscle (one of the deep muscles of your buttocks).

There are functional diagnostic tests to determine if and where the sciatic nerve is entrapped.  Active Release Techniques® (or ART®) has specific protocols to release entrapped nerves.  There are about 35+ ART® certified providers in Massachusetts and only 10+ ART® Nerve Entrapment certified providers, of which 3 practice at Performance Health Center. It amazes me on how many of the patients we meet have been living in pain, sometimes for years with sciatic nerve entrapment.  Having an entrapped sciatic nerve can manifest in many ways, not only leg pain. Since nerve entrapments are a functional condition it requires a functional solution and ART® provides one.

Recently I saw a patient who had bilateral foot pain for 3 years, initially caused by wearing bad running shoes too long.  Over the 3 years before I meet her, she was labeled with having many different pain syndromes from multiple medical providers. She even had nerve release surgery on both her tarsal tunnels.  The day I met her, she gave me her detailed history and I performed an exam with included sciatic nerve entrapment screening.  I uncovered poor motion of the joints of her low back and sciatic nerve entrapment.  The function test of the sciatic nerve was so obvious she understood and felt the tension as I performed the test maneuver.  When I explained to her what I thought was the problem, that her sciatic nerve was entrapped at the tarsal tunnel, and told her I thought I could help her, she teared up. She told me that of all the doctors she had seen over the years, I gave her the most thorough exam, explained her problem in a way she could understand it and gave her hope.

The good news is that after 8 treatments she is doing much better.  The pain level is significantly reduced. She can walk without pain. She is not running yet, but will be within the next 2 months. She had a functional problem caused by faulty biomechanics of her spine and sciatic nerve pathway.  Our functional treatment approach includes manipulation of her low back (where the nerves that make up the sciatic nerve exits the spine), ART ® on the muscles of the LB and leg, plus sciatic nerve entrapment ART® protocols, and Kinesio® Taping to minimize the tension on the sciatic nerve at the tarsal tunnel between treatments.  It is not possible to correct 3+ years of faulty motor patterns in the body overnight, but just like braces on teeth, if we continue to put a demand on the body, it will change.

Getting our patients out of pain is usually the easy part of treatment.  The next and most important phase is the rehabilitation, or re-education to optimize the body’s function.  Of course our patients have responsibilities too.  They need to improve the ergonomics at work and play. They receive stretches and strengthening exercises when appropriate, and are an active participant in their treatment.

If you or anyone you know is sick and tired of being sick and tired, and think they have done everything to get better.  Remind them if they have not had the benefit of ART®, they have not done everything!  As always, after the initial examination, if we do not think we can help, we will make the appropriate referral.  If you have any questions, please feel free to email me at: drbradweiss@performancehealthcenter.com

 

ART, A.K.A…Active Release Techniques

Having just done my annual recertification with ART two weekends ago, I wanted to take the time to write about it in this month’s news letter.  I will try and keep this somewhat short, and sweet, as I know ART has been discussed in previous news letters.

What sparked me to write about ART and remind everyone of what it is AND why we perform it at our office is all because of a black professional polo shirt with the ART logo on it that I bought at the re-cert this year.  Needless to say, it is just one of the many ART shirts I have in my wardrobe, and may provoke me to wear those more often then just at athletic events, which we are usually wearing our PHC polo shirts at anyway.

So…I wore the shirt one day last week and it actually sparked a lot of conversation – good conversation I think!  Many people commented on the shirt, and said how sharp and professional it was, and many just commented and started talking about ART during our treatment sessions and how great it is, and how it has helped them.  I was surprised however at the amount of people, whether my patients or other people/patients in the office passing by whom I did not know personally asking me what the logo on my shirt stood for?

Now, I really do think Dr. Ball, Dr. Weiss, and I do a good job explaining and educating people what ART is.  But…there is always room for improvement, I guess and that is why they call it “practice”.  I feel that sometimes patients don’t hear all of what we are saying on the first few visits because we are trying to educate them on chiropractic care, why it is important, what makes our office different then other chiropractic offices (hint, hint…ART), making them feel comfortable and assuring them they are in the right place for their care, not to mention ALL of the paper work that needs to be filled out before the visit and at the front desk before the patient even gets to see us!  JEEZ Louise, I don’t know about you, but I am getting tired just re-reading what I just typed.

Then… there are also the questions from our patients of how much is it going to cost?  Does insurance cover it?  More importantly, does MY insurance cover it?  What do I have, what is my diagnosis?  Can this office help me?  What is my treatment plan?  How long is it going to take?  What happens if this doesn’t work?  My other doctor said I shouldn’t come to a chiropractic office, should I? I am nervous about seeing a chiropractor; I have heard bad rumors, are they true? What is the difference between chiropractic and physical therapy? What is ART (my friend said I should come here because this stuff is the best)?

Reading the above two paragraphs, could one see why maybe someone in our office may not “quite” remember what exactly ART is at the beginning?  With that being said, it is our job as practitioners to be there for our patients and constantly guide them and remind them why they are in our office and what it is that we do, and how it can help them.  This doesn’t have be a long drawn out engaging conversation each visit, but it can easily and simply be discussed and talked about while treating the patient during the visit.  Though ART can be a little uncomfortable (but worth it) sometimes, as a practitioner it would probably be a good time to remind a patient of what we are doing in regards to ART when the patient isn’t grimacing and making the “ART face”.  Those of you that have been treated in the office by me know exactly what I am talking about 😉 ;).

Real quick, I am taking a paragraph right from the ART website, www.activerelease.com, explaining briefly and precisely what ART is:

“ART is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles”.

There is further definition of ART on the website as well, but it also helps to break up scar tissue and adhesions from new or chronic injuries and various surgical procedures as well.

I am not sure the exact number of ART providers in MA to this date, as more doctors may have become certified at this previous course held in Boston.  Just over a few years ago there were only a handful of practitioners certified in ART in MA, and two of them were in our office, now three in our office in total.

If you are looking to find an ART provider in your area, go to www.activerelease.com, and click on “provider search”.  When looking for a provider, try looking for a practitioner that has as many “badges” next to their name as possible.  If you are just looking for someone closest to you, then the provider closest to your address will usually pop up first.  If all else fails, you can message ART directly or ask around at your local CrossFit Box, local running, cycling or triathlon club, and one of these crazy folks will have most likely heard of ART or see a practitioner themselves!

If any of you or your friends and family have more questions in regards to ART and what it is, and if it could help you or them, feel free to reach out to me at drv@performancehealthcenter.com, or call the office and leave a message for me, and I will get back to you and help guide you in the right direction that is best for you!  Until next month all, salude!