North Dallas Chiropractic Blog – All Injury Rehab

I know that this isn’t a usual topic, but here it goes.
To Your Health
December, 2009 (Vol. 03, Issue 12)

Snow-Shoveling Safety Tips
By Dr. Douglas R. Briggs

If you live in an area of the country that sees snow during the winter months, or even if you’ve only visited a part of the country that does, you know fresh snow is one of the most beautiful and peaceful things to witness. However, you probably also know that with snow comes the need to remove it from driveways, walkways, and other traffic areas. That’s often where you – the snow-shoveler – come in.

Anyone who has shoveled snow before knows how good a workout it can be. When you consider that the average shovelful of snow weighs 5-10 pounds, the average driveway or walkway may hold hundreds of pounds of snow. But despite the benefits, shoveling snow can also be physically stressful; bending, lifting, and twisting, combined with the exposure to freezing weather conditions, can take a serious toll on the body.

Typically, the arms, shoulders and back get sore and may occasionally feel pain. The cold air invigorates most people into action; however, the same cold air can numb the sensations of pain and fatigue. Unfortunately, pain is a sign that an injury has already occurred or that mechanically you are doing something incorrect in shoveling the snow. In short, there is a right way and a wrong way to shovel snow, and paying attention to your technique can make a big difference in how you feel the next day. As with any project, the prep work is the most important. The following are some quick tips on how to shovel snow smarter:

Be prepared. Spray your shovel with Teflon so the snow won’t stick to it. The more snow that stays on the shovel, the heavier it gets and the more chance for injury – and frustration.

Do a warm-up first. A tight, stiff body is asking for injury. A few minutes of stretching can save you a lot of pain later. When you are shoveling, don’t forget to breathe. Holding your breath makes you tight and stiff.

Layer your clothing. Layered clothing will keep your muscles warm and flexible. You can shed a layer if you get too hot. Make sure you wear gloves that cover your wrists; if your wrists get cold, your fingers, hands and arms will be cold, too.

Wear the right shoes. Choose shoes with plenty of cushioning in the soles to absorb the impact of walking on hard, frozen ground.

Use the right size shovel. Your shovel should be about chest high on you, allowing you to keep your back straight when lifting. A shovel with a short staff forces you to bend more to lift the load; a too-tall shovel makes the weight heavier at the end. (Note: Save your money – don’t buy a fancy ergonomic shovel; studies have shown that in some models, the hook end is too deep. Twisting to unload a shovelful of snow with this tool may hurt your wrists.) Also keep one hand close to the base of the shovel to balance weight and lessen the strain on your back.

Timing is everything. Listen to weather forecasts so you can shovel in ideal conditions. If possible, wait until the afternoon to shovel. Many spinal disc injuries occur in the morning when there is increased fluid pressure in the disc because your body has been at rest all night.

Drink lots of water. Drinking water frequently throughout the day helps to keep muscles and body hydrated. Be careful with hot drinks like coffee or hot chocolate. Coffee contains caffeine, which has a dehydrating effect and adds even more stress to the body.

Use proper posture. When you do shovel, bend your knees and keep your back straight while lifting with your legs. Push the snow straight ahead; don’t try to throw it. Walk it to the snow bank. Try to shovel forward to avoid sudden twists of the torso and reduce strain on the back. The American Chiropractic Association recommends using the “scissors stance,” in which you work with your right foot forward for a few minutes and then shift to the front foot.

Take your time. Working too hard, too fast is an easy way to strain muscles. Take frequent breaks. Shovel for about five minutes at a time and then rest for two minutes.

See your chiropractor. Gentle spinal manipulation will help keep your back flexible and minimize the chance for injury. If you do overdo it, your chiropractor can help you feel better and prevent more injury.
So enjoy the snow this year, but remember that when it comes to shoveling snow, stay safe. Taking heed of these simple tips could make the difference between spending your day enjoying the new snowfall or lying in bed with a sore back, sprained ankle or other injury that could have been easily avoided. Talk to your doctor for additional information.

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Douglas R. Briggs, DC, Dipl. Ac., DAAPM, practices chiropractic, acupuncture and pain management in Wilmington, Del.

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3 Steps to More Energy (source http://www.toyourhealth.com/mpacms/tyh/article.php?id=1389)

Rise & Shine

If you aren’t an early riser and think the best way to increase energy is to stay in bed until noon or so, you’re missing out. Try rising with the sun on a more consistent basis and see how much more you accomplish (and how much energy you have doing it). Start the day with a brisk walk followed by a balanced meal, and your body and mind will be energized for the rest of the day.

Great Escape

There are countless energy sappers in life, but the way to fend them all off and retain energy throughout the day is to escape. Get away from the stress of your workload, the noise of the television, the constant demands of the kids. How do you possibly do that? Schedule time, whether it’s a five-minute escape from your desk every few hours or an hour of mandated quiet time at home.

Wind Down

No matter how much energy you start with and how well you replenish it, by day’s end, most people are exhausted. And mental and physical exhaustion can actually cause poor sleep, inadequate sleep or no sleep at all. The solution: wind down every night with a good book, your favorite music, a soothing bath, or even a calm review of the day with your significant other (or yourself).

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Source: ThirdAge.com

It’s not uncommon for people to complain about sore joints in cold weather, although the “why” of it is still a mystery to experts.

Rhodes recommended wearing an extra layer of clothing, as well as wearing gloves outdoors in the cold weather.

“The hands seem to be the thing that bother people the most,” Rhodes said.

Rhodes said the heated pool at the OMHS HealthPark helps, too, because activity generates heat in the joints, and that improves pain and stiffness.

“Our natural defense to cold weather is to protect the core of the body (which) will actually shunt blood from the extremities to the inside of your body,” he said. “You don’t have a lot of blood going to the exterior portion of your limbs because it wants to conserve the heat that you have.

“Unfortunately, that makes it even worse when you are arthritic because now there’s even less blood flow to your hands, legs, arms and shoulders. People need to wrap up really well.”

Last week’s snow was fluffy and measured only a couple of inches, so it wasn’t hard clearing sidewalks and stairs, but if and when the heavier wet snow arrives, shovelers should take care not to overexert themselves.

“You should try not to do too much, particularly people with heart conditions,” Rhodes said. “They’re the most at-risk. It’s a fairly strenuous activity if you’re doing a lot of snow removal with a shovel.

“Go at a measured pace, take breaks, go in and warm up. It’s going to be there for a while, so take your time and get it done. Don’t try to do it all at once.”

Extreme cold has long been associated with conditions such as arthritis and joint pain, affecting hips, knees, elbows, shoulders and hands.

“People with good joints don’t have pain related to weather, but those who have any kind of trauma to their joints or some arthritis, it’s very common to have them tell you it’s worse when the weather changes, or even when the barometric pressure changes,” said Dr. Gayle Rhodes, the director for Owensboro Medical Health System’s WorkHealth division.

Researchers haven’t solved the puzzle of cold weather relating to soreness, but apparently joints contain sensory nerves that respond to changes in atmospheric pressure. It’s believed that cold weather causes the joint lining to constrict, perhaps causing the discomfort.

“That’s been a theory that’s been promoted, but I’m not sure why that causes pain in your joints, or why you’d have a mechanism like that in the joints to detect barometric pressure in a normal person,” Rhodes said.

The solution, however, is easy — keep warm.

“People with sore joints tend to want to set the thermostat up a little bit higher, and that’s prudent,” Rhodes said. “If you set it too low to conserve energy, you’re going to wake up and have sore joints all day long.”

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When patients come into our clinic, and we ask what the pain is on a scale of 1-10, the answers vary. Explaining pain is hard for most. This post puts the pain in perspective with a new pain scale:

Boyfriend Doesn’t Have Ebola. Probably. (From http://hyperboleandahalf.blogspot.com/)

I took Boyfriend to the Emergency Room last night because he was vomiting up vast quantities of what I thought was blood but actually it was just Craisins. You guys, if you feel like you may become violently ill in the near future, stay away from red food. Failure to do so may create an atmosphere of unnecessary panic and chaos.

Anyway, the doctor wanted to make sure that Boyfriend didn’t have SARS or stomach AIDS or something, so he had to poke him a lot. While he was doing this to Boyfriend, he pointed to a little reference chart on the wall and asked Boyfriend to rate his pain::

You’ve probably seen some version of that chart before. You may also have noticed how inadequate it is at helping you. Based on the faces, this is my interpretation of the chart:

0: Haha! I’m not wearing any pants!

2: Awesome! Someone just offered me a free hot dog!

4: Huh. I never knew that about giraffes.

6: I’m sorry about your cat, but can we talk about something else now? I’m bored.

8: The ice cream I bought barely has any cookie dough chunks in it. This is not what I expected and I am disappointed.

10:You hurt my feelings and now I’m crying!

None of that is medically useful and it doesn’t even have all the numbers, so I made a better one with all the numbers:

0: Hi. I am not experiencing any pain at all. I don’t know why I’m even here.

1: I am completely unsure whether I am experiencing pain or itching or maybe I just have a bad taste in my mouth.

2: I probably just need a Band Aid.

3: This is distressing. I don’t want this to be happening to me at all.

4: My pain is not f*****g around.

5: Why is this happening to me??

6: Ow. Okay, my pain is super legit now.

7: I see Jesus coming for me and I’m scared.

8: I am experiencing a disturbing amount of pain. I might actually be dying. Please help.

9: I am almost definitely dying.

10: I am actively being mauled by a bear.

11: Blood is going to explode out of my face at any moment.

Too Serious For Numbers: You probably have ebola. It appears that you may also be suffering from Stigmata and/or pinkeye.

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Eighty percent or more of the people who visit a chiropractor, do so because of back pain.

Back pain can arise from a variety of conditions. The chief among them are:

• Pinched Nerves
• Slipped Discs
• Ruptured Discs
• Scoliosis
• Arthritis
• Muscle Pain

A chiropractor can pinpoint the cause of the back pain. He or she can make the necessary spinal adjustments to relieve the problem. In some cases, a chiropractor will recommend that you seek medical attention for your situation.

The 1994 Federal Agency for Health Policy and Research (AHCPR) guidelines for low-back pain concluded that spinal manipulation, chiropractic’s primary treatment technique, is one of only three treatments whose effectiveness is substantiated by rigorous research.

According to a 1992 RAND Corp. study, patients see a chiropractor primarily for low back pain and neck pain. Because back pain is so pervasive in our society, a recent study published in the British Medical Journal pointing out that back pain doesn’t go away that easily confirmed what chiropractors have always known. Only 25 percent of low back pain sufferers had fully recovered 12 months after their first visit to a general practitioner, the study said. This low number is in conflict with the commonly-held notion that low back pain episodes go away by themselves after a month. Doctors of chiropractic have long understood the cyclic nature of low back pain.

In 1999, Blue Cross/Blue Shield of Kansas in August 1999, presented a study aimed at determining the cost and effectiveness of treating back pain with chiropractic compared with other techniques. The results showed that 38 percent of the patients chose to seek chiropractic care rather than medical care. The results showed that chiropractic was more cost-effective than anesthesiology; neurosurgery; neurology; registered physical therapy; orthopedic reconstructive surgery; physical medicine and rehabilitation; and rheumatology. The study also showed that most of the chiropractic expenses 89%, were related directly to patient care, while only 45 percent of the medical costs were related to treatment of the condition with remainder of the costs being for diagnostic procedures. The study had excluded any costs for hospitalization, surgery, or any fees paid to orthopedists or neurosurgeons for costs associated with surgery. Without these additional costs being included in the study, the costs related to medical care were reported much lower than they actually were, and the savings from chiropractic care was actually much larger.

Chiropractors points out this study as vindication of their long-held view, “Patients suffering from back problems are in much better, and cost effective hands with chiropractic care.”

Satisfied Customers
A research journal, the “Journal of Manipulative and Physiological Therapeutics” published a study that showed high levels of patient satisfaction for those who went to chiropractors with what was classified as severe to moderate pain in either the back or neck. A total of 369 patients were sampled who had gone to chiropractors with these problems. These individuals were asked to complete surveys tracking all kinds of information from the type and severity of their problem to their level of satisfaction with care.

The results showed a very positive response from the study group in both the results they felt and their overall level of satisfaction with their care. The results of the published study summed it up best; “Based on the results of this survey, it seems that patients suffering from back and or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments. Moreover, the patients surveyed demonstrated a high degree of satisfaction with the care they received. Numerous other studies have demonstrated that chiropractic is as effective, if not more effective than conventional medical management of such complaints.”

Preventing Low-Back Pain

• Exercise regularly
• Keep objects close to the body when lifting them.
• Place a pillow or rolled-up towel behind the small of the back when driving long distances.
• Put work tables at a comfortable height.
• Use a chair with good lower-back support.
• Wear comfortable, low-heeled shoes.
• Wear a lumbar corset if you lift things frequently at work.
• When you sit for a long time, rest your feet on a low stool.

Visit us at All Injury Rehab for more information and to set up an appointment.