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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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.”

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

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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We’ve often heard that “you are what you eat”.  Well, what you eat can pain you, in more ways than one.

References
1. Cordain L, Eaton SB, Sebastian A et al. Origins and evolution of the western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81:341-54.
2.Franco OH, Bonneux L, de Laet C, Peeters A, Steyerberg EW, Mackenbach JP. The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%. Brit Med J 2004; 329:1447-50.
3.O’Keefe JH, Gheewala NM, O’Keefe JO. Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health. J Am Coll Cardiol. 2008;51(3):249-55.
4. Aggarwal B.B., Shishodia S. Suppression of the Nuclear Factor-{kappa}B activation pathway by spice-derived phytochemicals: reasoning for seasoning. Ann N Y Acad Sci. 2004;1030:434-41.
5.Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypotheses. 1992;39:342-8.
6. Chou R et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.
7.Bucci L. Nutrition Applied to Injury Rehabilitation and Sports Medicine. Boca Raton: CRC Press; 1995: p.167-76.

Getting A Handle On Pain And Inflammation
Anyone with chronic pain has typically tried non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen (Advil), or anti-pain medications like acetaminophen (Tylenol). Each medication is associated with side-effects, such as liver toxicity for acetaminophen and ulcers for NSAIDs. Interestingly, the second most common cause of ulcers is the regular use of aspirin and other NSAIDs.

In an effort to avoid the side effects associated with NSAIDs, many individuals seek out nutritional supplements that can be used as an alternative. There is a secret that must be understood before one searches out nutritional supplements to reduce pain and inflammation. Our diets substantially determine the inflammation levels in the body, which can directly impact upon the
development of pain.

The foods that cause inflammation and lead to pain include refined sugar, refined grains and related flour products (bread, pasta, bagels, etc.), refined oils, and obese meat. These inflammatory foods make up
approximately 80% of the average American’s calorie intake (1), and yet even 30-40% of calories from these foods is too much. Eating a diet comprised of the inflammatory foods creates a tsunami of inflammation within the body that will hit joint and muscle sooner or later causing pain and suffering. At this point, people start taking NSAIDs and Tylenol, and all the while continue to eat the same inflammatory foods that caused the problem.

In short, most people cannot turn off diet-driven inflammation and pain by taking medications or nutritional supplements. So it is important to make dietary changes to calm the inflammatory state. To expect that drugs and supplements will be curative is not reasonable.
Consider the term “nutritional supplement” it is supposed to supplement a healthy anti-inflammatory diet rather than one that is filled with the various inflammatory foods. The anti-inflammatory diet consists mostly of vegetables, fruit, raw nuts and potatoes in moderate amounts, and healthy proteins (lean meat, skinless chicken, fresh fish, omega-3 eggs or egg whites) (1-3). A little bit of dark chocolate, red wine, and stout beer are also anti-inflammatory. The best oils/fats include olive oil, coconut oil, and butter; and these should be used in moderation. A very popular oil supplement is fish oil that contains omega-3 fatty acids, which is famous for its anti-inflammatory properties.

Not well appreciated in America is that spicing our meals adds a substantial anti-inflammatory boost. Ginger, turmeric, rosemary, oregano, garlic, coriander, and nearly all spices tested thus far have proven to be anti-inflammatory (4).
Because NSAIDs cause ulcers and other dangerous side effects, researchers began to look for alternative substances that can reduce pain and
inflammation in a safer fashion. It was discovered that, when supplementing with ginger, certain individuals can substantially reduce chronic muscle and joint pain(5). For more acute pain, such as flair ups of back pain, research has shown that white willow bark can reduce pain as effectively as Celebrex over a 4-week period(6). Such studies led the American Pain Society and the American College of Physicians to view supplemental white willow bark as a recommended option for treating low back pain (6). There are also natural options for more acute injuries such as muscle strains and sprained joints. A unique enzyme called bromelain is found in pineapple and is known to have protein-digesting actions. It turns out that the inflammatory response associated with acute injuries involves the production of special proteins that are degraded by bromelain. Studies with bromelain and other enzymes demonstrate a reduction in recovery time after injury. In one study with ankle sprains, there was a 50% faster return to work and a 30% faster return to exercise (7).

In summary, if you desire dietary approaches towards a pain-free state, natural options are available. Basic dietary changes and certain key supplements can be very helpful. The most common symptom that brings a patient into a doctor’s office is pain that does not go away adequately, which is called chronic pain. Back pain, neck pain and headaches are some of the most common types of chronic pain.
David R. Seaman
DC, MS, DABCN

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

Patient Satisfaction Surveys going back to the late 1980s show that patients with neck or low back pain, headaches, and a variety of other physical complaints rate their satisfaction with chiropractic care much higher than they do conventional care provided by physical therapists or medical doctors.

Now let’s discuss the amazing results chiropractic can provide for pain relief. A 2005 study, from the prestigious medical journal Archives of Physical Medicine and Rehabilitation, titled Chronic Pain in Persons With Neuromuscular Disease interviewed patients on the pain relief they derived from a variety of procedures and medicines.

Pain relief was rated on a 1 to 10 scale (where 1 = none, and 10 = the highest relief). The highest rated score was for chiropractic manipulation (7.33), rating higher than Nerve Blocks (6.75) and Opioid Analgesics (6.37). There you have it…chiropractic is better than drugs, not to mention the fact that drugs wear off, while chiropractic correction has been shown to sustain for prolonged periods.

By Frank in Health, on June 28th, 2009 at 12:03 pm

You will find many more articles like this at the Patient Satisfaction With Chiropractic Page.

Be sure to visit North Texas Chiropractic Services for more information about Chiropractic.