A Fresh Coat of Paint

Regular Chiropractic Care and a Plan for Good Health

Worldwide, the number of people with diabetes, heart disease, and cancer continues to increase. Despite the expenditure of well over $100 billion in pharmaceutical research and new drug development, the impact on global health in the area of chronic disease has not been significant. It is reasonable to conclude that solutions to these dire problems lie elsewhere. In fact, lifestyle has come to be recognized as the key factor in both causation and treatment of these life-threatening disorders. A healthy diet, regular vigorous exercise, and sufficient rest are the cornerstones of such meaningful lifestyle change. Regular chiropractic care is a critical supplement to these healthy lifestyle choices, as it provides necessary support to the functioning of the nerve system, your body's master system. With a healthy nerve system, your body is able to make the best use of the good things you're providing in terms of food, exercise, and rest. Adding regular chiropractic care to your lifestyle plan contributes substantially to your overall health and well-being.

As all real estate brokers know, a fresh coat of paint will make any property look good. Whether your home is a row house in Baltimore, a Paris atelier, or even a Winnebago, a new coat of paint will bring a shine to the interior and put a smile on the faces of both residents and guests. You may find that a similar smile will appear on your face and the faces of your friends and family members when you engage in activities that provide you with a metaphorical fresh coat of paint. Specifically, you'll obtain your "new look" by incorporating a healthy diet and regular, vigorous exercise in your daily routine.^1,2
But what exactly is "a healthy diet," and what is really meant by "regular, vigorous exercise"? A healthy diet consists in a daily practice of consuming food from all five food groups: fruits, vegetables, grains, proteins, and dairy. Importantly, a healthy diet includes at least five daily servings of fresh fruits and vegetables. Overall, the more colors on your plate, the better. If you're consistently eating yellow, green, red, blue, orange, and purple foods such as squash, corn, grapefruit, kale, broccoli, apples, peppers, blueberries, carrots, oranges, potatoes, and eggplant, you're well on your way toward a lifelong healthy diet.
The grains food group contains whole grains such as whole wheat, brown rice, bulgur, and barley. For those who require gluten-free whole grains, the numerous choices include amaranth, buckwheat, quinoa, brown rice, and teff. The protein food group includes beef, lamb, chicken, eggs, fish, beans and peas, and nuts and seeds. There are plenty of protein sources for vegetarians and others who don't eat meat or other foods derived from animals such as eggs and milk. The dairy group is included to provide sources of calcium.³ These foods include low-fat and fat-free choices such as milk, yoghurt, and cheese. If you're a vegetarian or have allergies to dairy products, other sources of calcium include kale, collard greens, spinach, salmon, sardines, blackstrap molasses, and beans. For men and women aged 19 to 50, the recommended daily requirement for calcium is 1000mg. For women over age 50 and men over age 70, the recommended daily requirement for calcium is 1200mg.
Regular, vigorous exercise means doing at least 30 minutes of exercise five days a week. Walking, running, bike riding, swimming, using an elliptical machine or treadmill, and weight training are all good choices. Lifting weights three times a week and doing some form of aerobic exercise two times a week is one example of such a program of vigorous daily exercise. For some people, walking five days a week for at least 30 minutes each day represents an optimal program. Find out what works best for you and do that consistently. Change your program every few months to keep both your mind and body challenged. Again, the specific form of exercise is not critical. What works for one person will not work for another. The key is consistency. Five days a week, at least 30 minutes a day.
Your fresh coat of paint is not merely metaphorical. Once your new lifestyle changes take effect, probably within three to six weeks, you'll begin to develop an inner glow and an outer glow that will be visible for all to see.
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¹King DE, et al: Impact of healthy lifestyle on mortality in people with normal blood pressure, LDL cholesterol, and C-reactive protein. Eur J Prev Cardiol 20(1):73-79, 2013
²Lopresti AL, et al: A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise. J Affect Disord 148(1):12-27, 2013
³Nachtigall MJ, et al: Osteoporosis risk factors and early life-style modifications to decrease disease burden in women. Clin Obstet Gynecol 56(4):650-653, 2013

The Top Shelf

Shoulder Rehabilitation and Regular Chiropractic Care

Effective shoulder rehabilitation frequently depends on factors other than those related to the shoulder itself. For example, obtaining improved shoulder range of motion and improved shoulder girdle strength may be directly related to the functioning of your neck and the regional neck musculature. Your seven neck vertebras have a big responsibility. Not only do they support the weight of your head all day long, but they also provide a structural framework for the complex web of muscles that move your head in all directions and interface with chest muscles involved in respiration. Beyond this, regional neck muscles are closely interconnected with shoulder girdle muscles. Rehabbing the shoulder means paying attention to neck muscles as well. Regular chiropractic care helps ensure that the spinal joints and muscles of your neck are functioning at peak efficiency. Therefore, regular chiropractic care is a critical component of any successful shoulder rehabilitation program.

Many adults begin to develop shoulder pain, even though they may not have sustained a specific injury. It's important to pay attention to such shoulder issues, as a healthy shoulder joint is the key to full function of the upper extremities. We all know at least one person whose ability to perform normal activities of daily living has been significantly compromised by chronic shoulder pain. Conservative treatment may be of benefit, but the key, as always, is to prevent these problems before they occur. The primary prophylactic intervention, as is the case for most musculoskeletal conditions, is exercise.
We all agree that the human body's design is magnificent. Every component has a purpose, down to the smallest cell. Every system is deeply interconnected with every other. Miraculously, the whole is much greater than the sum of the parts. And yet, there are a few "gotchas" built-in to this ingenious design. With respect to the shoulder, the "gotcha" relates to the shoulder joint's extraordinary mobility. The shoulder joint has the greatest range of motion of all the joints in your body. But this extreme mobility comes at a price, that is, the shoulder joint is not a particularly stable joint. For example, shoulder dislocations comprise approximately 50% of all such injuries.
Shoulder pain in the absence of a specific injury often represents damage to the rotator cuff. Again, the design of the shoulder joint and surrounding soft tissues is implicated in these rotator cuff problems. The blood supply to the bones, muscles, ligaments, and tendons of the shoulder is consistently compromised during normal motion of the shoulder above 90º, as in placing an object on or taking an object down from the top shelf in a kitchen cabinet. If much of your day is spent with your arm elevated above 90º to the front or to the side, over time you may develop nagging shoulder pain. Worse, with persistent repetitive motion above 90º, nagging shoulder pain may become chronic pain that restricts activities.
The best approach to shoulder problems is to become aware of the rotator cuff's well-known tendency to develop degenerative changes. We can be proactive by doing strength-training exercises for the shoulder and incorporating these exercises in our weekly exercise program as soon as possible.^1,2 Beginning such exercises in the teenage years would be ideal. For those of us who are older, the right time to begin shoulder strength training is now. Shoulder exercises stimulate growth of new muscle fibers, increase the size of muscle fibers already in existence, and stimulate growth of nerve fibers bringing information to and from all shoulder girdle structures.
Shoulder exercises should be done once or twice a week as part of your overall fitness program. As with all exercise that's new to you, start slowly and gradually increase the level of difficulty over time.³ The result of all this activity is a dramatically improved blood supply to the shoulder region and a dramatically reduced tendency for rotator cuff degeneration and injury.

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¹Choi SH, Lee BH: Clinical Usefulness of Shoulder Stability Exercises for Middle-aged Women. J Phys Ther Sci 25(10):1243-1246, 2013
²Saltychev M, et al: Conservative treatment or surgery for shoulder impingement: systematic review and meta-analysis. Disabil Rehabil 37(1):1-8, 2015
Another example of a common issues
³Daenen L, et al: Exercise, not to exercise, or how to exercise in patients with chronic pain? Applying science to practice. Clin J Pain 31(2):108-114, 2015

Chiropractic: Not Just For Injury Rehabilitation

It’s no secret that chiropractic treatment has been shown to be effective at relieving back pain, neck pain and other musculoskeletal disorders, but many athletes don’t realize that proactive visits to a chiropractor can help prevent those injuries from occurring in the first place.
In 2010, a group of researchers tested the efficacy of preventative chiropractic treatments on 60 semi-pro Australian football players. The participants were split into two groups; both groups had sports science and medical care but the test group received chiropractic treatments in addition.  Chiropractic care was defined as manipulative therapy, soft-tissue therapies, and mobilization applied to the spine and extremities.
After playing in twenty-four matches, both groups of football players were evaluated for the frequency of lower-limb injuries. Although the rates of non-contact knee and hamstring injuries were similar between the two groups, the athletes in the group receiving chiropractic care did experience greater benefits than athletes who had not as the chiropractic patients experienced significantly less lower-limb muscle strains and missed playing time due to injury.
Research Take Away
The researches concluded that the addition of chiropractic care to the participants’ management corresponded with a  trend towards lower limb injury prevention with a significant reduction in primary lower limb muscle strains and weeks missed due to non-contact knee injuries.
Proactive chiropractic treatment provides many potential benefits for athletes, including injury prevention, enhanced recovery and improved athletic performance. For example, previous research has shown chiropractic care to one of the best methods for treating sports hernias in soccer players and has found spinal manipulation to be the most effective treatment for lower back pain in athletes. Research has also shown that chiropractic treatment can potentially improve the athletic performance of judo athletes and rugby by restoring pain-free range of motion.

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Harness the Power of Hybrid Vigor

Regular Chiropractic Care, Wellness, and You

Just as combining strength training and cardiovascular exercise produces enhanced benefits in many areas of fitness, and food combining helps you get the most out of your daily nutrition, regular chiropractic care helps you achieve your goals of long-term health and well-being. Regular chiropractic care is the "x factor" in obtaining high levels of health and wellness. Adding regular chiropractic care to the other healthful things you're doing increases the benefits of those activities. By identifying and correcting areas of spinal misalignment and helping remove nerve interference, regular chiropractic care helps your musculoskeletal, cardiovascular, digestive, and hormonal systems do their jobs better. As a result, your body is optimized to obtain the greatest benefit from all your other health-promoting activities. The combination of exercise, nutrition, and regular chiropractic care makes all the difference.

Certain things in life just go together naturally. In the kitchen, peanut butter and jelly is a classic combination. Another such pairing is apple pie and ice cream.Other categories of life experience, such as human performance, prize the association of freedom and creativity. And in the field of health care, exercise and nutrition are two pillars of a solid foundation for long-term wellness and well-being.
The combination of exercise and nutrition makes intuitive sense, of course, but it's useful and informative to drill deeper into this relationship. Regarding exercise, almost any type of this activity is beneficial.¹ "Whatever works for you" is a time-honored principle in fitness. Swimming, running, bicycling, lifting weights, playing basketball, doing yoga, and walking all provide substantial benefit for people. What's best is to do the things you like to do. Hidden beneath the surface, however, is a very interesting fact. If you combine certain types of exercise, specifically, if you do both strength-training activities and cardiovascular exercises during the course of a week, you'll obtain enhanced results. Interestingly, both your strength and endurance will improve more rapidly compared to doing only one type of activity.
Beyond expedited improvement (and the great satisfaction many of us derive from lifting heavier weights in the gym and running faster on the track), improved strength and endurance are very closely linked to numerous important indicators of optimal health and well-being. It's the combination that makes the difference.^2,3
Similarly, good nutrition is not only a matter of making sure that every food group is represented in your daily diet. Choosing foods from the fruits, vegetables, proteins, grains, and dairy groups is the key first step in all nutritional programs that provide lasting value. But, again, there are hidden relationships. Combining proteins and carbohydrates at every meal causes improved digestion and improved absorption of all nutrients. By more efficiently breaking down the food you eat and more effectively absorbing valuable nutrients, you derive enhanced benefit from the calories you're consuming. You gain more energy to use throughout the day and are able to perform at a higher level. As a result, your sleep is more restful and you wake up refreshed, ready to engage with whatever challenges the new day brings.
The principle behind the power of these various combinations is that of hybrid vigor. The concept is derived from studies of genetics in the 19th century in which it was discovered that cross-breeding often produced hardier plants. We, too, can harness this principle to become hardier ourselves, enabling us to enjoy long-term health, wellness, and well-being.
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¹Lackland DT, Voecks JH: Metabolic syndrome and hypertension: regular exercise as part of lifestyle management. Curr Hypertens Rep 2014 Nov;16(11):492. doi: 10.1007/s11906-014-0492-2
²Sigal RJ, el al: Effects of Aerobic Training, Resistance Training, or Both on Percentage Body Fat and Cardiometabolic Risk Markers in Obese Adolescents: The Healthy Eating Aerobic and Resistance Training in Youth Randomized Clinical Trial. JAMA Pediatr 2014 Sep 22. doi: 10.1001/jamapediatrics.2014.1392. [Epub ahead of print]
³Ho SS, et al: The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial. BMC Public Health 2012 Aug 28;12:704. doi: 10.1186/1471-2458-12-704

The Fast Lane

Regular Chiropractic Care and Core Fitness

Many exercise-related injuries are caused, in part, by deficiencies in core muscle strength. Weakness in core performance leads to a lack of biomechanical support for movements such as bending, lifting, pushing, and pulling. You're not aware of such lack of support until, for example, you attempt a dumbbell squat or try to run a little faster in an interval training session. Even a simple exercise such as a lat pulldown or triceps pressdown requires sufficient core stabilization. A strong core is critically important for a successful exercise program. The core muscular system consists of numerous inner layers of sheets of muscle and a vast array of small muscles that help maintain coordinated movement among your spinal bones, pelvic bones, and hip joints. By detecting and correcting spinal misalignments that cause nerve interference, regular chiropractic care helps ensure that your core muscles are receiving the nerve information they need to function properly and help you get the most out of your exercise time.

Driving fast is not necessarily a good thing. We want to get where we're going as quickly as possible, but we also want to arrive safely. If we drive too fast, we may encounter all sorts of problems. If we drive too slow, we're wasting time and may be causing traffic problems behind us. These competing considerations will both be fulfilled by maintaining an average velocity that is at or close to the posted speed limit. We want to find the "sweet spot," the happy medium that both saves time and helps keep us safe.
The same principles may also be applied when we're exercising. We want to improve, get stronger, and build more endurance as soon as we can, while simultaneously avoiding injury and staying healthy. Very often, these goals may conflict. It's important to ensure that we're exercising efficiently and making certain we're deriving the greatest benefit from our exercise time. These benefits are obtained by a steady approach, one that focuses on incremental gains accomplished over time.¹
It's natural to want to arrive at a desired outcome quickly. But as with any other form of training, whether learning to play the piano or becoming a competent chess player, substantial time is required to produce long lasting results. In the case of exercise, trying to hurry the process will usually cause an injury. You'll be set back at least weeks, if not months, and you'll have to start over, pretty much from the beginning.
For almost all of us the "tortoise" approach, rather than that of the "hare" in the well-known fable, will produce the health benefits we're hoping to achieve from our daily exercise. If you've never walked before and want to incorporate this aerobic activity as part of your exercise routine, start with a 10-minute walk. This doesn't sound like much, but that is precisely the point. Start by doing a little and build up gradually and consistently. Within 6 or 8 weeks you'll be doing 30-40 minute brisk walks several times a week, which will represent a very good aerobic exercise program. Incorporating strength training into your routine will employ a similar method. For each of your exercises (such as bench press, one-arm row, squat, toe raise, shoulder press, biceps curl, and lying triceps press), begin with a weight with which you can comfortably do 10 repetitions. If you can't do 10 reps, the weight is too heavy. Start with that weight and do 3 sets per exercise. Build up gradually by increasing the weight by 5%, if possible, each week or every 2 weeks. After 10 to 12 weeks you'll be noticeably stronger and your metabolism will begin to be more efficient.^2,3
By progressing slowly and steadily, you will build a solid base and make consistent and possibly substantial gains in your exercise routine. You will get where you want to get safely and effectively. The long-term outcome will be enhanced health, wellness, and well-being.

¹Marongiu E, Crisafulli A: Cardioprotection acquired through exercise: the role of ischemic preconditioning. Curr Cardiol Rev 10(4):336-348, 2014
²Huxel Bliven KC, Anderson BE: Core stability training for injury prevention. Sports Health 5(6):514-522, 2013
³Granacher U, et al: The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports Med 43(7):627-641, 2013

When the Cure Is Worse than the Disease

Regular Chiropractic Care and Chronic Disease

Regardless of the prescription medication you may or may not be taking, regular chiropractic care helps provide a strong platform for managing the effects of chronic disease. Although the ultimate causes of chronic diseases such as high blood pressure and diabetes are largely unknown, nerve interference may be reasonably postulated as a key contributor to the development and maintenance of these conditions. If as a result of nerve interference, your body's cells, tissues, and organs are not receiving timely and accurate information from your brain, then a host of symptoms may develop. Over time, chronic disease may be the unwanted outcome. Regular chiropractic care helps eliminate nerve interference by detecting, analyzing, and correcting spinal misalignments that result from normal, everyday circumstances involving work and stress. By helping restore spinal function and reducing irritation to the nerve system, regular chiropractic care provides an environment in which chronic disease is less likely to flourish and your health and well-being can be maximized.

Chronic diseases such as hypertension and diabetes have increasingly high prevalence in world populations.¹ Such prevalence is rising despite extensive use of prescription medications. Problematically, many people have two or more concurrent chronic disorders and are taking multiple medications. But frequently the various physicians are not in contact and are not aware of the patient's complete list of current prescriptions. No single physician or nurse is managing the patient's array of medications. As a result, potentially harmful drug interactions are a common occurrence.^2,3 Mistakes are made and patients may suffer serious side effects. In such adverse circumstances, the cure in fact may be worse than the disease.
In today's health care systems, people as patients need to be good custodians of their own care. In many health systems, a patient is lucky if he or she is able to spend more than five uninterrupted minutes with their doctor. Physicians are rushed and harried by numerous responsibilities related to management of their offices, all of which take precious time away from patient interactions. In such an environment, patients need to be proactive to do their best to ensure that recommended treatment is actually going to be helpful, rather than potentially harmful. This is a very difficult task, as most people do not have backgrounds that will help facilitate understanding of such decision-making. But especially for those with a chronic disease, it's critically important to master at least a basic level of information regarding their condition and various types of treatment.
In addition to expanding one's knowledge base, an important long-term strategy is to begin to make lifestyle choices that will support good health. Appropriate and effective lifestyle choices include regular exercise, a healthy diet, and sufficient rest. All three of these key components of good health can be started right now. An exercise program should consist of five 30-minute sessions of vigorous exercise every week. A healthy diet consists of daily selections from all five major food groups: fruits, vegetables, grains, proteins, and dairy. A daily diet should include at least five servings of fresh fruit and vegetables every day. Regarding sufficient rest, 7-8 hours of sleep per night is a good average for most people. If you're not waking up feeling rested and refreshed, you're probably not getting enough sleep.
Ultimately, each of us is responsible for our own health and well-being. Prescription medication may be necessary, but of course such treatment is primarily directed toward the effects of a person's disease or disorder. Changes in lifestyle are required to address the underlying causes of such conditions. Beginning to institute and maintaining healthful lifestyle choices will provide long-term benefit for the welfare and well-being of our families and ourselves.

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¹Bauer UE, et al: Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. Lancet 384(9937):42-52, 2014
²Rotermann M, et al: Prescription medication use by Canadians aged 6 to 79. Health Rep 25(6):3-9, 2014
³Marengoni A, et al: Understanding adverse drug reactions in older adults through drug-drug interactions. Eur J Intern Med 2014 Oct 10. pii: S0953-6205(14)00282-9. doi: 10.1016/j.ejim.2014.10.001. [Epub ahead of print]