Thursday, April 30, 2015

The Top Shelf


The Top Shelf Shoulder Injury
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

Wednesday, April 22, 2015

Mission Possible


Regular Chiropractic Care and Your Mission of Good Health
Several critical lifestyle choices support your mission of obtaining ongoing high levels of health and well-being. But these activities, such as engaging in regular vigorous exercise and a healthy eating program, should not be done in isolation. The missing ingredient, the specific action that makes all the difference, is ensuring that your nerve system is working properly so that you can make the best use of all your healthy lifestyle actions. Regular chiropractic care helps ensure optimal functioning of your nerve system by detecting, analyzing, and correcting spinal misalignments. Misalignments of the spine irritate spinal nerves and cause nerve interference, resulting in faulty communication between your brain and your other body systems. Such faulty communication leads to loss of good health and prevents your body from obtaining maximum benefit from your nutrition and exercise programs.
By correcting spinal misalignments, regular chiropractic care helps remove nerve interference and restore optimum functioning of all your body's systems. In this way, regular chiropractic care helps you and your family achieve greater levels of health and well-being.
Everyone knows what he or she "should" do to obtain good health. But the mere knowledge of what we should be doing is never enough. If we've not been in good shape for some time, if we can't remember the last time we did any meaningful exercise on a consistent basis, and if we've added more pounds over the years than we care to admit, then the task of getting back in shape seems an impossible mission. But like the Mission Impossible team in the fabled television series and the hugely successful film adaptations, we too can turn the task of regaining high levels of fitness into "mission possible".
The primary requirement for your personal restoration project is establishing a new mindset. No one wants to do what other people think they "should" do. Having your spouse tell you that you should lose weight or having your doctor tell you that you need to do more exercise is never pleasant. These admonitions never really work and only serve to create stressful encounters and interactions. Even though the people close to you have good intentions and want the best for you, they usually don't realize the willingness to change is never sourced from outside a person. The only way you're going to take on the time and effort of implementing new lifestyle activities is if you yourself choose to do so. Making the active choice to exercise and making the active choice to eat healthy foods will create the powerful difference by which you begin to actually accomplish the action steps necessary to change the quality and characteristics of your health and well-being.1,2
Thus, your own personal choice is what's required to get you started. Importantly, making such a choice is not a one-time event. Circumstances always intervene and your choice to exercise and eat nutritious foods will need to be reinforced frequently. There may come a time when you choose to sleep late and skip your exercise session for that day. Or you may choose to eat a whole pint of ice cream in the middle of the week. It will be helpful to recall that such deviations from your main plan are always your choice, and returning quickly to your regular exercise routine and regular food program will also be your choice.
None of this needs to be dull, boring, or onerous. Remember that if you think you "have" to do your exercise and "have" to eat fresh fruits and vegetables, then you probably won't do these things for very long. But if you remind yourself that you have actively made a personal choice to engage in healthy activities, then you will recreate your opportunity for powerfully participating in the ongoing restoration of your own vibrant health and well-being.3
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1Sardinha LB, et al: Criterion-referenced fitness standards for predicting physical independence into later life. Exp Gerontol  61:142-146, 2015
2Hafstad AD, et al: How exercise may amend metabolic disturbances in diabetic cardiomyopathy. Antioxid Redox Signal 2015 Mar 4. [Epub ahead of print]
3Crous-Bou M, et al: Mediterranean diet and telomere length in Nurses' Health Study: population based cohort study. Brit Med J 2014 Dec 2;349:g6674. doi: 10.1136/bmj.g6674

Thursday, April 16, 2015

Rice and Beans


girl_eating_watermelon.jpg
Regular Chiropractic Care and a Healthy Lifestyle
The importance of making healthy lifestyle choices is becoming increasingly well known. Vigorous exercise, a healthy diet, and sufficient rest are key components of a healthy lifestyle, regardless of a person's age. But in order to get the most out of the good things you're doing on your own behalf, your nerve system must be functioning at full capacity. Nerve signals, messages between your brain and the rest of your body, need to be transmitted accurately and on time. "Service interruptions" result when spinal misalignments and nerve irritation are present. Your musculoskeletal system and digestive system are prevented from working efficiently. Such problems may lead to pain, symptoms, and even disease. Regular chiropractic care corrects spinal misalignments and helps reduce and resolve nerve irritation. As a result, regular chiropractic care helps maximize the benefit of all healthy lifestyle choices, enabling everyone to achieve greater levels of health and well being.
Rice and beans is a well-liked combination of foods that is not only delicious, but also good for you. Other well-known examples of food combinations, such as corn and lima beans (succotash), tomatoes and avocados, and even orange juice and oatmeal, provide benefits beyond those gained by eating these sound nutritional choices individually.1
For example, the combination of rice and beans provides complete dietary protein (containing all the essential amino acids we need to build all the other proteins in our bodies). Similarly, the succotash combination of lima beans and corn contains high concentrations of essential amino acids. When you combine avocados and tomatoes, the fat from the avocado helps your body more efficiently use heart-healthy and cancer-fighting antioxidants such as lycoprene contained in the tomato. A heart-healthy breakfast consisting of real oatmeal, such as oatmeal made from rolled oats or steel cut oats, and real orange juice (not from concentrate) provides a potent combination of phenols that are associated with reduced atherosclerosis and cancer. 2,3
These combinations are specific examples of the more general principle of food combining by which you combine proteins and complex carbohydrates at every meal. When you combine these complementary sources of nutrition on a regular basis, you retrain your body's metabolism. By consuming a "slow-burning" energy source, you're providing high-quality fuel for the next three to four hours. Several very good things occur as a result. Energy utilization is optimized, that is, your body gets more benefit out of every calorie it's burning. Additionally, insulin levels are stabilized throughout the day. Over time, food combining helps a person become a leaner machine and helps reduce the likelihood of developing type 2 diabetes. These benefits are especially important for people who have been told they are hypoglycemic or pre-diabetic. Of course, you should always check with your doctor to make sure a food combining strategy is right for you.
When you add a program of regular, vigorous exercise to your food combining lifestyle choice, you obtain even more profound benefits. The vigorous exercise you're doing raises your body's basal metabolic rate. Your body begins to burn calories even when you're asleep. Owing to the increase in lean muscle mass you're gaining from exercising over time, you're burning more calories throughout the day. You find yourself craving more nutritious foods, that is, those that will provide higher-quality nutrition, such as the nutrition contained in such combinations as rice and beans and oatmeal and orange juice. Thus, your positive lifestyle choices contain their own positive feedback system. The better choices you make, the healthier you become, and the healthier you want to be. The long-term results are enhanced health and well being for you, your family, and your friends.

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1Liu RH: Health-promoting components of fruits and vegetables in the diet. Adv Nutr 4(3):384S-392S, 2013
2Hu D, et al: Fruits and vegetables consumption and risk of stroke: a meta-analysis of prospective cohort studies. Stroke 45(6):1613-1619, 2014
3Thomburg KL, Challis JR: How to build a healthy heart from scratch. Adv Exp Med Biol 814:205-216, 2014

Thursday, April 2, 2015

Your Own Personal Trainer


fitness-trainer
Regular Chiropractic Care and Personal Fitness
Getting regular exercise is not a cure-all. Although it's very difficult to maintain good health if you're not exercising consistently, exercise in itself is not enough. Additional components of a healthy lifestyle include good nutrition, sufficient rest, intangibles such as a positive outlook on life, and regular chiropractic care. Regular chiropractic care ties together all the other things you're doing to achieve high levels of personal health and wellness. By identifying, analyzing, and correcting spinal misalignments, your chiropractor is helping to reduce nerve interference and helping to facilitate optimal functioning of all your body's physiological systems. As a result, you're able to make maximum use of the good foods you're eating and get the most out of your exercise time. By making these healthy lifestyle choices, including regular chiropractic care, you're choosing to enhance your personal health and well-being.
Back in the day, there were no personal trainers. If you needed to learn how to exercise, you got a subscription to one of a few well-known "muscle magazines" and read several issues from cover to cover. Then you joined a "Y" and began to discreetly observe what was going in the weight room, trying to match up what you had read in the magazine with what you were seeing in the gym. Eventually, you put together a series of exercises, sets, and reps that worked for you. Back then, any strength training program you developed would be strictly based on a seat-of-the-pants approach. You learned by trial and error.
Today there is a vast body of scientific literature focused on the various benefits of numerous forms and types of exercise.1 However, scientific studies are not good at evaluating the how-to's of getting fit. Fortunately many informal resources are available, all intended to point you in the right direction. But not all of these resources are accurate or trustworthy, and the challenge is to identify a set of basic principles that will be applicable to your specific situation.
Firstly, before getting started you need to make sure that it's OK to actually get started. Let your  doctor (your family chiropractor, family physician, or internist) know what you're planning to do and have her tell you what you need to watch out for, if anything. Next, you need to make a commitment. Consistency is the key to deriving lasting value from exercise. Additionally, irregular exercise sessions will often lead to injury. If you're serious about getting fit, then make a commitment to yourself to participate in a 12-week program. At the end of 12 weeks, you'll evaluate how you feel, what you've accomplished, and whether you want to keep going.
In terms of strength training (that is, weight lifting), three sessions per week is ideal. By doing "split routines" you can exercise all the major muscle groups each week. On one day you'll do exercises for the chest and back. Another day you'll do exercises for the legs. On the third day you'll focus on the shoulders, biceps, and triceps. This set of split routines will produce optimal results for many people.
Importantly, you'll be doing chest and triceps (and back and biceps) on different days, thus avoiding the potential for overwork and injury. But you may find that an alternate set of split routines works best for you. The key is to start slowly and build up strength gradually. Once you have some experience and an improved level of fitness, you may branch out and vary your basic routine, experimenting and seeing what works best for you. In terms of sets and repetitions (reps), three sets per exercise and eight to 12 repetitions per set represent the classical, tried and true method of getting fit and making gradual strength gains over time. For any strength training exercise, start with a weight at which you can do eight repetitions comfortably. This should be neither too easy, nor too difficult. Of course, it's far better to err on the side of caution. You never want to do too much too soon.

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As you go along in your fitness program, you'll add core exercise routines2 and aerobics exercise such as walking, swimming, biking, and running. If you work out slowly and gradually and maintain consistency, you'll have a great deal of fun and gain substantially improved levels of health and well-being.3
1Storer TW, et al: Effect of supervised, periodized exercise training vs. self-directed training on lean body mass and other fitness variables in health club members. J Strength Cond Res 28(7):1995-2006, 2014
2Kahle N, Tevald MA: Core muscle strengthening's improvement of balance performance in community-dwelling older adults: a pilot study. J Aging Phys Act 22(1):65-73, 2014
3Huffman KM, et al: Metabolite signatures of exercise training in human skeletal muscle relate to mitochondrial remodelling and cardiometabolic fitness. Diabetologia 2014 Aug 5. [Epub ahead of print]