Research Exposure Therapy 1. A Case study on mood.
OK so this one might be a little different.
I thought that this year I would do something I have never done here before and actually use this blog space more like an ongoing blog.
To remain registered as a chiropractor, Martin and I have to meet certain standards, and part of those standards is ongoing education.
Often Martin and I will find ourselves reading research papers or hear about new research that changes how we practice, or has us excited about how we practice that has significant impact for the clients that we are lucky enough to see.
As always, we meet weekly, discuss the information and then try to implement it into our practice as we constantly strive to improve our care, but there might be a lot of you who are actually keen to learn along with us.
Which leads me to this post, I am not sure what form this will take eventually, but what I was wanting to do with them is not to just present the information like a summary of the research, but I would love for people to see what information is out there and then understand why it is significant to us at Align and you as a client.
I’m not intending to explain the methods etc, though I will always provide the citation for you. My goal is to outline what is some interesting research I have come across, and hopefully encourage people to understand more, perhaps it will be relevant to them or to a loved one, but we would like to encourage you to discuss it with Martin or myself if it does pique your interest.
So without further preamble. The research:
Hughes F. (2020) “Reduction of cortisol levels and perceived anxiety in a patient undergoing Chiropracticmanagement for neck pain and headache: a caseReport and review of the literature,” Journal of Contemporary Chiropractic, https://journal.parker.edu/index.php/jcc/article/view/95
Now to start with, a disclaimer, this is a case study only and as such is a starting point for further research, NOT a definitive research answer. Individual results of care may vary. If you have any questions about research design and why some are more highly valued compared to others, please ask Martin or myself.
In this case study, a chiropractor was managing the care of a lady suffering from neck pain and headaches.
As part of the care provided, the chiropractor had the client complete surveys regarding her mental state as well as for pain etc. and the client also had her cortisol (or stress chemical) levels measured at the outset and as reassessment points in her care.
What was discovered was that through ongoing chiropractic care including adjustment and home advice, not only did her neck pain and headaches improve, but the client’s cortisol levels decreased significantly as well as the client herself feeling less anxious in her day to day life.
This particularly stood out to us as anxiety was NOT what the client was intending to have managed by the chiropractor, nor was it the focus of the chiropractor’s care plan for the client, yet areas outside the initial complaint significantly improved, creating a better quality of life for the client.
This was significant to me as it certainly reflects what we often see in practice with out clients. Often we will have clients state how much more relaxed they feel after an adjustment, or that they can breathe easier, or a “weight has been lifted from their shoulders”.
This has been particularly common throughout the last 2 years as we have had…lets say more stress than is normal in our day to day lives because of the pandemic.
The main reason I was inspired to write something here though is because often when we are busy or when people have significant injuries etc that we are managing, as a practitioner it is easy for us to focus on just the issue clients might present with and in doing so, we might be missing significant contributing elements.
For clients this might be more important, as imagine if there was another issue you were putting up with and even though myself or Martin were in a position to help, we are not aware that we could be working with you to get on top of other issues at the same time.
At Align we use specific surveys to get a snap shot of where a client will be in regard to mood, energy, concentration and attempt to track these over time, but going forward, I want to make sure I am encouraging our clients to make sure they are getting the most out of their care.
If there is something else bothering you or you aren’t sure we could help with, then we would love for you to feel free to ask us. Hopefully we are in a position to help you, but even if we are not, I am confident that we will be able to find the right person who CAN help you with whatever issue you might have.
The advantage of being a practice that is over 30 years old is that we have contacts in many fields to help clients get where they need to go, because sometimes chiropractic, as wonderful as it is not the answer. But I bet we can find someone for you who is.
So next time you get adjusted, pay attention to how you feel, do you feel more relaxed? More alert? Sharper? Freer? We’d love to hear about what you find.
Still working from home? How to keep your Neck and shoulders moving
Even though Melbourne will be thawing out of Lock down 4.0, we are aware that a lot of our clients will still be working from home again for a while.
If this is you, Its very important that you keep on top of your spinal health while you re adjust to working from home for the foreseeable future.
Fortunately, during Lockdown 2.0, Martin made this comprehensive video outlining everything you can do to keep yourself moving stay on top of your posture, and free up a lot of the tension you have felt building, especially over the last few weeks of lock downs.
Avid readers of this blog will note that we posted this video in September last year, but given recent events, I feel like Martin’s video couldn’t be more poignant so I am reposting for your convenience.
If you have a specific issue please do not hesitate to contact the practice so we can see how we can keep you going.
As usual with our videos, the transcript is available below, but I strongly recommend you have a watch as Martin runs through some excellent tips, stretches, exercises and muscle releases that will have you feeling a lot more yourself during this period.
The video has a few sections so if you REALLY felt like it you can skip to a section you find most relevant, however the way that Martin has filmed it the segments build on each other to get the most out of each one.
Enjoy!
2:00 Todays video is about...
3:52- Where to begin?
4:15 Rotational Movements of the Neck
5:32 Lateral Flexion of the Neck
7:12 Flexion/ Extension of the Neck
8:07 Shoulder Exercise
9:28- 3 exercises to open shoulders
13:48- Overhead position for shoulders
14:54- Focus on Alignment
17:23- Intro Spikey Ball Exercise
18:27 Beginning of Spikey Ball Exercise
23:27 Conclusion
Hi, Martin here from Align Chiropractic. Today's video is a follow along video, meaning I'm going to be taking you through some things that you can do, and you can more or less just watch the video and follow on.
So, the purpose of this video, it's really about moving your upper spine, your neck, your shoulders, your middle back to get mobility in those areas but also to soothe those areas.
It's really based on the clinical model that we use in our practice where we see that there's a real benefit in looking at the spine in kind of a sequential way, that spinal problems generally what's happening is that segments of the spine rather than having the ability to move through their full range of motion and kind of jammed up from either trauma, or long periods of time in particular postures, or stress tightening up the muscles around it.
And then as the joints jam up that changes the way the nerves and muscles and all the other soft tissues work, which then changes the alignment of your spine, and this change in movement and alignment of the vertebra causes misfiring of nerves which has a whole range of effects on your body, but specifically it can affect your ability to kind of balance the whole system.
If you're not balancing the whole system then your spine's going to be less stable. It's much more common for you to have problems with your back, your neck and the rest of your body if things aren't stable. So, if we look at that it goes movement, then alignment, then balance, then stability and so a common thing that I’ll see is people talking about ‘I need to do stability work or core stability work’.
I actually think it's really important that we do the basics first we've got to get movement happening first, and then once we've got movement, then we want to have a proper alignment so that when we're stabilizing first of all it's more effective, but we're also locking in a good movement pattern and a good alignment pattern rather than locking in poor ones.
2:00 TODAYS VIDEO IS ABOUT...
So this one specifically, today's video is really about dealing with this upper part of the spine because many of us are locked into these postures working at a desk or the effect of stress tightens up our neck and shoulder muscles and pushes our head posture forward and so this is really about restoring movement to those areas and then getting our alignment back into that nice upright posture.
I'm also going to be combining some approaches that come from new research into the interplay between how we breathe and our stress response and in particular if you want to dive deeper into this, there's a neuroscientist called Andrew Hubermann who's based at University of California, sorry based at Stanford and we're going to be using a couple of different approaches to breathing that we're combining with the movement approach and using a ball- spikey ball, or a tennis ball, or a lacrosse ball that we'll be using to just release muscle tension and some of that will be just I'll be cueing you to breathe in through your nose, and then we'll also be using an approach called a physiological sigh, which is really where you just take in a deep breath through your nose and then another deep breath through your nose before
letting it out and the emerging evidence is that this is a really quick and easy way of us helping to unwind some of the neurological effects of stress which we know can have really significant impacts on how we feel and how healthy we are. So, let's dive straight into this follow along routine to help release tension in neck, shoulders, upper back, and get movement into those areas so that you can have a healthier, happier, more active body
3:52- WHERE TO BEGIN?
Well the first thing that we want to do is we want to encourage movement back into the neck, so with the postures that we've been in and the lack of movement and there's a tendency for our neck to kind of stiffen up, and there's a segmental part of that which is what wewould address in office with an adjustment, then there's kind of an overall regional movement that we can address with exercise.
4:15 ROTATIONAL MOVEMENTS OF THE NECK
So first movement we're going to do is we're going to be doing rotational movements. With this I just want you to be taking nice slow breaths, in through the nose, out through the mouth.
So first of all just turn your head all the way to the left, and then go all the way to the right. I'm going to go through this five times each way, and we're not pushing we're just holding at that end range- nice and gently.
Let's see it just easing into it letting your shoulders drop, just letting that tension, that sort of habitual tension ease away. That's it. I think that's four, probably need a better way to count to be able to do this. Okay, I'm going to say that's five.
5:32 LATERAL FLEXION OF THE NECK
So next we're going be moving into lateral flexion so we just need to be cautious with this, if you get any pinching, any sort of sharp sensation that says you don't want to go that far, you want to stop before that point.
All of these mobility things are done within what feels just you're touching that point of tension or restriction. So sideways it's going all the way over there.
I'm just pausing at that end range, maybe a count of three. Just working our way into that range, just getting every vertebrae in our neck and even into our upper back starting to move.
This is our third one. Maybe just pause a little bit longer there, any sort of knotty points you can just almost sort of focus on it, just get that movement happening, just nodding a little bit back and forward. Okay that's four. So one more to go.
Last round for lateral flexion. Lateral flexion's actually a really important movement there's not many day-to-day activities that we do to encourage this range of motion, so it's often an exercise that we'll have people do because getting lateral flexion actually encourages movement in the other range.
7:12 FLEXION/ EXTENSION OF THE NECK
So now we're going to go flexion/ Extension. Flexion I'm going to get you to go nice and gently on, because we all tend to spend a lot more time in flexion than we do an extension. With extension which is the one going back, again just be really mindful that you don'twant to be getting any pinching sensation with that. With this one I'm doing it up against the wall. If you feel any dizziness with this then back off, maybe skip this part of it. This is our last one, our fifth repetition. Okay.
8:07 SHOULDER EXERCISE
Now functionally interlinked with your neck is your shoulders, and so again all this time spent like this, there's an alignment component of that, but before we can really address the alignment we've got to get the ability for these joints to move, so first up I’m going to do a stretch across the body, trying not to mess up my mic here.
So come all the way across, and we're just going to breathe in through the nose, and out. I'm going to do this one for three breaths. Just going to go a little bit further on this third one. Okay and then we're going to swap our arms. Bringing the arm across, the other arm just hooks in next to the elbow there. Breathe in, out. Breathe in, and out.
9:28- 3 EXERCISES TO OPEN SHOULDERS
So, it started to get some mobility, but really if we want to be able to bring our shoulders back which is what most of us need because so much of our activity is in front of us, we want to be opening up and restoring that movement that way.
So what we're going to do here is spend sort of three exercises bringing and opening up this in the front of our shoulder.
The first one what we're going to do here is we're going to put our hand up on the wall above horizontal, so if that's horizontal first one we want is up here, and then i've got my body sort of facing away there my elbow is straight, and then i'm turning out this way, and then i'm going to do three breaths there. So in through the nose, and out. That’s two. I can just rotate a little bit more, and three.
I'm just going to take that tension off, and now i'm going to that horizontal level, and it'll feel a little bit different, it's going to hit a slightly different part of the shoulder.
So again in through the nose, and out through the mouth. And three. Now we're just going to do just below horizontal to again getslightly different part of the shoulder.
We're going to come across. One, Two, that’s three. Okay, so now we're going to repeat exactly the same thing but on the opposite side. So first one, if that's horizontal we're going up maybe 30 degrees above horizontal, rotating away feeling the stretch at the front of the shoulder maybe a little bit into the arm. One, Two, That's three.
Then we're going to a horizontal point now, taking that stretch back up, and then in through the nose, out through the mouth. That's three. So, I'm going to get out just below horizontal one there, take that stretch up. And then in through the nose, and out. Then that's it, just move your shoulders around enjoy that extra mobility there.
13:48- OVERHEAD POSITION FOR SHOULDERS
So next what we're going to be working on is bringing up into flexion or sort of like an overhead position for our shoulders. So, with this I'm standing sort of basically like arm length away from a wall, and I reach out, I put my hands down keeping my elbows straight and then what i'm doing from here is keeping my arms straight and dropping my body all the way down.
I'm not rounding my back, I'm keeping my back quite straight, and then getting that movement back into the shoulders giving them that full range. We're just going to do three breaths here, so in through the nose and then out.
14:54- FOCUS ON ALIGNMENT
So next what we're going to do is move on from looking at movement and we're going to focus instead on alignment. What we're really wanting to do is to reverse that tendency that we all have to have this sort of position, and so what we're going to do is do an exercise called a W exercise, which is where you make your arms into a W shape with the thumbs facing backward.
I always like to sort of correct the head posture so pull your head back, and I also like to look up slightly because that helps just release the activation here. What we're really wanting to do is use these muscles down here in between our shoulder blades. So, make the W shape look up slightly and then what we're doing is trying to not use these muscles but use those ones in between your shoulder blades.
We're squeezing back one two three. Relaxing one, two, three. One, two, three. One two, three. We're going to go for ten so that's four, three. One, two, three, so I'm going to say that one's four, and five
Six. If it's getting uncomfortable, if things are starting to burn just take a little break, six and seven.
So it's kind of this back and down movement that we're after- just caught myself looking down too much. Nine and last one. Good.
What we've done there is really kind of reset our alignment, and that'll mean that rather than when your heads forward everything through has to be working overtime just to stop your head from going forward with gravity. So we're going to use that we've gotmovement, we've got alignment.
SPIKEY BALL: 17:23
Now what I want to do is just kind of soothe this area. We're all doing a lot of this, let's just work through with some pressure on those areas, and for this i'm going to suggest that you use a ball, a spiky ball. In this case this is a lacrosse ball, and what we're going to start with is we're going to be doing three individual spots. We're going to be doing one right in between the spine and the shoulder blade here, then we're going to be doing one that's up, almost on the meaty bit above your shoulder blade, and then we're going to be doing this little corner in here where your arm joins onto your shoulder blade there.
We're going to do that on each side. We're going to use that slightly different breathing where rather than just breathing in through your nose and then out through your mouth, if you want to experiment with it, this is a really good place to use that physiological sigh, which just helps reset our nervous system from a stress sort of state, into what they call a parasympathetic state, which is putting your nervous system in a state to promote rest and relaxation and kind of de-stressing.
18:27 BEGINNING OF SPIKEY BALL EXERCISE
So let's start off. You put the ball against the wall, and then just drop it down a little bit so you can get into that spot and rather than rolling around, what I like to do for this is just find a tender spot, hold pressure there. And then we're going to go breathe in through the nose, and then second breath, and then out. So just moving into a slightly different spot there.
Breathe in, second breath, and out. Breathe in.
Now we're going to move to the top of the shoulder. So, for this one you almost need to angle back a little bit. I'm just going to find that fleshy bit there. All right so I’m going to breathe in. Okay, so that's our three breaths there. Now for this one, I've got a really a choice of going on the actual arm here, or for most people this area in the side of the shoulder blades the spot that you want to hit, so I'm going to hit that one.
If you're doing this by yourself you could maybe do an extra round where you go to the other one if you're feeling tender in both, but I'm on the side of the shoulder blade.
The easiest way of getting there is having your body sort of on a 45-degree angle there, just finding that tender spot- okay that's definitely it. And so I'm going to breathe in through my nose, that's number two, let's go for number three- that's a really tender one.
Okay, so now what we're going to do- oops dropped my ball. And i'm back. All right so same sequence, we're just going to do the opposite side. So again, ball against the wall, I'm just going to roll into that spot just next to my shoulder blade there. All right that's it, I've got the right spot, so I'm going to breathe in through my nose. Second breath.
So now I'm just going to reposition that ball. I'm getting ready from the top of that shoulder blade there. First breath, double breath. Second breath, that's our third breath there.
Now we're just going to move to the outside of the shoulder there. So again, looking for either on the shoulder blade or the back of the arm. So I'm going to keep it consistent that 45 degree angle here. I’m going for that spot on the shoulder blade just breathing in I'm just moving up a little bit, finding that real epicenter of tension there. All right that's it, so breathe in at that spot...really relax into it. One more, breathe in through the nose.
CONCLUSION: 23:27
So there we have it, we've got movement through shoulders, neck, sort of upper back as well, then we've reset our alignment so thatwe're in a nice upright position and then we've kind of reset the tension, reset the nervous system giving you the best chance of having ahealthier, happier more active body. Thanks for following along.
8 of our best stress busters!
This post is for anyone who feels they are holding onto the stress of 2020 or are struggling to feel up to speed in 2021, who could use a quick circuit breaker to manage their stress and feel more themselves.
As our live become “normal” again, with nearly everything being back at full capacity, very few places requiring face masks and your social lives (or at least your family’s social lives) picking up pace, many of our clients have been finding themselves more fatigued, worn out and just generally more stressed than they were back in the before times (aka pre March 2020).
It’s almost as if consciously we WANT to be back to normal, but our bodies haven’t decided to go along with us yet.
There are many possible reasons as to why this is, but the main themes I am hearing is that people are just waiting for the next round of lock downs to hit us at any moment, and the other is that a lot of people actually LOVED the slow down in the pace of their lives.
A lot of us are struggling to return to the glorification of being busy and the constant social demands on our attention and time.
Especially in Melbourne, we spent more of the last year being afraid of too much direct human contact than we did out in society. Now we are headed back to office and not only do we have to retrain our brain to be OK with having people around, but we have to be “on” all day, not just for the Zoom meetings we had!
It really takes a toll on us and has left a lot of our clients drained.
We know you don’t have time to research the best steps you can take to get back to feeling you, if only someone would accumulate years worth of stress related blogs in one easy to locate place and post it on their website amirite??
As always, we’ve got you covered!
May I present, here, for the first time in one place, the best of 6 years of stress specific blogs to get you back on track!
And No, one of the steps won’t be “Get adjusted”. If you’re on this blog you already know how relaxed and good you feel when you’re adjusted. This list is about what YOU can do, from the comfort of your own home to take control.
So without further waffle from me….
8 of our best Stress Busters
Make Stress your friend.
As you know, just saying “don’t let it get to you” is about as useful as a passport in a pandemic, but did you know you possess a huge power over how your body FEELS like it responds to it?
There is no making stress disappear but as I discussed in 2015, there may be a simple way to have lasting impact on what your body physically DOES with the stress and therefore changes how you feel about it.
when you have 15 minutes, watch the video as Kelly McGonigal explains it much better than I can.
The importance of saying ‘NO’.
Not just for little kids to annoy your parents, ‘no’ can be a powerful stress reliever.
You’ll heave heard of FOMO, the Fear Of Missing Out?
Well let me introduce JOMO, the Joy Of Missing Out.
If you have ever had a social event coming up and been wishing that it would get cancelled, then you need to connect with JOMO and embrace saying ‘NO’ more often.
Look at your upcoming weekends and recognise, its OK if we don’t do multiple things every day, I won’t say yes to dinner with ‘X’ or breakfast at ‘Y’s house. It’s OK to have enjoyed a few quiet weekends over lock down, to not always be available to everyone. After all, if your friends and family needed down time, you’d understand…and I hate to sound like your mother but if they DON’T understand your need to have some time to yourself then maybe they weren’t very good friends in the first place.
Improve your sleep!
As discussed at length on many occasions on this blog (most recently HERE) getting a good night of sleep is potentially the most important thing you can do for yourself.
For an explanation as to what sleep DOES to us to keep us healthy and reduce sleep, read the blog here about an interview with a sleep expert, but for Martin’s hottest tips on how to GET good sleep, watch the video.
Exercise your demons.
“I really regret that exercise I did and now I feel more stressed out” - Literally no one. Ever
This might seem really obvious but it is worth remembering. Pick an exercise you love to do and give yourself time to do it.
(Foam) Roll your way to relaxation.
Again, this one will seem a little too simple, but as Martin explains in this post, using a foam roller to help get rid of your tight stress shoulders and gert your body breathing again isn’t only easy to do but hugely effective as well!
Screen your screen time.
Think about what you’re doing on your screens and when.
Research shows that if the very first thing you do when you wake up is check your email, subconsciously you’re starting your day on someone ELSE’S agenda, and this increases the stress chemicals in our blood from the beginning of your day, and things cascade from there.
Try getting out of bed, setting a routine, even if its a short one like “I will have a shower and then open my email once I have made breakfast”, that way you open them on YOUR terms.
Also, while thinking about screen time, your devices will all have night modes for their screens, TURN THEM ON. Have them come on as the sun sets and timed to come back to normal as your day starts.
Theres a lot to this but basically, the orange/red of a night mode screen doesn’t wake your brain up the same way the blue/white light of a normal screen does. You’’ll fall asleep faster and better.
Meditate.
This one is obvious and yet feels like it will be impossible to fit into your day and even harder to stick with. There is some good news though, research shows that meditation is like exercise, the more you do it the easier it gets and SOME IS ALWAYS BETTER THAN NONE.
In fact, research shows you can start to get the benefits of meditation even from very short periods of doing it, the song “Someone like you” by Adel or “Strawberry swing” by Coldplay have been shown to start you in the right direction (personally, I’m an Enya man).
Why not try challenging yourself to listening to a song that relaxes you quietly while you take a minute to yourself for a week? Then after you prove you have 3-4 minutes to do that, the jump to a 5 minute guided meditation in an app like ‘smiling mind’ doesn’t seem like such a giant leap!
Try, Try again
Read our 3 simple steps to help keep a healthy change going.
No one expects you to be perfect or to do all 8 of these recommendations at once! Give yourself a break, you deserve to find out which of these tips suit you and only YOU can find out how they fit into your life.
As always, if there is anything we can do to help, any extra info we can provide, then please do not hesitate to get in contact with us!
A quick way to move and soothe your neck
This post is for anyone missing their normal routine and would like some tips on getting rid of the tension and restriction they are starting to feel in their neck, upper back and shoulders, but don’t have the time to watch or go through the whole sequence as described by Martin in an earlier video.
As most of you are aware, during the stage 4 restrictions in Melbourne allied health are only allowed to practice on a more urgent basis, meaning that a lot of our regular clients are missing out on getting their regular adjustments as well as maintaining themselves while living in lock down.
Never fear however as Martin and I are still in practice!
If you have a specific issue please do not hesitate to contact the practice so we can see how we can keep you going.
Below is the next instalment of our “Move and Soothe” series of posts.
Many of you expressed that although the original video was very helpful, it was a fairly long run time, so…you asked for it and we have delivered!
Martin has whipped together a quick video about how to keep yourself moving at home, helping your neck keep moving, free up a lot of the tension you have felt building, especially over the last few weeks of stage 4 lock downs.
As usual with our videos, the transcript is available below.
Enjoy!
0:00- intro
Hi, Martin here from Align Chiropractic. This is another follow along, move and soothe video. This one is designed to be a quick routine that you can do maybe in the middle of the day, or when you don’t have as much time. It’s really oriented at releasing tension, improving movement through your neck, and then extending out into the shoulder area.
So the idea here is that we use a sequence that we would use when we’re providing chiropractic care to deal with problems, which is we’ve got to create movement in the system first before we can then change alignment. Improving movement and alignment are the key to then creating changes in the way all the soft tissues work, so releasing tension, allowing nerves to function better. The nerves functioning better is what then translates into muscles functioning better because nerves control muscles, then that’s what creates an environment where you can create a spine that’s both more balances and more stable. So we look at is as movement, alignment, and then balance and stability come as a result of that. If we try and create stability without having movement and alignment- much less effective.
1:17- description
So let’s get into it. With this one you can do it either sitting at your desk, so if you’ve been spending hours doing this and you’re starting to notice that tension building up, or you can do it standing.
The first thing we are going to do is we’re going to double up and do our move and soothe together. So, we’re going to be moving our spine through ranges of motion, getting it to that end range of motion to encourage full range of motion in our neck, And we’re going to be applying a little bit of a release to the muscles that most commonly tighten up as a result of stress, or as a result of postural stress. With this one, you don’t need any equipment- in some of the other move and soothes will use a spiky ball, a tennis ball, or a lacrosse ball, but for today we are just going to be using our hands so that it’s super easy to do wherever you are
2:11- breathing
I’m going to be incorporating the physiological ‘sigh’ breathing that you might have seen on other videos. It’s an approach that I came across through the research of a neuroscientist called Dr Andrew Hubermann. I won’t go into a whole lot of detail, but basically it is where you take a deep breath in through your nose, and then when you get to that point where it’s tight, you just take a little breath over the top- so it’s a double breath. And then relax.
2:47- Lateral Flexion
So, to start off we’re going to be doing lateral flexion- probably the most important movement for us to have. To incorporate a soothe, what I’m going to get you to do is just reach across with the opposite hand and apply some pressure to this muscle up here and apply some pressure to this muscle up here in your upper trapezius or levator scap muscle. So just feel in there and find a point that’s feeling a bit tight- it’s right there for me, and then we are going to incorporate breathing in through our nose. Then we’re going to the other side, and then we’re going to breathe back over this side. Just letting that relax. I’m going to go one more time- breathing over to this side. Now just swap hands, and one more. That’s it, now we go to rotation
Rotation 4:20
So, hand across and this time, we’re going to be focusing on rotation away from the side that our hand is. So, breathing in. Swapping over. Breathing in, breathing in. Last one. Shrug your shoulders up and let them relax.
Conclusion: 5:38
There we have it. Just a quick follow along to help you release some tension, improve the movement, and have a much healthier, happier spine.
Home care during Stage 4: Move and Soothe your Neck and Shoulders
This post is for anyone missing their normal routine and would like some tips on getting rid of the tension and restriction they are starting to feel in their neck, upper back and shoulders.
As most of you are aware, during the stage 4 restrictions in Melbourne allied health are only allowed to practice on a more urgent basis, meaning that a lot of our regular clients are missing out on getting their regular adjustments as well as maintaining themselves while living in lock down.
Never fear however as Martin and I are still in practice!
If you have a specific issue please do not hesitate to contact the practice so we can see how we can keep you going.
Below is a video Martin made at home about how to keep yourself moving at home, helping your neck keep moving, free up a lot of the tension you have felt building, especially over the last few weeks of stage 4 lock downs.
As usual with our videos, the transcript is available below, but I strongly recommend you have a watch as Martin runs through some excellent tips, stretches, exercises and muscle releases that will have you feeling a lot more yourself during this period.
The video has a few sections so if you REALLY felt like it you can skip to a section you find most relevant, however the way that Martin has filmed it the segments build on each other to get the most out of each one.
Enjoy!
2:00 Todays video is about...
3:52- Where to begin?
4:15 Rotational Movements of the Neck
5:32 Lateral Flexion of the Neck
7:12 Flexion/ Extension of the Neck
8:07 Shoulder Exercise
9:28- 3 exercises to open shoulders
13:48- Overhead position for shoulders
14:54- Focus on Alignment
17:23- Intro Spikey Ball Exercise
18:27 Beginning of Spikey Ball Exercise
23:27 Conclusion
Hi, Martin here from Align Chiropractic. Today's video is a follow along video, meaning I'm going to be taking you through some things that you can do, and you can more or less just watch the video and follow on.
So, the purpose of this video, it's really about moving your upper spine, your neck, your shoulders, your middle back to get mobility in those areas but also to soothe those areas.
It's really based on the clinical model that we use in our practice where we see that there's a real benefit in looking at the spine in kind of a sequential way, that spinal problems generally what's happening is that segments of the spine rather than having the ability to move through their full range of motion and kind of jammed up from either trauma, or long periods of time in particular postures, or stress tightening up the muscles around it.
And then as the joints jam up that changes the way the nerves and muscles and all the other soft tissues work, which then changes the alignment of your spine, and this change in movement and alignment of the vertebra causes misfiring of nerves which has a whole range of effects on your body, but specifically it can affect your ability to kind of balance the whole system.
If you're not balancing the whole system then your spine's going to be less stable. It's much more common for you to have problems with your back, your neck and the rest of your body if things aren't stable. So, if we look at that it goes movement, then alignment, then balance, then stability and so a common thing that I’ll see is people talking about ‘I need to do stability work or core stability work’.
I actually think it's really important that we do the basics first we've got to get movement happening first, and then once we've got movement, then we want to have a proper alignment so that when we're stabilizing first of all it's more effective, but we're also locking in a good movement pattern and a good alignment pattern rather than locking in poor ones.
2:00 Todays video is about...
So this one specifically, today's video is really about dealing with this upper part of the spine because many of us are locked into these postures working at a desk or the effect of stress tightens up our neck and shoulder muscles and pushes our head posture forward and so this is really about restoring movement to those areas and then getting our alignment back into that nice upright posture.
I'm also going to be combining some approaches that come from new research into the interplay between how we breathe and our stress response and in particular if you want to dive deeper into this, there's a neuroscientist called Andrew Hubermann who's based at University of California, sorry based at Stanford and we're going to be using a couple of different approaches to breathing that we're combining with the movement approach and using a ball- spikey ball, or a tennis ball, or a lacrosse ball that we'll be using to just release muscle tension and some of that will be just I'll be cueing you to breathe in through your nose, and then we'll also be using an approach called a physiological sigh, which is really where you just take in a deep breath through your nose and then another deep breath through your nose before
letting it out and the emerging evidence is that this is a really quick and easy way of us helping to unwind some of the neurological effects of stress which we know can have really significant impacts on how we feel and how healthy we are. So, let's dive straight into this follow along routine to help release tension in neck, shoulders, upper back, and get movement into those areas so that you can have a healthier, happier, more active body
3:52- Where to begin?
Well the first thing that we want to do is we want to encourage movement back into the neck, so with the postures that we've been in and the lack of movement and there's a tendency for our neck to kind of stiffen up, and there's a segmental part of that which is what wewould address in office with an adjustment, then there's kind of an overall regional movement that we can address with exercise.
4:15 Rotational Movements of the Neck
So first movement we're going to do is we're going to be doing rotational movements. With this I just want you to be taking nice slow breaths, in through the nose, out through the mouth.
So first of all just turn your head all the way to the left, and then go all the way to the right. I'm going to go through this five times each way, and we're not pushing we're just holding at that end range- nice and gently.
Let's see it just easing into it letting your shoulders drop, just letting that tension, that sort of habitual tension ease away. That's it. I think that's four, probably need a better way to count to be able to do this. Okay, I'm going to say that's five.
5:32 Lateral Flexion of the Neck
So next we're going be moving into lateral flexion so we just need to be cautious with this, if you get any pinching, any sort of sharp sensation that says you don't want to go that far, you want to stop before that point.
All of these mobility things are done within what feels just you're touching that point of tension or restriction. So sideways it's going all the way over there.
I'm just pausing at that end range, maybe a count of three. Just working our way into that range, just getting every vertebrae in our neck and even into our upper back starting to move.
This is our third one. Maybe just pause a little bit longer there, any sort of knotty points you can just almost sort of focus on it, just get that movement happening, just nodding a little bit back and forward. Okay that's four. So one more to go.
Last round for lateral flexion. Lateral flexion's actually a really important movement there's not many day-to-day activities that we do to encourage this range of motion, so it's often an exercise that we'll have people do because getting lateral flexion actually encourages movement in the other range.
7:12 Flexion/ Extension of the Neck
So now we're going to go flexion/ Extension. Flexion I'm going to get you to go nice and gently on, because we all tend to spend a lot more time in flexion than we do an extension. With extension which is the one going back, again just be really mindful that you don'twant to be getting any pinching sensation with that. With this one I'm doing it up against the wall. If you feel any dizziness with this then back off, maybe skip this part of it. This is our last one, our fifth repetition. Okay.
8:07 Shoulder Exercise
Now functionally interlinked with your neck is your shoulders, and so again all this time spent like this, there's an alignment component of that, but before we can really address the alignment we've got to get the ability for these joints to move, so first up I’m going to do a stretch across the body, trying not to mess up my mic here.
So come all the way across, and we're just going to breathe in through the nose, and out. I'm going to do this one for three breaths. Just going to go a little bit further on this third one. Okay and then we're going to swap our arms. Bringing the arm across, the other arm just hooks in next to the elbow there. Breathe in, out. Breathe in, and out.
9:28- 3 exercises to open shoulders
So, it started to get some mobility, but really if we want to be able to bring our shoulders back which is what most of us need because so much of our activity is in front of us, we want to be opening up and restoring that movement that way.
So what we're going to do here is spend sort of three exercises bringing and opening up this in the front of our shoulder.
The first one what we're going to do here is we're going to put our hand up on the wall above horizontal, so if that's horizontal first one we want is up here, and then i've got my body sort of facing away there my elbow is straight, and then i'm turning out this way, and then i'm going to do three breaths there. So in through the nose, and out. That’s two. I can just rotate a little bit more, and three.
I'm just going to take that tension off, and now i'm going to that horizontal level, and it'll feel a little bit different, it's going to hit a slightly different part of the shoulder.
So again in through the nose, and out through the mouth. And three. Now we're just going to do just below horizontal to again getslightly different part of the shoulder.
We're going to come across. One, Two, that’s three. Okay, so now we're going to repeat exactly the same thing but on the opposite side. So first one, if that's horizontal we're going up maybe 30 degrees above horizontal, rotating away feeling the stretch at the front of the shoulder maybe a little bit into the arm. One, Two, That's three.
Then we're going to a horizontal point now, taking that stretch back up, and then in through the nose, out through the mouth. That's three. So, I'm going to get out just below horizontal one there, take that stretch up. And then in through the nose, and out. Then that's it, just move your shoulders around enjoy that extra mobility there.
13:48- Overhead position for shoulders
So next what we're going to be working on is bringing up into flexion or sort of like an overhead position for our shoulders. So, with this I'm standing sort of basically like arm length away from a wall, and I reach out, I put my hands down keeping my elbows straight and then what i'm doing from here is keeping my arms straight and dropping my body all the way down.
I'm not rounding my back, I'm keeping my back quite straight, and then getting that movement back into the shoulders giving them that full range. We're just going to do three breaths here, so in through the nose and then out.
14:54- Focus on Alignment
So next what we're going to do is move on from looking at movement and we're going to focus instead on alignment. What we're really wanting to do is to reverse that tendency that we all have to have this sort of position, and so what we're going to do is do an exercise called a W exercise, which is where you make your arms into a W shape with the thumbs facing backward.
I always like to sort of correct the head posture so pull your head back, and I also like to look up slightly because that helps just release the activation here. What we're really wanting to do is use these muscles down here in between our shoulder blades. So, make the W shape look up slightly and then what we're doing is trying to not use these muscles but use those ones in between your shoulder blades.
We're squeezing back one two three. Relaxing one, two, three. One, two, three. One two, three. We're going to go for ten so that's four, three. One, two, three, so I'm going to say that one's four, and five
Six. If it's getting uncomfortable, if things are starting to burn just take a little break, six and seven.
So it's kind of this back and down movement that we're after- just caught myself looking down too much. Nine and last one. Good.
What we've done there is really kind of reset our alignment, and that'll mean that rather than when your heads forward everything through has to be working overtime just to stop your head from going forward with gravity. So we're going to use that we've gotmovement, we've got alignment.
Spikey Ball: 17:23
Now what I want to do is just kind of soothe this area. We're all doing a lot of this, let's just work through with some pressure on those areas, and for this i'm going to suggest that you use a ball, a spiky ball. In this case this is a lacrosse ball, and what we're going to start with is we're going to be doing three individual spots. We're going to be doing one right in between the spine and the shoulder blade here, then we're going to be doing one that's up, almost on the meaty bit above your shoulder blade, and then we're going to be doing this little corner in here where your arm joins onto your shoulder blade there.
We're going to do that on each side. We're going to use that slightly different breathing where rather than just breathing in through your nose and then out through your mouth, if you want to experiment with it, this is a really good place to use that physiological sigh, which just helps reset our nervous system from a stress sort of state, into what they call a parasympathetic state, which is putting your nervous system in a state to promote rest and relaxation and kind of de-stressing.
18:27 beginning of spikey ball exercise
So let's start off. You put the ball against the wall, and then just drop it down a little bit so you can get into that spot and rather than rolling around, what I like to do for this is just find a tender spot, hold pressure there. And then we're going to go breathe in through the nose, and then second breath, and then out. So just moving into a slightly different spot there.
Breathe in, second breath, and out. Breathe in.
Now we're going to move to the top of the shoulder. So, for this one you almost need to angle back a little bit. I'm just going to find that fleshy bit there. All right so I’m going to breathe in. Okay, so that's our three breaths there. Now for this one, I've got a really a choice of going on the actual arm here, or for most people this area in the side of the shoulder blades the spot that you want to hit, so I'm going to hit that one.
If you're doing this by yourself you could maybe do an extra round where you go to the other one if you're feeling tender in both, but I'm on the side of the shoulder blade.
The easiest way of getting there is having your body sort of on a 45-degree angle there, just finding that tender spot- okay that's definitely it. And so I'm going to breathe in through my nose, that's number two, let's go for number three- that's a really tender one.
Okay, so now what we're going to do- oops dropped my ball. And i'm back. All right so same sequence, we're just going to do the opposite side. So again, ball against the wall, I'm just going to roll into that spot just next to my shoulder blade there. All right that's it, I've got the right spot, so I'm going to breathe in through my nose. Second breath.
So now I'm just going to reposition that ball. I'm getting ready from the top of that shoulder blade there. First breath, double breath. Second breath, that's our third breath there.
Now we're just going to move to the outside of the shoulder there. So again, looking for either on the shoulder blade or the back of the arm. So I'm going to keep it consistent that 45 degree angle here. I’m going for that spot on the shoulder blade just breathing in I'm just moving up a little bit, finding that real epicenter of tension there. All right that's it, so breathe in at that spot...really relax into it. One more, breathe in through the nose.
Conclusion: 23:27
So there we have it, we've got movement through shoulders, neck, sort of upper back as well, then we've reset our alignment so thatwe're in a nice upright position and then we've kind of reset the tension, reset the nervous system giving you the best chance of having ahealthier, happier more active body. Thanks for following along.
Refresher course on our 7 tips for surviving the lock down
Yep. We are as over it as you are. A few weeks ago, Martin and I were excited as we thought it looked like we could ease some of the social distancing restrictions in the practice. We were both looking forward to working together on the same shift again and being able to see the other staff members we have had to keep separate to protect the practice.
Sadly, this has not turned out to be the case.
It goes without saying that I hoped never to refer to this blog post again. I never wanted members of our community to need a survival guide to another lock down, even less than I wanted to update it.
The good news though is that we know how to get through this, and even though it seems like this one is a little more stubborn, and we are all a bit more frustrated than last time and lets face it, wearing face masks all the time is uncomfortable and boring, it is important to remember that we are in fact all in this together and we WILL pull through sooner or later.
So without further ado , please feel free to refresh your memory of Align’s top 7 tips for surviving the lock down.
7 LOCK DOWN SURVIVAL TIPS
Recognise that it is OK to be sad/angry/frustrated at the current situation.
Even if you don’t think your concerns or issues rate highly on the scale of how disastrous your issues can be, they still can have a large effect on your life and are therefore valid reasons for you to feel bad.
To recognise that how you feel about it all is important and you need to deal with that, not just say “it could be worse”. It could be, almost always, but that doesn’t mean that you aren’t being affected now.
If you feel hard done by that the things you would normally be doing to feel like you aren’t happening at the moment, then you are allowed to be annoyed by that. Don’t carry stress around thinking that you help people by not complaining. You don’t, you just get more irritated. Recognise it’s OK to be mad and express it healthily, exercise vigorously or speak up if need be.
Exercise.
I know right? obvious and boring, but it’s more powerful than you realise and usually overlooked.
One of our clients recently told me that they have discovered that without commuting and the incidental exercise they used to do purely from working in the city in an office, they have gone from averaging 8000 steps a day to fewer than 800.
In times of stress, volume of exercise is frequently one of the first casualties. Ironically, It’s also one of our best natural stress managers and anti depressants.
Ever regretted exercise? Ever felt MORE stressed after exercise even when it was only a small amount of it? No. No one has. Our nervous system registers stress by putting us in fight or flight, or survival mode. Still living on the other side of exercise tells our brain that we have successfully overcome a stressful situation and therefore we don’t need to be in survival mode.
Take some time out.
I know what you’re thinking, easier said than done right? Where are you going to find time or space when locked in your house with your family to have some time off?
I get it, sounds like a classic “this guy doesn’t have any kids” thing to say, but I don’t mean try find 45 minutes to fully relax. We all have lives to live, work to do and/or people to look after.
What we are talking about here is finding even quick “mini breaks” throughout the day that allow you to reset for a second.
Meditation is a great way to help relieve stress (as well as lots of other benefits). If you're looking to use your self isolation time to up your meditation game we highly recommend the Oak and Smiling Mind apps. Both are free and excellent!
The Resilience Project has an app that is a daily well-being journal. This app is suitable for and has programs designed specifically for primary & secondary school students, as well as adults of all ages wanting to improve their mental well-being.
Alternatively if meditation isn’t your thing, you can replicate some of the same effects by listening to songs you find especially soothing. The research into this phenomenon used the songs ‘Strawberry swing’ by Cold play, and “Someone like you” by Adel. Feel free to mix it up and don’t be afraid to admit to yourself that ‘Only time’ by Enya is your relaxation jam.
Watch your posture.
Never underestimate the importance of posture. Just like how research has shown that trying to have confident posture has been shown to release testosterone in our body that increases our feelings of strength and confidence, the opposite is true.
There is a reason that if I ask you to do an impersonation of a stressed or anxious person you slump forward and hold your shoulders tight and up near your ears. It’s because universally, that’s what our body does under extreme or chronic stress.
This posture increases stress chemicals in our body and just happens to be replicated by sitting for long periods, especially if using a computer, a laptop, a tablet or our phones. Sound familiar during iso anyone?
Lie on a foam roller along your spine from your head to your backside with your arms at 4 and 7 o’clock. Then just LIE THERE. If you can only manage 2 minutes, that is better than none. If you’re comfortable or have time to, then 15 minutes is better again.
If you can’t get access to a longer foam roller or posture pole, then in a pinch you can roll up a few beach towels, but a roller is best.
This position has the added bonus of improving your body and spinal health by decreasing stress and strain on your body, especially you neck, head and upper back.
Improved posture can decrease headaches and risk of injury.
If you have more questions about this position, want a photo of your posture that we measure to know exactly where you are at or want more information about what improved posture can do for you, please do not hesitate to get in touch as Martin and I would both love to be there to help.
Get Adjusted.
This can also work towards your taking some time out, but do not neglect your health during this period.
Do not put up with ailments that make it even harder to get through the day. Or if there is some annoying issue that you have had for ages that you haven’t felt like you have had time to manage or keep injuring because of your daily routine, now that you’re out of your normal routine is the PERFECT time to get on top of it.
Don’t lose any momentum you had heading into this situation!
Tune out the news every now and then.
I know the temptation is to try stay up to date on every little bit of coronavirus news, but eventually it can become fatiguing. Every now and then avoid hearing about it or reading the new story on your newsfeed.
This goes hand in hand with having a time out, but I wanted to keep it separate as it is it’s own addiction to break. It doesn’t always help us to know the latest doom and gloom. It will still be there tomorrow.
Take the time you would spend on the news to have the time out I mentioned earlier.
Ask for help.
Speak up. Let people know how you are feeling. It is OK not to find this situation easy, I know I haven’t. Find someone you can have a vent to or speak to someone professional who can help you if you’re feeling like you need specific help.
It goes without saying this but obviously, check in on your friends and family. We don’t want people coming out of this in worse shape if it can be helped.
Remember that you are not alone in this. Although the lockdown and it’s effects are felt individually as all our circumstances are our own, we are all in this situation together. We will all understand where you are coming from and everyone wants to help everyone else get through it.
The 5 Do’s and Don’t of Mid back, rib or chest pain
If you have pain in your mid back or chest and you aren’t sure what your next steps should be, then read on.
If you have been following this blog recently you will know that previously I have written about what causes rib pain as well as some ways to know if your mid back or rib pain might be something more worrisome that you shouldn’t miss. If you have missed it, read that post here.
However, during the last week I had a client who hadn’t been able to get into the practice for an extended period after their mid back pain had started and to make matters worse, not only did they not know what to do to try manage their issue, they had spent the best part of a week getting anxious about what was causing their issues.
This situation got me thinking;
“How do people what sort of chest/mid back pain they have and how do they know what to do for it?”
This thought inspired me to write these blog posts, the top 5 ‘Do’s’ and ‘Don’ts’ of how to manage chest/mid back pain.
The top 5 Do’s of mid back pain:
Get informed!
It is important to know your enemy. By far the most likely cause of your mid back/chest pain is something mundane and mechanical, but it is important to be aware of problems not to be missed that can cause your chest pain.
To read about some of the ways to screen to know if your mid back or chest pain is of more…immediate concern, read the “So how do I know if I need…to go the emergency room?” section of my previous post about rib pain.
Use ice and/or heat to calm down your inflammation and pain.
Yes, you CAN take an immediate active role in helping to calm down the discomfort you feel, even if you don’t wish to take pain killers or anti-inflammatories.
The correct use of heat or ice on your area of injury can help to decrease the level of pain you feel while still allowing you to take it easy while you have the injury.
There is a lot more to this topic but to make it as simple as possible; the general consensus is to try ice (frozen water…not the other type…that has too many side effects) if the injury is “acute”, that is, under 48 hours old.
Put the ice/icepack/peas on the effected area wrapped in a damp tea towel, 20 minutes on, then taking the cold off the area for 20 minutes. Repeat this for 1 hour and 40 minutes.
Beyond the first 48 hours the research suggests trying heat and Ice alternatively, or just heat.
To be completely honest with you, in my opinion, the research is not as conclusive as it was once thought to have been. As a result, although I recommend you try the guidelines, your only goal is to help ease inflammation and make the area feel better, if you find that one works better than the other, the goal is to make you feel better so that you can heal, so I would recommend that you use the modality that works best for you.
For a full run down of when you use, check out my previous post “Ice Ice Maybe”.
Keep moving.
If you have mechanical mid back or chest pain you’re likely to find that sitting is your worst enemy. Keep moving but don’t over do it.
When I say move I do NOT mean “take up squash”, “weed your garden” or “help your friend move house”, rather I mean that movement within your pain tolerance, at a relaxed and easy pace like walking, will help your body dissipate inflammation as well as start injured soft tissues to heal.
Listen to your body however, do not over do it! If you have decided not to take pain killers your body will be able to tell you if you’re doing too much. If you have taken pain killers, the absence of pain is NOT a signal that you have had the opportunity to heal and fix the underlying issue, the last thing that you want is for the pain killers to wear off only for you to discover that you are now in worse shape than you were before you took them.
Frequently in practice I will tell my clients to avoid sitting but don’t over do it, and if you ARE settling down to watch TV or a movie later in the day, commandeer the couch to lie down, preferably with ice or heat on the area, lying down doesn’t place as much strain on the affected tissues and so should give your body a chance to heal.
Watch your posture.
Specifically for mid back and chest pain, I am referring to Forward Head Posture (FHP). This one goes hand in hand with number 3, if your head is sitting forward compared to your shoulders it places an immense amount of extra pressure on your neck, upper and mid back, as well as promoting closing in and seizing up of your anterior chest structures.
In fact, I believe that FHP is a major contributor to mid back and rib pain, especially when its the “this came out of no where” type.
For discussion on posture, click here.
Get Help!
There is not prize for having the most pain in your mid back and chest. No one is helped by you waiting to see if it calms down only to arise again out of the blue down the track.
The faster you deal with issues like this the easier it generally is to get positive change. Not to mention, given how important it is to make sure you aren’t missing any of the more pressing reasons you might have mid back and chest pain, it is important that a health professional check you over and make sure you’re OK.
For more info about what you can do for your mid back, rib pain or chest pain, do not hesitate to get in contact with us.
The top 5 Don’ts of mid back pain.
DON’T have your partner or friend “crack” your back or stand on your back for you.
I know this might sound like I am being funny but it’s real. Believe me, I understand the temptation, especially when you feel like “getting it to crack” is all you need for it to feel like it will let go, but trust me when I say, that sort of thing is best left to the experts.
Chiropractors go to university for 5 years to learn how to adjust people be as specific as possible and minimise risk as well. Most importantly, we know when NOT to manually adjust someones mid back pain.
Your partner or friend might have good intentions but it is not worth putting that responsibility on them.
At the very least, you wouldn’t want someone to accidentally re-enforce the negative behaviour your mid back, rib or chest is exhibiting.
DON’T Panic!
Even if you are concerned that your chest pain IS something you will need to visit an emergency room for, panicking about a possible diagnosis will make things worse.
As I said before, the most likely cause of your mid back, rob or chest pain is mechanical and non life threatening, so be alert but not alarmed.
If you feel OK but are in pain and you want to do something about it, get in contact with us quickly so we can help you get on track ASAP.
However, if you are genuinely concerned about your chest pain, rib pain or mid back pain, and think it might possibly be a heart attack or stroke, DO NOT HESITATE to call 000.
There is no point worrying about what would happen if it turns out you didn’t need to go to hospital. I have spoken to several medical doctors and ambulance officers about this and all of them say the same thing, they would much prefer to see someone who didn’t have a heart attack than not at all when they did.
Again, if you think you’re having a stroke or a heart attack, do not wait for confirmation, call an ambulance immediately.
DON’T put off managing the problem or hope it will go away.
This sort of magical thinking does NOT lead to good health outcomes.
Imagine applying this type of approach to a car, if it’s not running properly and you haven’t gotten it serviced, you probably shouldn’t drive it to Queensland (assuming one day we can again).
Waiting to see if an issue like this calms down and “fixes itself” is in my opinion one of the best ways to create a chronic recurrent injury.
Commonly in practice we will see client’s who are on their 4th or 5th relapse of the same problem “only this time it’s just not calming down like it normally would.”
Typically injuries, even ones that come out of no where and can come and go will get worse over time. They get more frequent, take longer to calm down, get more painful and eventually, they become all 3.
The sooner you get onto your injury is generally the fastest way to recover and in my experience involves the least risk of recurrence.
DON’T work through it.
This one obviously goes with our last point as well as the “keep moving” point from before. Do not overdo it.
Your body is in pain for a reason, even if that reason isn’t always immediately evident.
If you have chest pain, rib pain or mid back pain, there is an underlying cause to it, and if that cause is mechanical, pushing through the pain and acting as you would normally runs the risk of injuring you further or exacerbating your pain.
DON’T go it alone.
This is potentially the most important point and yes, I am aware that this is literally the same as the “Get Help” section above.
Again, there is not prize for having the most pain in your mid back, ribs or chest.
Health care professionals are here for you to use when you need us. Living your life at half speed because you are in pain isn’t noble, it just limits your quality of life and no matter how good your intentions of not looking after yourself first and focusing on those around you, none of them want to see you suffer and all of them appreciate you the most when you are at full strength and not in pain.
For more info about what you can do for your mid back, rib pain or chest pain, do not hesitate to get in contact with us.
How to set up your car seat
If you spend a lot of time in your car then this post is for you…and let’s face it, if you're reading this you most likely live in Melbourne, so there is a good chance you DO spend too large a portion of your life driving, sorry, I mean, in traffic.
If reading this whole post isn't really for you, then feel free to skip down to the end where I will summarise how to set yourself up in your care in a checklist.
Note how her head is sitting comfortably above her shoulders? Ideally shed have 2 hands on the wheel also…
What is the issue?
As a society, we appear to give a lot of attention to ergonomics for when we are setting up an office work station, or using a computer, but thats often where our attention to the issue ends.
We are guilty of it too!
If you follow this blog you will know that we have recently posted about how best to set up your computer or your laptop, we have talked about ways to avoid text neck when using your smart phone or tablet. We have even discussed how to sit and the importance of limiting how long we sit for, yet all of those are predominantly centred around screen time, or when you are in an office.
The reality is, the office, be it at work or at home is only a PART of how we spend every day. Important as good ergonomics are during these times, we need to remember that improved spinal health, being mindful of our posture and maintaining high levels of function are 24/7 activities.
We are the result of what we do the most.
To be more precise, our body will get better at whatever we ask it to do the most, so it is important to ask yourself regularly throughout the day:
“What am I asking my body to do right now?”
This is why we often tell our clients that the most important thing they can do for themselves throughout the work day is to get up out of their chair and move around.
One place where getting up and moving around is not really an option however is when we are in the car.
Kieran, I will not be getting a beaded car seat cover so don’t even mention it.
Fair point. I wouldn't want one either. I am far too car proud for that.
Most of my clients will probably already know that I am into cars and that I love driving.
I am fortunate enough that my commute is very short, so much so that I mostly get the opportunity to walk or ride my bike to the practice. I do however get to spend a lot of time in the car though, as I enjoy driving almost everywhere else and spend most of my weekends heading out of the city to go camping, hiking or traveling to visit family in Bendigo.
One thing I don’t like about driving though, is how easy it can be to make myself very sore if I haven't set the car up properly.
A poor driving position can lead to (among other things):
Low back pain,
headaches,
sore shoulders,
pins and needles in your legs or arms,
fatigue,
Sciatic pain and most dangerous of all,
an inability to control your car properly.
Setting your car up is easy
Fortunately we live in a world where other people have done most of the hard work for us and your car is no exception.
Car companies have employed a literal team of people to make your car so that it is able to get you to YOUR ideal driving position, however most of us rarely use all of the functions they have bent hundreds of hours developing.
It doesn’t matter whether you drive something fun and sporty, or purely as a taxi you use to ferry your children, the following suggestions should be able to apply to nearly every car you drive.
Step 1: Seat height and distance
When it comes to how high you sit in the car, too much of anything is a bad thing. Too high and you have to bend down to see out of the window clearly, too low and you will struggle to see everything you have to avoid.
You want to be a comfortable height to be able to see everything easily over the steering wheel without extra effort. Seems like a no brainer I know but you do wee some weird things out there.
Distance from the pedals is important too. You never want to be reaching for the pedals…obviously but you don't want to have your knees too bent either.
If you are too close, you have to actively position your feet for too long leading to hip issues. On top of this, if your knee is close to or is resting on the dash board, then your leg bones will have to act like an air bag to slow you down in an accident…which is less than ideal if you're the kind of person that enjoys having legs.
Ideally, the best distance from the seat to the pedals would mean that in a manual car, your knee should be *almost* straight but not quite when you press the clutch in all the way. About a 5 degree knee bend in that position should be it.
In an auto, the same rule applies for you to be able to leave your foot on the foot rest (look for it, you most likely have one to the left of the brake pedal) but if you don't have one, you should have that same 5 degree knee bend when your foot rests on the firewall (thats the carpet behind the pedals).
This should also mean that when you take your left hand off the steering wheel it should be able to rest comfortably on the gear stick without having to reach for it, allowing your shoulders to remain relaxed.
Step 2: Steering wheel position
Have the steering wheel at a distance where you can relax your hands onto the 10 and 2 positions on the wheel without leaning forward and having to round your shoulders, keeping a relaxed bend in your elbows.
This means you have the most control of the wheel without having to grip onto it, strain your shoulders or your low back to reach for it.
Another easy way to know if its in a good spot, is when you rest your wrists onto the top of the steering wheel, it should sit *just* at your wrists.
Move it to a height where your hands can sit at 10 and 2 roughly in front of your shoulders, you don't want to have to go reaching up or down to find the steering wheel.
Most cars now have an electric steering wheel movement, but if not, its easy to unclip the handles on the steering column and play around with its position, moving it up and down or forward and back. Take your time with its one, when you get it right, you’ll know.
Step 3: Head position
If you have done the other two right then this should already be set, but just make sure your head isn't having to lean forward too far and is relaxed over the top of your shoulders.
If it is leaning forward, readjust your steering wheel closer to you.
Watch out for car seats that push your head forward. Bad posture is so common that engineers in some car companies have started building their seats to have the head rests moving forward to meet where they assume people with poor postures heads will be.
This forces you into a bad position and over time will GIVE you forward head posture. Personally I have not been able to buy certain cars because of this, and I know it has meant Martin has had to choose a different brand when replacing one of his.
You also shouldn’t need to rest your head back on the head rest.
The name is deceptive, you should have active control of your head, it shouldn't have to be pushed back into the head rest. Its the name of a safety feature in a crash, not a suggested use.
Step 4: Lumbar support
If your car has inbuilt lumbar support, don't be afraid to use it. When you find the right spot for you, you will be amazed that you ever drove without it.
If need be, you can always buy a lumbar support pillow to use when you are driving for long periods or on longer road trips.
Step 5: Never drive with something in your back pocket.
Thats right men who keep a wallet in your back pocket when you're driving, I am talking to you. I don’t care how long you have done it for, it causes an unevenness under you that WILL eventually lead to back pain and even sciatica in some cases.
The same goes for mobile phones. They seem small but even on a short trip they make a difference to how you have to sit. I don’t care HOW short the drive is.
Again, it seems obvious but people do it.
Step 6: Take breaks regularly.
Especially if you are driving a distance. They don't only stop you from feeling fatigued, they allow your body to wake up as well, and they don’t even have to take long! Even a 2-5 minute walk can do the trick.
As promised, here is the checklist:
Step 1: Height and distance
Seat at a height where you can see everything without straining to have your eyes above the wheel or below the sun visors.
Sit at a distance where your foot can relax at the back of the foot well with your knee bent slightly to around 5 degrees.
Step 2: Steering wheel
Bring it close enough to have a slight bend in your elbows when your hands are at 10 and 2, you should be able to rest your wrists on the top of the wheel without reaching for it with your shoulders.
Step 3: Head position
Like sitting at a computer, above your shoulders, not poking forward at the steering wheel.
Step 4: Lumbar support
Play around with it until it feels good for extended periods. This might take some experimenting. If you need to, buy a support cushion.
Step 5: Nothing in your back pockets.
Step 6: Take breaks.
If you have any questions or concerns, would like to chat about how to set up your car please contact us at Align, we would love to help you.
However, if you're happy with your car set up but would like to chat about cars specifically, please feel free to talk to me about it…don’t bother talking about them with Martin…they aren't really his thing.
Kieran
The most important step to choosing the right pillow
If you are one of the many people who are not sure where to start when selecting a pillow then please watch our quick video on what we think is THE most important step when making your choice.
Let's face it, there are too many options for pillows out there. There are so many materials, shapes, and seemingly random options for you to choose and the hardest part for a lot of our clients is that nearly all of them seem incredibly expensive!
Choosing the right pillow for you is very important but it shouldn't be something you lose sleep over.
At Align we believe that there is one simple factor that you need to consider above all else before settling on a new pillow.
If you have any further questions after you have watched the video about choosing a pillow or how best to approach sleep to manage your issues (be it posture, neck pain, low back pain or headaches), please do not hesitate to contact us at Align. We have a select range of pillows on hand at any time that are available to you even if you have never been in before.
Knowing how important sleep is to our community, we are always happy to offer a complimentary pillow fitting for you so that you can be confident that you are making the right choice.
Watch our video below to hear what advice Drs Martin and Kieran start with for anyone who is considering an updated pillow. If you'd prefer not to watch, the clip has been transcribed below.
Hi, Martin Harvey from Align Chiropractic here.
One of the most common questions that we get asked in practice is: “What sort of pillow should I be sleeping with?”
We have people coming in who have entire collections of pillows, made out of everything from feathers, through to the latest space-age materials, and they wonder:
“Why can't I find a pillow that’s comfortable for me?”
The first thing that we always want to make sure is that the pillow is the right size and the right fit for you.
Obviously some people are different sizes and there are also people who choose or are most comfortable in, different sleeping positions.
Make sure you check out our “which sleeping positions should you be using” video as well, but if you’re somebody who predominantly sleeps on your side, then you're going to need a larger pillow.
In side sleeping, the idea of the pillow would be to take up a significant amount of the space between your shoulder and your neck, so that it’s supporting your neck.
If it is not, when you’re sleeping on your side and it's too low, your pillow is going to force you to tip over quite a bit that way, and at the same time if it's too big for you, it's going to tend to tip you the other way.
If you're somebody who mainly sleeps on your back, then wanting to keep your head fairly balanced over your shoulder, you’re not going to want to big a pillow because a really big pillow is going to tend to force you forward quite a bit.
To that end, the type of pillow that typically is the best compromise if you're one of the many people who sleep a bit in both is a contoured pillow.
The contour allows the thicker part of your head when you're lying on your back to be in the contour and it also supports your neck without forcing you too far forward.
This is a low-profile pillow and this would be for somebody who primarily sleeps on their back or they're a smaller person who sleeps on their side.
If you're a bigger person who's a side sleeper, then you're going to want to go to a larger, higher profile pillow.
You can see here that it's much thicker than the other pillow, again it's the same basic structure.
So there you have it, a simple way of getting a bit of an idea of which pillow you should be using.
The most important first thing is that it's less about the material that it’s made from these ones are made out of latex which is a really comfortable and durable material but the most important thing is to make sure you get the right size based on how big you are, as well as your preferred sleeping position.
Simple exercises for people with neck pain
If you have neck pain, tight shoulders or headaches that come from your neck then I suggest you watch the video below.
In the video I run you though some very simple movement exercises to keep you mobile, try and get your neck moving again and hopefully help make you more comfortable as you go through your day.
I have tried to keep them very quick and easy so that you can incorporate them into your day simply and without having to make it too obvious that you're doing them.
If you are concerned about your neck pain or you have any questions, or if you experience discomfort doing them, then please do not hesitate to get in contact with us.
As always, the video has been transcribed below, but I recommend you watch to get a demonstration...and to see me in my solo video debut. Enjoy.
Hi I'm Kieran from Align Chiropractic. I just wanted to run you through a quick exercise for getting your neck moving.
Now if you're somebody that suffers from neck pain, a tight neck or headaches that feel like they come from your neck then this video is for you.
One of the main group of exercises that we recommend for our clients regularly are to get their neck moving again.
It's really important that your neck range of motion is even to both sides, it should be pain free and it shouldn't feel too tight one side compared to the other.
The important thing to remember when doing these exercises is don't push through a pain barrier or push to the extremes of your motion.
What we are wanting to do is get to the point of restriction and just relax into that position.
So its very simple to do; first of all we're looking at rotation.
Turning your head to one side holding it at that point of restriction for three seconds come back to the middle then turning the other side.
You're looking for it to be even on both sides and pain-free, hold for three seconds, back to the middle.
Next we go straight to side, lateral flexion for three seconds, back to the middle and then to the right-hand side for three seconds and finally, back to the middle again.
Remember, it’s three seconds on each side and you cycle through all four of those five positions 5 times to keep things moving.
If you are finding a lot of restriction or are particularly uncomfortable on one side more than the other, that can be an indication of a more significant underlying imbalance.
If you are feeling that or have any concerns about how your body is moving, I'd recommend that you get on to us and let's figure out what's happening for you.
What to expect when you visit us with Neck Pain
This post is for anyone with neck pain wondering what to expect as part of your initial assessment with us at Align.
Neck pain is one of the most common issues people will come to visit us for. We are chiropractors after all.
The goal of your first visit with us is to determine not only the likely cause of your neck pain, but the best course of action moving forward for you as well.
If you have been watching the other videos about initial visits that we have posted recently, you will notice there is a certain level of commonality between the different assessments.
This is by design.
The video outlines the common elements to our cervical assessment.
We want our examination process to be accessible to people with various levels of pain, injury or disability, and at the same time give us enough scope to individualise our assessment on an individual basis.
There is a transcript of the video below. Although why WOULDN'T you want to see it filmed live?
Hi, Martin from Align Chiropractic and Kieran...also from Align Chiropractic. This video is just going to give you a little bit of an idea of what to expect if you're coming to see us and you're concerned with having neck pain.
The first thing we're going to do, Kieran if you’ll pretend that you’re the person with neck pain is make sure that you get to tell me all that you need to tell me about your neck pain.
Certainly I have some questions about when it started, what makes it better, what makes it worse etc, and for a lot of people it's really important for us to understand what is it that their neck pain is making it harder for them to do, or stopping them from doing that they need to get back to.
It’s really important that you get to tell all about neck pain so that we know what's going on.
Step two: Palpation
When we're assessing somebody who's come to see us with neck pain is a palpatory exam. A plapatory exam is where we use gentle pressure to assess what is happening in your neck, are there areas where the joints are restricted in their ability to move? Are there areas where there's tenderness or discomfort? Are there areas where there's increased muscle tension?
Once we've assessed the neck, often, because the spine is one
integrated system it's all part of one whole system, we extend our palpatory examination through the rest of the spine.
Sometimes we will also assess other related areas such as your shoulders or your jaw.
Step 3: Show us your moves
When we are assessing somebody who's come to see us with neck pain is to assess how they bend, move and twist.
Often when you have neck issues that will affect how far you can go one way compared to the other. The way we measure that is we use inclinometry, which is where we use an accurate measuring tool to see how far you can bend to the left comfortably and then compare the left side to how far you can move to the right. Simple as that.
Step 4: Assess Alignment
When we're assessing somebody who's come to see us complaining of neck pain is that we have a look to see if there’s any alteration in alignment of their spine.
The way that we do this is we can use specialised software to take a photo of the person and then digitising that photo to see if there’s any misalignment or alteration in their posture.
The software works by taking a photo and it uses the iPad to make sure that we have a photo that is absolutely vertical.
The software then places our grid around exactly where straight up and down is and then we can compare landmarks on your body to measure against.
Your body's landmarks should also be aligned so we can then see exactly how straight up and down or symmetrical your posture is.