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.

HOW TO TRAIN WHEN YOU HAVE AN UPPER BACK INJURY FOR THE CROSSFIT, F45 AND HIIT ATHLETE

If you are a cross fitter, f45…er, boxer or just love that type of high intensity training and you have an injury then this post is for you.

At align we know that getting back to exercise is likely your number 1 priority!

Please watch our video or read the transcript below the video to get our tips on getting you back on track as soon as possible and learn how to maintain your gains despite injury.

As we said in our last posts on back pain and neck pain, taking time out of training is boring and can seriously impact on the gains that you have made.

When you have put the time and effort into your training to a level where you are really enjoying your high intensity exercise, taking time out for recovery can be tedious but can also hold you up on your way to achieving your goals.

The reality is, the better you allow your body to heal, the quicker you can be back to 100% and the less likely you are to have recurring injury, and the rehab is going to take some effort on your part, so what CAN you do to get back into it at full speed?

The first thing to work on is recognising that just like gains you have made, THERE ARE NO SHORT CUTS in healing your injury.

It is important to know what you CAN do to stay moving and enjoy your HIIT training without setting yourself back.

In the video below, Martin outlines some of our possible recommendations for managing upper back injury while still keeping up your training.

As always, if you have any concerns, upper back issues, be they old or new, or just want to get the most out of your training, we are here for you so don’t hesitate to get in touch!

Hi, I'm Martin here from Align Chiropractic and today's video what I’m going to talk about is a really common thing that we see in our practice which is: people who love doing high-intensity exercise. 

We're talking people who do CrossFit, people who do f45, and all the other versions of HIIT like boxing those type of things where the whole idea of it, is that it's something that people love doing and they want to do it regularly and obviously, it's something that you're doing at a high level of intensity so does create some pretty specific demands on your body.

Sometimes people have an injury and then they've got this sort of challenge where, they want to keep training, they don’t want to lose the gains in fitness that they've created but they’re also managing an injury and our experience is that there's a lot of things you can do where you can keep getting a lot of that metabolic effect, you can keep losing weight, can keep your cardiovascular fitness and you can keep a lot of your muscle mass by keeping training while you're having the injury addressed through chiropractic care. 

So one of the areas that we commonly see are people who have an injury in the upper back, so it might be that the vertebrae are jammed up there, which is a really common thing we see, can be a problem with the way rib is joined onto the vertebrae, can be a problem with the muscles in the area, there's a bunch of different things, a bunch of different types of injuries that you could have there but the common thing is that it makes a lot of high intensity movements uncomfortable and can actually be exacerbating the injury by doing certain movements. 

So there are things that we suggest you don't do to manage these injuries. Firstly you’re not doing things where it's really high highly dynamic, so burpees can be really uncomfortable, box jumps can be really uncomfortable, anything with jarring can be uncomfortable as well as things where you’re demanding a lot of range of motion from your upper back that you don't necessarily have. 

Within a CrossFit context, kipping pull-ups, within F45, battle ropes and those sort of things where there's a lot of movements for in that area that isn't moving properly it can create a demand that your body's not able to correct. 

The sequence that we look at is that early on if you've got an injury and we're actively trying to get things back on track we’re going to get a shift focus to doing a lot of the lower body exercise because you can work your lower body without having that impact on your upper body. 

For most people, air squats are completely comfortable and lunges are really good and that’s because of that single leg aspect to it it's a really good opportunity to develop that sort of balance and stability in your lower body when you're taking the load off your upper body. 

As far as not losing all your upper body strength, often what most people notice is while overhead stuff, pushing overhead and pulling overhead can be really uncomfortable, often reducing the load and going horizontally so we’re talking things like really slow controlled push-ups or a dumbbell press chest press or even a barbell chest press can be okay as long as you’re super conscious of your posture. 

We’re making sure that a head is staying over our shoulder because often the reason that people end up with these mid-back injuries is that it's not from the exercise it's from too long spending time at the computer in this crappy posture. 

Therefore, if you're wanting to maintain some upper body stuff we're going to do some horizontal pushing and we might do some horizontal pulling as well. 

In doing those actions, we’re going to work on pulling our shoulder blades back by doing actions like a ring row, where you’re lying down when you're pulling back towards yourself or you doing them with a machine, some sort of rowing exercise. So rowing is good and also push-ups can be good.  

The next level up from there let's say we've got some improvement but things aren’t 100% in terms of function and we're not out of the woods yet but once we've got some improvement and movement in that area, and we're starting to change in overall posture, we can start reintroducing some things. 

So what we might do in the early phase, while we've taken out jarring activities like box jumps out, we might get back into doing a step up or we might go back to doing some pull-ups.

Pull ups are where we are going overhead and doing a pulling movement, but rather than doing a more dynamic movement, like kipping pull-ups, we will make it a little less dynamic and only do strict pull-ups - even if that means that we are applying a band.

Another option that we could look at is some overhead pressing movement with a dumbbell but we're not going to have the dynamic ones where we're using momentum and that faster cadence that we might normally use in high intensity training. So we are just going to slow things down focus on very slow movements that are a little bit easier to stabilise through that area. 

The bottom line with this video is that - yes you love your training and yes it's inconvenient to have an injury but for most people they can maintain the momentum, they can maintain their gain, if they just tweak a little bit what they do, shift focus to the lower body, shift focus to slow controlled movements, cut out the overhead work initially and keep going when you training when you’re managing an injury. 

I hope you found the video interesting leave a comment if you've found it valuable, and we hope to catch you soon.

HOW TO TRAIN WHEN YOU HAVE A NECK INJURY FOR THE CROSSFIT, F45 AND HIIT ATHLETE.

If you love your HIIT, and you know who you are…I’m talking to you, CrossFitters, F45 junkies or you’re a boxer etc, we know that getting back to exercise is likely your number 1 priority! Watch the video or read below to get our tips on getting you back on track as soon as possible.

As we said in our last post on back pain, taking time out of training is boring and can seriously impact on the gains that you have made. When you have become addicted (in the healthiest possible way) to getting the most out of your body, training with intensity and seeing the huge improvements in your health and injuries take on an altogether more frustrating element the can affect your body and even your mental state as well.

The reality is, the better you allow your body to heal, the quicker you can be back to 100% and the less likely you are to have recurring injury, and the rehab is going to take some effort on your part, so what CAN you do to get back into it at full speed?

The first thing to work on is recognising that just like gains you have made, THERE ARE NO SHORT CUTS in healing your injury.

Sadly we cannot immediately heal injuries without letting your tissues repair themselves, but you CAN work smarter to reinforce healing, strengthen what you can strengthen, and make sure that you’re healing things properly to minimise risk of recurrence.

In the video below, Martin outlines some of our possible recommendations for managing neck pain while still keeping up your training.

For those of you who enjoy reading the video is transcribed below.

As always, if you have any concerns, neck issues, be they old or new, or just want to get the most out of your training, we are here for you so don’t hesitate to get in touch!

Hi guys Martin here from Align Chiropractic and what I wanted to talk to you about today is something that we see super commonly, which is people that we're taking care of who have are getting neck pain or other issues with their neck where they are also really keen on their cross fit, their f45 their boxing or other forms of high intensity training. 

The main question they ask us is:

“Do I have to stop doing my training for the injury to get better?”

What I want to talk through with you today are the things that you can do while you're managing an injury so that you're not making it any worse and you can keep the gains that you've made from the training so that you can keep the metabolic conditioning, you can keep losing weight and you can maintain muscle by keeping training even while you’re working through the process with us of sorting out the neck issue. 

First of all, we're going to get you to shift focus. So, neck issues are often exacerbated by upper body exercises and things that are super dynamic so people with neck issues can often find doing sit-ups are really uncomfortable because it strain you can strain your neck a little bit. 

Similarly they might find that pushing weight overhead is uncomfortable because of the position that your neck goes into.

So what we suggest you do is move to some exercises or rather, substitute exercises that are super comfortable. 

Often they are lower body exercises, so you can do air squats or you can do squats where you're holding a dumbbell or a kettlebell. 

You also can do lunges, in fact you can can do almost all of the lower body exercises. 

You may find that while performing more dynamic stuff that there can be a little bit of a jarring. So in that instance we're talking skipping or box jumps, Also running for instance might not be comfortable, so we're going to suggest that you substitute by maybe doing things on an exercise bike or do things where on a rower where you can make sure that you're keeping a more controlled cadence, but most importantly, you're looking after the alignment of your spine by making sure your head is nicely above your shoulder rather than coming forward. 

What we can do upper body wise when we're managing a neck injury: often horizontal things, such as horizontal pushups.

Pushups can be okay so long as you’re keeping your posture really neutral. 

Horizontal pulling like ring rows can be comfortable even though perhaps exercises like pull-ups might not be because of that neck extension that is commonly involved with it.

So key here then is focus on the lower body, get rid of really dynamic movements, like things that have jarring in them and substitute for things that eliminate the overhead stuff in particular. 

The second phase once we have been working with people and we are getting some improvement in the way that their neck is working but they're not a hundred percent, then we're going to start adding in some things that are a little bit more dynamic but are a little bit more forgiving on your neck. 

As we’re reintroducing things we might go “you’re not ready for box jumps yet but you can do step ups” for instance, or “you're not ready for skipping but you can do single leg hops as an exercise”

The key thing to remember here if you're training with a neck injury is first of all you just want to wind things back, shift focus and you can get a lot of benefit in working on lower body stuff then as things start to recover we will reintroduce things but in a modified form that reduces how much jarring and how much movement of your neck is required. 

The important thing to remember is, you can keep training through almost all injuries, the most critical thing though is to think through and get advice on what the things you need to avoid and what really clever substitutions you can put in place.

Back to school part 2: Are your kid's bodies ready to perform?

If you have ever looked at your child’s schedule and thought; “how do they manage that?” then this post is for you.

It’s weird. It feels like kids are exactly as lazy as they have always been, yet at the same time, busier than ever.

What I mean by that sentence is that it feels like kids of all ages are expected to participate in a lot more than has ever been expected of them in the past, yet at the same time, as people they are no different than we all were when we were their age.

Their time commitments may be larger than children even as little as 15 years ago, but their desire to not have to take out the rubbish, spend as much time in front of a screen as they can and at a certain age, exhibit inexplicably rude attitudes towards their parents is exactly as strong as ours was at the time.

I joke of course…when we were sarcastic and rude, we all had good reasons I’m sure.

Children are often expected to participate in at LEAST one (in my experience usually two or more) extra curricular activity, taking up multiple evenings throughout the week, then perform their chosen sports/activities on the weekend, as well as fitting in other commitments.

Yeah Kieran we get it, we are the ones who have to drive them around, what’s the point?

Thats a good question. The point is, if you think about how much is physically required of school aged children as well as mentally, the concept of performance becomes really important.

‘Performance’ doesn’t only applies to athletes.

Martin and myself have spoken to many work places about the concept of what we call Corporate Athletes. Let’s face it, if you are spending the time reading this blog, you likely already know hat I am talking about.

The term applies to anyone who, although they have a demanding schedule within their occupation (be it corporate or otherwise), as well as family and social commitments, they still demand and expect a lot from their body physically.

People are getting up earlier, finishing later and have less down time than ever, and on top of all this, we plan to exercise, play sport or even just actively participate in life and so we are forced to make choices that will support our body to keep up.

A lot of adults that we see don’t choose care because they are injured, in fact most of our clients see us to REACH and STAY at their peak performance, whatever that looks like to them.

The point, as you so rightly asked for earlier?

As adults we recognise that niggles and aches can be warning signs that we are not fully on top of things, yet we quite often think that because our children haven't had the time to build up issues and don’t have to live as busy a life as we do, that they should be able to push through.

With all due respect, I disagree.

I am not for one second think that I have EVER met a parent who doesn’t care more about their children’s heath than their own. Thats ridiculous.

I DO think that the traditional way that Australian society views personal performance, maintenance of health and injury prevention needs a re-think, especially when it comes to kids.

Think about your average week.

I don’t know who you are but I am willing to bet it contains varying amounts of the following:

• More screen time than you would like,

• less sleep than you know is ideal,

• stress (from anywhere, be it work, friends, deadlines etc)

• trying to exercise an appropriate amount,

• attempting to make the best choices for food as you can,

• socialising,

• commuting and if you’re lucky,

• some down time.

When you look at this list, does it vary that much from a child's week from late primary school onwards?

I don’t think that your kids have it harder than you do, but if you had to do all the same things that they are required to do in a regular school week, do you think your body would feel better, worse or the same as what it does now?

When you think about the recurring ‘niggles’ your body has built up over the span of your life time, if you could go back in time and stop yourself developing the habits that lead you to developing them, things like your posture, the way you run, the lack of rehab on that rolled ankle from basketball, when in your life would you go back to in order to make the biggest change to where you are now?

I am not a betting man, but I am prepared to wager that you’re thinking that when you were at school would have been the best time to get on top of those problems.

The reason we didn’t do anything about our issues then, is because children can’t feel issues they way we do as adults.

Younger people are actually not wired to feel the types of pain that you and I are as adults.

Ever wonder why an 18 and a 28 year old footballer can have the same injury on the same week, and the 28 year old might miss 2-3 games while the 18 year old seems to be back the next week?

It isn’t because they are stronger, it is because their nervous system hasn’t fully developed enough to tell them they are injured and need to take it easy.

Neurologically, we are adolescents until our early 20’s. The last section of our nervous system doesn’t fully form until we are around 24 years of age and I am sorry to inform you…that last section is dedicated to a type of pain that young people just can’t feel.

They can have the same injury, and the same amount of healing needs to take place as it does for older people, but they remain blissfully unaware of just how sore they should be.

This is why you just don’t bounce back the way you used to. Sorry.

I am not sure but i suspect it’s the same reason that hang overs only start to really exist later in your 20s…more bad news.

You are right about one thing though, their posture is getting worse.

Most parents that we see in practice went through school at a time when computers were something you had yo go to the computer labs for, and the internet was confined to one family computer that you only got to use when no one else wanted the phone line.

Sure, we sat a lot and watched TV, but long periods looking at laptops is relatively recent, and we NEVER got to look at a smart phone.

Think about your posture now, having had a childhood that only had you looking at desk tops and TV screens…can you imagine what you would look like now in your 30’s and 40’s if from a young age you didn’t just slouch, you put your head completely forward to look at a screen you hold at your chest of sat flat on your lap for hours a day?

The reality is, we don’t actually know for sure just how large an impact this terrible posture will have on our children by the time they are in their 40’s because the life they are living has literally never happened before!

So what can you do?

Thankfully, there is plenty.

Firstly, I want you to keep nagging them about their posture. You are right to be concerned. Remember that a forward head posture leads to headaches, neck and back pain, shoulder injuries, decreases shoulder range of motion and worst of all in most kid’s opinion, does NOT look cool as an adult. Help them be the only one of their friends who stands up properly in their 30s.

Secondly, encourage them to be proactive. Help them see that what they are doing week in and week out is a lot to ask of their body and they need to focus on how it is performing to stay at their peak.

Third, make sure they are wearing their back pack correctly and are aware of how heavy it is.

Finally, make sure they are in good shape to start the school year by getting their niggles from the school holidays checked before they jump straight back into it.

A large portion of our practice at Align are families with school aged children.

This is no accident. Both Martin and myself started seeing chiropractors when we were at school and Align has always been passionate about the health of whole families and so we strive to be accomodating to their needs.

I know I speak for the whole team when I say that we love it when a whole family comes to visit us, it is always a highlight of Martin or my day in practice.

We hope you have had a fantastic school holidays, looking forward to seeing you in the practice soon.

Back to school pART 1: Are your kids set up to succeed?

If your children are headed back to school later this month then read on, this post is for you even though it’s about them.

It’s time we talked behind your kid’s back. Literally.

Being a chiropractor I might sound biased, but now is the perfect time to set your child up for success at school this year and make sure that their bodies look after them throughout.

Over the space of two posts about getting ready to be back at school, I want to challenge you to think a little differently about how you send your little one (and let’s face it, they are always your little one even when they aren’t physically so little any more) off to commence their school year.

Back Packs

In the video below, the Australian Chiropractors Association have spoken to a number of parents about their thoughts and experiences with how their children are affected by their back packs.

I think it’s an important reminder that, especially when they are young, our children’s spines are still developing, so the stress and strain that we put upon them physically can literally play a role in how their body works for the rest of their life.

The rest of this post might seem familiar to a few of you, and that’s because it is a slight edit of our back to school post from last year. The reason it remains largely unchanged is that the information is still accurate, the message still relevant, and our commitment to you through free back pack fitting for your children is ongoing.

So what happens when back packs aren’t right?

An ill fitting, incorrectly worn or over weight back pack can be a precursor to spinal issues and even exacerbate existing problems.

in fact, research suggests that back packs should not be heavier than 10-15% of the body weight of the child carrying it, yet how many times have you picked up your child's bag and thought it would be uncomfortable for YOU to wear?

An international study printed in Spine found that 79.1% of children find their backpacks are heavy, and 46.1% complained that their bags caused back pain.

This is made worse by the fact that in the same study, it was discovered that even though nearly half of the students had back pain, 33% of all of the students were still wearing their back packs too low!

If you want an idea of what happens to posture and spines when you wear a back pack incorrectly, see the photos of our amazing practice model Nicholas below. Nicholas has great posture and is more active than an average boy of his age. (On top of that, he is hilarious and an absolute gun for being a part of this post!) As you can see, none of that matters when he wears his bag incorrectly.

Nicholas shows us what happens when your back pack is too low, note that his head is forward, his shoulders are rolled and his low back has increased curve. 

The reality is, this overloading and incorrect loading of your child's spine may be putting them at risk of longer term spinal damage.

Add that to the time spent sitting or looking at the screen of a phone or iPad and....well I don't need to tell you what this means for posture. 

I have previously discussed the issues with poor posture at other times in this blog, (for a look at a more in depth discussion about posture, read the post here) but in summary, poor posture is bad, and the longer it's left unmanaged the worse things get.

SO WHAT SHOULD YOU DO?

At Align we are concerned about the future of younger generation's health and posture, which is why Martin and I will be providing free back pack assessments to ensure that your child starts the year off with their best foot forward. 

It is always fascinating to see how a small adjustment to a child's backpack can have far reaching effects. 

If you would like to book a Back Pack assessment for your children, please do not hesitate to contact us on 9696 1057.

4 Keys to making successful New Year's resolutions!

If you are keen to start your year off right and really stick to your New Year’s resolutions, then read on.

HOWEVER, if you haven’t yet watched Martin’s video on the 3 biggest mistakes people make with New Year’s resolutions, then I suggest you click the link above and watch that first.

Done that? Great.

Now that you have seen what to avoid when MAKING your new years resolutions, the real question is:

How do I stick with my New Year’s resolutions so that I can achieve something?

It’s the perennial struggle. As Martin talked about in the last video, it is important that you make you goals right in the first place, but its equally as important to know how to make them work for you.

in today’s video, Martin talks us through his tips to really set yourself up for success with your resolutions, how do you prioritise, and how do you turn them into habits that become part of your routine for the rest of your life time, not just while your levels of will power hold out.

As always, for those of you who would prefer to read, the video has been transcribed below.

Hi, Martin here from Align chiropractic and this is the second in our series of New Year's resolutions videos. 

Last time we went over the biggest mistakes that people make in setting New Year’s resolutions,, and today we're going to flip that around and give you some really simple tips that you can use straight away, to make the next year the healthiest year for you. 

The most important thing when you're making resolutions to improve your health is, first of all:

Start really, small. 

So if you're wanting to get fit and part of that is you're wanting to increase your upper body strength and you are going to do push-ups, you might be able to do 10 the first day, that doesn't mean you can do 20 and 30 and 40 day after day after day. 

That sort of radical change can get you hurt, and it will tax your willpower really fast which is no good at all. 

If you start really small, the goal on day one is to do one pushup, and if we expand that out you can apply the same thing to running, to going to the gym, to doing any sort of healthy habit; it's easy to succeed. 

When you succeeded, when you've successfully been able to do just a very small behavior but you repeat that small, easy to achieve habit day after day, it starts to build a habit.

Habits are the superpower behind successful resolutions. 

What I mean by that is a habit doesn't cost you in willpower; you do them automatically. 

If your habit in the morning is you get up and have a glass of water, you don't have to force yourself to do it, it happens automatically. 

The thing that that derails most resolutions is where we’re relying on willpower, doing something that's too big, too ugly, too uncomfortable, that we have to will ourselves to do it day after day, and then we wake up by morning we don't feel like it, and all of a sudden our streak is gone, our lack of willpower has won. 

Small resolutions where we're looking for just a little bit of success is much more successful. 

It also avoids us injuring ourselves and the general if we're doing a physical exercise, you're looking to increase it by a maximum, not a minimum, a maximum of 10% a week while building a habit.

That keeps it easy to succeed and it gives you your muscles, your ligaments, your tendons and your nervous system time to adapt to a new pattern of behaviour while are you building that habit. 

Make it easier to succeed and hard to fail. 

So our second thing is:

Pick the most important thing. 

We spoke last time of having too many resolutions being a problem. 

Just pick one area, one resolution that you're gonna stick to and the most important one. so if your goal was not so much about getting fit but more about losing weight, you've got a choice there, you can either have a resolution where you're going to change some aspect of your eating where you going to eat more vegetables or you’re going to eat less sugar or something like that, or you could look to exercise more and all the research shows that if you want to lose weight, for 99% of people actually, diet trumps exercise. 

You can’t work out past a bad diet. 

So, dial in the diet first because then you can build in habits before you try to change too many things. 

You also create a really positive domino effect where once you've started eating better you kind of naturally feel like being more active and exercising. 

You get this virtuous cycle where you eat better, so you exercise more, and you exercise more, you feel like eating better and so the cycle goes, and you can build a much healthier you with small, incremental and achievable changes.  

If you're only able to change one thing, again it taps into this small change makes it easy to succeed, rather than creating this horrible lifestyle that is so alien to you that you want to stop it the moment that you can. 

Third point is:

Don’t go it alone!

Rather than going solo and trying to do it just on their own willpower and their own resources, If you get a buddy, somebody else who wants to make the same change, or somebody else who will hold you accountable, then it taps into the way that we're wired.

We're wired to be social creatures and you increase your chance of successfully sticking with a resolution if you get a buddy. 

Somebody who’s going to check in with you once a week to make sure you've done what you’ve committed to. 

You can even ramp it up further, by adding consequences. 

One of the the ones that I think is really amazingly successful is that there is research that shows that if you have a negative consequence for if you don't stick to your agreed resolution of eating more vegetables every day or of eating five servings of vegetables every day, you have to make a sizeable donation to an organization that you hate, so for example, if you are a Carlton supporter you have to give a thousand dollars to Collingwood and the way we're wired away from what we don’t want more towards what we do want, it’s a powerful incentive for people to stick to their resolutions. 

The fourth thing is,

If you’re getting physical, get a check up.

If you're doing a physical activity, you're doing a fitness oriented New Year's resolution, then I'm going to strongly suggest that you get a checkup. 

If you're a client of ours, or you'd like to be a client of ours, give us a call pop in we'll check to make sure that everything's working the way that it should, before you put your body under stresses that it's not used to, and related to that, we see soo many people who have ignored niggles and then end up with a more significant issue down the line. 

So if your body is giving you feedback that the new regime is creating a bit of stress for you, don't ignore that, get it dealt with quickly so that you're not derailed by injury in sticking to your resolution. 

I hope these videos will set you up for massive success in improving your health in the year ahead, shoot us a message and let us know what you think and what are new changes you're making in the year to come.

The 3 biggest mistakes with New Year's resolutions

If you, like most people, have tried year after year to make new year’s resolutions, only to find that before January ends, you’re out of the will power to keep them up and consign yourself to having “failed”, then this post is for you.

Resolutions can make a huge difference to your future, especially as most of us use them in an effort to improve our health!

The trick is to find ways to make them STICK and become part of your daily habits.

In the video below, Martin outlines some of the major mistakes that most people make in setting themselves new goals.

For those of you who prefer to read, the video has been transcribed below.

Hi there, Martin here from Align here from chiropractic and today's video is

really all about how to make good new year’s resolutions or more importantly in fact, how not to make bad New Year’s resolutions. 

You see, the data on this, the statistics, the research in this area is that 80% of people when they make a resolution, don't keep it for long enough to get a health benefit from it and the vast majority of New Year's resolutions are about improving our health, things like exercising more, eating better, meditating more or whatever it is. 

So there's a whole lot of social psychology research in this area and what I wanted to do today was first of all, make sure that you avoid the most common mistakes that people make when they're making a resolution, so that the year ahead can be a super healthy one for you. 

So what are the big mistakes?

Too big

The first one is people, when they're making a resolution, they make the size of their resolution too big, they're sick of being flabby and unfit, and then they decide they're going to exercise every day at a super high intensity when they've been spending the previous year on the couch. It's a recipe for disaster.

Too Many

The second thing that's kind of related to the first, is that they look at this blank slate of the year ahead and they try and change too many things at once. 

Now the problem with both of these things is not only that they don't work, but reason that they don't work is first of all they're too radical we really run our lives on habits. 

We kind of go through the same routines and when we're in that routine or habit, our behaviour kind of comes with zero need for willpower, but all of a sudden, we're going to be doing things differently, we're going to be eating different foods and putting ourselves through the discomfort and discipline of going to the gym. 

If we make too many of those things all at once, we tax our reserves of willpower super fast and a week later we are back to our old habits with no net benefit. 

Going Solo

The last big mistake that people make is that they go alone, they do they resolve to do something but without any social support, without having a buddy to help them through. 

You see we're social creatures and part of what is going to motivate us to get our the established patterns that we've got, is having somebody else that we're accountable to, somebody else that can support us when our willpower is feeling a little bit wobbly. 

So if you want to avoid the three big mistakes in making resolutions, we suggest you take this in into mind:

• don’t go too big,

• don’t have too many and 

• make sure that you've got a buddy

We're going to have a follow-up video that it will show you exactly how to do those things.

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.

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.

Neck Pain

Neck pain is a common condition that most of us will suffer from at some point in our lives. 

It can arise for a whole host of reasons but if you have ever suffered from neck pain, you know that even mild neck pain can feel like  it is taking over your life! It can make it harder for you to sleep, work, exercise and enjoy time with your friends and family.

The most common causes of neck pain  are day to day movements and postural stresses and  neck pain is rarely the sign of a more serious condition.

In case you aren't sure where neck pain is, here is a stock photo to indicate what a pain in the neck neck pain is. In this instance, pain is indicated by redness.

Neck pain can often refer to areas such as your shoulders, arms and upper back, as well as being a cause of headaches.  

Common causes of neck pain include:

•         Poor posture (the way your body is positioned when standing or sitting)
•         Sleeping in an awkward position.
•         Upper back and neck muscle tension.
•         Injury such as a muscle strain.
•         Whiplash. 
•         Prolonged sitting, especially when using a desktop or laptop computer.
•         Arthritis.
•         Degenerative changes in bones of the neck as a part of the ageing process or previous injury.

You will notice a common theme to the list above and that is; all of them appear relatively trivial when compared to the impact that neck pain has on our lives.

In fact, for a lot of our clients suffering from neck pain, that adds to the frustration. It doesn't matter if the pain is mild or severe, recent or decades old, most frequently, our clients will say that it just doesn't add up. “Why they are in so much discomfort? Why won’t the pain just go away by itself? Why does it keep coming back?”

How can something so mundane cause so much pain?

In these situations it is highly likely that there is an underlying imbalance of function that meant that their body was ‘on edge’. There was a build up of tension in an area of their spine and that mundane event was just the straw that broke the camels back (for the want of a better term).

Does it make sense to you that if your spine is functioning well that a trivial stress would be enough to make your neck hurt? If your range of motion was symmetrical, your muscles, ligaments and tendons were relaxed, elastic and strong  does it make sense that it would suddenly start to hurt you? 

Of course it doesn’t. 

An underlying imbalance of function is most likely why you notice neck pain that comes out of no where, or won’t calm down, or keeps coming back. 

This is why our initial assessment of someone with neck pain looks for two things:

1. What is the cause pain and how do we get it to calm down as quickly as possible? 
2. Is there an underlying imbalance and if so, what can you do to address it to minimise the chances of it coming back?

There are also more serious causes of neck pain that, although much more rare, we need to screen for. 

The more serious causes of neck pain are issues like fracture, disc prolapse compressing on nerves, cancer or meningitis.

We have designed our assessment to be able to determine if your neck pain arises from an issue that we can start to address immediately, requires referring for further testing (such as X-rays or MRI etc.) or if you require immediate referral for medical assessment. 

So how do I know if I need to see you or go to the Emergency Department?

If you are experiencing intense neck pain after a severe head or neck injury, have lost vision due to an accident, are having difficulty swallowing, have lost or severely altered bowel and/or bladder function or your neck pain is linked to intense fever, we advise that you visit your ED as soon as is possible to make sure that you aren’t suffering from more serious conditions. 

If you have any questions or concerns about neck pain, please do not hesitate to get in contact with us at Align.

What to expect when you visit us with Back Pain

This post is for anyone who has back pain and wants to know what to expect if they were to come and see us at Align.

Lets face it...as chiropractors, back pain really is our thing. You might have already guessed but along with neck pain and headaches, back pain makes up a large number of the people who come to visit us initially.

Unsurprisingly therefore, it is important for us to be able to efficiently find out what is happening in these cases and be able to determine their best course of action to move forward. 

The video below outlines very generally what to expect when you first come to see us. 

I use the term 'generally' as obviously, each person is different and so are their injuries, so we treat every client individually depending on their presentation. 

Sometimes back pain sufferers might require a neurological examination, for others we might require X-rays and for some, we may not be the first place they should be at all! 

We take pride in our initial examination's ability to individually assess back pain sufferers quickly and effectively to determine their needs and best course of action.

This video outlines the common elements of our exam.

For those who don't enjoy seeing Martin run an assessment on the Best Looking Chiropractor in Melbourne*, there is a transcript beneath the clip. 

*Not a real competition or title.

Hi, Martin and Kieran from Align Chiropractic and this is a short video to tell you what to expect if you're going to come and see us because you are concerned about back pain.

Step one: History

To be begin, we need for you to tell us all about your back pain; 

-what have you been feeling? 

-what makes it better? 

-when did it start? 

-what makes it worse? 

However mostly we want to understand is; what does the pain mean to you? 

For a lot of people, the pain is only a part of the problem. 

A big part of it is the impact that it's having on your life. What are the things that the pain is stopping you from doing that you love to do or need to do in your life? 

Step one then is for us to get a really good understanding all the ramifications.

Step two: Palpation

Next when you come to see us complaining of back pain, is a palpatory assessment. What we’re looking for with that assessment are areas where the joints are restricted in the motion.

When they are out of balance, they are not able to move the same left and right. 

We also want to see if there are areas where there's increased muscle tension and/or the presence of tenderness.

We are looking for the areas where things are just not working how they should. 

Once we've done that palpatory assessment of the area that is giving you problems, we will often also extend the examination beyond that area of pain because your spine is linked with the way the whole body works and so we will often then extend up into assessing how your neck is working or in other related areas.

Step Three: Assess Alignment

the next step when we are assessing somebody who has come to see us with back pain is we assess the alignment of their spine.

Posture is the window for us to be able to assess alignment.

To do this, we use specialised software where we can take a photo from the side and from the front. 

We then digitise those photos and then analyse them to see if there are indications of misalignment in the spine.

The way the software works is that we first take a photo and it uses the iPad to make sure that we have a photo that is absolutely vertical. 

The software then places a grid around exactly where straight up and down is and then we can compare landmarks on you that should also be aligned to see exactly how straight up and down or symmetrical your posture is.

4 Steps to Assess people with Headaches

If you or someone you know suffers from headaches than this post is for you. 

Below is a video Martin and I made about the steps we take when assessing a client who visits us at Align suffering from headaches. 

There are many different types of headache and not all of them respond to chiropractic care. This is why we go through our 4 step process to determine 

1. What type of headache you are suffering from,
2. Are you in the right place and we the right people to help you,
3. What steps do you need to take to get on top of your headaches.

If you are concerned about your headaches or just sick of dealing with them, contact us at Align and lets find out how to get you on track. 

The video is 3 minutes but for those of you who prefer to read, there is a transcript below the clip. 

Hi, Martin here and Kieran from Align Chiropractic and this is a short video to let you know what to expect if you were to come and see us because you've got concerns about your headaches. 

Step One:

The first thing when you have headaches, is you want to make sure that you get the opportunity to tell us all about what's been happening with you. 

There are a lot of different types of headaches and so we're going to be asking you some really specific questions about the type of headache you have, where in your head you get it, the sort of things that make it better or worse and also the things that your headaches are making it harder for you to do in your life. 

This is because while headaches are one part of the problem for, a lot of people the most important thing is to be able to get back to doing the things that they either love to do or need to do in their life. 

So step one we're going to be asking some questions and giving you an opportunity to tell us all about your headaches. 

Step two

When we're assessing somebody who's come to see us with headaches, is to do a palpatory examination. 

A palpatory exam is where we use gentle touch, gentle pressure to assess areas where joints might be restricted in their motion or muscles might have tightened up or there might be areas where there's tenderness that can be part of the trigger for head pain. 

We will also often extend beyond that area, once we’ve got an assessment of the neck and upper back to other related areas so we might be feeling out through the shoulders, palpating the jaw or palpating down through the lower back and rest of the spine. 

Step Three

When we are assessing somebody who has come to see us for headaches is we look at how their spine bends and moves and twists. 

Often when there are imbalances or problems in the way the neck is working it will affect how far you can bend to the left compared to the right. the way that we assess that is to use a process called Inclinometry, which is where we use a precise instrument, called an inclinometer to measure exactly how far you go to the left compared to the right. 

So we can assess all the way, comfortable range of motion one way and then see if going the other way is more restricted. 

Step Four: 

When we are assessing somebody who has come to see us complaining of headaches, is we assess the alignment of their spine. 

Posture is the window that we can use to assess how their how well aligned their spine is and we use specialised software to take a digital photo of them from the front and the side we then digitise that to see if there's any significant alteration in their alignment. 

The way the software works is we first of all take a photo and it uses the iPad to make sure that we have a photo that is absolutely the software then places our grid around exactly where straight up and down is and then we can compare landmarks on you that should also be aligned to see exactly how straight up and down or symmetrical your posture is.

Text Neck

This post is a slight change of pace for us, rather than reading about what is on my mind this week, for the first time we invite you to WATCH it instead. 

Leading into Spinal Health Week with a theme of “chiro can help”, Martin and I thought we would make a very quick video about the dangers of “text neck”. 

Please watch me make my video debut as we discuss the importance of this simple but very under appreciated element of daily life. 

For those of you not inclined to enjoy a video format, I will summarise below. 

Text neck is that happens to us when we spend too much time with our head in our phones. Look out your window right now (or just as likely if you're reading this on your smart phone or tablet, think about your own posture) and you are bound to see people leaning their head right forward into the screens of their devices. 

Craning our head forward towards a device causes our posture to follow. Eventually our head stays forward and our shoulders roll forward to follow it. 

This poor posture does not only affect adults, unfortunately it is now very common to see this position in children as they can spend even more time on devices than some adults! 

This head forward posture can lead to number of conditions that we see in practice every day, such as headaches, neck pain, migraine, shoulder pain, tight shoulders or a dowagers hump, just to name a few.

There are several exercises we regularly recommend in practice to clients that we identify need to work on this posture but for this video we wanted to keep it simple. 

Stop, being, in, that, position. 

It is as simple and as difficult as that. Stop training your body to only be good at putting your head forward. 

The solution we offer in the video is to merely hold your phone up higher so it’s in front of your face. Bring the device to you, not you to it!

I know it sounds too simplistic or even glib but we are being sincere, make yourself aware of your posture and what position you are training your body to be in, try to stop staring at screens as often as you can, and if you find yourself looking down at your screen, as yourself, why is it in my lap and not up in front of my face?

Ankle Sprain 2: Standing on your own two feet

A few posts back, I said I would outline some important points you want to be thinking about if you have an acute ankle sprain, as well as what you can do if you already ARE someone with a "bad ankle". 

Even if this isn't your first rodeo when it comes to ankle sprain, I would encourage you to read this post as every time you injure your ankle will little different from the last!

The first place to start when it comes to ankle injury is just how serious is it? 

So what can go wrong?

We all know its sore, and we have all seen a puffed up and inflamed ankle, but what exactly is going on when you injure it? 

By far, the most likely mechanism of injury in an ankle is rolling outwards or "over the top" of your ankle. This direction of movement accounts for the Anterior Talofibular Ligament (literally meaning, the ligament at the front that connects your ankle bone of your foot, or Talus, to the bone that runs on the outside of your lower leg making that bump on the outside of your ankle, your fibula) being the most commonly injured tissue in an ankle sprain injury.

In my opinion, it is this injury to ligaments that causes ongoing issues in regard to ankle sprain, as ankles can take 12- 24 MONTHS to heal completely (depending on the severity of injury) and most people don't continue their specific rehab for long after the ankle is no longer in pain, which is usually much faster than this. This lack of correct rehab leads to other issues longer term. 

What else can be injured?

Beyond the Anterior talofibular ligament, other sites on injury can include the ankle cartilage or even in more extreme cases, fracture of the fibular or the foot itself!

When do you need to X-ray?

There are various factors to take into consideration when determining if you need an X-Ray of your injury.

Some are best assessed by a health care professional such as exactly where it is sore, what type of pain do you have, as well as the exact mechanism of the injury. 

As a general rule though, if you have injured your ankle and you are trying to decide if you should go to the emergency department, the best thing to ask yourself, according to the Ottawa rules for determining need for X-ray is this:

- Could I weight bear immediately after the injury occurred?

and 

- Can I walk at least 4 steps now?

If either of these are a yes, it is likely a radiograph will be warranted and I would recommend either contacting your health practitioner and letting them know, or visiting the emergency room immediately.

But if there is no fracture, what else can go wrong?

As discussed above and in a previous post, a major issue can be the damage to relevant ligaments, but there is yet another structure that can be affected by intense or repeated ankle sprain, and thats cartilage. 

The cartilage in your ankle is special in that it possesses healing and regenerative properties that are better than many other areas of your body, to account for extra stress in such a mobile weight bearing joint. Yet, even this area can be permanently damaged. 

Due to the healing, the ankle is an unlikely region to suffer from arthritis as a primary issue, but is one of the MOST likely joints in the body to develop arthritis in response to an injury as secondary symptom. Another reason that ongoing and thorough management and rehab is paramount to insult to the ankle!

When can I be back on it and how much can I do?

This is the most important question in getting you  (for want of a better term), back on your feet. The main area of focus is OPTIMAL LOADING. Not too much too soon injuring you further, and not too little so as to hamper your recovery. 

This is best assessed in person with your health care practitioner. 

If you have any concerns about your ankle, or you re not sure who you SHOULD be seeing about your injury, please do not hesitate to contact us at Align, we would love to help you be back up and running as soon as possible.

Image of ankles doing what they are MEANT to do, take you confidently wherever you would like to go.