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
- What type of headache you are suffering from,
- Are you in the right place and we the right people to help you,
- 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.
9 tips for more comfortable travel
If you’re traveling and have back pain or you're concerned about making sure you're still comfortable once you actually REACH your destination, this post is aimed at you.
For Kieran and Martin’s 9 tips to prevent back pain, neck pain and headaches when flying, skip to the bottom this post.
For more back ground and some extra info about looking after yourself when you travel, please read on.
With the school holidays upon us, a number of our clients are planning to get away with the family for what we hope will be a fun and relaxing time for them all. With that in mind, we wanted to share a few tips on traveling in comfort to maximise how great you get to feel no matter where the destination.
Like I said...gloating. This was on my first day in Tokyo at Shibuya crossing, the busiest intersection in the world.
Anyone who follows me on Instagram was made very aware in the last few weeks that I went away for a few days… and lets be honest, isn't gloating really all insta is about?
My point is, if you looked at someone’s travel photos, you see beautiful views, drinking in glamorous locations and sometimes food (I don't really show food as I am too busy eating it) but there is a side to travel that you’ll never see on people’s insta profiles.
You never see the multiple times that you have to lift and shift luggage, the waiting in lines, the lack of opportunity to exercise and of course, the dreaded aeroplane seats and accompanying lack of leg room with its *ALMOST* enough to be comfortable but not quite level of recline.
I was contemplating this when I realised that even though it was only a quick trip and a relatively short flight, my girlfriend who has no injury and no major history of back pain and is quite fit and active, had me bring my activator along so that I could adjust her if need be while we were traveling.
Originally I was jealous because I would have LOVED to have travelled with my own private chiropractor.
Then I remembered that most of Align’s clients feel the same.
I cant tell you how many times people in the practice who are about to fly have joked “can I just take you with me to have you on call for the whole trip?”
Yet no matter how many times I have said “yes, pay for my flights and Ill see you at the airport.” no one ever takes me up on it.
What I mean by all this is, it doesn't matter if you're headed away for a holiday or work, long or short haul flying, everyone knows what it feels like on the other side of travel and wishes they could somehow avoid it.
The fact is, even though we are keen, even though we might have a person willing to be your travel chiropractor, for most of us (my girlfriend excluded) it is just not practical to bring one, nor does it seem possible to avoid the physical pitfalls of travel.
This even appears to be true for people I see who don't have to travel in the same class that I do, those fortunate enough to have seats that recline MUCH further and have access to vastly superior champagne.
It appears that our bodies just aren't built to be inactive for extended periods then immediately lift weights from above head height and repeatedly walk, stand in line, sit again, lift and twist until FINALLY we are at our destination. Who’d have thought?
Who are you to tell me how to fly?
For both Martin and myself, our interest in comfortable plane travel goes beyond seeing clients every week who are flying all over the world.
Me at Harajuku...not looking like a tourist at all. As you can see, NOT suffering a post flight migraine, the reason in flight health is so important.
As a lot of you are probably already aware, Martin regularly runs seminars and workshops on chiropractic education here in Australia, but what you might NOT know, is that he is actually a highly sought after speaker internationally as well. In just the last few years Martin has spoken in the USA, Argentina, New Zealand, the UK, Ireland, Holland and Spain and what always amazes me is how short his turn around times will usually be.
For instance, for his most recent speaking engagement in Scotland, Martin left the practice slightly early on a Thursday evening, flew to Edinburgh for a seminar and was back in Melbourne again Tuesday evening to start practice at 7am Wednesday morning. As someone 18 years his junior (I had to fit that in somewhere) it always astounds me how much energy he still has on the other side of those trips!
For my part, I began taking more than just a professional interest in healthier travel when as I got into my later 20’s, international flights started to trigger migraines.
Think of how fun you find airports and customs, and now imagine doing it with burred vision, an inability to deal with noise and a headache seemingly splitting your head in two from the back of your neck to just behind your eye.
Obviously, I was keen to avoid repeating this fate and so, in recent years have adjusted (pardon the pun) my travel habits to accommodate.
Well get on with it Kieran, what am I meant to do??
Kieran and Martin present:
9 tips to prevent back pain, neck pain and headaches when flying
1. Seating position
For tips about ideal degrees of seat back position, read my post on sitting here.
Don’t forget, that tiny pillow we are given on a plane that seems useless is a great substitute for short term lumbar support or to go under your legs if the seat cushion is pressing in behind your knees.
Another rule of seating position is to mix it up! Your back hates being still for too long and your circulation NEEDS us to change position. You wouldn’t fly to London without moving your ankles toes and feet to avoid DVT and you should think of your low back the same way.
There are at least 4 seating positions available to you no matter what class you travel in, upright, reclined, upright with lumbar support, reclined with lumbar support. Keep changing between these 4 options to allow your low back the chance for at least SOME movement.
2. Neck Pillows
No one can actively hold their head up while properly being asleep, as is characterised by the nodding and catching movement we do continually when sitting on planes.
I have a number of clients who return from flights (many people literally call us to come in on their way home from the airport!) with symptoms that are like mild whiplash. Tight neck muscles, headaches, pins and needles in their arms and restricted neck range of motion are just a few of the symptoms we regularly see after flying and a lot of these could have been avoided if they had been able to properly relax their necks while attempting to sit upright.
Believe me, I know how lame neck pillows look but there better/less daggy options out there and for me, a neck pillow has changed my life for when I arrive and the quality of my sleep.
If you are limited for space or forget one, a towel from your carry on or the blanket the airline gives you can be used in a pinch.
3. Hydration
Staying hydrated tends to be hard everyday in real life, and can seem especially hard when you have to ask someone else for water all the time, but for avoiding headaches, migraines, quality of sleep and relaxing your muscles it is essential.
The air in the plane tends to dry us out so you should always try to keep your water intake up. Some people travel with a small amount of high quality salt to put a sprinkle in their water to try retain fluid so that drinking doesn't mean too many trips to the bathroom but be careful not to go too far with that.
The most boring suggestion I have is to limit/don’t drink alcohol while flying. Alcohol inhibits the realise of Anti Diuretic Hormone (or ADH) from our brain, making us need to use the toilet more frequently leading to further dehydration, its one of the main reasons we get hangovers! For further proof of this phenomenon see: “You on a Sunday morning prior to having children”.
4. Sleep
Get as much as you can at the right time. Obviously we need to acclimatise our body to wherever we are traveling to, so if this is in a vastly different time zone, try to sleep like you are already. there.
Neck pillows (as discussed above), eye masks and good quality ear plugs are essential.
The rise in affordable noise cancelling ear plugs has been a God send, but Martin and myself recommend ‘in ear’ earplugs/headphones as larger over the ear ones can make it harder to get your head in a good position for sleeping.
5. Don't just sit there
Get up and move an annoying amount. Do not care what other people in the cabin think about you getting up and moving about the cabin.
Obviously this is recommended for avoiding DVT but has the added benefit of stretching and moving the soft tissues of your body.
My personal tip is to try do some discrete glut activation while you are up. Your gluten are you main pelvic stabilisers and your Glut Max is your largest muscle as its meant to be used for all your lifting, you need it to get your bag down from the overhead lockers and taking luggage off the carousel.
Remember, you aren't trying to be good at flying, you're actually wanting to enjoy yourself at the other end!
6. Travel light
The lighter your bags and the less bulky and awkward they are to move around, the easier it will be on your body, no matter how strong you think you are.
7. Prepare early so that you're rested
I cannot tell you how many times I have had to adjust people who have injured themselves PRIOR to leaving for a holiday because getting ready to leave has meant a lot of extra stress in and of itself!
Wry necks, disk issues and headaches are just a few of the issues we see that can be exacerbated or even caused by stress, so do everything you can to be ready early for wheels up - including at work. How often do you stress out about having to get things ready at work so that you can get away? Start looking after yourself in the weeks leading up to your departure and from day one you'll actually feel like you're on holiday.
8. Meditation
Let’s face it, travel can be stressful. Delays, anxiety about making a connecting flight and of course, your fellow passengers can be an ordeal.
It can pay to have a good meditation app or relaxing music (as I have said in a previous post I am an Enya man, but there are a few types of music more relaxing than others. For more tips on distressing that post can be found here) can make you more chilled while you fly, leading to a better rested version of you once you get out of the plane on the other end.
9. Have a brilliant time
You deserve to enjoy your holiday. If you have been putting these tips into practice, you'll be maximising your chances of having the trip you have planned, not one marred by injury.
Don’t worry! If you find yourself in a spot of bother while you are away, shoot us an email, you'd be surprised just how many places we will be able to fond someone great to get you back on track while you are away.
If you have any questions about these tips or any suggestions of things I have missed, please feel free to contact us at Align.
Have a safe and healthy school holiday!
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?
In a slump...Is it time to stand tall and stop your mum from nagging you?
Good Posture...I know, I can feel how bored you are already. I don't blame you. Can you even count how many times you have been nit picked about slouching?
And why the hell should you care right? I mean, who cares that you slump a little? Plus, its so hard to stop doing! You try so hard to be upright when you first get to your computer but sure enough, 2 hours later you find yourself leaning into the screen of your computer with your shoulders hanging from your ears and a back hunch that would make Mr. Burns envious.
A man displaying woeful posture...in need of nagging
As a Chiropractor, 2 things happen often in my life.
The first is that at almost every time I am introduced to a person or group, most people instinctively straighten their backs and sit or stand taller, as if they all instinctively know that 'Good Posture' is important (even if we don't know why) and that its something we only think about when prompted to (even though we know deep down that our posture isn't great in the first place)
The second is that poor posture is one of the leading causes the issues that we see in our practice every day!
Low back, neck pain, jaw pain, shoulder injury, predisposition to spinal degeneration, carpal tunnel type symptoms, migraines and tension headaches are some of the most common symptoms we see day in and day out and it doesn't take much Googling to find that a lot of these problems are either caused by, or at the least made worse by, poor posture.
So, how does having bad posture lead to these issues?
The answer is actually really simple and its actually a major part of understanding what we do as chiropractors:
Nervous system feedback and the body’s position in space
"The deeper layers of muscle are concerned with ‘sensing’ our position in space and relaying this information to the brain. If this function is taken over by muscles... (As a result) the brain gets an incomplete picture. The brain assumes that the body needs to be propped up to counteract the effects of gravity, so it triggers further muscle contraction. This adds to the general fatigue and pain felt by the person with poor posture." - The Victorian Government's better health website
The issues with poor posture appear to go beyond just the physical mechanics as well!
If I told you to imitate a person who is stressed out, anxious or depressed, I bet you would tighten and slightly raise your shoulders, pushing your head forward and making you shorter. Sound familiar?
Some authors discuss that consistently being in this position might actually lead to deepened depression, increases in perceived stress, circulation issues, as well as negatively affecting digestion, breathing mechanics and the we way we are perceived by ourselves and others!
So what can we do about it? Well I'm here to tell you that dealing with posture is both simple AND challenging.
Simple in that there are very basic ways that we can start to work on and improve how our body holds itself, yet challenging in that as Australian's, we are sitting or lying down for an average of 23 hours and 47 minutes, so we have a lot practice at bad posture to try and work against!
Over the space of a few more blog posts, I am hoping to talk you through some strategies to start tackling this problem, but until then, if you have any questions, or if yourself or someone close to you needs help getting out of their slump, please do not hesitate to contact us at Align on (03) 9696 1057.