Integrity Chiropractic – Chiropractor in Fort Walton Beach FL

3 important things to do after an Accident in Florida…

Mon, 08 May 2023 20:27:31 GMT

Otherwise known as a Motor Vehicle Crash (MVC)

Motor vehicle crashes, often referred to as accidents, are an everyday occurrence in this country. Make no mistake though, crashes almost always involve fault of a driver and less than 9% of crashes are due to mechanical failures. The National Highway Transportation Safety Administration (NHTSA) reports approximately six million crashes every year, approximately three million injuries and approximately 30,000-35,000 fatalities depending on the year. The data is compiled ONLY for Police reported crashes so the actual occurrences are higher. In the state of Florida between 2014 and 2016, there was an average of 371,000 crashes, which is just over 1000 crashes per day. There was an average of 241,000 injured occupants, and 2,870 deaths.

As a Chiropractic physician, Dr. Shawn Leatherman has been studying MVC trauma injuries for years and has completed multiple post doctorate certification courses with the below organizations. (Approximate hours of total coursework per organization)

The Spine Research Institute of San Diego (360 hrs)
The Center for Research into Automotive Safety and Health (60 hrs)
The International Chiropractic Association’s Council on Spinal Trauma (150 hrs)
Safe Kids Word Wide in conjunction with NHTSA (24 hrs)
The American Academy of Motor Vehicle Injuries (150 hrs)

Therefore, Dr. Leatherman is intimately aware of the most common crash injuries, understands the mechanism of injury, injury diagnosis and proper treatment. The Integrity Chiropractic office team has examined, diagnosed, and treated these patients along with their injuries on a weekly basis for the last 20 years. So what are 3 very important initial steps to take after you have been involved in a Motor Vehicle Crash?

Remain calm and stay inside of your vehicle until traffic around you has completely stopped and the site has had a few moments to calm down. It is often the case that other motorists may wind up having secondary crashes/impacts and you do not want to be outside of the vehicle if this happens. The only time Integrity Chiropractic would advocate immediately getting out of the vehicle after a crash, is if there is gas spilling out or if a fire has already started.

Concussions are also prevalent after an MVC. Dizziness, feeling dazed, tingling in the lips or face, blurred vision, disorientation and headaches are primary signs of a concussion, even if you do not blackout. Once you get your bearings it is also important to call the police and EMS if needed to document the crash and do an initial triage of injuries. Do not engage in blame or discussion with the other drivers about the crash. The police will handle those details. Always remember that your health and the health of your passengers is the most immediate concern.

Call your insurance company as soon as you can. It is imperative that you notify your insurance company representative that you have been involved in a crash so they can properly document the situation and so that a claim number can be generated. This will allow the process to get started for the repairs of your vehicle as well as medical costs to be properly handled according to your policy limits. In Florida we have required Personal Injury Protection (PIP) coverage.

FLORIDA REQUIRED BENEFITS. —An insurance policy complying with the security requirements of s. 627.733 must provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in the motor vehicle, and other persons struck by the motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle, subject to subsection (2) and paragraph (4)(e), to a limit of $10,000 in medical and disability benefits and $5,000 in death benefits resulting from bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle.

In addition to Florida mandatory PIP, there may also be (BI) Bodily Injury coverage, (UM) uninsured/under-insured motorist coverage, and (MED-PAY) additional injury coverage for what may NOT be covered under the PIP policy. I recommend all of my patients carry these additional coverages, as just a few hours inside the emergency department can deplete all of the required $10,000 in PIP coverage leaving you with no coverage for additional care that may be needed to heal.

Seek the care and evaluation of a qualified professional sooner than later. Specifically ask the doctor’s office about their MVC injury qualifications, certifications and specializations. Amazingly enough, the majority of medical doctors and chiropractors have absolutely NO training in these injuries and do not understand them. Moreover, in the state of Florida, Chiropractors are prohibited from their state board from actively publishing their advanced coursework credentials and certifications other than a simple listing on their website. The Florida state board only recognizes “300 hour diplomate certifications” of which there are none in MVC injury. For instance, Dr. Leatherman has completed over 600 hours of training in this field, but he cannot advertise his qualifications. Therefore, you must directly inquire about training and qualifications with any office you call.

Often crash occupants will not experience any pain for the first few days after a crash due to stress hormones, shock, or they will opine that their pain levels are mild or will get better on their own. Unfortunately, this is NOT the case, and MVC injuries can lead to chronic pain and permanent injuries if not addressed appropriately. It is also better to fully document what is going on after the crash when the memory of what happened is fresher and tissue healing factors have just started to maximize long term healing.

In the State of Florida you have only 14 days after the crash to seek care for any injury. If you are injured in a crash and do not have initial services and care provided to you within 14 days of the crash, you are barred from using your personal injury protection (PIP) coverage. Meaning if you are hit by a vehicle, believe you are ok, but then schedule a doctor appointment on the 15th day because your neck or back is hurting and it was the first day available, the doctor will not be able to bill your PIP insurer for the bill. No matter how badly you are hurt, you will be barred from the $10,000 in PIP coverage under your policy unless you are evaluated in the first 14 days.

For more general information on crash injury, injury management and treatment, chiropractic care, permanent injury determination, guidelines for care, PIP coverage, or additional questions, please feel free to call our front office at 850-864-5300. If questions are too specific for the front office, Dr. Leatherman can be scheduled for a phone consultation as well.

Sources:

Stretching Before Exercising – A Persistant Bad Idea

Mon, 08 May 2023 20:21:44 GMT

As a Sports Injury trained Chiropractor, with over 150 post-doctoral training hours with the American Board of Chiropractic Sports Physicians, Dr. Leatherman often has to discuss this topic. When our Integrity docs see someone stretching BEFORE running, cycling, tennis, swimming, or any other sport, they worry that the person doesn't know much about muscles. Integrity docs further know that they are actually INCREASING their injury potentials.

STRETCHING BEFORE EXERCISING WEAKENS MUSCLES:

Here are two studies show that stretching before competition and training weakens muscles. Stretching prevents you from lifting your heaviest weights or running your fastest miles. It limits how high you can jump, and how fast you can run.

~(The Journal of Strength and Conditioning Research, April 2013)

~(The Scandinavian Journal of Medicine and Science in Sports, April 2013).

Stretching weakens muscles by almost 5.5 percent: The longer you hold the stretch, the more strength you lose. Holding a stretch for more than 90 seconds markedly reduces strength in that muscle.

Stretching reduces power: How hard you can hit a ball, or how fast you can swim, run or pedal has nothing to do with flexibility…it has to do with contractility. Stretching also does not prevent next-day muscle soreness, and it does not prevent injuries. On the other hand, WARMING-UP (increasing your body heat) helps to prevent injuries and helps you to run faster and lift heavier.

HOW MUSCLES MOVE YOUR BODY:

Every muscle in your body is made up of thousands of individual fibers. Each fiber is composed of sarcomeres; repeated similar blocks, lined end-to-end to form the rope-like fibers. Each sarcomere touches the sarcomere next to it at the Z line.

Muscles move your body by contracting, a shortening of each muscle fiber. Muscles do not shorten (contract) equally throughout their lengths. Muscles contract only at each of thousands of Z lines. It is the cumulative shortening of thousands of Z lines that shorten fibers to make muscles contract and move your body.

HOW STRETCHING SAPS STRENGTH:

When you stretch a muscle, you pull on the muscle fibers and stretch apart each fiber at the thousands of Z lines. This damage occurs only at the Z lines throughout the length of the muscle fiber, to weaken the entire muscle. At Integrity Chiropractic, we incorporate muscle stretching all the time. Stretching is most effectively utilized in rehab, but NEVER directly before competition or performance.

PROLONGED STRETCHING LIMITS THE ABILITY OF MUSCLES TO STORE ENERGY:

Sports Chiropractors understand that muscles are like rubber bands. They stretch and contract with each muscle movement. Constant active stretching and contracting stores energy in the muscle. For example, when you run, you land on your foot and the muscle stops contracting suddenly. The force of your foot striking the ground is stored in your muscles and tendons and this energy is released immediately to drive you forward.

Your foot hits the ground with a force equal to three times your body weight when you run at a pace of six minutes per mile. Up to 70 percent of the force of your foot strike is stored in your Achilles and other tendons. This energy is released by your muscles and tendons to drive you forward for your next step. Stretching decreases the amount of energy you can store in muscles and tendons and therefore weakens you and you have less stored energy to drive you forward, so you have to slow down.

STRETCHING SAPS SPEED AND ENDURANCE:

Elite college sprinters were timed in 20 meter sprints, with and without prior multiple 30-second stretches of their leg muscles. Both active and passive stretching slowed them down.

~(Journal of Sports Science, May 2005).

STRETCHING DOES NOT PREVENT NEXT DAY MUSCLE SORENESS:

A review of 12 studies published over the last 25 years shows that stretching does not prevent muscle soreness that occurs 8 to 24 hours after you exercise vigorously .

~(The British Journal of Sports Medicine, December 2011; 45:15 1249-1250).

Researchers in Australia reviewed five studies, involving 77 subjects, to show that stretching does not prevent next-day muscle soreness.

~(British Medical Journal, December 2007; 325:468-70 and 451-2).

STRETCHING DOES NOT PREVENT INJURIES:

Review of scientific literature shows that there’s no good evidence that stretching prevents sports injuries. This review showed that stretching does not prevent shin splints, bone stress fractures, sprains, strains or other arm and leg injuries.

~ (Clinical Journal of Sports Medicine, March 2005)

Muscles and tendons tear when the force applied to them is greater than their inherent strength, so anything that makes a muscle stronger helps to prevent injuries.

Strengthening muscles helps prevent muscle and tendon tears, but stretching does not make muscles stronger.

SO, WHEN SHOULD YOU STETCH AND WHY?

Please do not take the above to mean that stretching is not important, because increasing flexibility does increase long-term performance as well as increase active ranges of joint motion and functionality. Thus the reasons why we actively stretch our patients in the office and also teach them passive stretches to utilize at home.

Effective stretching protocols should be applied AFTER an event, or AFTER training, and can serve as an effective cool down. Specific types of stretching, such as PNF (proprioceptive Neuronal Facilitation) stretching, can dramatically increase short term flexibility in as quickly as 1-2 sessions, but will need to be utilized serially for long term benefit.

INTEGRITY CHIROPRACTIC

www.INTEGRITYCHIRO.com

What is the S.M.A.R.T-est Way to Achieve New Year’s Resolutions?

Mon, 08 May 2023 20:12:35 GMT

Did you make 2020 New Year’s resolutions? Every year, Integrity Chiropractic always sets new goals for excellent patient experiences. A good portion of Americans make resolutions at the start of every year. However did you know that January 17th is known as “Ditch Day.” That is the specific day associated with quitting your New Year’s resolution. So what’s the best way to make your goals achievable?

Today on Ditch Day, Integrity Chiropractic shares statistics on New Year’s resolutions and reveals strategies to ensure success. Additionally, we’ll give tips for increasing your overall health and wellness (which should always be one of your top resolutions).

Research on New Year’s resolutions reveals…

40% to 50% of North American adults make one or more resolutions each year.
The most popular New Year’s resolutions involve weight loss, exercise, quitting smoking, better money management and debt reduction.

Reported Resolution success over time…

Past the first week: 75% success rate
Past two weeks: 71% success rate
After one month: 64% success rate
After six months: 46% success rate

Looks sad, however, the same research shows people who make resolutions are 10 times more likely to attain their goals than people who don't make resolutions. So, set your sights on making resolutions this year…it’ not too late. No matter what you choose for a resolution, use the S.M.A.R.T. system to improve your odds for success.

S = BE SPECIFIC

You cannot attain what you want without first defining it. Being specific allows you to sharpen your focus. Define your goal with the “W” questions which will also help you to develop a later action plan. With specific focus, your chances for success increase.

WHO: Who is involved in this goal?
WHAT: What do I want to accomplish?
WHERE: Where is this goal to be achieved?
WHEN: When do I want to achieve this goal?
WHY: Why do I want to achieve this goal?

M = MEASURE YOUR RESULTS

You need to quantify and measure what you want to achieve. How will you know you are on track for success, or if you’ve achieved your goal if you cannot measure it? Saying that you want to lose weight in 2020 is not a goal, it is a wish. Writing the goal of losing 15 pounds and 3 inches off your waistline is measureable. Being able to measure your achievements also allows you to create smaller milestones on your way to ultimate success.

Integrity Chiropractic tracks & measures every visit with our spinal rehab patients and measures detailed progress every month with re-exams. Integrity Weight Loss tracks & measures multiple parameters on every visit. We’re always tracking and measuring progress. Even small accomplishments are important in delivering positive reinforcement, providing a boost, and allowing for recalibration if needed.

A = ACHIEVABLE

With goal setting, the ultimate purpose is to achieve success in the endeavor. If your sights are set too high, it’s unlikely you’ll ever realize your goal. Furthermore, if goals are set with unachievable expectations, your feelings are more likely to be associated with failure instead of success. Ask pertinent questions and set your goals with a reasonable expectation of achievement, then set new ones after success. And Remember, setbacks are merely opportunities to practice your will power, resolve, and to help regain your focus.

Is the goal realistic and within reach? If not how should it be modified?
Is the goal reachable given the time and resources? If now, what resources do I need?
Are you able to commit to achieving the goal? If you are able, are you willing?

R = RELEVANT and REAL

What makes your resolution meaningful? Is it personal? Do you have a WHY? Goals are more likely to be completed if they are significant to you. What impact will it have on your life or the life of your loved ones in the days, weeks, months or years ahead? When you connect your goal with its value, you’re more likely to invest the time and energy to make the goal happen.

Example: Having regular chiropractic adjustments not only makes me feel good,

but improves the overall quality of my life!

T = TIME SENSITIVE

Do you have a timeline for attainment? Defining a specific time frame for accomplishment slashes procrastination and creates a sense of urgency. This year, make one of your resolutions to take good care of your mind and body. Every intention you set for 2020 will work better when you enjoy good health.

Example: Starting this week, I will see Dr. Leatherman or Dr. Bak at Integrity Chiropractic, 2X’s every month, on Wednesdays, for the next 12 months to help maintain optimum spinal health.

Example: Starting this week, I will see Dr. Sarah Leatherman at Integrity Weight Loss, every week for the next 4 months. I will lose 40lbs and 3 inches off my waist in the next 4 months.

Seven steps to improve your overall health and help with goal/resolution attainment

Get regular chiropractic adjustments – research has been published supporting that 2x per month is a great wellness frequency for those who don’t need intensive active spinal rehab plans.
Exercise regularly – movement prolongs the life of all bodily systems. Movement is LIFE.
Eat a healthy – fresh fruits and vegetables, lean proteins and healthy fats are a must.
Drink water – 50% of your body weight in fluid ounces daily. The body consists of 65% water.
Think positive – good thoughts lead to good feelings, good feelings contribute to good health, and positive thinking has been proven to re-wire your brain for success and health.
Sleep 7-9 hours per night – sleep is restorative and healing for all systems of the body.
Practice gratitude – Focus on being happy. Start by appreciating what you have now. Then, look forward to your New Year’s resolution as a means to enhance your life!

References:

https://www.usatoday.com/story/news/nation/2019/01/16/thursday-january-17-day-most-new-years-resolutions-fail/2539402002/
Norcross JC, Mrykalo MS, Blagys MD. Auld Lang Syne: Success predictors, change processes, and self-reported outcomes of New Year’s resolver sand non resolvers. Journal of Clinical Psychology 2002; 58(4):397-405.
https://www.mindtools.com/pages/article/smart-goals.htm
A theoretical basis for maintenance spinal manipulative Therapy for the chiropractic profession Journal of Chiropractic Humanities December 2011; Vol. 1; No. 1; pp.74-85: David N. Taylor DC, DABCN
Original Research Frequency & Duration of Chiropractic Care for Headaches, Neck and Upper Back Pain. John K Maltby, DC Bio, Donald D. Harrison, Ph.D, DC, MSE Bio, Deed Harrison, DC Bio Joseph Betz BS, DC Bio, Joseph R. Ferrantelli BS, DC Bio Gerard W. Clum, DC Bio [August 21, 2008, pp 1-12] Journal of Vertebral Subluxation Research
https://www.webmd.com/diet/features/water-for-weight-loss-diet#1
https://www.sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times

SIZE MATTERS!! … LOW BACK PAIN & OBESITY

Mon, 08 May 2023 19:55:18 GMT

Low back pain is an established worldwide problem. At Integrity Chiropractic, we deal with this debilitating issue on a daily basis. It’s estimated that approximately 80% of the North American population will experience significant low back pain at some point in their adult lives. Word wide estimates range between 50–80% of adults experiencing low back pain in their life. (1,2,3) in fact, low back pain (LBP) is the second most common cause of disability in US adults with an estimated 149 million days of work lost per year. (4) It is no surprise that people are increasingly seeking chiropractic care to find relief.

The link between low back pain incidence and obesity is alarming. According to the National Institute of Health (NIH) and the Centers for Disease control, CDC, the prevalence of being overweight was 70.2 % in 2013-2104 using NHANES data. Just the obesity portion of that number was 42.4% in 2017-2018. (5,6) Evidence confirms that obesity seriously impacts the spine and musculoskeletal system, increasing the risk of low back pain as well as osteoarthritis, spondylolisthesis, degenerative disc disease and spinal stenosis. (7) Studies have even shown that people who underwent surgery to help them lose weight experienced less low back pain, the link is genuine. (8, 9)

Cause and Effect: Obesity can drive Low Back Pain

Some authors suggest that the link between obesity and low back pain is inconclusive, (10) yet there are obvious reasons why an obese person would experience more low back pain.

First, let us look at the most common cause. Obesity in the United States is primarily related to poor nutrition and lack of exercise. Our meals are often high in refined carbohydrates and low in essential fatty acids and proper nutrients. This leads us to Pro-inflammatory states and inflammation causes pain. Consuming large amounts of sugary caffeinated beverages also robs the skeleton of calcium which can weaken weight bearing over time. (11)

Second, as a person packs on more fat, mobility becomes difficult. Therefore, many obese people choose to remain inactive, preceding joint problems. Sedentary lifestyle leads to spinal immobility and overload, both have which been shown to damage the disc and the joints of the low back. (12) Lack of movement in the joints can accelerate degenerative changes as seen in cases of osteoarthritis. If an obese person does remain active, the extra body weight creates surplus compressive stress and shear strain on the muscles, tendons, ligaments and joints.

Third, postural changes are common in obese people, caused by extra weight in the abdomen. As the size of the mid-section increases, the spine’s center of gravity shifts forward and the lower back curve is exaggerated (hyper-lordosis) to accommodate for these changes. (13) This even happens in children. (14) Hyper-lordosis increases compressive loads on the joints of the lower back, increasing subluxation and pain.

What Can You Do About Weight Problems?

When faced with weight issues, the first thing you should do is consult a healthcare professional with advanced training in weight loss. At Integrity Weight Loss, Dr. Sarah Leatherman has completed her 300 hour post-doctoral Chiropractic Internist program. (15,16) Dr. Sarah order’s blood tests, genetic tests, GI maps, and urinalysis when indicated to determine metabolic, hormone or GI disorders. The information aids in maintaining proper weight and body fat reductions. Dr. Sarah is also extremely knowledgeable in proper nutrition, portion control and meal planning. Eating because your body requires proper fuel is different than eating for comfort or pleasure. However, you can have delicious meals that are also health conscious, increase metabolism, reduce fat deposition and reduce chronic disease states. Your body is a high performance machine, proper fuel will keep it running smoothly.

Before starting an exercise program, also check with your doctor of chiropractic. Weeks, months or years of inactivity can leave your body too weak to pick up where you left off. Attempting to build strength on poor underlying spinal structure only drives more dysfunction. Dr. Leatherman and Dr. Bak frequently have to modify patient exercise programs for success. This gives you the best chance for continued progress as your exercise routine varies.

Above all else, value your health and stay positive, we have the tools to help. Dr. Shawn Leatherman and Dr. David Bak have successfully treated thousands of low back pain cases here at Integrity Chiropractic. Dr. Sarah Leatherman has helped patients drop thousands of unwanted pounds of fat at Integrity Weight Loss. Read about people who have achieved weight loss and/or pain reduction, and reach out to us for help.

References and Sources:

1. Rubin DI (2007) Epidemiology and risk factors for spine pain. Neurol Clin 25(2):353–371 https://www.ncbi.nlm.nih.gov/pubmed/17445733

2. Skinner HB. Current Diagnosis & Treatment in Orthopedics. Lange Medical Books. New York; 2000.

3. Volinn E (1997) The epidemiology of low back pain in the rest of the world: a review of surveys in low-and middle-income countries. Spine 22(15):1747–1754 https://www.ncbi.nlm.nih.gov/pubmed/9259786

4. From the Centers for Disease Control and Prevention. Prevalence of disabilities and associated health conditions among adults--United States, 1999. JAMA. 2001;285(12):1571–1572.

https://www.ncbi.nlm.nih.gov/pubmed/11302137

5. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity

6. https://www.cdc.gov/obesity/data/adult.html

7. Silveri CP & Spinasanta S. Back pain and obesity: connection to back pain and the development of obesity. Montclair, NJ: SpineUniverse; ©1999-2011. http://www.spineuniverse.com/conditions/back-pain/back-pain-obesity .

8. Melissas J, Volakakis E, Hadjipavlou A. Low back pain in morbidly obese patients and the effect of weight loss following surgery. Obes Surg. 2003;13:389–393. https://www.ncbi.nlm.nih.gov/pubmed/12841899

9. Melissas, J., Kontakis, G., Volakakis, E. et al. The Effect of Surgical Weight Reduction on Functional Status in Morbidly Obese Patients with Low Back Pain. OBES SURG 15, 378–381 (2005). https://link.springer.com/article/10.1381/0960892053576703#citeas

10. Mirtz TA & Greene L. Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question. Chiropractic & Osteopathy 2005; 13(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1151650/

11. Hernandez-Avila M, Stampfer MJ, Ravnikar VA, Willett WC, Schiff I, Francis M, Longcope C, McKinlay SM. Caffeine and other predictors of bone density among pre-and peri-menopausal women. Epidemiology 1993 Mar; 4(2): 128-34. https://www.ncbi.nlm.nih.gov/pubmed/8452901

12. Ian A. F. Stokes, PhD, and James C. Iatridis, PhD Mechanical Conditions That Accelerate Intervertebral Disc Degeneration: Overload Versus Immobilization. SPINE Volume 29, Number 23, pp 2724–2732. https://www.ncbi.nlm.nih.gov/pubmed/15564921

13. Mi-Yeon Song, Won-Suk Chung, Sung-Soo Kim, Hyun-Dae Shin. Correlation between Obesity and Lumbar Lordosis in Obese PreMenopausal Korean Females 2004. Vol. 25. No. 4. 43-50

Korean Journal of Oriental Medicine https://www.jkom.org/upload/06-Correlation%20between%20Obesity(105431).PDF

14. Jankowicz-Szymańska A1, Bibro M1, Wodka K1, Smola E1. Does Excessive Body Weight Change the Shape of the Spine in Children? Child Obes. 2019 Jul;15(5):346-352. doi: 10.1089/chi.2018.0361. Epub 2019 Apr 12. https://www.ncbi.nlm.nih.gov/pubmed/30977672

15. http://www.floridadabci.com/

16. https://www.dabci.info/

Integrity Chiropractic and Shoulder Problems … What’s the Connection?

Mon, 08 May 2023 19:50:14 GMT

The shoulder is the one structure that relies on all major areas of your spine for proper function – your neck (cervical spine), your upper back (thoracic spine) and your lower back (lumbar spine) – therefore it is super relevant to spine function and chiropractic applications.

Relationship to the Neck

Nerve supply to the shoulder (the suprascapular nerve, the axillary nerve and the lateral pectoral nerve) arise from the C5, C6 and C7 nerve roots of the neck. (1) As a result, any conditions that irritate the nerves as they exit the neck can cause symptoms in the shoulder, arm or hand. Disc bulges, joint degeneration and inflammation, as well as vertebral subluxations (improper joint motions of the spine or regional postural distortions) can all cause nerve irritation in the neck. If any of these conditions are causing shoulder pain, Integrity Chiropractic can help with postural rehab, structural rehab, adjusting the spine as well as adjusting the shoulder.

Relationship to the Upper Back

The shoulder blade (scapula) is the bone that contains the socket of the shoulder joint – A.K.A. the glenoid fossa. Since the shoulder blade rests against the ribcage in the upper back, irritation or improper positioning of this area of the spine can cause dysfunction that directly affects the shoulder, especially related to shoulder impingements and tendinopathy. Rib subluxations and vertebral subluxations are common in this area and improved with chiropractic care. (2, 3, 4, 5, 6)

Relationship to the Low Back

Additionally, your shoulder actually connects to your lower back area by a large muscle called the latissimus dorsi. This muscle is one of the prime mover muscles of the arm when used in any pulling motion. If your lower back is painful or dysfunctional, your latissimus dorsi can become affected, leading to shoulder restriction and pain.

Additionally, shoulder issues can influence the functional equilibrium of your back. Therefore, it’s important to have your entire spine checked by Dr. Leatherman or Dr. Bak, even when your symptoms are located in a single joint like the shoulder.

Specific Functional Anatomy

The shoulder joint is classified as a ball-and-socket joint, making it one of the most mobile joints in the human body. However, unlike the hip joint, the socket of the shoulder is shallow rendering it structurally more unstable than the hip. This relative instability allows for the greatest range of motion of any joint but requires an intricate system of muscles (rotator cuff) to support it. The rotator cuff is made up of four muscles: the Subscapularis, the Supraspinatus, The Infraspinatus and The Teres Minor.

Subscapularis - the strongest rotator cuff muscle responsible for internal rotation of the shoulder. This muscle is most commonly indicated as the cause of painful rotator cuff syndromes. (7)

Supraspinatus - this muscle sits at the top of the shoulder, and is the muscle that is usually involved in bursitis or tendinitis shoulder problems. This is the same muscle that is so commonly injured in throwing sports as well. (8)

Infraspinatus - this muscle, together with the Teres minor, serves to externally rotate the arm, and prevents the shoulder from dislocating when something is thrown, such as a baseball. The infraspinatus is the second most commonly injured rotator cuff tear usually along with the supraspinatus. (9)

The Predicament of Stability vs. Mobility

Unfortunately, these muscles are called upon to perform double functions: stabilization of the shoulder girdle and mobility of the arms and shoulder joint. The double duty leads to rotator cuff stress and strain, especially when the shoulder position is compromised by poor posture or repetitive movements. Therefore the joint complex is more prone to injury without trauma.

Rotator cuff problems are typically the cause of numerous shoulder symptoms like bursitis, tendonitis, shoulder impingement or peripheral nerve entrapment. (2, 3, 4, 5, 6, 9) Dr. Leatherman or Dr. Bak can check for these conditions through functional orthopedic examination tests, and suggest the best treatment options if dysfunctions or injury are found.

Proper Posture Sets the Tone

Good postural alignment is the starting point for proper function of any joint. The shoulder is no exception. With too much or too little mobility of the shoulder joint, proper alignment of the shoulder is very important. The length and strength of muscles around the shoulder joint determine the shoulder’s structural integrity and this is affected by poor spinal posture. Dr. Leatherman and Dr. Bak start every examination with a full postural analysis from the feet to the head due to this relationship.

Negative Contribution of Technology

According to the US. Census bureau’s Current Population Survey (CPS) and American Community Survey (ACS), since 1984 Statistics show that computer usage is increasing dramatically. “In 1984, 8 percent of households had a computer according to the CPS. By 2000, about half of all households (51 percent) had a computer. In 2015, this percentage had grown to 79 percent. The ACS, by contrast, indicated that in 2013, 84 percent of households had a computer (desktop or laptop, handheld, or other), with the percentage growing to 87 percent in 2015. In 2016, 89 percent of households had a computer. (10)

In 2016, the U.S. Census Bureau first measured smartphone, tablets, desktop or laptop computers: 76% percent of households had a smartphone, 58% of households had a tablet, but desktop or laptop computers still led the way with use by 77% of households. (11)

Many of us are guilty of spending hours sitting at the computer in a poor postural position. Laptops, tablets and smartphones are even worse than desktops. This can lead to the muscles of the chest and front of the neck being shortened, and the postural muscles of the upper back are lengthened, putting them in a weakened position. This is called: UPPER-CROSSED SYNDROME (UCS), also referred to as proximal or shoulder girdle crossed syndrome. This pattern of imbalance creates joint dysfunction, particularly at the skull, C4-C5 segment, cervico-thoracic joint, shoulder joint, and T4-T5 segment. These postural changes decrease shoulder stability. (12)

Over time, not only does this lead to stress and strain of the postural muscles around the neck and upper back, but it also places the shoulder joint slightly out of position. As a result, every movement the shoulder experiences in this faulty position increases the wear and tear on the joint and makes it vulnerable to arthritic changes.

In closing, shoulder problems are complex. They can be related to every major area of your spine - lumbar, thoracic and cervical. Postural and muscle imbalances often lead to shoulder joint problems. Pay attention to your posture, and be sure to exercise and stretch the muscles of the shoulders to maintain proper balance and shoulder position. Lastly, be sure to have your spine adjusted regularly to maintain proper spinal hygiene.

References:

Okwumabua E, Thompson JH. Anatomy, Shoulder and Upper Limb, Nerves. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526056/
38. Kardouni JR, Shaffer SW, Pidcoe PE, Finucane SD, Cheatham SA, Michener LA. Immediate changes in pressure pain sensitivity after thoracic spinal manipulative therapy in patients with subacromial impingement syndrome: a randomized controlled study. Man Ther. 2015;20:540–46. doi: 10.1016/j.math.2014.12.003. https://www.ncbi.nlm.nih.gov/pubmed/25595413
Munday S, Jones A, Brantingham J, Globe G, Jensen M, Price J. A randomized, single-blinded, placebo-controlled clinical trial to evaluate the efficacy of chiropractic shoulder girdle adjustment in the treatment of shoulder impingement syndrome. JACA Online. 2007;44(6):6–15.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215137/
Haik MN, Alburquerque-Sendin F, Silva CZ, Siqueira-Junior AL, Ribeiro IL, Camargo PR. Scapular kinematics pre- and post-thoracic thrust manipulation in individuals with and without shoulder impingement symptoms: a randomized controlled study. J Orthop Sports Phys Ther. 2014;44:475–87. doi: 10.2519/jospt.2014.4760. https://www.ncbi.nlm.nih.gov/pubmed/24853923
Boyles RE, Ritland BM, Miracle BM, Barclay DM, Faul MS, Moore JH, et al. The short-term effects of thoracic spine thrust manipulation on patients with shoulder impingement syndrome. Man Ther. 2009;14:375–80. doi: 10.1016/j.math.2008.05.005. https://www.ncbi.nlm.nih.gov/pubmed/18703377
Muth S, Barbe MF, Lauer R, McClure PW. The effects of thoracic spine manipulation in subjects with signs of rotator cuff tendinopathy. J Orthop Sports Phys Ther. 2012;42:1005–16. doi: 10.2519/jospt.2012.4142. https://www.ncbi.nlm.nih.gov/pubmed/22951537
Leahy, Michael: Altered Biomechanics of the Shoulder and Subscapularis. Chiropractic Sports Medicine; Vol. 5, No. 3, 1991.
Minagawa H, Yamamoto N, Abe H, et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. J Orthop. 2013;10(1):8–12. Published 2013 Feb 26. doi:10.1016/j.jor.2013.01.008 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768248/
Leahy, Michael: Myofascial Release Technique and Mechanical Compromise of Peripheral Nerves of the Upper Extremity. Chiropractic Sports Medicine; Vol. 6, No. 4, 1992.
Computer and Internet Use in the United States: 2016. American Community Survey Reports. Issued August 2018. https://www.census.gov/content/dam/Census/library/publications/2018/acs/ACS-39.pdf
Izraelski J. Assessment and Treatment of Muscle Imbalance: The Janda Approach. J Can Chiropr Assoc. 2012;56(2):158. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364069/

SCREECH! BANG! CRASH! The deceiving nature of WHIPLASH!

Mon, 08 May 2023 19:44:04 GMT

The traffic light is red. Your vehicle is completely stopped … and then B-A-N-G! Your vehicle is thrust forward, your spine lengthens and rises in the seat, your head snaps rearward, your body bounces off the seat-back into the harness system, the harness restrains your torso, your head and neck now rebound shifting forward, (this all happens in less than 600 mili-seconds) you’re dazed! Then the realization …. You were just smashed from behind! Was it an accident? NO! Accidents are when you trip, spill milk, or drop things. This is a MOTOR VEHICLE CRASH (MVC). (1)

When your vehicle is rear-ended, the neck and head bear the brunt of the forces. Nerves, ligaments and muscles are stretched beyond their natural limits due to abnormal motion in the lower neck vertebra which differs from normal motion. Injuries also happen in normal ranges of motion. (2) It’s the transfer of energy in less than ½ a second that causes the damage. Whiplash Injuries often occur at speeds less than 2-5 mph as well because vehicles bounce instead of crushing which increases the forces to the occupants of the vehicle. In fact there is no known minimal threshold for injury!

Despite possibly feeling fine afterward, you may have just received a common yet serious whiplash injury. Dr. Leatherman and Dr. Bak will tell you that it’s a deceiving injury, because whiplash is NOT a diagnosis, it is a mechanism. Pain may come on quickly or you may not develop symptoms for hours, weeks, or months. Your neck (cervical spine) contains muscles, ligaments, tendons, discs, joints and nerves confined to a relatively small area. Whiplash mechanism can injure all these body components.

Although it happens most frequently in rear-impact crashes, whiplash can occur in other crash directions: side-impact, frontal-impact, and offset angular impacts.

Besides the head, neck and upper back, pain from a whiplash Injury often extend into other areas of the body, such as the shoulders, arms, as well as the low back, hips, legs, knees and feet. You may also suffer muscle stiffness, spasms, burning or tingling sensations as well as headaches and numbness. Even if you don’t have any immediate whiplash symptoms, you should visit a chiropractor who has been trained in MVC injury as soon as possible.

Most common symptoms after a crash According to the Spine Research Institute of San Diego (3)

Neck Pain 92%

Headache 57%

Fatigue 56%

Shoulder pain 49%

Anxiety 44%

Inter-scapular pain 42%

Low back pain 39%

Sleep disturbance 39%

Upper limb paresthesia 30%

Sensitivity to Noise 29%

Impaired concentration 26%

Blurred vision 21%

Irritability 21%

Difficulty swallowing 16%

Dizziness 15%

Forgetfulness 15%

Upper limb pain 12%

Upper limb weakness 6%

Ringing in the ears 4%

Jaw/Facial pain 4%

What Can Affect Whiplash Injury Recovery?

The severity of whiplash injury and recovery depends on many risk factors. Age, sex, physical condition, posture and prior medical history can have a major effect on the acuteness and length of symptoms.

As you age, you lose flexibility, strength and hydration in your neck joints, discs and ligaments. Older adults may require more extensive rehabilitation for this injury.
Women are injured in whiplash mechanism crashes 2x more than men. Experts believe this could be because men have stronger neck muscles, women have smaller bone structures and due to hormonal differences between the sexes. Kids are at 2/3 the risk of an adult.
Health conditions like disc degeneration, arthritis and prior injuries can play a role.
If you're a smoker, obese or don't exercise, your chances of healing quickly are reduced.
Poor posture, poor seat position and unawareness of impact at the time of MVC can worsen the whiplash mechanism injury.
If your driver seat’s head restraint is too low, you may endure a more intense injury.

In Fact, regarded as one of the best prognostic indicators by multiple research publications, is risk factor analysis. Risk factors are factors or conditions that when present may impact the health of an individual involved in a motor vehicle collision (MVC). There are 17 factors that increase initial injury risk and 30 factors that contribute to chronic injury after a crash. (4)

Those 47 risk factors should not be regarded as all encompassing, but they have been studied and reported in the clinical literature, with enough validity to be considered real and accurate measures.

How Does Integrity Chiropractic Treat Whiplash Injuries?

At Integrity Chiropractic, both Dr. Leatherman and Dr. Bak combined have taken over 500 hours of advanced coursework in MVC and whiplash injury. Our doctors will conduct a specific physical exam to determine the extent of any injuries, will obtain the proper x-rays, and may order MRI’s, CT’s or diagnostic ultrasound to document specific tissue damage.

If whiplash injury is confirmed, Dr. Leatherman and Dr. Bak will also properly grade the injury according to the published guidelines (5, 6) and formulate an appropriate treatment plan to address each injury. This may include spinal adjustments to allow for proper spinal motion, soft tissue work to alleviate muscle spasms, active stretching to improve range of motion, active therapeutic exercises to aid in stabilization and proper movement, disc decompression to reduce bulges and radiating pain, dynamic spinal traction to restructure the spinal curves and address ligaments, therapeutic ultrasound to aid in pain and inflammation reduction, and home care protocols as well.

Fortunately, research has shown that chiropractic is an extremely effective approach to healing whiplash. In a study published in The Journal of Orthopaedic Medicine, researchers found 74% of those people in the study treated for whiplash with chiropractic care showed improvement. The researchers stated, "The results from this study provide further evidence that chiropractic is an effective treatment for chronic whiplash symptoms." The researchers also noted that other treatments for whiplash were disappointing. They concluded, “Chiropractic is the only proven effective treatment in chronic cases.”(7) Another study published in Injury, found “93% of patients improved following chiropractic.”(8)

Preventing Whiplash Injury Severity

Dr. Leatherman and Dr. Bak are also trained in prevention techniques as there are steps you can take to minimize the risk of whiplash injury. One of the best protectors is understanding head restraint geometry. Make sure your vehicle’s head restraints are correctly positioned. (9) The center back of your head should touch the center of the head restraint (which is a piece of safety equipment).

If you know someone who has suffered a whiplash injury from an MVC, let them know that Integrity chiropractic has been extensively trained in these injuries and that chiropractic may be able to help them recover!

1. Whiplash Injuries: The cervical Acceleration Deceleration. Syndrome. 3rd Edition. Foreman S., Croft AC. Lipincott, Williams & Wilkins (2002)

2. Motion Analysis of Cervical Vertebrae During Whiplash Loading – Kneoka K., Ono K., Hayashi K. Spine: 15 April 1999 - Volume 24 - Issue 8 – pp 763-769.

3. www.srisd.com

4. Whiplash and Mild traumatic Brain Injuries: A Guide for Patients and Practitioners. Croft AC., Spine Research Institute of San Diego Press (2009)

5. J Chiropr Med. 2016 Jun;15(2):81-6. doi: 10.1016/j.jcm.2016.04.009. Epub 2016 May 26.

Comparing 2 Whiplash Grading Systems to Predict Clinical Outcomes. Croft AC, Bagherian A, Mickelsen PK, Wagner S.

6. https://chiro.org/LINKS/GUIDELINES/ART_CROFT.Chap12.shtml

7. A symptomatic classification of whiplash injury and the implications for treatment. Khan S, Cook J, Gargan M, Bannister G., Journal of Orthopaedic Medicine 1999;21(1):22-25.

8. Chiropractic treatment of chronic whiplash injuries - Woodward MN, Cook JCH, Gargan MF, Bannister GC. Injury 1996;27:643-645.

9. https://www-esv.nhtsa.dot.gov/Proceedings/22/files/Session%208%20Written.pdf

Sacroiliac Joint Dysfunction, A PAIN in the BUTT!

Mon, 08 May 2023 19:32:15 GMT

Patients presenting with Sacroiliac (SI) joint pain tend to think they either have sciatica or tail-bone pain, and its common practice for doctors to the link low back pain with protruding disc even when neurological signs are absent. Pain caused by sacroiliac joint dysfunction can mimic discogenic (pain from the disc) or radicular low back pain, although, SI joint dysfunction is a distinct condition of its own. At Integrity Chiropractic, our doctors are keenly aware of the differences of pain presentations and utilize diagnostic skills to diagnose the SI joints, vs. facet joints, vs. disc, vs. ligamentous instability as the source of your pain.

The Anatomy

SI joint dysfunction is typically a very painful condition involving the joints that connect the three bones of your pelvis. The SI joint has rich pain nerves arising from the L2–S2 roots, and its posterior aspect is innervated by the posterior rami of L4–S3. The sacroiliac joints are formed by the sacrum, a bone at the bottom of the spine, located centrally at the beltline, along with the large iliac bones located on the left and right of the pelvis. Because of their anatomical position, SI joints can sometimes be considered part of your lower back or your pelvis. These joints support the upper body when it’s in an erect position.

What Causes SI Joint Dysfunction?

SI joint dysfunction is often caused by a fall or injury, but it can also appear without a clear cause. Postural changes due to an increased low back curve (hyperlordosis) or large abdominal size associated with obesity can irritate these joints. Structural imbalances in the legs such one shorter than the other (anatomical short leg), or having flat feet (pes planus) can also be causative. Moreover, muscular imbalances in the lower back or hips (lower cross syndrome) can irritate the SI joints. Sporting activities that require frequent use of these joints, such as running sports, golfing and figure skating may result in SI joint dysfunction.

Additionally, this joint problem often affects pregnant women. Ligaments holding SI joint have the main function to limit its mobility. Hormonal changes occurring during pregnancy can cause ligaments to relax through hormonal control (relaxin secretion). When this happens, the SI joints have a more extended range of motion and the broader flexibility along with the weight of a growing belly can lead to abnormal stress and inflammation on the joints.

If you have SI joint dysfunction, you may feel pain in various parts of your lower body to include the entire leg and including the spine, Fortunately, Integrity Chiropractic can help in this situation. In fact, a study revealed “91% of women with sacroiliac/pelvic subluxations and lower back pain reported relief of pain with chiropractic adjustments.”

The Integrity Chiropractic Approach to a Baffling Condition

How does Integrity Chiropractic determine if you suffer from sacroiliac joint dysfunction / inflammation?

First, a detailed health history is important. Many times, a correct diagnosis can be drawn from the history alone. Second, a functional physical examination to include orthopedic tests and active ranges of motion will be conducted to thoroughly exhaust all the above listed potential causes of pain. In fact, three specific physical tests showed great correlation with the diagnosis of SIJ dysfunction:

SI Joint compression test (94% agreement)
The thigh thrust test (90%) agreement
Yeoman’s test (88%) agreement.

Dr. Leatherman and Dr. Bak utilize these tests on every initial physical examination as well as other orthopedic and neurological tests that help differentiate the SI joint from the facet joints and the disc as pain generators. X-rays may also be necessary for visualization of the joints as well.

If your pain can be reproduced by these special orthopedic tests, challenging the structure of the SI joints, this increases your odds of having a dysfunction of these joints vs other anatomical structures.

Applying direct pressure to one of the SI joints, or to the base of the sacrum with a manual spinal manipulation (adjustment) is one of the main techniques used by Integrity Chiropractic to improve the SI joint mechanics. The goal is to normalize both the movement and position of this area and reduce inflammation to resolve the pain.

However, You may also be required to complete stretching and strengthening exercises for your lower back and pelvis areas to correct posture problems and gait patterns that may contribute to the inflammation of these joints. If excessive motion of the SI joints is thought to be the cause of the pain, (such as in pregnancy) Dr. Leatherman or Dr. Bak may recommend that you wear a special belt around your waist to stabilize the joints. It is important to understand though that instability of the SI joints is much less frequent than a restriction of proper motion.

Can You Stop SI Problems Before They Happen?

Often the answer is yes, and a quote by Ben Franklin sums this up nicely … “An ounce of prevention is worth a pound of cure.”

Maintaining proper posture, flexibility and an overall good physical condition helps prevent many problems related to joints, muscles and bones. The second piece of advice is to walk 1-2 miles daily at a brisk pace. Third, shed excess fat pounds as too much body weight (especially abdominal fat weight) places pressure on the joints and increases the possibility of inflammation and injury.

Lastly, periodic chiropractic adjustments and following Integrity Chiropractic lifestyle advice increases your chances of living a life virtually free of muscle and joint pain.

References:

Wong M, Kiel J. Anatomy, Abdomen and Pelvis, Sacroiliac Joint. [Updated 2019 Feb 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507801/
Slipman C, Patel R, Shin C, Braverman D, Lenrow D, - Pain Management: Studies probe complexities of sacroiliac joint syndrome – Biomechanics, April 2000
Pain Physician. 2001 Apr;4(2):143-52. Sacroiliac joint syndrome. Slipman CW1, Whyte WS 2nd, Chow DW, Chou L, Lenrow D, Ellen M. https://www.ncbi.nlm.nih.gov/pubmed/16902687
Sacroiliac subluxation: a common, treatable cause of low-back pain in pregnancy Daly JM, Frame PS, Rapoza PA. Fam Prac Res J 1991;11(2):149-159 https://www.ncbi.nlm.nih.gov/pubmed/1829312
The Journal of Orthopaedic and Sports Medicine Sections of the American Physical Therapy Associaton: Dysfunction of the Sacroiliac Joint and Its Treatment* RICHARD L. DONTIGNY, BS, PT. https://www.jospt.org/doi/pdf/10.2519/jospt.1979.1.1.23
Pain Medicine and Management by Mark S. Wallace & Peter Staats, McGraw-Hill Professional, 2004
The Role of Sacroiliac Joint Dysfunction in the Genesis of Low Back Pain: The obvious is not always right Archives of Orthopaedic and Trauma Surgery. December 2007 [e-pub] https://www.ncbi.nlm.nih.gov/pubmed/17828413
Bergström C, Persson M, Mogren I, Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy – pain status, self-rated health and family situation. BMC Pregnancy and Childbirth. 2014:14:48. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-48
Yoo H, Shin D, Song C, Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women. J of Physical Ther Sci. 2015. 27(1):279-284. https://www.ncbi.nlm.nih.gov/pubmed/25642091
Laslett M. Evidence-based diagnosis and treatment of the painful sacroiliac joint. J Man Manip Ther. 2008;16(3):142–152. doi:10.1179/jmt.2008.16.3.142 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582421/
Ward JS, Coats J, Sorrels K, Walters M, Williams T. Pilot study of the impact sacroiliac joint manipulation has on walking kinematics using motion analysis technology. J Chiropr Med. 2013;12(3):143–152. doi:10.1016/j.jcm.2013.05.001 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3838716/

POSTURAL IMBALANCES: THE GOOD, THE BAD, & THE UGLY

Mon, 08 May 2023 19:18:49 GMT

Remember the days of parents and grandparents nagging you to “stand up straight” and “STOP slouching”? Wasn’t that annoying? Well … they were right. Posture has huge influences on health.

Gradual shifts of body position over time slowly weaken the muscles and ligaments while wearing away at joints and discs. Forward head posture is one of the leading causes of neck, upper back and shoulder pain. Chronic pain syndromes, headaches and jaw issues may appear if arthritic changes progress and postural imbalances remain uncorrected. 1,2,3

Research has shown that not only can faulty posture be a pain in the neck, but the effects of poor posture can also pose significant health risks to many systems in the body, specifically the respiratory, circulatory and digestive systems. 4

“Posture affects and moderates every physiologic function from breathing to

hormonal production. Spinal pain, headache, mood, blood pressure, pulse and lung

capacity are among the functions most easily influenced by posture.” 5

The chiropractic adjustment is very effective in reducing pain caused by joint restriction (fixation) and malposition (subluxation). However, if poor posture is the cause of these subluxations, symptoms are likely to recur if your posture is not corrected. For that reason, Integrity chiropractors, Dr. Leatherman and Dr. Bak, have both completed over 200 hours of post-doctoral training in CHIROPRACTIC BIOPHYSICS (CBP), and continually train to specifically correct postural imbalances of the spine. 6

So what is Posture, Ideal Posture or an Ideal Spine?

Posture is the way your body is held in space – standing and sitting under gravity (gravitational load). If your body has proper posture, there is balance to your physical structures and your spine requires minimal effort to maintain your body in a neutral position. Certain physical structures in your body line up correctly with your center of gravity.

At Integrity Chiropractic, our doctors evaluate your posture visually from the front and the side as well as measure it on x-rays for a complete analysis. This has been extensively studied and normative values have been published. 7, 8, 9

There are over 220 published papers on CBP technique of correcting abnormal postures towards normal. Ask your CBP chiropractor to evaluate your posture according to the literature. 10

Typical Body Stressors of Bad Posture

Medical doctors have reported, and chiropractors agree that for every inch that your head is held forward, an additional 10 pounds of pressure is placed on the supporting tissues of your neck and shoulders. Muscles along the rear of your neck and the upper back are required to accommodate for this extra load. As a result, they’ll experience greater stress and strain. 11

Whenever the position of your body moves away from its center of gravity, your joints are taken out of their normal, stress-free positions and initiates abnormal wear and tear. Over time, joint cartilage erosion, bone spurs and pinched nerves are evidence of this phenomenon.

Common symptoms and pain presentation of poor posture may include:

Headaches: back of the head, front of the head and the sides of the head.
Muscle pain (aching or burning) and tightness
Nerve pain (shooting, sharp or aching) traveling down the arm or leg
Joint pain (aching, sharp or stabbing) and restriction
Ligament or tendon pain (aching, sharp or diffuse)
Loss of range of motion, stiffness, tightness, inability to look over your shoulders.

Without a trained Chiropractor, here are three quick self-tests you can perform to evaluate posture:

Look in a mirror. Eyes, ears, shoulders, elbows, hands and hips should each line up horizontally from left to right. You should also be able to draw a straight line from the ground upward which centers to the body from your knees, pelvis, belly button, sternum, chin, nose and forehead.
Stand with your heels, back and buttocks against a wall. Does your head easily rest against the wall too? If it doesn’t, you may have an increased back curve and definitely have forward head posture.
Lie down on your back on a hard surface. Does your head rest on the floor? Can you look straight up to the ceiling? If you feel your head tilt backward, or aren’t looking straight above you, your upper or lower back curve may be the cause of your faulty posture.

The basics of Improving Posture 12, 13

Be aware. Practicing awareness of your posture is a first step to correcting it.
Check the ergonomics of your desk/workspace and correct for poor postures while seated. At Integrity Chiropractic we have our patients get pictures of their workspace with them interacting in it so that we can correctly modify it to reduce spinal stress.
Take regular breaks from sitting at a computer. Research shows a strong correlation between neck pain and lengthy computer usage. 14
Use a proper pillow for sleep. Avoid sleeping on your stomach.
Stretch muscles that are too tight, and strengthen the weak postural muscles. A properly trained chiropractor can teach you correct techniques.
Get adjusted. When your spine moves properly, it has the best chance to position itself properly.
Seek out a CBP certified Chiropractor to correct the spine with mirror image traction. 15

REFERENCES:

Gore DR, Sepic SB & Gardner GM. Roentgenographic findings of the cervical spine in asymptomatic people. Spine 1986 Jul-Aug; 11(6): 521-4.
Gore DR. Roentgenographic findings in the cervical spine in asymptomatic persons: a 10-year follow-up. Spine 2001 Nov 15; 26(22): 2463-6.
Saunders ES, Woggon D, Cohen C & Robinson DH. Improvement of cervical lordosis and reduction of forward head posture with anterior head weighting and proprioceptive balancing protocols. J Vertebral Subluxation Res 2003 Apr 27: 1-5.
Martin-Du Pan RC, Benoit R & Girardier L. The role of body position and gravity in the symptoms and treatment of various medical diseases. Swiss Med Wkly 2004 Sep 18; 134(37-38):543-51.
American journal of Pain Mangement. 1994; 4: 36-39
Wallace HL, Jahner S, Buckle K, Desai N. The relationship of changes in cervical curvature to Visual Analog Scale, Neck Disability Index Scores and pressure algometry in patients with neck pain. Journal of Chiropractic Research and Clinical Investigation 1994; 9(1): 19-23
Spine (Phila Pa 1976). 1996 Mar 15;21(6):667-75. Comparisons of lordotic cervical spine curvatures to a theoretical ideal model of the static sagittal cervical spine. Harrison DD1, Janik TJ, Troyanovich SJ, Holland B.
J Manipulative Physiol Ther. 1997 May;20(4):246-56. Evaluation of the assumptions used to derive an ideal normal cervical spine model. Harrison DD1, Janik TJ, Troyanovich SJ, Harrison DE, Colloca CJ.
J Spinal Disord. 1997 Oct;10(5):380-6. Radiographic mensuration characteristics of the sagittal lumbar spine from a normal population with a method to synthesize prior studies of lordosis. Troyanovich SJ1, Cailliet R, Janik TJ, Harrison DD, Harrison DE.
https://cbpnonprofit.com/
Cailliet R. Soft Tissue Pain and Disability. Philadelphia: FA Davis Co.,1977
American Chiropractic Association. Tips to Maintain Good Posture. http://www.acatoday.org/content_css.cfm? CID=1452
Canadian Chiropractic Association. Back Facts: Posture. http://www.chiropracticcanada.ca
Smith L, Louw Q, Crous L & Grimmer- Somers K. Prevalence of neck pain and headaches: impact of computer use and other associative factors. Cephalgia 2009 Feb; 29(2): 250-7.
www.Idealspine.com/directory/

Injury, Pain & Sensation Changes from the Joint, What does your Doctor Know?

Mon, 08 May 2023 19:02:20 GMT

Considerations for Car Crash Injured Patients

Chronic pain affects 1/3 of the American adult population and it has been found to be due to injury to the joints of the spine (facet joint). Many of these people wind up trying chiropractic care. Integrity Chiropractors are consistently researching the mechanism of injury, the affected anatomy, the physiological pain mechanism and ways to promote healing and resolution. That being said, what do you know about your joints? What do you know about injured tissues? Better yet, what does your doctor know about it?

A 2013 paper published in Neuroscience Letters illustrates once the facet joints are damaged, neurological consequences arise, including over-excitability of pain nerves and irritation of the Central Nervous System (brain and spinal cord)! (1) And that’s not all, this happens in the first day after the injury and helps explain why patients after a motor vehicle crash have sensation changes and hypersensitivity, helping us identify injuries so we can help our patients.

The joints of the spine have been found to be primary pain generators in other research as well. “The cervical zygapophyseal joints may be a primary source of pain in up to 60% of individuals with chronic whiplash associated disorders (WAD) and may be a contributing factor for peripheral and centrally mediated pain (sensory hypersensitivity). Sensory hypersensitivity has been associated with a poor prognosis.” (2) WOW … it is very important for injured patients and treating clinicians to understand these issues ... too much pain nerve firing leads to chronic pain syndromes. (Zygopophyseal = facet = spinal joint)

KEY POINTS OF THE 2013 STUDY QUOTED and SUMMARIZED:

“This study investigated the development of hyperalgesia and neuronal hyper-excitability in the spinal cord at either 6 hours or 1 day after a painful cervical facet capsule stretch.” (The investigations of increased pain and increased nerve firing were done very quickly after the initial injury to the joint to document early changes)

“Neuronal hyper-excitability in the dorsal horn develops within 1 day after a mechanical facet joint injury, corresponding to the development of behavioral sensitivity. These results suggest that neuronal plasticity indicative of central sensitization develops early after facet joint injury and plays a role in the development of the behavioral sensitivity that persists at later time points in this model.” (Sensitivity of the nerves to drive pain mechanisms starts the second day after injury. This increased recognition of the pain mechanism actually teaches the spinal cord and brain to experience grater pain for a sustained period of time and with less input from the body)

“The facet capsular ligament is innervated by proprioceptive and nociceptive mechanoreceptors with projections largely to the same spinal level as the facet from which they originate.” (The ligament that holds the joint together has receptors that convey information to the brain about balance, movement, body awareness and pain)

“Increased peripheral neuronal input to the spinal cord can be sufficient to produce long-lasting central sensitization via increased excitability of dorsal horn spinal neurons, leading to hyperalgesia (increased pain sensitivity) and allodynia (painful response to normally non-noxious stimuli) that can be initiated as early as minutes or hours after the insult.” (Very quickly the nervous system learns to promote the pain experience and then exaggerates it as well which persists even when the pain receptors are not being fired. This is NOT good as your brain is learning the pain state as its new normal.)

“Nonetheless, taken together with the literature, the increased spontaneous activity in the spinal cord at 1 day after painful facet injury suggests that the etiology of pain and central sensitization following mechanical joint injury may be similar to peripheral neuropathic injuries.” (So, this tells us that pain radiation and sensory changes can happen without nerve compression. This is huge because some physicians believe that you can’t irritate a spinal nerve without compression. )

“This study suggests that dorsal horn hyper-excitability, a sign of central sensitization, develops very early after a persistent painful facet capsule injury, paralleling the onset of behavioral hypersensitivity. These findings suggest there is a critical and short time between injury and the development of persistent elevated spinal responses.” (So a central nervous system CNS insult is initiated very quickly after a spinal joint injury. This insult increases the pain experience and promotes the ongoing promulgation of that pain experience.)

HERE ARE SOME FINAL THOUGHTS

At Integrity Chiropractic we see injured spinal joints on a daily basis and have literally been through hundreds of hours of postdoctoral training in sports injury and auto crash injuries. Neck joints are the most easily injured in crash mechanism, but these issues are found not only in the neck but also in the low back. (3,4)

Excessive cervical facet (neck joint) capsular ligament stretch (such as what are found in crash injuries to the spine) induces persistent increases in neck pain. We have seen this corroborated in multiple papers in the literature. (3,5,6) And by the way, there are specific x-ray procedures utilized, as well as specific measurements utilized to document these injuries. Dr. Leatherman and Dr. Bak perform these on every injury patient at Integrity Chiropractic. An MRI is NOT the gold standard to diagnose these injuries.

Dorsal horn (region of the posterior spinal cord where the pain fibers are the nerve roots are found) hyper-excitability develops between 6 and 24 hours after facet injury. What does that mean? Your pain experience is being exponentially modified and increased by the spinal cord and brain very quickly. Seeking care early from a properly trained Chiropractor can help reduce this.

The development of mechanical pain increase (pain from movement of the injured joints), happens at the same time as the increases of the spinal pain transmission from the original injury mechanism.

Joint injury, and the ligaments that surround it, create pain and inflammation, the central nervous system learns to promote this pain experience even at rest even and without movement of the injured tissue. (1,7) This is bad deal for those in car crashes and a central reason why they need active based care such as chiropractic, functional and structural rehab.

Chiropractic adjustments, specific active resistive exercise protocols as well as structural spinal curve remodeling to target the ligaments are key to healing from these injuries.

Nathan D. Crosby,a Christine L. Weisshaar,a and Beth A. Winkelsteina. Spinal neuronal plasticity is evident within 1 day after a painful cervical facet joint injury. Neurosci Lett. 2013 May 10; 542: 102–106. https://www.sciencedirect.com/science/article/abs/pii/S0304394013002243?via%3Dihub
Schneider GM, Smith AD, Hooper A, et al. Minimizing the source of nociception and its concurrent effect on sensory hypersensitivity: an exploratory study in chronic whiplash patients. BMC Musculoskelet Disord. 2010;11:29. Published 2010 Feb 9. doi:10.1186/1471-2474-11-29 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829507/
Pearson AM, Ivancic PC, Ito S, Panjabi MM. Facet joint kinematics and injury mechanisms during simulated whiplash. Spine (Phila Pa 1976). 2004;29(4):390–397. doi:10.1097/01.brs.0000090836.50508.f7 https://pubmed.ncbi.nlm.nih.gov/15094535/
Perolat R, Kastler A, Nicot B, et al. Facet joint syndrome: from diagnosis to interventional management. Insights Imaging. 2018;9(5):773–789. doi:10.1007/s13244-018-0638-x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206372/
Ivancic PC. Facet joint and disc kinematics during simulated rear crashes with active injury prevention systems. Spine (Phila Pa 1976). 2011;36(18):E1215–E1224. doi:10.1097/BRS.0b013e31820545b1 https://pubmed.ncbi.nlm.nih.gov/21343848/
Chen HB, Yang KH, Wang ZG. Biomechanics of whiplash injury. Chin J Traumatol. 2009;12(5):305–314. https://pubmed.ncbi.nlm.nih.gov/19788851/
Singh S, Kartha S, Bulka BA, Stiansen NS, Winkelstein BA. Physiologic facet capsule stretch can induce pain & upregulate matrix metalloproteinase-3 in the dorsal root ganglia when preceded by a physiological mechanical or nonpainful chemical exposure. Clin Biomech (Bristol, Avon). 2019;64:122–130. doi:10.1016/j.clinbiomech.2018.01.009 https://pubmed.ncbi.nlm.nih.gov/29523370/

Infantile Colic without a chiropractor? Now that’s something to cry about!

Mon, 08 May 2023 18:29:10 GMT

Integrity Chiropractors understand that when a baby is in distress and inconsolable, it’s not only the child who suffers. A colicky infant affects the psychological, emotional and physical health of the entire family. At Integrity, all of the doctors are parents too, we get it.

According to medical literature, infantile colic is diagnosed by the rule of three:

Crying for more than three hours per day
Crying for more than three days per week
Crying for longer than three weeks in a month for an infant who is well-fed and healthy. 1

Experts have yet to come to a consensus regarding the cause of colic, but the most common theory is that the infant is having digestive difficulties, including excessive gas or reflux Breastfeeding moms are even recommended to avoid dairy products to see if it helps reduce the symptoms of colic. 2

Chiropractors and even some medical doctors agree to look at the spine. Childbirth can be traumatic for the immature human spine, with the neck and head experiencing a great degree of compression, rotation, extension and traction. Even an uncomplicated birth can have some negative effects for baby.

When an infant is brought to Integrity Chiropractic for colic issues, we first take vital signs and go through a history with the mother. Afterward our doctors examine ranges of motion, primitive reflexes, perform orthopedic/neurological tests and examine the child’s spine. For infant care, Integrity chiropractors locate areas of the spine that have decreased mobility or are not moving properly, and then apply gentle pressure to reestablish proper mechanics for the involved vertebrae. The result: happier babies, and happier parents!

In a case study, a 7-week old infant presented for chiropractic care with a medically diagnosed colic with reflux and disturbed sleep that was persistent since birth. Vertebral subluxation (spinal fixation) patterns were noted in the spine of the baby. In less than three weeks of treatments, this infant achieved complete resolution with chiropractic adjustments to the spine. 3

Additional published case studies support the use of chiropractic care for babies who are experiencing infantile colic symptoms. Often, only a few adjustments are needed to produce dramatic results. 4-6

In a prospective survey study, 316 infants with moderate to severe colic (average 5.2 hours of crying per day) were treated with chiropractic care. Responses to care were tracked by their mothers and compiled.

Ninety-four percent of the children showed a favorable response with an average of only three treatments within two weeks. Twenty-five percent of these infants showed great improvement after the first chiropractic adjustment! 7

In 1999, an RCT study was performed to investigate the effect of spinal manipulation in the treatment of infantile colic versus medication. Fifty infants were recruited and randomly assigned to two groups: Dimethicone medication daily for two weeks or spinal manipulation for two weeks by a local chiropractor. The infants in the chiropractic group received an average of 3.8 adjustments. During the two-week treatment period, the parents kept a colic diary and nurses visited the families and administered a weekly infantile colic behavior profile.

All of the chiropractic patients completed the entire course of treatments (100%). However, 9 out of 25 subjects (36%) dropped out from the medication side. When parents were asked why they left the study, two described their child's condition as "worsened" and two others described it as "much worsened." Had these four infants completed the study, they would have significantly lowered the apparent positive effects of dimethicone.

The results above shows the number of Colic Hours per day were reduced 50% better in the chiropractic group than the Dimethicone group, which strongly suggests that chiropractic is a valid treatment option for children with infantile colic. 8

In our office, Integrity chiropractic, we see 15-20 cases like this every year, and just as the research found, colic symptoms reduce favorably in just a few short weeks. So if your baby has colic symptoms, or the next time you hear someone complaining about their baby’s incessant crying, mention to them that chiropractic care may be able to help.

References and Sources:

Am Fam Physician. 2004 Aug 15;70(4):735-40.
Hill, D et al. Effect of a Low-Allergen Maternal Diet on Colic Among Breastfed Infants: A Randomized, Controlled Trial. Pediatrics 2005; 116: e709-e715.
Hipperson, AJ. Chiropractic Management of Infantile Colic. Clinical Chiropractic 2004; 7(4):180–186.
Van Loon, M. Colic With Projectile Vomiting: A Case Study. Journal Of Clinical Chiropractic Pediatrics 1998Aug; 3(1): 207-10.
Sheader, WE. Chiropractic management of an infant experiencing breastfeeding difficulties and colic: a case study. Journal of Clinical Chiropractic Pediatrics, 1999; 4(1).
Pluhar GR, Schobert PD. Vertebral subluxation and colic: a case study. J of Chiropractic Research and Clinical Investigation 1991; 7:75-76.
Klougart N, Nilsson N and Jacobsen J. Infantile colic treated by chiropractors: a prospective study of 316 cases. J Manip Physiol Ther 1989; 12(4):281-288.
Wiberg JMM, Nordsteen J, Nilsson N.The short-term effect of spinal manipulation in the treatment of infantile colic: A randomized controlled clinical trial with a blinded observer. J Manip Physiol Ther 1999; (22): 517-22.

Chiropractic Adjustments for Pregnancy and Newborn? Really? … But of Course!

Mon, 08 May 2023 18:15:04 GMT

Did you know that Moms, fetuses and babies all have spines? Chiropractic physicians know it, and have been adjusting pregnant mothers and treating pregnant and infant spines for over 100 years.

At Integrity Chiropractic, we have been treating pregnant moms and babies for over 16 years with the consent and encouragement of their midwives and OB/GYN’s. In fact, OB/GYN’s count for the largest amount of medical referrals to the Integrity Chiropractic office. Even now, this care is sometimes scrutinized and criticized by some medical personnel who are not familiar with the benefits. Interestingly enough, published research as far back as 1911, 1918, 1946 and 1952 in the osteopathic profession has shown the benefits of spinal manipulation in pregnancy. (1,2,3,4)

Growing research has shown chiropractic care to be a safe and effective treatment for pregnant mothers. Studies have reported that 50% of all women complain of lower back pain during pregnancy, and 75% experience back labor. (5,6,7,8) Dr. Leatherman and Dr. Bak’s wives were both adjusted throughout their pregnancies, and even in the delivery room.

As the baby grows, the additional weight increases stress on the back, postural shifts rapidly occur, and hormonal changes begin to relax the supporting ligament tissues of the spine and pelvis. This often leads to increasing aches and pains among other problems.

“Through compensation, the sagittal curvature of the remainder of the spinal column increases as well. The lumbar lordosis, designed to absorb some of the axial forces, loses integrity as a static support and may be a source of disc injury. In addition, the increase in circulating progesterone, estrogen, and relaxin throughout gestation, especially in the third trimester, brings about pelvic hypermobility and creates a decrease in spinal stabilization.” (10)

Incredibly, the ligamentous laxity brought on by pregnancy often makes spinal adjusting comparatively easy for Dr. Leatherman and Dr. Bak, allowing them to utilize the gentlest of movements. (11)

Chiropractic care has also been shown to significantly reduce labor time for women who had care throughout their pregnancy. A hospital study that looked at chiropractic adjustments during pregnancy, found a 50% decrease in the need for painkillers during delivery, due to adjustments during pregnancy. Dr. Joan Fallon published that first time moms averaged 24% shorter labor, while experienced mothers had a 39% reduction in the average labor time. (9,12)

Chiropractic treatment of the mid-back can help alleviate mid-back pain, shortness of breath, and heartburn. Treatment of the mid to lower back can help with other unnecessary problems such as constipation, frequent urination, leg pain, lower back pain, and pelvic pain.

What about the fetus and newborn?

Chiropractic treatment is not just beneficial for the mother. The developing baby can benefit from chiropractic treatment as well. Adjusting the mother helps reduce limitations to proper growth and development of the baby, as well as allowing the mother to avoid medications that may be harmful to the baby’s health.

The normal birthing process is a potential source of trauma to the infant's spine. Some chiropractors extend their understanding of spinal segmental dysfunction, or subluxation in chiropractic terminology, to apply to newborn spinal function, with the resultant concern for the health of the infant. The induced vector of force that may cause trauma to the newborn includes traction of the cervical spine coupled with hyperextension and rotation during the birth process. (13)

Moreover, the birth process can be complicated. Forceps, cesarean, and suction or vacuum extraction can also cause trauma to the newborn's cervical spine, thoracic spine and spinal cord (11) and may warrant chiropractic evaluation. Nerves between the neck and the armpit such as the Brachial plexus and cervico-thoracic nerve roots can be damaged, such as Klumpke's paralysis and Erb's palsy. These injuries are a potential result of applying common birthing methods. (14)

Dr. Leatherman’s boys were both adjusted in the hospital the same day after birth. Both births were complicated: one birth needed vacuum extraction after a prolonged labor and the other was a full breech presentation where forceps were utilized towards the end of the delivery. Additionally, Dr. Bak’s son was also adjusted shortly after a long but uncomplicated labor at a birth center. All three children have continued their chiropractic care since birth. And yes, even pediatricians refer to chiropractors.

In a review of 1000 infants, Dr. Guttmann suggested that birth trauma frequently affected the atlanto-occipital joint, (joint between the head and the neck) causing blockage or vertebral subluxation. (14) Correction of such a presentation may be accomplished through a light, precise, biomechanical adjustment, using various gentle techniques. The chiropractic adjustment of the neonate and infant is very light in nature and often only requires mild sustained pressure. It is vastly different than the techniques utilized with adults. (14,15)

At Integrity Chiropractic, our care also includes essential nutrition, stability exercise, and lifestyle modifications that contribute to a healthy pregnancy and delivery. Dr. Leatherman and Dr. Bak appreciate that research suggests chiropractic care helps reduce symptoms in up to 85% of women experiencing significant lumbo-pelvic pain during pregnancy. (16) To further illustrate that point, a prospective, cohort, outcomes study in Switzerland found that 52% of 115 recruited patients ‘improved’ at 1 week, 70% at 1 month, 85% at 3 months, 90% at 6 months and 88% at 1 year. (17)

A combination of good advice from the doctors at Integrity chiropractic results in a less stressful pregnancy and a more comfortable delivery for both mom and baby. So if you’re having pregnancy related spine symptoms, Dr. Leatherman and Dr. Bak are ready to help in any way they can.

References:

1. Whiting L.M. Can the length of labor be shortened by osteopathic treatment? J Am Osteopath Assoc. 1911;11:917–921. [Google Scholar]

2. Hart L.M. Obstetrical practice. J Am Osteopath Assoc. 1918:609–614. [Google Scholar]

3. Dooley W. Osteopathy's contribution to prenatal care. J Am Osteopath Assoc. 1946;46:6–7. [Google Scholar]

4. Jones M. The value of routine manipulation in pregnancy. J Am Osteopath Assoc. 1952; 51:554–557. [PubMed]

5. Phillips C.J., Meyer J.J. Chiropractic care, including craniosacral therapy, during pregnancy: a static-group comparison of obstetric interventions during labor and delivery. J Manipulative Physiol Ther. 1995;18(8):525–529. [PubMed]

6. Diakow P.R.P., Gadsby T.A., Gadsby J.B., Gleddie J.G., Leprich D.J., Scales A.M. Back pain during pregnancy and labor. J Manipulative Physiol Ther. 1991;14(2):116–118. [PubMed]

7. Berg G., Hammer M., Moller-Nielsen J., Linden U., Thorblad J. Low back pain in pregnancy. Obstet Gynecol. 1988;71:71–75. [PubMed]

8. Borggren CL. Pregnancy and chiropractic: a narrative review of the literature. J Chiropr Med. 2007 Jun;6(2):70-4. doi: 10.1016/j.jcme.2007.04.004. PMID: 19674697; PMCID: PMC2647084.

Reduced labor times

9. J.M. Fallon. Textbook on chiropractic & pregnancy. Arlington, VA: International Chiropractic Association; 1994: 52, 109.

10. DiMarco D.B. The female patient: enhancing and broadening the chiropractic encounter with pregnant and postpartum patients. J Am Chiropr Assoc. 2003;40(11):18–24.

11. Shaw G. When to adjust: chiropractic and pregnancy. J Am Chiropr Assoc. 2003;40(11):8–16.

12. Fallon J.M. Chiropractic and pregnancy: a partnership for the future. ICA Int Rev Chiropr. 1990;46(6):39–42.

Birth trauma and adjusting newborns

13. Esch S., Zachman Z. Adjustive procedures for the pregnant chiropractic patient. Chiropr Tech. 1991;3(2):66–71.

14. Howe C.A. Scientific ramification for producing pre-natal and neonate chiropractic care. Am Chiropr. 1993;15(3):20–23.

15. Peet J.B. Chiropractic pediatric reference manual. Rose Publications; Shelburne, (Vt): 1991. p. 25.

Conclusion

16. Borggren, CL. Pregnancy and chiropractic: A narrative review of the literature. Journal of Chiropractic Medicine 6(2):70-4 · July 2007 DOI: 10.1016/j.jcme.2007.04.004. [PubMed]

17. Peterson CK, Mühlemann D, Humphreys BK. Outcomes of pregnant patients with low back pain undergoing chiropractic treatment: a prospective cohort study with short term, medium term and 1 year follow-up. Chiropr Man Therap. 2014; 22(1):15. Published 2014 Apr 1. doi:10.1186/2045-709X-22-15.

Chiropractic Benefits go far beyond alleviating back and neck pain …MYTH or TRUTH?

Mon, 08 May 2023 17:58:33 GMT

125 years of Chiropractic care has resulted in millions of elated patients across the globe, and patient satisfaction scores are higher with chiropractors than any other classification of doctor. While Chiropractic physicians continue to develop as the second largest health care provider in the world, many medical doctors and mainstream medical institutions remain ignorant of the research and science behind the short and long-term benefits that Chiropractic adjustments provide for people of all ages, and yes, even for babies!

Most Common Myth: Chiropractic adjustments only help musculoskeletal

Injuries or help reduce spinal pain.

Truth: Chiropractic is proven to help musculoskeletal health and organ health while also

positively influencing hormones and human performance.

Let’s start with those babies … In 1992, research was published in The Journal of Manual Medicine on the pathogenic potential of the craniovertebral junction (base of the skull) in 600 newborns and young children with a history of birth trauma. Most babies had asymmetric posture, and the following:

1) Tilt posture of the head / torticollis.

2) The head is held in extension to the point where the baby was unable to lie on the back.

3) “Uniform sleeping posture, the child cries if the mother tries to change its position.”

4) Asymmetries of movement patterns.

5) Asymmetric posture of trunk or extremities.

6) “Sleeping disorders, the baby wakes up crying every hour.”

7) “Extreme sensitivity of the neck.” [Roy Sweat scanning test]

8) Asymmetry or swelling of the face / head.

9) Asymmetries of the gluteal muscles.

10) “Asymmetric hip development and range of movement / Retarded development of the hip joints.”

11) Fever of unknown origin.

12) Loss of appetite.

13) Feet deformities.

14) Pathological reflexes.

15) Mobility of the cervical or other spinal regions spine reduced by more than 30%.

16) The parent reporting that the baby does not eat or drink well.

This author noted and concluded that:

1. Babies with a contracted sternocleidomastoid muscle should not be subjected to operative measures to lengthen the muscle because they will nearly always respond perfectly to “Manipulation of the upper cervical spine.”

2. When treating pediatric C-scoliosis and movement asymmetries, manipulation of the suboccipital region is superior to physical therapy because “suboccipital strain is the leading factor.”

3. Manipulation of the occipital-cervical region leads to disappearance of problems that the parents had not reported because they did not see a connection with the spine. These parents would regularly note that their child would eat or sleep much better since the manipulation.

4. Doctors should check ALL CHILDREN for restricted movement of the head and for increased pain sensitivity of the upper cervical spine. (this is rarely done outside of chiropractic care)

Important nutrients delivered to the brain through proper alignment and movement of the spine account for why Chiropractic spinal care is so important. A study published in 2011 explained that a specialized group of hormones play a significant role in why Chiropractic adjustments achieve such great health results.

Hormones serve as chemical messengers that secrete directly into the blood and before being carried to organs and tissues to help direct function. Any procedure that influences hormones will powerfully and directly influence all bodily functions. Optimal health and performance only occurs when hormones are balanced and coordinated.

Research published in 2009 from Johns Hopkins University listed a group of symptoms or conditions linked directly to the increase of a specific hormone called noradrenaline.

The list includes: cancer, bipolar disorder, excessive body weight, hypertension,

type 1 autoimmune diabetes, type 2 diabetes, glaucoma, osteoarthritis,

rheumatoid arthritis, asthma, and immune system function.

One of the more notable symptoms linked to increased noradrenaline levels is excessive weight gain. Many patients of either gender have experienced some form of weight loss after starting Chiropractic care. Adjustments help restore hormonal balance and produce favorable health changes in overall body function. Balanced hormones through the power of the chiropractic adjustment helps maximize every lifestyle and health change adopted by a patient.

Chiropractic helps balance hormones by reducing central nervous system dysfunction and sympathetic dominance that exists due to vertebral subluxation. Science proves that chiropractic adjustments lower stress hormones while helping coordinate and balance other chemical messengers through improved brain and organ function. Even cardiac function and blood pressure have been shown to improve in the clinical research. Chiropractic physicians address the spinal educating the world about the deleterious health conditions that begin forming when influenced by improper spinal mechanics and bad posture.

Switching gears, what about depression and anxiety?

A case study published in the Journal of Upper Cervical Chiropractic Research in June 2013, reports on chiropractic helping patients with depression and anxiety. This case series was looking to follow up on previous surveys showing that out of 2818 patients who completed chiropractic care, 76% of those patients reported a mental/emotional improvement, as well as positive changes in stress and life enjoyment over a period of several months following the chiropractic care. Additional prior studies also showed chiropractic care assisting patients with these types of mental health disorders.

This case series study involved six patients who were not under any psychotherapy at the time and were given tests using standard scales of psychological testing to determine and measure their mental state prior to and after the chiropractic care.

All six participants also suffered from a variety of problems including: musculoskeletal pains, asthma, hypertension, gastrointestinal issues, and sleep disorders. Those who were taking medications made no changes to their medications during the study to rule out any improvement due to medication.

For the purposes of this study, care was limited to only 12 chiropractic visits over a six week period. A number of protocols were used both to monitor the chiropractic correction of subluxations as well as to measure improvement in depression or anxiety.

One participant left the program due to a family emergency, therefore results were recorded for five of the six participants. The remaining five participants all showed positive results in most of the areas that the researchers measured. All five also showed positive test results for a decrease in nerve interference from subluxation.

1. All five participants showed a “…significant decrease in depressive symptom ratings.”

2. All five measured a “…significant decrease in anxiety.”

Additionally, four of the five participants who completed the study also reported a self-feeling of improvement with their depression, enough to state that they would recommend this type of care to others with depression. Four of the five participants also reported significant improvements in the other health issues and problems they were suffering from at the beginning of the study.

In their conclusion the authors wrote, “The results provide tentative support for the effectiveness of upper cervical (neck) chiropractic care for anxiety and depression symptoms.” They also stated, “The present study found reduction in anxiety and depression symptoms and reduction in overall psychological distress among individuals with mild to severe depression, anxiety or both.”

In conclusion, chiropractic adjustments help maximize body function and should be utilized to improve health and performance for family members of all ages. The research reviewed here is just a small sample of what has been reported and published. Knowing this, some osteopaths and physical therapists manipulate the spine too, but over 95% of spinal manipulation is performed by chiropractors, who have the most education and training on the spine, posture and the health consequences. Anatomy, physiology, and scientific research have confirmed what chiropractic patients have known for years, CHIROPRACTIC WORKS!

References:

Eric Kandel, James Schwartz, Thomas Jessell, Principles of Neural Science. McGraw-Hill, 2000.
Proceedings of the National Academy of Sciences U S A. 2008 Jun 17; 105(24): 8369 – 8374. (Dean Ornisch genetics study)
Biedermann H. Kinematic imbalances due to suboccipital strain in newborns. J. Manual Med (1992) 6:151 - 156.
“Impact of Osteopathic Manipulation in Secretory IgA in Stressed Populations” Journal of Osteopathic Association. March 2011
"Relationship Between Vertebral Deformities And Allergic Diseases" The Journal of Orthopedic Surgery. 2004. Volume 2
Ogura T., Tashiro M., Masud M., Watanuki S., Shibuya K., Yamaguchi K., Itoh M., Fukuda H., Yanai K. (2011 Nov - Dec) “Cerebral metabolic changes in men after chiropractic spinal manipulation for neck pain”. Alternative Therapies Health Medicine Vol. 17; No. 6; pp.12-7.
Fitzgerald, P. J. Oct. 2009 "Elevated Noradrenaline levels an etiological factor in a number of diseases" Autonomic and Autacoid Pharmacology. 29(4):143-56
The Journal of Neuroscience, 1 August 2007, 27(31): 8324-8333 The Neurochemically Diverse Intermedius Nucleus of the Medulla as a Source of Excitatory and Inhibitory Synaptic Input to the Nucleus Tractus Solitarii. Ian J. Edwards, Mark L. Dallas, Sarah L. Poole, Carol J. Milligan, YuchioYanagawa, Gábor Szabó, Ferenc Erdélyi, Susan A. Deuchars, and Jim Deuchars
Reis MS, Durigan JL, Arena R, Rossi BR, Mendes RG, Borghi-Silva A; Effects of Postero-anterior Thoracic Mobilization on Heart Rate Variability and Pain in Women with Fibromyalgia; Rehabilitation Research and Practice; May 29, 2014 [epub]
J Human Hypertension 2007 (May); 21 (5): 347–352. Bakris G, Dickholtz M, Meyer PM, Kravitz G, Avery E, Miller M, Brown J, Woodfield C, Bell B. Department of Preventive Medicine, Rush University Hypertension Center, Chicago, IL, USA
Upper Cervical Chiropractic Care as a Complementary Strategy for Depression and Anxiety: A Prospective Case Series Analysis. Lauren Roth PsyD Bio, Diane Zelman PhD Bio, Lauren Clum DC Bio, Justin Roth DC Bio. Journal of Upper Cervical Chiropractic Research ~ June 20, 2013 ~ Pages 49-59

Chiropractic and Corona virus, what do we really know?

Mon, 08 May 2023 17:33:29 GMT

There’s been a lot of talk lately about the Coronavirus and what you can do to protect yourself. Integrity Chiropractic docs are here to support you with information and action steps that can help you and your family stay well, today and always.

Although the media has been fanning the flames of panic, they’ve also been reporting on really important facts like hand washing and social distancing. (1,2) Absolutely these things are important and easy to implement. Hand washing has been utilized since the mid-1800s. Studies by Ignaz Semmelweis in Vienna, Austria, and Oliver Wendell Holmes in Boston, USA, established that hospital-acquired diseases were transmitted via the hands of health care workers. More on handwashing below. (3)

COVID Mode of transmission:

Early reports suggest person-to-person transmission most commonly happens during CLOSE exposure to a person infected with COVID-19, primarily via respiratory droplets produced when the infected person coughs or sneezes. Droplets can land in the mouths, noses, or eyes of people who are nearby or possibly be inhaled into the lungs of those within close proximity. The contribution of small respirable particles, sometimes called aerosols or droplet nuclei, to close proximity transmission is currently uncertain. Airborne transmission from person-to-person over long distances is unlikely, but the virus does live on hard surfaces for extended periods, therefore cleansing surfaces is also important. (4)

Epidemiologic factors and testing:

Please realize there are guide decisions about COVID-19 testing and that only suspected cases are tested. You can’t simply request a test and expect for that to happen, but as more test kits become available, this may become easier. Documented COVID-19 infections in a jurisdiction and known community transmission may contribute to an epidemiologic risk assessment to inform testing decisions. Medical clinicians are strongly encouraged to test for other causes of respiratory illness (e.g., influenza) before considering any COVID-19 testing.

Mildly ill patients are encouraged to stay home and contact their healthcare provider by phone for guidance about clinical management, but this is strictly supportive care unless significant breathing issues arise. Patients who have severe symptoms, such as difficulty breathing, should seek care immediately. Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their physician early in the course of even mild illness. (5)

Hand Hygiene:

Health care professionals (HCP) should perform hand hygiene before and after patient contact, or contact with potentially infectious material. HCP should perform hand hygiene by using 60-95% alcohol or washing hands with soap and water for at least 20 seconds. Integrity Chiropractic has ensured that hand hygiene supplies are readily available to all personnel as well as patients in every care location. (6) The same information applies to you and your family … wash, wash, wash! By the way, we have hand washing stations in every treatment room, in our rehab bay, and in all 3 office bathrooms, there is no reason not to have clean hands at Integrity Chiropractic.

Disinfection and Prevention:

At Integrity Chiropractic we ensure that environmental cleaning and disinfection procedures are followed consistently and correctly. Routine cleaning and disinfection procedures (e.g., using cleaners and water to pre-clean surfaces prior to applying an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on the product’s label) are appropriate for SARS-CoV-2 in healthcare settings. (7) This is exactly what we are doing at Integrity Chiropractic. Tables, counters, door handles, door surfaces, computer screens and keyboards are all disinfected multiple times throughout the day. We additionally utilize a cleaner with surfactant that works for 24 hours to not allow bacterial or viral attachment to the surface.

SO WHY CHIROPRACTIC? -- Can that help and if so how?

It is important to state that we do not have enough quality evidence to support a specific causal increase in systemic immune function following chiropractic care at this time. However, there is published evidence that this does occur in specific immune cells. We just need more quality studies to be performed to properly understand and verify the chiropractic – immune connection. Here’s some research in the meantime.

Interleukin-2:

One of the very best ways to prevent and fight any virus is to have a strong and healthy immune system. Research from 2006, 2008 and 2010 determined that patients who received Chiropractic adjustments showed increased levels of a specific signaling molecule in the body called Interleukin-2. IL-2 regulates the activities of white blood cells which are responsible for immunity. The molecule impacts the body's natural response to microbial and viral infections and helps the body recognize and create specific responses that neutralize foreign invaders. This protein molecule was found to be higher in those who received Chiropractic spinal adjustments when compared to those who did not. (8,9,10,17)

Polymorphonuclear Neutrophils:

Another type of immune system cell, (PMNs), showed increased biological activity after chiropractic adjustment. PMNs are the most abundant circulating blood leukocytes. They provide the first-line defense against infection and are potent effectors of inflammation. (11) Researchers found a significant difference in the respiratory burst of PMNs in response to a particulate challenge, depending on the time of blood sample collection. The response of PMNs isolated from blood collected 15 min after manipulation was significantly higher than the response of cells isolated from blood collected 15 min before. (12)

Cluster of Differentiation 4

An important study was performed at the Sid E. Williams Research Center of Life Chiropractic University. Researchers took a group of HIV positive patients and adjusted them over a six-month period. What they found was that the “patients that were adjusted had an increase of forty-eight percent (48%) in the CD4 cells (an important immune system component).” These measurements were taken at the patients' independent medical center, where they were under medical supervision for the condition. The control group (the patients that were not adjusted) did not demonstrate this dramatic increase in immune function, but actually experienced a 7.96% decrease in CD4 cell counts over the same period. (13)

Another study showing the positive effect chiropractic care can have on the immune system and general health was performed by Ronald Pero, Ph.D., chief of cancer prevention research at New York's Preventive Medicine Institute and professor of medicine at New York University. Dr. Pero measured the immune systems of people under chiropractic care as compared to those in the general population and those with cancer and other serious diseases.

In his initial three-year study of 107 individuals who had been under chiropractic care for five years or more, the chiropractic patients were found to have a 200% greater immune competence than people who had not received chiropractic care, and 400% greater immune competence than people with cancer and other serious diseases. The immune system superiority of those under chiropractic care did not diminish with age. Dr. Pero stated: “When applied in a clinical framework, I have never seen a group other than this chiropractic group to experience a 200% increase over the normal patients. This is why it is so dramatically important. We have never seen such a positive improvement in a group…” (14)

Musculoskeletal Considerations of Coronaviruses:

Myopathic and neuropathic complications in patients diagnosed with SARS have been reported in the clinical literature previously. (15) This is an important consideration because SARS-CoV-2 is the virus that causes COVID-19. Muscular changes are frequently associated with severe acute respiratory syndrome. After the acute phases of initial care, these can present to chiropractic offices due to muscular weakness, muscular dysfunction and pain related complaints. Patients with varied neuromuscular complaints post-infection have reported short-term subjective improvements in their pain experience and quality of life with conservative chiropractic care. (16)

So, can Integrity chiropractors cure the Coronavirus, of course not, but there is published evidence to support that chiropractic care can positively influence immune modulators. (17) More evidence is need to state that chiropractic can specifically boost the entire immune system. (17) It is the duty of chiropractic physicians to educate and apply proper sanitary precautions to reduce COVID-19 transmission, and give great musculoskeletal spinal care so that we can free up the hospitals and acute care centers for addressing specific cases of respiratory infection and distress that require medical triage and support. Additionally, post-care of those who have been confirmed and recovered is absolutely appropriate.

REFERENCES:

1. https://globalhandwashing.org/resources/handwashing-and-coronavirus-fact-sheet/

2. Harry Stephens. Why Outbreaks like the Coronavirus spread exponentially, and how to flatten the curve. March 14, 2020. https://www.washingtonpost.com/graphics/2020/world/corona-simulator/?fbclid=IwAR0esC0GRJdV6JN5beO_eu3DNzFbOOF17B0HuCPuPU6G9RHVGkGUW6raFr8

3. WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Geneva: World Health Organization; 2009. 4, Historical perspective on hand hygiene in health care. https://www.ncbi.nlm.nih.gov/books/NBK144018/

4. https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html

5. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html

6. https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html

7. https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html

8. Teodorczyk-Injeyan JA1, Injeyan HS, Ruegg R. Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. J Manipulative Physiol Ther. 2006 Jan;29(1):14-21. https://www.ncbi.nlm.nih.gov/pubmed/16396725

9. Teodorczyk-Injeyan JA1, Injeyan HS, McGregor M, Harris GM, Ruegg R. Enhancement of in vitro interleukin-2 production in normal subjects following a single spinal manipulative treatment. Chiropr Osteopat. 2008 May 28;16:5. doi: 10.1186/1746-1340-16-5. https://www.ncbi.nlm.nih.gov/pubmed/18507834/

10. Teodorczyk-Injeyan JA, McGregor M, Ruegg R, Injeyan HS. Interleukin 2-regulated in vitro antibody production following a single spinal manipulative treatment in normal subjects. Chiropr Osteopat. 2010;18:26. Published 2010 Sep 8. doi:10.1186/1746-1340-18-26 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945351/

11. Emma Di Carlo , Guido Forni , PierLuigi Lollini , Mario P. Colombo , Andrea Modesti , Piero Musiani. The intriguing role of polymorphonuclear neutrophils in antitumor reactions. Blood. Volume 97, Issue 2 January 15 2001. https://ashpublications.org/blood/article/97/2/339/52823/

12. Brennan PC1, Triano JJ, McGregor M, Kokjohn K, Hondras MA, Brennan DC. Enhanced neutrophil respiratory burst as a biological marker for manipulation forces: duration of the effect and association with substance P and tumor necrosis factor. J Manipulative Physiol Ther. 1992 Feb;15(2):83-9. https://www.ncbi.nlm.nih.gov/pubmed/1373431

13. Selano JL, Hightower BC, Pfleger B, Feeley-Collins K, Grostic JD. "The Effects of Specific Upper Cervical Adjustments on the CD4 Counts of HIV Positive Patients." The Chiro Research Journal; 3(1); 1994.

14. Pero R. "Medical Researcher Excited By CBSRF Project Results." The Chiropractic Journal, August 1989; 32.

15. Leung TW, Wong KS, Hui AC, et al. Myopathic changes associated with severe acute respiratory syndrome. Arch Neurol. 2005;62:1113–1117. https://www.ncbi.nlm.nih.gov/pubmed/16009768

16. Stainsby B, Howitt S, Porr J. Neuromusculoskeletal disorders following SARS: a case series. J Can Chiropr Assoc. 2011;55(1):32–39. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044805/

17. Immune Function and Chiropractic. What Does the Evidence Provide? The International Chiropractors Association, March 2020 http://www.chiropractic.org/wp-content/uploads/2020/03/ICA-Report-on-Immune-Function-and-Chiropractic-3-20-20.pdf