If you have Blue Cross or Green Shield as your Extended Health Provider, we will now submit claims on your behalf.

Please don’t hesitate to contact the clinic to learn more about this service.

The monthly period. It is a pivotal marker for a woman’s fertility, and the body’s constitution and state of health have significant influence on how smoothly the body will undergo the menstrual cycle.

For some, the monthly period is just a minor inconvenience. But for many, the monthly period is a time of agonizing pain, cramping and other bodily discomfort that is met with dreaded anticipation every single month.

When women experience strong painful cramping before, during or just after the menstrual period, that is referred to as dysmenorrhea.

In Traditional Chinese Medicine there are five primary causes for painful periods:

1. Qi stagnation and blood stasis: seen as abnormal circulation or flow of energy and/or blood in the body
◦ Distending abdominal pain
◦ Pain aggravated by pressure
◦ Pain occurs just before or during onset of menstruation
◦ Often restricted menstrual flow during the first day
◦ Dark purple blood with clots or large pieces of decomposed tissue
◦ Breast tenderness
◦ rib/flank pain or discomfort

2. Cold-dampness coagulation and obstruction: seen as abnormal cold in the lower abdominal area
◦ Cold pain in lower abdomen just before or during menstruation
◦ Pain that worsens with pressure, but is relieved by warmth
◦ Light menstrual flow
◦ Dark purplish blood with clots
◦ Loose stools or diarrhea
◦ Dislike cold temperatures

3. Qi and blood deficiency: seen as lack of energy and blood in the body
◦ Persistent dull pain during or after menstruation
◦ Pain relieved with pressure
◦ Heavy or very light flow
◦ Pale thin blood with no clots
◦ Tendency for fatigue, dizziness and palpitations

4. Insufficient Liver and Kidney: seen as overworked or exhausted Liver and Kidneys
◦ Dull pain in lower abdomen after menstruation
◦ Light flow
◦ Dark blood with no clots
◦ Aching lower back and knees
◦ Tinnitus or ringing in the ears
◦ Occasional feverish sensation

5. Down Pouring Damp-Heat: seen as abnormal heat in the lower abdominal area
◦ Pain or burning sensation in lower abdomen during menstruation
◦ Pain is worsened by pressure
◦ Distending pain the lower back
◦ Thick dark red blood with clots
◦ Frequently have yellowish vaginal discharge
◦ Frequent low fever

Acupuncture and TCM herbal therapy have a long history in aiding reproductive health. They can help harmonize and correct your body constitution to alleviate painful periods.

If you are experiencing painful periods just recently, it is advisable to go see your family doctor or gynecologist to check for any functional or structural abnormalities first before seeking alternative therapies.

Book your appointment at Vitality Clinic at 604-687-7678, or contact myself ([email protected]) to see if acupuncture and TCM would be right for you.

Have a great day,
Clarissa Low, RTCMP
Vancouver Registered Traditional Chinese Medicine Practitioner

Happy Thursday Everyone!

Now is the time of year when routines take shape again and patterns emerge.  If you haven’t sought out Chiropractic care, now is a perfect time to take those first steps.

Related Links:
Why Seek Out a Chiropractor
Is Chiropractic Safe?
What to Expect at Your First Chiropractic Visit
Chiropractic isn’t all About The “Crunch”
Low Back Pain
Neck Pain
Headaches
Lower Back Stretches
Upper Body Stretches
Core Exercises

Have a great day,
Dr. Crysta Serné
Chiropractor and owner of Vitality Clinic

You can see the tell-tale marks as more and more people sport large circular bruises on their bodies. You are starting to see them on athletes and celebrities in the media. Maybe you have noticed those marks peeking out of a friend or coworker’s shirt collar. What on earth are those marks, and why are people getting this done to their bodies?

“Cupping” is the name of this technique used to produce these marks and is an excellent method in the Traditional Chinese Medicine scope to help treat pain and facilitate healing. It uses small circular cups of various sizes applied strategically onto the skin with suction. The primary concept of this method is to increase local blood circulation to stimulate the local area and treat or prevent disease.

The lifting and stretching actions the cups have on underlying tissues help with breaking up stagnation to the channels/tissues, assist in draining excess fluid and cellular waste that may be trapped within the fibres causing tightness or inflammation, and invigorate the local areas with increased blood circulation to nourish and repair tissues.

It is interesting to to note only injured tissues or channels will show bruising with cupping. Healthy tissues may become pink or flushed with the vacuum-action, but that will fade very quickly after the cups are removed. Injured tissues, on the other hand, may show bruising ranging from bright red, brownish-red, purple, to even blackish-purple. The intensity of the colour often indicates the severity of the injury and will change over the course of several treatments (ie. darker bruising will eventually become lighter in colour and density with repeat treatments). The bruises typically take about 7-10 days to completely fade away, and during that time the skin may be tender. Massaging locally can ease the bruising, but no other special care is normally required after treatment.

Common applications for cupping include arthritis, chronic headaches, lumbago/lower back pain, shoulder pain, neck pain, and general muscle joint pain.

Those with infected, ulcerated or overly-sensitive skin, or edema should AVOID cupping. Pregnant women should also AVOID cupping over the abdominal or lumbosacral areas.

If you are interested to know if cupping is right for you, please contact Clarissa for more information at [email protected] or call 604-687-7678 to book your appointment today!

Clarissa Low, RTCMP

Are you one of the lucky ones looking forward to a much deserved holiday or extended travel? If you are, then congratulations and have an amazing trip! But if you are an individual who has a regular workout routine, chiropractor, or massage therapy treatments helping you to maintain your optimal health, consider planning ahead for the sudden change in your routine. Carrying luggage, sitting and waiting beforehand in the terminal or during your flight, and sleeping on a different mattress may aggravate an already existing ailment. Conditions such as piriformis syndrome, sacroiliac (SI) instability, sciatic pain, lower back, and knee pain. We put together a valuable list of tools you can easily incorporate into your journey to help keep you feeling fantastic!

Lower Back Support

Even if your flight is only a few hours in duration, sitting on the airplane can be uncomfortable and may aggravate ailments you already have; especially for the hips, lower back, and knees.

Sitting without support causes your lumbar spine to reverse it’s curve (slouch), adding compressive pressure to your sacrum and relevant joints. Your pelvis tilts posteriorly (backwards) and your hip flexors tighten into a shortened position. A lumbar support cushion will protect your spine by encouraging a proper posture. Otherwise, ailments like piriformis syndrome, sciatica, sacroiliac weakness, and hip flexor tendonitis will be aggravated and cause pain.

Before you take off, ask your chiropractor or massage therapist for a lower back support. They should be able to order you a proper fitting cushion.

Take Stretch Breaks

These days, unless you have a whole row to yourself, there is generally not enough room at your seat to properly stretch. If you’re on a long flight, please consider taking some time to stand up and implement some stretch breaks. Use the privacy and space of the washroom to stretch your hips and quads. Squat down to stretch your hips and grab an ankle at a time to stretch your hip flexors.

Sweat It Out

You may be exhausted from the travel but taking an hour to warm up your body once you have reached your destination is crucial. Additionally, if you are dealing with jet leg this is even more vital to your overall well-being. Exercise releases positive hormones that will help you feel great and boost your energy levels.

A cardiovascular workout will soften adhesions and loosen tight joints. A low impact workout like swimming, cycling, yoga, or treadmill walk are a few examples. If your destination does not provide a gym or yoga studio, using nature or hotel stairs can make for excellent substitutions!

Fascial Stretching

After working out, follow it up with this stretching program. Hold each stretch for 1-3 minutes and practice strong diaphragmatic breathing during each posture.

Water

Stay hydrated! It can be tricky with security check points to always have water with you, but do you would being yourself a disservice if you didn’t bring your water bottle to fill after. You’ll be encouraged to finish it at each check point keeping you hydrated and energized.

Proper water intake will help with
• Immune support
• Decreasing fascial adhesions
• Increasing energy levels

If you can incorporate all these tips, or even most of them, you will certainly appreciate the benefits!

Happy Travels,
The Vitality Clinic Team

Ahhh, summertime at last! Flip-flops are a mainstay of summertime footwear, but they can be painfully bad for your feet and legs. Unlike sturdy shoes, flip-flops aren’t recommended for extensive walking because they offer no arch support, heel cushioning, or shock absorption.

Flip Flops allow your arches to remain as flat as they want to be and for some people, that may be OK depending on the structure of their foot. However, if you have a foot that tends to over pronate (fallen arches), you’re not receiving any additional support to help counter your biomechanics concerns. Your body is one large kinetic chain; all its parts are interconnected, with one part affecting another.  Not unlike the childhood nursery rhyme, your feet are connected and affect your ankles, knees, hips, and your spine. When you stand, walk, or run, you subject your body to the natural forces and postures that can cause stress and strain to that very kinetic chain. Simply put, your feet are the foundation for your entire body; they are the tires to your vehicle. When people walk in flip-flops, they alter their gait which may result in problems and pain from the foot that then travels up into the knees, hips, and lower back.

So then what happens? The short answer- your body compensates like it was built to do. A tweak here, a twinge there, and now you have changes to your entire posture.

Am I asking you to throw out your flip-flop? No! I’m asking you to use your logic. Concert all day? Walk along the Seawall? Wear some shoes that provide good support and are comfortable. The beach? Not a lot of walking? Flip-flops? Sure; it can be that simple. Although, if you get to the “my back is really sore and/or tight” stage, you may need a spinal adjustment as well. The moral of the story- the sooner you start walking with some support to your daily footwear, the better off you will be. Most of you already know if you have some issues with your feet or low back.

Here’s an interesting and fun test: next time you’re near a pool step in the water and then onto a dry patch of cement. Now look at your footprint. How does your imprint look? Do you have an arch (can you see an imprint of your toes, the ball of your foot, and your heel but there is a dry spot where your arch can’t reach the ground)? Or is the imprint flat (the whole foot is seen with no dry areas)? If you have little or no arch you have answered your own question, haven’t you? Consider having an evaluation to determine the cause of your fallen arches. You may require some adjustments to clear out a functional leg length discrepancy, a treatment plan to resolve an ankle or knee injury, or you may require orthotics. If you have arches keep in mind those arches will fatigue when you put a lot of strain on them (like walking around all day in flip-flops). It’s natural; the muscles in your feet are used to some support and if you have chosen a shoe without any, you are going to show some signs of fatigue. They will begin to drop thus initiating a change in your kinetic chain.

Hope this helps and as always, if you’re unsure, seek out the advice of a health care practitioner.

Have a great day and enjoy the sun,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Related Articles:
Ankle and Foot Adjustments may Alleviate Low Back Pain
Sunscreen
Vitamin D and the Sun

Stir the pot – no, not the chili – the exercise that is touted as one of the best core exercises on the planet by Canada’s own top spine researcher Prof. Stuart McGill, should be considered as an addition to your workout routine as soon as possible (after consulting a health practitioner).

Stir the pot puts dynamic strength and stability demands on your core, with muscles such as rectus abdominus, transversus abdominus, and internal and external obliques firing to keep the spine and pelvis in a neutral position while you balance on a Swiss (exercise) ball. One of the key aspects of this exercise is the somewhat unpredictable movements the spine will perform while the body attempts to keep balanced on a unstable surface. Compare this to a plank on the ground (planks are still great!); the ground is not moving, and is not going to move, and your body and spine know this. This forces the muscles to activate, but it is in a predictable fashion. Compare this to an unstable surface such as the exercise ball, which represents a real time scenario of, for example, getting out of a car. Your spine has to bend forward into flexion, rotate, laterally bend, and then extend while standing up straight.

Unless in an acute stage of low back pain, most people don’t think about stabilizing specific muscles to do this motion, instead, they just do it. In dynamic training with “stir the pot”, we attempt to put your core in a situation where it reacts to unpredictable stability demands on the fly, more like a real time situation. Reiterating that planks are a great exercise, as is side planks, superman’s, and a tonne of other core exercises, consider adding “stir the pot” to your exercise routine after consulting your favourite health practitioner at Vitality!

Have a great day and contact myself, Dr. Lucas Tisshaw or Dr. Crysta Serné at Vitality Clinic, to discuss a core stabilization program that is tailored specifically for you.

Sincerely,
Dr. Lucas Tisshaw
Vancouver Chiropractor rand ART Provider

Ask anyone who steps into my Chiropractor and Sport Therapy Clinic- I am a HUGE advocate for introducing core exercises into your home care regime. Stretching is important too, but it’s if you don’t have the muscle endurance to keep those joint where they are meant to be, you will find your back health doing a roller coaster ride between healthy and injury prone. Along with maintenance chiropractic adjustments, core exercises are a key ingredient to eliminate low back pain and restore healthy activities of daily living.

Once you have the basics down (pelvic tilt, prairie dog, plank, single leg heel taps, Supermans, etc) you are ready to move on to incorporating the ball into your exercises. The ball adds an extra element of dynamic stability so any core exercise done on the ball should be considered moderate to advance in difficulty. Make sure you are comfortable with where you are on the core strength continuum before initiating any of these exercises.

First, it’s important to remind you the MOST IMPORTANT factor in performing any exercise is technique. If you feel you are struggling with maintaining proper technique, stop, and do a few lesser challenging exercises to build the muscle memory back up. It is OK!- any core exercise is better than none and the last thing you want is to injure (or re-injure) yourself.

Starting, Push up Hold, or Plank Position   (as shown in the feature photograph)

With the exercise ball in front of you, lower yourself down so your stomach is resting on the ball. Now walk your hands forward until you reach a point where you feel your back muscles and abdominals are working; the ball may be at the level of your knees, shins, or feet. As you gain strength in your core, you will find your able to increase the distance between the ball and your hands. Ultimately, you want to end up having only your feet and lower ⅓ of your legs touching the ball.

You should be completely flat with your legs straight. The shoulders should be positioned ever so slightly behind your hands. (*Even in the photograph, I should have my back just a tiny bit less rounded than it is!)

This position in and of itself is a great core exercise- it is considered a bilateral isometric exercise as both sides of the body are working and the muscles are neither increasing nor decreasing in length.

Hold the position until you feel a slight tremor in either your core muscles or arms, and then slowly walk your hands back towards the ball until your stomach is resting on it. Repeat 5 times.

If you are using the position as a starting position only, here are just a few of the multitude of exercises you can perform!

Jack Knife

When doing a jack knife, the key is to keep the knees as parallel with the floor as possible. You want to avoid having your knees pointing down towards the floor. By maintaining an elevated knee position, you are engaging your hip flexors and learning to perform a pelvic tilt at the end of the jack knife. Remember to keep your mouth open or sing a song as this will prevent you from holding your breath.

Repeat 10-15 times and then hold the plank position for as long as you are able to maintain proper technique.

Slowly walk your hands back towards the ball until the ball is once again positioned under your stomach. Take caution when you stand up as the blood may have rushed to your head while performing the exercise, and you may get a very mild dizzy spell. Anther way to dismount off the ball is to one at a time lower each knee/foot to the ground when you are in the plank position.

Pike Up

A pike up is an extremely challenging core exercise as you are not only balancing your feet on the ball but you are also utilizing a fair amount of shoulder and arm strength as well.

Start in the push up position and then roll the ball towards your chest with your feet while pushing your bum into the air at the same time. Once you have reached as high as you can with your bum, slowly return to the starting position.

Repeat 10-15 times.

If you want to increase the difficulty even further, lift one leg straight into the air when at the peak of the pike up.

Step Downs

This is a great unilateral core exercise as you are tapping one toe onto the ground while maintaining the plank position with the other leg on the ball.

Once in the starting position, lift one leg up and slowly lower it to the ground- do not rest your foot on the ground. It is meant to tap and then return to the plank position. Repeat on the other side. You have the option of performing all 10 on the same side before repeating with the other leg, but I enjoy the increased dynamic element when having to alternate between each leg.

Russian Twists

If at any time during exercising you feel pain in any body part, discontinue the exercises, and consult with your Chiropractor. As always, I assume no responsibility for exercises performed without my authorization.

Lastly, it’s NEVER to early or late to start a core exercise program!

Enjoy!
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

This is a great core exercise geared towards those just starting out and/or anyone who has suffered from any type of sciatic pain, disc pathology, or spinal stenosis. This core strengthening exercise is one of my personal favourites as it can easily be modified to increase or decrease difficulty depending on rehabilitation needs, as well as having the option to make it an unilateral or bilateral exercise.

Although core exercises are a fundamental component of any chiropractic treatment plan, not all core exercises are suitable for every back ailment or condition. If you have back concerns, please consult with your Chiropractor or health care practitioner to ensure this exercise is suitable for you.

Step 1: Start by lying flat on your back. Engage your lower abdominal muscles and perform a pelvic tilt. Place your hands in a triangle shape and position them directly under your sacrum. They should rest in and about the same shape as your sacrum (the triangle bone at the very base of your spine.)

Step 2: Raise both legs and place them in a table top position (both knees and hips should be at roughly 90º angles). The key to having this exercise engage the correct muscles is to ensure the hips and knees are stacked on top of each other or the knees are even slightly angulated away from the torso (as demonstrated in the picture to the right).  If  you allow your hips to be drawn closer to your chest, you will find the exercise much easier as it will not isolating the lower back and pelvic floor muscles.

Step 3: Slowly lower one foot towards the floor while continuing to maintain your hand position under the sacrum. This forces the pelvis into a pelvis tilt, allowing you to properly execute the move without arching your back and increased risk of injury.  DO NOT HOLD YOUR BREATH! Only if you have an extremely strong core, and no current back concerns, should you consider removing your hands and performing the heel tap.

Step 4: Alternate sides and repeat each leg 5 times. It should take about 5 seconds to lower one leg to the floor.

If you would like to increase the difficulty of the exercise, attempt to perform the exercise with alternating straight legs or with both legs lowering simultaneously.

Have fun!
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

*Dr. Serné assumes no responsibility for anyone attempting to perform these exercises without her specific approval.

Back pain during pregnancy is unfortunately an all too often occurrence. Typically, women gain between 25 and 35 lbs during the course of the pregnancy and this weight, along with the change of centre of gravity, puts a lot of sprain/strain on the ligaments and joints in the lower back. Another reason for increased back pain may be a result of the hormone, relaxin,  as it’s main purpose it to relax joints, ligaments, and muscles as your body prepares for birth.

Low back pain is one of the most common areas to have pain occur.  However, you may also experience it in your upper back, between the shoulders, and neck during your pregnancy or once you begin nursing your little one.

One of the best tips I can offer is to start seeing a Chiropractor before you even get pregnant! Set your body up for success by ensuring your muscles and joints are aligned (balanced) before all the wonderful changes that accompany pregnancy occur. As you progress throughout the pregnancy it’s nice to have a health practitioner team supporting you every step of the day. It’s also very helpful to have a Chiropractor who works closely with a Registered Massage Therapist, and Naturopath as these services may also come in extremely handy. This is in conjunction with you visiting your GP (OB/GYN), midwife and/or Doula throughout your pregnancy as well.

The treatment you receive from your chiropractor will change as your body changes during the course of the pregnancy. This should be discussed with you at almost every appointment.

There are also quite a few things you can do on your own to alleviate any discomfort you may be experiencing. Here’s a few:

1. Posture

You should always be mindful of maintaining a neutral posture, but even more so when pregnant. As mentioned, when your baby grows your center of gravity shifts forward. To avoid falling forward, you may compensate by leaning back which can strain the muscles in your lower back and contribute to back pain during pregnancy.

Keep these principles of good posture in mind:
1. Stand up straight but not so rigid you take on a military posture.
2. Work on your pelvic tilts so your not thrusting your pelvis forward.
3. Keep your shoulders relaxed and lowered. In colder weather, make sure you wear a scarf to avoid hiking your shoulders closer to your ears.
4. Keep your knees slightly flexed.

When you stand, consider a stance where your feet are just a bit wider than your shoulders (tripod stance). This allows for a more even weight distribution. If you must stand for long periods of time, rest one foot on a low step stool, and take time for frequent breaks.

Maintaining good posture also means sitting with care. Choose a chair that supports your back, or place a small pillow behind your lower back.

2. Exercise

Maintaining a level of physical activity throughout your pregnancy is highly beneficial! It keeps your muscles strong, joints lubricated, and blood flowing. I wouldn’t recommend an exercise you are not already engaging in (with the exception of an aqua class) and I would encourage you to check in frequently with your health care practitioner. If you are getting tired or pain occurs, stop immediately and speak to your Chiropractor.

3. Stretch

Not all stretches you performed prior to pregnancy are advised so please consult with your health care provider first. You may want to consider joining pregnancy specific classes, such as a pregnancy yoga class. It also provides you an opportunity to meet other momma’s to be!

4. Hot and Cold Therapy

Depending on the nature and location of your pain, heat, ice, or a contrast of both may be indicated. Speak to your Chiropractor to find out which option is most suitable for you.

5. TENS unit

A TENS unit is designed to alleviate pain. It is extremely useful and safe (when properly directed on its use) for low back pain. It is also HIGHLY RECOMMENDED to have one for when you are in labour. We sell them at the clinic and the cost is often reimbursable back to you if you have an extended health plan.

6. Sleep

Make sure you are receiving adequate and restful sleep. It is recommended you sleep on your side as much as possible. Consider investing is a body or pregnancy pillow to help you achieve the good night’s sleep you and your baby need.

Here are sone related articles:
Sleep Hygiene
A, B, Zzz’s of Sleep
Stretches for Nursing Mom’s

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Lumbar spinal stenosis is classified as either central (narrowing of the spinal canal) or lateral (encroachment of the spinal nerve in the lateral recess of the spinal canal or intervertebral foramen). The majority of lateral stenosis is considered acquired and often related to degenerative changes, spondylolisthesis, post surgical scarring, or intervertebral disc herniations. Although most causes of lumbar spinal stenosis are degenerative in nature, it is not necessarily a progressive deterioration.

Interestingly, symptoms related to spinal stenosis are not directly proportional to the amount of stenosis found. In fact, many people with spinal stenosis are asymptomatic.

Common presenting symptomatology includes:
1. Unilateral or bilateral leg pain  (~90% and most patients report it occurring below the knee)
2. Neurogenic claudication  (~65%
 and it is often poorly localized pain, paraesthesias, or cramping of one or both lower extremities bought on by walking and relieved by sitting.)
3. Symptoms worsen with extension or weight bearing, and improve with sitting, standing (with lumbar flexion), or lying down
4. Patients find it easier to walk uphill than downhill.
5. Patients will often use a walker or lean on a grocery cart to put spine into forward flexion.
6. Lower extremity sensory or motor disturbances or balance disturbances are less frequent.

Clinical findings are often minimal and nonspecific, and may not help rule in or out the diagnosis of spinal stenosis.

The following should be considered:
1. Most common finding is decreased spinal extension.
2. Decreased or absent ankle reflexes in approximately 50% of patients.
3. Reports of objective weakness vary from 23% to 51%
4. Sensory deficits in 51% of patients
5. Positive straight leg raise in approximately 50%

In light of the importance of postural and mechanical factors of spinal stenosis, lower extremity musculature should routinely be evaluated. Also, the proper exercises need to be chosen for therapeutic intervention based upon physical examination findings. Specific analysis of hip flexors and extensors should be performed for their flexibility. Reduced flexibility of the hip flexors leads to excessive anterior tilt of the pelvis and causes extension of the lumbar spine. Hip extensor weakness should be evaluated secondary to this and is recommended to be done in the prone position with the knee flexed to 90 degrees. Assessment of abdominal musculature is also very important as weakness can produce anterior pelvic tilt and a lordotic posture.

Typically, the treatment in the past has mostly been composed of surgery for people who suffer from spinal stenosis. This is starting to change slightly as more health care practitioners are recommending alternatives to surgery first. A very popular alternative is chiropractic care. A Chiropractor focuses on restoring proper joint mechanics of the spine. Often, when a vertebrae doesn’t move as well as it should (is sublimated), the end result is the the bone and surrounding tissue structures put pressure on the nerves and spinal cord exiting at the same level.

Over time, as there is lack of motion in the spine, the disc spaces between the bones start to decrease. As the discs decrease, arthritis sets in to stabilize that area, which complicates things for people who are already susceptible to spinal stenosis. A chiropractic adjustment balances out the nervous system, gets the joints moving again, and often times leads to a reduction in the symptoms experienced by spinal stenosis. Utilizing flexion-based exercise programs along with the chiropractic adjustment has also been utilized successfully.

Therapeutic exercises also need to be prescribed based upon history, physical examination findings, and the patients ability to utilize the program. This is based on co-existing factors such as cardiovascular or pulmonary disease, as well as being sure it does not exacerbate pre existing conditions.

Exercise protocols should be implemented as the following:
I. Stretching exercises
1. Hip flexor stretching
2. Hamstring stretching
3. Lumbar paraspinal stretching

II. Strengthening exercises
1. Abdominal and pelvic floor strengthening: pelvic tilt, bridges, isometric abdominal exercises
2. Gluteal strengthening: bridging, clams, side leg raises and circles

III. Conditioning exercises
1. Inclined treadmill
2. Stationary recumbent bicycle
3. Hydrotherapy (water) exercises

IV. Education in proper posture and body mechanics

Have a great weekend,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

As a Naturopath working in a busy sports medicine and sports therapy clinic, I see many patients with sore, stiff, achy muscles.  Many patients have been lead to believe that muscle pain and tension are normal facets of aging that should be expected, and that popping over the counter pain relievers is ok in moderation, and necessary to achieve a pain-free existence.

For many of my patients, additional factors contribute to muscle pain and when addressed, impart significant relief.  More often than not, simple nutrient support is required, and often includes vitamin D, B vitamins and Magnesium.  Without sufficient magnesium, muscles are unable to fully relax, lending to chronic muscle tension, trigger points and pain.

When patients explore their own symptoms, they often recognize that other muscles in their body are chronically tight and unable to relax as well, this is where high blood pressure and constipation enter the picture.

Your blood vessels contain smooth muscle that contract and relax, contributing to your body’s intricate ability to control blood pressure.  If your blood vessels aren’t able to full relax due to reduced magnesium, blood pressure goes up.

Similarly, when magnesium stores are low in the muscles of your intestines, constipation ensues as these muscles remain contracted, and are unable to fully relax and function appropriately during bowel movements and normal digestion.

Additional presentations associated with low magnesium include migraine, cluster or tension headaches, insomnia, asthma, arrhythmias, depression, ADHD, premenstrual syndrome and osteoporosis.

Addressing micronutrient deficiencies before they develop into major health concerns is by far the most cost-effective and preventative approach.

Not sure if you are suffering from low magnesium?  

Common signs include tired, stiff muscles, infrequent bowel movements (less than 2 daily), high blood pressure, headaches and difficulty sleeping.

If you’d like to see whether magnesium is a good option, try it! Unless you suffer from diarrhea, kidney disease, or have a sensitivity to magnesium, supplementing is safe in the dosage schedule outlined below:

Take 1 capsule daily, before bed for 3 days. If after 3 days, you aren’t having 2-3 bowel movements daily, increase your dose to 1 capsule 2x daily. Continue to increase your dose in this fashion until you achieve 2-3 bowel movements daily. It is fine to take the magnesium in 3 divided doses over the course of the day, ideally with food. Magnesium capsules are available in doses ranging from 50 mg-1000mg, although lower dosed capsules are the most useful, as they allow the most sensitive dose titration. At Vitality Clinic patients are prescribed NFH Magnesium bisglycinate, containing 150 mg of elemental magnesium.

If you are able to find it, magnesium bisglycinate is the most effective form of oral magnesium when it comes to improving tissue stores. With time, as your magnesium status improves, you’ll likely need to lower your daily dose to avoid loose stools. If you’re unable to find magnesium bisglycinate, magnesium citrate is suitable. However, the body tends to excrete magnesium citrate much more readily.

Additionally, try to increase magnesium containing foods in your diet. Greens such at spinach, kale and collards in addition to beans, nuts and whole grains are good sources. Although increasing dietary magnesium is a great idea, many people find their need to supplement decreases, but is not eliminated entirely.

Correcting low magnesium can be an incredibly simple, yet effective tool in managing a myriad of health concerns. Sore, tired muscles really are the tip of the iceberg!

Have a great day,
Dr. Kaleigh Anstett
Vancouver Naturopath

If you sit for a large portion of your day and you habitually cross your legs one way, BEWARE! First, it can potentially lead to a change in blood pressure and circulation of your lower extremities. Second, it could be exacerbating or creating low back pain due to muscle imbalance and joint misalignments.

When you sit with neutral posture, your trunk weight is evenly distributed between your ischial tuberosities (aka sit bones- the bones you feel right under your gluts when you sit). However, when you sit cross legged the weight resting on your pelvis is confined to just one of the bones. This rotates (twists) your lower spine – a twist your body will compensate for by automatically creating another curve in your back. This places a strain on your pelvis and lower back, stretches the muscles on one side, and ultimately results in abnormal joint mechanics.

In addition, when you sit cross legged the quadratus lumborum muscle (QL) shortens causing an imbalance between the left and right side. Your QL inhabits the space between the bottom rib, the pelvis, and the transverse processes of the first four lumbar vertebrae.  Best known as the ‘hip hiker’ muscle, its primary function is to bring the hip and rib cage closer together (lateral flexion or side bending).

This “hiking” in turn causes your iliopsoas to engage, your pelvis to rotate, and ultimately creates ligament laxity (over stretching of the ligament), once again resulting in abnormal joint mechanics and spinal misalignments.

Low back pain may be caused by a plethora of different reasons. Take preventative measures to ensure your posture while sitting is not contributing to it!

First: Stop crossing your legs and be vigilant about it. An easy way to create a new habit is to put a post-it note on your computer screen that says ‘uncross your legs’ as a reminder. Remember, it takes 21 days to make or break a habit so be consistent and don’t give up.

Second: consider performing the following stretches:
low back stretches
hip opening stretches

Hope this helps!
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

So you’re thinking about purchasing a new mattress, but you are wondering about which one is best suited for you. This is a topic of conversation I have on an almost daily basis with my chiropractic patients. I don’t claim to be the expert on mattresses, but I do know a lot about backs and back health.

Here are a few things to consider:

1. Mattresses should be replaced every 8-10 years.

2. Size- Deciding to go with a Queen or King sized mattress can mean the difference of a few hundred dollars so it is an important decision. If you are a tall individual, a King is a must as you need to ensure your legs don’t hang off the end of the bed! You don’t want to always have to resort to sleeping on the diagonal. Do you share your bed with a loved one… including your furry friends? If so, the extra room may be necessary.

3. Firmness– For the majority of my chiropractic patients, I advocate a semi-firm mattress; it’s the half way point between medium and hard. Far too often mattress are purchased too soft because they initially feel more comfortable. Unfortunately, they often don’t have the coil count to support the weight necessary, especially if there is more than one of you in the bed.

4. Coil count– most semi firm mattress have a coil count between 800-1000.

5. Pillow Topper– PLEASE do not purchase a mattress with a pillow topper attached! This will SIGNIFICANTLY reduce the life span of the mattress as the material will break down over the years due to different pressure points of your body. Your hips and pelvis region are heavier than your legs and your head and shoulders are heavier than your chest so the pillow topper will start to form this shape. You end up with lumps, bumps, or rolls. If you purchase a mattress you feel is a bit too firm, consider buying a pillow topper as an add-on. The second point to consider is if you purchase a mattress with a pillow topper attached, you forfeit the ability to flip your mattress. Rotating and flipping your mattress periodically is essential for maintaining it’s life span.

6. Comfort-  All things considered, you still need to make sure you receive a decent night’s sleep! If a mattress hits all the points listed above and felt super comfortable in the store but you are constantly tossing and turning (even after the appropriate break in time), you may need to choose a different mattress. Most stores realize you aren’t going to be able to determine whether the mattress is truly the right one for you by lying on it for 15 minutes in the store so most have a great exchange policy.  However, be sure but to check with the store on their particular exchange/return policy prior to making this investment.

7. Pillows– choosing a pillow is equally as important as the mattress yourself. I’ve recommended the same pillow for 14 years as I feel it is the best on the market. Why you ask? It is the only pillow I have found that provides the perfect amount of support and it allows you to sleep both on your side and on your back.

I can’t stress enough how important a good mattress (along with maintenance chiropractic care ) is to help maintain a healthy back!

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Related articles:
Sleeping Position
Sleeping Position for Neck Pain
A, B, and Zzzz’s of Sleep
Sleep Hygiene

I feel great! Do I still need to do core exercises?

Yes, yes, and yes! I’m sure yo’ve heard the old adage “if you don’t use it, you’ll lose it.” Well even though you may think you are doing tons of core work when you are at the gym by doing a plank, deadlifts, and some abs, you aren’t working your core enough.

In order to truly maintain your core, you need to do at least 4-6 exercises geared solely on the core- I refer to these exercises as micro-movements. Sure, you’re working your core when you are doing box jumps and squats, but you are doing macro-movements and your core in engaged, not being isolated.

The sole premise for doing core exercises is to increase the endurance of the really small muscles (intrinsic) of the back (multifidus, rotatores, interspinalis, ) so your back doesn’t fatigue as quickly. It is not about power and strength, which is really what squats, deadlifts and back extensions are for. Don’t get me wrong- if you have a healthy back, these are great exercises to incorporate into a well rounded workout routine.

Here are many examples of core exercises you should incorporate into your exercise routine:
Supermans
Plank
Bridge
Single leg Bridge
Reverse crunch
Prairie Dog
Superheroes
Supine Heel Taps
Russian Twist
Ball Core Exercises
Mountain Climbers

There are a plethora of exercises to choose from so don’t limit yourself to just the ones mentioned above. If you want an individualized program based on your back concerns, please book an appointment and we will be happy to design one for you.

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Did you know having your ankle or foot adjusted can alleviate low back pain?

Whether you’ve been standing on your feet all day, dancing, or running, your feet can take a beating. They are analogous to the wheels of your vehicle; aside from helping you get from one place to another, they also help reduce and absorb the shock that travels from the ground up.

So if you experience low back pain, knee pain, hip pain, a leg length inequality, scoliosis, ankle sprains, or headaches, you should have your feet checked as part of your regular maintenance chiropractic visit.

Ask your Chiropractor to evaluate them at your next maintenance visit!

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Related Articles:
Causes of Low Back Pain
Rehabilitation Back Injuries
Sciatic Pain
Lower back Stretches
Correcting Faulty Posture
Orthotics
Sleeping Positions
Tips to Consider When Purchasing a New Mattress
Running Injuries
Core, Core, and More Core

Vancouver, BC – The British Columbia Chiropractic Association (BCCA) is urging all parents to help children avoid back pain and injuries by using a simple set of guidelines when choosing a backpack for the new school year.  As a doctor, I want to do what’s most important for my patient’s long term health,” said Dr. Crysta Serné, Chiropractor and owner of Vitality Chiropractic and Sports Therapy Clinic.

“Before going out to buy a backpack, it’s helpful to talk to your kids about the type of backpack you want to buy. By following a few simple guidelines, you can help your child choose a backpack they like and avoid serious back problems.”

As many as 55 percent of today’s students are carrying loads far in excess of the recommended 15% of bodyweight, with some students’ packs topping the scales at an alarming 40 pounds. According to the Consumer Product Safety Commission, there has been nearly a 300 percent increase in backpack-related injuries among school children in America since 1996. “This is an important issue for doctors of chiropractic because we focus on wellness and preventative care,” said Dr. Serné. “Our job is to help prevent health problems and that’s why doctors of Chiropractic are so concerned about children carrying backpacks that don’t fit well or that are too heavy.”

Backpack Safety Checklist: When choosing a backpack, look for:
Padded shoulder straps
Padded back
Lumbar support
Waist belt
Multiple compartments
Correct size

How to pack:
Loaded backpacks should weigh no more then 15% of the child’s body weight
Distribute the weight properly; load heavier items closest to the back

How to wear:
Take the backpack off when standing for a long time
Wear both shoulder straps
Tighten straps until snug, but not tight
Use the stabilizing waist strap

Chiropractic is a health care discipline which works to improve the function of the spine and other joints in the body to allow the inherent power of the body to heal itself without the use of drugs or surgery.

Have a great day,
The Vitality Team

*information courtesy of BC Chiropractic Association

On several occasions every day in my Chiropractic practice, I am presented with patients who suffer from chronic inflammation; osteoarthritis, tendonitis, overuse injuries, old injuries, ect, ect. I have blogged in the past about the foods that one can take to help eliminate inflammation in the body (The Anti-Inflammatory Diet), but unless you want to gnaw on a Boswellia branch, sometimes food alone isn’t enough. Ibuprofen/Advil is often the patient’s drug of choice to combat that nagging, low grade, chronic pain one feels. I would like to provide you with information so that you have options, and then potentially reach for a natural alternative.

Dr. Meschino is a Naturopath, Chiropractor, and has his Masters in Nutrition. He is also the founder of Adeeva, a Canadian owned nutraceutical company. He has developed, in my opinion, the best natural anti-inflammatory product. Nature’s Relief* is comprised of four ingredients and depending on the dosage, can help alleviate acute and chronic inflammation.

I could speak volumes about the benefits of this product (in combination with other nutraceuticals and a healthy diet,) but it is so nicely summed up in the following video.

Should you wish to learn more about this product and many others, please call the office to book and appointment.

Enjoy your weekend!
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

*please consult with a health care professional prior to taking product as there are contraindications and considerations.

A significant number of my chiropractic and sports therapy patients already have a TENS unit at home or end up purchasing one from me as it can be a valuable adjunct to the services I provide at the clinic.  I purposefully did not go into detail about what specific conditions you should use the TENS for; it is very important you seek out your health care provider to give you specific instructions pertinent to your individual health needs. Further, the embedded article goes into detail about the machine parameters and mechanism of action.  It is quite lengthy but if you have a TENS unit, the material will be very beneficial to you.

TENS is a method of electrical stimulation, which primarily aims to provide a degree of pain relief (symptomatic) by specifically exciting sensory nerves. It can be used in several different ways, each being best suited to different pain relief mechanisms. Success is not guaranteed with TENS, and the percentage of patients who obtain pain relief will vary, but would typically be in the region of 70%+ for acute pains (strains, sprains, contusions, etc) and 50%+ for more chronic pains (fibromyalgia, chronic fatigue, osteoarthritis, etc). The technique is non-invasive and has few side effects, when compared with drug therapy. The most common complaint is an allergic type skin reaction (about 2% of patients) and this is almost always due to the material of the electrodes, the conductive gel, or the tape employed to hold the electrodes in place.

TENS Treatment setup – typical applications

1. Traditional TENS (Hi TENS)

Usually use stimulation at a relatively high frequency (90 – 130 Hz) and employ a relatively narrow pulse width (start at about 100 µs). The stimulation is delivered at normal intensity – definitely there but not uncomfortable.

It is suggested that in order to reach deeper lesions, the pulse duration should be increased.

2. Acupuncture (Lo) TENS

Use a lower frequency stimulation (2-5 Hz) with wider (longer) pulses (200-250 µs). The intensity employed will usually need to be greater than with the traditional TENS – still not at the patients’ threshold, but quite a definite, strong sensation.

3. Brief Intense TENS

This a mechanism which can be employed to achieve a rapid pain relief, but note, some patients may find the strength of the stimulation too intense and will not tolerate it for sufficient duration to make the treatment worthwhile.

The pulse frequency applied is high (in to 90-130 Hz band) and the pulse width is also high (200 µs plus). The current is delivered at, or close to the tolerance level for the patient – such that they would not want the machine turned up any higher. In this way, the energy delivery to the patients is relatively high when compared with the other approaches. It is suggested 15 minutes at this stimulation level is the most it would normally be used.

4. Burst Mode TENS

As described above, the machine is set to deliver traditional TENS, but the Burst mode is switched in, therefore interrupting the stimulation outflow at rate of 2 – 3 bursts/second. The stimulation intensity will need to be relatively high, though not as high as the brief intense TENS.

Electrode placement

Target the stimulus at the appropriate spinal cord level (appropriate to the pain). Usually start with the electrodes either side of the involved area. You can use other stimulation points so long as the TENS activates the sensory nerves that enter the cord at the same neurological level. One can therefore employ nerve roots, the course of the appropriate peripheral nerve, motor points, trigger/acupuncture points, the same dermatome, myotome, or scelerotome. If the pain source is vague, diffuse, or particularly extensive, one can employ both channels simultaneously, and some health care professionals use a cross over technique in an attempt to increase the intensity of the stimulation.

TENS parameters and mechanism of action

If you have a TENS unit and would like a greater understanding of it’s applications, please consider booking a consultation with one of our Chiropractors.

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Spina bifida occulta is common. A recent study of the available literature suggests that the most accurate estimate is that 5-10% of people whose spines have been examined have spina bifida occulta. Even though these people have a very slightly increased chance of a slipped disc, very few people with spina bifida occulta will ever have any problems because of it. If a person has no symptoms from spina bifida occulta as a child, then it is unlikely that they will have any as an adult.

Most people will not even be aware they have spina bifida occulta unless it shows up on an x-ray, for which they have for some unrelated reason. For the majority of people with spina bifida occulta, it is a minor fault involving one vertebra in the lower back. The unfortunate use of this term for such a minor fault can lead to distress for the person concerned.

It should be considered as insignificant, both for the person and his or her children. It must be emphasized, for the vast majority of those affected, having spina bifida occulta is of no consequence whatsoever. Often people only become aware they have spina bifida occulta after having a back x-ray for an unrelated problem. However, for a few (about 1 in 1,000) there can be associated problems. For people with spina bifida occulta, there may be associated difficulties which may include: leg length inequality, gait abnormalities, foot deformity, back pain, weakness and reduced sensation of the legs, change in hand function, bladder infections and incontinence and bowel problems. These problems arise because the spinal cord becomes tethered to the backbone. The Chiropractors at Vitality Clinic are trained to treat any of the symptoms associated with spina bifida occulta.

Often a child who is previously symptomless may experience difficulties during the rapid growth of adolescence. This is due to the nerves of the spinal cord being overstretched and therefore, the symptoms may become progressively worse.

Enjoy your day,

Dr. Crysta Serné

Chiropractor and owner of Vitality Clinic

SEMG is a clinical tool used by chiropractors in the treatment of aberrant joint movement, musculoskeletal pain, and some neurological disorders.

Surface EMG may be used to better understand how a fixated joint is causing a broader problem; it allows one to see how the mobilization of a joint has allowed the muscles to reorganize themselves. When used as at training tool, one can teach the patient how to use their body and/or muscles differently so that the joint fixation won’t replicate itself in the future.

In conditions which involve chronic pain, antalgic postures may readily be identified. Surface EMG can help find the tension in a reputed tension headache; the source of such pain can reside at a distance from the site of reported pain. Potential perpetuating factors associated with myofascial pain disorders may be described, and the SEMG feedback to the patient as part of the retraining process.

Surface electromyography can provide Chiropractors the information necessary to evaluate and follow pain sufferers with muscle impairments, as well as to establish selective treatment protocols in a scientific manner. It is well known that muscular tension maintains a substantial role in the development of the pain-spasm circuit, which can be treated using techniques of self-regulation in the form of biofeedback. Traditionally, biofeedback has been associated with relaxation training as a means to lower the emotional arousal component involved in pain.

The development of “static muscle scanning” techniques in the 1980s (Cram and Steger, 1983) better allowed the practitioner to precisely map areas of chronic asymmetric muscle tension, better describing one of the characteristic of the pain syndromes. In addition, studies of the recruitment patterns (amplitude and timing) of selected muscles may show asymmetries of muscle function amongst synergists and antagonists, providing a stronger description of how pain creates and is associated with disordered movement patterns. Both the static and dynamic sEMG findings can serve as landmarks for potential biofeedback assisted relaxation or muscle retraining sites, thus enhancing the efficacy of these endeavours.

The clinical use of SEMG in the assessment of pain related disorders was originally introduced by Edmund Jacobson in the 1930 as he began to study the effect of imagination on a variety of muscles. Janet Price, in 1948, utilized multi-site recording procedures and noted that muscle bracing patterns associated with chronic pain seemed to be asymmetrical, and eventually migrated to areas other than those of the original site of pain. Later, George Whatmore (1974) one of the students of Edmund Jacobson saw disease as resulting from “dysponesis” or inappropriate muscular efforts. He conceptualized EMG activation patterns from the point of view excessive bracing, the over-representation of emotional events, inefficient movements, or inappropriate attentional efforts.

Basmajian and Wolf were one of the first teams to document a specific neuromuscular deficit in low back pain patients. Here, they noted the lack of a “flexion relaxation” response in the erector spinae muscles of back pain patients. More recently, the work of DeLuca and his colleagues has focused on changes in the energy spectrum of the muscles in back pain patients. Using spectral technique, they have noted that these individuals tend to demonstrate a higher level of muscle fatigue than compared to normal data.

Surface EMG represents the summation of all of the alpha motor unit activity which reaches the recording electrodes. Typically, the electrodes are placed close together and the recording area is relatively small and specific. Rather than considering these recordings as representing innervations from specific nerve roots, it is more appropriate to think of this activity in terms of motor or muscle function. Such function is organized at multiple levels, including a segmental level.

Also, one should consider the dynamic interplay between the excitation associated with muscle spindle activity versus the inhibitory influences of the golgi tendon organ. The gamma motor system modulates much of the sensitivity of this interaction and is partially regulated by the cerebellum. It is also excited by nocioception. These afferent fibers give rise to an excitatory push on the gamma motor system, providing the basis for “muscle splinting” around the injured area or joint. This may also modulate posture, potentially leading to learned alpha and gamma motor behavior and antalgic postures. If this postural adjustment is maintained over an extended period of time, trigger points as well as changes in the resting lengths of muscles will ensue. The patient will eventually learn to move differently, usually restricting his or her movement, while substituting inappropriate muscle groups. Lastly, the pain patient may experience changes in emotional tone associated with pain. Recent evidence has demonstrated that the muscle spindle is activated by ANS activity associated with stress. Fear of pain may increase the resting tone in the muscle due to increased sympathetic tone.

In addition, the patient may become anxious about their pain and avoidant behavior patterns may develop. Problems of learned disuse of injured muscles or muscles associated with an injured or fixated joint, may need to be addressed. All of the above described changes in muscle function associated with pain can be documented using surface electromyographic techniques.

References:
Cram JR and Kasman GS. (1998). Introduction to Surface EMG, Aspen Publishing, Gathersburg, PA.
Donaldson S, Clasby B, Skubick D and Cram JR. (1994). The evaluation of trigger point activity using dynamic sEMG techniques, American Journal of Pain Management, 4:3, 118-122.
Kasman G, Cram JR and Wolf S. (1998). Clinical Applications in Surface EMG, Aspen Publishers, Gaithersburg, MD.

Have a great weekend,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Related Articles:
What To Expect During Your First Chiropractic Visit

Do you experience back pain, a chronically tight hamstring, or feel like one leg is heavier than the other?  You may have a leg length inequality.  One of the easiest ways you can determine if you have a leg length discrepancy is to perform a wall hamstring stretch.

Lie on your back and place your legs against the wall- ideally your legs should be at 90 degrees to your back, and there should not be a bend in your knees.  Flex your feet towards your head.  Now look at where your heels rest on the wall – do they line up?  If one leg rests higher on the wall than the other, you have a leg length inequality.  It may be functional and caused by conditions such as, but not limited to, pelvic rotation or imbalances in the muscles attaching to the pelvis.  Alternatively, it may be anatomical and caused by conditions such as scoliosis of the spine, a previous fracture of one of your leg bones (femur, tibia, or fibula), joint degeneration, or a combination of functional and anatomical inequalities.

Regardless of the nature of the leg length inequality, if you notice a discrepancy in the height of your legs, get checked out.  It’s important to find out the cause.  Read on to learn more about leg length inequalities.

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

If you’re reading this article, it’s a good bet you have a radiating pain running down the back of your leg that just won’t go away. If what I’m about to tell you sounds familiar, don’t worry, help is on the way.  However, in order to get rid of your sciatic pain you must first know what is commonly causing your pain.

Sciatica refers to a collection of symptoms, but is not a diagnosis as it does not address the cause of the pain.  Sciatic nerve pain is caused by pressure being placed on the sciatic nerve and there are primarily four conditions creating this.  You may have one or more of the following:

Condition #1- Discopathy
Discopathy refers to pathology of the disc- this can be a result of a herniation, bulge, or swelling.  A dic herniation is when the disc wall fails and the contents spill out, very much like when you squish a jelly donut too hard.  This is often caused by a traumatic event such as a motor vehicle accident, or by months or years of uneven pressure due to joint misalignments and muscle imbalances. This can sometimes cause sciatic pain, but it is also important to note that many people with herniated discs don’t even experience pain or symptoms.  Many don’t even know they have the condition.

Condition #2 – Piriformis Syndrome
The most common cause of sciatic pain and is created when pressure is placed on the sciatic nerve by the piriformis muscle. Muscle imbalances pull the hip joints and pelvis out of place and this changes the positioning of the piriformis muscle, which then places pressure on the sciatic nerve.  The sciatic nerve runs under the piriformis muscle the majority of the time, however, it occasionally will run through or around the piriformis.  Whatever the case, muscle imbalances may cause significant problems and are often the underlying cause of piriformis syndrome.

Condition #3 – Spinal Stenosis
Pressure caused by spinal stenosis, which is a decrease in the space in the spinal canal.  This is primarily caused by uneven pressure and compression due to osteoarthritic changes and resultant muscle imbalances.

Condition #4 – Spondylolisthesis
Pressure caused by isthemic spondylolisthesis, which refers to when a vertebrae “slips” or is malpositioned.  This can sometimes pinch the sciatic nerve but often times people who have this condition don’t have any sciatic pain, symptoms, or even know they have it!

If you are not sure which one of the four is causing your sciatica, I recommend you book an appointment to allow a professional, like myself to diagnose the problem. As most cases of sciatic pain are caused by joint malpositions and muscle imbalances, we usually begin to work on correcting the joints and often the muscle imbalances decrease. You may start to see improvement right away…. and likely decrease your sciatic pain in a few weeks or less.

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Related Articles:
Causes of Low Back Pain
Lower Back Treatments
Lower back Stretches
Correcting Faulty Posture
Ankle and Foot Adjustments For Low Back Pain
Sleeping Positions
Tips to Consider When Purchasing a New Mattress
Running Injuries
Core, Core, and More Core

Many individuals develop imbalance and pain as a result of a leg-length discrepancy.  If one leg is longer, it is similar to driving around with one car tire slightly larger than the others. The center of gravity changes as weight is transferred to one side of the body. Often, one shoe heel will wear away faster than the other.  Due to improper weight distribution and stresses placed upon then, one side of the posterior chain  (foot, ankle, knee, and hip) will be undergo compensatory changes. Scoliosis develops with eventual premature joint degeneration on one side of the spine and wight bearing joints. The short-leg syndrome has been an enemy to athletes, Sports Therapists, and Chiropractors for many years.

Questions such as the following are asked daily: (1) Can it be an aggravation to, or cause of, low back pain in lower extremity problems? (2) Should a heel lift or orthotic be put in the shoe of the long leg or the short leg? (3) Will I always have to run on beveled road shoulder to have even lengths? The first thing that should be considered is that there are two types of short-leg syndrome:

1.Anatomical Short Leg. The measurement from the bony protuberance (the greater trochanter) of the hip joint to the lateral ankle measures shorter on one side than the other. This is seen in approximately three percent of all short-leg syndromes.

2.Functional Short Leg. The measurement from the same two points is equal on both sides, but there is still an apparent short leg.  With this type, there is usually a rotation or displacement of the pelvis on one or both sides. This causes abnormal stress on all muscles, nerves, and joints that are involved. The longer a person has this type of short-leg syndrome, the greater the chance for a secondary compensatory problem somewhere else in the body, usually in the upper back, shoulders or neck. Common symptoms include muscular pains in the involved areas, headaches, numbness and/or tingling in the arms or hands.

There is a relatively simple test to determine which short-leg syndrome you may have; it is known as the Deerfield Test.  With the individual lying face down, check the length by correcting any pronation or supination of the feet so that the heels are parallel and perpendicular to the plane of the legs. This is easier to visualize with shoes on than with bare feet because the shoe has a flat heel as opposed to the foot’s rounded heel. After noticing which leg is short, flex both knees to 90°. If it is anatomical shortness, the difference in leg length will be identical in positions 1 and 2. If it is a functional shortness, the short leg will either become longer as the other leg or longer when in the flex position. If it is functional shortness, the short leg will be either become as long as the other leg or longer when in the flex position. This is called cross-over. Whichever syndrome one is suffering from, the weight distribution through each leg will be uneven. As a result of the increase in poundage and stress on the body and legs during impact, the symptoms will be more pronounced in someone who is involved in more impact oriented activities, such as long distance running, soccer, rugby, etc.

What symptoms should make a person consider short-leg syndrome?
Any symptom exaggerated by impact, such as low back, hip, knee, ankle, or foot pain.  Second, a tendency to repeatedly strain the same muscle even given sufficient time to heal.  Shin splints and sciatic neuralgia (inflammation of the sciatic nerve that produces pain in the buttocks and down the back of the leg) are also commonly associated with SLS.

How does a functional leg-length difference develop?
Over a number of years, one side of the spine may develop stronger than the other.  Sleeping on one side; carrying items on one side; running clockwise on a track; using the phone on one side; facing traffic when you run; lifting suitcases; carrying kids; acquiring injuries when as a child, or even forceps delivery at birth, for example, can result in functional imbalances.  An individual with a large discrepancy in leg length will often notice postural irregularities in photographs of him or herself.  One shoulder may be elevated, and the head tilted towards the side of the high shoulder.  Your tailor may be the first to notice a leg-length discrepancy. Many runners with leg-length discrepancies report their cadence changes and they feel they impact one side greater than the other.  Some runners state that they feel  “lopsided” when running and as noted earlier, one heel usually wears away faster than the other.

After it has been determined which syndrome is evident, a correction should be considered.  With an anatomical shortness, correction is made simply by placing a heel lift in the shoe of the short leg.  The lift can either be inserted in the shoe itself or constructed into an orthotic.  This can be done by any of the Chiropractors at Vitality Clinic.  When addressing a functional shortness, the first thing to consider is the underlying cause of the short leg.  A functional leg-length discrepancy is present in three out of five people and the difference may vary significantly.  If the difference is minimal, the patient is often asymptomatic.  Over time, however, a minimal difference always becomes greater.  With individuals sustaining a greater amount of impact, the change in leg length is more rapid,  due to the increased vertical impact.  Gravity eventually wins if nothing is done to combat the imbalance.

Some common causes are:

• Arches are not symmetrical in both feet. (correction can be aided with the arch supports or orthotics).
• An abnormal range of motion in the joints. Each joint, including ankle, knee, hip, and low back, should be put through a full range of motion to ensure normal equal motion.
• A weakness of one or more lower extremity muscles, which allows the pelvis to rotate either anteriorly (forward) or posteriorly (backward) in relationship to the other side.
• Bad habits, such as poor posture, slouching in chairs, crossing legs while sitting, standing with all your weight on one leg, always running on the same side of a beveled roads or insufficient stretching.
• Poor quality running shoes.

Correction of functional shortness involves a number of factors.

First, correction of any structural faults has to be made to allow for normal weight distribution and normal functioning of the joints and muscle involved. This is done by correcting any muscular imbalances (right vs. left and front vs. back) that become apparent after a through examination by a Chiropractor.  After correction of the muscular imbalances, adjustments of the involved joints is often performed to correct any structural imbalances. This allows all joints to functional under a proportionate weight distribution.

Second, a visual observation of the patient running is often required to determine if there are any abnormalities in the gait or stride (cadence), such as one arm held close to the body in its correct motion.

Third, correction of the short-leg syndrome is made to prevent further stress on the joints.  During every Chiropractic patient’s first visit, we examine and determine potential leg-length discrepancies.  Within four weeks of treatment, we re-evaluate to determine what changes have occurred.

Spinal and SLS screens are recommended for everyone, but especially school aged children.  Corrections made early enough have the potential to last a lifetime.

Be proactive, not reactive when it comes to your health.

Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Chiropractic Holistic Care
A Chiropractor is a holistic doctor (Complimentary Alternative Medical providers, abbreviated CAM) and even specific conditions, such as a herniated or ruptured discs, can be treated in a whole body context. Chiropractors consider stress, nutritional, and lifestyle factors, especially as they relate to pain perception and reduction of inflammation.

Conditioning and exercise, stress management, and improved nutrition and eating habits are all considered when the acute phase of pain and inflammation has been resolved. In addition to addressing the lower back, the Chiropractor here at Vitality Clinic may also address possible spinal joint restrictions in the neck, mid back, and extremities that may need correction.

Manual adjusting techniques are often the treatment of choice, however, low force techniques may also contribute to a successful outcome. This article speaks to the alternative treatment choices often utilized in addition to manual adjustments.

Chiropractic “Pelvic Blocking” Techniques
Chiropractors use pelvic blocking techniques (SOT blocks) as part of another low back disc protocol. Under blocking technique, disc patients are categorized according to a set of findings including traditional orthopedic and neurological testing. Treatments using pelvic blocking techniques include the use of cushioned wedges, which are placed under each side of the pelvis along with gentle maneuvers. This allows gravity and changes in mechanics to draw the disc away from the nerve. Disc injuries are treated in a series of non-force treatments with monitoring and evaluation. If subjective signs and symptoms are not improving, referral for imaging and spine specialist referral are standard of care.

TENS (transcutaneous electrical nerve stimulation) 
A TENS unit uses electrical stimulation to modulate the sensation of low back pain by overriding the painful signals that are sent to the brain. A trial of electrotherapy with the TENS unit is usually done first, and if the patient experiences substantial pain relief, a TENS unit may be used at home for low back pain relief on a long-term basis.

Interferential Current (IFC) and Ultrasound (U/S)
IFC and U/S treatments are utilized to decrease inflammation and promote healing.  These modalities have proven to be effective in relieving long-term pain or in making bouts of acute low back pain shorter.

Orthotics
Some people with chronic low back pain may not limp because they hurt; rather, they may hurt because they limp. A small study examined the gait of 32 patients with low back pain who had not experienced significant pain relief with previous treatment. The results indicated that all the patients had gait abnormalities. Each patient was then fitted with a custom made orthotic, which was designed to correct these imbalances. Average follow-up time for study participants was nearly 14 months. Of the 32 patients, 27 (84%) experienced less back pain than before. The average reduction in pain symptoms was 66%.

Physical Activity and Exercise
The Chiropractors at Vitality Clinic are advocates for physical exercise.  We may recommend you modify your physical activities when you are experiencing back pain. In general, when pain is severe, you should avoid the following:
• heavy lifting
• twisting, bending forward, or reaching while lifting
• sitting or standing for long period

A gradual return to normal activities, including exercise, is recommended. Your doctor can help you decide what level of activity is safe for you. You may want to discuss your chiropractor’s recommendations with your employer or supervisor. Exercising when you have back pain can help you feel better faster and prevent more back problems.

Even if you have mild to moderate low back pain, you can do the following without putting much stress on your back:
• Walk short distances.
• Stretch and do flexibility exercises.
• Use a stationary bicycle.
• Swim.

It is important to start slowly and to gradually build up the speed and length of time that you do the exercise. At first, your symptoms may get a little worse when you exercise or become more active. Usually, this worsening is nothing to worry about. However, if your pain becomes severe, ensure that you speak with your chiropractor right away. Once you can return to normal activities comfortably, your chiropractor may recommend additional aerobic and back exercises.

Supplements

Often supplements can provide inflammatory relief, muscle relaxation, and aid in encouraging support of connective tissue.

Preventing General Low Back Pain
Steps you can take to prevent back pain include the following:
• Maintenance chiropractic visits
• Wear comfortable, low-heeled shoes.
• Consider having your gait evaluated and corrected, if appropriate, with fitted shoe inserts (orthotics).
• Make sure your work surface is at a comfortable height for you.
• Use a chair with good lower back support that may recline slightly.
• If you must sit for long periods, rest your feet on the floor or on a low stool, whichever is more comfortable.
• If you must stand for long periods, rest one foot on a low stool.
• If you must drive long distances, use a pillow or a rolled-up towel behind the small of your back. Also, be sure to stop often and walk around for a few minutes.
• Attempt to sleep on your back with a pillow under your knees or sleep on your side with your knees bent and a pillow between your knees.

If you are experiencing low back pain, please consider consulting with one of the clinic Chiropractors to receive a diagnosis before attempting to engage in any physical activity.

Have a great week,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Approximately eighty percent of people will have low back pain at some point in their lives. The good news is that very few people who feel pain in their low back have a serious medical problem that requires surgery. Ironically, the severity of the pain is often unrelated to the extent of physical damage. Muscle spasm from a simple back strain can cause excruciating back pain that can make it difficult to walk or even stand, whereas a large herniated disc or completely degenerated disc can be completely painless.

Most low back pain symptoms will get better with time (anywhere from 2 – 12 weeks) and non-surgical care. There is usually no single identifiable cause for an episode of back pain. Most back pain comes from the soft tissues of the spine (ligaments, muscles and joints.) One of the most common factors in back pain is that your spine is out of align causing excess fatigue to your joints, muscles and connective tissue. This can be triggered by prolonged sitting or standing in a poor position, or prolonged bending. The problem can also be made worse by heavy or repetitive lifting.

Many conditions can cause back and neck pain, ranging from injury to infection to simply twisting the wrong way. An injury sustained in an automobile, skiing, diving or other type of accident may cause damage to bone, muscles, tendons, ligaments, joint capsules, and nerves.

Acute pain in the lower back that does not extend to the leg is most commonly caused by a sprain or muscle tear, usually occurring within 24 hours of heavy lifting or overuse of the back muscles. The pain is usually localized, and there may be muscle spasms or soreness when the doctor touches the area. The patient usually feels better when resting.

A strain is the result of a heavy load or sudden force applied to the muscles before they are ready for activity. The muscle essentially rips, along with the blood vessels within the muscle tissue. This may cause bleeding into the injured area. It can take up to two to three hours before sufficient bleeding or irritation sets in to produce significant pain. This can help explain why many people often can tolerate finishing the task at hand, only to suffer from intense pain later.

Sprains refer to an overstretching of one or more of the ligaments of the back. The ligaments can be stretched beyond their natural integrity and in some cases can completely tear. It is common to have both ligament sprains and muscle strains occurring together. This is especially the case in severe falls and motor vehicle accidents.

Degenerative joint disease – The joints that allow mobility and stability are subject to wear and tear. Facet joints allow movement of the spine. These consist of two knobs, or facets, that meet between each vertebra to form a joint. As facet joints degenerate, they may not align correctly, and the cartilage and fluid that lubricates the joints may deteriorate. Bone then rubs against bone, which can be very painful. In degenerative joint disease (also called osteoarthritis), the shiny, smooth cartilage that lines the joint wears away, leaving bone to rub on bone, a painful situation.

Degeneration of the disc is called spondylosis. Spondylosis can be noted on x-rays of the spine as a narrowing of the normal “disc space” between the vertebrae. It is the deterioration of the disc tissue that predisposes the disc to herniation and localized lumbar pain (“lumbago”) in older patients. Degenerative arthritis (osteoarthritis) of the facet joints is also a cause of localized lumbar pain that can be detected with plain x-ray testing. These causes of degenerative back pain are usually treated conservatively with chiropractic care, intermittent heat, rest, rehabilitative exercises, and supplements to relieve pain, muscle spasm, inflammation as well as others to increase the cartilage between the bones.

Sacroiliac Syndrome – Your Sacroiliac or SI joints sit on either side of your tailbone at the base of your spine. They are large joints which are important in everyday life because they move when you walk and they dampen the shock that each step places on your body. Think of them as shock absorbers.  But they can become locked which causes a generalized dull ache in the low back which may also be felt in the buttocks or even down the back of the thigh. Protective muscle spasm may also occur which limits normal activity; however, there are no muscles that actually cross the SI joints. That is one of the reasons this type of low back pain does not respond to stretching and exercise alone and often requires chiropractic adjustments to releive the pain.

Facet Joint Syndrome – This is a very common cause of lower back disorders. Facet joints occur in pairs at the back of each vertebra and they prevent excessive motion of the spine. When these joints are exposed to excessive trauma – from sports, work, normal aging, etc. – they can become inflamed and motion may be restricted at a particular level of your spine. This may cause low back pain or even pain which is felt in the back of the thigh. Once again, protective muscle spasm may further complicate the situation.

Ruptured Discs – The term “slipped disc” is actually a misnomer which does not really occur. Each vertebra is separated from its neighbour by a cushioned disc. Each disc is tightly attached to its neighbouring two vertebrae and can therefore, never “slip” out of place. What can happen, though, is that a disc which has weakened due to repetitive injury or small traumas may rupture. This allows some of the soft center material to leak out through the tough outer casing into the vertebral canal. This “leak” can press on the nerves which go to your legs, causing sharp pain down to your toes. This leg pain is often worse than the back pain itself. This is a less common form of back pain than SI or Facet Joint Syndrome, but it is somewhat more serious.

If you are concerned about the possibility of a ruptured disc, look for these symptoms:
• deep dull ache in the lower back and/or buttocks
• leg pain with numbness, tingling or weakness
• body tilts to one side to relieve the pain
• movement is restricted and slow
• leg pain with coughing, sneezing or straining

A Word About Sciatica – Many people are confused about the term “Sciatica”.  Sciatica simply means pain down the leg along the path of the sciatic nerve.  This is not a diagnosis! it is only a description of a symptom associated with certain types of back pain.  In other words, the term sciatica doesn’t tell you where the pain is coming from, only that it includes some leg pain.  You can’t properly treat the symptom of sciatica if you don’t know exactly where it’s coming from.  Pain is often experienced along the large sciatic nerve, from the lower back down through the buttocks and along the back of the leg. It may occur with or without lower back pain. However, it is most commonly caused by peripheral nerve root compression from intervertebral disk protrusion or intraspinal tumor. Compression may be within the spinal canal or intervertebral foramen by disk protrusion, tumor, or bony irregularities (e.g., osteoarthritis, spondylolisthesis). The nerves can also be compressed outside the vertebral column, in the pelvis or buttocks. It could also be related to a disc herniation, facet problems, SI joint problems, piriformis syndrome, etc.  If you’ve been told you have sciatica, that’s only part of the story.  You need to find the cause of the sciatica.  The focus of a chiropractic examination is to find the root cause of your problem, not just identify the symptoms.  From there, we can formulate a treatment plan to correct your problem.  Remember – treat the cause, not the symptoms.

Pregnancy – A woman’s body undergoes significant hormonal and physical changes during the nine months of pregnancy. For most women, this can lead to back pain as an unavoidable side effect during this time. Early in pregnancy, certain hormonal changes result in increased joint laxity. As a result, the spine, abdominal and back muscles, and posture of the lower back change and become more relaxed. Poor posture and poor muscle tone prior to pregnancy can affect how the back adjusts. The lumbar (lower back) curve begins to increase slightly as the pelvis tilts backward. This posture begins to influence the weakened and now fatigued lower back muscles. A woman may experience mildly painful spasms, which can be the first sign of a persistent backache in early pregnancy.

Spinal stenosis – Narrowing (stenosis) of the spinal canal can be caused by calcium deposits in ligaments, degenerative joint disease or disk disease, or it may be present since birth. Any of these problems alone or in combination can lead to pressure on the spinal cord or a nearby nerve, causing pain. Conditions that cause spinal stenosis include infection, tumors, trauma, herniated disc, arthritis, thickening of ligaments, growth of bone spurs, and disc degeneration. Spinal stenosis most commonly occurs in older individuals as a result of vertebral degeneration. Spinal stenosis occurs as intervertebral discs lose moisture and volume with age, which decreases the disc spaces. Even minor trauma under these circumstances can cause inflammation and nerve root impingement, which can produce classic sciatica without disc rupture. Spinal stenosis is a less common mechanism for sciatica that results from lumbar spinal canal narrowing, causing pressure on the sciatic nerve roots (or rarely the cord) before their exit from the foramina. It may mimic vascular disease by simulating intermittent claudication. The disorder occurs in middle-aged or elderly patients.

Spondylolisthesis – Spondylolisthesis is a relatively common condition, especially among older persons, in which one vertebra slides forward on another. When a tiny defect or fracture in the bones at the back of the vertebrae is also present, the condition is called spondylolysis. In either case, the spinal cord or nerves leaving the cord can be compressed, causing pain in the back or legs. Spondylolisthesis is a condition in which one vertebra slips forward on the one beneath it. It may result from a number of causes, including trauma to the spine or osteoarthritis (wear and tear) of the spine, or it may have been acquired from birth. The amount the vertebra has slipped forward on the one beneath it may be minimal or very significant. There may be no symptoms or there may be back pain and the back may feel stiff. If the slip has caused pressure on a nerve root, pain may be felt in the buttocks or thigh. With a major slip, an increase in the bend of the lower back can be noticed (called increased lordosis). Treatment depends on the severity of the condition and the symptoms. This may range from simple exercises and physical therapy to spinal fusion (hyperlink glossary) to stabilize the spine.

Osteoporosis with compression fracture – By itself, osteoporosis is painless, but it increases the risk of fracture of the hip, wrist and vertebrae. The fracture itself or the resulting abnormal curvature of the spine or pressure on nerves may be a source of pain. In osteoporosis – a progressive disease that commonly affects postmenopausal women – the bones become weaker and more porous. Although osteoporosis is painless, it increases the risk of fracture of the hip, wrist and vertebrae. Vertebral fractures themselves may be painful, as can be the resulting abnormal curvature of the spine or pressure on nerves.

Fibromyalgia – Fibromyalgia may cause chronic back pain and is believed to be a result of inflammation of the body’s connective tissue. The condition is characterized by widespread muscle pain, fatigue, and multiple tender points on the body. Fibromyalgia is more common than most people realize. In many sufferers, pain is present most of the time and may last for years. The severity of the pain goes up and down, and the location of the back pain as well as the generalized pain can vary. Lower back pain resulting from a diagnosis of fibromyalgia is real, but can also be subjective. Many people with this condition find that emotional stress makes the pain worse. Fatigue is also a common aspect of this condition. Chronic pain, along with anxiety about the problem and how to get well, can be fatiguing by itself. In addition, the inflammatory process within the body produces chemicals that are known to cause fatigue.

The next article posted will discuss treatment options for low back pain.

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

Posture is essential to the position of the body in space. Optimal posture is the state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity, whether at work or at rest. Correct posture involves the positioning of the joints to provide minimum stress on the joints of the body. Conversely, faulty posture increases stress on the joints. This increased stress can be compensated for by strong muscles, but if they are weak or the joints lack mobility or are too mobile, joint wear and modification can occur. As well, damage and changes to the surrounding tissues can occur. Posture can also involve the chain link concept of body mechanics in which problems anywhere along the body chain can lead to problems above or below that point.

For example, knee pain can arise from pelvic joint disorders. Without good posture, your overall health and total efficiency may be compromised. Because the long term effects of poor posture can affect bodily systems (such as digestion, elimination, breathing, muscles, joints, and ligaments), a person who has poor posture may often be tired or unable to work efficiently or move properly. Even for younger people, how you carry yourself when working, relaxing or playing can have big effects.

Did you know that just fifteen minutes reading or typing when using inappropriate biomechanics will exhaust the muscles in your neck, shoulders, and upper back?

Causes of Poor Posture
The causes of poor posture can be divided into two categories: positional and structural. Structural causes are basically permanent anatomical deformities not amenable to correction by conservative treatments.

Positional causes of poor posture include:
• Poor postural habit for whatever reasons the individual does not maintain a correct posture
• Psychological factors, especially self esteem
• Normal developmental and degenerative processes
• Pain leading to muscle guarding and avoidance postures
• Muscle imbalance, spasm, and contracture
• Respiratory conditions
• General weakness
• Excess weight
• Loss of proprioception – the inability to perceive the position of your body in space

Physiology of Posture
Posture control involves static and phasic reflexes. Static reflexes involve sustained contraction of the musculature while dynamic, short term phasic reflexes involve transient movements. Both types of reflex are integrated at various levels in the central nervous system (CNS) from the spinal cord to the cerebral cortex and are largely affected through extrapyramidal motor pathways. Postural reflex patterns from reflexes, such as the stretch and withdrawal reflexes, result in a coordination of many joint movements and combinations of muscle actions. These include contraction of prime movers, synergists, and stabilizers, along with the necessary relaxation of antagonists. These muscles are regulated for contraction intensity, speed, duration, and sequential changes in activity. The integrative pattern of posture is predominantly automatic and unconscious, resulting from the incessant shifting of weight (postural sway.) Postural corrections are continually mediated by the myotatic stretch reflex. Posture is further mediated by the visual, labyrinthine, neck righting reflexes, and by the interplay of joint reflexes. While the control of posture is primarily controlled by various reflex mechanisms, there is also extensive input from the higher centers of the central nervous. Therefore, posture to some extent can be relearned (corrected) just as it was learned in the first place. What does perfect posture look like?

Normal Posture
Perfect standing posture is when the following are properly aligned:
• The points between your eyes, chin, collarbone, and midpoint between your ankles
• From the side, you can easily see the three natural curves in your back
• From the front, your shoulders, hips, and knees are of equal height
• Your head is held straight, not tilted or turned to one side
• From the back, the spinous processes of your spine should be in straight line down the center of your back
Obviously, no one spends all day in this position. But, if you naturally assume a relaxed standing posture, you will carry yourself in a more balanced position and with less stress in your other activities.

Poor Posture
When you have poor posture, the body’s vertical position is out of alignment and the back’s natural curves become distorted. Head forward or slouched posture:
• Rounded shoulders
• Head forward, rounded upper back
• Arched low back
• Protruding buttocks
• Chest flattens
• Abdominal organs sag, crowding and making more work for your heart and lungs
• Seen often in women who have osteoporosis in later years

Military Posture:
• Head pulled back
• Shoulder blades tightly pulled back
• Arched lower back
• Knees locked (hyperextended)
• Minimizes the spinal column’s ability to be a shock absorber for the body
Slumped sitting posture:
• Upper back humped or too rounded
• Head forward
• Rounded lower back

Tests for Postural Faults
The Wall Test- Stand with the back of your hand touching the wall and your heels six inches from the baseboard. With your buttocks touching the wall, check the distance with your hand between your lower back and the wall, and your neck and the wall. If you can get within an inch or two at the low back and two inches at the neck, you are close to having excellent posture. If not, your posture may need professional attention to restore the normal curves of your spine.

The Mirror Test- (Anterior View) Stand facing as full length mirror and check to see if:
1. your shoulders are level
2. your head is straight; no chin deviation; ears are level
3. the spaces between your arms and sides are equally spaced
4. your iliac crests and hips are level
5. kneecaps face straight ahead
6. a 5° foot flare is shown
7. arches are not flat
8. there is no Achilles deviation, and
9. no evidence of scrunching of the toes

Check for the following:
1. head is erect, not slumping forward or backwards; no anterior head carriage
2. chin is parallel to the floor; no hyperlordosis
3. shoulders are in line with the ears, not drooping forward or pulled back,
4. stomach is flat; neutral spine
5. knees are straight, and
6. pelvis is neutral (slight anterior tilt)

Correcting Postural Faults
A patient’s postural faults must be accurately diagnosed before they can be effectively corrected. Examination and diagnosis should include the following:
• observation of the patient as they sit and move about
• measurement or estimation of the deviation from the ideally erect postures using plumb lines, inclinometry, and posture guides
• three dimensional analysis
• spinal segmental alignment
• flexibility tests
• muscle length and strength tests

The importance of muscle testing to postural analysis can not be over-emphasized. Also, much of the specific therapy in posture correction relies on muscle tightness and weakness found during the examination.

Conventional Corrective Therapies
Five main modalities are employed in the conventional treatment of faulty body mechanics and hence postural faults: chiropractic treatments; hydrotherapy; soft tissue work (MRT); and stretching and strengthening exercises. Shortened agonist muscles must be stretched before the antagonist muscle can be optimally exercised to increase their strength, or vice versa. Depending on the condition, manipulation may also be required to release and accompanying fixation.

Orthotics
Often postural faults are the result of a leg length discrepancy; either functional or structural (anatomical.) Correction of functional shortness involves a number of factors. First, correction of any structural faults has to be made to allow for the normal weight distribution and normal functioning of the joints and muscles involved. This is done by correcting any muscular imbalances (right vs. left and front vs. back) that become apparent. Adjustments allow all joints to function under a proportionate weight distribution which is essential as they are the holding elements for muscles. Lastly, orthotics are prescribed to maintain any structural discrepancy remaining.

Article submitted by Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic

(original article provided by Dr. Weatherall  at http://www.advancechiro.on.ca.)

How was chiropractic discovered?

Chiropractic was discovered by Daniel David Palmer in 1895. D.D. was a self-proclaimed magnetic healer, using his hands to restore the energy flow of the body. There was a janitor in his office building that had not been able to hear for approximately seventeen years. One day D.D. offered to help the janitor, Harvey Lillard, if he could. D.D. palpated Harvey’s spine and found a bump on his neck. Harvey explained that he had “heard a snap” one day while bending over and then the bump appeared. D.D. placed his hands on the bump and gave a thrust. Harvey’s hearing was restored and chiropractic was discovered.

How does chiropractic work?

A person’s spine is made of twenty-four bones called vertebrae. At the top of the spine is the skull which houses the brain or master computer. From the brain, the nerve impulses travel down the spinal cord (which is protected by the vertebrae.) Nerves branch out between the vertebrae and travel to all areas of the body. A person cannot take a step without the brain telling the body to move. When the vertebrae become misaligned or “out of place,” they put pressure on the nerve. This is called a “subluxation.” The message from the brain is slowed down and the life energy carried by the nerve is unable to reach the organs and tissues at 100% of its potential. A chiropractor aligns the vertebrae through gentle adjustments to the spine, relieving the pressure on the nerve and allowing 100% of the nerve energy to reach the tissues it serves.

What are the effects of subluxations?

It is easy to understand if you compare the nerve to a hose. If your garden is desperately dry and needs moisture to grow, you will hook up a hose and water the garden. However, if someone comes along and steps on the hose cutting off the water supply, the garden will become sick and eventually die. Likewise, if the hose is released, the water supply will be restored and the garden can grow. Your body reacts in the same manner to subluxations. After a subluxation has existed for a period of time, symptoms will occur. The various symptoms of subluxations differ greatly. In some cases, the person may experience pain, numbness, or tingling. In other cases, the symptoms may go unnoticed except that the person is more susceptible to colds, tires more quickly or starts having problems with an internal organ. Remember, the energy which travels down the spinal cord and through the nerves serves every area of the body. Therefore, any area of the body can be affected by a subluxation.

When does the first subluxation occur?

Often the first subluxation occurs at birth. Think of that fragile spine being twisted and turned as the doctor pulls the infant through the birth canal. Can you imagine how much trauma that causes? Learning to walk, riding bikes, and climbing trees are often other causes of subluxations. Adolescents who participate in sports also experience problems. As adults, there may be auto accidents, work injuries or stress that affect the spine. Many of the activities of daily life can cause subluxations.

How long will it take to heal?

It all depends. Many times a subluxation has existed for a period of time before the person starts experiencing symptoms. The muscles of the spine have adapted to the incorrect position of the vertebrae. For that reason, it may take a series of adjustments before the muscles become accustomed to holding the vertebrae in the proper position. The muscles have to be retrained. It is almost like playing tug-of-war with your body for a while. The doctor adjusts the spine and the muscles, ligaments and tendons pull it back out. Many patients will not seek chiropractic care until the symptom appears. By that time, the vertebra has been misaligned for some time. That is why periodic spinal checkups are so important; prevention is the key to maintaining health.

What do chiropractors do?

Let’s first understand what they don’t do. They will not prescribe drugs, perform surgery or treat symptoms. They find and correct the cause of the symptoms; that is, they find and correct subluxations.

How do they treat the cause?

Chiropractors gently move the bones of the spine into place which relieves the pressure on the nerve. When the spine is aligned, the body receives the energy needed to heal itself naturally.

As we so often receive calls from new patients setting up their first chiropractic appointment, we thought a breakdown of what you can expect during your initial consultation and treatment would be helpful.

History and Symptoms
In preparation for the chiropractic consultation, an individual will be asked to fill out forms that provide background information about their symptoms and condition. Once your forms are completed, the chiropractor will go through them with you, asking specific questions in order to gain a thorough understanding of your background and the specifics of your complaints.

The types of questions your chiropractor is likely to ask you include:
1. When and how did the pain start?
2. Where is it located?
3. Is it a result of an injury?
4. What provides relief?
5. What aggravates the discomfort?
6. Description of the discomfort
7. Have you experiences other sensations- numbness, tingling, or weakness?
8. General activity levels
9. Sleeping position

Patients are also asked to provide information on family medical history, any pre-existing medical conditions or prior injuries, and previous and current health providers and treatments.

The Chiropractic Exam
A complete chiropractic exam will then be performed.  In this examination, you will undergo a postural evaluation, global and specific range of motion tests, segmental joint evaluation, orthopaedic tests specific to the area in question, and a complete neurological examination.   

The goal of these tests is to establish:
● Range of motion of the affected part
● Muscle tone
● Muscle strength
● Neurological integrity

Diagnostic Studies to Supplement the Chiropractic Exam
Based upon the results of the history and chiropractic exam, diagnostic studies may be helpful in revealing pathologies and identifying structural abnormalities that can be used by the chiropractor to more accurately diagnose a condition. Diagnostic studies are not always necessary during the chiropractic exam, and the practitioner will discuss if they are clinically warranted prior to administering.

The most common diagnostic studies during chiropractic exams include:
SEMG (surface electromyography)- a muscle scan
X-ray exam
MRI (Magnetic Resonance Imaging) scan
Other laboratory tests

Our clinic performs muscle scans, but x-Rays, MRI scans, and more extensive imaging studies will be referred to an outside centre.

Patient Diagnosis after the Chiropractic Exam
History, physical examination, and any diagnostic studies lead to a specific diagnosis. Once the diagnosis is established, the chiropractor will determine if the condition will respond to chiropractic care.

Our Chiropractors will explain a patient’s:
Diagnosed condition
 Individualized chiropractic treatment plan (or other treatments)
Anticipated length of chiropractic care

For more on chiropractic treatment plans following diagnosis, see the next section of this article.

Chiropractic Treatment Plan
Most often, our Chiropractors begin treatment during the patient’s first visit.

● Chiropractic treatment recommendations may include some, or all, of the following:
● Adjustments to key joint dysfunctions
● Modalities to improve soft tissue healing and pain control, such as ultrasound, electrical stimulation, and traction
● Exercises to improve muscles balance, strength, and coordination
● Patient education to improve posture and motor control
● Other treatments such as ART, massage, heat/cold application, and nutraceutical recommendations.

Goals of the Chiropractic Treatment Plan
The chiropractor will establish specific goals for a patient’s individual plan for treatment:

Short-term goals include reducing pain and restoring normal joint function and muscle balance.

Long-term goals include restoring functional independence and tolerance to normal activities of daily living.

To reach these goals, a specific number of chiropractic visits, such as 1 to 3 chiropractic visits/week for 2 to 4 weeks, may be prescribed and followed by a re-examination by the Chiropractor.

We look forward to meeting you,

Dr. Crysta Serné

Vancouver Chiropractor and owner of Vitality Clinic

Many individuals thrive on the sound they hear when they seek out chiropractic treatments; they feel robbed if they don’t hear it. However, the high velocity low amplitude adjustment that renders that cavitation, or sound, is not for everyone….. The hard part is having the chance to speak to the patient about their options before they come in.  A lot of patients don’t seek out Chiropractic care because they don’t like the thought of hearing that sound, or want their neck or body moved in a particular way. It doesn’t have to be like that! I have found that an overwhelming number of patients utter these words at some point in their treatment plan; “if only I had come to you sooner!” It is both a source of frustration and a challenge to me because I want to be able to help individuals but I can’t have a living room chat with everyone to try and change their perspective on Chiropractic and the level of care that I can provide.

Case In Point  

My mother’s friend was at the house seeking out answers to questions he had about his particular condition. He was never fully informed of why he was having such excruciating back pain when he visited a previous health care Practitioner, nor was given a diagnosis. I sat down with him for an hour and explained the anatomy of the area in question and the cause of his concerns. I questioned him as to why he never sought Chiropractic care and he went into a long diatribe about how his wife had seen someone but he was nervous and wasn’t sure it was for him. He then exclaimed that as a  result of talking to me, I changed his attitude about Chiropractic and more importantly, gave him some very needed optimism that he could recover from his ailments.  Unfortunately, I can not reach everyone this way…

When you first seek out treatment from a Chiropractor, it is usually for one of a few reasons. Mostly, it is due to feeling of being “out of alignment, stuck, or locked,” that causes you discomfort, pain, or lack of mobility. During the initial assessment, I perform an extensive examination and history. Before a treatment is EVER rendered, I will determine what treatment options will work best for you and talk to you about them; your comfort level is one of the most important elements when rendering an adjustment. Let me explain what a high velocity low amplitude (HVLA), or manual, adjustment is. I personally find that it one of the most useful techniques for most patients, as it creates the largest change in the joint over a relatively short period of time. The most important factor though, is ensuring that the muscles are relaxed and you can deliver the adjustment quickly. The other chiropractic techniques I implement are useful, but I find that they take longer to yield the same results. Activator is a mechanical tool that looks a lot like a leather puncher. It has a nice rubber stopper on the end that with the force of the coil, causes the joint to move, with out ever rendering a sound or having the patient in an “awkward” position. Activator is also very useful for small joint like the fibular head, or some of the ankle or wrist articulations. In addition, it is an EXTREMELY useful tool to use on patients that are apprehensive or don’t like hearing any sound.

The drop table technique is a very useful to tool to use as it takes the muscles out of play so the patient is always relaxed. I find the drop piece very useful for hips, pelvis, shoulders, and stubborn low backs.  These techniques, combined with soft tisue therapy, stretches, strengthening exercises, modality work, supplement recommendations, and home care advise are all taken into consideration when developing a specific treatment plan.

Once again, chiropractic CAN be for everyone. It is just a matter of understanding your needs and comfort level.  I hope this allows you to have an open mind when perhaps making a decision to visit us.

Have a great day,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic