Toronto Health Blog

Are the physical requirements of daily activities becoming a chore? Well, simple stretching exercises can go a long way to relieve muscle pain while improving your flexibility and mobility. Consider the following activities to find out if you would benefit from a fitness regimen that incorporates flexibility as a component.

Flexibility Quiz

Have you recently experienced difficulty with any of the following:

1. Getting out of bed in the morning?
2. Climbing up or down stairs?
3. Rising from a seated position?
4. Getting in or out of your car?
5. Bending down to put on your socks or tie your shoes?
6. Keeping up with your friends or kids while walking or during other activities?
7. Reaching to retrieve an item from a high shelf?
8. Turning your head to shoulder check while driving?
9. Buttoning your shirt or fastening your bra?
10. Participating in your regular recreational activities?

If you answered yes to three or more of these questions, you may be losing valuable flexibility. It is important to develop a program that is both safe and effective with the help of a qualified health care professional. It is never too late to develop or maintain a healthy level of flexibility.

Slow, repeated stretching decreases resistance in muscles and connective tissues, leading to improved mobility and decreased muscle soreness. Recent research suggests that stretching before exercise or a physical activity is as important as doing so afterwards.

Remember, Doctors of Chiropractic are specialists, who understand how your bones, muscles, joints and nerves work together to keep you flexible and functioning on a day to day basis. They can also provide you with advice and exercises to stretch and strengthen muscles so you can stay healthy and active. : )

Best wishes to all for a holiday season and new year filled with health and happiness. From my family to yours. : ) – Dr. Evans

Plantar fasciitis is inflammation of the bottom of the foot, through the arch. It is a thick band of fibrous tissue that originates at the heel bone (calcaneus), extends forward under the arch, and inserts under the balls of the feet (metatarsal joints). The purpose of the plantar fascia is to maintain the arch of the foot by binding the bones, muscles, ligaments, and soft tissues together. This gives the foot some support.

As we take thousands of steps every day, there is a lot of stress that is put on the foot and the plantar fascia. Other mechanical stressors, such as running, puts four times your body weight of force into your feet. This can cause micro trauma to the tissues of the feet including the plantar fascia. Healing occurs which causes the tissue to get stuck together with adhesions and results in a tight, stiff foot. Then, even with simple walking, the tightness of the plantar fascia can pull and tug on the heel attachment causing inflammation and pain. The result is that the body tries to deal with this inflammation and replaces the inflamed tissue with bone. That is how heel spurs form. Therefore, it is important to listen to your body and pain symptoms early in order to avoid long term damage to your feet.

More importantly, a flattened arch whereby your midtarsals have collapsed can cause excessive stretching of the plantar fascia with the same results as mentioned above. Having supportive footwear is a must in keeping your feet and body healthy in the long run.

Typical causes of plantar fasciitis:

• Overuse situations such as walking or standing for long hours as well as increases in activity that the body is not used to.
• Flat feet, high arches, and weak ankles
• Altered mechanics of the feet and gait pattern (how you walk)
• Weight gain or excessive body weight relative to overall physical conditioning and musculature.
• Pregnancy
• Unsupportive footwear or footwear that is worn out

Typical effects on your feet:

• Pain in the heel is the most common symptom, although pain may develop under the middle, or arch of the foot to the balls of your feet
• Pain is initially worse in the morning. This can subside for awhile to then ache as the day progresses
• Lower leg, knee, hip, and low back pain may develop as patients try to compensate for the pain and alter their stance and gait pattern

Treatment options:

• Custom made orthotics: These devices help to support proper mechanics of the skeleton, muscles, feet, and fascia in the correct position
• Stability footwear: These types of shoes are built with a wide sole base that can provide medial and lateral support which is available in athletic shoes, walking shoes, sandals, and boots
• Ice: ice can help to control the inflammation and pain
• Rolling the plantar fascia: Rolling your foot both first thing in the morning and at night can help to relieve tension in the plantar fascia and help provide the foot a chance to heal. This can be accomplished with a ball such as a tennis or baseball, or a can of soup for example
• Seeking treatment: Treatment of the foot and plantar fascia are a must if the condition has been a problem for a while. The difficulty is to take the tension off the plantar fascia often enough and consistently enough to allow the tissue a chance to heal. Remember, ignoring and leaving symptoms too long can result in other adverse affects that can be avoided early

I treat this condition very successfully often. It is not complicated to fix but it does take some effort and a lot of consistency. You do not have to live with foot pain or hope that is goes away, as it is very treatable. : )

Running is a popular sport for people interested in getting into shape, building strength and endurance, and reducing stress levels. Running can be done virtually anytime and anywhere, and is relatively inexpensive, aside from the cost of a good pair of running shoes.

Regular aerobic exercise, like running, has been proven to lower blood pressure, reduce the risk of heart disease, and combat daily cumulative stress. A recent study showed that running protects against disability and early mortality in older adults [4]. With so much evidence supporting the benefits of running, it’s easy to see why so many people are putting on their running shoes and taking to their local trails and tracks.

Unfortunately, many runners assume they can warm up as they go, and skip critical steps, such as stretching and strengthening, thereby risking getting hurt. Since running puts forces of up to four times body weight on the knees and feet, runners of all ages and skill levels experience sport-related injuries. A recent study suggests the overall injury rate amongst runners is nearly thirty percent [3]. Whether you are a seasoned marathoner or a recreational jogger, it is important to take preventive steps to avoid common running injuries. Consider the following questions below.

Do you experience any of the following symptoms during or after running?

1. Aching in the muscles along the shins?
2. Discomfort along the outside of the thigh, that gets worse when going down stairs?
3. Twisting or swelling of the ankles?
4. Aching in the ball of your foot?
5. Heel pain that is worse in the morning?
6. Cramping of the calf and/or thigh muscles?
7. Aching around the kneecap after running?
8. Stiffness in the knees that is worse in the morning?
9. Sharp pain in a small area along the shin, that gets worse when you tap or press on it?
10. Light-headedness, difficulty breathing, and/or chest pain?

If you answered yes to one or more of these questions, you could be at risk of developing, or already suffering from, a running-related injury. Consult your chiropractor for a thorough assessment of your symptoms and risk factors.

Remember, running-related injuries most commonly affect the feet, legs, knees, thighs, and hips. The good news is that these injuries tend to arise from several categories of risk factors, many of which are preventable [1, 2]. Find out more about these risk factors below.

Unresolved Previous Injuries:

If you have a joint or muscle injury or condition, beginning a running or jogging program could aggravate it and prolong your healing time. Consult your chiropractor to make sure running is an appropriate activity for you. In addition, if you suffer from cardiovascular disease or experience shortness of breath, lightheadedness or chest pain during physical activity, be sure to consult a healthcare practitioner before attempting to jog or run.

Inappropriate Footwear:

Wearing running shoes that fit poorly, are too old or too worn to provide you with enough support and cushioning, can lead to injuries. In addition, not all types of shoes are appropriate for every runner. If your feet have low or high arches, you will likely benefit from a running shoe designed to support your particular needs. Some runners even make use of custom-made foot orthotics, which are shoe inserts custom molded to your feet and designed to compensate for mechanical faults, such as low arches. Whatever foot type you have, choosing the right pair of shoes and replacing worn-out shoes regularly will go a long way to minimizing your risk of injury.

Tight and/or Weak Muscles:

Regular stretching both before and after running decreases resistance in the muscles and connective tissues, leading to improved mobility and decreased muscle soreness. In addition, if the muscles of your legs or thighs are weak, you may benefit from a strengthening exercise routine. Unfortunately, no single stretching or strengthening routine works for every person, and certain stretches or strengthening techniques can be dangerous for individuals with joint or muscle problems. Your chiropractor can help you develop a regimen to meet your particular needs.

Improper Training Techniques:

Though many runners aim to improve their speed and endurance, increasing your distance or speed too fast and running too often can place excessive strain on your muscles and joints, resulting in injuries, which may include stress fractures in the bones. It is important to pace yourself when training, set realistic goals, and take time to rest your joints and muscles by not running everyday.

Improper Nutrition and Hydration:

Since running places great demands on the body, a proper dietary balance of proteins, carbohydrates, fats, as well as vitamins and minerals is essential for preventing injuries and attaining your peak performance levels. In addition, when you run, you sweat out essential fluids and minerals; therefore, it is important to hydrate yourself by replacing those substances using water as well as sports drinks. Proper hydration has been shown to reduce muscle cramping, as well as the risk of dangerous conditions, including heat stroke.

Whether your goal is to take up jogging or win a race, running requires planning and preparation to do safely and comfortably. If you experience joint or muscle pain or discomfort while running, your chiropractor can help. Doctors of chiropractic are specialists trained to treat and prevent disorders of the spine and extremities. They also offer gentle hands-on treatment to the joints and soft tissues, which has been shown to improve mobility and function. Your chiropractor will be able to provide you with tips and advice on injury prevention, so you can hit the road running.

References:

1. Chorley JN, Cianca JC, Divine JG, Hew TD (2002). Baseline Injury Risk Factors for Runners Starting a Marathon Training Program. Clin J Sports Med; 12(1): 18-23.
2. Johnston CA, Taunton JE, Lloyd-Smith DR, McKenzie DC (2003). Preventing Running Injuries: Practical Approach for Family Doctors. Can Fam Physician; 49: 1101-9.
3. Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD (2003). A Retrospective Case Control Analysis of 2002 Running Injuries. Br J Sports Med; 37(3): 239-44.
4. Wang BW, Ramey DR, Schettler JD, Hubert HB, Fries JF (2002). Postponed Development of Disability in Elderly Runners: A 13-year Longitudinal Study. Arch Intern Med; 162(20): 2285-94.

You are anxiously awaiting the pitter patter of tiny feet, but you are having a hard time preparing the nest because of back pain. You are most definitely not alone. Fifty per cent of pregnant women experience some form of back pain, with 10 per cent reporting severe discomfort that prevents them from carrying out their daily routines.

Weight gain during pregnancy places stress on the back, feet, ankles, and knees. As the baby grows, the abdominal muscles become stretched, and their tone and strength is reduced. Pregnancy weight also causes the your centre of gravity to shift forward. As a result, there is an increase in the pressure on the discs and the joints of the lower back and pelvis, which now work overtime to keep you upright and balanced.

In a study of 170 Canadian women with pregnancy related back pain, 72 per cent reported back pain during labour. However, women who received chiropractic care reported less pain during both pregnancy and labour.

In another study of 67 pregnant women, daily performance of a single seated pelvic exercise significantly reduced the intensity of back pain during the third trimester. In addition, low impact cardiovascular activities, such as swimming, can help relieve pain and maintain fitness. Most women can usually continue with regular activities, such as running for example, if they have already been doing a certain program for a while. However, always consult a health care practitioner before participating in a new exercise regimen.

Adequate rest restores your energy and gives your back a chance to relax. Lying on your left side has been shown to reduce the weight of the uterus on large vessels in your abdomen, allowing for optimal blood flow to both mother and baby. Supporting your weight by placing a pillow between the knees or leaning against a body pillow will take pressure off your lower back and allow your spine to be in its natural position while you sleep.

Don’t let pain hold you back during this exciting time in your life. A chiropractor can provide safe, effective, and drug-free manual care to relieve pain by decreasing the pressure on joints, muscles, and nerves of the spine and pelvis. Chiropractors are trained to provide treatment and up to date information tailored to meet the specific needs of women during all stages of pregnancy. Take care and listen to your body. It is easy to say that it will go away, or that you can deal with it. There are, however, better and healthier ways to enjoy your pregnancy and the birth of your child.

How can you tell if your office environment is safe and conducive to your comfort and productivity? Consider the following questions:

At the office, do you:

1. Sit for long periods of time
2. Perform repetitive arm or hand movements
3. Spend a lot of time on the telephone
4. Have to turn your head to see your computer monitor
5. Take few or no breaks
6. Sit under dim or flickering lights
7. Spend a lot of time looking down at papers on your desk
8. Experience headaches or neck pain
9. Experience aching, numbness, or tingling in your fingers and hands
10. Experience back pain

If you answered yes to one or more of the above questions, you could be at risk of developing, or are already suffering, from repetitive strain injuries related to your office environment.

If you are experiencing pain while at the office or after returning home, you are not alone. In a recent survey of office workers who spent an average of five hours each day on the computer, a staggering 70 per cent reported symptoms in their neck, arms, and hands along with neck disorders related to the repetitive tasks they performed. Amazingly, 60 per cent of the surveyed workers did indeed have information about ergonomics, but fewer than 10 per cent actually implemented them effectively or at all.

Listen to your body and your instincts with regards to your health. It is important to deal with ergonomic issues for short and long term health.

Around ninety per cent of travel in North America is made in motor vehicles. However, we place little emphasis on our safety and comfort until pain and discomfort sets in. If you feel stiff or experience back, thigh, or leg pain after a drive, you could be at risk of developing driving-related injuries.

Recent surveys of taxi cab and truck drivers has shown that approximately 50 per cent have had low back pain related to their jobs. Other at risk groups includes couriers, forklift operators, and commuters who drive for more than an hour and a half during most weekdays.

Sitting for long periods of time can cause the natural curvature of your lower back to flatten. This flattening places forward pressure on the discs that lie between the vertebral bones of the spine, while muscles spasm to support the area, resulting in pain and muscle fatigue. All these factors leave the body less prepared to handle the stress and effects of continuous vibrations from bumps and potholes in the road.

Not to worry. These simple tips can be very effective in reducing musculoskeletal problems related to driving.

The drivers seat.

Position the seat so that you can hold the steering wheel and depress the gas and brake pedals without leaning forward. Then, when your feet are on the pedals your knees should be at the level of, or slightly higher, than your hips. Finally, the seatback should recline at an angle of approximately 100 – 110 degrees in order to relieve pressure on the discs of the spine.

The Headrests

Ensure that the top of the headrest is level with your eyes and a maximum distance of 2 – 5 cm from the back of your head for optimal safety.

Exercises

While holding the steering wheel, try to shrug and move your shoulders in small circles forwards and backwards. Regularly tighten or flex the muscles of your thighs, buttocks, and calves to encourage circulation.

Take frequent breaks!

Really try to take a break of at least five minutes every hour. Perform gentle activity and stretches during your breaks. For example, walk around, stand on your tiptoes, and then your heels. Take your lower back through its natural range of motion by bending backwards, bending forward, and bending sideways at the waist for a number of repetitions.

Set yourself up to arrive healthy and safe.

Using the right positional and ergonomic techniques can go a long way in enabling you to have fun gardening and be pain free. Positioning your body correctly reduces unwanted strain on muscles and joints. Try the following tips to enjoy the gardening season from beginning to end.

• Alternate your tasks. Switch between heavy chores such as digging and lighter, less physically demanding tasks such as planting.
• Do the scissors when you rake. Stand with one leg forward and one leg back when you rake. Switch legs and hands every few minutes.
• Kneel to plant and weed. Constant bending can put strain on your back, neck, leg muscles and joints, so kneeling is recommended. Use kneepads or a kneeling mat (with handles) to make kneeling more comfortable and to minimize the amount of bending required. Make sure you keep your back straight.
• Change positions frequently. Make a point of changing position every 10 to 15 minutes. Move from kneeling to standing and from planting to digging.
• Pace Yourself. A minimum of three brief breaks each hour is highly recommended. Take a few moments to move around, stretch your muscles, have a drink, or simply sit and relax. Spread the work over several days – you will still achieve the same great results.

Commonly individuals try to do too much at any given time. When you overextend yourself you end up becoming fatigued. This is the point where your back is unprotected and increases the chances for injury to occur. Listen to you body, follow the above tips, and enjoy your hard work in comfort.

Safety tips that can help gardeners avoid injury and stay active.

Spring is upon us and gardeners of all ages are out in force. To novice gardeners, the pastime may seem like a bed of roses, but authentic green thumbs know there is plenty of hard work required to create and make your garden grow. Lifting, hauling, digging, aerating, and planting are all good exercise, but they can also lead to injury if the gardener is not properly prepared or warmed up.

Improper gardening techniques can cause:

1. Repetitive strain injuries of the wrist and elbow
2. Sprain and/or strain injuries to muscles throughout the body, especially in the lower back
3. Wear and tear on joints and muscles

Try a few of the following stretching tips that will help you make your garden the envy of the neighbourhood while helping you to stay pain free.

First, warm-up with a short walk to get your body temperature up and some blood flowing, then gently repeat each of the following stretches five times. Hold all stretches for 15 to 20 seconds. Please, stop if they are painful.

Thigh Stretch

With one hand on the wall or a tree, bend your left knee, then reach back and hold your ankle with your right hand. Pull your heel toward your buttocks and hold for 30 seconds. Relax and repeat with the other leg. To stretch the back thigh muscles (hamstrings), with one hand on the wall or a tree, put one foot on a chair, stump, or step. Slowly bend forward from the waist until you feel the pull at the back of your thigh and knee. Hold for 30 seconds. Relax and repeat with the other leg.

Back Stretch

Sit on a chair or bench and slowly bend your body forward from your hips, putting your head down and resting your hands on the floor. Hold, then relax.

Shoulder Rolls

With your arms hanging loosely at your sides, slowly rotate your shoulders in a circular motion forward, then backward.

Wrist Extension

Hold one arm straight out as if you were giving a stop signal. Then use your opposite hand to hold this position. Hold. Repeat with the other hand.

Wrist Flexion

Hold one arm out in front, palm down. Bend your fingers until they point toward the ground. Use your opposite hand to hold this position.

Enjoy the upcoming gardening season. Be healthy.

Have you ever thought you were too out of shape, too busy, or too old for active living? Wish you could find an easy way to stay fit or lose weight while avoiding the costs and time commitments of your local gym? You are in luck. The sport you have been searching for is walking.

People of any age, anytime, and anywhere, with minimal risk of injury, if done correctly, can do walking. As the weather is improving, NOW makes a great time to start your new walking program. Aside from a sturdy pair of walking shoes, this pastime is virtually free. Still, many people consider walking to be wimpy and unglamorous. They may not realize that brisk walking can burn as many calories per mile as jogging, while placing less stress on the joints of the body. In addition, walking is as effective as running in strengthening the bones and reducing the risk of diseases like osteoporosis.

The additional benefits of walking are well documented. Walking conditions the heart and lungs, reducing the risk of heart disease and strokes. It has been shown to lower blood pressure, cholesterol, and even blood sugar levels. Some studies have linked walking to reduced disability and reliance on painkillers in people suffering from arthritis of the knees and low back conditions, and chronic pain syndromes. But wait, that is not all! Regular aerobic exercise, such as walking, has been linked to improved function of the immune system and reduced risk of certain cancers, including colon and breast cancer.

If that is not reason enough to start getting active, walking also relieves tension and stress. One recent study of over 400 people suffering from depression showed that regular walking reduced depressive symptoms and improved overall quality of life.

Why should you walk? Regular walking promotes:

1. Weight and fat loss
2. Lower blood LDL cholesterol levels
3. Lower blood pressure
4. Decreased risk of developing diabetes
5. Improved mood and reduced symptoms of depression
6. Decreased symptoms of chronic pain syndromes, including fibromyalgia
7. Decreased pain and disability due to arthritis of the knees and low back conditions
8. Reduced risk of cancers, including colon and breast cancer
9. Improved functioning of the immune system
10. Decreased risk of osteoporosis

How much walking do you have to do in order to reap the above benefits? Most studies agree that walking for thirty minutes three to four times a week is sufficient. That may be as simple as walking to work in the morning or taking a brisk stroll during your lunch hour. But what if thirty consecutive minutes is too much for you? No problem. Research also shows that three short bouts of brisk walking for ten minutes accumulated throughout the day are as effective as a continuous thirty-minute walk in reducing the risks of cardiovascular disease and improving your mood.

How fast should you walk? General guidelines suggest you should be able to carry on a conversation comfortably throughout your walk. Remember to pace yourself and slow down if you experience significant shortness of breath or pain.

Where should you walk? Your route can be as simple as a brief stroll to the corner store. However, walks through local parks and ravines, may provide interesting scenery, but you need to consider the safety of your route as well as its terrain, since many hills or stairs will increase the difficulty of your walk.

Regardless of your age, fitness level, or schedule, it is easy to make time for walking. If you’re interested in getting involved, contact your local community centre for walking programs in your neighborhood, or better yet, start your own walking group with other people who have similar goals.

Ideas to help incorporate walking into your daily routine:

1. Walk to the store instead of driving
2. If driving, park further from your destination and make a point to walk to it
3. Walk part of the way or all the way to or from work or school
4. Use the stairs instead of elevators or escalators
5. Walk during your breaks or lunch hour
6. Walk your dog (or borrow a dog from a friend)
7. Take a walk in the evening after dinner to burn more calories
8. Make walking a social event by arranging to meet with friends for a stroll
9. Push your child in a stroller or wheelchair bound friend or relative
10. Make a point to get up and walk around the house or office for 5 minutes every hour

Get started right now. It is as easy as finding a comfortable pair of walking shoes and plotting a route. Remember to set a few minutes aside to stretch the muscles of your calves, thighs, and lower back both before and after walking. If you experience pain or difficulty breathing when walking, or if you have concerns about starting a walking program, consult a healthcare practitioner.