Background: the spine is made up of a number of bones called vertebrae, and between each pair of vertebrae, lies a disc. The bones of the spine are connected by joints, which are held together by ligaments and are surrounded by muscles that move these joints. All these structures work together to make us flexible while spreading out the many forces placed on the spine during our daily activities (e.g. lifting). Too much pressure on a small area of the back and spine can result in injury. Injuries can affect the muscles, ligaments, joints, discs, and nerves of the spine. The end result is often stiffness and pain, which can be localized to the back or may even radiate down into the buttocks and legs.

Practicing safe lifting techniques can go a long way in saving you from back injuries. The back is the most common area injured at work, and about two-thirds of back injuries in the workplace occur as a result of improper lifting. Most importantly, it is estimated that as many as 89 per cent of workplace lifting injuries are preventable.

Lift light and carry right using back-safe lifting techniques.

1. Stand close to the load being lifted.
2. Place your feet shoulder-width apart.
3. Keep your back straight with your feet and body facing in the same direction.
4. Squat down to the level of the object and test the weight of the load.
5. Use the strength of your leg and arm muscles to slowly lift the load.
6. Keep the load close to your body. Always avoid twisting.
7. Pivot with your feet to turn and face the intended direction of travel.
8. Bend your knees and slowly lower the load to its intended place again keeping your lower back straight.
9. Try not to lift heavy objects above your waist.

In Canada, almost 16 million workdays are lost due to injuries each year. That is the equivalent of one year of work for about 67,000 people! Health Canada has estimated that musculoskeletal disorders, including back pain, cost society $16.4 billion in combined direct (treatment and rehabilitation) and indirect (lost productivity) costs. Unfortunately, the effects of workplace back injuries extend far beyond the plant or office.

Doctors of Chiropractic are back care specialists, who offer drug-free, hands-on treatment that targets the source of your pain. They can also provide you with advice and exercises to stretch and strengthen muscles in order to promote efficiency and productivity.

Where workplace injuries are concerned, prevention is the key to success. Lift carefully and correctly using the tips above, listen to your body, and let your chiropractor help get you back to work safely.

Safe lifting on your own.

1. Stand close to the load to be lifted.
2. Place your feet shoulder-width apart.
3. Keep your back straight.
4. Squat down to the object’s level and test the weight of the load.
5. Use the strength of your leg and arm muscles to smoothly and slowly lift the load.
6. Keep the load close to your body.
7. Pivot to turn and face the intended direction of travel. Proceed with the load.
8. Avoid twisting your body while carrying the load.
9. Bend your knees and slowly lower the load to its intended place.

Lifting objects from high places with a partner.

1. Stand on a secure platform or sturdy ladder with a helper nearby.
2. Slowly lift the load, keeping it close to your body.
3. Pass the load to your helper, or safely rest the object at a slightly lower level, as you work your way back down to the ground.

Our inactive lifestyle is damaging our backs. Many of us spend our days driving or hunched in front of computers and personal devices, often without any postural support. Studies show that sitting puts significantly more pressure on the joints and discs of the spine than either standing or walking. After all, our bodies were built to move.

We spend upwards of 21 billion dollars annually on back pain products, including over-the-counter pain medication. Yet, amazingly, most people wait up to six months to seek treatment, while 30 per cent do nothing at all in the hope that the back pain will eventually go away. I get comments quite often such as: I should have come to see you earlier.

Nearly one third of back pain cases last longer than a month and a significant portion become chronic and persist for months to years. Research suggests that back pain treatments are most effective in the acute and early stage, and that the longer the problem is allowed to linger, the more difficult and lengthy the healing process may be.

Try to keep in touch with your body and the symptoms you are having. Try to be preventative rather than waiting for something to happen. Remember, doctors of chiropractic are specialists, who provide drug-free, hands-on treatment that targets the source of your pain.

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. : )

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. : )

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.

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.

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.

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.