Toronto Health Blog

Many back problems are indeed preventable. By following some of the simple tips below, you can help your back stay healthy, keeping you on the job and the best you can be. Workplace safety is essential to your health, now and for the future. Watch for these common causes of back and neck trouble at work:

1. Lifting heavy and awkward loads.
2. Long periods of standing.
3. Long periods of sitting.
4. Poor posture.
5. Poorly designed work stations (home and office).
6. Poorly fitted or set up chair (home and office).
7. Computer screen at the wrong height or angle.

Does your work day involve heavy or awkward lifting? Does it require long periods of sitting in front of a computer? Do you spend hours behind the wheel driving? If you answered yes to any of these questions, you are at increased risk of back strain or injury. This could lead to recurring problems or pain if not managed properly. Below are important tips to help keep your back healthy at work.

If your job involves physical labour:

1. Warm up with some stretches before you begin work. Five or ten minutes of simple movements can make all the difference to your day. Try some lunges, partial squats, toe push ups, and knee to chest stretches. Wrap your arms around yourself and turn as far as you can one way, then the other. With hands on your hips, bend to one side, then the other. Rotate each ankle, then each wrist. Now you are ready to start your work day.
2. Lifting can be a source of serious trouble for your back and spine. Position the object you are lifting close to your body and use your knees, and arm and leg muscles, to slowly lift the object. Make sure you keep the load close to you body as best you can. Keep your back straight and be sure that the trunk of your body is pointed in the same direction as your feet. In other words, try not to twist your back in relation to your feet.

If your job means standing for most of the day:

• Take mini breaks and move around a bit. Do some easy stretches, like bending side to side, stretching your arms overhead, and shaking out your legs and arms. When working, try to stand with one foot slightly raised and resting on a rail, block, or whatever makes sense in your work area and is acceptable to your supervisor or workplace safety coordinator.

If you sit all day:

You may work at a desk, a computer screen, or take phone calls all day. Sounds easy on the body, but non-active or static work posture can also take a real toll on your health. Here are some tips to help you along the way:

1. Never cradle the phone receiver between your shoulder and neck. Try to hold the receiver in your hand, use a headset, or use a speakerphone.
2. Avoid sitting with your legs crossed. If you must cross them, alternate sides from time to time or cross your ankles. This will put less strain on your lower back.
3. Try to arrange your desk so that the items you use most frequently are closer to you or at least within arms reach.
4. If you do a lot of computer work, centre the monitor in front of you, positioning it so that the first line of text, or window you are working wth, is at eye-level. Place the keyboard directly in front of you and lay out your papers just to the side of your keyboard. Even better, put your reference material in an upright document holder, so that you do not have to constantly raise and lower your head, which may cause a tension headache.

No matter how many safety precautions you take and warm-ups that you do, inevitably, there will come a time when you will experience some kind of injury. From mild to severe in nature, below are five simple rules to help speed your rate of recovery in the first 72 hours of ligament sprains or muscle strains. However, be sure to remember if you are unsure of the severity of your injury, consult a qualified health provider to diagnose the injury properly.

Whether it is an ankle, knee, shoulder, or wrist sprain-strain, all you need to remember is PRICE as explained below.

P is for Protection.

Protect the injured area from sustaining any more damage. A sling or elastic wrap (tensor bandage) is most often used to support an area. Avoid activities that aggravate the injury or make it worse.

R is for Rest.

Rest will allow the injured area time to heal. Again, avoid activities that cause pain, especially sharp pain, swelling, or discomfort. However, it may be hard but try not to avoid all activities. For example, if you injure your shoulder, you may still be able to go for a walk. Try to do some form of exercise to keep up your cardiovascular levels of fitness and also prevent muscles from becoming weak.

I is for Ice.

Ice should be applied to an injured area as soon as is possible to control pain. You can use an ice pack, frozen vegetables, or a bag of crushed ice wrapped in a damp towel. The damp towel will provide protection to your skin from burns and help to transmit the cold to the tissue more effectively. Ice can be applied every hour for as many times as possible in the first 72 hours. You can apply the ice for 15 minutes at a time maximum and try not to fall asleep with it on. Then keep the ice off for 45 minutes to allow the tissue to return to normal temperature. If you notice a white area on the soft tissue stop icing immediately as it could indicate frostbite. If you have diabetes, vascular disease, or any other disease involving decreased sensation, consult a health professional before applying the ice. The ice will help to reduce pain and inflammation to your injured muscles, joints, and other soft tissues. It may even slow bleeding if a tear has occurred.

C is for Compression.

Use a tensor bandage to wrap the injured area. Ensure that the wrapping is not so tight as to cut off or impair blood circulation. Compression is used to help stop swelling. When wrapping, begin at the end furthest away from the heart. For example, when wrapping an ankle, begin at your toes and work your way up to your calf.

E is for Elevation.

Raise the injured area above the level of the heart, especially at night. This can be done by putting a pillow or two under the affected area. This uses gravity to help reduce swelling by draining excess fluid.

Then what?

After the first 48 hours, slowly start to use the injured area again and continue icing for another day. You should gradually see improvement in the ability of the affected area to move without pain and to support your weight. If your injury is not improving by the fourth or fifth day, consult a chiropractor or other qualified health professional. Various treatment modalities can be used to help decrease pain during the acute phase and during rehabilitation. Stretching and specific exercises can be prescribed to help prevent future injuries. Adjustments and mobilizations may also be used to increase joint mobility.

Tension type headache, you can take control.

Tension type headaches are one of the most common forms of headaches and yet they are not well understood. Most people describe having a band of pressure around their head that can last from 30 minutes to a week or more. Tension type headaches can be related to muscle hypertonicity, or tension, in the upper back, neck, and scalp. One of the best ways to combat tension headaches is through lifestyle and ergonomic changes. The following are some helpful tips.

Exercise regularly.

Exercise can help reduce the frequency and intensity of headaches. Exercise relieves stress, relaxes your muscles, and increases the levels of beta-endorphins, which are a natural stress reliever of the body. So try not to just sit around, go for a walk, bike ride, or run.

Healthy lifestyle.

Behaviors that promote general good health may help prevent headaches. This includes following regular eating and sleeping schedules and avoiding excess caffeine and alcohol.

Stress management.

Stress is a commonly reported trigger for tension type headaches. Reduce stress in your life by organizing your day ahead of time. Try relaxation techniques such as deep breathing, yoga, and meditation. Take time away from your busy life to do the things you love to do. Consider seeing a counselor to develop new coping skills. Be aware they are also trained to help you identify events that trigger headaches and work towards a resolution.

Muscle relaxation.

Muscle tension is associated with tension headaches. Applying heat or ice to sore muscles in the shoulders and back of the neck may ease the tension. Usually you can not go wrong with heat if it makes it heel better. However, if it makes your headache worse or your neck throb try using ice to deal with the pain. Massage is another way to relieve muscle tension. Gently massage the muscles of your head, neck, and shoulders with your fingertips. Or better yet, have someone else do the massage for you. A warm bath can also do wonders for those tight, achy, and stiff muscles.

Perfecting your posture.

Good posture can help keep your muscles from tensing up and reduces strain on your body. A jutting head (anterior head carriage) combined with slumped shoulders (slouching) can bring early fatigue and tension to your neck and upper back. When standing, your head, shoulders, hips, and ankles should line up, one comfortably above the other. Have a friend or family member look at you from the side. Your knees should be slightly bent and your feet should be shoulder width apart.

Telephone.

Use your hand to support the telephone against your ear and alternate sides regularly. Do not cradle the phone between your ear and your shoulder. If you are on the phone a lot, consider using a headset or speaker to reduce strain on your neck and arms.

Headache diary.

Record when your headaches occur and what you were doing before they started. Try to recognize the factors that cause or aggravate your headaches. This can be invaluable in defining how to manage your headaches. Be sure to tell your health care provider if you have noticed any changes in your usual headaches such as frequency, duration, or intensity. Also, be very sure to let them know if your headaches begin to worry you (i.e. the worst headache you have ever had).

Dealing with some of the above issues can help you get back on track to controlling your pain and discomfort. A visit to a chiropractor or other health care provider may be necessary to rule out any mechanical or structural issues related to your tension headaches. There are better ways to be comfortable and healthy.

All the best to everyone for the holiday season and have a prosperous and healthy new year. May all your resolutions come to pass. Also, be sure to check out last years holiday post for great stress relieving ideas.

In a pervious post I talked about how Hockey can be a great way to get in shape and have fun for the whole family. However, proper warm-up and cool-down is an important aspect of the game that allows you to stay healthy and active all season long.

Remember:

• Never stretch a cold muscle. Always warm up actively by getting your heart rate up a bit for improved blood flow before stretching.
• Do not overstretch and be comfortable while doing it.
• Do not bounce when stretching.
• If you experience pain that lasts longer than your usual post-game soreness, ice the area and consult a chiropractor.

Pre-game stretches:

Hamstring Stretch:

1. Lay on your back and bend one knee towards the ceiling. Hold the back of the thigh with both hands and straighten the knee as much as you can by raising your foot towards the ceiling. Hold the stretch for one second, then bend the knee and straighten again. Repeat 20 times on each leg.

Groin Stretch:

2. Stand with your feet slightly wider apart than your shoulders. Bend your knees. Shift your weight to the right leg. Reach down and across your body with your left hand to touch your right foot. Point your right hand up to the ceiling at the same time. Keep your back parallel to the ground. Then shift your weight to the left leg. Repeat 10 times on each side.

Hip Flexor Stretch:

3. Stand with you feet shoulder-width apart. Step forward with your right foot into a lunge position. Your right knee should be directly over the toes of your right foot. Keep your left leg and you back straight. Extend your arms straight in front of you and bring your palms together. Turn your upper torso to the right keeping your pelvis and hips stationary. Hold for one second and repeat 10 times on each side.

Post-game stretches:

Quad Stretch:

1. Stand with your back to a wall or the rink boards. Kneel onto you right knee (you can use a pad for cushioning) with your right foot flat against a wall. Your left knee should be bent in front of you at a 90 degree angle for support. Place your hand on your left knee for balance and lean back slightly to stretch your right quad muscle. Hold the stretch for 10 seconds. Switch legs and do 3 stretches on each side.

Glute Stretch:

2. Sit on the ground with one leg slightly bent behind you (outside of leg facing up) and one leg slightly bent in front of you (inside of leg facing up). Lower your chest toward your knee keeping your back straight and holding your chin up. Hold the stretch for 10 seconds. Switch legs and repeat 3 times on each side.

Hip Stretch:

3. Lay on your back with your knees bent and feet flat on the floor slightly more than shoulder width apart. Lower your right knee to the floor and place your left ankle on top of it pushing the knee towards the ground. Keep your hips flat on the floor at all times. Hold the stretch for 10 seconds. Switch sides and do 3 stretches on each side.

Play safe, stay fit, and have fun.

Cell phones emit radiation when you talk and send text messages between yourself and other callers. Health risks are not confirmed at this time; however, some but not all studies of frequent cell phone users suggests an increased risk for brain and mouth tumors and children’s behavior problems. Therefore, to be on the safe side, the Environmental Working Group recommends following the tips below to help reduce your exposure.

Buy a low radiation phone.

1. Look up your phone on the EWG’s buyer’s guide. Your phone’s model number may be printed under your battery. Consider replacing your phone with one that emits the lowest radiation possible and still meets your needs.

Use a headset or speaker

2. Headsets emit much less radiation than phones. Choose either wired or wireless as both seem to emit the same amount. Some wireless headsets emit continuous, low level radiation, so take them off your ear when you are not on a call. Using your phone in speaker mode also reduces radiation to the head.

Listen more and talk less.

3. Your phone emits radiation when you talk or text, but not when you are receiving messages. Listening more and talking less thus reduces your exposure.

Hold your phone away from your body.

4. Try holding your phone away from your torso when you are talking, not against your ear, in a pocket, or on your belt where soft body tissues absorb radiation.

Choose texting over talking.

5. Cell phones use less power (i.e. less radiation) to send text than voice. Also, texting keeps the phone, and thus radiation, away from your head unlike when you speak with the phone at your ear.

Poor signal? Stay off the phone.

6. Fewer signal bars on your phone means that it emits more radiation to get the signal to the tower. Make and take calls when your phone has a strong signal.

Limit children’s phone use.

7. Young children’s brains absorb twice the cell phone radiation as an adult’s. The EWG, along with numerous other health agencies recommends limiting children’s use to emergency situations only.

Skip the radiation shield.

8. Radiation shields such as antenna caps or keypad covers reduce the connection quality and force the phone to transmit at a higher power with higher radiation.

Visit the Environmental Working Group-Cell phone radiation webpage for more detailed information on this topic. Talk to you soon

Your first visit with a healthcare professional is very important for your health and can be most effective when you plan ahead. Research has shown that patients who are most involved in their healthcare achieve much better and longer lasting results.

Before your first visit.

• Find out the basics of the office you are visiting such as address, appointment time, nearby parking, and how long the initial paperwork takes to fill out.
• Write important questions and concerns down before you leave for your appointment.
• Try to bring, if possible, copies of relevant medical records from other healthcare providers. For example, a list of medications, herbs and nutritional supplements, and previous treatments.
• It is a good idea to note operations and diagnosed conditions for future reference.
• Dress appropriately if you can. For spine and problems involving the arms and legs, you may need to change into a gown or a pair of shorts.

Getting the most out of your healthcare visit.

• Ask questions no matter how silly you may think they are.
• Take notes. This will help you remember what your healthcare provider said during the visit.
• Tell your healthcare provider as much as you can about your problem and concerns. For instance, explain not only the physical symptoms but also your thoughts and feelings as well. Let he or she know if you need more time.
• Try to take information home with you by getting the healthcare professional to write instructions down for you.
• If you don’t understand something, say so! Ask for a sketch or illustrations that explain what you don’t understand.
• Do not be afraid to ask for a second opinion. The healthcare professional would be happy to confirm results if it would make you feel more comfortable about your treatment.

When you get home

• Review all the materials you received. If you do not understand something, simply call the office. They would be happy to clarify your questions.
• Follow the recommendations set out by the provider and inform them of any changes in your health status.

Visiting a health professional for the first time can be a huge first step in gaining health; however, it can also be a nerve racking one. The more you are prepared the easier it can be where the road to recovery and health can be that much more rewarding.

As I am presently getting ready to fly I thought I would mention a few travel tips for before and during your flight to keep you as comfortable as possible.

Comfort is certainly not the first word that comes to mind when you mention flying. Sitting in cramped spaces for long periods of time could be the perfect scenario for low back and other pains. Therefore, try following the tips below for a more enjoyable trip.

Before you leave.

The secret to seat selection.

Most airlines fill up the plane from front to back so ask for a seat in the back row to increase your chances of having an empty seat next to you. If the arm rests lift up, you might even be able to lay down.

Eat a light, non-fatty meal.

Before you leave for the airport, eat a light, non-fatty meal and avoid caffeinated beverages and fried food. This can make handling pressure changes and motion sensitivity a little easier.

Try to get the most calming seats.

If you are susceptible to motion sickness or flying is not your favorite activity, try requesting a seat over the wings and schedule flights on larger airplanes. Seats beside a window can also help if you gaze into the horizon.

Pack some chewing gum.

Chewing, yawning, or sucking on hard candies can help to relieve the pressure that builds up in your ears as the airplane ascends and descends. This is not recommended for toddlers. For your children, sipping a drink may help.

During the flight.

Stretch those legs.

Try to get an aisle seat or a seat on an emergency exit for maximum leg room. These seats are also less claustrophobic and allow you to get up and walk around more easily. Sitting in a confined space will not only be uncomfortable for your back but you could also strain your knees or get leg cramps. If possible, try not to place anything under the seat in front of you so you can use that space to stretch.

Keep moving.

Moving around is good for your circulation and helps to prevent swollen feet and ankles. Wear loose clothing and walk about the cabin periodically every 60 to 90 minutes. Wear shoes you can slip off easily. Every so often, draw circles with your toes and contract your calves to help prevent blood from pooling in your legs. Tapping your feet as if keeping time to music can also help increase circulation and reduce the chance of muscle cramping. For a quick and easy stretch, stand up and raise your arms above your head. Try not to worry about standing out, you just might start a trend on the flight. If your neck muscles get sore from sitting, rotate your shoulders back and forth, bend your neck by bringing your ear to your shoulder and by bringing your chin to your chest.

Dry like a desert.

The air on most airplanes has a humidity of less than 20 percent. It dries out your skin and can cause eye and nasal dryness. Take a moisturizer with you for your skin and eye glasses instead of contact lenses to prevent eye dryness. Drink enough fluids and steer clear of caffeine and alcohol as they further dehydrate you. Alcohol can also interfere with your ability to sleep.

Good posture while you are seated.

When sitting for a prolonged period of time, position your lower back flat against the back of the chair to obtain the greatest amount of support for your spine. A rolled sweater can also be used for added support. Use the footrests on your seat. Most importantly, try not to stay in one position for a long period of time. Accept whatever pillows and blankets are available and use them to change the pressure distribution of your body weight in the seat when sitting for a prolonged time.

Remember: on a long flight, try not to sit tight.

An important function of a running shoe is to protect the foot from the stress of running, while permitting the athlete to achieve his or her maximum potential. Even for people who use a running shoe as a walking shoe, the same rules and benefits apply. With so many different types and styles of running shoes today, it can be very confusing to know which one is right for you.

You first need to know a little about your own feet. For instance, people with low arches (flat feet at the extreme), who are pronators, will need a shoe that provides more longitudinal arch stability. A shoe with good cushioning is important for people with high arches, who are supinators, as the foot is more stiff.

The three main features of a shoe that you need to consider when picking out a running shoe are shape, type of construction, and the midsole.

Shape

To determine the shape of a shoe, look at the sole. Draw a straight line from the middle of the heel to the top of the shoe. In a curve-shaped shoe, most comfortable for supinators, the line will pass through the outer half of the toe. A straight-shaped shoe will have a line that passes through the middle of the toe. These shoes are built to give pronators added stability.

Construction

There are three types of shoe construction. To evaluate this, take the insole out and look inside the shoe at what type of stitching is used on the bottom. In board-construction shoes, built specifically for pronators, the bottom of the shoe will not have any visible stitching. Combination shoes, appropriate for both mild pronators and supinators, will have stitching that begins halfway. On slip-construction shoes, you will see stitching running the entire length of the shoe providing the flexibility supinators need.

Midsole

Most of the cushioning and stability of a sunning shoe is determined by the midsole. A dual-density midsole provides shock absorption as well as some stability, perfect for pronators. Single density midsoles offer good cushioning but are not great at providing stability, making them better for supinators.

Other important tips

• Shop in the afternoon or evening, as your feet tend to accumulate fluid and swell throughout the day. What may have been comfortable earlier could later be tight.
• Not all shoes are created equal. The same shoe sizes can have different fits depending on the maker. Make sure to try several sizes to find the most comfortable shoe.
• Avoid buying shoes that you feel need a break-in period. Shoes should be comfortable from the first time you put them on if at all possible.
• Select a running shoe store with knowledgeable staff who can provide advice on the shoe that best suits your activity, body structure, and type of foot (i.e. pronator, supinator, or normal function).
• If you are unsure about how your feet are functioning, visit a chiropractor to have them evaulated and your posture and gait checked for abnormalities.
• Running shoes are an investment in your health. Better quality shoes may cost more but will pay off in terms of support and sturdiness. A mid-priced shoe may offer the best value.
• The most important aspect is that your running shoes must be comfortable. Go for a short jog inside the store to test them out.
• In order to prevent injury, remember to replace your runners every 400 to 600 miles or every 6 months, whichever comes first.

Remember: generally people with fallen arches, or flatter feet, are pronators while people with high arches are supinators.

Great fitting and performing running shoes can be an important ingredient to guality of life and health for the young and old. Take the time and invest in good shoes for improved health now and in the future.

Spring is finally here. For many people it is time to do a thorough household spring clean inside and out. Although this cleaning is an annual ritual, it also carries some potential health risks due to the change and sudden increase in physical activity.

Weekend sports warriors are not the only ones susceptible to springtime injuries. It is just as easy to overdo it around the house.

Sweeping

Try to avoid twisting your body when you pull a broom toward you. Use your legs to shift your weight forward and back.

Vacuum

Push the vacuum in front of you, walking forward several steps, then pulling back several steps. Avoid the combination of bending and twisting as it puts you at risk of a back injury.

Lifting

Protect your lower back by lifting heavy loads with your legs. Separate your feet shoulder apart. Bend at the knees, not at the hips or lower back. slightly arch your back, keeping your abdominal muscles tight to help support your back. Then lift with your legs, not your back. Be sure to get help when lifting very heavy objects.

Squatting

Avoid prolonged deep squatting as it stresses vital tissues within the knee joint such as cartilage and ligaments. Instead, kneel on one knee being sure to alternate knees, or if possible, try to sit.

Ladders

Many spring cleaning chores such as cleaning gutters and trimming trees involve the use of a ladder. Select the right height of ladder for the job. Check it for loose or broken rungs, missing or loose screws, or defective hinges. Set it up on a firm, level surface. Avoid over reaching as it can lead to back and neck pain. Be sure to reposition the ladder as necessary to be close to your work. Do not climb ladders if you have a balance disorder or are taking any medication that may affect your balance. Most of all do not be too pround to ask for help.