The Fast Lane

Regular Chiropractic Care and Core Fitness

Many exercise-related injuries are caused, in part, by deficiencies in core muscle strength. Weakness in core performance leads to a lack of biomechanical support for movements such as bending, lifting, pushing, and pulling. You're not aware of such lack of support until, for example, you attempt a dumbbell squat or try to run a little faster in an interval training session. Even a simple exercise such as a lat pulldown or triceps pressdown requires sufficient core stabilization. A strong core is critically important for a successful exercise program. The core muscular system consists of numerous inner layers of sheets of muscle and a vast array of small muscles that help maintain coordinated movement among your spinal bones, pelvic bones, and hip joints. By detecting and correcting spinal misalignments that cause nerve interference, regular chiropractic care helps ensure that your core muscles are receiving the nerve information they need to function properly and help you get the most out of your exercise time.

Driving fast is not necessarily a good thing. We want to get where we're going as quickly as possible, but we also want to arrive safely. If we drive too fast, we may encounter all sorts of problems. If we drive too slow, we're wasting time and may be causing traffic problems behind us. These competing considerations will both be fulfilled by maintaining an average velocity that is at or close to the posted speed limit. We want to find the "sweet spot," the happy medium that both saves time and helps keep us safe.
The same principles may also be applied when we're exercising. We want to improve, get stronger, and build more endurance as soon as we can, while simultaneously avoiding injury and staying healthy. Very often, these goals may conflict. It's important to ensure that we're exercising efficiently and making certain we're deriving the greatest benefit from our exercise time. These benefits are obtained by a steady approach, one that focuses on incremental gains accomplished over time.¹
It's natural to want to arrive at a desired outcome quickly. But as with any other form of training, whether learning to play the piano or becoming a competent chess player, substantial time is required to produce long lasting results. In the case of exercise, trying to hurry the process will usually cause an injury. You'll be set back at least weeks, if not months, and you'll have to start over, pretty much from the beginning.
For almost all of us the "tortoise" approach, rather than that of the "hare" in the well-known fable, will produce the health benefits we're hoping to achieve from our daily exercise. If you've never walked before and want to incorporate this aerobic activity as part of your exercise routine, start with a 10-minute walk. This doesn't sound like much, but that is precisely the point. Start by doing a little and build up gradually and consistently. Within 6 or 8 weeks you'll be doing 30-40 minute brisk walks several times a week, which will represent a very good aerobic exercise program. Incorporating strength training into your routine will employ a similar method. For each of your exercises (such as bench press, one-arm row, squat, toe raise, shoulder press, biceps curl, and lying triceps press), begin with a weight with which you can comfortably do 10 repetitions. If you can't do 10 reps, the weight is too heavy. Start with that weight and do 3 sets per exercise. Build up gradually by increasing the weight by 5%, if possible, each week or every 2 weeks. After 10 to 12 weeks you'll be noticeably stronger and your metabolism will begin to be more efficient.^2,3
By progressing slowly and steadily, you will build a solid base and make consistent and possibly substantial gains in your exercise routine. You will get where you want to get safely and effectively. The long-term outcome will be enhanced health, wellness, and well-being.

¹Marongiu E, Crisafulli A: Cardioprotection acquired through exercise: the role of ischemic preconditioning. Curr Cardiol Rev 10(4):336-348, 2014
²Huxel Bliven KC, Anderson BE: Core stability training for injury prevention. Sports Health 5(6):514-522, 2013
³Granacher U, et al: The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports Med 43(7):627-641, 2013

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The Power of Cross Training

The Power of Cross-Training

Chiropractic Care Optimizes the Benefits of Exercise

Cross-training places numerous physiological demands on your cardiorespiratory and musculoskeletal systems, as well as on your digestive, hormonal, and immune systems. These demands are necessary for your ongoing health and well-being, following both the principle of "use it or lose it" and Wolff's Law (bone remodels along lines of physiological stress). But in order to maximize our cross-training gains, we want to make sure that our body's underlying structure is intact. Our various physiological systems must be able to communicate with each other efficiently, and each system must be able to receive and transmit information to the master system, the nerve system. Regular chiropractic care helps ensure these necessary interactions are taking place, consistently and over time. By detecting and correcting spinal misalignments and by removing nerve interference, regular chiropractic care helps optimize all physiological functioning and helps you get the most out of your cross-training activities.

Cross-training refers to a combination of different methods of exercise. Specifically, cross-training refers to the combination of strength training and cardiovascular training in your overall exercise program. Whether you're a 14-year-old just starting out on your first fitness program, or whether you're a 74-year-old who hasn't exercised in more than 40 years, cross-training will provide optimal results for the time and effort you spend on exercise.
In cross-training, it's not that you're doing aerobic and strength-training activities simultaneously. Rather, you're incorporating both methods in your weekly exercise regime. One week you might do three sessions of strength training and two sessions of cardiovascular activity. The next week you could do three sessions of aerobic exercise and two sessions of strength training. The result is that, overall, approximately half of your exercise time is devoted to each of these two methods.
The remarkable outcome of combining two distinctly different training modes is that both sets of results are enhanced.^1,2 Doing cardiovascular exercise on alternate days makes you stronger. In other words, your muscular strength and size are greater than they would be if strength training were your only form of exercise. Correspondingly, doing strength training on alternate days provides you with heightened cardiovascular gains. Specifically, your stroke volume (the amount of blood pumped on each contraction of your heart muscle) and vital capacity (the amount of air you can take in on each breath) are greater than the results you would have obtained by only doing aerobic exercise.
The benefits of cross-training are automatic. There's nothing you need to do intentionally to achieve these gains, other than engaging in your cross-training program five days a week. When you train your heart and lungs by doing cardiovascular (really, cardiorespiratory) exercise, your skeletal muscles automatically participate in your walking, running, biking, or swimming activity. When you do strength training, exercising your chest, back, shoulders, arms, and legs (on different split-training days, of course), your heart and lungs automatically participate, pumping the extra blood and breathing in the extra oxygen required for any vigorous physical activity.
The synergy created by the cross-training format potentiates the results obtained from each method.³ The improved performance of your heart and lungs, derived from aerobic training, enables greater strength training gains. A stronger musculoskeletal system, derived from training with weights, causes your heart and lungs to become more efficient to meet new demands. A positive feedback loop is established from which you obtain improved health and enhanced wellness and  well-being.
The best time to begin your new cross-training program is today. Start slowly, increase duration and intensity gradually, and evaluate your gains at 6- and 12-week intervals. Your chiropractor is experienced in exercise rehabilitation and will help you design a cross-training program that works for you.
¹Fournier SB, et al: Improved Arterial-Ventricular Coupling in Metabolic Syndrome after Exercise Training. Med Sci Sports Exerc  2014 May 27. [Epub ahead of print]
²Kolka C: Treating Diabetes with Exercise - Focus on the Microvasculature. J Diabetes Metab 4:308, 2013
³Dos Santos ES, et al: Acute and Chronic Cardiovascular Response to 16 Weeks of Combined Eccentric or Traditional Resistance and Aerobic Training in Elderly Hypertensive Women: A Randomized Controlled Trial. J Strength Cond Res 2014 May 19. [Epub ahead of print]

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Heavy Lifting

Chiropractic Care and Core Training

Core training focuses on the deepest muscular layers of your body, including small muscles such as the multifidi and intertransversarii that lie directly on the spinal column and help move individual spinal vertebras. In order to train these deep muscles properly, the spinal vertebras need to be able to move freely throughout their full range of motion. This is where regular chiropractic care comes in. Chiropractic care identifies, analyzes, and corrects sites of limited spinal mobility, making it possible for you to optimally train your core muscles. Returning to fitness requires an ongoing commitment of time and effort. In order to get the most out of your investment in yourself, it’s important to make sure that your body will respond effectively to your exercise activities. Regular chiropractic care helps ensure that you’ll achieve such success.

All of us who’ve experienced a back injury of one sort or another have been told at some point to “avoid heavy lifting.” That type of advice appears to be a no-brainer or at least redundant, as no one whose back is hurting is going to try to pick up an air conditioner or even a 100-foot reel of garden hose. In this context, it’s important to remember the words of Shakespeare’s Cassius: “The fault, dear Brutus, is not in our stars, but in ourselves”. The problem isn’t the heavy lifting, as such. The real problem is in us, that is, in our overall level of conditioning or physical fitness.
Most back injuries don’t occur as a result of heavy lifting, but rather are caused by a seemingly innocuous event such as bending over in the shower to retrieve a bar of soap that has fallen to the floor. Other likely pain-producing scenarios are bending over to place a bag of groceries in the trunk o f a car bending over to tie a loose shoelace. None of these circumstances involved lifting extraordinary weight.  Rather, the common elements are lack of flexibility and lack of appropriate muscle tone and strength to support the weight of your body in a forward flexed position.
The problem isn’t lack of big muscles. Picking up a bar of soap or positioning a 15-pound grocery bag doesn’t require bulging biceps or massive lats. The problem is lack of conditioning. Most of us no longer do actual physical work on a regular basis. We spend the large majority of our day sitting, either working, reading, or watching entertainment on television or other devices. The result of such lack of activity is twofold. Muscles lose strength and muscle fibers are replaced by fat. Additionally, tendons and ligaments contract and become tight, losing their necessary composition of elastic fibers. The functional loss associated with these physiological changes is profound. We experience these change every time we feel a twinge, or worse, in our backs.
The fix is easy and primarily focuses on building up core muscle strength.^1,2 Core training is directed toward your deep abdominal muscles. The main such muscle is the transverses abdominis, which surrounds your entire waist, protecting and supporting your lower back. You can think of this critically important structure as your internal weight belt. Activation of the core muscles is required for all effective physical activity.³ Without this essential foundation, any minor attempt at work, even bending over to pick up a pencil, can lead to disaster in the form of excruciating back pain.
Core training includes exercises such as the scorpion, lying windmill with bent legs, pushups, squats, and the plank. Many good books and numerous online videos are available to provide instruction in the performance of core exercises. Your chiropractor is experienced in rehabilitative exercise and will help guide you to the training methods that are best for you.
¹Inani SB, Selkar SP: Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: a randomized clinical trial. J Back Musculoskel Rehabil 26(1):37-43, 2014
²Brumitt J, et al: Core stabilization exercise prescription, part 2: a systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain. Sports Health 5(6):510-3, 2013
³Wang XQ, et al: A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One 2012;7(12):e52082. doi: 10.1371/journal.pone.0052082. Epub 2012 Dec 17

Heavy Lifting

Chiropractic Care and Core Training

Core training focuses on the deepest muscular layers of your body, including small muscles such as the multifidi and intertransversarii that lie directly on the spinal column and help move individual spinal vertebras. In order to train these deep muscles properly, the spinal vertebras need to be able to move freely throughout their full range of motion. This is where regular chiropractic care comes in. Chiropractic care identifies, analyzes, and corrects sites of limited spinal mobility, making it possible for you to optimally train your core muscles. Returning to fitness requires an ongoing commitment of time and effort. In order to get the most out of your investment in yourself, it’s important to make sure that your body will respond effectively to your exercise activities. Regular chiropractic care helps ensure that you’ll achieve such success.

All of us who’ve experienced a back injury of one sort or another have been told at some point to “avoid heavy lifting.” That type of advice appears to be a no-brainer or at least redundant, as no one whose back is hurting is going to try to pick up an air conditioner or even a 100-foot reel of garden hose. In this context, it’s important to remember the words of Shakespeare’s Cassius: “The fault, dear Brutus, is not in our stars, but in ourselves”. The problem isn’t the heavy lifting, as such. The real problem is in us, that is, in our overall level of conditioning or physical fitness.
Most back injuries don’t occur as a result of heavy lifting, but rather are caused by a seemingly innocuous event such as bending over in the shower to retrieve a bar of soap that has fallen to the floor. Other likely pain-producing scenarios are bending over to place a bag of groceries in the trunk o f a car bending over to tie a loose shoelace. None of these circumstances involved lifting extraordinary weight.  Rather, the common elements are lack of flexibility and lack of appropriate muscle tone and strength to support the weight of your body in a forward flexed position.
The problem isn’t lack of big muscles. Picking up a bar of soap or positioning a 15-pound grocery bag doesn’t require bulging biceps or massive lats. The problem is lack of conditioning. Most of us no longer do actual physical work on a regular basis. We spend the large majority of our day sitting, either working, reading, or watching entertainment on television or other devices. The result of such lack of activity is twofold. Muscles lose strength and muscle fibers are replaced by fat. Additionally, tendons and ligaments contract and become tight, losing their necessary composition of elastic fibers. The functional loss associated with these physiological changes is profound. We experience these change every time we feel a twinge, or worse, in our backs.
The fix is easy and primarily focuses on building up core muscle strength.^1,2 Core training is directed toward your deep abdominal muscles. The main such muscle is the transverses abdominis, which surrounds your entire waist, protecting and supporting your lower back. You can think of this critically important structure as your internal weight belt. Activation of the core muscles is required for all effective physical activity.³ Without this essential foundation, any minor attempt at work, even bending over to pick up a pencil, can lead to disaster in the form of excruciating back pain.
Core training includes exercises such as the scorpion, lying windmill with bent legs, pushups, squats, and the plank. Many good books and numerous online videos are available to provide instruction in the performance of core exercises. Your chiropractor is experienced in rehabilitative exercise and will help guide you to the training methods that are best for you.
¹Inani SB, Selkar SP: Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: a randomized clinical trial. J Back Musculoskel Rehabil 26(1):37-43, 2014
²Brumitt J, et al: Core stabilization exercise prescription, part 2: a systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain. Sports Health 5(6):510-3, 2013
³Wang XQ, et al: A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One 2012;7(12):e52082. doi: 10.1371/journal.pone.0052082. Epub 2012 Dec 17

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Entropy, the Gym, and You

Chiropractic Care and Ongoing Good Health

Optimal health and well-being depend on more than a consistently good diet and regular vigorous exercise. Regular chiropractic care is needed to derive the maximum benefit from these key ingredients of health. A properly functioning nerve system is required to efficiently digest, metabolize, and use the nutrition you’re obtaining in your daily diet. Similarly, your muscles, joints, and bones need to receive a proper nerve supply to effectively perform all the elements of your exercise routine, including cardiovascular activities and strength training. All your body systems must receive and send accurate, timely information so that your body works well as a unified whole. Your body’s master system, the nerve system, makes this possible. Regular chiropractic care helps ensure that your nerve system is functioning at peak efficiency. The result, in combination with the other health-promoting action steps you’re taking, helps ensure high levels of health and well-being over the long-term.

Let’s say you’ve been taking some time off from the gym. Maybe you reached the end of your 12-week training cycle and you’re taking a week off. It’s possible that one week turns into two or even three or four weeks. Life happens, you need to attend to some pressing matters, and going to the gym starts to take a back seat. Before you know it, two or three months have passed by. Suddenly, you’re no longer a person who goes to the gym, but a person who needs to figure out a way to get back to the gym on a regular basis. “What happened to me?” you wonder. “Where did the time go?” Now you have to actually exert effort to fit “workout time” into your schedule. You scratch your head and ponder. “I thought I had this all covered,” you think, not for the first time.
What happened to you and your well-made plans was entropy, that insidious force in the universe that turns order into disorder. The basic rule is that any organized system, left unattended, will immediately begin to break down. As a mundane example, those piles of papers on your desk keep reaccumulating as a result of entropy. The weeds in your garden? Entropy. The dust bunnies in your attic and basement? Entropy. The collapse of your plan for doing regular workouts? Entropy.
What’s worse, entropy takes a serious toll on your physical fitness.^1,2 If you miss enough time from the gym, all your fitness gains begin to melt away. First, your muscles begin to lose their stores of energy. Glycogen, the complex sugar that supplies energy for muscle work, is broken down for use elsewhere. Arterioles and capillaries, small blood vessels that were needed to supply nutrients to your growing muscles, are no longer required and rapidly disappear. Muscle fibers that were continually added to support your exercise activities are cannibalized, so that their constituent parts may be used for other physiological processes. Entropy launches a process of randomization that breaks down your carefully built-up muscular structure. Your body, being very smart, metaphorically swoops in and moves all those metabolic components to other structures and systems for more efficient use.
The superficial result is loss of muscle definition. The deeper result is loss of muscle tone.³ Your cardiorespiratory system (heart and lungs), digestive system, and metabolism are all affected, as these physiologic systems are no longer required to be functioning at peak to support a regular vigorous exercise program. Entropy sets in to all these systems, as well. The overall result is a profound impact on your health and well-being.
The good news is we can help keep entropy at bay. But doing so requires attention and determination. We want to attend to our bodies as carefully and regularly as we attend to the environment of our home, office, and garden. Just as our cars, motorcycles, and bicycles require periodic maintenance, our bodies require much more frequent care, care on a daily and weekly basis. It’s fine to occasionally skip a week or two, or even a month if needed, of exercise. But we must make sure we get right back on schedule to ensure benefits to our short-term and long-term health.
¹Barwais FA, et al: Physical activity, sedentary behavior and total wellness changes among sedentary adults: a 4-week randomized controlled trial. Health Qual Life Outcomes 2013 Oct 29;11:183. doi: 10.1186/1477-7525-11-183
²Loprinzi PD, Lee H: Rationale for promoting physical activity among cancer survivors: literature review and epidemiologic examination. Oncol Nurs Forum 2014 Mar 1;41(2):117-25. doi: 10.1188/14.ONF.117-125.
³Ricci-VItor AL, et al: Influence of the resistance training on heart rate variability, functional capacity and muscle strength in the chronic obstructive pulmonary disease. Eur J Phys Rehabil Med 49(6):793-801, 2013

Low Back Pain

 

Effective Diagnosis and Treatment of Low Back Pain

Healthy Backs and Regular Chiropractic Care

Regular chiropractic care helps your body function at peak capacity. Your body is a dynamic structure and, as in all finely crafted machines, it's possible for subtle things to go wrong. The problem, of course, is that as these problems are subtle we don't know about them until, in a sense, it's too late. Too late, that is, from the point of view of how long it may take to get better now that the problem's been going on for some time. By receiving regular chiropractic care you're helping to nip various physical problems in the bud. For example, low back stiffness, which if left unattended might develop into a mechanical problem and ultimately a herniated lumbar disc, is identified at the outset and lessened or resolved by regular chiropractic care. By helping you improve your overall health and well-being, regular chiropractic care is a modern implementation of the old proverb, "an ounce of prevention is worth a pound of cure".

Here's an all-too-common situation. You develop low back pain that lasts for more than a few days and you're uncomfortable enough to go see your primary care physician. He or she tells you it's not clear what's going on and sends you for a magnetic resonance imaging (MRI) study of your lumbar spine. The study comes back showing one or two herniated intervertebral discs. [Intervertebral discs are cartilaginous shock absorbers interspaced between pairs of spinal vertebras.] Your doctor informs you that you have "herniated discs in your back" and prescribes medications and a course of physical therapy. Your doctor may even refer you to an orthopedic surgeon to evaluate the need for surgery on your back.
Now, all of these recommendations may be necessary. Or none of them may be necessary and all that's needed is some rest and an exercise rehabilitation program that you could do on your own if you were given the proper instructions. The culprit here is how the presence of the herniated disc or discs is interpreted. It's important to remember that not all herniated discs are a problem requiring a solution. In fact, a sizable proportion of such disc herniations (30% or more)¹ represent the progression of natural processes and are not a problem at all.^2,3 But many family doctors and even specialists are not appropriately trained in accurate differentiation among the various possibilities. When faced with MRI evidence of a herniated disc, such doctors see it as a disorder or disease that needs to be treated and fixed. Such an approach results in significant stress and leads to unnecessary procedures and financial hardship for many patients.
Given the frequency of occurrence of such instances of "over-diagnosis", how can a person with back pain expect to receive appropriate care? Of course, people as patients are usually not in a position to be able to overrule their doctor's recommendations. The answer lies in obtaining relevant information. Let your doctor know you're aware that up to one-third of normal persons have herniated discs, and ask whether it's possible that your disc herniation is in fact unrelated to your back pain and merely an incidental finding. Further, if your back pain is not accompanied by leg pain radiating below your knee, it may be that the disc herniation is not affecting spinal nerve roots and may be treated by very conservative measures such as rest followed-up with exercise.
Thus, not all disc herniations have the same impact on a person's health. Some represent normal findings, even if they are present in a person who has back pain. Let your doctor explain to you exactly why your particular problem requires more than watchful waiting. Your local chiropractor will be able to provide you with the very best expert advice and recommendations for any necessary treatment.
¹Takatalo J, et al: Does lumbar disc degeneration on magnetic resonance imaging associate with low back symptom severity in young Finnish adults? Spine (Phila PA 1976) 36(25):2180-2189, 2011
²Spontaneous regression of herniated lumbar discs. Kim ES, et al: J Clin Neurosci 2013 Oct 24. pii: S0967-5868(13)00552-3. doi: 10.1016/j.jocn.2013.10.008. [Epub ahead of print]
³Endean A, et al: Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine (Phila PA 1976) 36(2):160-169, 2011

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Testimonial

Thanks for helping me feel better. Since I've been seeing you, my headaches have gone away. I have never been to any Dr. that explains what they're doing and what they think is going on with my health like you do. I will continue to refer anyone that might need your assistance.

Rick Chandler -
Mankato, MN