Cervical & Lumbar Plexus

In anatomy, a plexus is an area where several nerves and blood vessels bundle together as they pass through the same spot. The result looks like a tangle or net that, while great at saving space, can be very problematic when damaged.

The brachial plexus is located in each shoulder and contains nerves going from the spinal cord to the shoulder and down to the rest of the arm. These nerves are responsible for the movement, feeling, and strength of the arm they connect to, and so when they’re irritated or damaged, the effect can extend through the entire arm. Minor injuries where the nerves get too stretched or squeezed are common in sports, although they can also come from inflammation, tumors, or even from birth in newborns. These injuries usually come with a sharp electric or burning pain, numbness, and weakness along the arm. They typically last only a few seconds or minutes, but they can sometimes last a day or more.

More severe injuries usually come from motor vehicle accidents. They occur when the nerves are seriously hurt – even torn or broken. In the most severe cases, the nerves can be disconnected from the spinal cord at their roots. This causes much more severe pain, and other symptoms can range anywhere from weakness and loss of muscle control to complete numbness and paralysis. These especially require medical attention as a bad injury can have permanent effects.

Similar to the arms, the legs and hips are also controlled by nerves going through the lumbar plexus, located near the bottom of your spine. Injury or irritation can lead to the same symptoms as the nerves in the brachial plexus, but in the legs, hips, and the lower abdomen. Since these nerves connect to multiple other organs, a bad injury here can also lead to a loss of bowel and bladder control.

Treating an injury to either plexus involves treating the source of each symptom. In cases where the issue is from an underlying condition like cancer or untreated diabetes, the first priority is to take care of those to stop the injury from getting worse. Then, you can focus on the immediate effects of the injury, and eventually on healing and restoring function to the affected limbs. This is where your chiropractor can help!

Chiropractors are trained to handle problems of the muscles, bones, and nerves, and know how to take physiological stress off of injuries. They can help you with regular exercises and procedures that get your muscles and bones used to moving once again.

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Cervicogenic Headaches

A cervicogenic (literally “coming from the neck”) headache is a form of chronic headache and neck pain that occurs when the muscles, nerves, or spine of the upper neck get irritated and painful. They may start as an occasional headache and gradually become chronic. They are usually described as steady or dull instead of throbbing, and radiate from the back of the neck to the side of the head and sometimes into the arms. They are usually side-locked, meaning the pain only affects the left or right side of the body.

These headaches are often triggered by poor posture or a sudden movement of the neck, such as coughing or sneezing, and are linked to workplace hazards or neck trauma. However, the underlying problem can vary. They can come from any form of injury or wear and tear to the spine and a part of the neck called the suboccipital region.

The suboccipital region lies right below the occipital bone (hence the name) at the back of your skull, and it houses some important muscles, nerves, and bones. If one of these gets injured, irritated, or has too much load put on it, it can lead to a headache. For example, trauma like whiplash from a car accident can stretch or bend a muscle or nerve, and the resulting damage can lead to a lot of pain. A slow wear and tear can also lead to headaches, such as when an arthritic joint in the spine starts to scrape against its surroundings.

Additionally, when anything in this region is under pressure, they can respond with pain. For example, a poor posture can strain the many small muscles responsible for keeping the head balanced by putting them in the wrong position for a long time. Pressure on the spinal cord, also very painful, or on neighboring nerves can come from conditions such as a herniated disc (when one of the soft discs cushioning your spine ruptures and leaks its insides), a bone pinching the spinal cord, or even growths or tumors.

A chiropractor can treat cervicogenic headaches by making sure the bones, muscles, and nerves causing them are working properly. A chiropractic adjustment and posture training can help move back and neck bones (especially in the spine) and muscles that may have moved into the wrong spot, and posture training can help fix an abnormal strain on muscles. Both of these reduce pressure that the bones and muscles of the neck put on each other and on their surrounding nerves, which relieves the pain and recurrence of cervicogenic headaches.

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A Homuncu-what!?

If you’ve ever had the misfortune of seeing this creature, called a sensory homunculus, you’ve probably wondered what it is. In short, this model is a visual representation of the way the human brain perceives the sensory information it receives from the body.

The body is equipped with receptors that sense touch, feeling, temperature, and pain; and they relay information about that touch through the nerves and into the brain. This information is sent by electrical and chemical “messengers” to an area of the brain called the somatosensory cortex. This area is responsible for interpreting and understanding these senses and the information it relays (for example, you can tell by touch whether a surface is rough or smooth).

The cortex is fairly large, but it still has a limited amount of space and therefore only has so many signals it can process at a time. This is why it has to consider where it would be most useful to focus more of its processing power. There are areas of the body where it doesn’t need to pay as much attention to the fine detail of what it senses from outside – for example, the leg or chest – since they don’t usually receive too much information at a time. There are other places, however, that receive much more information and require a lot more effort to understand.

For example, we explore a lot of the world using our hands. We pick things up with them and use them to feel objects or environments around us, meaning they’re constantly picking up a lot of sensory information. This is why it’s useful for the brain to spend a lot of processing power on interpreting the many signals coming from the hands. The lips and tongue are also very important to understand, because they come into contact with everything we eat. They receive detailed sensory information very often, so much like the hands, the brain devotes a lot of sensory “real estate” to interpreting the information they collect.

All this means that the sensory centers in your brain aren’t evenly divided, with much more space dedicated to analyzing the most “important” areas. This is, finally, where the sensory homunculus (literally meaning little man) comes in – the more space and sensory processing power the brain devotes to a certain area, the more exaggerated the area is on the homunculus. This results in a somewhat cartoonish figure with a gigantic head, mouth, and hands; much like the one you see above. In a sense, it represents how this part of the brain sees your body when it processes everything you touch.

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What is connective tissue?

In human biology, tissues are categorized into four types: nervous, muscular, epithelial, and connective. Connective tissue, as the name implies, serves to connect one tissue to another. These tissues use stretchy collagen and other fibres to help connect your organs and keep them in place, and denser collagen to make up the tendons and ligaments in your muscles and joints.

In the musculoskeletal system, connective tissues keep your bones, muscles, and joints functioning properly by keeping them together and in good shape. Tendons, for example, connect muscles to the bones they move and can even facilitate their motion, while still maintaining a high resistance to tension thanks to their dense collagen fibres. Ligaments, on the other hand, keep joints together and ensure proper function by connecting bones to other bones. While they are tough, if a ligament stays in the wrong position or endures too much load for a long time, it gets weaker and becomes more prone to future problems, such as dislocations.

Muscles in general are composed of very small fibres strung together into larger structures by a connective fascia wrapping around large groups, giving them the strength they need to contract properly and connecting them to other muscles. These fasciae also connect to the skin, sitting just under the lowest layer, called the dermis. When fasciae become tight, weakened, or scarred, due to injury or inactivity it can impair movement. This is why fasciae are important in chiropractic – since they are attached to the skin, a chiropractor can use a roller or exercises to loosen them. Adjustments and regular exercise can also strengthen and loosen fasciae in between muscles, allowing for better, less restricted motion.

These fasciae and other connective tissues aren’t only in the muscles and skin – they are present all around the body, notably around the brain and spinal cord. These are called the meninges, and they protect the central nervous system from infection and injury. When the meninges around the spine are disrupted, it can lead to pain, paralysis, or loss of bowel or bladder control. While bacterial infections of the meninges should be treated with antibiotics, a chiropractor can relieve pressure on the meninges by adjusting posture and making sure the muscles and joints of the spine are in their proper place.

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Men Are Insensitive?

Relax! This statement is not a jab at men. When trying to understand how our body perceives pain, we will often bring the conversation to discussing what happens in the brain. After all, that is where all pain signals are processed no mater where the signal starts. It is important to know that there are established differences in how that pain is processed between a male or female.

Imagine an analogy of two guitars connected to amplifiers. In this scenario, both guitars are playing the same tune but one amplifier is set at a lower setting than the other. The end result being that this amplifier will produce a lower volume of sound compared to the other.

As pain signals from different parts of the body travel up the spinal cord, they will eventually end up in areas of the brain that are meant to process them. One such part of the brain essentially serves as the amplifier of these signals and research shows that it is naturally less sensitive in males as compared to females.

So, how do we make sense of all of this? Does it mean that men are stronger than women? Or that women have a natural disadvantage? No.

With evolutionary roles in mind for each sex, our bodies are designed to facilitate the roles we have played for centuries. Parts of a female’s brain that are sensitive to the amplification of pain signals are also parts of the brain that contribute to her having the ability to be more empathetic, feel more emotion and create familial/social bonds. Men are not just less sensitive to pain signals, they are naturally less sensitive to the other aspects described above.

These are generalizations based on research. When applied to the masses, we know that there will always be outliers to these rules. For instance, females who show less sensitivity to pain and men who show more. However, these are points of interest in a clinical setting or for research because it encourages us to engage with patients in a way that is more suitable and appropriate to their condition. It is also an important consideration when we start to discuss why we see more females presenting with chronic pain type symptoms as compared to males.

As a family member, friend or significant other – people of the male gender need to be understanding and support females in their immediate circle who are complaining of feeling pain that is hard to describe, difficult to diagnose and has not yet been treated properly.

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Reducing Inflammation Through Diet

As previously discussed, we want to review the most common general recommendations to reduce inflammation through dietary change. As always, you should speak to your family doctor before making drastic changes to make sure they are suitable for your health profile.

A diet that controls inflammation is high in antioxidants from fruits and vegetables that are known for their anti-inflammatory properties. Incorporate these foods in your diet. Remember to stay within your allowed macros and calories listed previously.

  • Fruits: apples, acerola berries, fresh pineapple, guavas, grapefruits and rhubarb, kiwi fruit, lemons, limes, oranges, kumquats, black currants, blueberries, raspberries, mulberries and strawberries, papaya, cherries, and tomatoes.
  • Vegetables: Spinach, sweet potatoes, bell peppers, cabbage, bok choy, onions, leeks, garlic, green onions, broccoli, cauliflower, broccoli sprouts, brussel sprouts and greens.
  • Herbs & Spices: basil, oregano, mint, cloves, turmeric, cayenne peppers, chili peppers, parsley, rosemary
  • Fish & Meats: Cod, Halibut, Salmon, snapper, bass, whitefish, herring, trout, sardines, grass-fed beef, pork, naturally-raised (not on grain) chicken and turkey.
  • Whole Grains: brown rice, whole wheat, buckwheat, barley, rye, millet, spelt.
  • Fats: extra virgin olive oil, avocado, hazelnuts, almonds, walnuts.

Foods you should avoid because they have been shown to increase inflammation in the body:

  • Scientists and health practitioners know that consuming sugar, margarine, too many nuts and too many omega-6-polyunstaturated oils like corn, soy, walnut, vegetable and canola oil will increase inflammation in the body. They do this by traversing your arteries and activating prostaglandins in the body that are responsible for inflamed tissues.
  • What happens is this: you eat a food. That food is then digested. The individual component parts of that food get absorbed in your bloodstream and travel throughout your body. If you ate a carbohydrate food, such as bread, sugary desserts, rice, cereal, milk products, pasta and candy – that food will affect the pancreas and send a signal to release insulin. Insulin brings down the blood sugar level. The higher the insulin level, the more that insulin will cause effects in the body. Some of these effects will cause increased inflammation. It makes sense to cut your “added” sugar consumption down to nothing.
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Dangers of Chronic Inflammation

You may have heard the term inflammation being used to describe the swelling that happens when you get injured. This type of swelling is considered acute (short-lived) and is a response from your body to send the appropriate cells to heal the affected tissue. Immune cells will release various substances such as hormones bradykinin and histamine. They cause the small blood vessels to become wider (dilate), letting more blood to get to the injury. For this reason, inflamed areas turn red and feel hot. Both of these hormones also irritate nerves and cause pain signals to be sent to the brain.

Different areas of the body will swell at different rates when they are injured. Areas that are highly vascularized (supplied with more blood vessels than others) like the ligaments in your ankles or the discs in your spine, will have more inflammation happen as they heal. Typically, acute inflammation can last 6 – 10 days and the body will naturally reduce it once the injury is healed.

Chronic (long-term/persistent) inflammation can occur due to many reasons. Sometimes it is a response to systemic disease and other times it can be a response to your body reacting to a “perceived” injury – one that may not lead to a damaged tissue but perhaps mimics the presentation of one due to poor mechanics.

Whatever the reason may be for chronic inflammation, it is a largely concerning problem because it affects different areas of the body. When a local area gets inflamed due to injury for a short term, the inflammatory cells are limited to that region. With chronic inflammation, the inflammatory cells can stay elevated in your blood stream and affect different areas of the body. Research shows that chronic inflammation can contribute to heart disease, diabetes, arthritis or even cancer.

The good news is that there are a lot of natural ways to at least reduce chronic inflammation (even if it cannot be completely treated due to another health issue). Things like eliminating pro-inflammatory foods from your diet, taking the right supplements, breathing techniques and meditation/exercise have shown to effectively help with reducing levels of chronic inflammation. Next time, we will elaborate on a few of these suggestions that you can start at home to manage chronic inflammation.

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“Bullet Proof” Low Back?

What exercises are the best to create strength and stability in the low back region? There is an on-going and evolving discussion on this matter. The short answer is, “it depends”. There may be some general guidelines that the majority of the population can benefit from but depending on your health history, results of a physical examination, x-ray or other imaging findings – the priority of what you need to do first might be different than someone else.

At the very basic core (no pun intended) of the discussion is the fine line between flexibility and strength. Often, these two features of any mechanical area of the body have an inverse relationship. Flexibility of a region might come at a loss of some stability/strength. It doesn’t always have to – but at extreme ends, this is what we commonly see in practice.

Few questions to ask first are:

1) Are you currently in pain? If yes, what structure(s) or tissues are causing the pain? This helps determine what your initial goal should be: immediately work on loosening a tight area or go straight to stability or strength.

2) Do the results of your physical examination suggest there may be some mechanical compromise that currently is not the source of your pain, but will definitely play a role in how your body will receive load when you exercise? For example, we will commonly find that hips, buttocks and hamstrings are often involved in patients experiencing low back pain. Sometimes, the mid back region can contribute to it. It might seem counter-intuitive, but working on areas away from the site of pain can often be an appropriate strategy.

3) What pace should you do these stretches and exercises and how should you increase progression? Should you lift heavy but not do it as often? Should you keep it light but engage with it everyday?

The vast majority of research currently suggests that prolonged static postures (whether sitting behind a desk or standing for long periods of time) are culprits in leading to fatigue and weakness in the lumbar spine. Generally speaking, compound movements like deadlifts and squats are a good recommendation. However, if you are not conditioned for exercise, it is a great idea to start with what we consider to be body-weight “foundational movements”. Refer to the videos available on our website to get a glimpse of what that may look like. ( www.kanatachiropractor.com/exercise-rehab )

It is also recommended that you engage in mobilization/stretches of the hips, hamstrings and buttocks as an over-all strategy to make your low back more resilient to stress/fatigue.

As always, an appropriate and thorough assessment by a chiropractor is recommended before you engage with any significant exercise program to make sure it is appropriate for you.

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Kinetic Chains

It is very tempting to start compartmentalizing our symptoms in the body. In fact, many of our common approaches to managing disease and illness is done in a compartmentalized fashion. This is typically how the average senior will end up taking up to 11 different medications – all prescribed for different ailments treating different areas of the body. Sometimes, one is being prescribed due to the side-effects of another. 

This approach is already problematic when we consider the over-all interconnection of the body’s physiology. However, it is a system that works really well in a crisis. If you are in a traumatic accident and have suffered an injury to your hip, you will be rushed to the ER and see an orthopaedic specialist who primarily treats injuries like yours all the time. You can rest assured that your immediate needs related to your injury will be met and you will be discharged doing better than when you first walked in. 

Where this model fails is when the average person is presenting to a local clinic with pain or mobility problems related to a long standing mechanical issue. This could be poor posture, an old injury that you  ignored and never got addressed properly or perhaps it is a nagging ache that has been there all your life. The symptoms might be experienced in one part of the body whereas the problem might be in a completely different region. 

A more holistic look at how people move, how they think and how their pain is perceived needs to be the topic of discussion as opposed to where the pain is what can be done to get rid of it right away. The reason why people have the same problems return over and over again is because the underlying structural and functional components were not addressed appropriately. 

Our body has interlinked “chains” of movement that rely on one area to move well for the other to function the way it is supposed to. Looking through a limited view at only where the pain is leads people to be frustrated with on-going mechanical problems. These kinetic chains pass through different parts of the body. Some require more stability and strength whereas others need to be more flexible/mobile. Limitation in one can create a domino affect where problems can manifest many years down the road. 

Have a look at your posture in front of the mirror today. Do you find that you drop one shoulder and an opposite hip? For example: a right shoulder + left hip or a left shoulder + right hip? Chances are you would benefit from getting a proper and thorough structural and functional assessment done.

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Common Myotomes

Strength testing is a valuable assessment tool to determine the appropriate treatment recommendations at the clinic. Many of our patients are surprised to learn that strength is not just a function of how much muscle tissue you have or the training you have done to load it – but instead, is also related to how your nervous system is able to help your body contract and relax it. 

Myotomes are “maps” of the muscles that shows us which nerve is responsible for controlling the function of different muscle groups. Below you will find the commonly affected ones that we see in the clinic all the time. 

    • Have difficulty bringing your shoulder up past 90 degrees? Your C5 nerve may be a contributing factor.

 

    • Do you find it difficult to put weight on your feet when walking or going up/down the stairs? Your L4/L5/S1 nerves should be examined.

    • Do you find you drop things often? Or have difficulty holding on to pens/forks/knives? Your C6 to C8 nerves should be checked. 

Every muscle in the body is supplied by a nerve that controls it’s function. In this case, the traditional physical therapy & strengthening may not work. Our expertly trained chiropractors will be happy to identify if a nerve may be involved. Contact us to see if we can help!

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