“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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Dermatomes of The Arms & Legs

Dermatomes are areas of the skin that a particular spinal nerve is responsible for. This spinal nerve carries information to the brain about the sensations you feel on that part of the body. Any altered feeling from normal such as numbness, tingling, burning or pain can be a sign that these spinal nerves are irritated or under mechanical pressure. Knowing which part of the spine is responsible for what area of the body helps our chiropractors determine the most efficient way to help the body restore that function.

These spinal nerves are assigned a letter and number to help us determine where they are originating from. The letters assigned are related to one of the four regions of the spine.

C = Cervical (Neck)

T = Thoracic (Upper & Mid back)

L = Lumbar (Low back)

S = Sacrum (Fused bones below the low back and above the tail bone)

The numbers start from 1 and increase in order until the last nerve for that region is accounted for. The number of nerves that exit each region of the spine varies. For instance, the numbers go from 1 to 8 in the cervical spine (neck) whereas they go from 1 to 12 in the thoracic spine (upper & mid back).

For the purpose of this discussion, we will only highlight the different spinal nerves that control the relaying of information from the arms and legs (upper and lower limbs).

Have a look at these images:

“Upper limb dermatomes”
“Lower limb dermatomes”

When was the last time you experienced altered feeling in one of these regions? Has it been persistent or progressive? We would be happy to help if you are curious and want to discuss this further!

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Highway of Communication

Have you ever heard the analogy of our nervous system as a highway of communication in our bodies? Well, this month we wanted to bring to your attention the different types of information that is being communicated via these pathways.


If we expand on that analogy, you can start to imagine our spinal cord (big bundle of nerves continuing from the brain into our back) as the main highway. From there, there are exits that lead to further roads and creates pathways. There are lots different forms of vehicles carrying different information on this highway. Some are carrying our ability to sense hot/cold or sharp/dull. Some are carrying messages from the brain telling our muscles how to move and others are taking messages to the brain giving it information about what is happening in our body.

In a general sense, the highway (spinal cord) further divides into two smaller exits (roots). The one at the front of the spine is carrying information that goes to our muscles and the one in the back is carrying information from our body going to the brain.

Further away from the spine, these nerves are combining into one carrying multiple types of information. The path that these nerves take is somewhat predictable and has helped us create a map on our body showing us what nerve is controlling what action. The map of the muscles these nerves control is called the myotome (myo = muscle) whereas the map of our sensation on our skin is called the dermatome (dermis = skin).

This is tremendously helpful when patients are complaining of weakness in muscles or altered sensation in different parts of the body. Following these maps, we are able to distinguish which nerves are involved and further investigate what part of the spine needs to be treated to help the body function the way it is supposed to.

Over the next few blogs, we will go into the details of what these maps look like in different parts of our bodies.

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headaches

Common Types of Headaches

You or someone you love may have experienced headaches. It may have been a passing feeling that only happened a handful of times or it may be something that is constantly recurring in nature.

One thing is for certain: There is no such thing as a “normal” headache.

It’s fascinating what our bodies can get used to. Having an ache or pain for a long period of time can make it so that it feels normal – because you can’t remember not having it. However, it is almost always pointing to an underlying cause that should properly be examined and addressed.

To properly diagnose your headache, our chiropractors will often evaluate the following details:

  • Intensity
  • Location
  • Frequency
  • Cause

Based on the above criteria, headaches are divided into two types: Primary & Secondary.

A primary headache is the most common type and occurs when there is no underlying disease or illness contributing to it. The pain associated with primary headaches is caused by the inflammation of pain-sensitive parts of the body in and around the neck and head, including:

  • Nerves
  • Blood vessels
  • Muscles
  • Joints

Even if these structures are the cause of the headache, your triggers can be many. Some people get primary headaches due to stress while others may get it due to poor posture, dietary sensitivities and previous traumas. Just trying to avoid these triggers is not an appropriate strategy. The structures contributing to the cause need to be treated to eliminate the headache. This is where we can help.

A secondary headache is caused by another condition that triggers pain-sensitive areas in the neck and head. Secondary headaches are rare, but they can also be much more serious than primary headaches. Secondary headaches can be a warning sign of a more serious underlying condition, including:

  • Brain tumors
  • Aneurysm
  • Meningitis, a bacterial or viral infection causing inflammation of the brain
  • Neck or brain injury

Secondary headaches typically start out of nowhere and are excruciating. When we suspect a secondary headache, a referral to another health care provider for advanced imaging might be appropriate.

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Ergonomics: At the desk

One of the most significant factors leading to repetitive use injuries is poor posture. Proper ergonomics can help to limit the impact of your environment on your musculoskeletal and neurological health.


Although every situation is unique and should be assessed on an individual basis, there are a lot of people that struggle with finding an appropriate solution for their workstation. Here is a checklist to keep in mind when working at the desk:

  1. Your thighs should be parallel to the floor

You can adjust the height on most chairs and may be able to change the angle of the seat to accommodate for this correction.

  1. Your feet should lay flat on the floor or on a footrest

Adjust the height of the seat to get the appropriate foot position. You should always stand up occasionally and move around to avoid tightness regardless of positioning.

  1. Back of the knees should be clear of the front edge of the seat

This can be achieved by buying a chair that has the correct seat depth to begin with or having the ability to adjust the depth of the seat. You should be able to fit your fist between the knee and the seat’s edge.

  1. Your lower and mid-back should be well supported

Every chair will have different support systems for this. You should at the bare minimum be able to adjust the height of the backrest to have appropriate lumbar support. If necessary, a small cushion can be placed in the low of your back.

  1. Your forearms should be supported and your shoulders relaxed at all times

Your forearms should be able to freely move when performing tasks, yet be supported at rest so that you are not straining the lower neck and upper traps. Avoid hunching over as much as possible and make sure your elbows stay tucked in close to the sides of your torso.

  1. Your elbows should be at approximately the same height as the keyboard

Either your work surface of keyboard tray needs to be adjusted to accomplish this.

  1. Your wrists should be straight at all times and your hands in line with your forearms

The angle that is created where your wrists rest on the keyboard should be as straight as possible. Either change the height of your chair or lift up the keyboard so that you are not straining the wrist.

  1. The monitor should be at a comfortable reading distance and height

The typical viewing distance that is appropriate for most people is approximately the length of one’s arms. The monitor should be at eye level as much as possible. Looking down at it or having to look up constantly will strain the neck and mid back regions.

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spinal cord

Chiropractic 101

There are two aspects of spinal health: Structural & Functional.

The structural aspects within a chiropractic clinic are usually addressed with an x-ray. This type of imaging is important to determine the health of the joints but also to be able to see their mechanical position. For patients, these are easier to focus on because they are tangible and observable. However, functional aspects are equally as important and include excessive/limited movement in spinal joints and it’s effects on the surrounding soft tissues (muscles, fascia, ligaments and nerves). The combination of these effects is often called a vertebral subluxation.

Outside of improving movement in joints, the purpose of an adjustment is to change the function of nerves.

Our bodies constantly need to be able to monitor changes in our environment (both internal & external) and change bodily functions accordingly. This control is under what is called the Autonomic Nervous System.

For instance, when you start running, your heart rate and breathing rate needs to adjust to the activity or when you get nervous before an exam and your nervous system starts churning your stomach, your plams get sweaty or heart rate elevates – all of this is under the control of your Autonomic Nervous System.

However, nothing in excess is ever good!

Many areas can get affected when certain nerves are functioning improperly and keeping vital functions of your body elevated or depressed for a long time.

A chronic vertebral subluxation can contribute to an altered sense of feeling, ability to maintain balance, blood pressure, heart rate, breathing rate, regular stomach and bowel function and reproductive function – just to name a few.

An ADJUSTMENT is a direct, specific movement of a joint administered by a chiropractor.

It is aimed at correcting a vertebral subluxation which is causing decreased movement and improper function of the nervous system & spine

An Adjustment directly influences the nerves exiting the spinal cord and going to different areas of the body. The three main areas are the following:

1) Feeling-Improper neurological function can cause pain, burning sensations, numbness, tingling, decreased/increased or loss of sensation.

2)Healing: Your body replaces 50 to 70 billion cells each day under the control of the nervous system. If affected, your body can’t heal properly causing increased health issues.

3) Function: Compromised nerve function can affect the immune system, blood pressure, balance, posture, organ Systems, disc and muscles causing muscle spasms and joint pain

Just like the electricity that runs through your house powering all the electronic devices you own, so to does the nervous system control every function in the body. By correcting it’s function with an adjustment, the POWER is turned back on and your body is able to heal and communicate the way it was always meant to.

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Arthritis

Arthritis & It’s Presentation

Arthritis is a condition characterized by swelling and tenderness of a joint in the body. Depending on the type of arthritis that you have been diagnosed with, sometimes it is related to an underlying disease (such as auto-immune conditions, infections or tumors) and sometimes it is a symptom of poor mechanics or movement (either due to posture or old injuries).

A diagnosis of arthritis should be properly done following imaging such as x-rays, MRI or CT scans. Some types of arthritic conditions also have markers that can be picked up on blood tests. However, having arthritis does not always mean that you immediately have pain. This is why some people will get diagnosed during routine tests and imaging. For instance, osteoarthritis causes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint — to break down. Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.

Uric acid crystals, which form when there’s too much uric acid in your blood, can cause gout. Infections or underlying disease, such as psoriasis or lupus, can cause other types of arthritis.

Even if pain and limitation in movement has not affected you yet, you should determine what steps you should be taking depending on the type of arthritis you have to prevent these issues from getting worse or occurring in the first place. Symptoms will typically worsen with time from onset (not always age dependant).

The main goals of arthritis treatments are to reduce symptoms and improve quality of life.

Common Misconceptions

  1. You have to stop exercising and lifting weights because of your arthritis.

    Generally speaking, this is not true. If you have decreased bone density due to a disease that has caused your arthritis then exercises and load bearing movements might not be appropriate for you. However, most people will at some point develop osteoarthritis (OA). In this case, movement through appropriate exercises is advisable and appropriate for you. Make sure you speak to your health care provider before beginning any exercise program.
  2. You are not a good candidate for chiropractic, massage therapy or physical therapy because of arthritis.

    There are many ways a trained health-care provider can help you with symptoms arising from your arthritis and the rate at which your arthritis is progressing. Our providers help patients with arthritis all the time.
  3. You will always have to take medication now because you have arthritis.

    Although sometimes appropriate based on the type of arthritis you have, medication is not the only answer. Mechanical issues related to arthritis require a mechanical solution to be properly addressed.
  4. Arthritis is inevitable because you are getting older.

    It is true that our bodies will degenerate to a certain extent as we get older. However, what we always educate our patients on is that asymmetrical or premature wear and tear of a joint is completely preventable. Majority of people who have age related arthritic changes will not loose function and have severe pain. In the case of osteoarthritis, these symptoms are related to poor movement and posture and can be addressed if caught early.
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Weight loss and Chiropractic

With summer around the corner, many people start considering shedding a few pounds of weight to fit into clothing or swimwear. Obviously there are merits beyond just aesthetics when considering this topic. It is no surprise that if you are carrying excessive weight, then loosing some in a healthy fashion can have a significant positive impact on your over-all health. A higher than normal body mass index, or BMI, for an extended period of time has been linked to decreased cardiovascular function, adrenal dysfunction and GI dysfunction to name a few.

There is also a very important and clear relationship with carrying increased/excessive weight and pre-mature wear & tear (degeneration) of our joints.

Let’s consider for a moment that the human body is a very well thought out weight-bearing structural entity. Our mechanisms related to movement have certain parameters and rules that they have to follow. Not all of our joints are built the same, not all bones have the same properties and not all muscles function the same way. There is a healthy “normal” that they are meant to be able to tolerate and thrive in. For instance, did you know that your joints are designed to take nutrition from pressure gradients? Certain joints in the body NEED load to even stay healthy at all. This is why inactivity is sometimes just as bad as overactivity when it comes to joints. Or did you know that not all muscles need movement to get stronger? Some need to be trained by holding the same position for long periods of time to build their endurance.

When it comes to weight, the conversation is two-fold. On one hand we have to talk about ideal load and on another hand we have to discuss how that load is actually distributed to the joints and tissues. Both of these elements together can help start the discussion that comes up very frequently at our clinic.

“Can loosing weight help reduce my neck pain, mid back or low back pain?”

1. Optimal weight has a lot to do with your body type, make up, genetics and activity level. There is no one right answer. We know that muscle is heavier than fat and that bone composition can be different from person to person. This is why the conversation should often shift gears towards a variety of more useful metrics. These can be your waist circumference, your body fat percentage or your BMI to name a few. Speak to a health professional to get these metrics done or find easy to use methods available online to do this at home yourself. The number on the weight scale does not hold as much value as these.

2. Weight distribution patterns change when we talk about different regions of the body and discussing all of them is beyond the scope of this blog. What you should take away is that our joint surfaces where the load of our bodies crosses from one bone to the other should be as close to an “optimal” position as possible for that load to be healthy and received well. Putting load unsymmetrically or favouring one side more than the other can be the cause of pre-mature wear and tear. This can lead to early onset arthritis and other mechanical problems.

At the end of the day, reducing weight and finding relief from pain can be a reality but it is more complex than that. You could have great BMI and weight for your body type and height – however, if your weight distribution is not optimal, you will still experience pain like someone who is in fact over weight.

We would love to have this conversation more specifically for you at our office. Let us know if we can help!

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