Woodbridge VA Chiropractor

Great it’s time to pick all those tomatoes!

Hopefully all your plants survived the kick off to summer and now the current hot stretch.  Getting the garden ready for harvest can be a lot of work and Your Woodbridge, Dale City VA chiropractor wants to make sure you don’t get hurt.  Plus, if you have a few extra tomatoes that you want to get rid of let me know.

Gardening can be enjoyable, but it is important to stretch your muscles before reaching for your gardening tools. The back, upper legs, shoulders, and wrists are all major muscle groups affected when using your green thumb.

A warm-up and cool-down period is as important in gardening as it is for any other physical activity,” says Dr. Scott Bautch, a member of the American Chiropractic Association (ACA) Council on Occupational Health. “Performing simple stretches during these periods will help alleviate injuries, pain and stiffness.”

To make gardening as fun and enjoyable as possible, it is important to prepare your body for this type of physical activity. The following stretches will help to alleviate muscle pain after a day spent in your garden.

Garden Fitness Stretches

Before stretching for any activity, breathe in and out, slowly and rhythmically; do not bounce or jerk your body, and stretch as far and as comfortably as you can. Do not follow the “no pain, no gain” rule. Stretching should not be painful.

While sitting, stretch your leg out in front of you, knee straight, and prop your heel on a step. Then lean forward until you feel a stretch in the back of the thigh, or the hamstring muscle. Hold this position for 15 seconds. Do this once more and repeat with the other leg.

Stand up, balance yourself, and grab the front of your ankle from behind. Pull your heel towards your buttocks and hold the position for 15 seconds. Do this again and repeat with the other leg.

While standing, weave your fingers together above your head with the palms up. Lean to one side for 10 seconds, then to the other. Repeat this stretch three times.

Do the “Hug your best friend” stretch. Wrap your arms around yourself and rotate to one side, stretching as far as you can comfortably go. Hold for 10 seconds and reverse. Repeat two or three times.

Finally, be aware of your body technique, body form and correct posture while gardening. Kneel, don’t bend, and alternate your stance and movements as often as possible to keep the muscles and body balanced

After the Bulbs Are Planted

If you feel muscle aches and pains after your day in the garden, there are ways to alleviate the discomfort. Apply a cold pack on the area of pain for the first 48 hours or apply a heat pack after 48 hours, and consider seeking the services of a doctor of chiropractic in your area.

Doctors of chiropractic (DCs) practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. While best known for their expertise in treating the musculoskeletal system and their use of spinal manipulation, DCs have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Keep your head on a swivel!

Injuries to our joints tend to add up.  So over time they become less and less mobile and more and more painful.  It is always a good idea to try and maintain as much of a ROM as possible.  The use it or lose it saying applies here.  Your Woodbridge, Dale City VA Chiropractor has a few easy things you can do to maintain you cervical ROM.

Maintenance of the neck range of motion is easier than you would think and pretty basic but doing it daily makes a world of difference.  One of the main reasons for neck pain is poor posture.  So I tell all my patients to try and break up long periods of sitting at the computer.  If you get up every 45 minutes or so and do some of these stretches you can help your neck a bunch.

That being said you need to start in a good neutral position so when you do the exercises you aren’t creating another problem.  Start with you neck squarely over shoulders with your shoulder relaxed at your side.

Rotations. Sitting or standing, turn your head slowly to the left and then to the right as far as you can, comfortably. Hold each stretch for 10 seconds to 30 seconds.

Shoulder circles. While standing, raise your shoulders straight up, then move them in a circle around, down and back up again. Circle in both directions.

Side stretches. While standing, stretch your neck slowly to the left trying to touch your ear to your shoulder. Repeat on the right side.

Resistance exercises. Place your right hand against your head above your ear and gently press, resisting the movement with your neck. Do the same with your left hand on the other side.

Head lifts. Lie on your back with your knees bent and feet flat on the floor. Lift and lower your head, keeping your shoulders flat on the floor. Next, lie on 1 side and lift your head toward the ceiling. Repeat this movement on your other side and while lying on your stomach. Demonstration of head lifts.

These should help you maintain a pain-free range of motion but seeing your chiropractor on a regular basis will help you maintain alignment and also decrease muscle spasms.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Maplink

A real pain in the butt!

Obviously as your chiropractor in the Woodbridge, Dale City VA area I see lots of low back pain.  The interesting thing about low back pain is there are many causes.  Other complaints are pretty specific.  Knee pain really only has about 4 possible causes but the low back area has tons.  One of the most common causes isn’t even in your low back.

Anatomy

The piriformis muscle originates from the anterior (front) part of the sacrum, the part of the spine in the gluteal region, and from the superior margin of the greater sciatic notch (as well as the sacroiliac joint capsule and the sacrotuberous ligament). It exits the pelvis through the greater sciatic foramen to insert on the greater trochanter of the femur. Its tendon often joins with the tendons of the superior gemellus, inferior gemellus, and obturator internus muscles prior to insertion.

The piriformis, pyramidal in shape, lying almost parallel with the posterior margin of the gluteus medius.

It is situated partly within the pelvis against its posterior wall, and partly at the back of the hip-joint.

It arises from the front of the sacrum by three fleshy digitations, attached to the portions of bone between the first, second, third, and fourth anterior sacral foramina, and to the grooves leading from the foramina: a few fibers also arise from the margin of the greater sciatic foramen, and from the anterior surface of the sacrotuberous ligament.

The muscle passes out of the pelvis through the greater sciatic foramen, the upper part of which it fills, and is inserted by a rounded tendon into the upper border of the greater trochanter behind, but often partly blended with, the common tendon of the obturator internus and superior and inferior gemellus muscles.

The piriformis muscle crosses over top of the sciatic muscle and if the muscle spasms it will compress the sciatic nerve and cause pain in to your buttock and leg.  Once you have been properly diagnosed by your chiropractor or healthcare provider it is time to start treatment.

Treatment

Now that we know what the piriformis is and how it can cause us pain by compressing the sciatic nerve stretching it is one of the first things you should try.  Video

Lie on the back with the legs flat. Pull the affected leg up toward the chest, holding the knee with the hand on the same side of the body and grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee towards the opposite ankle until stretch is felt. Do not force ankle or knee beyond stretch. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

 

Lie on the floor with the legs flat. Raise the affected leg and place that foot on the floor outside the opposite knee. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or a towel, if needed, until stretch is felt. Do not force knee beyond stretch or to the floor. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

Lie on the floor with the affected leg crossed over the other leg at the knees and both legs bent. Gently pull the lower knee up towards the shoulder on the same side of the body until stretch is felt. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

These stretches work great for after care and between visits but active care may be needed by your chiropractor to help eliminate any other causes of the sciatic compression.

 

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Bedtime… Ugh

Who would have thought sleeping was a full contact sport!  But there are nights I go to sleep and wake up wondering who beat me up.  Low back pain is one of the most common sleep related complaints I see as your Woodbridge, Dale City VA Chiropractor.

Sleep sounds like such a great thing, 6 hours of resting.  Sadly, you wake up and everything hurts!  There are a few tricks you can try to help prevent these injuries.  Back pain can make it tough to get a good night’s sleep. At the same time, how you sleep may make things worse — while certain sleep positions put strain on an already aching back, others may help you find relief.

Although back pain and sleep problems are linked, the connection isn’t well understood. “There is not a lot of science behind sleep as a major cause of back pain,” says Santhosh Thomas, DO, MBA, a spine specialist with the Cleveland Clinic and associate medical director of the Richard E. Jacobs Medical Center in Avon, Ohio.

Experts do believe, however, that people with sleep problems experience more problems with back pain. “Sleep deprivation is known to affect mood and functional ability and negatively impacts perception of pain,” Dr. Thomas says. Pain in turn can affect the quality of your sleep, according to the National Sleep Foundation, leading to a lighter sleep state and more frequent waking throughout the night.

What’s more, there’s a relationship between the severity of pain, overall mood, and the ability to function — and a good night of sleep can improve all these symptoms, at least temporarily, according to a study published in the November 2016 issue of the Annals of Behavioral Medicine.


Worst Sleep Positions for Back Pain

Some sleep positions can put added pressure on your neck, shoulders, hips, lower back, knees, and even your heels, all of which can lead to pain, Thomas says. There’s no one-size-fits-all sleep position to kick back pain, but you can try a few tricks to get it under control so that you can sleep more soundly.

The most common offender? Sleeping on your stomach. “Typically, sleeping on your stomach can flatten the natural curve of your spine, putting some additional strain on your back muscles,” Thomas says.

Plus, stomach sleeping means that your neck is rotated, which can actually result in neck pain or back pain between your shoulders, says Paul Grous,  a physical therapist and spine specialist with Penn Therapy & Fitness in Woodbury Heights, New Jersey.

Don’t worry about keeping your body in the same position all night. It’s normal for you to move around a bit while you sleep, and that’s a good thing because a little movement can help ease pressure on your back. “Any sleeping position has the potential to amplify back pain if you maintain it for too long,” Thomas says.

Grous adds that the real culprit may not be sleep position but your daily activity — or a lack of it.

“My opinion of the biggest causative factor for back pain in our population is the amount of time we spend sitting during waking hours,” he says. “We sit too long and we don’t sit properly — we sit slouched with our backs rounded.”

During daylight hours, try to vary your posture as much as possible, and practice good posture when standing and sitting to help ease back pain at night.

Sleep Positions That Help Relieve Back Pain

First, you’ve got to be comfortable to get a good night’s sleep. Thomas suggests making a few simple modifications to your regular sleep position to help take a load off your back:

 

If you’re a back sleeper: Put a pillow under your knees to allow your spine to maintain its natural curve.

If you’re a stomach sleeper: Put a pillow under your lower abdomen and pelvis to ease back strain.

If you’re a side sleeper: Draw your legs up slightly toward your chest and sleep with a pillow (a full body pillow can be comfortable) between your knees.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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My aching head!

With all the stress that people are under at this time it is no wonder your Woodbridge, Dale City VA chiropractor has seen an uptick in headaches as a complaint.  Headaches can come from your head but they can also be caused by your upper neck.  This seems to be a high percentage of the headaches we are seeing at this time.

 

Occipital neuralgia can be debilitating but there are treatments, including chiropractic, that are very effective. Understanding occipital neuralgia can help patients better manage it so they can minimize the pain and symptoms of the condition.

 

What is occipital neuralgia?

Occipital neuralgia is a neurological condition that affects the occipital nerves which run from the top portion of the spinal cord, through the scalp, transmitting messages to and from the brain. There are two greater occipital nerves, one on each side of the head, from between the vertebrae located in the upper neck through the muscles that are located at the base of the skull and back of the head.

While they do not cover the areas on or near the ears or over the face, they can extend over the scalp as far as the forehead. When those nerves are injured or become inflamed, occipital neuralgia is the result. A person with this condition may experience pain at the base of their skull or the back of their head.

 

What are the symptoms of occipital neuralgia?

Pain is the prevalent symptom of occipital neuralgia. It often mimics the pain of migraine headaches or cluster headaches and is described as throbbing, burning, and aching.

There may also be intermittent shooting or shocking pain. Typically, the pain begins at the base of the skull but may radiate along the side of the scalp or in the back of the head. Other symptoms include:

Pain is experienced on one side (but sometimes both sides)

Pain behind the eye of the side that is affected

Tenderness in the scalp

Sensitivity to light

Pain triggered by neck movement

 

What causes occipital neuralgia?

Irritation or pressure to the occipital nerves are what actually cause the pain. This may be due to tight muscles in the neck that squeeze or trap the nerves, injury, or inflammation.

However, much of the time doctors are unable to determine the cause. There are several medical conditions linked to occipital neuralgia:

 

Tight neck muscles

Diabetes

Trauma or injury to the back of the head

Gout

Tension in the neck muscles

Whiplash

Inflammation of the blood vessels in and around the neck

Infection

Neck tumors

Cervical disc disease

Osteoarthritis

 

What are the treatments for occipital neuralgia?

Occipital neuralgia treatment focuses on pain relief. It often begins with conservative treatments that include:

Chiropractic

Rest

Heat

Physical therapy

Anti-inflammatory over the counter medication

Massage

In more severe cases the patient may be prescribed a stronger anti-inflammatory medication, muscle relaxants or in some cases an anticonvulsant medication.

If these therapies are not effective or do not bring about the desired level of pain relief, then doctors may recommend percutaneous nerve blocks and steroids. Sometimes surgery is recommended in cases where the pain is severe, chronic, and is unresponsive to more conservative treatments.

 

Chiropractic for occipital neuralgia

Chiropractic was once considered an “alternative” treatment for occipital neuralgia, but now it is often a regular part of recommended patient care. The advantage of chiropractic over medication or surgery is that chiropractic does not come with the side effects of drugs or the risks of surgery.

 

Another advantage is that chiropractic seeks to correct the root of the problem, not just manage the pain like other treatments.

Chiropractic treatment for occipital neuralgia may include lift adjustments, heat, massage, and traction. This will bring the body back into proper alignment and take the pressure off of the nerves as it loosens the neck muscles.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Make sure your back is healthy too!

People generally assume being healthy means you don’t have a cold.  For the most part that is a sound way of thinking but you can’t overlook back health.   Your back does require a little maintenance and most people who have had back pain understand.  Your Woodbridge, Dale City VA Chiropractor has a few tips to help you have a healthy back.

A healthy spine is an often overlooked and essential part of a healthy lifestyle. People who suffer from back pain, particularly if it is long-term, are generally less healthy than those who do not. In fact, back pain costs are staggering not only financially, but also in terms of lost time from work and because of psychosocial problems that arise during the healing process associated with long-term back pain.

Unfortunately, approximately 80-90% of the population suffers from spinal pain at some point. People who are overweight or obese, and who smoke, lift heavy objects, or had a previous episode of back pain, are more likely to experience back pain.

Because so many people suffer from spine pain, it’s important for you to try to keep your spine as healthy as possible. Following simple posture, lifting, and healthy lifestyle guidelines can help you keep your back in good shape.

 

The American Chiropractic Association recommends the following spinal health tips:

 

Standing

When standing, keep one foot slightly in front of the other, with your knees slightly bent. This position helps to take the pressure off your low back.

Do not stand bent forward at the waist for prolonged periods of time. The muscles in your low back become deconditioned in this position, which may lead to pain.

Lifting

At all times, avoid twisting while lifting. Twisting is one of the most dangerous movements for your spine, especially while lifting.

If the item is too heavy to lift, pushing it is easier on your back than pulling it. Whenever possible, use your legs, not your back or upper body, to push the item.

If you must lift a heavy item, get someone to help you.

Sitting

Keep your knees slightly higher than your hips, with your head up and back straight.

Avoid rolling your shoulders forward (slouching).

Try to maintain the natural curve in your low back.

Reaching and Bending

When reaching for something above shoulder level, stand on a stool. Straining to reach such objects may not only hurt your mid-back and neck, but it can also bring on shoulder problems.

Do NOT bend over at the waist to pick up items from the floor or a table.

Instead, kneel down on one knee, as close as possible to the item you are lifting, with the other foot flat on the floor and pick the item up.

Or bend at the knees, keep the item close to your body, and lift with your legs, not your back.

Carrying

When carrying objects, particularly if they are heavy, keep them as close to your body as possible.

Carrying two small objects—one in each hand—is often easier to handle than one large one.

Healthy Diet and Exercise

While the proverbial jury is still out, we suspect that extra weight puts undue strain on your spine. Keep within 10 lbs. of your ideal weight for a healthier back.

“Beer belly” is likely the worst culprit, as it puts unwanted pressure on the muscles, ligaments and tendons in your low back.

The most efficient and effective way to reduce weight is by eating a sensible diet and exercising regularly.

Consult with your doctor before beginning any exercise program, particularly if you have a health condition.

Sleeping

Sleeping on your back puts approximately 50 pounds of pressure on your spine. Other positions may be better.

Placing a pillow under your knees while lying on your back cuts the pressure on your spine roughly in half.

Lying on your side with a pillow between your knees may also reduce the pressure on your back.

Never sleep in a position that causes a portion of your spine to hurt. Most often, your body will tell you what position is best.

Quit Smoking

Smokers have more spine pain than nonsmokers, and they also heal more slowly when they have an episode of back pain because the chemicals in tobacco smoke restrict the flow of blood to the tissues in and around your spine.

 

While following these instructions is no guarantee that you’ll be free from back pain for your entire life, it can certainly reduce your risk of developing it. These simple steps will help you keep your spine in good shape, making you a healthier, happier person.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Time to put your back on ice!

This seems fitting to say with all the snow shoveling and back pain I am seeing… ICE the lower back along the pant line!  Your Woodbridge, Dale City VA Chiropractor has seen a big uptick in low back complaints lately.  I wonder what it could be from?  Ice is a pretty good idea especially if the pain is along your waist.

General comments

Icing may be used along with compression, elevation, bracing, and/or support when treating acute injuries.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can produce a similar effect to icing. However, they may delay healing with acute injuries (like sprains, strains, and fractures). If your doctor recommends medicine, make sure you are aware of the right dosage and when to take it, and if there are any side effects.

The use of ice and heat is just one part of a treatment program. Even if symptoms are relieved, there is usually a need for exercises to restore flexibility and joint motion, strength, general fitness, and sport-specific skills.

 

Basically 2 water to 1 rubbing alcohol!

Use of ice

Effects of ice: Decreases circulation, metabolic activity, and inflammation and numbs the skin.

Benefits of ice: Decreases pain, swelling, inflammation, and muscle spasm/cramping. Best used after exercise or after pain-producing activity.

Risks of ice: Prolonged use can cause frostbite.

Methods for applying cold therapy: Ice packs, ice bath/ice whirlpool, ice massage.

When not to use ice

Immediately before physical activity

If area of icing is numb

When the pain or swelling involves a nerve (such as the ulnar nerve or “funny bone”)

If the athlete has sympathetic dysfunction (an abnormality of nerves that control blood flow and sweat gland activity)

If the athlete has vascular disease (such as poor circulation due to blood loss, blood vessel injury, compartment syndrome, vasculitis, blood clots, or Raynaud disease)

If there is skin compromise (such as an open wound; a wound that has not healed; skin that is stretched, blistered, burned, or thin)

If the athlete has cold hypersensitivity, including cold-induced urticaria (hives from cold)

How long to use ice

Two to 3 times per day (minimum); up to once per hour.

Duration varies with technique; usually 20 to 30 minutes per session. (See “Options for applying ice.”)

Ice may continue to be useful in treatment as long as there is pain, swelling, inflammation, or spasm. There is no need to switch to heat after 48 hours or alternate between ice and heat.

3 options for applying ice

  1. Ice packs are best for icing larger areas of pain, swelling, or spasm (like a swollen knee, deep thigh bruise, muscle strain, shoulder tendonitis, or neck or back spasm).

 

Materials

Small cubes or crushed ice in plastic bag.

Bag of frozen vegetables (such as frozen peas).

Reusable commercial ice pack or circulating “cryocuff” (made specifically for therapeutic icing). Do not use blue ice packs directly on the skin; they are colder than frozen water and can cause frostbite

Method

Place on the affected area for at least 20 minutes per session. Hold in place with a towel, elastic wrap, or shrink-wrap.

 

  1. Ice bath/ice whirlpool is used to reduce swelling in peripheral joints (such as with ankle sprain, wrist sprain, or severe shin splints).

 

Materials

Bucket or tub with mixture of ice and water

Method

Immerse affected area for 20 to 30 minutes per session. Do not use an ice bath if there is an open wound, bleeding, or a skin infection.

 

  1. Ice massage is used to reduce superficial, well-localized inflammation (for example, tendonitis of the hand, wrist, or elbow; heel or elbow bursitis; ganglion cyst; apophysitis; or irritation of a growth plate).

 

Materials

Ice cube or frozen ice cup (made by freezing water in a paper or Styrofoam cup)

Method

Rub ice in a circular pattern over the affected region for 8 to 10 minutes per session.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Try to remember…

Proper lifting is something we always pretend we do.  In a quick moment you twist, bend, lift and say ouch!  As your Woodbridge, Dale City VA chiropractor I am obligated to tell you how to lift properly but my business relies on you not lifting properly.  Fortunately for me most read this go ohhh yea than bend, twist, lift and say ouch.

Back pain and injuries from improper lifting techniques typically lead to three kinds of injuries to the muscles, vertebral discs, and joints.  Some injuries from incorrect lifting include:

Disc injury

Joint injury

Muscle injury

With improper lifting, you may experience a tear, rupture, or shift out of position of the soft cushions between your vertebrae, called discs.  If this injury does occur, the fibrous rings surrounding the soft leathery discs can bulge and even rupture.  This can cause the dislocated or ruptured disc to press against a nerve, causing pain and numbness to radiate down into you buttocks or leg.

Because of the numerous joints in your spinal column that connect all of the various bony structures, injury may occur.  A joint injury can be caused by a bad lift because it causes excessive strain on your joints, irritating tissue within them, and in some cases, locking them up.  As well, if you change position during a lift, you can place a lot of stress on your lower back muscles.  This added stress can easily strain and injure your back, usually in the form of a small twist or tear of a single muscle or group of muscles.

 

&;

An important rule to remember when lifting is to never bend from your waist and then stand upright to lift an item from the ground.  Keep your back straight and crouch first by bending at the knees or hips.  This all depends on where the item is that you are lifting and allows your arms and shoulder muscles to do the brunt of the lifting, rather than your back.  Some simple lifting techniques include:

Make sure you have a place to put the object you are lifting.

If you need to turn while lifting the object, use your feet to pivot, not your back.

Your leg muscles should be the ones providing the power during your motion to stand erect, not your back.

Keep the object close to your body in order to maximize the use of your arms and shoulder muscles.

Keep your chest forward and bend at your hips, or knees, not your lower back.

When lifting, push your chest out, pointing forward.  Avoid twisting or turning during your lift as this will cause injury.

Lead with your hips, not your shoulders and keep your shoulders in line with your hips.

Don’t lift any objects that are obviously too heavy.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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To brace or not to brace….

Wearing a back brace for a low back injury isn’t always the best thing you can do for yourself.  Some times it can help and lots of times it can cause more problems.  Your Chiropractor in the Woodbridge, Dale City VA area wants to help you better understand when to use a back brace.

So let me give you some background on back braces and do they really help.

The truth is that wearing an elastic or other support around your waist to help your back may be both good and bad.  And whether wearing such a back belt will prevent back problems is controversial.  A new study that found workers who routinely wear these support belts while working at Wal-Mart, were just as likely to injure their backs as those who did not.(1)  However, some previous studies have shown back belts to prevent injuries, such as the UCLA study conducted with Home Depot workers, which found a 1/3 decrease in back injuries due to wearing back belts.(2)

Let’s look at the scientific evidence about whether back belts might help to support the back, whether there are any risks associated with wearing them, and whether such belts should be recommended or not.

How might back belts help to support the back?  They do not hold the back in, as many presume. Back belts function primarily to hold the stomach in, thus increasing intra-abdominal pressure.  This has led some to refer to these belts as abdominal belts rather than as back belts.  But how does increasing intra-abdominal pressure support the spine?  We will briefly review the intra-abdominal balloon theory and a more modern theory.

Intra-Abdominal Balloon Mechanism

It was originally proposed by Bartelink in 1957 that increased intra-abdominal pressure would decrease the compressive load on the spine through the intra-abdominal balloon mechanism.(3)  To begin with, you must think of the abdominal cavity and the abdominal organs as a squishy liquid.  Then realize that the abdominal cavity becomes a closed chamber when we bear down and hold our breath, which we instinctively do when we lift heavy things.  This chamber is closed on the bottom by the anal sphincter and on the top by the diaphragm.  When bearing down, the abdominal contents tend to push outwards.  But if we contract our deep abdominal muscles—the obliques and the transverse abdominus muscles—or we wear a thick belt, the abdominal contents are forced upwards rather than outwards.(4 p.109)  This theoretically provides a decompressive effect on the lumbar spine.  Since the crura of the diaphragm is attached to the first 3 lumbar vertebrae, when the diaphragm is pushed upwards, it exerts a traction force on the lower lumbar spine (L4 and L5).  It was also theorized that since this balloon mechanism makes the spine more rigid, it would decrease the amount of work required of the erector muscles to prevent us from falling forwards.   Kapanji estimated that this abdominal support mechanism acts to reduce compression forces on the L5/S1 disc by 30% and reduces the force required by the erector spinae muscles by 55%. (4, p.198).

But more recent scientific evidence fails to support some of these theoretical assumptions.  Such recent studies reveal that an increase in intra-abdominal pressure actually results in an increase (rather than a decrease) in compressive force on the lower spine.(5,6) And there is no decrease in the amount of work required of the lower back muscles.(7)  However, by stiffening the trunk, increased intra-abdominal pressure may prevent the tissues in the spine from strain or failure from buckling.  Such intra-abdominal pressure may also act to reduce anterior-posterior shear loads.(8)  In other words, support for the spine is provided, without reducing compression to any appreciable degree.

Belts may also help to protect the spine by limiting the range of motion that occurs when bending or twisting, though this effect is less than expected.(9,10)  However, since when the spine bends more, it is more vulnerable to injury, if these belts reduce extreme bending at all, they may be beneficial.

Are there any risks associated with wearing a back belt?

The main risk associated with wearing a back belt is that during the period of wearing it, the supportive spinal muscles—the deep abdominal and back muscles—that normally support your spine will become weaker.  These muscles are less active while your spine is being artificially supported by the belt.  Muscles need to be consistently exercised in order to stay strong.  If these muscles become weaker, when you stop wearing the belt, you may be more likely to hurt your back.  And at least one study seems to suggest this.  In this study, there was an increase in the number and severity of back injuries following a period of belt wearing.(11)

Another risk associated with wearing a back belt is that it causes an increase in both blood pressure and heart rate.(12)  This may pose a problem for those individuals with existing cardiovascular disease or risk factors, such as hypertension.

A third risk associated with wearing a back belt is that workers may be inclined to lift heavier objects while wearing them.  These belts may be giving workers a false sense of security.  This could result in an increased risk of injury.

REFERENCES:

Wassell JT, Gardner LI, Landsittel DP, Johnston JJ, Johnston JM.   A prospective study of back belts for prevention of back pain and injury.  JAMA.  2000; 284(21): 2727-32.

McIntyre DR; Bolte KM; Pope MH. Study provides new evidence of back belts’ effectiveness. Occup Health Saf.  1996; 65(12): 39-41.

Bartelink DL, “The Role of Abdominal Pressure in Relieving Pressure on the Lumbar Intervertebral Discs,” J Bone Joint Surg, (Br) 1957, 39B: 718-725.

Kapanji, IA. The Physiology of the Joints, Vol. III.

McGill SM, Norman RW.  Reassessment of the role of intra-abdominal pressure in spinal compression.    Ergonomics. 1987; 30: 1565-1588.

Nachemson AL, Anderson GBJ, Schultz AB. Valsalva maneuver biomechanics. Effects on lumbar spine trunk loads  of elevated intrabdominal pressures. Spine. 1986; 11: 476-479.

McGill S, Norman RW, Sharatt MT. The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics. 1990; 33:147-160.

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Hurts to breath!

Back pain around the shoulder blades can be muscular but it can also be a rib subluxation.  Also known as a popped rib!  It sounds horrible but it is very common and your Woodbridge, Dale City VA Chiropractor has seen quite a few.

1  Moist Heat, One of the biggest complaints, when a rib is out, is muscle spasming. Heat will help you endure a muscle spasm. There is a caveat, however. Heat brings blood to an area and it can help with lactic acid build up as well.

2  Massage, but be careful. As mentioned, muscles are often tight when a rib is not functioning properly. massage can really help to calm down the muscles. Here again, a word of warning. Often times, the person giving the massage will feel a good sized bump and mistake what is really the head of the rib for a muscle knot. Rubbing this bump will not only be painful but can increase symptoms. Working on the areas around it can be quite helpful. Massaging after the rib is moving again is great.

3  TENS or Electric Stimulation. A great, non-drug option for killing a spasm and managing pain is to use e-stim, TENS or something similar. These are basically devices that send electrical pulses through wires and patches over muscles.

4  Get it adjusted! At the end of the day, until the rib starts moving properly it will cause problems. Not all chiropractors are great at adjusting ribs as they can be difficult. Likewise, you really need to have the specific rib adjusted and not just do a general spine adjustment. Even after you get it adjusted it may still feel out. Remember that the muscles have most likely tightened around it and formed a knot. Symptoms can take a while to settle down.

5  Mind your posture and quit trying to stretch it. Typically, ribs go out because of a forward head and shoulder posture. So, why do we always try and stretch that same way to get it to feel better? Likewise, stretching spasming muscles does not really work. It drives me crazy when I adjust a rib and the first things my patient does is check to see if stretching forward still hurts. That is like separating a wound to see if it has healed yet. If you keep doing it, it will never heal. Instead, look straight ahead and pull your shoulder blades down and back. Here is the vintage YouTube video I created to demonstrate. If you do this exercise and it is still really painful, chances are the rib is out again.

Ribs can definitely be tricky. Sometimes they stay in after one adjustment and sometimes they take several adjustments. Usually, the longer it is out the more adjustments it will take. The rib joints at the front where it connects to the sternum can go out, too. These are also very painful and can be adjusted, although it is a different method. Please remember that although rib pain is brutal, it is not that damaging. Stressing about it will only complicate the healing process. If you have pain to one side of the spine by the shoulder blades, in the front next to the sternum, radiating along the ribs, or all of the above, just come in and we can either help you or, at least, point you in the proper directions.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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