Simon Spine Blog

NBA Coach Sidelined with Back Injury

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Wondering why Steve Kerr, head coach of the Warriors is on the Injured Reserve? Steve Kerr missed the last 2 games of the 1st round due to health concerns involving his back. Following the 2014-2015 season Kerr underwent back surgery, which led to a series of documented complications. He missed most of the 2015-2016 season due to complications stemming from cerebrospinal fluid that arose following the surgery. He is now reporting that symptoms with his low back have made it difficult to remain on the sidelines, resulting in more missed time this season.

Discussions of spinal surgeries occur numerous times a day. The message we want everyone to understand is- when dealing with back pain, there is no “silver-bullet” cure or treatment. We typically find that with any painful condition of the back, there is an underlying bio-mechanical issue that needs to be addressed. Patients will typically experience numerous flare-ups or periods of pain, until the mechanical issues are addressed. Understanding that the condition will not resolve overnight and sticking to a program is important, and that the program will at times be lengthy. Re-operation rates for back surgeries are staggering. – Some of these surgeries include- discectomy, microdiscectomy, laminectomy, and fusions. This makes it difficult to ensure complete pain relief or improved function following these types of interventions. The successful surgeries are typically followed up with an appropriate rehabilitation program with corrective stretches and exercises. Understanding that there are conservative options like chiropractic and rehabilitation is important.

Kerr has advice for those even thinking about having back surgery. “I can tell you if you’re listening out there, if you have a back problem, stay away from surgery. I can say that from the bottom of my heart,” he said.

Tips, when contemplating back surgery…

1) Conservative measures should be attempted as first line measures. (Chiropractic, Rehabilitation, Acupuncture, and other alternative therapies)

2) Lifestyle changes should be assessed and addressed if need be- Diet (non-inflammatory), weight management, activity level, stress management.

3) Utilizing a medical intervention, such as medication or injections, to reduce pain may be used in conjunction with chiropractic or rehabilitation if pain levels are severe. It is important to understand that these interventions are addressing symptoms that prohibit the bio-mechanical correction.

http://abc7news.com/…/warriors-coach-steve-kerr-ad…/1912051/

 

Chronic Pain , There Is A Safer Solution

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What is Chronic Pain

Chronic pain is defined as any pain that lasts longer than 3 months, or pain that persists longer than the typical time for tissue healing to take place. Chronic pain is unfortunately a major concern to our society. It is constantly being researched for an understanding of why it exists, how it develops, and solutions to this problem. Chronic pain is one of the highest reasons for diminished quality of life and disability in America.

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Many chronic pain situations stem from underlying musculoskeletal conditions. The National Center for Health Statistics reported in 2012, that musculoskeletal conditions were the highest reported chronic medical condition in the adult population (54% of all reporting adults, 2nd was circulatory conditions at 31%). Opioids and other pharmacological solutions are being replaced by complementary and alternative therapies as first line treatment options. Opioid and pharmacological therapies have proven to be effective in reducing pain in the short term, however they have very little long term effectiveness or improvement in functional capacity. There has also been a strong concern for dependence and risk for harmful effects associated with using opioids and similar drugs.

If you are dealing with chronic pain, it is important to understand your options and individualized benefit-risk assessment of any therapy you and your doctor decide on.

The Safer Solution

The CDC, FDA, and even the Institute of Medicine have called for safer solutions than prescribing opioids in addressing chronic pain. Here is a scary statistic- overdose deaths of opioid drugs have quadrupled since 1999, and sales of these drugs have seen an paralleled upward trends in that time. Also, 18 billion is the estimated dollar figure costs to American employers from opioid abuse. This is seen in lost productivity, sick days, and medical expenses. Not only are opioids potentially harmful for the patient, but they are also a major burden on society.

New clinical guidelines throughout the medical community are focusing on non-pharmacological options in dealing with chronic pain. Chiropractic care is one of the most utilized alternative care options in the United States. Chiropractic is a hands-on approach at restoring optimal function of the musculoskeletal system. Research has found that acute and chronic chiropractic patients report better outcomes in pain, disability, satisfaction of care, as well as better cost-effectiveness in treatment plans.

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Chiropractic has shown evidence in avoidance in surgery. A study conducted by the Journal Spine reported that roughly 42% of patient who first saw a surgeon had surgery, as opposed to only 1.5% of patients who were first seen by a chiropractor for similar conditions. The results indicated savings in costs to the patients and superior outcomes. Another study of Blue Cross Blue Shield insured patients with low back pain saved around 40% in health care costs if they saw a chiropractor, compared to patients who saw their primary care doctors.

Put out the Fire, instead of turning off the smoke detector

All though we all know how annoying smoke detectors may be at times, we understand their value. A smoke detector does just that-detects smoke. It does not find or detect fire. In a scenario where your are alarmed by a smoke detector you have 2 options- 1. Turn off the smoke detector(s) OR 2. Find the fire. If you were to just shut off the smoke detector, you would neglect the underlying issue and the fire would grow and grow. Pain is very similar to the smoke detector. Pain is the signal that something is wrong and there is potential injury occurring somewhere in our body. Opioid and pharmacological solutions to pain are similar to turning off the smoke detectors, without putting out the fire. They are effective in the short term, with getting rid of the pain (AKA, the annoying beeping of a detector), but they do not address the underlying issue. Chiropractic care has proven effective at addressing the root of musculoskeletal problems.

 

 

 

Position of Sleep Influences Your Pain and Performance

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A question that has been asked a lot recently is- “Can my sleeping position be causing my pain/performance?” Let me start by stating that sleep is an important facet for both, the person in pain and the athlete. There are important biological processes that occur through sleep. For people in pain, sleep may be the time that the body is able to spend resources on driving down the inflammation process and promote the healing process. For athletes, sleep is required for recovery to take place and prepare the body for the next practice or competition. With that said, sleeping positions could potentially affect pain and performance in a number of ways and we will discuss both scenarios.

Here is a glimpse of some different sleeping positions… take some time and mark off which ones you frequently find yourself in.

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Facts on ZZZZZ

  • The average person sleeps 6-8 hours a night
  • Melatonin has been shown to shorten the time it takes to get to sleep, as well as reduce the number of awakenings.
  • The average person will spend 1/3 of their lifetime sleeping. That is roughly 25 years or just under 230,000 hours.
  • Each person may experience multiple instances of REM (rapid eye movement) throughout the night. Typically each REM stage increases in duration through the night.

 

Sleeping positions with pain

In any injury an important part of healing is reducing the stress placed on the injured tissue. Your sleeping position could be aggravating your injury by placing undue stress on the area of complaint. Here is a quick example, the picture below shows someone sleeping on their stomach. Many low back injuries occur due to over extending the low back. We would want to avoid anything that created significant extension or increased rounding to the low back. Sleeping belly down may be detrimental to your healing low back, straining the area. It is important to understand if your sleeping position alleviates or aggravates the injury.

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The Athlete

Position of sleep can lead to different problems that can affect performance. Posture is the position of which the body is held at any given moment. Sleep happens to be one of the longest sustained postures assumed throughout life. Holding sustained postures for extended periods of time your body will adapt to those positions. The adaptations may be muscle shortening/lengthening, muscle imbalances, or changes in range of motion. Lets look at a popular position…(Picture below)

The thing that sticks out is the position of the left leg, which is in a position of hip flexion. This is going to cause shortening of the left hip flexor muscles. Muscles have certain length and tension relationships, a shortened muscle has more tension. Increased tension leads to the muscles functioning on a sub-optimal level. Runners sometimes state that one hip feels tighter than the other. They may even complain that stretching never helps. After some digging, it becomes evident that they happen to be sleeping in this position or something similar.

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Tips for optimizing your positions

  • Attempt to maintain a neutral spine. Eliminate exaggerated bends in our neck or low back.
  • If you sleep on your side, try to stack a pillow or blanket between your legs. This will support your pelvis and spine.
  • Firmer mattresses are typically more supportive for your spine
  • Avoid dramatically asymmetrical positions ( i.e. one leg up, always looking to the right, constantly waking up with your left arm under your pillow etc.)

 

 

 

 

 

 

 

 

The Pain Cycle

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Majority of the people we see, come to us for help with some sort of pain. The brutal truth is, virtually everyone, at some point in their lifetime will experience pain. It is not a matter of IF, but WHEN. Also, understand that feeling pain is a good thing, it is a warning from our body requesting change. When we are in pain, there is a very predictable cycle, that we believe is beneficial for you to understand. This also may help you understand why we may be doing a certain therapies, like- spinal adjustment, exercise, or manual therapy. Hopefully this will give you a better understanding of pain, and what our body is going through during the process.

For the most part we deal with conditions or pain occurring with the musculoskeletal system. That means pain with the muscles, joints, tendons, ligaments, or peripheral nerves. No matter what may be driving the pain, everyone will go through a very similar experience. Let us take a look at exhibit A, the Musculoskeletal Pain Cycle…..

This pain cycle is, for the most part, a perpetual cycle…meaning until something is addressed it will continue. Our goal, as chiropractors, is to intervene and break the cycle at one or many of the stages. Let’s go through each stage and what exactly is occurring for a greater understanding.

We will begin with pain, because typically that is why people come to us in the first place. Pain may develop for a multitude of reasons- trauma (we rolled our ankle stepping off a curb), posture (yes, sitting at a desk 8 hours daily can lead to some pain), overuse (not giving your body adequate rest), or many other reasons. Pain is a noxious stimuli, meaning it is a warning signal from our body telling us something we are doing is creating actual damage or potential damage somewhere in the body.

Pain leads to voluntary muscle contractions. These contractions result in compensatory movements, unnatural movements with the hopes of preventing further injury. Whether that is bracing, limping, avoiding certain movements, we just move differently when in pain. Typically we see the voluntary contraction around the site of pain.

One result of extended time under voluntary muscular contraction is a decrease in local blood flow. There is circulatory retention (poor circulation of blood) when muscles stay contracted for a prolonged period. If you think of blood as your body’s grocery store, which supplies our tissues with oxygen and nutrients to ensure optimal function, a lack of blood flow can be detrimental. This could lead to diminished healing or extended healing times.

Over time  involuntary muscular contractions develop. Meaning the muscles will be in a shortened state with increased tension. “I carry my stress in my shoulders”, everyone knows this feeling. The muscles that just feel tight, and seem to not let up, no matter how much we stretch them.

The involuntary muscular contraction leads to a disruption in the normal resting tension and length of our muscles.  These muscles will no longer function properly and will result in reduced range of motion or restricted movement. 

The culmination of everything prior will lead to dysfunctional movement patterns. Not only does this affect the primary issue but this may also lead to potential injury elsewhere.

Like mentioned earlier this is a perpetual cycle and will continue until it is addressed. Our goal is to help break this cycle with a variety of methods. To see some of these methods, feel free to visit our services tab located at the home page. If you have any questions, feel free to call the office.

 

 

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How To Be Smart With Your 2017 Exercise Program

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With the 2017 new year approaching, there are sure to be a few new year resolutions. The beginning of the year is a very popular time to start a new exercise program. This however, is a time where we see many many exercise related injuries due to inappropriate planning and execution of our new routines. Hopefully we can give you a few tips, to jump start your exercise in 2017, all while staying healthy and injury- free.

When starting new exercise programs, three things should come to mind: frequency, duration, and intensity. There should be consideration of each of these qualities of exercise and we should be mindful of how they are implemented, and increased throughout our programming. We will discuss what each of these qualities are and how to appropriately increase them, to avoid increasing our risk of injury. We will teach you the “RAMP” method, that can be utilized for all of the exercise qualities.

A “RAMP” protocol, is a gradual increase in any of the qualities of exercise (frequency, duration, and intensity). We should increase frequency, then duration, and lastly intensity. WE will discuss what each of these mean next.

Frequency- this is how often we are exercising. How many days of the week do we perform physical activity. For health benefits we should be exercising on most days of the week. However, if we are just beginning a new routine, it would be ill advised to begin exercising this much. We want to give our bodies time to respond and adapt to the stress that comes with exercise. There is an increase in risk of injury by not allowing our body appropriate rest. A good goal is to begin at 2-3 days per week. These days should be separated with at least one rest day between. If we do not experience any adverse symptoms (anything beyond typical soreness related to exercise), then we can safely increase our frequency. Add 1 day every 2 weeks, until we are at our desired days of exercise (most days of the week).

Duration- this is the length of our exercise bout. For health benefits we should be exercising at least 30 minutes a day. An old school of thought use to be, this needed to be continuous exercise lasting 30 minutes. Recent research has shown that this exercise does not need to be continuous to reek benefits. For example, 3 bouts of 10 minutes of exercise may be equally as beneficial as 1 bout of 30 minutes. This will provide you with options on how to begin a routine. Once again, we should take a RAMP approach (gradual increase) to increasing our duration to minimize risk of injury. A good rule of thumb is to increase duration 10-20% every 2 weeks. For example if we begin at 20 minute bouts, we will increase to approximately 25 minutes after 2 weeks (using 20% increase).

Intensity- this is how hard we are working or how much energy we are using to complete our task. The intensity at which you exercise is an important factor, and can determine many of the physiological effects that result from exercise (one of which being what you burn for fuel, fat or carbs). There are three intensity levels we can work at- light (30-50%), moderate (50-70%),  or high/vigorous (above 70%). Here are two simple ways to gauge our exercise intensity, heart rate and rate of perceived exertion or RPE. With the heart rate measurement we first need to obtain our maximum heart rate. A good way to estimate this is by subtracting our age from 220. For example,  for a 30 year-old, the estimated maximum heart rate would be (220-30=) 190 beats per minute. SO when using heart rate as our measure, you will determine the intensity by the measuring what your heart rate is during exercise. Using the same 30 year old, exercising at a moderate intensity level his heart rate should be between 90-126 beats per minute.  The other way to gauge intensity is using RPE, which there are multiple scales that can be found online. We believe the 1-10 scale is easiest to use, 1 being very light activity and 10 being maximal effort. Exercising at a moderate intensity levels most days of the week is ideal for health benefits.

Keeping these simple things in mind when designing your new program, may be the keys to keeping you pain free. Injuries can derail your new goals and keep you from the gym for weeks at a time. Be smart about how you go in to 2017, and your new exercise routine.

 

Program tips

-Do not drastically increase any of the three modes (every 2 weeks adjust one of the three). Use the RAMP protocol, of gradual increases.

-Adjust frequency, duration, then intensity. (in this order, for safe transitions)

-If there is an increase in intensity, there will be more rest required.

-Longer exercises (higher duration) can ideally be coupled with lower intensity. On the flip side- higher intensity exercises, can be of shorter duration.

-Have FUN. The most important aspect of attaining a sustainable exercise plan is finding something you like. Find something that increases your heart rate and allows you to break a sweat.

-KISS- Keep It Simple… Silly.

If you need help with any exercise program design, feel free to ask us. If you are experiencing any pain, let us help you, so that you can be sure to kick off 2017 with your best foot forward.

 

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Call to schedule an appointment at either our Sugar Land or Clear Lake office,  832-886-4054

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To Sit, or to Stand

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This year, there has been a lot of debate on whether to sit, stand, kneel, or rub your head while patting your stomach. Due to American’s extended work weeks and technological advances, our need to stand up and move has significantly decreased. You may have even heard’ “sitting is the new smoking.”

We are starting to see the impact that a sedentary lifestyle has on an individual and society as a whole. The American Medical Association agrees that prolonged periods of sitting have significant adverse effects on personal health.

 

Here are some statistics…

-Over 66% of American adults are either overweight or obese

-5 of the top 10 leading causes of death in America are associated with obesity

-Obesity is directly linked to arthritis and other musculoskeletal conditions

-Estimated annual cost associated with obesity is over $125 billion dollars

-Average American work week is 35-40 hours (much of this time is spent sitting @ the desk)

-Sedentary individuals who spend at least 8 hours a day sitting are more than 50% more likely to die in the next 10 years, compared to their active counterparts. (60-75 minutes of moderate exercise most days of the week).

 

So obviously there is a simple solution for the desk jockeys… STAND UP! One new trend is the standing work station. However, we should not neglect the fact that a reason we transitioned to desk, was due to long periods of standing (seen in the industrial era). A good take home point is this, too much of anything can be bad. Long periods of sustained posture can create many different postural imbalances that can lead to pain and injury. Bob Marley said it best, “Get up, stand up…”

 

Some tips to stand more throughout the day…

-take the stairs

-park in the back of the lot (this could avoid nasty door ding too)

-stand while on the phone

-while at work, take frequent water and restroom break (you can tackle hydration, two birds one stone)

 

 

Call us to schedule an appointment, or for an assessment of your work station

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Who RUNS the world?

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While Beyonce made her quick run through Houston this past week for her Formation Tour, many of our friends and patients are gearing up for another running season. At Simon Spine, we love helping our runners reach their individual goals. Whether you are a weekend fun-runner or ultra-marathoner, we truly enjoy seeing you reach your goals.

 

Training for races can be a long grueling process that begins months prior to race day. The key to breaking a personal record is being able to sustain your training regimen. Injury can be a huge set back, possibly sidelining you for weeks at a time.

 

Some of the most prominent injuries we see associated with runners, in no particular order….

-Plantar fasciitis

-Shin splints (medial tibial stress syndrome)

-Achilles tendonitis

-Stress fracture

-IT band syndrome

-Patelofemoral pain sundrome , classic knee pain

 

Each of these conditions can disrupt you training and prevent you from hitting the road throughout the week. The good news, is we can help! Each condition is managed very differently, and two people with the same condition may need two different treatment plans.

 

Here are some helpful training tips to prevent injury…

RECOVER!!! Recovery may be the most important aspect to your training.

-Nutrition and hydration. Make sure your diet and water intake support your training needs. (We can help  individualize a plan for you)

-Mix in strength/ resistance training days. Resistance training will help with injury prevention, and make you a stronger and more efficient runner.

-Intensity and frequency (miles per week and time of run) should be progressively increased. This allows for your muscles, ligament, tendons and joints to adapt to the new stress. A good goal is to increase 10% every 1-2 weeks.

 

We have many methods for supporting your recovery needs. Our Recovery Boots and Gameready Unit are just two ways we can help you get from one training session to the next.

 

This running season, we are offering one FREE 15 minute Recovery Boot session. All you need to do is call in, schedule an appointment, and bring in your medal from your most recent race. Let us know the any other ways we can help support your training this season (nutrition, programming, etc.).

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If you are experiencing any pain during or after training periods, or have dealt with any of the conditions mentioned above, give us a call and schedule an appointment. We want to see you PR your next race.

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You can lead a horse to water…

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You have probably heard the saying, but we will go ahead and finish it… “but you can’t make it drink”. Unfortunately, the same could be said with the general population. Reports have stated that possibly 75% of Americans may suffer from chronic dehydration.

 

Water is the most important nutrient to our bodies daily function. Did you know, that you can live up to 2-4 weeks without eating food? While death from dehydration only takes 3-4 days.

 

Functions of water…

-Bathes our cells and tissues

-Helps remove waste in our body

-Drives metabolic reactions that give us energy

-Regulates body temperature (which happens to be rather important in Houston)

-Marco polo, cannon balls, and the Frio river all depend on it.

 

Water is extremely important to our physiological function on a day to day basis. Unfortunately, many of the beverages we consume can have a negative effect on hydration. Some of them have a diuretic effect, meaning they force you to loose more water, which contributes to our chronic dehydration. While fall is upon us, and the temperature is slowly beginning to drop, try not and forget about your hydration needs.

 

Problems associated with dehydration…(far from an all-inclusive list)

-Headaches

-Muscle cramps

-Delayed healing

-Decreased mental acuity and focus

-Irritability

 

Tips to increase your water intake…

-Leave a glass of water bedside, and finish it before you get up in the morning

-Purchase a reusable bottle that you keep with you, and keep filled

-Consume 8-10 eight ounce cups of water a day

-For ever caffeinated drink, consume 2 eight ounce glasses of water

 

Water intake requirements vary from person to person. Also, there is such thing as TOO MUCH water. If you have any questions on your individual hydration needs, feel free to contact the office and schedule an appointment.

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