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ARE YOU SITTING YOURSELF TO DEATH?

How a Sedentary Lifestyle is taking its toll on your body

Sitting Disease is a modern day health epidemic associated with prolonged sitting in poor posture.  If this sounds like you, then you could be suffering. 

You sit at a desk all day at work, then you go home from a long workday and check your social media and watch TV.  After watching a couple of shows you go to bed and repeat the same sedentary behaviors tomorrow.  You end up sitting 8-12 hours per day, and sleeping another 8.  Resulting in 16-20 hours of inactivity. 

Before you know it you have gained weight, you feel exhausted after a day at work, your back hurts, and you can see your health diminishing right before your eyes.  You want to make changes, you wish you could be more active, but your job requires you to work at a desk.  So you keep sitting yourself sick. 

Did you know that prolonged sitting in poor posture predisposes you to depression, neck and back pain, obesity, chronic disease?  Men and women who sit more than 6 hours per day are more likely to more chronic health issues than active individuals.   

If your job requires you to be seated, don’t worry, there is a solution to overcome Sitting Disease that doesn’t require you to quit your job.             

The Postural Ergonomic Solution

Postural Ergonomics is the solution to synergistically transform your workplace and your health.  The purpose of Postural Ergonomics is to improve your function, posture, and cognition within your workplace so you can be more active and productive while taking care of your body. 

Postural Ergonomics will take care of you in your workplace with your unique needs.  You can schedule a consultation at Pain-Free Me Studio, or we can come to you and perform an On-Site Ergonomic Evaluation in your workplace. As we follow social distancing guidelines. If you prefer to have a Virtual Workspace Assessment performed, this can also be arranged.

Posture is declining at the speed of technology and modern day workers are getting fat faster and sicker quicker.  If you don’t take an active stand for your health, then no one else will. We have designed solutions to help you overcome Sitting Disease.   

Find the solution that is best for you and your business by contacting Michael Jones, MS, Certified Ergonomist, and an expert in Postural Ergonomics. 

Have a Pain-Free Day,

Michael Jones, MS, CErg

www.mikejonestoday.com

painfreeme2017@gmail.com

What is Scoliosis?

Scoliosis is an abnormal sideways curvature of the mid back and/or the lower back.  Most cases of scoliosis arise due to an unknown origin, called idiopathic scoliosis.  Scoliosis impacts females more than males and is most often detected during the growth spurt from ages 10 to 18. 

The incidence of scoliosis varies in different countries and among different references between 2% and 13.6% (Weinstein et al., 2008).  Scoliosis is considered one of the main musculoskeletal changes of adolescence and is the most common spinal disorder in childhood (de Assis et al., 2021).   

Scoliosis is a progressive and deforming musculoskeletal dysfunction of the spine.  If an abnormal curve of the spine is detected, it should be monitored to prevent curve progression.

Adolescent idiopathic scoliosis is found predominantly in adolescent females, with a 10:1 ratio of female to male (Adhoot, Fan, & Aminian, 2021).  Adolescent idiopathic scoliosis is the most common form of scoliosis and is distinguished from other types of scoliosis by the absence of underlying congenital or neuromuscular abnormalities (Kuznia, Hernandez, & Lee, 2020).

Adolescents with scoliosis have the highest risk of curve progression during the period of rapid growth prior to skeletal maturity.  Females should be checked for scoliosis from ages 10 to 12 and males should be checked from ages 13 to 14 (Zapata, Sucato, & Jo, 2019). 

Types of Scoliosis:

• Idiopathic scoliosis = scoliosis that arises due to an unknown cause
• Congenital scoliosis = scoliosis that develops before birth
• Neuromuscular scoliosis = scoliosis caused by a disorder such as cerebral palsy, spina bifida, or muscular dystrophy
• Degenerative scoliosis = scoliosis that develops in the lumbar spine due to “wear and tear” 

Signs of Scoliosis:

• Sideways curvature of the middle or lower back
• One shoulder is higher than the other
• One hip is higher than the other
• One scapula is more prominent than the other

How Scoliosis Can Impact Your Health:

• Aesthetic changes
• Musculoskeletal restrictions
• Back pain
• Severe scoliosis may be associated with respiration dysfunction or heart damage

Risk Factors for Scoliosis

The causes of scoliosis vary and are classified broadly as congenital, neuromuscular, idiopathic, and spinal curvature due to secondary reasons such as degeneration (Janicki & Alman, 2007).  80% of cases of scoliosis in childhood are idiopathic, meaning they arise from an unknown origin (Negrini et al., 2012).

Schoolchildren are more susceptible to scoliosis because they go through a rapid growth phase in adolescence, are sedentary at school, and have a low daily level of physical activity.  Schoolchildren being classified as irregularly active is considered a risk factor for the development of scoliosis (de Assis et al., 2021). 

Contributing factors to Scoliosis: (Karimi & Rabczuk, 2018)

• Genetic predisposition
• Hormonal dysfunction
• Change in bone mineral density
• Abnormal platelet calmodulin levels
• Biomechanical factors
• Central nervous system abnormalities
• Lack of physical exercise
• Poor posture
• Neuromuscular conditions
• Birth defects
• Spinal infection

Potential Complications of Scoliosis:

Not all patients with scoliosis will experience symptoms.  While some people may experience back pain, others may not.

Complications may occur due to severe scoliosis.  With severe scoliosis, it is possible to have rib deformities, pulmonary dysfunction, and even heart problems.  These complications are rare, but they may occur in severe cases.   

Scoliosis Screening

If you think that you or a family member may have scoliosis, you should get it checked sooner rather than later to prevent curve progression.  An initial screen will be performed including a posture analysis and a forward bend test.  The posture analysis and forward bend test will provide initial information to the practitioner that there may be a scoliosis curvature. 

If there is suspicion of scoliosis, your healthcare provider may recommend having an X-ray analysis performed to confirm the diagnosis.  On the radiograph your practitioner will evaluate the Cobb Angle of the curvature.  A Cobb Angle of more than 10 degrees is considered scoliosis.    

A complete analysis will include a case history, physical examination, and radiographs.  Your practitioner will evaluate your spine and check for musculoskeletal restrictions such as decreased range of motion, neurologic symptoms such as poor balance, and functional deficits such as gait abnormalities. 

Treatment Options for Scoliosis

Treatment of scoliosis will vary based upon the severity of the curve.  Curves with a Cobb Angle of 10-39 degrees are considered mild to moderate.  Mild to moderate scoliosis can be managed with conservative care options.   

Conservative care for mild and moderate scoliosis includes physical therapy, manual therapy, posture rehabilitation, physical activity, and posture correction habits for your activities of daily living.   

• Physical Therapy – may include exercises, mobilization and distraction of the spine and joints, whole body vibration, and soft tissue work to improve alignment and manage pain.

• Manual Therapy – spinal manipulation and mobilization to improve alignment and spinal flexibility.

• Posture Rehabilitation – posture exercises to reduce the lateral curvature and to correct other postural distortion patterns associated with the scoliosis.

• Physical Activity – aerobic activity and frequent movement breaks for sedentary occupations and schoolchildren. 

• Posture Correction Habits – auto correction habits to correct your posture and flatten the scoliosis curve during daily activities. 

A brace may be recommended for scoliotic curves greater than 30 degrees. 

Severe scoliosis is a Cobb Angle of 40 degrees of more.  Severe cases of scoliosis should be referred for a surgical consultation.

How Can We Help?

We can help you if you are considering conservative treatment options.  To determine if you are a good candidate for conservative care, we recommend a consultation and a complete posture analysis for specialized patient centered care options. 

After ruling out complications with your physician we can discuss best options based on objective measures.  All new patients are valued, will felt heard, and will have an objective analysis performed prior to discussing treatment options. 

References:

Ahdoot, E. S., Fan, J., & Aminian, A. (2021). Rapid Recovery Pathway for Postoperative Treatment of Adolescent Idiopathic Scoliosis. JAAOS Global Research & Reviews, 5(3).

Burns, K. (2021) Scoliosis, American Posture Institute Blog

de Assis, S. J. C., Sanchis, G. J. B., de Souza, C. G., & Roncalli, A. G. (2021). Influence of physical activity and postural habits in schoolchildren with scoliosis. Archives of Public Health, 79(1), 1-7.

Janicki, J. A., & Alman, B. (2007). Scoliosis: Review of diagnosis and treatment. Paediatrics & child health, 12(9), 771-776.

Karimi, M. T., & Rabczuk, T. (2018). Scoliosis conservative treatment: A review of literature. Journal of craniovertebral junction & spine, 9(1), 3.

Kuznia, A. L., Hernandez, A. K., & Lee, L. U. (2020). Adolescent idiopathic scoliosis: common questions and answers. American family physician, 101(1), 19-23.

Negrini S, Aulisa AG, Aulisa L, et al. (2012) 2011 SOSORT guidelines: orthopedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis. 7 (1):3.

Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA. (2008) Adolescent idiopathic scoliosis. Lancet. 371(9623), p. 1527–1537.

Zapata, K. A., Sucato, D. J., & Jo, C. H. (2019). Physical therapy scoliosis-specific exercises may reduce curve progression in mild adolescent idiopathic scoliosis curves. Pediatric Physical Therapy, 31(3), 280-285.

What is a Concussion?

A concussion is a mild Traumatic Brain Injury (mTBI).  The American Congress of Rehabilitation Medicine (1993) defines mTBI as an “acute brain injury resulting from mechanical energy to the head from external physical forces” (American Congress of Rehabilitation Medicine, 1993). 

Concussions can be caused by physical trauma such as a contact sports injury, a fall, an assault, or car accident.   A concussion occurs from a sudden trauma or blow to the head, in some cases the brain moves within the skull.   

According to the Center for Disease Control, the sudden movement of the head can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells (CDC, 2019).

3.8 million cases of concussion occur each year in the United States, 65% occur in children and adolescents (Faul, Likang, Wald, & Coronado, 2010).  Concussions result in 1.365 million emergency room visits and 275,000 hospitalizations annually with associated direct and indirect costs of $60 billion in the United States (Daneshvar et al., 2011). 

What is Post-Concussion Syndrome?

Post-concussion syndrome is lingering symptoms for weeks or months following a concussion.  Deficits may last up to 6 months.

Post-concussion syndrome is diagnosed by having 3 of the following symptoms after an injury to the head: headache, dizziness, vertigo, fatigue, memory problems, difficulty concentrating, insomnia, irritability, depression, anxiety, personality changes, sensitivity to noise and light (Bowman, 2019).

Patients over 40 years of age are more likely to experience post concussion syndrome.  Prevalence rates of post-concussion symptoms vary between 11-82%, depending on diagnostic criteria (Polinder et al., 2018).

Signs of a Concussion

• Jolt, bump, blow, or trauma to the head
• Loss of consciousness
• Confused after the injury
• “Blacked out” or can’t remember events prior to the injury
• Mood and behavior changes
• Poor balance
• Slow reaction time

How Can a Concussion Impact Your Health? 

• Headaches
• Nausea or vomiting
• Balance problems or dizziness
• Double or blurry vision
• Bothered by light or noise
• Fatigue
• Concentration or memory problems
• Ringing of the ears

Risk Factors for Concussion:

To prevent concussions wear a seat belt while riding in the car and wear a properly fitted helmet while playing sports.  Avoid contact sports such as American football, rugby, hockey, soccer, etc. 

If a concussion does occur, follow your healthcare provider’s advice for a period of initial rest followed by rehabilitation to prevent post-concussion syndrome.    

Potential Complications of a Concussion:

Concussions may be an emergency.  In rare cases a hematoma or bleeding of the brain may occur.  Computerized tomography (CT) scans are specialized imaging to rule out red flags. 

What to Do if You Have a Concussion:

If you think you have had a concussion, consult a specialist right away for a neurological examination.  Try to recall the mechanism of injury and how you felt during and after the injury.  Did you lose consciousness, feel dizziness, or experience nausea?  If the concussion was sports-related, cease playing sports until receiving medical clearance to return to sport.

Your practitioner will monitor your progress.  They will recommend a brief period of physical and cognitive rest before beginning rehabilitation.  Common rehabilitation techniques include neck and upper back treatments, eye movements, and balance training.  

Concussion Assessment:

To assess for a concussion your practitioner will perform a thorough case history and neurological examination.  In some cases specialized brain imaging may be recommended.

Assessment for concussion will include the following components:

• Neck assessment to assess for musculoskeletal dysfunction
• Vestibular assessments to assess your balance and postural stability
• Oculomotor assessments to assess eye movements and postural stability
• Motor function to assess reaction times and motor impairments
• Exertion tolerance to determine tolerance level to exercise

 (Quatman-Yates et al., 2020) 

Treatment Options for Concussion and Post-Concussion Syndrome:

Researchers studied when was the best time to implement physical rehabilitation after a concussive injury.  They mentioned allowing for physical and cognitive rest for 24-48 hours post concussion (Schneider et al., 2017).

Physical therapy is considered feasible and safe even within the first few weeks after injury to help facilitate prompt recovery and prevent the onset of secondary effects from post concussion symptoms (Lennon et al., 2018).

Researchers recommend a multimodal approach that combines balance rehabilitation of the vestibular system, eye movements for rehabilitation of the visual system, and cervical rehabilitation (Grabowski et al., 2017). 

Cervical Manual Therapy

• Research shows that manual therapy and exercise for cervical dysfunction demonstrated clinical and patient-reported benefits (Wong et al., 2021). 

Vestibular Rehabilitation and Vision Therapy

• Vestibular rehabilitation in children with concussion is associated with improvement in symptoms as well as visuovestibular performance.
• Vision therapy had a successful or improved outcome in the vast majority of cases that completed specific eye movements (Gallaway, Scheiman, & Mitchell, 2017).

Neuromotor Retraining

• Manual therapy is recommended to restore cervical spine range of motion, vestibular rehabilitation is recommended to improve gaze stability and visual motion sensitivity, and neuromotor retraining is recommended to improve postural stability and sensory integration (Teare-Ketter, Fiss, & Ebert, 2021).

How Can We Help?

We can help you if you are considering conservative treatment options for concussion or post-concussion syndrome.  To determine if you are a good candidate for conservative care, we recommend a consultation and a complete posture analysis for specialized patient centered care options. 

After ruling out complications with your physician we can discuss best options based on objective measures.  All new patients are valued, will felt heard, and will have an objective analysis performed prior to discussing treatment options. 

We care about you and your health outcomes.

References:

American Congress of Rehabilitation Medicine (ACRM). Definition of mild traumatic brain injury. J Head Trauma Rehabil (1993) 8:86–7.

Bowman, J. (2019) Post-Concussion Syndrome, Healthline

Burns, K. (2021) Concussion and Post-Concussion Syndrome, American Posture Institute Blog

Center for Disease Control and Prevention (2019) Heads Up, Brain Injury Basics, What is a concussion

Daneshvar, D. H., Nowinski, C. J., McKee, A. C., & Cantu, R. C. (2011). The epidemiology of sport-related concussion. Clinics in sports medicine, 30(1), 1-17.

Faul M, Likang X, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths 2002-2006. Atlanta, GA: US Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.

Gallaway, M., Scheiman, M., & Mitchell, G. L. (2017). Vision therapy for post-concussion vision disorders. Optometry and vision science, 94(1), 68-73.

Grabowski P, Wilson J, Walker A, Enz D, Wang S. (2016) Multimodal impairment-based physical therapy for the treatment of patients with post-concussion syndrome: A retrospective analysis on safety and feasibility. Phys Ther Sport. 23:22–30.

Lennon, A., Hugentobler, J. A., Sroka, M. C., Nissen, K. S., Kurowski, B. G., Gagnon, I., & Quatman-Yates, C. (2018). An exploration of the impact of initial timing of physical therapy on safety and outcomes after concussion in adolescents. Journal of neurologic physical therapy: JNPT, 42(3), 123.

Polinder, S., Cnossen, M. C., Real, R. G., Covic, A., Gorbunova, A., Voormolen, D. C., … & Von Steinbuechel, N. (2018). A multidimensional approach to post-concussion symptoms in mild traumatic brain injury. Frontiers in neurology, 9, 1113.

Quatman-Yates, C. C., Hunter-Giordano, A., Shimamura, K. K., Landel, R., Alsalaheen, B. A., Hanke, T. A., … & Silverberg, N. (2020). Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy, American Academy of Sports Physical Therapy, Academy of Neurologic Physical Therapy, and Academy of Pediatric Physical Therapy of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 50(4), CPG1-CPG73.

Schneider, K. J., Leddy, J. J., Guskiewicz, K. M., Seifert, T., McCrea, M., Silverberg, N. D., … & Makdissi, M. (2017). Rest and treatment/rehabilitation following sport-related concussion: a systematic review. British journal of sports medicine, 51(12), 930-934.

Teare-Ketter, A., Fiss, A. L., & Ebert, J. (2021). The utility of neuromotor retraining to augment manual therapy and vestibular rehabilitation in a patient with post-concussion syndrome: a case report. International journal of sports physical therapy, 16(1), 248.

Wong, C. K., Ziaks, L., Vargas, S., DeMattos, T., & Brown, C. (2021). Sequencing and integration of cervical manual therapy and vestibulo-oculomotor therapy for concussion symptoms: retrospective analysis. International journal of sports physical therapy, 16(1), 12.

What is Whiplash?

Whiplash is a soft tissue injury to the neck caused from a sudden extension and flexion of the cervical spine.  It occurs when the soft tissues of the neck, such as the muscles and ligaments, extend beyond their typical range of motion. 

Whiplash is caused by an impact such as an automobile accident.  Whiplash-associated disorder is the most common injury following a motor vehicle collision.  Whiplash injury may also be caused by contact sports or physical assault.

Whiplash-associated disorder is the most common injury following a motor vehicle collision (Teasell et al., 2010).

Neck pain from a whiplash injury occurs in 65% of patients within 6 hours, 93% within 24 hours, and nearly 100% within 72 hours.  Many factors can influence the extent and location of pain, such as the condition of the patient’s neck, the speed, and the direction of impact. 

20% to 50% of people with a whiplash injury report persistent interference in daily life up to 1 year later.  Neck pain from whiplash is associated with disability, decreased quality of life, and psychological distress (Walton & Elliott, 2017). 

Inflammation, decreased range of neck motion, disturbed neuromuscular control, and impaired neck muscle function is associated with whiplash injury.  Impaired muscle function of the neck is important for stability, coordination, and postural control (Peolsson et al., 2017).

Whiplash consists of multiple symptoms after the impact such as a neck sprain or strain, neck pain, decreased cervical range of motion, headaches, and dizziness.  Headaches present as chronic symptoms in 70% of patients (Atesok et al., 2019).

In some severe cases people suffering from whiplash may experience memory loss, paresthesia, sleep disturbances, fatigue, nervousness, blurred vision, or depression (National Institute of Neurological Disorders and Stroke, 2019).

Symptoms of Whiplash

• Neck pain: it is common to experience neck pain, decreased neck range of motion, stiffness, and tenderness
• Shoulder stiffness and tenderness: stiffness and tenderness may also be experienced in your shoulders
• Headaches: headaches are a common side effect of whiplash.  The pain commonly starts in the neck and projects up to the head
• Dizziness: be aware if you experience dizziness and/or instability after the whiplash injury.  Consult a specialist if you experience dizziness
• Tingling of the upper extremity: you may experience pain or abnormal sensation down your arm

How Whiplash Can Impact Your Health

• Abnormal sensation of the upper extremity: persistent pain or abnormal sensation down the arm
• Chronic neck pain: neck pain that persists beyond 6 months after your whiplash injury
• Psychological distress: stress, anxiety, depression, or PTSD associated with the whiplash injury
• Jaw pain: “popping” of the jaw or jaw pain, especially while opening your mouth to chew

Risk Factors for Whiplash

• Motor vehicle accidents
• Sports collisions and trauma

Potential Complications of Whiplash

If you have experienced a whiplash injury, diagnostic imaging after the injury will be performed to rule out red flags such as a spinal fracture.  If you have experienced dizziness, nausea, severe pain, memory loss, or blurred vision be sure to communicate this to your doctor to rule out severe complications of head trauma.  

What to Do if you have Experienced Whiplash

If you have experienced a whiplash injury consult a physician to rule out any emergencies.  

Once you have ruled out severity of injury consider the following treatment options for conservative care.  The purpose of conservative care for whiplash is to manage pain such as neck pain and headaches and to improve function such as an improvement of range of motion of the neck. 

Treatment Options for Whiplash

Recovery time from whiplash will vary from patient to patient.  It may be a few days to several weeks.  Most people will recover fully within 3-months, although some people will experience persistent chronic neck pain (National Institute of Neurological Disorders and Stroke, 2019). 

Continue to monitor how your body is feeling in response to treatment and communicate with your healthcare provider.  If you are experiencing psychological distress consider the importance of seeking advice from a trained psychologist.   

Physical Therapy:
Exercise-based interventions targeted at the cervical spine appear most beneficial for adults with chronic whiplash-associated disorder.  Exercise programs targeting the cervical spine for strength, endurance, flexibility, and postural control appear to be effective in reducing pain and disability (Anderson et al., 2018).

Heat and Ice Therapy:
While working and resting use heat and ice therapy in intervals of 15 minutes.  Ice will help with inflammation and heat will help with muscle tension.  Do not apply heat or ice directly to the skin.  Place a small towel between the heat or cold pack and your skin.

Check Your Posture:
Keep your neck in a neutral posture.  Relax your shoulders and retract your neck back so your ears are aligned over your shoulders.  Keep your eyes up, looking forward.  Avoid looking down for prolonged periods of time, and avoid clenching your jaw or tightening your shoulder muscles.

Chiropractic or Osteopathic Spinal Mobilization:

Mobilization treatments to the cervical spine had a beneficial effect on the physical as well as the mental aspects of late whiplash syndrome.  The outcome measures showed significant relief of neck-related pain and disability and quality of life (Schwerla et al., 2013). 

Acupuncture:

Acupuncture treatment has been associated with significant alleviation of pain and has been shown to be a safe and effective treatment for whiplash-associated disorder (Kwak et al., 2012).

How Can We Help?

We can help you if you are considering conservative treatment options.  To determine if you are a good candidate for conservative care, we recommend a consultation and a complete posture analysis for specialized patient-centered care options. 

After ruling out complications with your physician we can discuss the best options based on objective measures.  All new patients are valued, will felt heard, and will have an objective analysis performed prior to discussing treatment options. 

References:

Anderson, C., Yeung, E., Tong, T., & Reed, N. (2018). A narrative review on cervical interventions in adults with chronic whiplash-associated disorder. BMJ open sport & exercise medicine, 4(1).

Atesok, K., Tanaka, N., Robinson, Y., Pittman, J., & Theiss, S. (2019). Current Best Practices and Emerging Approaches in the Management of Acute Spinal Trauma.

Burns, K. (2021) Whiplash, American Posture Institute Blog

Kwak, H. Y., Kim, J. I., Park, J. M., Lee, S. H., Yu, H. S., Lee, J. D., … & Choi, D. Y. (2012). Acupuncture for Whiplash-associated disorder: a randomized, waiting-list controlled, pilot trial. European Journal of Integrative Medicine, 4(2), e151-e158.

National Institute of Neurological Disorders and Stroke (2019) Whiplash Information Page https://www.ninds.nih.gov/Disorders/All-Disorders/Whiplash-Information-Page

Peolsson, A., Karlsson, A., Ghafouri, B., Ebbers, T., Engström, M., Jönsson, M., … & Peterson, G. (2019). Pathophysiology behind prolonged whiplash associated disorders: study protocol for an experimental study. BMC musculoskeletal disorders, 20(1), 1-9.

Schwerla, F., Kaiser, A. K., Gietz, R., & Kastner, R. (2013). Osteopathic treatment of patients with long-term sequelae of whiplash injury: effect on neck pain disability and quality of life. The Journal of Alternative and Complementary Medicine, 19(6), 543-549.

Teasell, R. W., McClure, J. A., Walton, D., Pretty, J., Salter, K., Meyer, M., … & Death, B. (2010). A research synthesis of therapeutic interventions for whiplash-associated disorder (WAD): part 4–noninvasive interventions for chronic WAD. Pain Research and Management, 15(5), 313-322.

Walton, D. M., & Elliott, J. M. (2017). An integrated model of chronic whiplash-associated disorder. journal of orthopaedic & sports physical therapy, 47(7), 462-471.

 

What is Disc Herniation?

Between each vertebrae of the spine are intervertebral discs, or cushions for support and mobility of the spine.  The intervertebral discs act as shock absorbers for the spine.

The center of the disc, which is a liquid-like substance, is called the nucleus pulposus.  The annulus fibrosus is a fibrous tissue that surrounds the nucleus pulposus.  Disc herniation is a bulging of the nucleus pulposus into the annulus fibrosus of the intervertebral disc.

When the disc herniation pinches the spinal nerve you may experience pain down your leg if the disc herniation is in the lower back, or pain down your arm if the disc herniation is in the neck.

Disc herniation can occur at any spinal level, although it is most common in the lumbar spine, followed by the cervical spine.

The incidence of a herniated disc is about 5 to 20 cases per 1000 adults annually (Dydyk, Massa, & Mesfin, 2020).  Lumbar disc herniation is one of the most common causes of low back pain (Kerr, Zhao, & Lurie, 2015).

The most common levels of disc herniation of the lumbar spine are L4-L5 and L5-S1.  The most common levels of disc herniation of the cervical spine are C5-C6 and C6-C7.

90% of people who experience back pain due to a disc herniation will have a decline in symptoms within 6 weeks.  Herniated discs are more common in people over the age of 30, and are about twice as common in men as they are in women (Institute for Quality and Efficiency in Healthcare, 2020).

Symptoms of Disc Herniation

It is possible to be asymptomatic.  Some people don’t realize they have a disc herniation until symptoms begin or it is identified on specialized imaging.  The symptoms experienced are dependent on where the disc herniation is located, whether it is in the neck or the lower back.

• Neck pain: if the disc herniation is in your neck it can cause neck pain with stiffness, tightness, and decreased range of motion

• Low back pain: if the disc herniation is in your lower back it can cause back pain with stiffness, tightness, and decreased range of motion

• Shooting pain: pain can shoot down your arm or leg. The pain may feel “electric” and go from your neck down your arm or from your back down your leg

• “Pins and Needles”: you may have abnormal sensations such as the feeling of “pins and needles” or numbness in your arm or leg.

How Can Disc Herniation Impact Your Health? 

If left untreated, disc herniation may continue to affect the sensory and/or motor function of your upper or lower extremity.

• Motor Weakness: you may have weakness in your arm or leg that can lead to clumsiness, difficulty performing certain tasks with your upper extremity, or difficulty walking in advanced cases. A decreased motor function can be associated with poor balance and an increased risk of falls.

• Abnormal Sensation: you may have abnormal sensations such as “pins and needles” or numbness in your arm or leg that can get progressively worse. Numbness may impact proprioception and balance.

Risk Factors for Disc Herniation

Disc herniation is caused by “wear and tear” and dehydration of the discs.  “Wear and tear” can be caused by occupational demands such as repetitive lifting, twisting, pushing, pulling, and bending, especially with heavy loads.  The discs may lose their pliability and become dehydrated from smoking and weight gain.

• Occupational Demands: Persons who perform repetitive lifting, twisting, pushing, pulling, and bending, especially with heavy loads are predisposed to disc herniation

• Weight Gain: Obese and overweight persons are more prone to disc herniation due to increased weight on the discs

• Smoking: Persons who smoke may experience “drying” of the disc due to less oxygenation of the intervertebral disc

Potential Complications of Disc Herniation

In rare cases, disc herniation can be an emergency.  If the disc protrudes into the spinal canal restricting the nerves of the cauda equina, the patient may experience bilateral weaknesses, loss of sensation in a saddle anesthesia presentation of the inner thighs and around the rectum, and deficits of function of their bowel and bladder control.

Prevention Strategies

To prevent disc herniation it is important to consider lifestyle factors such as staying active, preventing weight gain, and avoiding smoking.

Also, consider the importance of proper posture and ergonomics in the workplace.  Sit with proper posture and perform occupational tasks such as lifting with proper posture.

Avoid compromised postures, such as sitting for prolonged periods of time with slumped forward posture.  While seated your head should be retracted back so your ears are over your shoulders, your shoulders are pulled back and not slouched forward, your hips are underneath your shoulders, your knees are at a 90-degree angle with your knees over your ankles, and your feet flat on the ground facing forward.

Avoid crossing your legs, slouching your spine, looking down for prolonged periods of time, and shifting your hips forward in your chair.

Avoid lifting heavy objects by bending forward at the waist.  For proper lifting posture, stand close to the item you are lifting, bend with your legs, not from your hips, keep your back straight, and make sure you have proper balance.  Lift the item up straight and do not twist your spine while lifting.  Hold the item close to your body so it is easier to lift.

Treatment Options

Conservative treatments for the management of pain associated with disc herniation may include:

• Postural correction

• Ergonomics

• Chiropractic

• Physical therapy

• Acupuncture

• Yoga

These treatment options are not considered medical advice.  Please consult your physician if you think you are having an emergency and for information regarding medication and surgery.

How We Can Help???

We recommend considering conservative treatment options.  To determine if you are a good candidate for conservative care, we recommend a consultation and a complete posture analysis for specialized patient-centered care options.

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References:

Burns, K. (2020) Disc Herniation and Posture, American Posture Institute Blog

Dydyk, A. M., Massa, R. N., & Mesfin, F. B. (2020). Disc Herniation. StatPearls [Internet].

Kerr, Dana, Wenyan Zhao, and Jon D. Lurie. “What are long-term predictors of outcomes for lumbar disc herniation? A randomized and observational study.” Clinical Orthopaedics and Related Research® 473.6 (2015): 1920-1930.

Slipped Disk: Overview, National Library of Medicine, PubMed Health. 2020.

Institute for Quality and Efficiency in Healthcare.

 

Working from home has forced us to make some pretty abrupt changes in our daily routines. We have the best intentions to meet your daily step goals. It can be harder to do when you’re spending more time in the house. Working from home has increased our risk of sitting disease.  We are sucked into a more sedentary lifestyle when you don’t really have anywhere to go and the couch is literally right there.

 

When you’re spending more time in the house, getting in 10,000 steps can be a bit challenging. These tips and tricks will help get you there.

 

1. Set an alarm to stand up. Because of Covid, we have evolved to be sedentary. Technology has made it all too easy for people to spend their lives moving from car seat to office chair. Standing is Paramount for our health. Standing relieves some of the pressure on the spine. When you sit down your core muscles relax putting all the stress on your (lower) spine, this causes frequent back pain and the so-called ‘Tech Neck’ and ‘ihunch’. Stand as much as you can…whenever you can. Walking, stretching and exercises burns 3-5 times the calories than sitting does.

 

2. Drink more water: Several studies have shown that even mild dehydration in men can lead to increased fatigue and anxiety. It can also negatively affect memory and cognitive performance.  Similarly, other studies showed that slightest dehydration in women can cause decreased concentration, depression, headaches, or migraines. The simplest tip which unfortunately is the least practiced by office workers is keeping body fluids replenished by drinking water regularly to perform better mentally as well as physically. Lastly, you will have to urinate more. Forcing you to get up

3. Alternate your office chair. Sure, your chair should be (for the most part) ergonomically correct. Who’s to say that you have to sit in that chair all day, though? Swap out your chair for an exercise ball that you can use at certain times of your workday instead. You’ll be exercising your core and leg muscles without even realizing it as you work on those expense reports. For an even bigger benefit, take your laptop with you; place it on your kitchen counter (or any other high shelf) and work while standing up.

If you are ready to improve productivity and be more comfortable as you work from home. Shoot me a DM to set up your virtual posture screen. So, we can make your desk more Ergonomically sound.

 

Follow me on Instagram for more posture and ergonomic hacks so you can work comfortably from home.

 

Forward head posture occurs when your neck slants forward, placing your head in front of your shoulders. It’s caused by bad habits, such as spending long periods sitting at your computer or looking down at your cell phone. Forward head posture forces the muscles in your neck and back to work harder to keep your head upright.

When dealing with this “new posture” of today. I treat it similarly to treating whiplash. I address the scales which is a group of muscles located on the side of the neck. Originating from the neck vertebra, they run all the way down to the first rib. The primary purpose of the scalene muscles is to laterally flex the neck (i.e., to tilt your head sideways).

How to perform a Scalene Release
1. Locate your lateral scalene by placing your fingers right above your collarbone, halfway out to your shoulder. There you should feel the muscle attachment of the scalene.
2. Hold down the muscle and bend your head to the opposite side. …
3. Do this combination of movements until you feel the muscle release.

👋🏾Follow me on IG @mikejonestoday for daily fitness, rehab and #selfcare tips!!!

You’ve carried your little one for 9 months. But, 9 months postpartum you are still having trouble losing the excess weight around your core? The answer may be this often ignored condition called, Diastasis Recti.

When you are pregnant, your stomach stretches to accommodate the baby growing inside of you. Your stomach will stretch where there is the least resistance. Which is usually right down the middle.
In some cases, the fitter you were or the harder your abs were before pregnancy, actually can make it more difficult to snap back!

What is Diastasis Recti?

Diastasis (which means separation) recti (outer abdominal muscles) are the separation of the outermost abdominal muscles. When the muscles separate the connective tissue joining this muscle stretches sideways. The job of these muscles (called rectus abdominis) is to support your back and your organs.

100% of moms have some level of Diastasis Recti by the third trimester. Even men can acquire this condition from fad dieting or from performing incorrect weightlifting techniques.

Your chances of ab separation are increased when having a child after age 35, delivering twins/triplets, or have more than one child.

What are some signs of a diastasis?
Feelings of weakness and back pain after pregnancy are common, so diastasis is something that often gets missed

Although diastasis isn’t painful and is not typically obvious until the postpartum period, it can sometimes be detected around the 25-week mark during pregnancy via a physical exam or ultrasound.

Signs during pregnancy is when the belly takes on a cone or dome-shaped look when you activate your abdominal muscles as you’re leaning back on the couch or trying to sit up in bed

Other signs include:
• Weakness in core
• Low back pain
• A bulging belly
• Poor Posture
• Outie belly button
• Constipation
• Half football bulge when bringing the shoulders off the floor
• A belly that gets bigger after eating and at the end of the day
• Urine leaking while laughing or sneezing

A lot of moms say their core feels weak when they go to pick up something like a bag of groceries—it feels like there’s nothing there

Diastasis is not bad—it’s what your body is naturally supposed to do to accommodate the growth of your baby. Postpartum, it’s bringing the abs back together and restoring function in those muscles that are important.

So why should you care if your muscles are separated?
Because separated muscles are weak muscles. Separated muscles cannot do their job of supporting your back and organs. To achieve a strong core, your muscles must be close together. The sideways stretching of the connective tissue causes it to become thinner and weaker.

So, what happens is this weak saran wrap-like connective tissue is NOT effectively supporting your belly button, low back, and organs. They are only supported when the muscles are close together.

What are the effects of a diastasis on the body?
Back pain, abdominal hernias, poor posture, pelvic floor problems, gastrointestinal disturbances like constipation and bloating are all effects of a diastasis.
They occur when the support system for the back and organs are the weak connective tissue instead of the muscles. Most women who have had a baby do have diastasis recti.

Steps for testing

• Lie down on your back with both knees bent
• Place your index and middle finger directly above your belly button.
• Raise your head and shoulders off the supporting surface and feel for any gap or dip under your fingers. Note the width and depth of separation.
• Lower your head and shoulders back to starting position

Repeat this test 1-2 inches below your belly button and about 1-2 inches below your sternum.

Clinically, Diastasis Recti is defined by a separation > 2.5 cm wide, this is about 2 fingers wide. But it is really the depth that indicates how strong your connective tissue is which is what will keep your tummy in.

And the difference in depth when engaged which shows how well your TVAs are firing.

How to heal Diastasis Recti

Don’t freak out if you’re less than eight weeks postpartum—healing takes time. During this period, some women are lucky enough to have what is called a “spontaneous recovery,” meaning the connective tissue linking the large ab muscles knits back together or comes close enough to restore normal core function.

Most women will say, ‘I look like I’m still five months pregnant. I’ve lost my weight, and I’m back in my normal jeans, except for my tummy. Usually, it’s not baby weight. It’s the diastasis.

I’ve known some of my clients to wear corsets to bring the abs back together. Unfortunately, this a short-lived option because you still are not addressing the muscles of the core.

Before you get down on the floor to exercise and do 100 crunches a day. You should know that most common core exercises—crunches, abdominal twists and, when done incorrectly, planks—can all worsen the condition.

The best ab exercises for women with diastasis are the ones that target the deep core stabilizers.

These exercises tend to be low impact exercise that won’t even make you break a sweat. They are just as effective and more beneficial for your condition than you dong a 30min core class at the gym.

Things you should avoid:
Avoid traditional crunches, sit-ups, and planks postpartum until your abdomen is healed from diastasis recti. These exercises can make the condition worse.
• Strenuous exercises where your ab muscles are bulging out
• Holding your baby on one hip, if it’s painful
• Lifting or carrying heavy loads
• Coughing without supporting your ab muscles

If you have any questions please comment below, and if this was useful for you please share this article. Don’t let other mommy’s wonder WHY they can’t regain their flat belly.

It’s never too late to get it looked at. There’s always something you can do!

For more information on how to heal Diastasis Recti visit: www.mikejonestoday.com 

For 30 Day core correcting program: http://www.mikejonestoday.com/coreclass

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“The stretches and exercises Mike taught me has made a huge difference in my low back”
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“I tried this program for the initial 30 days and I was blown away.”
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“I have learned so much about how to take care of my body and live pain free.”
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Always on the go with no gym in sight? Try this exercises to correct posture and give you nice, toned shoulders and arms.

When doing the seated row with a resistance band, it’s important to sit up straight — to get the most benefit from this back strengthening move and to avoid injuring your back.

Step 1

Assume start position as shown by sitting on floor and wrapping tube around feet. Make sure to sit up as straight as possible.

Step 2

Bend at elbows and pull band toward body.
Step 3

Squeeze shoulder blades

Step 4
Return to start position

Lost in the gym and looking for a quick workout routine? Check out: https://www.mikejonestoday.com/fit-functional-challenge/