Plasker Family Chiropractic Blog

Hitting a Home Run for Family Wellness

Chiropractic has been part of our family’s health care since my brother’s seizures were alleviated as a result of chiropractic care.  We visited our chiropractor whenever a member of the family had health concerns, as well as to maintain wellness.  As a result we enjoyed better health than most.

When my brothers or I were not feeling well, my mother’s car made 4 distinct stops along our road to healing.  First, she would take us to our trusted family pediatrician (Dr. Gorelick), then to Uncle Howie’s pharmacy to pick up any prescriptions that needed to be filled. Next, we headed straight to Dr. Ernie’s office to check our spine for subluxations. Immune function can be diminished by spinal misalignments pressuring the body’s nerve system.  Mom knew that removing subluxations with a chiropractic adjustment would boost our bodies healing power. 

After our adjustment we would head home.  If you plotted our course on a map, these 4 stops were a diamond shape, just like a baseball diamond.  This was my Mom’s strategy to hit a home run for our family’s health! 

Today, due to my education and background, my wife and I have chosen a different strategy to hit a home run for wellness.  We get chiropractic checkups regularly because if we can prevent a problem we don’t have to treat it.  Should a challenge arise our health strategy goes in the following order.  Chiropractic first, nutrition and supplementation second, medical treatment last.  Our family has benefited by this strategy.  And utilizing chiropractic first has helped my family tap into the innate healing powers within the human body.  My kids are now grown up and they make there own healthcare choices, but remarkably after a combined 47 years of life our children have only been on medications maybe five or six times.  I am truly proud of my family and the rich health we have enjoyed to date.  We thank God for our blessings and reserve the use of medicine for emergencies that we have thankfully been able to avoid.

In my opinion there is no right or wrong healthcare approach for everyone.  What is most important is that you trust yourself and your practitioner.  If you include chiropractic care in your family’s healing process you will cover all the bases.  This summer, score a home run for your family and have your family’s spines checked.  

On an icy Colorado ski slope in 1986, Jan Patenaude crash-landed after taking a jump. In the tumble, she badly twisted her right knee, rupturing her anterior cruciate ligament (ACL), which runs under the front of the kneecap and provides stability to the joint.

Doctors told her that she had two options: have surgery to rebuild the ligament using tissue from a cadaver — a new and risky option 30 years ago — or strengthen the leg muscles with exercise to support her knee, and live without the ligament. Patenaude chose the latter.

In the years since, her pain has come and gone, but now, for the Hawaii-based dietitian, it’s mostly gone. Patenaude attributes this to exercise and, crucially, joint-friendly foods and supplements.

Twelve years ago, Patenaude decided to try an elimination diet — avoiding certain foods for a set time to watch her body’s reaction. In doing so, she discovered that tomatoes, refined wheat, grapes, soy, and sugar aggravated the pain in her knee. So she stopped eating them altogether.

Around the same time, she started giving glucosamine to her dog in hopes that it would help his aging hips. Within a few weeks, he went from limping to jumping into the back of her truck. So she started taking glucosamine supplements, too, and soon felt the difference.

Patenaude is certainly not alone in her joint troubles, or in seeking an alternative approach to treating her pain. As she and a growing number of joint-pain sufferers are experiencing firsthand, nutrition can play a vital role in alleviating inflammation and managing joint pain.

“Without this diet and glucosamine, my knee would probably be hurting all the time,” says Patenaude, who’s now in her 50s. “I’d probably be on my way to knee-replacement surgery.”

The Inflammatory Response

An estimated 63 million Americans suffer chronic joint pain, aching, or stiffness, according to the Centers for Disease Control and Prevention (CDC). Joint pain from an old injury is common and can lead to arthritis — inflammation in the joints that can in turn cause cartilage to break down. Arthritis can also result from wear and tear over time, which is why so many older people have it: Nearly half of Americans over 65 are afflicted with the disease, the CDC reports.

Include those who suffer from acute joint injuries and the painful swelling associated with autoimmune conditions like rheumatoid arthritis, and you’ve got a whole lot of people in pain, much of it persistent.

A common hallmark of joint pain is chronic inflammation in the joint and the surrounding tissue.

“Inflammation is chemical war on the joints,” says Vonda Wright, MD, an orthopedic surgeon and spokesperson for the American Academy of Orthopaedic Surgeons.

Of course, inflammation is a vital part of good health: It’s the first stage of healing, the result of the immune system defending the body against invaders like bacteria and viruses or repairing damaged tissue. It is also a process that can go awry.

The cells in damaged tissue release a bevy of chemicals to respond to the assault, including prostaglandin, a lipid, and two types of proteins: nuclear factor kappa beta (NF-kB) and cytokines. These substances send signals to the body’s immune system, causing white blood cells to rush to the scene, directly triggering inflammation.

Once a wound has healed, the inflammatory response is supposed to cease. But in the joints, the off switch often doesn’t get hit, leaving residual swelling that wreaks havoc on elbows, ankles, and knees.

“Some tissues, like bones and muscles, heal really well, but joints, for whatever reason, just don’t sometimes,” says Farshid Guilak, PhD, vice chair of orthopedic surgery and director of orthopedic research at Duke University.

With ongoing swelling, joint tissue continuously sends distress signals, one substance cyclically igniting the next. White blood cells attack healthy tissue, changing cartilage from smooth and rubbery to rough and cracked. (Chondrocytes, the cells in cartilage, can even release prostaglandins that tell the immune system to attack that very cartilage.) The continued release of NF-kB, cytokines, and prostaglandins summons yet more white blood cells, which causes further inflammation. Joint experts refer to this process as an “inflammatory cascade.”

Halting this ongoing inflammation is essential not only for relieving pain, but also for protecting joints from further cartilage loss.

While reaching for a bottle of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may be a natural instinct, these meds can trigger a host of problems, including further degradation of the joints over time. (For more on issues with NSAIDs, see “This Is Your Body on Ibuprofen“.)

Adding and Subtracting Foods

On a recent family visit, Patenaude ate pizza and cake at her niece’s birthday party. The next morning her right knee throbbed. “I knew right away I’d eaten my trigger foods,” she says — refined wheat in the crust, plus tomatoes and sugar. So Patenaude went back to fresh produce and wheat-free whole grains, and within a few days the pain was gone.

Physicians and clinicians looking to combat patients’ inflammatory cycles are increasingly prescribing a change in menu.

One of the key ideas behind their recommendations is that the anti-inflammatory properties of many foods — particularly those high in omega-3 fatty acids — may reduce swelling in the joints, easing pain and slowing further cartilage damage.

A 2002 study found that patients with controlled, but active, rheumatoid arthritis who followed a Mediterranean diet (fish, whole grains, fruits, vegetables, healthy fats like olive oil) experienced reduced inflammation and increased physical function.

An often-unintended benefit of modifying your nutrition is weight loss. Keeping off excess pounds is indisputably beneficial for your joints: Obesity is a significant nutritional risk factor in osteoarthritis.

“If you’re overweight, you have at least three times the chance of developing knee osteoarthritis, and up to twice the chance of getting arthritis in your hip,” says Rowland W. Chang, MD, a rheumatologist, epidemiologist, and director of the Institute for Public Health and Medicine at Northwestern University.

Know Your Body

Taking a nutrition-based approach to managing joint health requires a willingness to experiment, as well as a certain amount of patience. The anti-inflammatory compounds in foods occur in lower doses than prescription drugs, so nutritional treatments act more slowly than medications.

“If people take some kind of analgesic, they feel better pretty quickly,” says Leslie Bonci, RD, director of sports nutrition at the University of Pittsburgh Medical Center’s Center for Sports Medicine. “It’s not like that with nutrition. They have to build up to a therapeutic dose in the body — it might take two weeks.”

A nutritional approach also requires a healthy dose of self-awareness. Medical research on the effects of certain foods on joint inflammation specifically — versus on the body globally — is limited and preliminary. (The National Institutes of Health is funding further research into nutritional supplements, but most demonstrated results remain in the lab so far.)

In the meantime, you can start with an elimination diet, keeping a food journal to note when and how things change in your body. (For more on how to do an elimination diet, see “The Institute for Functional Medicine’s Elimination Diet Comprehensive Guide and Food Plan“.)

“It’s most important to pay attention to what you eat and how you feel,” says Chang. Ultimately, it comes down to what works for you.

What to Eat

1. Omega-3 Fatty Acids  “What you want to do is create an anti-inflammatory milieu in the body,” advises orthopedic surgeon Vonda Wright, MD. Omega-3 fatty acids are particularly good for this: They change the fatty-acid composition of cells, tamping down those inflammation-instigating cytokines.

Sources: 

• Coldwater fish, particularly salmon, mackerel, and herring. A good daily dose of omega-3 is 1,000 mg: “That’s equivalent to an iPhone-size piece of fish,” says Leslie Bonci, RD, of the University of Pittsburgh Medical Center.
• Flaxseed oil. This omega-3 is a plant-based alpha-linolenic acid (ALA) that the body must convert to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to reap anti-inflammatory benefits.
  A tablespoon of flaxseed oil delivers 700 mg. Mix into food — or slurp it straight if you’re up for it.
• Eggs and pastured eggs enriched with omega-3s. Hens lay eggs with more of the healthy fatty acid if they’re fed flaxseeds, fish oil, or algae.

2. Sulfur  This naturally occurring mineral is the cellular scaffolding on which connective tissue is built, including cartilage, tendons, and ligaments.

Sources:

• Eggs, poultry, fish, and legumes. These protein-rich foods are good sources of amino acids that contain sulfur.
• Garlic, onions, and leeks. Alliums contain the flavonoid quercetin, an antioxidant with anti-inflammatory properties.
• Cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts. Experts recommend a daily serving of these sulfur-rich veggies.

3. Calcium and Vitamin D  You need calcium for strong bones and teeth, but this mineral also assists in muscular contractions. Without enough calcium, you could be putting yourself at risk for bone loss, diminished bone density, and ultimately osteoporosis. Vitamin D is crucial to your body’s ability to absorb calcium.

Sources:

• Dairy products, including milk, yogurt, and cheese (unless you have a sensitivity or allergy), are rich in calcium. Choose organic to limit your exposure to antibiotics and hormones.
• Collard greens, kale, turnip greens, arugula, and mustard greens. These and other dark leafy greens are packed with calcium.
• Egg yolks, and fatty fish like salmon and mackerel. Complement your calcium intake with these excellent whole-food sources of vitamin D.

4. Anthocyanin  An antioxidant that gives fruits red, blue, and dark-purple hues, anthocyanin has been shown to stop production of cytokines.

Sources:

• Stone fruits such as plums and cherries. Note that sweet cherries contain the powerful pigment, but in lower amounts than their tart cousins. Bonci suggests her patients drink 8 to 16 ounces of tart cherry juice daily in place of other calories, determined by how much pain they’re trying to treat. Since tart cherry juice also contains melatonin, it might cause drowsiness. “You may not want to take it midday right before a big presentation,” she says. “It’s better at the end of the day.”
• Blueberries, strawberries, raspberries, bilberries, cranberries, and black currants. Indulge in these delicious anthocyanin sources to your heart’s — and your joints’ — content.

5. Fiber  Richard Diana, MD, an orthopedic surgeon and clinical instructor at the Yale School of Medicine, recommends eating fiber-rich foods to slow carbohydrate absorption. In Healthy Joints for Life, he explains that fiber helps control blood-sugar levels, which keeps glucose and insulin in check, restraining inflammation.

Sources:

• Whole-kernel grains like oatmeal, brown rice, and quinoa.
• Legumes, including black beans, split peas, and lentils, which contain about eight times more fiber than whole-grain bread.
• Artichokes, green peas, kale, and spinach. As a general rule, the darker the color of the vegetable, the higher the fiber content.

What to Avoid

1. Refined Sugars  Wright advises her patients to stop eating all refined sugars. White sugar and high-fructose corn syrup are found in a wide range of prepackaged foods and drinks. The digestive system breaks down processed sugars into basic sugars, including glucose; in response, the pancreas releases insulin. Glucose is considered an inflammatory agent, and research has shown that high levels kick-start the release of NF-kB and cytokines.

2. Simple Carbs  Bonci recommends being mindful of carb intake and opting for whole-kernel grains. While many fruits and dairy products (like milk) fall into the “simple carb” category, the most problematic are highly processed foods: white bread and white rice, cakes, cookies, crackers, and breakfast cereals. These carbs are “simple” because, unlike fiber, their chemical structure is weak — just one or two sugar molecules. They quickly break down into glucose once ingested. As with refined sugars, this rush of glucose summons the body’s inflammatory response.

3. Unhealthy Fats  While the body needs omega-6 fatty acids, they are beneficial in far smaller amounts than what’s typical in the Western diet. Many omega-6 fatty acids trigger a pro-inflammatory release of cytokines. Partially hydrogenated oils, known as trans fats, can also stoke swelling. A study published in the American Journal of Clinical Nutrition found that the intake of trans fats is positively associated with global inflammation in women. Avoid excess omega-6s by steering clear of refined vegetable oils like soy, corn, safflower, and cottonseed. Bonci advises avoiding commercial fried foods because of the low-quality oils that are typically used. Diana lays out an entire dietary program in Healthy Joints for Life that recommends ditching all prepackaged, processed, and refined foods.

4. Food Sensitivity Triggers  Like Jan Patenaude, many people have “trigger foods” that set off inflammation in their bodies. An elimination diet can help you determine whether certain foods trigger joint pain. Common culprits include gluten and casein (proteins found in wheat and dairy, respectively) and additives like aspartame and MSG.

• "I just get out of bed in the morning with pain, but feel fine by the time I am out of the shower."

• "I can drive to work and not be in pain until I get out of my car and try to stand up, but by the time I walk into the building the pain subsides."

• "When I am at my desk sitting and working I am fine, but if I am there for more than 25 minutes, I have pain when I try to stand." 

• "I have pain daily that is constant, it's not so bad, except for when I drive in my car or sit at my desk for any length of time then the pain becomes sharp and runs down my leg."

Option #1. Go To The ER

PROS:  

1. By going to an emergency facility, you may be able to be seen immediately.

2. You will get an exam and/or diagnostic tests x-ray/MRI to determine if you have any broken bones, torn muscles or ligaments.  

3. There is also the possibility of getting meds or an injection to reduce pain, however very rarely does this give you a solution to your condition.

CONS:  

1. Although you can theoretically be seen right away, emergency rooms often experience very long wait times. One to five hours of waiting is common depending upon the number and seriousness of patients presenting that day.  

2. Generally, you will be referred to another doctor for follow up care.  The doctors in the emergency facility are rarely sports oriented and geared towards moving you towards your goal.  

3. The pain meds will mask the symptoms and not allow you to feel the pain. This creates the possibility of you doing something you would not do if you felt the pain causing more injury to yourself.

Option #2: Visit your GP

PROS:  

1. Generally you can be seen within a short period of time, 1-5 days.  

2. By going to your GP, you get to be seen by a professional that knows you and is familiar with your history.  They can evaluate you to determine if there is any need for emergency care and make the referral for further testing if necessary.

CONS:  

1. Most GP’s are not experts on sports type injuries.  They generally do not treat these conditions and will end up referring you to an orthopedist, to better evaluate your injury.  This can waste more time and more money in your attempt to get back to your training.       

Option #3: Go To an Orthopedist

PROS:  

1. An orthopedist is an expert on broken bones, torn muscles and torn ligaments.  They can reduce fractures and cast them.  They can surgically repair torn ligaments and tendons if necessary.  

2. Often if this is not the case, and there is a strain, sprain, and/or change in function, they will recommend PT or Chiropractic.

CONS:  

1. Because they are experts at severe injuries like broken bones, torn ligaments or muscles they use immobilization as care.  They are not experts on the structural function aspects of these injuries, unless you go to a sports orthopedist.  Those that are sports oriented have a PT or Chiropractor that they will refer you to for follow up care.

Option #4: Go To a Sport Centered Chiropractor

PROS:  

1. Generally you can go to a chiropractor to be evaluated within 24 hours.  

2. Most offices have x-ray equipment to rule out fracture and can assess the structure and integrity of the affected area.  

3. If you go to a sports oriented chiropractor they can determine the extent of your injury, and often find out what caused the injury to occur by assessing your structure and function.

CONS:  

1. Full permanent casting does not happen at a chiropractic office.  

2. As a profession chiropractic chooses not to prescribe medication.  Meds are mostly viewed as a vehicle to cover up symptoms and not as a fix of the problem.  If the check engine light went on in your car, taking meds is like covering the light with tape.  If you continued to drive the car, there is a great chance you will damage the engine more.  What do you think would happen if you cover your symptoms with painkillers? 

So which way do I go?

There is no simple answer to this question.  Different people will have success with different approaches and no one approach is right for everyone.

Like I said I am obviously biased, and recommend a sports oriented chiropractor because it is extremely safe, all natural (no drugs or surgery) and the care creates no added scar tissue. The sports centered chiropractor is usually the easiest office to make the quickest appointment. Most offices have the preliminary diagnostic tests available and are likely to be able to care for the non-fracture injury immediately by providing a structural and functional solution to expedite healing.

Recently I have been writing a lot about how to train for a race and stay injury-free. I have already published articles about how to properly schedule your training sessions to reduce the risk of injury; How to properly stretch before a training session; and how to test yourself for an injury if you feel pain while training. Today I'll share some tips to treat an injury at home if you have one.

Self care at home

Self care is essential to learn when you are an endurance athlete.  As you build from being a couch potato to that next level, invariably you will have some growing pains.  How you treat those growing pains is essential for your future success.  

First things is first, remember the acronym R.I.C.E.  

“R” stands for rest.  Slow down and rest the injured area, get off your feet, your body is a self healing organism, give it a chance to heal.  

“I” stands for ice, there are many different opinions on the application of ice.  My belief is that when we get injured inflammation is one of the body’s first responses to the affected muscle, ligament, bone, or joint.  If you add heat to the fire, the fire gets hotter, so ice it for 15-20 minutes to cool off that inflammation.  

“C” stands for compression, wrap the affected area in an ace bandage to keep the ice on the area and once you are through icing, re wrap the area to compress and keep excess inflammation from infiltrating the area.  

“E” stands for elevate.  While you are resting keep the affected area higher than the level of your heart.  This helps the affected area and inflammation drain from the lymphatic system into the blood system to enhance healing.  Once you have rested, used ice, kept the area compressed and elevated, it is time for a self assessment again.  When you wake up the next morning, I suggest you check in with the affected area and do a cross training day.  Test and see if working the area on a bike or in a pool can be done.  Movement, if not increasing the pain, generally will help pump the body’s lymphatic system and aid in the healing process.   If you cannot do the other movements because the pain increases or does not lessen it may be time to seek help.

Stretching

Stretching is a great way to keep your muscles supple, relaxed and fluid.  Excessive exercise often causes micro tears in muscles as they are expanding and growing in function and capacity.  If these tears do not heal appropriately, scarring and adhesions result, which can make injury more likely.  Stretching or foam rolling is a good idea to prevent adhesions from happening maintaining a supple and fluid muscle function.  Several stretches which can help keep your muscles in great shape include:

Foot and calf stretches to help or prevent plantar fascitis or calf strain are as follows:

Foot conditioning: Roll a golf ball along the bottom of your foot while sitting on your couch.  Roll for 30 sec - 2 minutes at a time and you can vary the pressure by putting more weight on the ball.  

Calf stretch- Stand with one foot entirely on a step, and the other foot half on the step with the ball of the foot at the edge.  With your leg straight of the half on foot, gently drop the heel towards the floor and you will feel the calf muscle stretch.  Hold the stretch for a count of 10 -15 seconds and repeat on the opposite side.  

Tensa fasciae lata stretches to prevent knee or hip pain consists of the following:  While lying on your back bend your knees and place your feet flat on the floor.  Take your right foot and place your ankle just above your left knee in a figure 4.   Reach your right hand between your legs and  claspe your left hand behind. Lift your left knee and pull it towards your left shoulder.  Hold for 10-15 seconds and repeat on the opposite side.  Done correctly when the right leg is over the left you will feel the stretch on the lateral side of right hip, glute and knee.  And the opposite when you do the other side.  

Lower back and hip stretch to reduce injury and maintain fluidity consists of the following:  While on the floor lying on your back, bend your knees and place your feet flat on the floor.  Raise one knee at a time and grab it with both hands bringing it to your same side shoulder.  Pull the knee towards your shoulder and hold for a count of 10-15 seconds.  Repeat on the opposite side.  Next, in the same position, grab your knee and pull it toward the opposite shoulder and hold for 10-15 seconds.  Repeat on the opposite side.  The first stretch you will feel in your lower back and glutes and the opposite shoulder stretch you should feel the stretch in the lower back, glutes and hip.

I hope this helps! Remember if you have a question you can always click here to ask, I usually get back to people within 24 hours.

I see it all the time at the gym or in my office, some people are concerned about how they look but not necessarily about their health.

The problem is that many things that are good for your short-term body image may not be good for your long term health.

If you are not sure of the difference between being body conscious or health conscious, check out this quick reference chart:

So, which are you Body Conscious or Health Conscious? 

Are there any changes you know you need to make? 

We are here to support you to be the healthiest version of you possible!

A few weeks ago I was training for a race with a local celebrity named Sheila.

I used Sheila’s principles to construct some good training templates that you are free to use. These templates will help you schedule enough training before your chosen event without overdoing it:

For a half marathon training schedule, click here

1.  Back pain:  If you have a spine that is out of alignment, jogging or jumping rope would create downward pressure with each step or hop over the rope. This acts like a hammer banging a bent nail into a board.  Have you ever tried to drive a bent nail with a hammer?  What often happens to that nail? The same thing happens to your spine if it is bent out of alignment.  Therefore, running and jumping rope are not good ideas in this case.  Perhaps, swimming, cycling or using a non pounding elliptical machine would be a better way to get an aerobic workout.  If you loved jumping rope or running ask your sports oriented chiropractor for ways to help this condition and allow you to run the races you desire.

2.  Hip pain:  If a person has one hip higher than the other, exercise can cause hip pain.  This shift and imbalance can be a physiologic result of a pelvic misalignment or an anatomical result of one side growing longer than the other.  Both of these conditions will cause an imbalance in weight bearing, most commonly leading to the short side carrying more body weight than the longer side.  If the short side is carrying 10 lbs more for 1,000 steps in a workout, that translates to 10,000 more pounds affecting that short side with each workout.  Which side do you think will wear out faster?  You can choose to stop working out or fix the problem and continue to work out towards your goals.  The solutions are generally a heel lift for a person that has an anatomical imbalance which will create the balance necessary or if the person has a physiologic imbalance we can make the appropriate chiropractic adjustments necessary to create proper balance.  Ask the sports oriented chiropractor, if you would like more information.

3.  Knee pain:  Often happens when there is an upper lumbar misalignment, a pelvic misalignment or a foot imbalance.  Your exercise can be causing you more harm than good if your knee pain is coming from anyone of these three issues.  Often times we exercise in a linear plane, for example running a straight line, cycling in a straight line or swimming in a straight line.  This creates repetitive linear motion of the spine, pelvis and feet which leads to knee pain.  This repetition often causes excessive wear at the area between the spine, pelvis and feet which is the knee.  You can attempt to vary your exercise to incorporate lateral or diagonal movements which can prevent injury that results from straight forward linear repetitive motion. If the varied directional exercise does not help, the underlying foot, pelvic or spine issue must be addressed.  If the lumbar spine or pelvis is involved a specific scientific chiropractic adjustment is needed to re-align it.  If the foot is involved, sometimes adjustments to the foot joints are necessary and a foot leveler spinal pelvic stabilizer support is needed.  If the change in exercise does not work feel free to ask your sports oriented chiropractor.  

• A bent mis-aligned spine can become worse with pounding type exercise like jogging or jumping rope.  Switch your exercise or get your spinal mis-alignment fixed.

• Unbalanced hip levels can lead to premature wear and tear of your hip joints unless it is leveled out. Think of an unbalanced out of aligned car.  If you leave the car in the garage and do not drive it, the tires will not wear out prematurely.  Drive it and drive it hard and it will wear down quickly. 

• Misaligned lumbar spine, pelvis or foot can often lead to knee pain.  Add lateral and diagonal exercises to create greater balance of the musculature around the knee joints.  If that does not change it, ask your sports oriented chiropractor about specific scientific chiropractic adjustments or spinal pelvic stabilizers.