Plantar Fasciitis Part 2

Last week I discussed the nature of plantar fasciitis as a common cause of foot and heel pain.  The best way to avoid this condition is to maintain a healthy weight and wear proper fitting and supportive shoes especially when exercising or working on hard surfaces such as tile or concrete.  Most often this condition begins with fallen arches of the feet.  To check for fallen arches, stand up straight while looking straight ahead and have someone on the ground looking at your feet.  They will be looking to see if the achilles tendon on the back of the heel is bowed instead of straight up and down and they should feel if they can get 3 or 4 fingertips under the middle arches of your feet.  They can also look for a bulging toward the inside of the heel.  If any of this is observed, you should probably be checked by a chiropractor or podiatrist for orthotic (arch) supports.

If you already have plantar fasciitis, I would highly recommend custom orthotic supports immediately.  Chiropractic adjustments of the feet and ankles often help.  There are numerous stretches, taping techniques, therapies and exercises that should be performed to provide lasting relief.  For more information on these treatments, I like the website heelspurs.com. 

Here in our office, we use a low-level laser treatment for plantar fasciitis. This combines laser treatments in combination with a handheld percussion massager to release muscle tension. If you are struggling with this condition and would like more information about these treatments, please call the office at (812) 273-4325.

In dealing with plantar fasciitis remember that it starts as an annoyance, but can become a difficult and chronic condition very fast.  So, listen to your feet and take good care of them!

Plantar Fasciitis Part 1

Over the next two weeks, I’d like to discuss an easily preventable condition that I see much more often this time of the year.  The condition is called plantar fasciitis and is most commonly experienced by pain in the heels and soles of the feet.  It often begins as a painful annoyance that can quickly develop into sharper pain preventing you from exercising or even walking and can become a more chronic condition.

Plantar fasciitis occurs when the muscles and the plantar fascia ligament along the bottom of the foot become inflamed or torn.  Most of the pain is felt in the middle of the heel where these muscles and ligaments attach.  For this reason, if the condition goes unresolved, the tension on the heel can remodel the bone into a heel spur which is much more painful difficult to deal with.

Why is this condition more common in the summer (especially with women)?  Two words – Flip Flops!  Improper fitting and unsupportive shoes are the most common cause for any foot problem, and for many people flip flop and other sandals are a recipe for trouble.  Another reason for the seasonal nature of this problem is people jumping into an exercise or running routine that they are not used to for the summer.  While the intention is good, you need to start slow and wear supportive shoes.

Next week I’ll discuss how to prevent and resolve this condition.

There’s Another Way

It has come to my attention after 20+ years in practice that one of the main reasons people avoid or discontinue chiropractic care even when they are getting good results is that they are uncomfortable with the “popping” feeling and sound of the manual chiropractic adjustment particularly in the neck.  In the past, I’ve reported that this sound is merely pressure releasing from a swollen, injured joint.  This pressure is largely made up of nitrogen gas that is only there as a byproduct of the inflammation in the joint.  What I’m beginning to understand is that even knowing this, some people still cannot get comfortable with the whole idea.

I always emphasize that chiropractic is meant to be a de-stressing experience.  Much like exercise and massage, research has shown that chiropractic adjustments interrupt the stress response at a brain level.  So, the last thing I want is someone experiencing stress from their adjustment.  This is why almost every chiropractor gets trained in low-force, gentle adjusting techniques that are easy, effective and do not elicit the stereotypical “popping” release of pressure.  These techniques may involve an instrument, a special table or simply light touch and my experience is that sometimes less is more, and an alternative technique can often prove more effective for some people.

By restoring the spine back to its normal anatomy and function, and reducing interference to the nerves that communicate between the brain and body, chiropractors get to see peoples pain reduce and health return literally at their fingertips.  It troubles me to know there are so many people suffering unnecessarily and aging prematurely without at least attempting to see if chiropractic care could help.  If it’s anxiety over the hands-on, audible adjustment that is keeping you from seeking or continuing care, my advice to you is to literally interview your chiropractor about any concerns you may have and work together to agree on a method that you are comfortable and still gets the results anticipated through a series of adjustments.

Inflammatory Response

I try not to repeat myself in these articles, but this is a request from a client who asked me to discuss the causes of chronic inflammation.  This is a big deal because several years ago a large amount of research was devoted to this inflammatory response in the body.  The outcome of this research determined that inflammation is implicated and at the root of not only all forms of pain but of every disease known to man.  In effect, if you can reduce inflammation in the body, you reduce your risk of every disease out there.

The inflammatory response should be considered synonymous with the stress response.  So when we look at inflammation, we need to evaluate the cause in terms of physical, chemical and emotional stress.  The main culprit with physical stress can be trauma from recent or old injuries.  This is where chiropractic, massage and physical therapy come into play.  But the biggest physical stress is a sedentary lifestyle – you have to move your body!  Exercise of the joints and muscles stimulates the coordination center of the brain which feeds into the emotional system to inhibit the stress response.  In terms of chemical stress, it amazes me in this day and age that people don’t see the connection between how they feel with what they eat, drink and breathe.  Sugars, grains (yes, all grains!) and oils are all pro-inflammatory.  They will feed into the stress response and increase your pain/inflammation levels.  Fortunately, nature provides us with an antidote.  The minerals and antioxidants found in fresh fruits and vegetables shut off the stress response in the brain and reduce inflammation in the body.  Omega three fatty acids from fish oil and flax seeds are essential building blocks for all your anti-inflammatory hormones in your body and should be included.  I’m a very big fan of doing regular detoxification programs to reduce the environmental toxins we invariably take in regardless of how clean our diets are.  Emotional stress can be the hardest one.  This is the essence of the stress response and since our way of thinking is a habit, it can be hard to change.  Just like the diet, you start eliminating negative emotional stress by replacing it with positive thoughts and feelings.  This is literally how the brain works.  Instead of focusing on all your worries, regrets, and fears, make a gratitude list that you add to every day and review in the mornings and evenings.  Purchase a guided meditation c.d. where someone walks you through the process of quieting your mind and reducing the stress response.  This should be a 10 minute ritual every day.  The biggest thing with emotional stress is simply becoming more aware of your thoughts and learning to cultivate you way of thinking.  The brain is just like a garden – it will grow flowers and weeds equally well.

Reducing inflammation may be the single most effective thing you can do to feel better and achieve a higher level of wellness.  Arthritis, fibromyalgia, chronic fatigue, bowel disoreders, heart disease, stroke, and diabetes are all directly related to increased inflammation associated with the stress response.  Look at some of these tips to see where you can make the biggest impact in your lifestyle to begin turning things around.

The Problem with Pain

A few years ago in the Journal of Manual Therapy, a research group looked at patients with chronic neck pain.  The intent of the study was to see if there was a possible connection to spinal pain and other health complications.  The outcome of the study determined, “It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles.”  They continued that the respiratory weakness seemed to be related to local and global muscle weakness around the area of injury to the neck.

In this study, they are telling us that people with chronic neck problems are more likely to have other health problems.  In this case they determined that those with neck problems are more likely to have weakness and dysfunction of their respiratory system.  These findings would support numerous prior studies that showed a connection between asthma, allergies, bronchitis, and other respiratory problems with spinal conditions of the neck.  The point I’d like to make here is that the pain is not the problem.  Remember that pain is your body’s smoke alarm that serves to tell us that something is not functioning properly.  Thus we need to move our focus from how we are feeling to how we are functioning.  When all we do is manage pain with pain relievers and anti-inflammatory drugs, without addressing the function of the anatomy and physiology, the real root of the problem continue to progress.  The first thing that is taught in Anatomy and Physiology is that Anatomy dictates Physiology – meaning our structure determines our function.  They were so close in this study to getting the big picture that chronic neck pain is a sign of a structural and functional problem.  When the neck becomes misaligned or subluxated, resulting in inflammation and degeneration of the vertebrae and discs and tension or pressure is placed upon the nerves of the cervical spine, function will always be compromised.  In this case, the nerves that exit the holes between the vertebrae of the neck are the very nerves that go to control the muscles of the neck, shoulders, and chest; but they are also the nerves that go to control the function of the lungs themselves.  The chronic neck pain is a sign of a chronic neck problem.  While the study did not look at the function of the nerves, most likely the connection between the respiratory function and the neck pain was directly related to a compromised function of the nerves of the neck as a result of pressure from misalignment or degenerative changes (arthritis) as a result of years of excessive wear-and-tear of the cervical spine.

We are cultured to treat the pain in our society.  When you have pain, begin to ask the question, why?  Disciplines such as chiropractic, massage, physical therapy and various other health services look to restore function in order to reduce the pain.  When function is restored, health can be expressed and there is no longer a need for pain.

Chiropractic & Kids

The Journal of Clinical Chiropractic Pediatrics has often featured articles about the chiropractic care of children. Here are three cases that might surprise you.  I find that even the most devoted chiropractic adults don’t think about getting their kids checked.  Obviously this is not out of a lack of concern or neglect it’s simply that many people believe you need to have back pain or headaches to benefit from chiropractic care.  Here are a few published cases that might change how you look at things.

The first case was from England and focused on chiropractic care for infantile colic.  Colic is also known as inconsolable crying syndrome and it affects up to 25% of newborns.  The cause is unknown but is thought to be secondary to gastric reflux, migraines or another undetectable problem.  In essence, the baby is crying for hours at a time for no clear reason.  In the study, they looked at 100 infants and compared results from those being treated with chiropractic versus those treated medically with different drugs.  They found that most cases resolved with both treatments but that the cost of the medical care was nearly 20 times greater than that of the chiropractic care.  The average number of visits to get results under chiropractic was just four adjustments.

Another case looked at pediatric cough and chiropractic care.  The researchers were looking to see if there was a connection to the nervous system and something as common as a cough.  Not only did they find a connection, but they recognized an unusual pattern.  They found that a wet (mucus) cough was associated with nerve irritation and spinal levels in the upper neck while a dry cough is associated with nerve irritation and spinal levels in the upper back.  While this information is more important to the chiropractor, it should be noted that nerve pressure at a spinal level can be related to mucus production (from the neck) and constriction of the bronchioles in the lungs (from the upper back) and conversely that reduction of that nerve pressure can be helpful to resolve such conditions.

A final case involved a 14-year-old ballet dancer with hip pain on both sides and restriction of movement that was keeping her from performing.  The pain came without warning or cause and was not responding to other treatment.  Full-spine chiropractic adjustments were applied following an exam to identify misalignments to the spine.  The result with ten adjustments was complete resolution of pain and restricted hip movement and the young girl was able to return to ballet without complication.

If you talk to any chiropractor about these cases, you will find that they all have similar stories and results.  As for myself, I’ve seen miraculous results with pediatric asthma and constipation.  The reason it’s so much easier to get rapid results with kids is that they are still developing and their systems are very adaptive.  Furthermore, they haven’t had the time and opportunity to accumulate all the physical, chemical, and emotional stresses that cause distress and dis-ease in the body to begin with.  This is precisely why the standard pediatric guidelines to chiropractic care is on average around 6-10 adjustments.  The most important take-home from these cases is to realize that chiropractic care is more than just back pain.  When you restore the spine back to its normal alignment and movement to reduce pressure off the nervous system, the body adapts better and performs more efficiently.

Why Before What

One of the concepts emphasized in our Wellness Program is to always put the “Why” before the “What.”  In other words, we all know “what” we could be doing for better health and wellness, but until we have a big enough “why” to do those things, we probably won’t change our habits.  With this in mind, I’m still shocked at how many people I speak to that have never even considered supplementing with an omega 3 fatty acid such as fish oil; even when fish oils have been proven beneficial in reducing symptoms in everything from arthritis to Alzheimer’s.  The only logical reason is that they don’t understand why omega 3 fatty acids are truly so essential.

First of all, even though fish oils have been proven helpful in a long laundry list of ailments and symptoms, this is not why you should take them.  The only reason to take fish oil is to provide your body with the essential omega three fatty acids that are required to produce the hormones that reduce inflammation.  When you reduce inflammation in the body you effectively reduce your risk of every disease known to man.  Most every client I see is burdened with symptoms of chronic inflammation that is usually the result of prolonged low level stress and/or poor dietary choices.  The problem with omega 3’s is that your body doesn’t produce them – we must get them from outside sources.  Why shouldn’t we get these naturally from our diet?  The truth is, we should get omega 3’s from diet, but we’ve screwed this up.  Beef, chicken (and other meats) that are raised on grass are considered “free range” and produce healthy proteins that are rich in omega 3’s.  Unfortunately, most all our sources are raised on grains that are pro-inflammatory and produce omega 6 fatty acids.  Why do we need to take a fish oil capsule; why not just eat more fish?  Two reasons for this: first most of our fish is now farm raised and farmers have found a way to produce a pellet made from corn that fish will eat.  This is a pro-inflammatory grain that no self-respecting fish would normally ever eat.  Secondly, for various reasons, our water supplies have become so toxic with mercury that consuming the fish that would normally be our highest quality protein is not safe to eat more than 2-3 times per week.  Most fish oil is caught in the wild from the south of Africa and purified to eliminate all the mercury.

While I’m a big believer that we should be able to get everything we need naturally from a healthy and balanced diet, I just don’t see that we have a choice with these omega 3’s.  Vegetarians will often need to supplement more.  If you are a vegan and won’t do the fish oil, you will have to take larger amounts of things like flax seed, walnuts or algae oil to satisfy your requirements because fish oil is ten times stronger than these other sources.  Whatever the case, consider these healthy oils for better wellness.

Heart Rate Variability

The end goal of chiropractic care is to improve the overall function and well-being of the patient. This includes improving the function of the spine, joints, nervous system, and organs. Proper functions of the body allow for a healthier and more adaptable human, giving the person the ability to deal with the stresses of everyday life.

A quick, easy, and effective way to determine the function of the autonomic nervous system and the adaptability of the body is to measure heart rate variability (HRV). The autonomic nervous system controls all of the vital functions of the body including heart rate, and is divided into the sympathetic (fight or flight) and parasympathetic (rest and digest) nervous systems. If a patient is healthy and highly adaptable they can quickly switch back and forth between fight or flight, and rest and digest. This patient would have a high HRV measure. If a patient is unhealthy and not highly adaptable they cannot quickly switch between fight or flight and rest and digest. This patient would have a low heart rate variability.

Adaptability is important for every person because we shouldn’t always be stuck in either fight or flight, or rest and digest. When someone is always stuck in fight or flight their body is going to be highly stressed and they may experience restlessness, anxiety, muscle pains, etc. Vice versa, if someone is always in rest and digest mode they may have cardiovascular issues, obesity, and the list goes on.

Stop into Rivertown Chiropractic to get your adaptability tested! Ask for your heart rate variability test. 

Early Onset Scoliosis

What is scoliosis?

            Scoliosis is defined as any lateral curvature of the spine that is greater than 10 degrees when measured. It is classified depending on the age of the patient and the magnitude, direction, location and cause of the spinal curve. There are three classifications based on the age at which the curvature began. Infantile scoliosis starts from birth up until 3 years old. Juvenile scoliosis begins between the ages of 4 and 9. Adolescent scoliosis begins after the age of 10. The earlier the curvature begins, the greater the risk for curve progression. The most common area for a scoliotic curve is in the thoracic spine, but it can develop at any spinal level. The direction of the curve is also important. The curve can either have its convex side on the left or on the right. This has a large impact on the prognosis and potential for future problems and symptoms. A left sided curve has a greater risk to impede on heart and lung function.

How is scoliosis treated/managed?

            The treatment/management of scoliosis varies depending on the classification of scoliosis. However, the main goal in all cases of early onset scoliosis is to limit the progression of the curve until the patient is skeletally mature, along with preserving proper heart and lung function. Once skeletally mature the progression of the curve is almost always stopped. Different treatment options include, casting and bracing, surgery if absolutely necessary, chiropractic care and physical therapy.

References:

1. Larson, Natalie. “Early Onset Scoliosis: What the Primary Care Provider Needs to Know and Implications for Practice.” Journal of the American Academy of Nurse Practitioners, vol. 23, 2011, pp. 392–403., doi:https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1745-7599.2011.00634.x.