Keeping Athletes in the Game

It also wasn’t long ago that we heard about Sidney Crosby’s astounding recovery thanks to chiropractic treatment.  Even further back, during the 1997 Skydome race against Michael Johnson in Toronto, Donovan Bailey received treatment from his chiropractor just minutes before sprinting to a first place finish that maintained his title as the world’s fastest man for three more years.  On an even larger scale, the 2010 Winter Olympics were proud to be the first to fully integrate chiropractic into host medical services.  Even with this recent success, chiropractic doctors were already working directly with sports teams and Olympic athletes decades before the Vancouver Games.History has shown us that chiropractic is widely recognized in the athletic arena. Professional sports teams understand the importance of retaining a team chiropractor who can attend to players on the sidelines during games.  The list of examples is endless (golf pros, MMA fighters, hockey players, extreme snowboarders, etc.).  Whether an athlete is on a team or participating in an individual sport, chiropractic has probably played a role in their athletic development.  There is a staggering amount of evidence and research that supports the effectiveness of chiropractic, but it is even more telling to note just how many athletes depend on chiropractors to keep them in the game.Athletes are backed by healthcare teams that consist of several different medical professionals and more often than not include a chiropractor or two.  This team approach is key to the athlete’s well-being and efficiency in their sport.  As such, athletes receive some of the best health care available from a wide range of qualified providers.Having a chiropractic doctor as part of the healthcare team is even more important when you consider the forces and stresses athletes subject themselves to.  Their bodies are pushed to the limit which means they must be in peak physical condition at all times.  Training and performing at this level may cause the athlete to be more susceptible to injury.  Some of the demands of the sport may also be unnatural to the human body, say for example taking strides while skating, which can pose increased risk.  Let’s not forget environmental hazards where athletes compete: a slippery field, a hard running surface, high altitudes or blistering heat just to name a few.  By working with coaches and athletes themselves, chiropractic doctors can recommend specific exercises and techniques to promote quality movement specific to their sport and help mitigate the risk of injury.The truth is chiropractors are well positioned to work with athletes.  Musculoskeletal and neurological function forms the core of a chiropractic doctor’s scope of practice.  Biomechanics, physiology and biochemistry are just a few of the topics chiropractic students will study during their 7-8 year education.  In conjunction with the expertise offered by other health professions, the athlete is at the centre of care and is able to take advantage of multiple perspectives.Of course, not all of us are pro athletes, but many of us still receive the benefit of chiropractic care.  Approximately 80% of Canadians will experience a spine or spine related problem and that’s not just the high performance types.  The one thing we do have in common is that we all have a back, something all chiropractors understand very well.

Be thoughtful about workplace safety

Apart from our homes, the workplace is where we spend most of our time.  Most of the tasks we are conducting at work are repeat tasks – Sitting at a desk, driving a vehicle, lifting boxes, hammering nails or a countless list of other duties that make up our day to day work life.  The danger lies in repeat movements and sedentary postures.  As benign as they may seem, patients with workplace injuries would tell you otherwise.Nearly 100,000 claims for workplace injuries were accepted in 2009.  Over 50% of these injuries are attributed to back and other body strains.  Most, if not all of these accidents are preventable if we take the time to stop and be considerate about our workplace environment and situations.  Do you feel alert and ready for work?  Have you taken a few moments to “warm up” before lifting boxes or conducting other physical activity?  Do you have the right equipment available for a safe day at work, including an ergonomic chair or keyboard?  If these questions bring up concerns, it may be time to address them with your employer.  Happy, healthy employees are productive employees – all good things that your employer benefits from.Of course posture, taking frequent breaks and stretching before work are all excellent preventative methods.  Perhaps the most important prevention step of all is simply stopping to think about your actions before you start.  Is it really a surprise that the day you have a huge deadline and are flustered with the details is the same day you accidentally sent an email to the wrong recipient?  It could also be the day that you reach for that box in the mail room that is on the highest shelf.  Not allowing yourself enough time to consider your plan of attack can be hazardous.  There are no deadlines in this world that are more important than your safety.All of us are guilty of “not thinking” at one time or another and chances are it has resulted in an injury.  If you do find yourself in a bit of a sore spot [pardon the pun], it is a good idea to talk to your family chiropractor about recovery options.  Injuries that are caught early are less likely to become chronic.  Let’s not forget, what affects us at work is going to follow us home and impact the activities in life that we enjoy.Getting hurt also gives us pause to stop and think about how we can work safer.  Remember, the things that you do to make your workplace safer benefit everyone.  Now, are you ready to speak with your boss about getting you that ergonomic keyboard?

Improving mobility in ankylosing spondylitis patients

Most patients who are given the diagnosis of ankylosing spondylitis have no idea what the disease is all about. Essentially, ankylosing spondylitis is a form of inflammatory arthritis that localizes in the spine. Because it is an auto-immune disease, the body attacks the facet joints between the vertebra, resulting in fusion and the hallmark forward stooping posture. It is difficult to diagnose and patients can live with it for years undetected. Arthritis is generally thought to be an old person’s disease, however, ankylosing spondylitis is most commonly seen in individuals between 17 and 35 years of age.A new class of drugs called biologics have revolutionized the treatment of auto-immune diseases and many patients are able to improve their quality of life as a result. Dr. Carlo Ammendolia at the University of Toronto says that the use of these drugs actually control the inflammatory process and are life changing for those struggling with the pain ankylosing spondylitis, however, they do not address the fusion of the joints that can impair mobility. Since most people are young when they receive their diagnosis, the thought of not being able to enjoy all of life’s activities because of spinal fusion can be devastating. Through his research, Dr. Ammendolia is working with patients to develop management approaches to help minimize or slow the fusion process.Dr. Ammendolia has identified several tailored exercises that when combined with the drugs can help improve or slow the fusion process. “The exercise program is really geared towards lifestyle and self management where patients are doing things sitting, standing, walking and sleeping in a posture that mitigates that risk to fuse in that posture.” The goal is to improve the muscles around the joints so that optimal posture is maintained. Chiropractic care also plays a role, with carefully considered treatments known as “adjustments” adding to the overall treatment plan to help maintain mobility. Push/relax techniques are used to help regain neck flexibility. In cases where joints are already fused together, adjustment or manual manipulation is not performed.As much as we hate to admit it, most health care, especially disease management, requires commitment from the patient to improve or maintain their wellness. That is of course what Empowered Health is all about, right? With these protocols, Dr. Ammendolia hopes that individuals suffering from ankylosing spondylitis will be “kick started” into self management of the condition. Next steps include developing tools and resources that will help patients track and monitor their progress. For more information, be sure to consult your family chiropractic doctor.

What does excessive weight really mean to your joints?

It is common knowledge that being overweight is associated with many negative health outcomes.  Heart disease, diabetes and cancer are linked to obesity and are usually the diseases we jump to first.  There are also other very real dangers to our muscles and joints that often present before these diseases manifest as a result of the extra weight.For those who are overweight, there is significantly more stress on the musculoskeletal system.  The demand on the muscles, joints and bones increases exponentially as body mass increases.  In one example, Dr. Michael Lyon, MD, who is actively involved in research around diet, nutrition and weight loss, suggests that every extra 10 pounds contributes to at least 40 pounds of added stress per knee.  Consider that your spine is made up of 24 bone and their related joints.  This extra weight is amplified throughout each of these joints, causing severe strain on your muscles, facets, vertebral discs and nerves which could result in arthritis, stenosis or other mobility issues.Extra weight also throws off your centre of gravity due to far from optimal body mechanics.  Your spine, joints and muscles need to adjust to this change that impacts balance and mobility.  Simply bending down to lift a box is much harder than it once was and puts overweight individuals at a higher risk of injury.The second factor working against your joints and muscles is the activation of the body’s inflammatory response.  This is a biochemical reaction involving the vascular and immune systems that is triggered when the body senses injury or infection.  Essentially, the body believes it is in a diseased state.  Inflammation around the joints contributes to pain, swelling and loss of mobility and is ultimately a precursor to very serious conditions like heart disease and diabetes.Once your vascular system is impaired, blood has a difficult time supplying the tissues of the body with the oxygen and nutrients they need.  Nerve, muscle and other body systems suffer as a result of poor circulation.  Your muscles may feel more tired, you will most likely grow physically weaker and breathing with be more of a chore.Of course, most people do understand the risks and negative aspects of being overweight.  The difficult part is overcoming and maintaining a healthy body weight after suffering from obesity.  Statistics from 2011 suggest that approximately 1/2 of the adult Canadian population self reported as being overweight or obese.  Plus, our country is on track to see these numbers skyrocket in the near future.  It’s a huge problem that most people struggle to overcome.  Dr. Michael Lyon is featured on the Empowered Health show (Mondays at 8:30pm and Thursdays at 4pm on ChekTV or check local listings)  in a two part series highlighting the challenges we encounter when trying to lose weight and more importantly, keep it off.  He offers several suggestions on how to work with your body, rather than against it.

Narrowing the evidence-practice gap

Healthcare research is conducted daily around the world and we often see headlines published on a single topic in newspapers or broadcast on the news. Some of these findings are nothing short of amazing, disc regeneration for example, but most studies provide small steps forward to improve prevention opportunities and recovery time. While most research papers do not garner airtime due to the volume of research, this should not dismiss their significance. But how do we get the attention of the public, or more importantly, the health professional when it comes to these types of studies?Dr. André Bussières DC, PhD holds the CCRF Professorship in Rehabilitation Epidemiology at McGill University. His goal is to develop methods and resources to narrow what some call the evidence-practice gap. This “gap” refers to published comprehensive research and what is practiced by the healthcare provider in the clinic setting. Dr. Bussières says that 30-40% of patients do not receive the best care as a result of this “gap”, so patients aren’t receiving care that is reflective of the latest research. Knowledge transfer is an extremely tricky process and it usually takes a long time to convey the latest best practices to clinicians.One of the reasons why communication is so difficult is because the research is scattered throughout many different journals and publications. To help centralize the information, Dr. Bussières and his team at McGill plan to look at all of the evidence and research available for a given condition or therapy. Once the review is complete and the research is scrutinized, qualifying studies are synthesized into one comprehensive document (also known as a Clinical Practice Guideline or CPG) that explains the research resources and demonstrates best practices supported by the research at that time. This creates somewhat of a road map that the health professional can use to assist with diagnosis and treatment. In addition, CPGs can reinforce a doctor’s experience with patients in practice (practice based evidence) through evidence-based research (what is learnt in the lab).Comprehensive CPGs can be very useful in the transfer of knowledge and support best practices in the clinic setting. These resources are also valuable when discussing expected outcomes and recovery times with insurance providers or patients themselves. The public is more informed about their health now than ever before so it is plausible that patients will have questions and ask for reassurance when receiving a diagnosis and recommended care.