Snow, Ice and OUCH!

Now that we are officially having Winter weather in Ohio, it seems like a good time to discuss the what to do if you are injured due to snow or ice.

What you should do depends on what you did to start with and how severe your pain is.  Did you fall and hit your head, your rear or knee?  Did you strain your back shoveling?  Not all pains are equal.  Here are a few things to consider:

• Do you think "it" is possibly broken?  If you fell hard enough that you suspect fracture, call your doctor or chiropractor or head to the ER.  
• Can you move or use it?  This is not a sure thing to determine fracture, but you are probably OK waiting to see how it feels the next day if you can still use the injured body part.  
• Do you need stitches?  If you cut yourself and think you may need stitches, it is best to find out.  If something isn't stitched up within a few hours, the chance of infection is much greater and may prevent stitches, which at the very least will lead to a bigger scar.  
• Did you hit your head and are now dizzy, disoriented or very drowsy?  That warrants a trip to the ER.  If you just have a knot and a headache, it's OK to wait see if it gets better.
• Are you having symptoms of a heart attack?  Chest pain, shortness of breath, left arm or jaw pain are common symptoms of heart attack and should not be ignored, especially if you have been "over-doing-it".  

If you don't suspect serious injury, you may still be wondering when it is best to call the chiropractor or doctor.  My rule of thumb is 48 hours maximum.  If you are sore from overexertion, your pain should start decreasing by that time.  If it isn't, make the call.  It is always easier to help someone get well when the condition is new.  When someone waits weeks before seeking treatment, it will generally take longer to get well.

During the first 48 hours, use ice.  Apply the ice for 15 minutes at a time and wait 60 minutes in between applications.  Do not stay in bed, but try to avoid things that make the pain worse.  If it doesn't hurt, you can do it.  It's a simple rule, but it usually works!  

Ice and snow are here for the next few months.  Be careful out there!

Chiropractic and Exercise: The Best Combination for Pain Relief

Chiropractic care is a very effective treatment for back and neck pain that stems from most causes.  By using a combination of chiropractic adjustments or manipulation and physical therapy modalities, traction and muscle work, most conditions can be effectively cured or controlled.  This process varies in length, depending on the cause of the pain.

When progress is slow or incomplete, exercise can be a very effective catalyst to get over the progress "hump".  This is true for acute injuries and advanced arthritis.  Movement is essential to healing.  Why does it work so well?  Several reasons.

1.  Exercise stimulates increased blood flow.  This helps to nourish muscles, discs and other tissues.  It facilitates waste removal which helps decrease inflammation.  Inflammation is the main pain driver most painful conditions.
2.  Exercise produces endorphins.  This will block pain and elevate mood.
3.  Exercise helps set muscle resting length to the appropriate level.  Proper muscle length improves spinal function and aids in proper breathing and posture.
4.  Exercise increases energy and improves mood.  The more you move, the better your body will function as a whole.  You will produce many mood elevating chemicals and hormones.
5.  Exercise increases strength.  Increases strength supports the spine and helps decrease the chances of re-injury.
6.  Exercise helps to maintain or stimulate weight loss.  Proper weight allows the spine to distribute forces the way it was designed to, which will decrease pain, injury and inflammation.

Exercise isn't just about your heart health or your weight.  Your body needs it to function at a healthy level.  It is extremely important to pick the right exercise for your body and fitness level, but EVERYONE can exercise.

For more information, contact Dr. Wente-Moeller.

Keep Off the Weight, Cut Down on Your Back Pain

One of the most significant factors in back pain is obesity.  Most people know that being significantly overweight can lead to increased pain, but most don't make the connection with just a few extra pounds.  Unfortunately, even having an extra 10 or 15 lbs around the middle will significantly increase your chances of having back pain.  It causes a shift in your center of gravity.  The body has to counteract it by leaning backward slightly.  This increases pressure on areas of the spine that are not designed to bear weight.  Over time or with heavy exertion, this can lead to pain.

With the holidays approaching, it is a good thing to keep in mind.  While most of us will gain a pound or two, the more exercise you get and the less you gain, the better you will feel.

Since most of us are extremely busy right now, I am going to make my next several posts very short and to the point.  For more information, please contact me at DrWente@AllianceChiroCenter.com.

Minimizing Holiday Weight Gain

The holidays are rapidly approaching.  With that comes weight gain for most people. It’s hard not to gain weight with all of the additional parties and goodies. The biggest problem for most people is that they take an all-or-nothing attitude when it comes to diet. So, naturally, when the holidays come, they stop trying to control their food intake and plan to take care of it after the New Year.

This attitude backfires for the majority of people.  My advice:  try to minimize the damage by paying a bit of attention to what you are taking in during the holidays.  After a month of partying and travel, most people are worn out and never take off all of the weight they gained, leading to that yearly creep of weight that so many experience.

Let's "do the numbers."  A pound of fat is equal to 3,500 calories. The average exercise will burn 200-500 calories per hour. So even at 500 per hour, that is 7 hours of exercise! The average person eats 1600-2200 calories per day (or should) so that is a 1 1/2 to 2 days of food! Now, multiply that by the SEVEN pounds that the average American gains each holiday season. Scary.

Now, if you can minimize the gain to 1 or 2 extra pounds, that might seem a little more doable. The key is paying attention to what you are taking in, not denying yourself all of the goodies the holidays have to offer.

Here are a few tips:
1.  Avoid standing next to bowls of food. It is way too easy to just reach out and grab another cookie when they are right next to you. Stand a little further away, so that you have to think about it before you grab one.
2.  Think about what you drink. Stay away from the pop. With all of the other things you are taking in, you don’t need the extra 220 calories a can of soda has to add! A light beer has about 100 calories. Think of drinks like deserts, because that is essentially what they are. Hot chocolate, egg nog, punch and many others are full of calories.
3.  Watch your portions. Try to take a little of everything, not a lot of everything.
4.  Try to eat healthy when you are at home. If you know you have a bunch of parties coming up, plan low fat, healthy meals for rest of the time.
5.  Sneak in some exercise, even if it is only 15 minutes. It’s 15 less you’ll have to do after the holidays, AND it makes you think about fitness, which may encourage you to “behave."  Finding time for a quick workout gives you some “me time” and helps keep your energy up while traveling, shopping, etc.  It also relieves stress.

While no one wants to diet through the holidays, using a little restraint can go a long way to minimizing the damage.  You can still have a great time and not hate yourself  in January!

Dangers of a Sedentary Lifestyle

What happens to someone when they spend most of their time in a chair?  Lots of things, and none of them good!  Here’s a list of some of the possibilities.

1. Poor posture leading to neck pain and headaches.

2. Forward rolled shoulders that limit shoulder and back movement, causing injury, pain and eventually arthritis.

3. Sciatic pain resulting from pressure on the low back and shortened muscles that cause imbalances even with standing.

4. Weight gain and poor physical condition.  This can lead to overall poor health and a weakened immune system.

5. Blood clots in your legs.  Clots can cause lower leg pain and swelling and, in a few cases, can dislodge and cause a medical emergency known as a pulmonary embolism.

6. Hemorrhoids.  These can cause enormous discomfort and lead to a very painful surgery. 

7. Hip and knee pain.  Constant pressure on the hips and shortened muscles from too much sitting can and will cause pain in the hips and knees over time. 

The moral of the story?  Move it or lose it!  Find something you like to do, want to try or used to enjoy and gave up and go have some fun!

Not sure what is safe?  Contact your chiropractor or other medical professional.

How Pregnant Women Can Benefit From Receiving Chiropractic Care

As always, the Ohio State Chiropractic Association provides great articles and works hard to promote and expand chiropractic by improving understanding.  Thanks to the OSCA for another great article! ~ Dr. Wente-Moeller

Posted by oscachiro on October 17, 2012 in health tips

If you’ve got a baby on the way and are experiencing back, neck or joint pain, chiropractic care may be the best way to ease your symptoms. And yes, it’s perfectly safe to receive chiropractic adjustments during pregnancy. There are no reasons why you shouldn’t see a chiropractor when you’re expecting. Additionally, you can rest assured, knowing that all chiropractors are trained to work with pregnant women.

During pregnancy, your body is undergoing plenty of changes to prepare for a new baby. According to the American Pregnancy Association, pelvic changes, a protruding abdomen, an increased back curve, and postural changes could potentially result in misaligned spine, pelvis or joints. When your pelvis is misaligned it can decrease the room available for a growing baby. It can also make it harder for the baby to get into an ideal position for delivery—which can affect your ability to have a natural birth. Chiropractic care can help you obtain pelvic balance and restore alignment, which can result in a smoother delivery.

When your pelvis is balanced, your baby has a better chance of getting into the best position for birth, and it may avoid breech (feet or buttocks first) or posterior (baby is head-down but facing your stomach) presentations. If your baby is in an ideal position for birth, it also decreases the chance of difficult labor, and can make the delivery safer for you and your baby. Back pain (which chiropractic care can help alleviate) can also make it difficult for you to get into the upright, active positions that can make for a more efficient, smoother labor.

Additional benefits of chiropractic care during pregnancy include:

-Having a healthier pregnancy

-Reducing labor and delivery time

-Controlling symptoms of nausea

-Alleviating back, neck, or joint pain

-Preventing a possible C-section

There are also things that you can do at home to improve the alignment of your pelvis:

-Avoid carrying your other children (if you have any) on your hips.

-Avoid staying in semi-reclining positions, such as sitting on a lounge chair for long periods of time. When in this position, try to not cross your legs.

-Avoid wearing high heels.

-Use a supportive mattress and pillow for spinal support.

-Avoid staying in one-sided positions and performing repetitive motions on one side.

-Consider taking up yoga or swimming—great prenatal activities.

Please don’t hesitate to contact us if you have any more questions. We are here to help you and make your pregnancy more comfortable.

Keeping Your Energy Up While the Days Grow Shorter

While many of us are enjoying the cooler temperatures and bright fall colors, few of us are enjoying the decrease in day light hours.  Suddenly, it is dark when we wake up and soon after we arrive home for the evening.  This can have a serious impact on energy levels.  This is especially bad when coupled with fall allergies which can lead to chronic headaches, stuffiness and sluggishness.  While nothing can be done about the shorter days, there are a few things you can do to help keep your energy level high.

1. Keep a regular sleep schedule.  Studies show that going to bed and getting up at the same time each day improves the quality of sleep. 

2. Avoid caffeine and alcohol before bed.  Again, this helps improve the quality of your sleep.

3. Get some sun.  Sun exposure elevates mood and increases energy.  Try to get outside for 15 to 20 minutes a day whenever possible.

4. Take a Vitamin D supplement.  This helps with calcium absorption, mood and immune function.  The supplement can help counteract the natural decrease in sun exposure that comes with shorter, colder days. 

5. Drink lots of water.  Dehydration decreases energy. 

6. Get regular exercise, but not right before bed.  Exercise helps keep energy levels high and improves mood.  It also decreases stress and helps ward off winter weight gain. 

7. Turn some lights on right away when you wake up.  No, it isn’t the same as sunshine, but you will feel more awake if the house is bright. 

8. Eat breakfast.  A healthy, balanced breakfast that contains some protein and minimal sugar is best.  Fruit, not fruit juice is good for energy too. 

It is easy to go into “hibernation” for the winter, but it certainly isn’t healthy!  Don’t settle in and wait for spring, get out and enjoy winter.  It isn’t  ALL bad!

Ear Infection Article from the OSCA

Chiropractic Care May Help Ease Ear Infections in Children

Posted by oscachiro on September 20, 2012 

Ear infections can be extremely painful for children and are the most common illness that affects babies and children—with 10 million cases of ear infections reported every year. Traditional treatment usually involves drugs and in some severe cases, surgery, but research shows that chiropractic treatment may help, and may even be more effective than the two aforementioned treatments.

According to the American Chiropractic Association, nearly half of all children will have at least one middle ear infection before they turn one, and two-thirds will have had one by the time they are 3. Some children will develop them regularly, which can result in hearing damage and speech and developmental problems.

Ear infections are either viral or bacterial. Antibiotics are typically used to treat the infections themselves, but are ineffective if the infection is viral. Taking antibiotics regularly also can cause drug-resistant bacteria and might not be a good idea. Frequent ear infections can also be treated using surgery, and are the second most common reason for surgery in children under 2. However, if the thought of sending your young child into a heavy routine of antibiotics or surgery makes you cringe, you may want to consider chiropractic care as a viable option.

A study published in the Journal of Clinical Chiropractic Pediatrics suggested that chiropractic treatment may significantly decrease the number of reoccurring ear infections in children. Each study participant, ranging in age from 27 days to 5 years, was given a series of chiropractic adjustments. The study showed that 80 percent of the 332 children in the study did not experience another ear infection for six months after their initial visits. During the six-month period, the participants received maintenance treatments every four to six weeks.

While this study produced staggering numbers, the author of the study, Dr. Joan M. Fallon, who also treated the children, thinks that this is just the starting point that will lead to further research and treatment options of these types of infections in the Chiropractic world. According to Fallon, “Chiropractic mobilizes drainage of the ear in children, and if they can continue to drain without a buildup of fluid and subsequent infection, they build up their own antibodies and recover more quickly.” In other words, rather than attacking the infection with medicine, a process which can allow the infection to return due to a weakened immune system, Chiropractic treatment addresses the source. Using the strength of one’s own body and immune system is one of the pillars of good Chiropractic care. In the case of treating an ear infection, it works!

There are some other great ways to naturally decrease your child’s risk or lessen the frequency of ear infections, which can compliment regular visits to the Chiropractor. Some of the best ones are breastfeeding, avoiding crowded daycare centers, keeping your child’s nasal passages clear by using saline drops, and improving their day-to-day diet if they’re old enough to eat solid foods.

Infections of any kind can be serious things, so please don’t hesitate to contact us if you feel like your child is showing symptoms. Chiropractic care is both safe and beneficial for children of all ages, and can not only help your child get well, but actually prevent them from getting sick in the first place.

Thanks to the OSCA for their tireless work in advancing chiropractic awareness, accessibility and understanding.  We chiropractors cannot do it alone and you are always there to support us!  

Sports Play and Chiropractic

Many of my  patients ask me about their bringing their children in to be checked while they are in sports.  There are several reasons why a check up or two before, during or after the season can be a great idea.

Why before?
When someone is about to begin a regimen of intense exercise, like that associated with conditioning, it is a great idea to make sure that their spine, muscles and extra-spinal joints are properly aligned and have full range of motion.  This can prevent injuries and greatly improve performance.  Think of it as creating a solid base to build on.

Why during?
Again, keeping the body functioning properly can help reduce injury and improve performance.  Most sports involve serious impact with other players or the floor/ground or both.  When a football player is hit or hits another player, it puts serious stress on the joints, especially since the impact is never perfectly balanced.  The same is true when a volleyball player hits the ground.  Sports also tend to overuse some muscles, while not using others as much.  Baseball, tennis, volleyball and many others all tend to favor the dominant hand for hitting, throwing, etc.  This can lead to muscle imbalances and overuse syndromes.  Chiropractic care can help prevent these conditions or help heal them.  This can keep players playing the sports they love.

Why after?
After is a great time to get things realigned and help to relieve any built up dysfunction the sport may have created by overusing certain muscles.  It will speed healing and help with off season training.

Sports are a fantastic way to keep kids active and to teach them great life skills.  They are also FUN and great for physical fitness.  Chiropractic can help to keep the fun in the sport by keeping players from injury and pain.

Want to read more?

The Pain is Gone! What Now?

Okay, you have successfully completed the initial phase of chiropractic care.  Your pain is gone and you feel great.  What now?  Are you done?  Will it come back?  Should you schedule maintenance?

These are very common questions.  My answer is different for each person.  I determine my answer based on a few questions of my own...
What does the patient do for a living? Hobby?
Is there an underlying permanent condition?
Has this happened more than once in the past?
What are this patient's long term goals for wellness?

Not everyone who comes in to my office is looking for increased overall wellness.  Not everyone is looking to just get out of pain.  You really have to take a look at each person as a whole.

Say you have a patient with low back pain who is an avid runner who is on a healthy diet.  This person may be pain free in a week or two, but ending care may not be the best thing for this person.  If the back pain is a result of the training or a combination of the training and other lifestyle issues (such as a desk job), continued monthly visits may keep the pain from returning, improve athletic performance and overall energy and health for this patient.  If your everyday life is what is causing your pain, you need to do things to counteract that or you are likely to continue to have episodes of pain.  In addition to that, the episodes, as proven scientifically, tend to increase in their frequency, intensity and duration over time.  A maintenance care regimen can significantly reduce the chances that someone will have multiple worsening episodes and can help prevent degeneration and arthritis.

Now take the case of a college student who stayed up all night studying and developed severe, sudden neck pain.  This type of condition will generally resolve in a week or two with treatment, just like the last case.  However, the need for any type of maintenance or preventive care is probably not there unless there have been several episodes prior to this one.

Lastly, consider a patient who is a truck driver, has 2 degenerative discs in his back and is 70 lbs overweight and smokes.  You may be able to help resolve the episode of pain with a month or two of care, but the likelihood of future episodes is nearly a certainty.  Plus, the disc degeneration creates an unstable environment, which is likely to worsen.  This is especially true when you factor in the extra weight and the smoking.  What does smoking have to do with it?  Smoking slows healing and increases the body's inflammatory response.  It is estimated that a smoker can heal up to 50% slower than a non-smoker.  This person will benefit immensely from maintenance care.

Bottom line:  Every person is different.  Every injury or pain is different.  A treatment plan is never one size fits all.  They generally start out similarly, but the ending is determined by individual factors.  Not sure where you fall?  Discuss it.  Ask questions.  Think about what you really want- long term and short term- and work with your chiropractor to form a plan that is right for you.

Protecting Your Feet Can Help Protect Other Parts of Your Body

Our feet are typically overlooked and can receive stress by simply walking or standing during the day. Each step we take immediately sends force to the ankles, calves, knees, and thighs, respectively.

Add a rigorous activity into the mix and the impact can increase immensely. 

A BBC News article states, “…champion male sprinters can hit the ground with a force that’s around 2.5 times their body weight (most people manage around two times).”[1]

The added force upon the feet during exercise can really open up room for injuries.

Since our feet are the initial point of contact for most exercises, wouldn’t it make sense to prepare the body with proper footwear for different activity levels?

Running

Runners place great stress on the body every time their feet touch the ground. Some runners will heel strike first, while others land on the balls of their toes. The bottom line is –impact on the feet when running is heightened and at a more frequent rate.  

It is important for running footwear to be accommodating under all aspects of gait. Footwear should have adequate support for the heels, the medial arch, and for toe-off – as well as protection from side-to-side movement of the foot.

This support will ease the impact and pressure on the feet, knees, and joints during those long miles. More support from shoes can offer less stress on the body and less soreness after exercise.

Gym Exercise / High Intensity Interval Training

The new craze in the fitness world revolves around total body exercise and high intensity interval training.

The feet and legs move less repetitively in this type of activity than a runner’s would. But support from proper footwear is needed greatly, as exercise can involve shifting frequently, pivoting, and rapidly jumping.

In order to ensure correct techniques, our bodies rely on the feet to provide balance, stability and posture. This type of activity calls for footwear that is relatively stable on the sole’s surface that can control impact from all angles.

High intensity training enthusiasts should avoid footwear that offers too much cushion, as it is like trying to lift weights on a gel pad. The unevenness of the cushion while under the pressure of lifting or shifting the body can reduce stability.  

 or 

In this case, it is important for the bottom of gym exercise footwear to be fairly minimal with an even foundation.

No two people will have the same foot size, arch structure, and activity level.  For any situation, getting the right fit in footwear is important.

By combining proper footwear with individually designed Stabilizing Orthotics, athletes can control posture and stability during their workout – optimizing their overall performance.    

Taking care of the feet will help take care of other parts of the body and help to avoid common exercise injuries.

[1] Yong, Ed. (July 13, 2012). Will we ever…run 100, in under nine seconds?http://www.bbc.com/future/story/20120712-will-we-ever-run-100m-in-9-secs/1 

For More from Foot Levelers:  https://www.facebook.com/notes/foot-levelers/the-right-fit/10151089957107943
or http://www.footlevelers.com/

Dr. Moeller's Take:

I have been prescribing orthotics for patients for several years now.  When I notice uneven wear on shoes or bunions sticking out of flip-flops, it is like a red flag.  Not only can these foot problems hurt the feet, they wreak havoc on the knees, hips and low back.  It can delay or prevent healing in the spine by constantly unbalancing the forces within the spine.  

I have personal experience with this in addition to clinical experience.  I have high arches, am an overpronator and have hammer toes.  Last year my toes started to hurt.  After a month or two of dealing with it, I scanned my feet in the office.  Sure enough, I needed orthotics.  I ordered both a full length and a dress set to fit the majority of my shoes.  After less than a month in them, not only was my foot pain gone, but the bursitis in my left hip--that I had been struggling with for over a year-- was completely gone too.  I had done rehab and cut a great deal of my high impact activity and was managing the pain, but I had no idea that getting rid of it would be so easy.  Doctors are often blind when it comes to their own issues, and, sadly, I was too.  I am just thankful that my feet started hurting!  If I had not developed that symptom, I would still have an inflamed hip that was slowly developing arthritis.  

Orthotics can really be life changing for some patients.  For others, it is more about prevention.  Either way, I cannot express the importance of proper foot support enough.  

Be well!

If You Could Bottle Attitude...

Every once in a while, you see someone who has taken complete and total responsibility for his or her own health and it just makes your day.  I have seen a few of those people lately.  Very refreshing in a world where it seems like everyone wants to eat whatever they want and not exercise and still feel good.  Isn't there a pill for that?  

I have a patient who has been making changes over the past six months with the goal of getting off all medication.  He is a family man with a very high stress job.  He was gaining weight steadily and was taking blood pressure and diabetes medication.  He drives 2 hours a day for his commute.  He was experiencing increasing neck and back pain, as well.  

He started working out and making smarter choices with his food.  He still has to drive and has a high stress job and small children at home, but he works on the things he can control.  Over the past 6 months, he has lost over 40 pounds.  His diabetes and hypertension is under control and he expects to be off all medication after the next check-up in three months.  His energy is up and his pain and stress are coming down.  

The best part is that the credit belongs to him.  It is rewarding to set a goal for yourself and to achieve it,  to stop feeling like health conditions are "happening to you" and to start seeing that you can change things.  You don't have to accept that you are diabetic (unless you are type I).  You can make changes, while taking your medicine and gradually get away from it.  You don't have to always have hypertension because you currently have it.  Things can change if you change.  

My job as a chiropractor has become increasingly difficult in the past 15 years and I expect that to continue. The reason is the declining health of the general population and, more importantly, the unwillingness of most people to make any significant changes in their unhealthy habits.  

Back and neck pain is affected by the following: 

*Weight

*Smoking

*Diabetes

*Inactivity

*Poor Diet

*Poor posture

ALL of those things can be controlled or affected by the patient!  

There are no pills to make arthritis go away.  There are no pain-killers that have no side effects.  There aren't going to be any time soon.  The things we can control in this world are our own habits.  Good habits do not guarantee that you will not have pain or that you will not get sick, but they will help you get better faster.  It's a fact.  It is also easier than you think once you make the decision to do it.  Habits can be broken.  New habits can be formed.  Take control of your own health.  It is an awesome feeling to see that kind of change and to know that no one made it happen but you!

The Surgery Myth

I am quite certain that surgeons suffer from the same frustration I often do:  explaining to patients that there isn't a surgery to help every pain.  I would have a nice little nest egg if I received a dollar every time a patient said, "maybe I just need to have surgery".  Surgery is usually not an option.  You cannot "cut out" overuse or overweight issues.  You cannot fix most low back pain with surgery.  Even if you are a candidate for surgery, the surgeon is usually the first one to tell you that it isn't going to take away your back pain.  It will provide relief from leg pain and nerve compression, but most times, the back pain remains to some degree.  Do not misunderstand me, surgery has its uses and is can be life-changing for some patients.  Those patients are generally the ones with large disc herniations.  If the surgeon can remove the portion of the disc that is compressing the nerve, it is an instant relief to patients who have been suffering from terrible leg pain and weakness.

What is so hard to get patients to understand is that most low back pain is caused by a combination of factors.  They are looking for a diagnosis that has a specific cause and cure. This is complicated by the fact that you cannot see many causes on an X-Ray or even an MRI.  Even if there is degeneration present, it may not be what is generating the pain.  I see people on a regular basis who have moderate to severe degenerative changes but almost no pain.  I also see people who have no visible abnormalities but severe pain.  This is not a surprise to me, but it can be very, very hard to explain to a patient who wants to know why they hurt so badly.  Inflammation, overuse and other non-visible factors just don't seem like an adequate explanation for that much pain!

The truth?  Most low back pain is caused by overuse, repetitive stress or muscle imbalances and poor conditioning.  It is inflammation driven.  The things you do-or don't do- on a regular basis play a major role in healing and continued pain.  Arthritis can exist without pain, as can a disc herniation.

What to do?  The number one thing you can do to help heal back pain and keep it from coming back is exercise.  If you are already in pain, you need to consult your chiropractor or other physician for the best exercise to choose.  The good news- this is something you can control.  The bad news- you have to DO it!  Other things that play a huge role:  smoking and nutrition.  Smokers can take up to twice as long to heal.  This is a fact, not something your doctor says to get you to quit smoking.  Smoking increases inflammation in the body and slows down healing.  What you eat makes a difference too.  Sugar, red meat and fried foods increase inflammation.  They create a poor environment for cell repair.  Weight also plays a role.  If you are carrying an extra 30 lbs on your stomach, your back is under constant strain.  This will create a constant low level inflammation.  That makes little strains into big strains and makes healing much harder.

The longer I practice (15 years this year!), the more I realize how complicated healing is.  Every person is different.  These differences between people have a huge impact on healing.  There are few "text book"  cases.  For a growing majority of patients, getting well requires a multi-faceted approach and a true partnership between doctor and patient.  It often requires a partnership between more than one doctor and the patient.  I don't see this changing anytime soon.  Our diets, weight and polluted environment continue to weaken our systems, leading to mysterious symptoms, auto-immune disorders, obesity and diabetes.  Until we start cutting the chemicals and taking true responsibility for our own lives, the problems will continue to worsen.  Sadly, even when people try to do this in their lives, we still end up with exposure to so many chemicals and toxins in our environment that there can still be ill effects.  That doesn't mean that we shouldn't try, and it doesn't mean that you won't get well if you are in pain.  It simply means that we need to start paying attention to other factors and working harder to be healthy.  There are no simple solutions to complicated problems.  I wish there were!  Be happy and be well.  

Exercising With An Injury

It may seem contradictory to exercise something that is injured.  However, most of the time, it is better to be active than to try to rest something completely.  The key is picking the appropriate activities and the right level of exercise or use.  Scientific data shows that for most injuries, the closer someone can stay to normal activities, the faster they will get better. Obviously, this does not apply to all injuries or activities. If something is fully or significantly torn, such as a ligament, you may need to immobilize it to allow the fibers to heal together again just like you would a broken bone. But for most injuries, the best thing you can do is use it, you just need to use a little common sense too!

There are many reasons why this is true of healing.
1. Movement increases blood flow to all areas of the body and will bring nutrients and materials needed for healing to the injured site at a faster rate if it is moving.
2. Moving an injured area directs proper fiber growth when healing muscles, tendons and ligaments. If something is not moving, the tissue does not know which direction to place the new fibers.  When the fibers are not aligned properly, scar tissue results and the strength and flexibility of the tissue is decreased.
3. Decreased motion will lead to deconditioning and can lead to illnesses or blood clots. When you stay in the same position too long, you are more prone to develop blood clots, which can lead to severe problems. You can also get pneumonia. It doesn't take weeks or months for the likelihood of these to increase. It happens in a day or two.
4. Muscle tone lost is muscle tone that has to be rebuilt. If you do not get things back to where they were before the injury, you can be left with a weak spot, allowing the same injury (like an ankle sprain) to occur again and again.

With all of that said, you do need to be careful with an injury. Avoid heavy strain. If you work out, you will have to modify things for a little while. But MODIFY is the key word. Walk or ride a bike instead of running. Switch to little or no weight for your toning. Focus on stretching more than you used to. But don't stop moving! Keep in mind that some pain is OK.  Ice the area after use.  If something feels "wrong," skip it until you have asked your doctor.  If you aren't sure at all what is safe, ask your chiropractor, trainer or medical doctor for advice.

Surviving Summer Picnics

Summer is a good time to get more exercise, but it is also full of healthy-weight hurdles.  With each new cook-out, the goodies seem to multiply: cheesy potatoes, seven layer salad packed with bacon and mayo, potato and pasta salad, every dessert imaginable.  It is amazing how so much delicious fresh food can be turned into caloric catastrophe.  So, what should you eat when you are faced with what seem to be all bad choices? What should you serve if you are hosting?

First, let's talk about a cook-out you are not hosting.  First things first, if you are asked to bring a side, make it something that is good for you.  Fresh cut up melon or fruit medleys are good choices.  A lettuce based salad with a healthy dressing is a good choice.  You won't be the only one who appreciates having something there that won't drive your pants size up!  Not all things served at cook-outs are terrible for you.  Try eating a chicken breast or even a hot dog or hamburger with no bun or half a bun.  Do not put cheese or mayo on it.  You can use ketchup, pickle, mustard, onion and/or tomato to dress it up.  Do NOT take more than one piece of meat and make sure it is a reasonable size.  Go for fresh fruit or veggies but go easy on any dips that accompany them.  Corn on the cob is usually a pretty good bet.  Coleslaw isn't great but it isn't horrible.  Same for baked beans.  Steer clear of the dips.  You can eat half a bowl of taco dip before you even know what happened- I've done it!  When you get to the end of the table--the dreaded desserts--choose one, and only ONE. Take a small amount and eat it slowly so you really enjoy it.  Lastly, what your drinks.  I don't just mean alcoholic beverages.  It is easy to drink several sodas on a hot day.  4 sodas can top 1000 calories!   REMEMBER THIS:  there will be another cook-out next week!

So what are some good choices for your own cook-out?  I will take them step by step.
1.  Meat--It is OK to serve burgers and dogs.  However, when making the burgers, make sure that you use a lean beef and keep them pretty small.  You could even try mixing beef and turkey or serving turkey burgers.  Ground chicken is also a good choice.  You could flavor the chicken with jerk seasoning and serve it with a jalapeno and fruit salsa for topping.  Shish-Kabobs are really your best bet, health-wise.  Use chicken and/or beef and a variety of fresh veggies.  You can marinade them or barbecue them or both.

2.  Sides--these are where it tends to really go off the rails.  Try doing baked potatoes on the grill.  I usually microwave them until they are about 3/4 cooked and then brush them with olive oil and sea salt and grill them.  Light butter and sour cream used in moderation are OK.  Grill a vegetable medley or zucchini strips.  Delicious!  Make a light salad, like Greek with a home-made olive oil based vinaigrette.  Feta cheese has a lot of flavor, so you don't need much, and combo'd with tomato, red onion, cucumber, Greek olives and dressing it it SO good!  Corn on the cob is also a good choice, as long as you don't drench it in butter.

3.  Dips and appetizers--Put out salsa, a home-made corn and black bean salsa and tortilla chips.  Guacamole is not a bad choice, because although fattening, it has healthy fats.  Chop up a watermelon and some other fresh fruits.  Skip the dip.  Make popcorn.  It's a better choice than chips.

4.  Dessert-- This is a tougher one.  Try making sugar free jello with light cool whip.  You could do a sugar free pudding with bananas and light cool whip and crumble a few Nilla Wafers on top.  A light cobbler made with Stevia is an OK option.  Popsicles or Fudgesicles work pretty well too.  It keeps the amount down and keeps people from eating them all day, because they will need to be put back in the freezer.

5.  Drinks--Try sugar free Kool-Aid flavors with Stevia.  You could also do a punch with diet soda.  Make sure there is plenty of water out too.  A lot of people will choose water if it is an option.

This is where my sisters would tell me that I am no fun.  I ask you this...Why do you really go to a cook-out?  Is it to eat or to see and spend time with friends and family?  It is a little of both, but I can guarantee that you will still have fun with healthier food if you try!

Summer Exercise Ideas

Oh SUMMER, how I love thee!  It is my favorite time of year.  The best part?  Getting outside.  If you are bored with your winter exercise routine, now is the time to change it up!
Try a few of these:
1. Hit the trails.  No matter where you live, there is a park or a good place to walk nearby.  Changing the scenery makes old boring walking or jogging new again!
2.  Try canoeing or kayaking.  There are great day trips around if you don't have your own equipment.  It's fun and it works different muscles.  You will feel your arms, back and abs in short order.
3.  Join a race.  Almost all "races" out there have walking options.  The bonus: giving to a great cause.
4.  Golf- without the cart!
5.  Find a park with multiple things to do and "cross train."  My favorite spot has a dam for stair work, trails for walking and a beach for walking in the water, swimming or just cooling off after.  Bonus: I see deer almost every time I go!
6.  Garden.  'nough said.  It is hard work!
7.  Pick up or league volleyball.  A great way to get some exercise and hang out with friends.
8. Pedal an old railway.  Rails to Trails are great places to bike free of the obstacle of cars and the danger that goes with it.

There are a million great ways to enjoy the outdoors.  Pick one (or 8!) and enjoy yourself.  Just don't forget the safety equipment and the sunscreen!

Yard Work is HARD Work

It is beautiful out there, and many of us are starting to garden and mulch and do all kinds of outdoor projects.  In our rush to make our yards beautiful, we often forget how physical the work is- until the next day!

While it is normal to feel some muscle soreness after yard work, there are some things that aren't normal and some ways to minimize your soreness and chance of injury.

First, let's discuss how to minimize soreness:

1.  Drink lots of water while you are working.  Dehydration can not only be dangerous in terms of heat exhaustion, it will also make you much more sore after a day in the yard.  Save the caffeinated and alcoholic beverages for later.
2.  Take lots of breaks, especially if it is hot.  It is easy to overdo it.  Even if you are in great shape, the muscles you are using may not be used to the load and your body may not be used to the sun and heat.  Most of us get better at withstanding outdoor workouts as the summer goes on, but early in the year it can be a shock to the system.
3.  Wear sunscreen.  Nothing makes post-work soreness worse than a good sunburn!
4.   Wear light colored, breathable clothing.
5.  Warm up and cool down, just like you would with a normal workout.
6.  Switch tasks periodically to avoid spending long periods squatting or digging or hauling mulch in a wheelbarrow.  If you have someone helping you, try trading tasks back and forth.

So what if you are already hurting?  What should you do?  When should you call a doctor?  It can be difficult to know when to seek medical attention after overdoing it or injuring yourself.  Here are a few tips:

1.  If you are confused, having chest pain, pass out or have moved to a cool place and are still experiencing dizziness, a rapid heart rate or confusion, you need to seek medical attention immediately.  Heat stroke is real and so are heart attacks.  Don't ignore serious symptoms.
2.  If your pain is so severe that you cannot move, call the doctor.  Otherwise, there is no harm in applying some ice and resting a while to see if it improves. If you have sharp pain or swelling, do not use heat.  Apply ice for 15-20 minutes and then take it off for an hour and repeat.
3.  If your pain is no better after 48 hours, I recommend calling the chiropractor or primary care physician.

Yard work and gardening are extremely rewarding.  They are good for the body and good for the mind.  There is a great sense of peace to be found in the outdoors and a great satisfaction to "tiring yourself out" creating something.  This is especially true for those of us who spend our days indoors.  Get out there and soak up a little sun- just don't burn!

Headache Treatment

I have been seeing a large number of headache patients over the past several weeks.  I believe this crazy lack of winter and up and down spring has a lot to do with it.  This year's allergy sufferers are going to have a tough year.  Unfortunately, this factor increases the chance of getting all kinds of headaches, as they do tend trigger each other.  So, I have decided to revisit an article from 2010 regarding headaches:

Suffer from frequent headaches? Chiropractic care may be able to help. There are many reasons why headaches occur. They can be migraines, tension, trauma induced, sinus, cluster or multiple other types, each having its own causation. Headaches are a very complex topic and are not well understood by a large portion of the population. On health intake sheets at my office, I very often see migraine circled, only to discover that the patient simply thought that denoted a severe headache. While migraines are severe headaches, not all severe headaches are migraines. Getting to the root cause of the headache will help determine if the headache is likely to respond to chiropractic care. But, as with most things in the body, there are no perfect rules and there is a lot of overlap of headache causes. For example, a migraine sufferer may also get a tension headache. If he or she gets enough of those headaches, it can cause a "ramping effect" and trigger a migraine. 

As a chiropractor and a tension headache sufferer, I am well aware of the benefit of chiropractic care for tension headaches. I have also had great success with helping migraine sufferers decrease the frequency of their headaches or control headache pain during times when taking their medication is not possible, such as pregnancy. Trauma induced headaches that linger beyond a few days also respond well to chiropractic care. Cluster headaches are more difficult to control with chiropractic, and sinus headaches only respond if you can manage to relieve the sinus pressure, which can sometimes be achieved with chiropractic care. 

You may be wondering what chiropractic care for a headache consists of. Generally, I will use 3 or 4 different elements. The chiropractic adjustment is number one. Headaches almost always have a link to the cervical spine, or neck. This link may be direct or indirect. Secondly, I use trigger point therapy to relieve muscle tension. I will also frequently incorporate passive modalities like electrical muscle stimulation or ultrasound. Lastly, home stretching and/or exercises are added to relieve muscle tension and re-establish proper muscle balance. 

The amount of time that it will take to get your headaches under control will vary person to person, but if you are going to see a change, it should start within 2 weeks. Many people experience dramatic improvement after just one treatment. BUT, like everything with headaches, it varies. However, it is generally a relatively small time and money investment to see if chiropractic care can help.

Pregnancy Pain and Chiropractic Care

I have been seeing a large number of pregnant patients as of late and thought a review of the benefits of chiropractic for pregnant women might  be in order.  Pain during pregnancy is a major problem for a lot of women.  It is estimated that over 70% of women experience significant low back pain during pregnancy.  Most women think this is normal and that they need to "live with it."  In most cases, this is just not true!

Chiropractic care can offer a safe, effective option for managing pregnancy-related pain.  For most patients, the pain decreases by 50-100% within the first 2 weeks-all without medication.  In my office, I use a specialized table for pregnant patients.  You can see a picture here.  The middle of the table drops out to accommodate growing tummies.  The back of the table goes up and down, which stretches the low back and helps relieve pressure on the nerves and joints.  There is also a "drop piece" on the lower portion that pops up and down.  This accelerates force, allowing a minimal amount of pressure to create enough force to move the joints without causing too much discomfort.

Chiropractic care is often overlooked or misunderstood where pregnancy pain is concerned.  Doctors and the general population, who don't fully understand what we do, may be afraid that it is unsafe.  They may assume that we will not treat pregnant patients.  I work very hard to educate my patients, area doctors and the general public about chiropractic care and pregnancy.  It is one of my favorite conditions to treat.  Few things make you feel better than helping a woman to better enjoy her pregnancy.

For more information, feel free to email me.

Lumbar Stenosis- What Can Be Done?

Lumbar stenosis is defined as a narrowing of the spinal canal, resulting in nerve compression.  This condition can cause a wide variety of symptoms and can be tricky to treat.  The most common stenosis scenario is a 50+ patient who comes to the office complaining of low back and bilateral leg pain.  The pain is often worse on one side, but can switch sides.  The pain is made worse by walking and is relieved by sitting down or leaning on a grocery cart.

I have had great success in treating this condition using an extremely simple approach.  Of course, nothing works for everyone, but the vast majority of my stenosis patients have had significant improvement using a very simple combination of Flexion/Distraction (a specialized form of traction), gentle manipulation and a home exercise/stretching program.  The idea is to decrease the lumbar lordosis and allow more room for the nerves, thereby decreasing the pressure and symptoms.

The best thing about this treatment?  There are three.
1.  It is non-surgical.
2.  It is relatively inexpensive and is covered by most insurance companies.
3.  You will know whether it will help you within 4 weeks or less.  Some people start to feel better within the first week.

So, if you have been diagnosed with stenosis or know someone who is suffering from it, chiropractic care is a great option.  Questions?  Email me.

Health Tips You Might Want to Ignore

I try to stay up on the latest fitness and nutrition trends.  I read online articles just to see what is out there, because the advice being given is often being written by people with no background in health or nutrition.   I read an article last week that nearly caused me to fall off my chair.  If this is the latest advice, I can see why our country continues to struggle with obesity, diabetes and other weight related issues.

The article was discussing health rules you can break.  The #1 rule to break- 8 glasses of water a day.  The author's suggestion- eat your water.  Now, I get what they are saying- fruits and vegetables have a high water content and can help with hydration.  However, why on earth would someone substitute a healthy, calorie-free practice for one that contains calories?  An orange is a great source of water, but it also has 62 calories.  No where in the article did it discuss offsetting the 62 calories by eating less.  PLEASE EAT THE ORANGE, just not as a substitute for a glass of water.  Eat the orange with a glass of water.  Water helps you to feel full and will keep your hunger more in check.  When dehydrated, the body will trigger hunger in addition to thirst.  Why risk the confusion?  There is such a thing as too much water, but we are talking gallons, not glasses.  Stick with the water.

The #2 rule to break- Eat 9 servings of fruits and vegetables a day.  The new recommendation-fill half your plate with fruits and veggies.  Honestly, the new rule is OK advice, but the old rule is much more specific.  The vast majority of the population does not get enough fruits and vegetables (french fries don't count!), so I think it is extremely important to keep stressing the actual amount.  If people followed this rule, we would be a lot lighter, have fewer heart attacks, lower incidence of diabetes and less cancer.

Why attack these two wonderful pieces of advice?  Some things do not need updating.  Especially when the "updates" can be so easily misunderstood or manipulated to make bad habits seem healthy.  Looking at the top rule makes a smoothie seem like a better idea than a water bottle.  Rule number two is vague and will result in a person eating less fruits and vegetables.  I will stick with the outdated advice!

Splitting the Work

If there was one thing that I can say is the biggest factor in recovering from pain or injury, it is patient cooperation.  I don't just mean showing up for appointments, although that is obviously a big part of getting better.  I mean following orders at home and being active.

When most people are in pain, their first instinct is to protect and immobilize the painful area.  This is generally not the best plan of action when healing common muscular and skeletal issues.  Bodies heal better when they are moving.  Blood flows better, which increases the nutrients coming to and the waste products leaving an injured area.  This helps reduce swelling and supply the necessary ingredients for cell repair and healing.

Unfortunately, patient compliance in this department is low.  People get busy and put things off.  They listen to everyone around them, get many conflicting opinions and then ultimately do nothing.  Or, they just don't think it is important, so they skip it.  We are a "pop a pill" culture.  Having to do "homework" doesn't fit in.

I know that it isn't fun and it isn't easy, but the only way to regain strength and coordination after an injury is to do the work.  No doctor or physical therapist or pill can do it for you.  We do our part, and the rest is up to the patients.  Remember what is at stake the next time you suffer an injury- not just your current pain, but possibly your future pain too.  Please do your "homework".

Common Sense for Exercise

Yesterday, my sister told me  about a presentation at her work regarding fitness.  She was telling me how  "over the top" the speaker's recommendations sounded.  I was truly amazed at the unrealistic and outright silly things he encouraging.  He was literally giving them body-builder advice.  It was not good advice for the average person looking to get fit and lose or maintain weight.  Here are two essential things to consider when talking about fitness, diet and exercise:

1.  Everyone can workout, but not everyone can do the same workout.
2.  Dietary recommendations related to training are not the same for everyone.

Some of the recent fitness trends are pretty extreme.  P90X, Crossfit and Boot Camps have become very popular.  These workouts are great for some people, but there are WAY too much for a good portion of the population.  They contain a lot of high impact moves, plyometrics, chin-ups, rope climbing and more.  For the young and healthy, this can be a fun way to change things up.  For those of us with arthritis in our hips and knees, they can be a quick road to pain.  I long for the days when I could run suicides, but I also know that they are over if I want to walk without a limp.

You need to choose a workout that suits you.  Who cares if you neighbor can run a marathon!  What can YOU do safely and consistently?  You don't need to train everyday, but you should work out a minimum of 3 days per week.  On the days you don't work out, try to get a brief walk or some physical housework in (or something similar) in your day.

Your workout should contain 4 things:
1.  A warm-up of about 5 minutes where you do whole body moves that get your body ready for activity (for example, walking in place, mini squats with reaches and/or knee lifts with arm pull downs).
2. Cardiovascular activity for 20-60 minutes.  You may need to start smaller but you should aim for 20-60.
3. Resistance training or weight training 2-4 days per week.  You do not need a gym membership for this.  A pair of dumbbells will do.  Resistance bands are great too.
4. A cool down that includes stretching.  This should last 5-10 minutes and allow your heart rate to return to near normal and include stretching for the legs, back and upper body.

If you are not training for a marathon or other distance event, body building or some other sort of intense activity, you do not need to add any special things to your diet.  Protein shakes are not necessary, neither is carb loading or Gatorade or any of the other things that get pushed at you as essentials for being "in training."  Those things will sabotage most people's diets and slow weight loss.  Eat a healthy diet.  Period.  Drink lots of water.  Period.  Skip the post workout smoothie- you don't need it.  Fill up your water bottle and eat an orange if you want a post workout snack.

Have a GREAT WORKOUT!  Enjoy what you can do and don't worry about anyone else.

Sneaking Some Extra Nutrition Into Your Meals

Need a few ideas for easy, healthy dinners that pack a nutritional punch?  Try these.  All too often we just "pick something up" because it seems like too much trouble to make anything.  If you have the ingredients on hand, you will probably save time-and your waistline-by cooking at home.  We have several "go to" meals at my house for long, late days.  They can be ready in 20 minutes or less and involve little or no chopping.   It is great to use fresh vegetables when you have time, but frozen have nearly the same nutritional value and can cut your prep time considerably.  

Pasta With Hot Italian Turkey Sausage

Pasta (whole wheat or rice) prepared al dente

1 jar marinara sauce (no meat or cheese)

1 can petite diced tomatoes

1 cup diced onion and 1 cup diced green peppers (I use bagged frozen)

1 cup frozen chopped spinach

1-2 teaspoon chopped or minced garlic

2 hot Italian turkey sausage, thawed.

Directions:

Add 1 T olive oil to a large, deep pan and add onion, green pepper, garlic and sausage, squeezed from casings.  I add some Italian seasoning and dried or fresh basil too.  Cook until sausage is done.  Add spinach and cook until hot.  Add tomatoes and heat for 1-2 minutes then add sauce and simmer for 5-10 minutes (however long it takes to finish the pasta).

Toss sauce with pasta and top with a pinch of parmesan.  This takes traditional spaghetti to a whole new nutritional level!

Wild Rice Pilaf

This is an easy dish to throw together while you are home and doing other things.  It takes an hour to cook, but you only have to check on it and stir it.

2 cups Wild Rice or wild and whole grain combo– uncooked.

3 cups chopped veggies, including carrot, onion, celery (you can use frozen, pre-chopped– they even make bags with all 3 in them already).  A cup or 2 of frozen asparagus makes a really tasty addition too.

2-3 teaspoons chopped or minced garlic

3-4 cups of vegetable broth (organic is best) or chicken broth (no msg)

1 bay leaf

Sea salt and pepper, to taste

Directions:

In 1-2 T olive oil, cook veggies until mostly soft (5 min) with garlic.  Add rice, broth, bay leaf and 3 cups water.  Simmer for 50-60 minutes, stirring occasionally and adding more water if it is getting dry.  It is really hard to overcook this as long as you keep enough water in it so that it doesn’t burn.  When it's done, fish out the bay leaves.  I cook this on Sunday afternoon and save it for a night when I am in a hurry or take it for an easy meatless lunch. 

Recipe Switch Out– Turkey Tacos

Use ground turkey instead of beef with taco seasoning and add chopped green peppers, onion, tomatoes and jalapeño or habanero peppers.  Top with salsa, lettuce and guacamole.  Use cheese sparingly.  

TAKE AWAY TIP:  Adding extra veggies to any meal increases the nutritional value, decreases the calories per serving and increases the total volume.  It will turn 1 jar of pasta sauce into the volume of 2 or 1 lb of taco meat into enough to feed twice as many people. If you have frozen on hand, it doesn't add more than a few minutes to your cooking time, either.  

Stretching– When and How Much?

Stretching recommendations have changed a lot over the years.  The “old school” method was to stretch before exercise.  Stretching was optional afterward.  Then, it was both before and after (better, but still not right).  The best time to stretch is after exercise.  Why?  When you are “cold”, as in before a workout, your muscles can be strained by too vigorous a stretch.  After exercise, your body and muscles are warm and stretching is easier and safer. 

So what to do before exercise?  A Warm-up.  This involves lighter intensity full body movements that allow your body to heat up and get ready for a more intense activity.  You should warm up for 5-10 minutes before undertaking a vigorous workout.   Afterward, you should cool down for about 5 minutes and then stretch.  Stretches should be held for 20 seconds with NO BOUNCING.  If you are prone to low back pain, you should stretch your hamstrings on your back using a towel.  Seated or standing stretches are more likely to irritate the low back, especially if you aren’t very flexible. 

What if you are stretching but not working out?  When you are stretching only, you don’t need to “warm-up,” but it is best to make sure that you have at least moved around a bit.  It may be convenient to stretch before you get out of bed, but your body is too tight after sleeping for that to be a good time.  The best time is after a hot bath or shower.  However, it is not necessary to do that first.  Make sure that you stretch to the point of feeling a stretch but not pain.  Again, no bouncing.  This is especially important when you are not warm.  You can easily strain a muscle doing that.  Non weight bearing stretches are best when you are not “warm.”   They are also best for those suffering from low back pain.  “Old school” toe touches are not safe for someone who is suffering from low back pain, especially the twisting kind.  That is the most common position to herniated a disc.

How many times a day should you stretch when trying to heal an injury or gain flexibility?  No less than once and no more than three times is my rule.  When you are feeling good, once is probably enough.  When you are in a lot of pain, it is tempting to stretch more often, but it can cause irritation if done too much. 

If you aren’t sure what stretches to do, ask your chiropractor, trainer or physical therapist.  Don’t make up your own.  I see this a lot and often find that people are doing some very unhealthy and potentially harmful things. 

You don’t have to be a yoga master, but a good stretching routine can benefit every person, pain or no pain.