Coping with Chronic Pain

This post is brought to you by one of our blog readers! Jackie Waters reached out to us and has some excellent advice for living a healthy lifestyle. Jackie was diagnosed with rheumatoid arthritis in her mid-20s, and she has found a way to make many lifestyle changes to help manage the ups and downs that can come with rheumatoid arthritis. Check out her article below on coping with chronic pain! It is filled with great advice and good links to other sources to help you, and don’t forget that chiropractic care can also be a great adjunctive therapy to manage RA or any source of chronic pain.

Dealing with the shock of a life-altering diagnosis can turn your world upside down. It’s important that in the middle of it all, you remember that there is hope and ways to safely manage your symptoms. Here’s some advice on how you can deal with your newly diagnosed condition and how to cope with the chronic pain that may come with it.

First take the time to process the news as well as your emotions. The Center for Advancing Health points out that, “There is rarely only one way to treat a disease, so take time to do some research, investigate your options, get a second opinion and find the right specialist.” Feelings of hopelessness and depression are perfectly normal. Make time for yourself and find support in those around you. It’s okay to be afraid, and sometimes the best medicine is that of a listening ear.

There are also several relaxation techniques to consider that will make your life easier, one of which is exercise. While you may be tempted to avoid exercise due to the pain, according to Exercise Right, “Research has shown that exercise can be an effective way to reverse this downward cycle of deconditioning and worsening pain, and gradually over time help those with chronic pain engage more in activities of enjoyment and essential activities of daily living with greater ease.” Start slowly and opt for shorter workouts instead of going for the long haul. Routinely monitor your pain levels and focus on flexibility, stretching when winding down a workout to avoid stiff muscles. Mix it up and pick something fun to do so you’re not concentrating on pain. Consider low-impact exercises such as swimming, biking, walking, dancing, and even gardening. Warm water especially relaxes your muscles, and meditation as well as yoga are also healthy coping mechanisms to practice. You should, however, try to limit your physical activity to time frames when your medication is in full affect.

Getting a pet can bring a calming influence into your life and help cheer you up. A pet also will keep you active and provide endless companionship. Consider spending more time pursuing a hobby like knitting, pottery, or photography to bring peace to your mind and ease your worries. Get plenty of rest, stick to a routine, and practice good posture. Additionally, breathing exercises and aromatherapy relax the body as well as the mind. Try escaping by reading a good book, visualizing a serene and happy place, or indulging in a warm bath and spa treatment. Heat and ice work to reduce inflammation and pain. However, you should also consult a doctor or therapist and take any medication he or she prescribes you regularly.

Creating a healthy and peaceful home environment will also help you to keep a positive mindset and control any anxiety. Work to achieve minimal clutter by getting rid of things you don’t use or that don’t bring you joy. Rearrange your items for storage for better organization and even rethink your furniture placement in order to make room for a meditation space. Decide what you want to be the focal point in your house, whether it be a window, fireplace, or entertainment system. Let lots of natural light in so you have a warm and cozy atmosphere. Paint the walls with tranquil colors and fill your home with comfortable seating, candles, greenery, books, art, blankets, soft music, and pillows. This will help manifest an intimate setting where you feel at home.

Lastly, take solace in knowing that you are not alone. There are others out there suffering too, and by joining a support group, you may find additional comfort and companionship. Others suffering from chronic pain also may offer solutions based on their own experiences that you may not have thought of.

Want to learn more from Jackie? Check out her website! Have any tips of your own? Let us know in the comments! 

IT Band Syndrome

2018 is the year of running (at least for Dr. Emily). With this, Dr. Emily is spending more time with runners, and she is hearing more about aches and pains with runners. Enter this blog post about IT Band Syndrome! 

Definition and Causes of IT Band Syndrome

First things first – what is the IT Band? IT stands for iliotibial; the IT band runs from your ilium to your tibia. The ilium is the science term for your hip bone and your tibia is one of the bones in your leg. Check out this picture to better visualize the IT band.

Looking at this photo, you can see the white tendinous fibers if the IT band. The top part of the IT band is thinner and fanned out. It is made up of fibers from tensor fascia latae (TFL) in the front, gluteus maximus in the back, and gluteus medius on the underside. As you travel down the IT band, fibers from vastus lateralis (one of the 4 muscles to make up your quadriceps) contribute a bit. The lowest portion of the IT band is a narrow, thick band that you can feel just above your knee.

So now that we are familiar with the IT band, we can look into IT band pains. IT band pains can come whenever the IT band isn’t able to move and support your body the way it is supposed to. If any of those muscles we talked about get too tight/aggravated, it can pull on the IT band and alter the biomechanics of your hip, knee, and leg. But there’s even a bigger picture than that! The IT band is not only connected to those muscles but to the ilium and the tibia. Both of those bones also serve as attachement sites to MANY other muscles. That means that any number of muscles can affect the ability of the IT band to work as it is supposed to.

There are some activities that can put more stress on the IT band. These include running downhill, running on slanted surfaces, always running on the track in the same direction, or simply over exertion. Wearing shoes that are worn out can also change your biomechanics and put more stress on the IT band.

Signs and Symptoms

IT band pain presents differently depending on where the problem started. Some common symptoms are:

• Nagging pain on the outside of your knee
• Sharp pain at the outside of your knee
• Swelling pain around your knee
• Feeling a click, pop, or snap on the outside of your knee
• Pain up and down the outer part of your upper leg

Many times the pain around the knee comes on during a certain part of a run and gradually gets worse. Many runners will feel that this pain is worse while going downhill.

The pain may also be noticed while cycling. It can come and go during the downward pedal stroke and upward pedal stroke (when your knee is bent around 30 degrees).

Sometimes the pain will go away with rest, but it will return with activity.

Chiropractic Approach

First off, a chiropractic exam is performed to determine the cause of the IT band irritation. A series of orthopedic tests, movement assessments, and palpation of the muscles and joints give us a good understanding of what is causing your pain. Through this exam, we can usually identify what the cause(s) of the pain are. The cause of the IT band syndrome dictates the treatment. 

If the cause is any of the muscles whose fibers directly feed into the IT band, the treatment will likely be focused on soft tissue therapy to those muscles. Manual soft tissue treatments (like massage) and instrument assisted soft tissue treatments (see this page for more info) are often very effective in treating IT band syndromes caused by this.

If the cause is due to joint restrictions (either in your feet, ankle, knee, hips, pelvis, or low back), we can correct those through chiropractic adjustments.

If the cause is due to muscle imbalances pulling on the ilium or tibia restricting the natural movements, we will work on correcting that imbalance by strengthening/activating the weakened muscles and stretching the tight/overactive muscles.

Some patients may have multiple causes contributing to their IT band syndrome, so we treat all the causes. We are also a big fan of home stretches and exercises to help eliminate future flair ups. Many patients benefit from foam rolling or using massage sticks over the musculature of their thighs and legs. 

After your first treatment, we will go through specfic exercises and stretches that are targeted towards correcting YOUR causes of IT band syndrome. 

There is no need to live with insistent, irritating pain. Call us today! 

New Year, New Me!

Happy (almost) New Year!

As 2017 draws to a close, it's a natural time for reflection on the year. There were likely many ups and downs in 2017, but there's nothing quite like a new calendar year for a clean slate! One of the best ways to make 2018 the best year yet is to focus on YOU! Focus on your health! Eating well and exercise does the body good, and it can be wonderful for your mental health, too! If you are struggling on ideas for resolutions, we've got some suggestions for you! 

1. Better Posture! 
2. Eat Healthier
3. Exercise More

Better Posture

Good posture is its own reward! When you have good posture, there is less strain on the muscles, ligaments, and joints in your body. Poor posture can also decrease your lung capacity by up to 30% - which can leave you feeling sluggish and groggy. So in 2018, focus on showing your body some love by focusing on your posture! 

One way to start working on posture is to set posture reminders! Every hour during the work day you can have an alarm beep, and use that time to refresh! Reset your posture when that alarm goes off. Also make sure your car and work place are set up for good posture! Here are some resources for your better posture resolution:

• Setting up lumbar support in your car
• Stretches/exercise to combat "tech neck"
• American Chiropractic Association's guidelines for sitting, standing, and lying properly

Getting adjusted can also help with better posture! Schedule an appointment to get adjusted, and Dr. Emily will offer you some more individualized posture tips! 

Eat Healthier

Come January 1st, eating healthier sure does sound appealing. We've had Halloween candy in October, Thanksgiving in November, then all the cookies, sweet treats, and drinks associated with the holiday season in December. Eating healthier is such a vague statement, it can sometimes make it hard to implement. There is a whole spectrum of healthy approaches to food, there is no right way. Here are some dietary resolutions that may work for you:

Whole 30 is one way to start the year off. Warning - the Whole 30 food plan can be challenging, but it can be life changing. In the Whole 30 program, you commit to 30 days of eating whole foods. When I say whole foods, I don't mean the grocery store, I mean you eat fruits, vegetables, and meats. The Whole 30 program has an awesome website, and they give you a lot of information. They have a shopping list for you, so you can confirm if foods are ok! the Whole 30 cuts out all the processed grains and dairy. 

This link is a great resource for reassuring yourself during the Whole 30 journey, or if you are a more visual person, check out this picture:

If the Whole 30 plan seems a bit too much for you, you can try something a bit less restrictive.

You can resolve to add more vegetables into your diet. Strive for 5 can be a reality for you! Try cooking with vegetables you aren't as familiar with! Add vegetables to more meals. A great recipe resource can be found on the Meatless Monday website; they have a browse recipe by ingredients option! Going meatless on Mondays could also be a resolution for you! 

• Meatless Monday Recipes

If you want to make a nutrition resolution and you want more guidance, you can always book an appointment with Dr. Emily! 

Exercise More

Exercise is so beneficial to the body! Set a goal to exercise more! Exercising doesn't have to be scary, either! If you are struggling with where to begin, the Couch to 5k app is great! It may cost a few dollars in the app store, but it will guide you through each workout! You can also try the couch to 10k app! The cost of the app is still less than a gym membership!  

• Summary of the Couch to 5k program

If you are located in Carlsbad/North County area, you can also join one of the countless running groups in the area. Dr. Emily enjoys runs with Run North County! They are a free running group, and they have group weekly runs! There is a run somewhere in north county every day of the week. Most of the week day runs start around 6 PM. If you want to learn more, check out their website! 

• Run North County - Click on the Weekly Runs and pick a day to see your options

You can also join Dr. Emily in making 2018 the year of running! Want to run a race with her? She'll be running the Carlsbad Half Marathon, La Jolla Half Marathon, and America's Finest City Half Marathon! She is also resolving to do these foot drills every day to keep her body happy.

• Foot drills

Don't let weird body aches and pains keep you from exercising! We've got you covered! Questions? Comments? Concerns about resolutions? Ask away! We want to help you make 2018 the best year yet! 

Hidden Causes of Low Back Pain (Part 2)

Last blog we talked about how your low back pain may not be coming from your low back! Quick refresher: Sitting all the time at a computer/desk job can leave us with hyper-kyphotic (hunch back) posture. Sitting can also lead to tight hip flexors and lack of movement in your hips and pelvis. The idea is that if your thoracic spine and hips can’t move the way they are supposed to, your lumbar spine (low back) will try to compensate and do the work for them. That means that your low back is working over-time!

Last post we covered mobility drills for your thoracic spine, and so this time we will talk about how to open up your hips.The muscular around your hips/pelvis is quite extensive. Check out the image below to get an idea of the muscles we are targeting with these stretches. 

90-90-90 Hip Stretch

The easiest way to start the 90-90-90 hip stretch is to start sitting on the floor with both legs in front of you. Have your heels on the ground and your legs bent to about 90 degrees. From there, let both knees fall to the right side. Your right leg will likely be close to the ideal position, but you may have to move your left leg back a bit but keeping your knees bent at 90 degrees. You want your legs to make ALL the right angles. (Ignore that my left knee may be a bit smaller than 90 degrees.) 

Depending on how tight your hips are, you may already start feeling a stretch. When moving into the next stretches of this complex, only stretch as far as feels comfortable. This should never feel painful! 

From this 90-90-90 position, lean forward on your front leg (your right leg). As you lean forward, you can support yourself on your hands/elbows. When you do this, you should feel a deep stretch in the posterior muscles on your right leg and gluteal region. You may also feel some stretches other places. It depends on where exactly your tightest muscles are. If you are familiar with yoga, this should feel similar to pigeon pose. 

Next slowly come back to your seated 90-90-90 position. From here try to square your shoulders so you are directly facing your back leg (your left leg). I think of trying to line up my sternum with my leg. Then slowly lean back until you feel a good stretch in the front of your left leg. Again you can support yourself on your hands/forearms depending on your flexibility. You should feel a stretch on top of your left leg/front part of your hip. You may feel stretches other places, too, this again depends on where your tightest muscles are. 

Slowly come out of this stretch, then switch your legs, and repeat! 

Modified Lunge 

The modified lunge stretch is just that! For this one, you need a prop! It can be a stair, sofa, or chair (leopard print optional)! You may also want to do this on softer floors or put a yoga mat down for padding. To get into this modified lunge, rest the top of your foot on top of your prop, then drop into a lunge position. Having your foot elevated, will increase the stretch down the font of your leg.

Focus on kneeling really tall. You should also focus on having a posterior pelvic tilt to feel the stretch more. This means make sure that you are NOT sticking your butt back and out along with letting your abdomen go forward. To initiate a posterior pelvic tilt, I think of pulling my belly button in trying to approximate it to my spine then moving my butt down and forward. To better understand pelvic tilts, check out the image below of the side view of the pelvis. 

Make sure to do each of these stretches on BOTH sides! I recommend holding each stretch for at least 30 seconds and going through these 2-3 times. 

Questions? Hopefully these stretches will help with your hip mobility. We can also always go through them during your next appointment. Don't have a next appointment yet? Call us today to set one up!

Hidden Causes of Low Back Pain (Part 1)

“My low back hurts! Why are you messing with my hips and mid back?” That’s a great question! Low back pain can’t just be lumped together in a simple category. Two people may both have low back pain, but they can each have a different cause of low back pain. For example, two people may be coughing. One could be coughing because he choked on some food while the other could be coughing because of a cold. You shouldn’t go offer both cough medicine because of their presentation; they have different causes!

This week we will be looking at how to do some at home mobility work for your thoracic spine (mid-back). Next week we will continue by looking at your hips. Sitting all the time at a computer/desk job can leave us with hyper-kyphotic (hunch back) posture. Sitting can also lead to tight hip flexors and lack of movement in your hips and pelvis. The idea is that if your hips and thoracic spine can’t move the way they are supposed to, your lumbar spine (low back) will try to compensate and do the work for them. That means that your low back is working over-time!

When looking at mobility for your thoracic spine, you can always consult our older blog post on exercises/stretches for better posture. We also have some new mobility drills for you to work on.

Basic Foam Rolling

This is a good way to warm up and do a broad sweep of mobilizing your spine. When foam rolling, I like to start just above the curve in my low back and roll up to the base of my neck. I often like to have my arms crossed across my chest like I’m giving myself a big hug. (Why not hug yourself! Show your body some love!) I feel this is nice in the area between my shoulder blades. You can also use your hands to support your head if your neck starts to get sore holding up your head. (It’s hard being smart and having such a heavy brain.) Do this for a minute or so, and then move on to the other stretches.

Double Tennis Ball

Grab two tennis balls, and use athletic tape or a wide enough tape to attach the two balls together. These are going to allow you to really work out the muscles on either side of your spine. Check out the picture below to get an idea of how the double tennis ball will cradle your spine while massaging the muscles.

Lay on the tennis balls where the divot between the tennis balls aligns with the spinous process (the sticky outty part of your spine that you can feel on your back). From there just relax on top of the ball and then crunch up a little. Think of bending your back around the balls. Then move the tennis balls up your spine and repeat. Some spots may be a little more tender than others. Feel free to hang out in those spots for a little while. Focus on your breathing and trying to relax, and the sore spots in your muscles will hopefully do the same.

Quadruped Rotational Drill

This drill can be done in two positions. You can either be on your hands and knees or go back to a position where you are sitting on your heels. For some people, the hands and knees positioning is more comfortable, especially if they lack the mobility to get in to the position where they are sitting on their heels. Once you are in position, place one hand on the back of your head, and work on rotating from the ground then looking up towards the sky. When doing the rotational movements, think of making all the movement come from your mid-back. Keep your low back, hips, and pelvis all stationary. The kneeling position can allow for a bit easier isolation of the thoracic spine movement. Do 5 rotational reps on each side and repeat 1-2 times. Each set try to rotate a bit further.

Questions? Hopefully these drills will help with your thoracic mobility. We can also always go through them during your next appointment. Don't have a next appointment yet? Call us today to set one up!