Tis the season

Now is the time of year that snow, ice and frigid weather blast into town. When starting winter activities you level of conditioning can affect your fun. Winter sports like skiing, skating and even sledding can cause painful strains or tears if your body isn’t ready for them. Walking outside in cold weather without layers of warm clothing can have an effect. As muscles and blood vessels contract to conserve the body's heat, the blood supply to extremities is reduced. This drop in blood flow may lower the functional capacity of many muscles, particularly if your cardiovascular health isn’t the best. Preparation for an outdoor winter activity, including conditioning the areas of the body that are most vulnerable, can help avoid injury and costly health care bills.

Cross country Skiing is a great exercise in the  winter

Many people each year are injured when shoveling snow. Shoveling snow the wrong way can pose the potential for soreness, or even strains and sprains. Here are some tips to avoid injury, while clearing snow:

• Layer clothing to keep your muscles warm and flexible. Layering also let you regulate your temperature easily, as you can remove articles of clothing one at a time, thus preventing overheating/cooling.
• If you must shovel snow, be careful. Make sure you get up early and have time to shovel before work, without needing to rush.
• When you do shovel, push the snow straight ahead. Avoid sudden twisting and turning motions, these are the motions most likely to cause back pain. Don't try to throw the snow, instead walk it to your snow bank.
• Shoveling can strain "de-conditioned" muscles in all of your back, buttocks and legs. Prevent this by stretching before you grab that shovel. Maybe try some snow angels to warm up! (an idea I got from Dr. Rash of Assurance Chiropractic in Denver, CO)
• Also, to prevent back injury when shoveling, use the muscles of your legs and arms to do the work, not your back.
• Take frequent rest breaks to take the strain off your muscles. A fatigued body asks for injury.
• Stop if you feel chest pain, or get really tired or have shortness of breath. You may need immediate professional help.

After shoveling, if you are sore, apply an ice bag to the affected area for 20 minutes, then take it off at least an hour. Repeat a couple of times each day over the next day.

If you continue to feel soreness, pain or strain after following these tips, it may be time to visit a chiropractor, physical therapist or other manual healthcare provider.

The dangers of Tylenol...

Many of us, when we have aches and pains reach for medication. One of the most popular over the counter medications today is Tyelnol. Because this drug is easy to obtain, many think that it is harmless, they couldn't be more wrong. Two weeks ago the British Journal of Pharmacology released a paper showing the dangers of what is termed a staggered overdose of acetaminophen, which is better known in the US as Tylenol.

Picture from beatsmedia.com

What is a staggered overdose? This term refers to the time when a person repeatedly exceeds the daily recommendation through small overdoses. This is important for people to realize since the paper shows a staggered overdose is more deadly than one large overdose. Researchers also commented  about a compounding factor with staggered overdose, alcohol use. Alcohol greatly increases the toxicity of acetaminophen and in there study someone suffering a staggered overdose was more likely to have encephalopathy due to the acetaminophen/alcohol combination. 

Many people have a misguided belief that small overdoses will not cause any problem, or even worse don't even read their medication to find how many pills is the maximum dose per hour/day. Read more about the paper here.

Why take Tylenol at all, you might ask? Tylenol's active drug acetaminophen addresses pain without the risks of ulcer in the stomach, but an increase toxicity to the liver. Also acetaminophen doesn't address inflammation the way that ibuprofen (Advil) does.  The best way to approach taking any medication, over the counter or prescription is to talk about the drug with a doctor. Key issues/points to discuss with your doctor are:

• What you hope the drug to do - At times people expect a drug to do more than than they should.
• Known side effects of the drug, and how common these effects are - being aware is the best.
• Safe dosages - something you should know about any drug even cough syrup.
• Duration to use the drug - some drugs need to follow a specific course.
• Foods to avoid with the drug - such as avoiding alcohol with acetaminophen, or grapefruit with many medications. 

The take home message of this paper? Take note, and pay attention to your recommended doses on all of your medications.

If you have a headache? Rather than reach for Tylenol, check this blog post from Dr. Molly Ouellette about potential causes of headaches.

December marks the beginning of Flu season

Every year the onset of the cold weather is followed by flu season. Many people brush off the flu, thinking it is trivial, this viewpoint can be dangerous. In 2007 more than twice as many people in the US died from influenza and pneumonia  than died from homicide - 52,000+ vs 18,000+ (paper on mortality).

Picture of influenza virus
from  medical-definitions.com

Because of the severity of influenza many healthcare providers recommend flu shots for those most at risk, namely those over 65 and the children 6 months to 6 years old. While the flu shot is not a guarantee against getting the flu, it does offer some protection and it is a passive way to obtain immunity. Recent studies show that the flu shot helps prevent flu in 5-7 out of 10 people who had the injection (study 1 study 2).

Because the flu shot isn't 100% effective, and some people choose abstain from vaccinations, there are a number of things that one can do to avoid the flu. The following five rules of thumb, help to give you an active way to stay healthy during the flu season.

1- Avoid people who are sick, and if you are sick, stay out of public places.
2- Wash you hands before and after dealing with people.
3- Avoid touching your Eyes, Nose and Mouth when in public, especially when touching things that many others touch like subway seats, stairway handrails, doorknobs or door handles. Many people forget they are in public and inadvertently infect themselves this way.

4-  Cover you mouth when you cough and promote others to do so too.

proper cough/sneeze technique
from kevinmd.com

5- Lastly, and possibly most importantly, practice health promotion: Eat healthy foods, drink plenty of fluids, get enough sleep, avoid stress, and be physically active!

A great way to help reduce the stress on your body during the flu season is to see a manual medicine specialist, like a chiropractor. Taking care of your body is paramount if your want to stay healthy, especially during the stressful holidays. Often you will not notice the stress your body is under until it is too much, and you have symptoms of it. A chiropractor will help to prevent you from becoming run down to the point where your natural immune defenses become weak.  

Happy Thanksgiving

This is one of my favorite holidays, with all of the traditions of giving thanks and of family many feel the same way. Unfortunately Thanksgiving doesn't have many healthy traditions associated with it. My tip for the week is to take time on the holiday for your health.

One of the best ways to do this is to take a family walk after dinner before the treats. Just spend 30-60 minutes reveling in the wonder of the fall weather and of the company of family. This is a great time to bond with your family, get your blood pumping and give thanks for the bounty at your table.

If the weather is bad, try to get do something active like help cooking, or help cleaning.


have a happy and safe Thanksgiving

With winter approaching don't forget your vegetables...

As the leaves fall off the trees and the thermometer drops it is easy to forget about the bounty of summer, and neglect to eat your recommended vegetables. However, since people are usually inside more during the winter months this may lead to the dreaded holiday weight gain.

picture from vegetablesnutrition.net

 

The best way to loose the holiday weight is to NOT GAIN it in the first place. Vegetables are full of fiber and nutrients that help promote fullness without the calories of many winter foods, so be sure to pay special attention and keep the leafy greens in your diet.

Many people find that as the temperatures cool they want to have warm food, the key thing to remember is that leafy greens can be served warm. It is easy to put a hot serving of fish onto a fresh salad, this way you get both vegetables and omega-3's. If you like Thai food, there is usually a dish like swimming rama.that incorporates hot protein with vegetables.

One of my favorite winter vegetable dishes is a warm spinach soup... this recipe is great, it has a hint of nutmeg - delicious on a cold evening!

Also remember our good winter friends... root vegetables... they keep very well and with their rich colors you know they pack a nutrient punch. Roasting a yam of butternut squash is a great way to put a vegetable on your winter table.

picture from thephilosophie.com

 

Exercise triumphs over genes!!!

It turns out that your grandmother was right, exercise can change your body. Even with all of the research out about the genes related to obesity, exercise is king. As a recent paper published in the public library of science (found here) further research has shown that exercising for 30 minutes a day, 5 days a week will nearly negate obesity genes impact one's body.

a young Jack Lalanne

an older Jack Lalanne

This further proves the sage wisdom of people like Jack Lanne, who pushed for exercise and proper diet for his whole life. He was a chiropractor who emphasized the healing power of exercise.

I don't know about you, but i am going to go out and get 30 minutes of exercise today.

Fall weather... Falling leaves, and falling temperatures.

As the beautiful foliage starts to turn, it should be a reminder to pay increased attention to your activity regimen.

Many active people enjoy the dip in temperatures from the summer months and find they are able to increase their exercise routines. Others ramp up their exercise routines with the thoughts of the impending holiday/over-eating season. Either way the autumn season has it's own hazards, just like the summer. While the chances of heat exhaustion diminish there are many different conditions to watch out for. Such conditions include, hypothermia, muscle strain (induced by activity without proper warm up), frostbite, even dehydration.

One injury that seems to affect the adult population during the fall is muscle strain. There are many reported risk factors for muscle strain, several of these seem to correspond with the season of fall; improper stretching, shortened warm ups and increase of ballistic motion. As the days get shorter and cooler, many athletes feel they need to get the most in during the time they have, which can lead to the risk factors listed above. As you enter into the cold/cooler months of fall be sure to avoid the easy trap of decreasing your warm up routine, when you should be increasing it. A proper warm up should prepare your muscles and heart for the upcoming exercise. While your muscles are cool you should avoid ballistic maneuvers (ie jumping, quick kicks, sprints), even if you see others performing them. Also an easy way to cause a muscle strain is to have a sudden unexpected stretch to a muscle (ie slipping on a bunch of wet leaves, falling from slipping in the mud or from an unexpected  patch of autumn ice.)

The AAOS urges children and adults to follow these tips for preventing cold weather sports injuries:

• Never participate alone in a cold weather sport.
• Keep in shape and condition muscles before participating in activities.
• Warm up thoroughly before playing. Cold muscles, tendons and ligaments are vulnerable to injury.
• Wear appropriate protective gear, including goggles, helmets, gloves and padding.
• Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Layering allows you to accommodate your body’s constantly changing temperature. Wear proper footwear that provides warmth and dryness, as well as ample ankle support.
• Pay attention to warnings about upcoming storms and severe drops in temperature to ensure safety.
• Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help, if injuries occur.
• Drink plenty of water before, during, and after activities. Dehydration is still a risk, even in cold weather. Alcohol increases the risk of dehydration, decreases your ability to perform sport specific tasks (even though you might THINK you are skiing better), and actually makes you more prone to hypothermia as it shunts blood away from your core and out to the skin, where you suffer heat loss even faster, although you FEEL warm due to the flushing effects of the alcohol. Overall, alcohol and cold weather add up to serious risk of injury.

Study shows spinal adjustments may be as effective as surgery!!!!!

In a study that was published in the Journal of Manipulative and Physiological Therapeutics showed that adjustments are equally effective to micro-discectomy surgery for sciatica after a disc herniation.

Picture from www.back.com

This shows, once again, that a conservative approach may save you money, time and heartache. Spinal adjusting is much safer than the compared treatment, not to mention drastically less expensive.

If you have sciatic pain, consider seeing your local chiropractor before leaning to surgery.

http://www.medicalnewstoday.com/releases/224957.php

October is National Chiropractic Health Month

With the approaching fall weather and the winter months ahead, now is the time to think about your health. Winter is a time of the year when deconditioning can lead to accidents. Depending on where you live it can also be a time of accidental slips and seasonal overexertion (ice and snow can be dangerous!).

This is a great time to talk with a Doctor of chiropractic about your health and ask about ways to prevent seasonal injury. A chiropractor will be able to help you avoid injury with core strengthening, advice on lifting and make sure your nervous system is operating at it's peak.

This year the ACA (American Chiropractic Association) is centering its focus on the problems that can be created with the the overuse of technology. For some ideas on avoiding these visit the ACA's technohealthy website.

Condition known as Blackberry thumb
From ACA's technohealthy website

This website covers injuries like blackberry thumb and text neck among other tech-related injuries.

Have a great first week of October!
-In health,
Dr. Bramble

Small quote from Dr. Bramble on Patch of Andover

Andover Days on Saturday September 24th was a great day. Dr. Bramble enjoyed meeting the people and other businesses in the area.

Dr. Bramble was even quoted by Beth Daigle for Patch.com. Find the article here

Dr. Bramble is excited to offer chiropractic services at upcoming Off-Season Sports events. The Brickman Triathlon on October 2nd will be the next event that Dr. Bramble will be attending.

Dr. Bramble now practicing in North Andover, MA

Dr. Bramble is excited to open his new clinic located inside the Off Season Sports facility. theoffseason.net

In addition to his extensive education in the diagnosis of disease, Dr. Bramble is experienced in multiple forms of bodywork. He has been trained in many of the most modern and evidence-based treatments, including diversified adjusting, SOT, muscle energy techniques, cross-fiber friction massage, gua sha, and instrument assisted soft tissue mobilization. Dr. Bramble’s goal is to find the root cause of a problem and help each patient’s body to heal itself. Treatment with Dr. Bramble is centered around both the structural and mechanical correction of dysfunction, and include body work and adjusting. He believes that to truly make the changes needed to help your body heal; nerves, muscles and bones need to addressed in each treatment. He is able to blend his science background with the art of chiropractic in to achieve that goal. Dr. Bramble strives to give each patient a focused and unique treatment to help them quickly get back to their active life.

Dr. Bramble believes his participation in organized and unorganized sports to helped him in every aspect of his life, and knows sports are truly a positive addition to one's life. In addition to a life of playing sports, he has used his expertise to treat athletes at a variety of events; from elite triathletes and runners at the Pacific Crest sports weekend in Sunriver Oregon to youth soccer players at the Oregon soccer classic. He enjoys running, skiing, playing soccer and cycling in his free time.

Eat this or you are going to DIE!

Eat this or you are going to DIE!

This is the way that many nutrition recommendations sound these days. The idea of drastically changing one's diet to fit the varied recommendations usually seems like such a big change. So big, that many of us don't make any changes to our diets at all. 

There are many diets that will help to give you more energy, improve your cognitive function, and help you to maintain your ideal weight. Many people try to change from their current diet to a different one, all at once.  This approach may be a mistake, because most times if giving up things that one loves in their diet all at once, leads to failure.

Here are a few suggestions that are a good step in the right direction, while not being all that drastic, because every step towards better health is a good one.

Cut down your salt intake

In the US, when people say salt, they are generally referring to one type of salt, sodium chloride (NaCl). The sodium of the salt causes the problem with blood pressure. The 2010 Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 mg a day — or 1,500 mg if you're age 51 or older or have a condition that increases your sensitivity to sodium. 

However, many people either disregard this advice or don't realize that they are getting too much sodium (the average American gets about 3,400 mg of sodium a day).  Why not just give up salt? Well... salt makes food taste good. One product that may help you to reduce your sodium intake is light salt. This is usually a mixture of ½ potassium chloride and ½ sodium chloride, and potassium doesn't affect blood pressure the same way (plus many people don't get enough potassium). Reducing sodium may help to decrease your blood pressure, and this is a rather painless way to do so.

-Please note that the first week when using this is a little strange, as initially the light salt tastes a little metallic. This sensation should subside, personally I can't tell the difference anymore. 

Watch the fat you eat

Two really easy things to switch in your day to day life are the spread you use and your daily dairy.

1- Butter is high in saturated fat, which can be very bad for your arteries and has even been linked to a poor complexion. Better to use something like Earth Balance, which has a fat profile close to olive oil, which has been shown to be a better source of fat.

2-Dairy fats. Many times people don't even realize that they are getting as much fat as they are from their dairy products. Switching the milk you use down one step in the fat profile can help to decrease your saturated fat intake (if you use whole switch to 2%, if you use 2% switch to 1%, etc).  If you enjoy yogurt, try one of the various types of greek yogurt, which has an increased protein content and is generally fat free.

Doctor Bramble
..
None of the above should be taken as advice for or against treatment, just as information for edification and to discuss with your doctor

 

Summer is here! - however, good weather often brings injuries.

Summer fun can often lead to summer injuries. One of the most common ways to bring summer fun to a halt is an ankle sprain. The most common ankle sprain is the inversion sprain.

Inversion sprains, what most people refer to when they say they have rolled their ankle, are the most common forms of leg injury, and account for up to 85% of ankle sprains. The injury occurs when the one lands with the toes pointed down and slightly toward the bodies midline. This position 'unlocks' the joint, which means the joint is in position to injure ligaments, blood vessels, muscles and cause a lot of pain. Below is a picture that many of us are all too familiar with.

image from americaspodiatrist.com

Because ankle sprains are so common, many people do not seek professional evaluation of their injury. This can lead to a lifetime of ankle problems. A good rule of thumb with any ankle sprain is to play it safe and see a healthcare provider who is trained in the joints, especially if you have difficulty taking 4 steps with the injured foot. The reason for this is that, even though many ankle sprains just stretch the ligaments, more severe sprains tear or even rupture them. Untreated torn and ruptured ligaments lead to future pain and injury.  Luckily, most healthcare professionals are well trained at how to deal with the pain and swelling involved with any sprain. However a good doctor will also address rehabilitation of your ankle after the pain is gone (discussed after treatment). Some of the best joint specialists are chiropractors, as they spend over 4000 hours in school addressing the science behind proper joint motion.

So I sprained my ankle, what now?

One of the most effective treatment routes for an inversion sprain is the adage P.R.I.C.E. What many people don't realize is that swelling can cause damage to an injured area. Swelling stretches the tissues, prevents proper blood flow to the area and worst of all prevents or delays healing. Following the P.R.I.C.E guidelines will aid in recovery. Using the following before seeing a joint specialist will improve the healing process as well.

P- Protect – prevent  further damage. - Stop using the injured area use padding, protection, splints or crutches to take the weight off your ankle injury.

R- Rest - Allow an injury time to heal. - Being brave and using an injured ankle is not wise.

I - Ice - apply ice or ice pack to the injury (a pack of frozen peas will also work). - This will reduce pain and inflammation. Ice can induce hypothermia or a cold burn so wrap the ice in a cloth. Ice should be applied for ONLY 20 minutes with 60 minutes between applications, as ice can damage your body, even resulting in paralysis, if used improperly.

C- Compression- compress the swollen area with an Ace wrap. - This will help to reduce the swelling. IMPORTANT-->If you feel any increase in pain, numbness, tingling, swelling or coolness below the wrap, you have wrapped it too tightly. Remove and re-wrap with less tension.

E- Elevate – elevate the injury above the level of your heart. - This will help to draw the fluid from the ankle and decrease swelling and pain.

After the extent of your injury has been determined and dealt with  what comes next? Is P.R.I.C.E enough to achieve a full recovery?

The fact of the matter is that even if the pain is gone, the tissues of a sprained ankle are weakened and more prone to re-sprain. So how does good doctor handle this?

Simple, your doctor may adjust the foot to help restore neurological input to the healing tissues. They may use deep tissue techniques like cross-fiber friction, Gua sha or Graston to insure that the fibers of the healing tissues align in the appropriate directions. However, one of the most important things your doctor may do is to give you strengthening and proprioceptive exercises. Strengthening will help your muscles to prevent future injury and preconception, the ability to know where body parts are in space, will help you to prevent injury by avoiding ankle positions that make injury likely.  These exercises will work with the adjustments and deep tissue techniques to ensure that you don't go through another sprained ankle.

An example of an ankle rehabilitation exercise..

Also a good doctor will look at your knees and low back to see if they were injured when you sprained your ankle. These areas should also be screened during rehabilitation of your ankle, in case limping has caused any problems in the joints in these key biomechanic areas.

Further questions? Come see me in North Andover. Or find your local chiropractor, physical therapist, or other healthcare practitioner...

Doctor Bramble
..
None of the above should be taken as advice for or against treatment, just as information for edification and to discuss with your doctor