Doctor’s Library

An Ancient Remedy for Modern Times

What is Acupuncture?

Acupuncture is a therapeutic method used to encourage natural healing, reduce or relieve pain and improve function of affected areas of the body. Acupuncture is safe and effective and is often successfully used as an alternative to medications or even surgery. Relief is often obtained when traditional medical therapy has failed.

Acupuncture involves the insertion of very fine needles through the skin and tissues at specific points on the body. There is no injection of any substance and the treatment itself causes minimal discomfort. “Classical” acupuncture was developed in China as a system of diagnosing and treating pain and disease. It defines acupuncture as one component of Traditional Chinese Medicine which aims to balance energy and blood in the body in order to keep it functional and healthy. Although proven successful for hundreds of years without the benefit of modern medical knowledge, it is only in recent years that the scientific and medical communities of Europe and North America have begun to study acupuncture to understand and explain its effectiveness. “Anatomical” acupuncture refers to a more modern approach taken today by the Acupuncture Foundation of Canada Institute (AFCI) and other western trained acupuncture therapists. When combined with a knowledge of anatomy, physiology, modern therapists can use acupuncture effectively.

Modern technology has allowed variations in acupuncture treatment. Electro-acupuncture involves stimulation of inserted needles with gentle electrical impulses. Rubber electrodes or moistened cotton-tipped applicators can also be used to deliver electrical stimulation to acupuncture points (transcutaneous electrical nerve stimulation or T.E.N.S.). Low power laser may also be used instead of needles to stimulate appropriate points.

How Does Acupuncture Work?

Acupuncture stimulates the body to produce its own pain relieving chemicals called “endorphins.” These chemicals mimic morphine by attaching to opiate receptor sites found throughout the nervous system. Endorphins help to block pathways that relay pain messages from the body to the brain, resulting in relief of pain, general relaxation and biochemical restoration of the body’s own well-being.

How is Acupuncture Used Today?

Acupuncture is very effective in treating a variety of painful disorders, both acute and chronic.

The World Health Organization has identified the benefits of acupuncture in the treatment of a wide range of medical problems including:

In treating any illness or affliction, a correct diagnosis is important before any decisions are made regarding therapy. Once the diagnosis is established, a qualified practitioner can advise whether acupuncture is appropriate

Are there any adverse effects or risks to the treatment?
One of the most striking aspects of acupuncture is the almost complete absence of adverse effects and complications from its use. Most patients find that the treatments are relaxing and cause minimal discomfort.

People with pacemakers should avoid electrical stimulation unless approved by their cardiologist. Women in early pregnancy and haemophiliacs should be treated with caution.

The AFCI recommends that only sterile disposable needles be used, preventing any risk of transmission of the AIDS or hepatitis viruses when sterile disposable needles are used.

Does it hurt?

People experience differing sensations with acupuncture. Most patients feel only minimal discomfort as the needles are inserted: some feel no pain at all. Once the needles are in place, there should be no significant discomfort.

Acupuncture needles are extremely fine and are made from stainless steel. Two or three needles would fit inside the barrel of a regular hollow needle used for injections.

How many treatments will be required?

The number of treatments will vary with each individual and the condition being treated. For acute problems, only a few treatments may be required. In some cases, one treatment will be sufficient.

For complex or longstanding conditions, one or two treatments a week for several weeks may be recommended with less frequent treatment as improvement occurs. Treatment sessions usually last between 15 and 30 minutes. Relief may be immediate or occur within a few hours, or after a few days.In some conditions, several sessions may be required before improvement is noticed Eighty to ninety percent of patients respond well to acupuncture with noticeable improvement. Acupuncture can be used as the only form of therapy or it may be combined successfully with other forms of medical or physical therapy.

Do I have to believe in acupuncture for it to work?

No. Acupuncture is used successfully on cats, dogs, horses and other animals. These animal patients do not understand or believe in the process that helps them get better. A positive attitude towards wellness may reinforce the effects of any type of treatment. A neutral or negative attitude (“I don’t know if I really believe in this”) will not block the effects of acupuncture.

Is there any special advice to follow before an acupuncture treatment?

Acupuncture treatment can be done at any time. Patients are advised not to eat unusually large meals before or after treatments. It is best to avoid alcohol or sedatives for four hours prior to treatment. Pain medications may be taken as required.

What about after treatment?

If possible, a short rest after treatment is desirable, but not essential. Some patients feel unusually relaxed and prefer to plan activities accordingly. Strong exercise is not recommended immediately after treatment.

For painful conditions, avoid strenuous activity for 48 hours after treatment. Alcohol, and ideally caffeine and cigarettes, should be avoided for at least two hours. Medication, as directed by your physician, may be taken as required.

~Acupuncture Foundation of Canada Institute

What are they?

An IgE antibody-mediated immune reaction causing release of histamine & other inflammatory mediators form mast cells and basophils resulting in swelling, inflammation, and tissue damage.

Goals:

Reduce allergic threshold (reduce airborne & food allergens)
Strengthen the immune system
Adopt a healthful lifestyle (good dietary habits, regular exercise, reduced alcohol consumption, quitting cigarette smoking, improved coping strategies for stress)

Avoiding airborne allergens:

Food allergens/intolerances:

As females reach the 45 plus age group, most women experience a significant decline in their body’s ability to manufacture estrogen. This can trigger a wide spectrum of physical, psychological and age related signs and symptoms which can significantly affect the quality of life and life span of postmenopausal women. While some women escape the most significant side effects of menopause, females should be aware of the most serious health concerns they may face in there postmenopausal years which include: heart disease, osteoporosis and breast cancer.

In the past, most medical doctors prescribed estrogen replacement therapy (often combined with the hormone progesterone) to combat the signs and symptoms of menopause. However, hormone replacement therapy (HRT) has been shown to increase the risk of breast cancer, stroke, pulmonary embolism, and cardiovascular heart disease. Recently, the National Heart, Lung and Blood Institute’s (NHLBI) “Women’s Health Initiative” study showed that for each year that a woman is on hormone replacement therapy, she has a 2.5% increased risk of developing breast cancer as compared to an agematched woman not on hormone replacement. This effect is cumulative over time and therefore, after ten years of HRT she has a 25% increased risk of developing breast cancer and a 50% greater chance of developing breast cancer after 20 years of HRT.

While, most health care professionals agree that hormone replacement therapy is still necessary for women who show moderate to severe bone loss and/or significant risk for cardiovascular disease, if a women is otherwise free of these problems a more natural approach can be quite effective in managing menopausal symptoms and preventing more serious complications.

Black cohosh (cimifuga racemosa) is the most extensively used and widely researched natural supplement used to manage menopausal symptoms. It has been used in Europe since the 1950’s as an effective alternative to HRT without the life threatening side effects. Soy Isoflavones have been shown to increase the bone mineral density in postmenopausal women, as well as lowering blood cholesterol, and having a cardioprotective effect. Many women commonly consume less than the recommended daily intake of vitamin D. Adequate intake of Vitamin D is extremely important for bone health and supplementation has been shown to decrease the risk of osteoporotic hip fractures in postmenopausal women.

Other recommendations for postmenopausal women include: getting regular weight bearing exercise; maintaining a low stress level; substituting garlic or onion powder for salt when cooking (this prevents the urinary excretion of calcium associated with salt consumption); avoiding excessive alcohol, caffeine, and sugar intake; avoiding the consumption of spicy foods, hot soups and drinks as they can trigger hot flashes; and meeting adequate calcium intake (1500mg per day).

Women live over one-third of their lives in their postmenopausal years. It is important to consider all options available for dealing with the signs and symptoms associated with menopause in order to maximize one’s quality of life and lifespan. For more information on alternatives to HRT-contact your health care provider.

Reference:

Food Triggers:

Pain Safe Foods:

Treatment:

4 Week Anti-Arthritis Diet:

How the Body Heals

You’re having fun playing with the kids when you make a sudden move and end up on the ground doubled up in pain. What happened and how are you going to fix it are the first thoughts that go through your mind. Our fascination with our bodies takes on a whole new meaning when we are injured. The extent of injury is first of all dependent on the mechanism of injury and the amount of stress you were subjected to. The trauma may be severe injuring even the most robust individual or it may take place insidiously over a long period of time in the form of micro-trauma. If it was a single event, how much damage was done to the tissue and how many fibres were actually disrupted? In the case of micro-trauma, how much damage occurred before you reached the injury threshold? Answering these questions helps to explain some of the problems with healing but there are questions left unanswered. How do you explain an injury that occurs with a simple movement that you have done easily thousands of times before? Regardless of the mechanism of injury the extent of injury and its ability to heal will also be greatly determined by your body mechanics (alignment, strength, flexibility and coordination) and the integrity of the tissue (circulation, nutritional status, nerve supply and the inherent strength of the tissue). Understanding all of this will help you to understand how your body heals and how to prevent the injury from happening again.

Stages of Healing

When tissue damage occurs the body goes through three stages of healing;

Inflammation

Mention the word inflammation and patients cringe and want to do everything possible to get rid of it. Inflammation usually gets a bad rap. Inflammation is not only a reaction to cells being damaged but it is also a process that is absolutely necessary in order for these damaged cells to heal. What we should be doing when we treat inflammation is not eliminate it, but rather keep it under control. The inflammatory process is the body’s way of stimulating our immune system when an injury occurs. This reaction occurs to protect us from possible infections that could ensue and to mobilize the body to rebuild the damaged tissues. The problem is that often the body overreacts to the injury resulting in more inflammation than is necessary and other times inflammation occurs when there is little or no injury present, such as in arthritis. What we want to do is contain the inflammatory response so that the body can do its job of defending us against infections and rebuild the damaged tissue in the quickest and most painless manner.

What Happens When We’re Injured?

Tissues are stressed and damaged by being overstretched, torn, pulled, crushed or are damaged by metabolic changes within the body, especially when the tissues are deprived of oxygen. The damaged cells release several chemicals that stimulate nerve endings causing pain. These chemicals also cause changes in the local blood vessels resulting in more blood spilling into the injured area causing swelling and more pain. This results in additional cells being irritated bringing about the production of more chemicals that add to the inflammatory process. The inflammatory process varies depending on the site of the injury and the extent of tissue damage. This process is necessary because it recruits cells that will gobble up the debris from the injury and start the repair process with the formation of granulation tissue or early scar tissue. The inflammatory phase generally lasts 3 to 7 days providing that the source of injury is removed and that there is no infection, toxic agents or autoimmune reaction. This is known as “acute inflammation”. The process leads to tissue repair with the restoration of blood vessels and connective tissue to the injured area. In some cases acute inflammation does not resolve. The failure may be due to repeated trauma or micro-trauma, infections, toxic agents and autoimmune disturbances. This is called “chronic inflammation” and is identified by different cellular change and can last weeks, months and in some cases an indefinite period of time.

Can You Stop Inflammation?

No you can’t stop inflammation, but you can keep it under control and reduce some of its effects. Once the damage is done a series of events takes place that will influence the amount of pain and swelling you will experience. These changes occur primarily in the local blood vessels. With acute inflammation you first stop doing anything that causes further damage to the tissues. Next you cool the injured area by applying ice or dipping the body part in ice-cold water. The sooner you do this the better it is. Starting to apply ice even within the first few minutes of the injury will make a noticeable difference to the amount of pain and swelling and eventually your healing time. Ice should be applied for no more than 20 minutes at a time, take a 5 minute break and reapply the ice for another 20 minutes. If you have the time and patience, you can continue doing this all day or take periodic breaks for an hour or two during the day. By cooling the injured area you achieve two things: (1) you slow down nerve transmission, specifically pain sensations which helps to reduce your pain (2) you cause the muscles in the blood vessel walls to constrict reducing the amount of blood going to the area so less bleeding and less swelling occurs. Less swelling results in less pain and faster recovery. The therapeutic strategy is slightly different chronic inflammation. Instead of wanting to shut down the blood supply to the injured area, you want to increase blood supply. There are three basic ways that this can be done and are ranked in order of efficacy:

Rest
Ice
Compression
Elevation

Of course there are other factors and other treatments which will help to control inflammation. Physical therapy in the form of interferential current, ultrasound, and transcutaneous nerve stimulation, can help to reduce pain and swelling, thus restoring function much earlier. Nutritionally there are many options available for controlling inflammation. Dietary changes may be needed with either the addition of certain foods or the elimination of others. Supplementation with vitamins and/or minerals has helped certain individuals. Studies have also supported the use of certain natural compounds. This approach requires extensive investigation and close supervision. Consulting a health practitioner who has training in this area, such as a naturopath, is recommended. Medical treatment involves the use of pharmaceutical drugs to reduce pain and inflammation. Too much pain relief may give the patient a false sense of security resulting in repeated trauma to the injured tissue. Too much reduction of the inflammatory process with the administration of anti-inflammatory drugs has been shown to slow down the healing process and may lead to ineffective healing. Anti-inflammatory drugs seem to play a greater role in the management of chronic inflammation such as with arthritis.

The Repair Phase

The repair phase may last from a few days to a few weeks and basically results in the restoration of normal living tissue. It is characterized by the connective tissue replacement and growth and differentiation of cells in the injured tissue. Some tissues, such as skin heal very quickly while others such as nerve tissue and heart muscle may never regain normal structure and function. The success of this phase of healing is dependent upon the proximity of injured surfaces to each other. If the surfaces are closer together the scar forms more quickly and the tissue regains greater function. Nutritional and metabolic factors also greatly influence the repair phase and since the remodeling and maturation phase overlaps the repair phase, appropriate physical stress to these tissues will ensure a renewed and viable tissue. From a chiropractic perspective treatment is still very important in this phase with ongoing physical therapy to reduce pain and swelling, improve circulation to the injured area and reduce excessive scar tissue formation. Patients usually also need to restore normal biomechanics through joint manipulation or mobilization and soft tissue work. Exercises become more vital in the treatment plan starting with stretching, mobilizing and gentle strengthening exercises which increase in intensity as the repairing tissues become stronger.

The Remodeling and Maturation Phase

Although this phase is critical for completion of the healing process, it is also the phase of healing that is most often taken for granted by patients and doctors. By this time, which is usually weeks or months after the injury, patients are suffering little or no pain. No pain means no problem, right? …. Wrong. The tissues are still very weak and in order to prevent a re-injury you have to stimulate the tissue to heal properly. During the remodeling phase there is a constant turnover of collagen tissue, a gel-like cement that holds connective tissue together. Maturation of collagen progresses to form fibrils that will give the connective tissue (muscle, ligaments, tendons, fascia) its tensile strength. In healthy tissue, fibrils are laid down parallel to each other in a systematized manner to give the tissue its greatest strength and flexibility. Applying stress to these tissues in the remodeling phase will stimulate them to organize the fibrils in such a manner as to resist the stress. The stress can be applied through soft tissue therapies such as massage, Trigenics or myofascial release techniques, or through passive stretching or active strengthening exercises. When tissues are not stimulated, the fibrils will form in a haphazard manner leaving the tissue weakened and very inflexible. The replacing of collagen and formation and re-organization of fibrils into healthy viable tissue may take over a year from the time of the injury. The end result of healing depend on several factors such as the extent of injury, the age of the patient, the availability of nutrients for the healing process, the type of tissue injured, the size of the scar and the forces acting on the scar during the healing process.

The Active Health Centre Approach to Healing

With our knowledge of the healing process, we work with patients to minimize the damage and changes to injured tissues. We maintain a variety of physiotherapeutic equipment and keep abreast of the latest conservative treatments and exercise protocols for soft tissue injuries. We don’t just “crack bones”. We place great value in the use of the various soft tissue therapies and exercise as well as manipulation and mobilization techniques to restore normal joint function. We appreciate that it sometimes can be depressing and demoralizing to suffer through a long convalescence. We strive to keep patients motivated and provide reassurance, guidance and knowledge that with time and effort they will enjoy better health.

Major Causes of Running Injuries:

Description

Scoliosis is not a disease but a descriptive term. All normal spines have curves; both the neck and low back bend backwards, called lordosis and the thoracic spine or mid-back bends forward called kyphosis. Some curvature in the neck and back is normal. Humans need these spinal curves to help the upper body maintain proper balance and alignment over the pelvis. Scoliosis is however, a termed used to define abnormal side-to-side (lateral) curves in the spinal column. The vertebrae involved are also usually rotated.

The prevalence of scoliosis varies depending on the severity of the curvature; however, scoliosis affects 2% of women and 0.5% of men in the general population. Scoliosis are broadly divided into structural and non structural types. Structural scoliosis refers to those curvatures that are fixed and cannot be corrected by side bending of the spine. Non-structural or functional scoliosis lessen or disappear with side bending of the spine. There are more than 50 conditions associated with scoliosis. Some of the more common causes of scoliosis include congenital spine deformities, genetic conditions, neuromuscular problems and limb length inequality. Other causes for scoliosis include cerebral palsy, spina bifida, muscular dystrophy, spinal muscular atrophy and tumours. Over 80% of scoliosis cases, however, are idiopathic, which means that there is no known cause. Most idiopathic scoliosis cases are found in otherwise healthy people.

Symptoms:

There are number of different “warning signs” to look for to help determine if you or someone you know may have scoliosis.

Early detection is vital, if you notice any of the signs mentioned above you should make an appointment with your health care practitioner.

The role of the chiropractor is to recognize and monitor scoliosis. Once suspected, scoliosis can be confirmed with a spinal x-ray. The scoliosis can then be measured and classified in terms of significance. Curves are generally considered significant if they are greater than 25 to 30 degrees. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment. Adolescents and juveniles with curvatures less than 20 degrees should be monitored for progression every 3-6 months. This is important as progression of the curve will likely require more aggressive treatment options.

Prognosis and Treatment:

Currently, treatments for scoliosis include bracing, electrical stimulation, surgery, chiropractic care or a combination of all of these. Bracing should be considered when curves are between 20 and 40 degrees. Surgery is usually considered when the curvature is beyond 50 degrees. Prognosis for scoliosis varies depending on a number of factors including: age at time of diagnosis (curves below 30 degrees do not usually progress following skeletal maturity), stage of skeletal maturity (scoliosis progress more rapidly in skeletally immature patients), vertebral rotation, and the magnitude and pattern of curvature.

Trigenics

Control Local Circulation to Speed Up Healing:

Acute Phase: (first 2 to 4 days)

To reduce blood flow to the injured area:

Subacute and Chronic Phase: (after 2 to 4 days)

To increase blood flow to the injured area:

Our bodies are made for movement and without it we will definitely experience ill health. Every cell in our body is stimulated by movement and it enhances the performance of every organ. Movement occurs at joints, which are made up of bones that come together in a complex of tissues allowing for movement and stability. For this to happen easily, the ends of the bones are covered in a silky smooth material called cartilage. The joint is encased in a fibrous material called a capsule and the inside lining of the capsule produces a thick fluid material that lubricates and nourishes the joint cartilage. The bones are held in place by thick fibrous elastic material called ligaments. The ligaments end up forming the outside walls of the capsule. Movement of the joint is made possible by the contraction of muscles that are attached to the bones near the joint by tendons. Other structures often found in or around joints include nerves, blood vessels, and cartilage structures called menisci, bursae and fat pads. Collectively these structures other than bone are known as soft tissues. It is also important to know that structures around the joint, especially the capsule and ligaments are well endowed with nerve endings making them very pain sensitive and also very important in posture, balance and coordination.

What Happens?

The adjustment is a painless, short amplitude, high velocity thrust that causes the bones to separate or move through a normal physiological range of motion. Essentially it is a way to bring about stretching without eliciting the stretch reflex. The stretch reflex occurs whenever a muscle is stretched. It involves contraction of the muscle that you are trying to stretch. In many cases the stretch ends up being counterproductive because the muscle that you are trying to stretch tightens up to resist the stretch. There are other ways to circumvent the stretch reflex but the adjustment is the quickest way and has many other benefits.

The Benefits:

The chiropractic adjustment may provide the following benefits:

How Does This Happen?

All these benefits occur because the adjustment affects the joint in two major ways:

1. Mechanical:

2. Neurological:

What is the Crack?

The joint space is surrounded by the capsule and is filled with joint fluid that has the consistency of raw egg white. The chiropractor positions the patient to take out the “joint slack” with the joint near its limit of normal range of motion. He then imparts a very quick, low amplitude thrust which takes the joint into the safe para-physiological range of motion. This happens so quickly that the soft tissues and the patient are unable to resist the movement of the bones of the joint. Separation takes place and a gap in the joint is created. The joint fluid that normally fills the joint space cannot fill the gap quickly enough, so a relative vacuum is created in the gap. Instantly gases that are normally present in the joint fluid will form gas bubbles that pop when they are drawn into the vacuum of the gap. The cracking sound is not the bones being put back into place such as when a joint is dislocated, but a gas bubble popping. A dislocated bone being repositioned makes a clunking sound. It takes from 30 minutes to 2 hours for the gases to be reabsorbed into the joint fluid and by this time the original space in the joint has been reinstated. That is why you can only get a crack out of your knuckles every hour or two.

How Safe is an Adjustment?

When performed by a trained and licensed practitioner, the adjustment is an extremely safe procedure. Very few complications occur from the adjustment. If any do occur, it is usually joint irritation and localized muscle soreness that resolves quickly with the appropriate care. There are definite precautions that have to be taken with certain patients and chiropractors are well trained to either modify the procedure or refrain from adjusting in these instances. There has been controversial press coverage in the last few years about the possible risk of damage to the vertebral arteries in the neck after neck manipulation. Epidemiologists who study the incidence of diseases find it very difficult to put a number on the incidence of stroke like symptoms following neck manipulation because it is so rare. When pressed for a number they usually say that it ranges between 1 million and 3 million adjustments to give rise to stroke like symptoms, which can resolve within hours or days in most cases without any complications. Recent studies at the University of Calgary found that the action of turning your head fully puts twice the amount of stress on these vertebral arteries than does a neck adjustment. Although the risks when adjusting are infinitely less than the risks involved in taking anti-inflammatory drugs, chiropractors are always very careful to minimize the side effects. This is one of the reasons why chiropractors have one of the lowest mal-practice insurance premiums in health-care.

How About Self-Manipulation?

Although this practice is socially unacceptable, it is relatively safe. The adjustment is essentially a stretching maneuver and as long as you position yourself properly and don’t overstretch the soft tissues, no damage is done. If you do exceed the limits of the soft tissues you will feel pain and are not likely to want to do that again. Most people that self manipulate do so because they feel better afterwards. It is more dangerous to let an untrained person manipulate you than doing it yourself. Although it is likely that you will irritate the people around you when you crack your knuckles it is a myth that it will cause you to develop big knuckles and arthritis in your fingers.

How Often Do I Need to be Adjusted?

The answer to this question varies from person to person. If your joint mechanics are relatively sound and corrections are made early then very few treatments are needed and joint health can be maintained through an appropriate exercise program. If however you are unfortunate enough to be endowed with poor body alignment, have developed disorders which cause damage to joint structures or you have suffered injuries which have changed the architecture of your joints, you will require more treatment and in some cases constant care to prevent further deterioration. Individuals who place extra stress on their bodies by either being overweight, adopt poor posture or continuously subject themselves to repetitive strain are also likely to need extra care. It is always best to take care of these problems early and not wait until the condition has deteriorated. If you do, you can minimize the damage and the care required to correct it and you can keep it under control with proper exercise and health habits. What makes management of these problems more difficult is that people don’t always feel discomfort at the outset of these problems. By the time pain develops extensive tissue changes may have taken place. It is more prudent to have a physical checkup before problems arise, similarly to having your car alignment checked before your tires and bearings start to wear out.

If you have any questions about he adjustment and how it can help you, feel free to contact us.

Run

Don’t Run

If the Pain Starts at the Start of the Run But Disappears

If the Pain Starts Part Way Into Your Run

If the Pain Starts After the Run

Starting Back After an Injury or Long Lay Off

Resting After Race

N.B. These general guidelines are meant to help you plan safe and effective workouts. Consult your coach or health practitioner for more detailed advice.