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Dr. Dunaway

Re-Posturing: Relief From Repetitive Stress Pain

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Re-Posturing: Relief From Repetitive Stress Pain

Drills To Desensitize Your Painful Tissues

A Lesson From Boiling Water

Stress to your body can come in many different mechanisms.  It may seem odd, but doing nothing and doing too much can cause similar pain syndromes because each of those scenarios have a common thread; they are performed with a certain posture for a prolonged time with no rest.  Re-posturing is a way of relieving that pain from the repetition of daily life.

For better understanding, let’s compare our perception of pain to a pot of boiling water.  If we take a pot of water and heat it up (stress it) we expect the water to boil at a certain point, it’s just a matter of time.  Once reaching that threshold we can do 2 things to stop the boiling; add cold water or remove it from the heat (stressor). 

Adding cold water without removing the heating source will keep the water from boiling for a period of time, but eventually the water will continue to boil.  The amount and the frequency with which you add water will alter how long the boiling stops.

Removing the heating source will also keep the water from boiling, but the temperature of the water remains high so it takes less time to reach boiling point if the heat is introduced again.

Cold water in this analogy includes any treatment including massage therapy, physical therapy, chiropractic, stretching, etc. All of these options are great and necessary for certain conditions.

The trick comes in removing the heating source (pain mechanism) for long enough to decrease the water temperature (pain threshold) so it’s not as easy to boil the water, or elicit a pain response.   The problem with repetitive stress is it’s often associated with a job description, and quitting your job isn’t a viable option for most.  So enter the concept of Re-Posturing.

Essentially, with one exercise we are trying to take our joints through ranges of motion they would otherwise not be taken through in our normal posture.  This exercise will be performed for 10-30 seconds every 30 min. This “micro break” done repeatedly throughout the day will alter the stresses in the body enough to allow the overloaded tissues to heal and decrease their pain threshold. This desensitizes the tissue so it won’t be so easy to aggravate your painful condition and any therapy performed will have a more long lasting effect on the pain.

Here is an example of Re-Posturing for someone who sits/drives every day: (Video Here For further Description)

Hands: fingers spread apart as far as possible and palms turned towards the ceiling.

Elbows: Tucked to your sides

Shoulders: External rotation with slight extension

Spine: Stand/sit tall, Chin retracted, breath from belly

Hips: Extended or flexed beyond 90 degrees

Knees: End range extension and flexion

This is just one example but is very common.  The more important key is the concept of performing the drill frequently 1-3 times/hr and within your comfort zone while in the stressful posture. 

Keep the reposturing principle in mind when attempting to resolve pain which has not been caused by obvious trauma.  It may be just the tip you need to recover and enjoy a pain free, mobile life!

For more information on Chiropractic treatment, education on Body Maintenance techniques, or coaching for sustainable exercise programs visit www.ChiroStrength.com or call the office 931-321-1414 to schedule your FREE consultation with Dr. Dunaway.

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Post Workout: Are You Doing It Right?

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Post Workout: Are You Doing It Right?

So when you ingest that sugary post workout drink right after your workout, your body will immediately dump insulin into the blood stream to manage the increase in blood glucose, and in the process, circulating levels of testosterone decrease.

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Step 1 to Preventing or Relieving Back Pain

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Step 1 to Preventing or Relieving Back Pain

When spinal hygiene is neglected you find yourself saying, “All I did was bend down to put my socks on and my back went out!”.  Indeed, you did, but it wasn’t just one time, it was 5,000 times and it was done with a flexed low back and no core activation.

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"I Just Need to Be Cracked Doc."

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"I Just Need to Be Cracked Doc."

Why It Cracks

A discussion as to why this is a dangerous belief

This is a quote that, as a movement snob (admittedly), is like nails on a chalk board when I hear these words.  Allow me to explain why.

The reason for an area of the spine being locked down to the point where you feel the desire to “pop” it, is almost always due to an attempt of the brain to lock down that area to prevent further injury.  Without proper stability, the brain engages large muscles around the aggravated joint or tissue to keep further movement from causing more damage to the area.  Left unresolved for a long enough period of time, the brain encounters a catch 22.  Satisfy the mobility desire by letting down the protective bracing and risk further damage to joints, or keep the area locked down and starve the cartilage in those joints of proper nutrition resulting in degeneration (cartilage “feeds” by being moved through daily full ranges of motion).  Given these choices, the brain opts for the stiff, starvation route because at least the damage occurs at a slower pace.  By ONLY applying a self manipulation or focused chiropractic adjustment, you could be robbing the body of this desired stability.

The true fix is a combination of increasing the mobility of the stiff area while addressing the lack of stability elsewhere.  Sometimes this stability is a strength issue and sometimes it’s a motor control issue.  Meaning, sometimes the stability can be regained by performing simple exercises in a progressive manner, i.e. strengthening.  A motor control issue is resolved by relearning a movement pattern.  A good example of this is teaching someone how to hinge at the hips instead of flexing from the low back and/or knees when picking something up, pushing something, etc.

The only way to figure out what is needed post mobility is being screened by a qualified professional who is trained in peeling the layers of movement away to find that compensation.  Once found and properly addressed, the patient/client can be educated on what needs to be done to fix the lack of stability. Adding progressive routines to challenge this new stability and mobility will engrain a new movement pattern which the brain will use to perform a given task whether that be running, lifting, throwing, etc.

“I just need to be cracked” is a request which, as a knowledgeable professional, would be unethical for me to grant.  Therefore, at the very least, you should always follow us a mobility session with a stability session.  Not doing so will lead to occasion after occasion of temporary relief until eventually enough damage is accumulated, and conservative treatment is no longer the answer.

Lastly a few notes on stability/mobility. 

Strength does not equal stability.  I’ve known many strong guys (over 500lb squat and deadlift) that had stability issues.  Strong muscles just means strong compensations.

For those of you who compete on a regular basis (sport or hobby), stiffness is par for the course.  Although stability fixes are often needed, repetitive activities will eventually over stress tissues even with the best body maintenance habits.  In this case, assistance from a therapist of some sort will be needed from time to time.  However, this will be very infrequent and the damage to the tissues will be much less when a proper approach to manage your issues is taken.

So next time you find yourself cracking your own back, or going to the chiropractor to “just get cracked”, know there is more work to be done if a more complete fix is desired.  Restoring proper movement is a multifaceted approach and requires consistent work and proper habits to achieve, and with this approach, the results are much longer lasting and healthier tissues. 

So the moral of the story? Don’t Just Mend. Transcend!

Dr. Scott Dunaway is a Doctor of Chiropractic practicing in Clarksville Tn and owner of ChiroStrength.  He specializes in treating chronic ailments associated with repetitive overuse habits by combining chiropractic adjustments, Active Release Techniques, and global movement assessment and corrections.  To schedule an appointment call the clinic at 931-321-1414 or submit the new patient form on www.ChiroStrength.com

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Rolling your IT band is getting you nowhere

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Rolling your IT band is getting you nowhere

Rolling your IT band is getting you nowhere

“Runner’s knee” is a common phrase used around the running community and is often correlated with a sensation of tightness on the outside of the leg and pain on the outside of the knee.  The Iliotibial (IT) band is the commonly accused culprit for this condition, and the most common do-it-yourself approach to fixing this problem is using a foam roller on the painful leg.

Because foam rollers have been shown in the literature, at least initially, to increase range of motion and reduce pain in muscles, it’s a reasonable approach.  However, the IT band is not muscle, it’s what’s called fascia, and it reacts differently.   

The IT band has deep attachments to the femur (the long thigh bone) and is very strong, but not very elastic.  It’s so strong in fact, that you, or any manual therapist, will never be able to “lengthen” this tissue.  However, a therapist can improve tissue movement at the junction between different hip and leg muscles which the IT band crosses, but the ‘shearing force’ required to make improvements can’t be done with the foam roller.  And finally, the IT band is almost always being over stressed already, or over stretched if you will.  You're better off staying away from the actual site of pain aside from maybe ice. 

Foam rolling the muscles around the IT band in the quads, hamstrings, and calf will assist in improving the condition, but it’s an incomplete approach at best. This condition is not typically a knee issue.  It’s a hip, foot, or core issue, so try this instead.

Roll the foot comfortably on a ball to ensure the joints of the foot are getting good movement, and make sure the big toe is sufficiently mobile.  While weight bearing, you should be able to pull your big toe off the ground with ease to about 60 degrees of extension.  You can also simply spend time out of your shoes on a natural surface which will “wake up” the tiny support muscles in the foot. Without a mobile foot, especially in the big toe, you will likely have less activation of the gluteal muscles which help stabilize the hip and therefore, has a huge effect on the knee.

For the hip, you need quality extension and internal rotation.  Most people have very poor hip extension, and when they get into what appears to be hip extension (think of your back leg on push off), they arch in the low back creating a focused area of extension in the small of their back which will lead to joint and muscle pain of the lower spine/SI joints.  Performing a good hip stretch followed by active hip range of motion will provide better joint motion over time.  For a few good stretches for the hip YouTube the following phrases: “Bretzel 2.0” and “tactical frog”.  For an example of active hip motion I’ve posted a video on ChiroStrength’s Instagram page.

Also, staying with the hip and core, you need to have good balance. Runners spend up to 95% of their race on one leg, however, most people don’t train any one legged exercises.  A little more advanced, but fantastic exercise, is the single leg dead lift (with or without weight).  This is a challenging exercise when a focus is put on maintaining a neutral spine and good hip extension on the up leg.  And because we are bipedal creatures (walk on 2 legs), we must train more transverse plane core exercises instead of frontal plane exercises.   That simply means, core exercises need to be focused on controlling or resisting rotational forces, (think Chops, Lifts, or Pallof Presses) instead of frontal plan exercises like planks, sit ups, or leg raises.  A core that can properly handle the rotational force associated with throwing the right leg and left arm out in front of the body, for example, will be better able to support the lumbar spine, pelvis, and hips thereby saving the stress on the knees.

When these areas are ignored in a runner’s routine, you’ll commonly see them land on a knee that cave’s in, which stresses the IT band.  Not because the knee is somehow functioning improperly, but the support system is failing.  Runner’s knee is almost always a mix between stability and mobility problems, so if you want to foam roll the painful leg, follow it up with some quality stability routines or be prepared to deal with this issue for a long time.

Dr. Scott Dunaway is owner and Chiropractor at ChiroStrength Located in Clarksville TN.  This facility combines corrective treatment with group classes in order to educate clients on how to maintain their bodies regardless of what their sport or hobbies are.  Visit www.ChiroStrength.com or call 931-321-1414 to learn more.

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Why ChiroStrength?

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Why ChiroStrength?

Why ChiroStrength?

Teaching the Right Way, Not the Easy Way

My journey through the Healthcare field has been one of many lessons.  Lessons in communication with patients, lessons in treatment of patients, but most importantly, lessons in understanding where I offer the most value.  After 3 years of shaping my professional career, I’ve come to the following conclusions:

  1. Our current healthcare model is failing.

  2. Not enough people are working to guide patients through the transition of being pain free into engaging exercise with low risk of re-injury.

  3. My calling is to teach.  Not just to make people feel better.

To make my first point, type this phrase into google search:

“World Health Organization – America’s Health statistics compared to other countries”. 

Spoiler alert, we spend the most on health care and have the overall worst rank (11/11) when compared to other developed countries.  Why is this?  In treating life threatening or traumatic injuries, westernized medicine and the advances in technology has made America the place to be for this type of care.  However, as smart and advanced as we’ve become, we have been unable to fully comprehend the complexity of the ecosystem that is our body.  Therefore, lifestyle diseases or disorders such as diabetes, high blood pressure, degenerative joint disease, and other spinal/joint pains, have been grossly mistreated due to our false sense of understanding.  Our current approach is symptom relief, which at best, simply muffles your body’s natural warning system that something needs to change.  By suppressing the symptoms we lure ourselves into thinking all is well and we go on about our business as usual until the next thing breaks down.  We take zero responsibility for the outcome of our lives and place the blame on “bad genes”.  Clearly genetics plays a role in our health, but you don’t have bad knees because they “run in the family.”  And the almost criminal component to all of this, is insurance pays for people to be sedated by the host of symptom suppressing drugs, but not for life changing habits like fitness or nutrition engagement.  This by far was my most frustrating lesson.

If you have received Chiropractic care, massage therapy, or physical therapy, only to have the exact same pain a year, months, or even weeks later, it was because there was no transition from being symptom free into a sustainable movement/exercise routine post treatment. Ever wonder why you always need massages in the same spot, or the same spot in your back keeps “slipping out”?  It is because of this lack of transition!  It is my opinion that the fitness industry, accompanied by chiropractic and physical therapy, makes much better sense at resolving musculoskeletal issues than any other combination.  Why?  Because the true answer to alleviating symptoms in the human body, is developing a solid foundation with which that body can move often (sometimes meaning exercise) without breaking down so easily.  Sadly this required time and lots of effort from both the professional and the patient and is not seen as practical enough to be covered by insurance.  It is a lack of healthy movement that is keeping us sick and in pain.  After all, the #1 reason for the development our brain’s outer cortex (you know, the part that distinguishes us from all other species), is for learning and application of movement.

And lastly, my passion for teaching.  I believe my patients thoroughly appreciate the amount of time I spend, not only with hands on treatment, but educating them about their issues and what THEY can do outside the clinic to accelerate their healing.  Though my experience, and also learning from my mentors in this profession, I believe the best thing I can be for my patients is be their teacher, not their “Doctor” (for the record “doctor” is derived from the Latin verb ‘docer’ which means “to teach”.)  The human body is an amazing vessel which can adapt and withstand huge amounts of insult, and also has an amazing resiliency to bounce back if put in the right conditions.  The most valuable thing I can do is teach a patient what these good conditions are, and how to avoid the bad conditions which result in pain and rapid degeneration.  With this knowledge, my treatment will be much more effective and longer lasting.

With this in mind, I have developed the Chiropractic and Fitness integrated facility; ChiroStrength.  I will use my background in Chiropractic, Active Release Technique, and biomechanics to address and eliminate as much dysfunction/pain in the joints and tissues as possible.  When we have accomplished this, the patient will be guided through programs designed to make them injury resistant by improving the quality of their movement.  My semi-private and group training programs are based on a brilliant quote from movement expert Ido Portal, “If you can not move your body and control it, then what business do you have moving other objects outside of your body.”  These programs are not designed for the purpose of losing weight, gaining muscle, or improving cardiovascular endurance, because all of these can only be accomplished with low risk after improving your movement literacy. To accomplish this, we use a combination of body weight and kettlebell training.  After going through my programs you can either return to your gym of choice with the confidence of being able to sustain your level of fitness with less risk of injury, or continue to be part of the ChiroStrength family and further your injury resistance and fitness goals.  The aesthetic results of fitness will come naturally if you have the ability to move well.  Because once you move well, you can move often, and when you move often you become stronger, regardless of where you’re starting from.   

 

For more information please find ChiroStrength on Facebook, Instagram, Youtube and Twitter.  I hope in the future I can help you in your journey to a pain free, active life!

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