Dr. Robbi’s Blog

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A few weeks ago, I was on briefly Facebook and noticed an old high school friend’s daughter was having some serious problems with her neck and back. I thought about suggesting she see a chiropractor in her area, but saved that idea for later in the day. It turns out I wasn’t the only one with that thought.

By that afternoon Shelley had already taken her 12 year old to an Urgent Care Clinic for x-rays and other work. She was told Megan was suffering from Wry Neck and given “large doses of Ibuprofen and muscle relaxants.” Mom says none of these were giving her relief and the pain was so severe that Megan had fallen, grabbing her neck and screaming in pain. Shelley says Megan had spent much of the summer sleeping more than normal for a pre-teen. She could even see the muscles spasms in her neck and upper back. When Shelley tried to massage them, they were rock hard and hot to the touch.

After another friend suggested she call a chiropractor and I chimed in that “As an employee of a chiropractor, YES, you need to call a chiropractor”. She did.

Megan got in to Mountain View Chiropractic in Great Falls, Montana, that day. Dr Wiley examined her closely, listened to her complains and asked a lot of questions, then educated her on what was going on with Megan’s neck and back. Shelly goes on to say, “He took the time to show us on a model skeleton where her pain was originating. He showed us and explained which muscles were irritated and why. After one adjustment, Megan was feeling much better. She had mobility in her neck again and was much more comfortable. She went for a second adjustment the next day and was showing even more improvement. Dr. Wiley believes Megan will be feeling much better after one or two more treatments. I’m anxious to see how the adjustments affect her overall health. I’m hoping for improvement in many areas. Hopefully, she will start to feel more energetic. I’ve even noticed an improvement in her attitude already.”

Fortunately, Megan was able to start school on day one with a clear head (no side effects from pain pills and muscle relaxants). Consider if Megan’s mom hadn’t thought about chiropractic care, Megan could end up on a series of pain pills and other drugs and dealing with their side effects, instead of getting on with the busy life of a 12 year old.

Best wishes to Shelley and Megan and hopefully they continue through with their recommended care.

This is also the mission of Dr. Robbi Long and all of the doctors at the Back and Neck Center, on 156^th and Blondo. If you ever have a problem that you think might be solved with chiropractic care, please call 493-6800 or feel free to email DrRobbi@yahoo.com

With summer finally here, less people will be entering your office with injured backs from shoveling snow, slipping on ice or other winter activities. However, millions of Americans are dusting off their golf clubs and hitting the links, a location that is teeming with back pain and potential patients.

There are some 25 million golfers in America. A significant percentage of them suffer with chronic back pain. Many golfers pop aspirin and over-the-counter anti-inflammatory drugs like candy. What about chiropractic care? Surprisingly, as of 1994 the available

data suggest that less than two percent of golfers chose to visit a chiropractor.1 The same source revealed that MDs and PTs treat most golfers. This information is somewhat shocking considering that back pain is the most common problem among

golfers.

Although the percentage of golfers who see chiropractors may be higher, it is safe to say that chiropractors have yet to make a significant dent in the golf market. A quick glance at Golf Magazine’s website illustrates this fact. Their fitness section recommends

many fitness experts with whom golfers should consult, the majority of which are physical therapists; none are chiropractors (see www.golfonline.com/fitness).

Why golf has seemingly to overlooked chiropractic is unclear. Considering that golfers suffer mainly with spinal nociceptive pain, i.e., mechanical back pain, one would think that DCs would be the caretakers of choice. This article will discuss some of the basic

mechanics of the golf swing and suggest some ways that chiropractors can access the golf market.

Swing Myths that Promote Injury

I recently wrote an article that discussed many of the myths associated with modern golf instruction.2 One of the biggest myths involves the notion that club head speed at ball impact is dependent on maximum spinal rotation during the backswing. In this regard,

the term “x-factor” has been coined to describe the difference (in degrees) between hip position and shoulder position at the top of the backswing. Many instructors advocate this theory and recommend that golfers keep their pelvis as stationary as possible while

the spine is maximally rotated. These swing positions are popular because it is believed that maximal spinal rotation somehow engages the “big” muscles of the back, allowing for a sling-shot effect during the downswing, i.e., the modern golf theory of power

generation.

With respect to the “big muscle” theory, we are never told how maximal spinal rotation helps to engage spinal muscles or muscles such as the latissimus dorsi. Nonetheless, it is difficult to understand why modern golf instruction would promote such concepts.

Regarding spinal muscles, it is known that they provide only five percent of the torque generated during spinal rotation, the abdominal obliques doing nearly all the work.3

Like the spinal muscles, the latissimus dorsi have nothing to do with generating spinal rotation. Nor is maximal spinal rotation necessary for the latissimus dorsi to perform its normal function, i.e., adduction, medial rotation and extension of the humerus.4

The true source of power generation in the golf swing involves the creation of elastic energy, which is thought to be the power generator for most athletic maneuvers.2 Briefly stated, elastic energy is created by imparting a short, quick stretch on the muscles involved in performing a particular movement. In the case of the golf swing, it is

generally thought that the rotator cuff, latissimus dorsi and pectoralis major muscles are the “power muscles,”2 as well as the muscles of the arm and forearm. To effectively prestretch these muscles, no spinal rotation is needed.

The only purpose for pelvic and spinal rotation in the backswing is to achieve a body position that allows for effective club head delivery at ball impact. There are three main reasons to urge your patients to adopt a short backswing that reduces spinal rotation:

1. A short swing with less spinal rotation gives a golfer more control of the golf club and club head throughout the swing, which translates into better control of the golf ball.

2. Research has demonstrated that short backswings achieved the same clubhead speed at ball impact as long backswings.2

3. A short backswing will help to minimize the torsional stress in the lumbar spine.

Watkins explains that golfers should keep their shoulders and pelvis parallel to each other throughout the majority of the golf swing. He calls this rigid parallelization, the loss of which can generate rotational strain in the lumbar spine.5 With this information in

mind, you can imagine how stressful and injurious the golf swing can be when golfers try to achieve a large x-factor. This swing method is dangerous and should be abandoned.

Chiropractic Intervention

There are several avenues of care that chiropractors can offer golfers, including spinal adjustments, preventive swing advice, rehabilitation exercises and anti-inflammatory nutrition. As most DCs know, spinal adjustments are known to be effective in reducing

pain and improving spinal mobility. While the adjustment provides these beneficial outcomes, it is important to realize that adjustments cannot prevent injury. For this reason, DCs need to urge their golfing patients to reduce spinal rotation during the swing to lessen the chance of torsional injury. Golfers should be urged to adopt the

principle of rigid parallelization throughout the golf swing, which requires rigid abdominal

control.5

As previously alluded to, an aggressive lumbar spine rehabilitation program should be instituted as both a therapeutic and preventive measure. The golf swing is inherently stressful and injurious to the lumbar spine. Thus, it is very important to make sure the

lumbar spine’s stabilization mechanism is well trained. Treating golfers without taking this into consideration can lead to reinjury and dependence on passive care. Research has recently demonstrated that lumbar stabilization exercises can reduce pain and

disability in patients with spinal instability caused by spondylolysis and spondylolisthesis.6 McGill has recently discussed the stabilizing exercises that impart the least amount of stress on the lumbar spine, which included the cat stretch, curl-ups, isometric horizontal side support, and the quadruped track of exercises.7 These

exercises will also help golfers develop the rigid abdominal control needed to maintain pelvis and shoulder parallelization during the swing to reduce torsional strain.

Nutritional factors should also be considered when treating golfers. As mentioned earlier, golfers commonly self-medicate with aspirin and NSAIDs to help deal with inflammation and pain. These medications are known to cause gastrointestinal ulceration and reduce connective tissue healing. It would be wise for golfers to adopt a diet that is rich in dark green and other colorful vegetables, which are known to be sources of anti-inflammatory omega-3 fatty acids, bioflavonoids and other phytochemicals.

Supplementation with omega-3 fatty acids, flavonoids, ginger, turmeric, Boswellia and bromelain can add additional anti-inflammatory support,8 while supplemental glucosamine and chondroitin sulfate are useful for enhancing the repair of

connective tissues.8,9

Very few golfers hit the fairways armed with the modest amount of information presented in this article. Even if you do not play golf that should not stop you from engaging the golf market, as golfers desperately need the services provided by chiropractors.

By David Seaman,DC,MS,DABCN,FACC Dynamic Chiropractic, Volume 17, Number 17

References

1. McCarroll JR, Mallon WJ. Epidemiology of golf injuries. In: Stover CN, et al. eds. Feeling up to

Par: Medicine from Tee to Green. Philadelphia: FA Davis; 1994: p.9-13.

2. Seaman DS. Back pain in golfers: etiology and prevention. J Sports Chiro Rehab 1998; 12(2):45-

54.

3. Macintosh JE, Bogduk N. The axial torque of the lumbar back muscles: torsion strength of the

back muscles. Aust N A J Surg 1993; 63(3):205-12.

4. Cramer GD, Darby SA. Basic and Clinical Anatomy of the Spine, Spinal Cord and ANS. St Louis:

Mosby; 1995: p.73.

5. Watkins RG. Lumbar spine injury in the athlete. In: Liebenson C (ed.) Rehabilitation of the Spine.

Baltimore: Williams & Wilkins; 1996, p.341-54.

6. O’Sullivan PB et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back

pain with radiologic evidence of spondylolysis or spondylolisthesis. Spine 1997; 22:23959-67.

7. McGill SM. Low back exercises: evidence for improving exercise regimens. Phys Ther 199;

78:754-65.

8. Seaman DR. Clinical nutrition for pain, inflammation, and tissue healing. Hendersonville, NC:

NutrAnalysis, 1998.

9. Bucci LR. Nutrition Applied to Injury Rehabilitation and Sports Medicine. Boca Raton: CRC Press,

1995.

Give Your Body What It Needs Every Day

By Dr. Donald L. Hayes

The word protein is of Greek origin, from the word proteios, which means “of prime importance,” and when it comes to the human diet, protein’s importance cannot be understated.

Examples of proteins in our bodies that make life possible are hormones, enzymes, muscles, tendons, cartilage and other types of structural tissues and transport molecules. Proteins are constructed as long chains of amino acids, of which there are eight that must be provided by the food we eat. They are called “essential” because our bodies cannot make them. If our food lacks enough of even one of these eight essential amino acids, then the body will have a harder time making new proteins.

Why does the body need new proteins? Because our body’s protein tissues wear out on a regular basis and must be repaired and replaced. This replacement process is accomplished by eating foods that contain protein. After eating protein, the digestive system breaks it down into a brand new supply of amino acids that become the building blocks that are used in repairing and replacing those that are worn out.

Various food proteins are said to be of different quality, depending on how well they provide the amino acids needed to repair our body’s tissues. Simply put, what quality really means in this context is the ability of the food protein we eat to provide the right kind and amount of amino acids for our body to repair worn-out tissues. Let’s compare a few different types of protein and see why the concept of protein quality is more complicated than it seems when it comes to our health.

Animal Protein: The Highest Quality Protein Isn’t Always the Healthiest

Most animal-based foods can be used very efficiently by our body because they have the right amounts of each essential amino acid, and therefore are often referred to as “high quality.” Among animal foods, the proteins of milk and eggs represent the best amino-acid matches for our body and thus are considered the highest quality. Plant proteins are often referred to as “lower quality” because some individual vegetables may have a low level of one or more of the essential amino acids (although as a group plant-based proteins do contain all eight essential amino acids).

It would be great if the highest quality protein equaled the greatest health, but it doesn’t, and that’s why the term quality is misleading. In fact, compelling research shows that “low-quality” plant-based protein, which allows for slow but steady repair of new body tissues, is the healthiest type of protein. Chronic inflammatory conditions exist in millions of Americans who eat too much dietary animal protein. Just consider the number of allergy-related symptoms attributed to consumption of milk-based protein (milk, cheese, etc.) and the cholesterol- and fat-related conditions caused by consumption of eggs and red meat.

Clearly, animal protein is not the best for your overall health, at least not in the quantities consumed by most Americans. The RDA (Recommended Daily Allowance) for protein is 0.80 grams of protein per kilogram of body weight per day, which is an RDA of about 54 grams a day for a 150-pound adult. And the U.S. Surgeon General’s Report on Nutrition and Health in 1988 stated, “The average man in the U.S. eats 175% more protein than the Recommended Daily Allowance and the average woman eats 144% more.”

Plant Proteins: The Best Option for Your Protein Needs?

We now know that through enormously complex metabolic systems, the human body can derive all the essential amino acids from the natural variety of plant proteins we encounter every day. It doesn’t require eating higher quantities of plant protein or meticulously planning every meal. Dean Ornish, MD, a graduate of Harvard Medical School, has proven that a change in eating habits can slow, stop and even reverse the most common and deadly diseases including heart disease, cancer and diabetes. Dr. Ornish in his latest book, The Spectrum, states; “in general, plant-based proteins are more healthful than those derived from animal sources.”

A Note About Soy Protein

There is increasing controversy regarding the value of soy as a vegetarian protein option. On the positive side, soy is a bean and usually doesn’t go through a lot of processing, so it retains all of the nutrients - proteins, fiber and the good fats. It also has vitamins and minerals. Soy proteins are very high in quality and they have a cholesterol-lowering effect, which is very heart-healthy. So much so that soy supporters suggest incorporating 2-3 servings of soy per day into diets. Supporters say clinical research studies show that soy does not lower testosterone levels, raise estrogen levels or affect sperm count.

However, there is also research out there that raises concerns regarding consuming this type of protein. For instance, one study showed that soy protein contains a natural chemical that mimics estrogen.

Several cancer studies funded by the National Institutes of Health showed that estrogen-dependent tumor growth increased as the isoflavone content increased in the soy-based diet. (Journal of Nutrition, November 2001) Another study frequently referred to that was published in the Journal of Urology in April 2003; it states that a chemical found in soybeans (genistein) may contribute to the development of abnormal reproductive organs that may lead to sexual dysfunction.

Start Your Day Right

Eating breakfast is an important part of attaining and maintaining a healthy lifestyle, and studies show that eating a low-fat breakfast high in complex carbohydrates from fruits and vegetables and with at least some protein will help you lose weight. Many Americans routinely skip breakfast under the false belief that eliminating morning calories may help with weight loss. By choosing not to include breakfast, particularly breakfast that includes some protein, you may be putting your health in danger.

In fact, studies have shown that people who do not have protein at breakfast are more likely to be overweight, have less energy and have higher cholesterol levels than those who always eat a healthy, well-rounded breakfast. Research conducted at the University of Pittsburgh School of Medicine states: “Eating breakfast, particularly if it contains some protein, can hold off hunger for hours. Your body converts the amino acids from proteins into blood sugar. Amino acids act as tiny blood sugar time-release capsules that can keep you from overeating.”

Don’t know where to start when it comes to breakfast? Choose foods that are natural and unprocessed. Eat whole fruit rather than fruit juice. Whole fruits provide extra fiber. Protein sources include a variety of vegetables, eggs, fish, lean meat, seeds and nuts. If your excuse is that you don’t have time to include healthy protein at breakfast, here’s your answer: Try one of the many delicious tasting breakfast meal replacement shakes on the market. Make sure you choose a shake that is not loaded with chemicals and tons of sugar. With a little research you can find a great tasting vegetarian/vegan shake that uses plant proteins. Other key ingredients to look for include a super greens blend and essential fatty acids. A meal replacement shake can be made in a minute and fuels your body right through the morning. It’s the ultimate fast food and so good for you. Ask your doctor for a recommendation.

Harness the Power of Protein

When it comes to protein, don’t fool yourself, “fuel” yourself. Build a protein-based breakfast into your morning breakfast routine and make sure you get protein throughout the day. Remember, don’t overload on animal-based protein; small amounts of lean meat like chicken, turkey or fish are OK (4 ounces a day at most), but make sure plant proteins form the staple of your diet. You’ll look better, feel better and improve your quality of life, all at the same time.

To Your Health
March, 2010