Gardening

Gardening – Don’t overdo it with the trowel!

As a nation, we love our gardens and spend a considerable amount of time and money on them. As we rush to get those jobs in the garden done, there is a risk that gardeners may injure themselves. What everyone wants is to be fit and healthy enough to actually enjoy sitting in their garden and enjoy the fruits of their labours come summer time, so here are some helpful tips from the British Chiropractic Association.

Clothes

 Don’t wear clothes that are tight or could constrict your movement.

Warm Up 

 Gardening is like any other exercise; you need to warm up first. Don’t go straight into heavy garden work; start off with lighter jobs as this will lessen the chance of muscle strain.

Using a ladder

·         When using a ladder or steps, make sure you are always facing it, keeping your shoulders, hips and knees pointing in the same direction.

·         Rather than leaning or reaching, move the ladder or step regularly to keep up with where you are

·         Any kind of ladder must be firmly and safely planted in position and, if possible, have someone else there to keep an eye on things.

Clever pruning

·         Get as close as possible to the things you are pruning and avoid overstretching to reach the area you are dealing with.

·         Invest in some long handled secateurs to reach plants and bushes that are beyond normal reach.

Take a break

·         Vary your activity by spending no more than 20-30 minutes on any one thing and make sure you take regular breaks. Be clever with the paving

·         If laying a patio, keep the slab close to your body and bend your knees; it is sometimes better to bend one knee rather two, as your supporting leg gives you a position of strength.

·         If using railway sleepers, two people will probably be needed.

Plan ahead

·         If you are planning a trip to the local DIY store to buy heavy items such as cement or gravel, buy smaller bags rather than one big bag as they are easier and safer to carry.

·         If you do buy heavy items, use a trolley and if on your own, ask an assistant at the store to help you.  If buying things like compost, sand or gravel in bulkier amounts, shovel the contents of the large bags straight into smaller containers or wheelbarrow from the back of the car.

·         Don’t lift with your arms straight out, keep the elbows bent and to your side to minimise the stress on your back.

·         If having items delivered, have them unloaded as close to where you need them as possible; this will save the effort of moving them again.

·         A specialist garden trolley might be worth investing in to move these sorts of materials around, especially if you have lots of patio pots to move around as well.

Courtesy of British Chiropractic Association

Your doctor or chiropractor may be able to write you a letter for your airline and flight crew. A letter to explain your condition may be enough to persuade the crew to allow special accommodations i.e. upgraded to more legroom, allowed to lie on the floor during long flights, given extra blankets and cushions, or to be allowed to walk around as often as you need.

• Accommodate you with special shuttles and elevator platforms for boarding.
• Give you tips for traveling (and getting through security) with your transcutaneous electrical nerve stimulation (TENS) unit.
• Allow non-medical assistants to accompany you through security and boarding.

• See your GP or pharmacist to see what medications they recommend for your travels.
• Take your recommended pain medication around one hour before your flight, to give it time to get into your system.
• Carry your pain medications together in a clear plastic bag and have them on you at all times, in case you need them during the flight.
• Inform flight attendants that you are on medication. This way they can monitor you if necessary.

• If you have lower back pain, providing support behind your lower back with a back roll or even a couple of pillows, is a good way to prevent slumping or slouching in your chair which aggravate your pain.

• Neck pillows can help on board to help with neck pain.

• Back braces, tube-shaped pillows with microfibers inside, and other supports can be purchased to help provide relief. Ask your chiropractor for advice on the best type for you.

• Wrap in kitchen towel/pillow case, to prevent direct contact with the skin, as that can cause heat or ice burns.
• Apply for 15-20 minutes on the affected area/s, and this can then be
• Repeat every 1-2 hours.

Both should feel comfortable, not painful, if this is the case the packs are either too hot/cold, and a thicker barrier should be used i.e. towel, until the temperature is comfortable but can still be felt.

NB: Do not use if you suffer from diabetes or poor circulation.

• Stock up on inexpensive heating options like ThermaCare heat wraps or warm gel packs and apply them while in the air.
• Bring an empty hot water bottle and ask the flight attendant to fill it up during your flight.
• Carry a small gel pack on the plane and have the flight attendant store it in the fridge when you are not using it. 
• Have a Ziploc bag on hand and ask the attendant to fill it up with ice that you can apply to your back.

Be sure to check in with the airline to see what items are acceptable to carry on.

This time of year is a great opportunity to get away, whether for day trips, the weekend, or the start of a longer break.

Unfortunately, many others have the same idea too! If you are facing a long or potentially delayed journey, keep our car travel tips in mind.

• Finally roll your shoulders back and down so they are relaxed against the seat

Make adjustments

• If you share a car, make sure the seat position is adjusted to suit you each time you get in. 
• The back of the seat should be set slightly backwards, so that it feels natural and your elbows should be at a comfortable and relaxed angle for driving.

Steering wheel

• Once you have adjusted your seat correctly, your hands should fall naturally on the steering wheel, with just a slight bend in the arms.
• If the wheel is too high and far away, tension will build up in your shoulders and upper back. If it is too low and close to you, the wheel may be touching your legs, which will reduce your ability to turn it freely, putting strain on the wrists and the muscles of the upper back.

Mirrors

• Your reactions must be quick, so you should not need to move your head a lot. The mirror positions should allow you to see all around the car with the movement of your eyes with minimal head movement.
• Set your mirror positions to suit you before you drive off. 

Seatbelts

• Your seatbelt should always lie across the top of your shoulder and never rub against your neck or fall onto the top of your arm. 
• Depending on your height, you may need to adjust the position at which the seat belt emerges from the body of the car. (If the adjustments available are insufficient, it is possible to purchase clips that help you adjust your seat belt height without impairing safety.)

Footwear

• Once you have adjusted your seat correctly, your feet should fall naturally onto the pedals. You should be able to press the pedals to the floor by mainly moving your ankle and only using your leg a little. 
• Avoid wearing wear high heels, or very thick-soled shoes, as you will have to over-extend the ankle in order to put pressure on the pedals. As well as making it much harder to deal with an emergency stop, this position will raise your thigh from the seat (reducing support to your leg) and create tension (and possibly cramp) in the calf. This, in turn, will impair the blood flow on a long journey.

Relax

• A relaxed driving position reduces stress on the spine, allowing your seat to take your weight.
• Take regular breaks - stop and stretch your legs (and arms!) at least every two hours, more often if possible. You should certainly stop more frequently if you are feeling any discomfort.
• Clench your cheeks - If you are stuck in traffic, exercise in your seat. Try buttock clenches, side bends, seat braces (pushing your hands into the steering wheel and your back into the seat – tensing and relaxing) as well as shoulder shrugs and circles.
• Leave the tight clothes at home - They will restrict your movement.
• It’s all in the timing - Allow plenty of time for journeys to avoid stress.

If I haven't answered all your questions feel free to ask on your next visit! 

Quick Top Tips

• Take short frequent breaks, we're built to move. Many working from home are missing the mini-breaks they had working in an office environment, less distance to the kettle! 
• Set an alarm/timer every 30 minutes to remind you to change position and correct posture.
• Build postural stretches and exercises in to your daily routine.
• Mix up your tasks during the day to use different muscle groups. 
• Consider a standing desk to help vary the pressure on different parts of your body
• Those using laptops consider having a separate monitor or wireless mouse and keyboard so that you can position all well. 
• Reduce screen time by listening to audio books or podcasts during your spare time, instead of watching TV or using phones.
• If you aren't able to access a computer chair remember to support your lower back with extra cushions.
• When choosing where to set up consider appropriate natural light, screen glare, and sight line. Ideally position somewhere you can occasionally look in to the distance to reduce eye strain (so not facing a wall or with sunlight directly behind you).

As home working seems likely to continue long term, more patients are considering investing in their own desks and office equipment. For our suggestions on how to set up your workstations, equipment ideas and more, please read on below.

Desk

Chair

Monitor

• Reduce glare and reflections, by ensuring neither you or the monitor face the window. Tilting the monitor slightly downwards can help with glare, and adjust the monitor’s brightness to a comfortable level.
• Remember to rest your eyes every 30 minutes or so, by looking away into the distance.

Keyboard

• Put reference documents either between the monitor and the keyboard or directly alongside the screen in a document holder so the keyboard is not pushed too far back on the desk, disrupting your posture.
• The keyboard should not be so close to you that your wrists rest on the sharp edge of the desk.

Mouse

Laptops and Tablets

• Docking the laptop into a desktop computer at a suitable workstation.
• Connecting the laptop to stand-alone equipment such as a separate screen, keyboard and mouse. 
• Transferring your information onto a desktop computer if working for long periods. 
• Use on a desk where possible with a suitable chair.
• If on lap use a tray over a cushion to elevate the laptop, and the tray will insure the fans aren’t blocked.

• Song, C.; Ikei, H.; Park, B.-J.; Lee, J.; Kagawa, T.; Miyazaki, Y. Psychological Benefits of Walking through Forest Areas. Int. J. Environ. Res. Public Health 2018, 15, 2804. https://doi.org/10.3390/ijerph15122804 -
• Olafsdottir G, Cloke P, Schulz A, et al. Health Benefits of Walking in Nature: A Randomized Controlled Study Under Conditions of Real-Life Stress. Environment and Behavior. 2020;52(3):248-274. doi:10.1177/0013916518800798. https://journals.sagepub.com/doi/abs/10.1177/0013916518800798
• Hori H, Ikenouchi-Sugita A, Yoshimura R, Nakamura J. Does subjective sleep quality improve by a walking intervention? A real-world study in a Japanese workplace. BMJ Open. 2016;6(10):e011055. Published 2016 Oct 24. doi:10.1136/bmjopen-2016-011055. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093382/

Did you know there’s currently 10 million people in the UK living with back pain?² What’s more, research from the British Chiropractic Association found that cases of back pain rose by a third during the pandemic and resulting lockdowns³. Despite this increase, only 10% of people experiencing symptoms sought support from a GP or chiropractor, with 46% of people not taking any steps at all to tackle their back pain, indicating a large portion of the population is still living with daily symptoms into 2022.⁴

Whilst these numbers may seem high, by actively taking simple steps as part of your daily routine evidence shows that symptoms and the risk of developing a more challenging musculoskeletal condition can be reduced.

Here are our five top tips from that anyone can take to support their back health:

1. Start the day right and keep on moving: Physical activity can be beneficial for managing back pain, so aim to incorporate at least 30minutes of movement into your day. It’s important that if this is of a moderate to high intensity that you warm up and down properly to get your body ready to move. If a previous injury is causing you pain, adapt your exercise or seek some advice. Activities such as swimming, walking or yoga can be less demanding on your body, while keeping you mobile!

2. Take a break: If you sit for long periods of time as part of your job, ensure you stand up and move around every 30 minutes – particularly so for hybrid work set ups and working from home if you don’t have ergonomic office equipment.

3. Lifting and carrying: If you’re taking on DIY or spring-cleaning projects this Easter, remember to bend from the knees, not the waist when lifting heavy items. Face in the direction of movement and take your time. Hold the object as close to your body as possible, and where you can avoid carrying objects which are too heavy to manage alone, ask for help or use the necessary equipment.

4. Sleep comfortably: The Sleep Council recommends buying a new mattress at least every seven years. Mattresses lose their support over time, so if you can feel the springs through your mattress, or the mattress is no longer level, your mattress is no longer providing the support you need. Everyone has different support requirements, so when purchasing your mattress ensure it is supportive for you. If you share a bed and require different mattress types, consider two single mattresses which are designed to be joined together, to ensure you both get the support you need.

5. Seek out support: If your symptoms of back or joint pain last more than two weeks, or prevent you from carrying out your daily routines, see a chiropractor or GP for advice. You can find a registered chiropractor on our ‘Find a Chiropractor’ page.

Feeling physically well positively impacts every aspect of how we live our day-to-day life, so maintaining good back health is extremely important. In partnership with the BCA, we want to raise awareness and show that anyone can be proactive about their back health this Chiropractic Awareness Week!

Easy changes can make a significant difference, but if your pain doesn’t reduce or is prolonged, you should always see a health professional for further guidance.

Unless you have had back problems previously to being pregnant, or during previous pregnancies, it is uncommon that you should have any in the early stages.

In the mid to later stages women develop an increase in the lumbar curve due to the increased weight being carried out in front. This puts more pressure on some of the joints of the spine, causing discomfort and, for some women, pain.

As pregnancy progresses into the final stages, relaxin is released in order to prepare for birth which softens the muscles, ligaments and tendons. At this time the body is more unforgiving, old problems with the back and joints are highlighted, and it is easy to overstretch or lift something and it cause more of a problem than normal.

Some chiropractors have under taken post graduate studies to train to work with women who are pregnant, and there are many adaptations we can make to our treatment methods and benches to ensure the comfort of our pregnant patients.

Evidence suggests it is very beneficial to both mother and baby if the pelvis and lower back functions biomechanically at its best during pregnancy, and especially during the birth. The three joints of the pelvis need to work and expand equally during pregnancy and birth to reduce the risk of over stretching which can lead post-natal pain in that joint. There are also some research articles that suggest chiropractic can reduce labour times and the need for pain relief, due to decreased pressure on the back. 

For further details of the benefits and research follow this link to the International Chiropractic Pediatric Assiociation

For a personal account of an experience of chiropractic during pregnancy follow this link to Natural childbirth Education 

• Talk to your healthcare professional to discuss stretches and exercises that are suitable for you.
• The fitter you are and the more muscle tone you have before pregnancy, the more likely you are to be able to cope with the body’s postural changes. 
• Sleeping with a pillow between the legs, or supporting your bump may help with lower back pain.
• Core exercises are very useful and you can talk to a chiropractor, GP, midwife or other healthcare professional for advice on this.  During pregnancy specialist yoga classes, taken from 12 weeks onwards, can be very beneficial.  Swimming and aqua natal classes are also of benefit, as being in the water takes the pressure off strained joints whilst providing good exercise and relaxation.  
• Avoid high heels and wear comfortable, supportive shoes.  If you have children already, it can be difficult as they will need lifting and carrying. 
• Always lift with your spine straight and bend knees to avoid leaning, stretching or bending.  
• Do not sit for prolonged periods, take regular breaks and, when sitting, let the seat take your weight and, if possible, keep as much of your body in contact with the chair so that your whole body is supported. Knees should be lower than your hips. 
• Try to keep stretching leg muscles to make sure unnecessary extra pressure is not put on the knees.
• Elevate legs whenever possible to offset any weight pressure and reduce any swelling - ankle circles will also help. 

Neck and mid back pain is also common during pregnancy due to an increase in breast size;

• Get measured for bras regularly throughout your pregnancy. This will help make sure you are wearing the right size and, therefore, getting the maximum support possible. 
• Do neck and shoulder stretches regularly to relieve tension in the muscles.

The more rapid the onset and the more acute the onset, the more likely it is that this could represent a stress fracture.  Stress fractures are subtle fractures that occur in the bone as a result of putting too much constant stress on the bone, to the point where the bone starts to break — initially at a microscopic level.  Stress fractures are common in athletes or runners who have changed their training schedules, increased the amount of time that they are playing or running… or simply bad luck.  The pain from a stress fracture will typically be present from the first step you take on the court or the road.  

The pain from shin splints or medial tibial stress syndrome tends to build gradually and is a form of compartment syndrome.  You can usually initiate a run, or a game and then the pain begins shortly thereafter, or possible after the game or run itself.  Medial tibial stress syndrome (or ‘shin splints’) is characterised by pain along the lower part of your leg or tibia, and the pain is along the inner border of the tibia.  This is a very common cause of disability in runners and they often develop after sudden changes in physical activity, such as running longer distances or on hills, or increasing the number of days you exercise each week. Flat feet (weak arches) are another factor that can contribute to increased stress on the lower leg muscles during exercising.

Chiropractic care and Sports Massage have been shown to be a great option for athletes in both treating and preventing sports injuries and pain. One such study found that chiropractic treatments led to less muscle strains in the legs. Another study showed that chiropractic adjustments improved athletic performance among competitive athletes (references below). Through soft tissue techniques and spinal manipulation, combined with advice, we can work to prevent injury occurrence.

Botelho, Marcelo and Bruno Andrade. “Effect of Cervical Spine Manipulative Therapy on Judo Athletes’ Grip Strength. Journal of Manipulative and Physiological Therapies. 2011; 35(11): 38-44.

Hoskins W, Pollard H. The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized control trial. BMC Musculoskeletal Disorders 2010;11:64.

Reinking M, Austin T, Hayes A. A survey of exercise-related leg pain in community runners. International Journal of Sports Physical Therapy 2013; 8(3): 269-276.