A common complaint seen at TWC is Tendonitis, increasingly referred to as Tendinopathy. 

Tendonitis is caused by tendons - the thick cords that join your muscles to your bones- becoming irritated or inflamed.  Tendinopathy refers to damage done to a tendon usually due to repeated use. Tendonitis / Tendinopathy can cause acute pain and tenderness and make it difficult to move the affected joint. 

Any tendon can develop tendonitis, but it is more likely to develop in the shoulder, knee, elbow, heel, or wrist which is why it is often referred to as:

• swimmer’s shoulder
• pitcher’s shoulder
• jumper’s knee
• golfer’s elbow
• tennis elbow

Tendinopathy is more usual in the  Achilles tendon and Rotator Cuff tendons.

What causes tendinitis?

Tendons help us to make a certain movement over and over. Tendonitis may develop if the same motions are frequently made, such as when while playing sports or working, and the risk increases if the motion is performed incorrectly.

Tendonitis can also result from:

• Injury
• Aging
• Certain diseases, such as diabetes or rheumatoid arthritis
• Certain antibiotics (quinolones such as Levaquin)

Athletes who participate in particular sports, such as tennis, golf, bowling, or basketball, are at a higher risk of tendonitis. Individuals may also be at a higher risk if their job requires physical exertion, overhead lifting, or repetitive motions or tasks.

Symptoms

The pain from tendonitis is typically a dull ache concentrated around the affected area or joint, which increases when the injured area is moved. The area can also be tender to touch, feel tight and difficult to move, and there may also be some local swelling.

What are the treatment options?

Treatment options for tendonitis help reduce pain and inflammation in the tendon. Some basic home remedies include:

• Resting the tendon
• Applying heat or ice
• Taking medications, such as pain relievers and anti-inflammatories.
• Stretches and exercises to build strength and improve mobility in the area

A single corticosteroid injection can reduce pain and inflammation, but repeated injections can cause the tendon to weaken and increase your chances of injury.

It may be helpful to have imaging of the area such as ultrasound to determine how advanced the changes are in the tendon.

Chiropractic Treatment

Before commencing any treatments, our Chiropractors would take a thorough case history and perform a physical examination to determine which structures are affected, as well as exploring potential causes.  They would then implement management strategies which would be tailored to the patient and their needs.

For example - hands-on care for tennis elbow would include, education, muscle and tendon manipulation, acupuncture/dry needling, kinesiology taping, exercise and tissue loading management. 

When treated early, tendonitis usually resolves quickly. For some people, it can recur and become a chronic or long-term problem. If repetitive movements or overuse led to your tendonitis, you should change those behaviors to reduce your risk of developing it again after it heals.

How to keep tendon inflammation at bay

Take these simple steps to lower your chances of developing tendonitis:

• Keep physically fit and build your muscle tone.
• Warm up before exercising.
• Avoid over use and repetitive motions.
• Cross-train if you are an athlete.
• Use proper posture when working at a desk or doing other tasks.
• Don’t remain in the same position for too long. Move around periodically.
• Use proper equipment at work and during athletic activities.

If you begin to feel the pain of tendonitis, stop your activity. Take a 20-minute break to apply ice and rest.

Look out for our blog next month where we will look at how the use of Vitamins and Supplements may help with certain inflammatory conditions.

Janda's Theory -' The Domino Effect of Forward Head Posture 

Professor Vladimir Janda is one of the biggest contributors to our understanding of nervous systems influence over muscle control. Through his observations he provided original theories that scientists, via improved experimental methods are now able to confirm.

One prominent area of his studies was the development of three stereotypical patterns associated with distinct chronic pain syndromes;

•         upper-crossed syndrome(UCS)
•         lower-crossed syndrome (LCS)
•         layered syndrome (a combination of UCS and LCS)

These syndromes are characterized by specific patterns of muscle weakness (inhibited) and tightness (facilitated) that cross the body (as shown in the diagram above).

Specific postural changes seen in UCS, include forward head posture, increased cervical lordosis and thoracic kyphosis, elevated and protracted shoulders, and winging of the scapulae. Specific postural changes are also seen in LCS including anterior pelvic tilt, increased lumbar lordosis, lateral lumbar shift, lateral leg rotation, and knee hyperextension.

We know that when our centre  of gravity changes the rest of our body shifts its balance to compensate, below explains how UCS can lead to Layered Syndrome.

An example of the domino effect can be seen below:

Janda found that the UCS pattern of imbalance caused spinal joint dysfunction, particularly at the atlanto-occipital joints, C4-C5 segment, cervicothoracic joint, glenohumeral joint, and T4-T5 segment.

He also found that LCS created joint dysfunction, particularly at the L4-L5 and L5-S1 segments, SI joints, and hip joints.

Correcting these muscle imbalances through stretching and strengthening can help reduce stress on your joints and muscles and in turn reduce pain.

For further details of Janda’s life and contributions, read the paper by Morris and colleagues, Vladimir Janda, MD, DSc: tribute to a master of rehabilitation. (Spine. 2006 Apr 20;31(9):1060-4.)

Text adapted, and image taken from http://www.jandaapproach.com/ cited 11/2/2013

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

One in five UK adults (21%) – the equivalent of 10.3 million consumers - purchased at least one new digital device as a result of spending more time at home because of the COVID-19 pandemic, according to Deloitte’s Digital Consumer Trends 2020 report.   

What might the repercussions of this increased use of technology be?

Gaming:
 
Gaming has sky rocketed in the 21^st century, with some gamers even earning millions by entering into various competitions. Some of the top pro gamers even admit to training for up to 15 hours a day.  Needless to say that our bodies do not favour this amount of time spent sitting down. If you think you fall into the category of a ‘gamer’ it is recommended that you stand up and stretch your legs for 10 minutes every two hours or so. This will reduce the risk of our muscles seizing up and potentially leading to more serious injuries.

For more information follow this link:
 https://www.techradar.com/uk/news/pro-gamers-in-south-korea-train-for-15-hours-a-day-heres-whats-involved

With the change of seasons, we find ourselves tackling our gardens ready for summer time.  

Even though gardening is not considered as a sport it is very physical and time consuming, resulting in the body being in the same position for long periods of time. 

Gardening involves a lot of forwarding bending and at times can result in us twisting ourselves into awkward positions.  

These can result in spinal and surrounding structures to be strained and therefore resulting in back pain.

We have put together some helpful tips for you to incorporate into your gardening regime in order to prevent or manage any low back pain you may experience due to gardening. 

Warm up First 

It is a good idea to warm the muscles up first prior to gardening, as you would with any other type of work out.  This could be a brisk 5 minute walk with or without some gentle stretching. Below is a few stretches that will help to loosen the low back ready for gardening. 

If you already suffer with low back pain we would advise that you speak with your Chiropractor or healthcare practitioner in order for them to advise you on what stretches would be most appropriate for you.

Use support aids

Try to use support aids to make you feel more comfortable such as chairs or cushions.  Getting up and down from positions, especially up from the ground, can be a difficult task so use aids to help you alter your height.  

Ask for help

Do not be afraid to ask family, friends, neighbors etc for help.  If a task is is too much for one person or you are suffering with any discomfort as someone to help or take over.  It is important to understand your own limitations.

Chiropractors specialise in assessing, diagnosing and managing conditions of the spine. They are highly trained in finding the cause of pain in the spine. In the UK they undergo a minimum of four years’ full-time training. Importantly, chiropractors are regulated by law and must work within strict professional and ethical boundaries.

Before starting treatment, a chiropractor will do a full assessment. This will involve taking details about your condition, current health and medical history, and performing a physical examination. Sometimes it may be necessary to refer you for other tests, such as X-rays, MRI scans or blood tests. It is important for your chiropractor to gather as much information about your back pain as possible so that the most precise diagnosis can be made.

Your chiropractor will then explain what is wrong, what can be done and what you can expect from chiropractic treatment.

Chiropractors are best known for manual treatments such as spinal manipulation, where they use their hands to free stiff or restricted joints, or mobilisation, which is the gradual moving of joints.

But they may also use other recommended treatments such as certain types of acupuncture, electrotherapy, stretching exercises and rehabilitation, all of which form part of a chiropractor’s package of care. Your chiropractor may also offer lifestyle advice to help recovery and to prevent repeated episodes of back pain.

If your chiropractor does not think you can be helped by chiropractic treatment, you may be referred back to your GP or to another health professional. Chiropractors do not prescribe medication, so if this is needed, you may be referred back to your GP. As chiropractors support a joined-up approach to care, they may ask if they can send a brief report to your GP.

Many people who suffer long-term back pain benefit from regular, supportive chiropractic care to reduce the risk of recurrent episodes.

Chronic stress can have a negative effect on our physical health as well as our mental wellbeing. It can play a role in our susceptibility to illness and disease, but also in day-to-day functional problems such as aches, pains and stiffness.

There are many steps we can take to improve our ability to cope with stress and the role of nutrition is an important one. What and how you eat can help manage your stress.

To cope well with stress we need our food to provide us with balanced, sustained energy. Foods that quickly break down into glucose and are quickly absorbed - such as sugary foods and fast-releasing carbohydrates - may give us a burst of energy but can cause blood sugar to peak and then dip. This can actually increase our body's stress response and stress hormone levels, as well as making us feel irritated and out of control. As well as eating regularly, getting enough food is important when you're dealing with stress. 

Going on a weight loss diet - whether it's low-calorie, low-carb or low-fat - during a stressful time can add to your stress levels and in fact lead to yo-yo dieting. Instead, focus on balancing your blood sugar as outlined above, by eating regular meals, getting enough protein, healthy fats and non-starchy vegetables and cutting the refined carbohydrates and junks foods.

1. For Living Longer – Jogging

A US study showed that adults over 65 who ran or jogged for at least 30 minutes 3 times per week were as healthy as young adults in their 20s.[1] This might not sound important, but your walking style is a key indicator of mortality, so the longer you can stay spritely on your feet, the longer and healthier your life should be. Meanwhile, another study found that light jogging (between 70-120 minutes per week) was linked to the lowest mortality rate compared to sedentary people and heavy runners - so little and often is key here. [2]

When it comes to good physical and mental health, it's not a big surprise that research has shown January is the worst month of the year. All contributed to by the days being short, cold, and wet (let's not forget the come down from the festive period), and the summer feeling so far out of reach.

This January we wont let these feelings get to us, the tough year that was 2020 is finally behind us and we are looking forward to a better a new year, with hope and a chance to start a fresh. 

The Public Health Sectors are launching the 'Better Health - Every Mind Matters' campaign to support the nation's mental wellbeing with the encouragement that 'When things aren't so good out there, make inside feel better'. The campaign is being supported by the NHS, local authorities and a range of mental health charities, health organisations, as well as other charities and commercial sector partners. 

They have very helpful information and advise about anxiety, low moods, stress, sleep and others. 

To find the information you may need on The Every Mind Matters Platform, please click the image below.

Surprisingly, Chiropractic Clinic's around the country see an increase in patients with back aches and pains which have appeared during the Christmas period. There are many ways you can hurt your back at Christmas; whether it's bending and lifting heavy items like Christmas trees, furniture or even the turkey can easily strain your back or exacerbate existing aches and pains.

If you do hurt your back or neck during the holidays, your first thought might be to put your feet up on the sofa and watch some festive films and wait until the pain disappears. Although this may seem like a tempting option, it is much more beneficial for your back to keep your muscles moving. 

So, our first tip..

Keep Active

We know it's easier said than done, as the Christmas period for most means to relax, BUT that doesn't mean sitting on the sofa for 2 weeks eating your body weight in sugar. Prolonged periods of rest is bad for your joints and we are designed TO MOVE! So, try and get at least 30 minutes of gentle to moderate exercises 3-5 times per week in order to keep your joints and muscles healthy and your mind happy. Whether that's starting your days with a brisk walk out in the cold, fresh air or following an online exercise/pilates class.

Wrapping

We are all guilty of this, we sit on the floor, cross-legged, for a long time wrapping that never-ending pile of presents. This is not the best position for your and can cause extra strain on your neck and lower back. Why not try standing or sitting at a table instead. Another good way, standing at your ironing board as this height can often be adjusted to suit you and does not require you to be slouched over too much. 

Tree's a Crowd..

When it comes to putting up your decorations like the Christmas tree, get some help. The more help the better, even with the stages before the decorating; we have to get them from somewhere, so be mindful when digging them out from the attic or loft, always have someone else with you. When decorating be sensible, use a step where necessary. Don’t overstretch, don't take short cuts or move in awkward ways that your body isn’t used to!

When carrying heavy boxes or bending down to get that turkey out of the oven, be sure to bend and lift properly, squatting and using the knees rather than bending at the waist. 

Cleaning and Cooking

It's so stressful making sure your home is clean for your visitors, never mind the mammoth task of cooking for everyone, so try and delegate your load. Split the cleaning up amongst family members and even with the cooking if you trust others enough. But if you are like most people and would prefer to take full control of the Christmas Dinner then try to avoid being stuck over that stove for hours-on-end. Do some bits and bobs the day before, like the veg for example! 

Travel 

Always get yourself comfortable before you start your travels, making sure you are sat upright and your mirrors are correctly adjusted; especially your rear-view mirror. Because lets face it, it's so easy to slowly sink and slouch during a long journey, so use that mirror as a gage to know whether you need to sit up more. HAVE A BREAK, make a stop or two at a service station to stretch those legs, as well as some fresh air. 

...and most importantly, have fun this Christmas! 

From us at The Whitchurch Clinic, we hope you have a Merry Christmas and a Happy New Year!

 For more information contact us on 02920 617700 or email info@thewhitchurchclinic.co.uk

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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.