The Last Straw!!!

DOC! I think I broke my rib! Agh!

How did you manage to do that?

Ow-ow-ow! Don’t touch it! I think I broke it when I sneezed… I put heat on it right after it happened to try to ease the pain, but it just keeps getting worse!

(chuckles and shakes his head) Mr. Smith, you must have lungs like Hercules to break a rib by sneezing… We just took x-rays on you last week, and there was not even the slightest indication of a fracture. Are you SURE that there is nothing else that might have caused this pain? And remind me to talk to you about ice vs. heat later…

Stop poking me! You’re the devil, you know that? I am sure there is nothing else… I’m telling ya… I just sneezed… and POP! There it went!

If you don’t relax, Mr. Smith, it is going to make this even more uncomfortable. Stop squirming. Have you ever… say… fallen? Oooor, been in a car accident?

I’ll relax when you get yer thumb outta my back! YEOW! Well… I fell off of a loadin’ dock about 5 months ago… and got drug by a horse when I was 27… and was in a car accident about 3 ½ years ago… BUT THAT WASN’T my fault! He was in MY lane and I-

Mr. Smith… I think I know what we are dealing with here. Take a deep breath in- this is gonna sting a little- breathe all the way out… I’m gonna give a little push-

OWWW! FOR THE LOVE OF JAMISON AND ALL THINGS HOLY!!! I don’t like you very much right now doc! I… OW! You ARE the devil!

Does a sneeze cause a "slipped disc" or a “broken rib”?

A “slipped disk” in the low back and a jammed rib is almost always the result of several things. Just like in most chiropractic cases, the problem starts with a simple fall or imbalance that seems harmless enough, and then it continues to build until it becomes symptomatic. We have all heard the proverbial saying about the “straw that broke the camel’s back”… but I think it is a VERY fitting illustration.

Just like the patient above, a simple sneeze can make someone experience sudden back pain that then proceeds to leg pain or pain in the ribs that can mimic a broken bone; in some cases, it can even mimic a heart attack. However, it wasn’t the sneeze that caused the disc to "slip" or the rib to jam, but it does represent the final "straw" in a much more involved process. Some factors that contribute to the pain and symptoms of back injury include dehydration, unusual stress on the spine, and too much weight bearing on a concentrated area of the spine.

The spine works together as a whole, so if there is a mechanical problem in one part of the spine, even as far away from the low back as the neck, it can cause problems in another area of the spine. Imbalances and problems in the pelvis, sacroiliac joints, and low back, as well as restriction in joint motion in the mid-back and neck, can contribute to the process of disc degeneration and eventual injury in the entire body.

A "slipped disc" or jammed rib usually happens when a lot of these and other factors work together and cause disc injury. For example: A middle-aged blue collar worker who stands for long periods of time, suffers from dehydration, has poor posture from weak abdominals, and lack of range of motion from years of repetitive movement, then lifts a heavy piece of equipment and experiences sudden acute low back or rib pain. Or perhaps many months after lifting the piece of furniture, he experiences no pain at all until he sneezes. Bingo. “The last straw”.

SO! Can a sneeze break a bone? TECHNICALLY… yes. BUT! That is only in severe cases of osteoporosis or rare bone disease. By in large… 99.9% of the time, no. A sneeze cannot cause a bone to break.

"Staff" Infection

No, I didn’t spell that wrong. I am talking today about the importance of a good staff in your office. A wise chiropractor once said, “Give me a great doctor and a mediocre staff, and you will have a mediocre practice. However, give me a mediocre doctor and a great staff, and you will have a great practice.”

Whether or not you want to admit it, your staff sets the tone for the type of practice you will have. The patients see and hear from your staff more than they do you. Your staff is the face of your practice. If they are having a bad day, so will your practice. If they are on the top of the world, your practice will thrive.

We have all been to the dentist and seen that staff member at their office. She complains every time she is asked to do something. Especially if it differs from the way they have “always done things in the past since the practice opened 26 years ago.” She hasn’t been at her best since “the accident” 12 years ago, which she reminds everyone of at least three times a day. She starts drama with the other employees and acts like everyone’s mother and boss. It is not a priority to her to work quickly; 60% efficiency is enough. Although, when she is working at 100%, she is nothing to write home to mom about. She barks orders like she owns the place, but you know by her character and work ethic, that is not the case. Yet, each time you go in to see your doctor, there she is- still getting on everyone’s nerves and shooting angry looks at patients across the room.

Now, I know that she has been a familiar face in the office for some time now, has been there with you through thick and thin, and that you are loyal to the core. HOWEVER, the storms she has weathered with you have left her worn out with a bruised ego and a chip on her shoulder. Everyone sees it but you. Sometimes, the powder blue adjusting tables and lavender vinyl traction tables are not the only things that you need to let go of during spring cleaning. This is not heartless! This is a business decision to liberate you and your practice.

Here are some hints that it is time to let her go:

• If you pull up to your office and sigh because her car is not yet in the parking lot… it might be time to let her go.
• If you dread telling her that you are implementing a new office policy and know that she will not only not do it, but give you a laundry list of reasons why it is a bad idea… it might be time to let her go.
• If she doesn’t seem to understand, no matter how many times you tell her, that it is not appropriate to wear cartoon character underwear underneath her white scrub pants… it might be time to let her go.
• If she is out on vacation for a week, and none of the patients ask why she isn’t there… it might be time to let her go.
• If she is out on vacation for a week, and some of the patients make comments like, “Oh good, chiropractic wasn’t the profession for her,” and you have to explain that she IS coming back to the patient’s disappointment… it might be time to let her go.
• If she still doesn’t understand that her foot fungus and trouble with the in-laws over the weekend is not appropriate waiting room conversation… it might be time to let her go.
• If she rescheduled all of your patients one day just because she decided she needed a day off… it might be time to let her go.

Bottom line... if they are bringing your office down... its time to let them go.

Disinfect your office!

"Water water everywhere, but not a drop to drink... where am I?"

THE OCEAN!!! Hahaha... This famous childhood riddle is very fitting to my topic today... hydration!

Water makes up nearly 85% of our brain, about 80% of our blood and about 70% of lean muscle. Because our bodies are 1/2 – 4/5 water, then a lack of water - dehydration - could impact our health. If water is such a key component of our bodies, why do most people not consider it necessary to drink it? You would think that common sense would mean “ when you’re thirsty, take a drink. That’s what you need.” However, did you know that in 37% of Americans, the “thirst indicator” is so weakened in their bodies, that it is mistaken for hunger? People are dehydrated and don’t even know it!

Cassie, why are you talking about water? What does THAT have to do with chiropractic?

GLAD YOU ASKED! Let me show you…

In the immortal words of Tin Man: “Oooil caaan… Oh- oil my arms, please – oil my elbows. Oh!”

Water acts as the body’s “oil can”, if you will, to the joints. Since the majority of our body is made up of water, it stands to reason that it also includes our joints, ligaments, and muscles. Think of a prune. A raisin. Both, while once juicy pieces of fruit, are now dehydrated, wrinkled, and tough. Our muscles act in much the same manor. If you are not supplying enough water to your body, your muscles begin to shrivel and tighten. This can cause excruciating pain in the body that no amount of adjusting the spine can cure. Research shows that 8-10 glasses of water a day could significantly ease back and joint pain in 80% of sufferers. Wow!

It is so simple, yet we over look it. We often blame our dehydration symptoms on other things, but let me give you some statistics that might shock you:

• A 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on a computer screen or on a printed page.
• Lack of water is the Number 1 trigger of daytime fatigue.
• One glass of water will shut down midnight hunger pangs for almost 100 percent of the dieters studied in a University of Washington study.
• Even MILD dehydration will slow down one's metabolism as much as 3%.
• Drinking 5 glasses of water daily decreases the risk of colon cancer by 45 percent, it can slash the risk of breast cancer by 79 percent, and one is 50 percent less likely to develop bladder cancer.

I think that it is time to start taking our hydration more seriously. If not, you might find yourself one day to be high and dry…

Hip to be square...

Patellofemoral syndrome, also known as "runner's knee," is a fairly common knee condition that is treated in chiropractic offices. Treatments can consist of many different therapies from taping, mobilization, active stretching, or strengthening programs. Too many times, the treatment focuses mainly on the knee area, but in order to treat this condition most effectively, we have to consider the rest of the body as well. Instead of only focusing on local areas, you must look distal (away) from the site of injury... particularly the hips. That is where the focus of this article will be...

There are so many different causes of patellofemoral syndrome, the most common one being weakness in the leg muscles (i.e. hamstring, quadriceps, or TFL [Tensor Fascia Latae]). Recently, there has been a general shift in focus toward looking at hip muscles and joints, specifically the TFL. By adding strengthening of these muscles, we can not only decrease the pain associated with "runner's knee", but also increase mobility in the body during day-to-day tasks. "Hey Cassie! Tell me how!" Gladly... :)

Initial treatments should consist of mild to moderate stretching of these tight muscles as well as regular adjustments to the lumbar spine (low back). To the patient's tolerance, light exercises can be added into the treatment. Side-lying clam exercises should be initiated to address the TFL and gluteus muscles. The patient should be positioned in a side-lying position with their feet together and knees at 45 degree flexion. Then instruct them to lift the top thigh up and back.

Next, you can progress to weight-bearing exercises involving both limbs, such as squats. Throughout the duration of treatment, hamstring flexibility should be watched. If the length of the hamstring is reduced it can increase pain during these exercises.

The next phase of rehab can include single-leg weight-bearing exercises. These can be in the form of single-limb sit to stand, step-downs, squats, deadlifts, and eventually lunges. Lunges should be done with a long stride instead of a short step. Why? Short step produces more compression on the knee joint. The longer lunge puts more emphasis on the glutes.
*** Side note: When doing treadmill exercise, remember to lengthen your stride in relation to the above mentioned information. ALSO, make sure that the treadmill is not bringing your foot back on the stride. You should be pushing the foot backwards as if you were walking on a stationary surface. Why? Allowing the treadmill to do the work for you will cause over strengthening of the frontal leg muscles, but an overall weakening of the glutes and backs of the legs.

SO! LOOOOONG story short, though the hip joint is one of the most over-looked areas in the treatment and rehabilitation of "runner's knee", by addressing the TFL and hip joint with appropriate stretching, exercises, and adjustments, we can provide a much more effective rehab program.

Stay hip... and stay loose... :)

Manipulation Myth Buster is Striking out against Strokes

"You should never allow a chiropractor to 'crack,' or even touch, your neck, because cervical adjustments are very risky. They lead to strokes, broken bones, or worse!"

If you are in the chiropractic profession, these words hit you in the gut and give you the 'creeps'. The same kind of creepy feeling you can't shake after walking through a spider-web in the dark. Yuck! These thoughts about chiropactic have plagued our profession for years, and I don't know about you, but I am sooo over it!

Chiropractic, in general, is a much safer approach to health care than medical care. It is restorative, preventative, drug free, noninvasive, and has no side affects. This is shown to be true by two considerations. First, chiropractors, by-in-large, are careful, conservative adjusters, and use no more force than is needed to get the proper adjustment. Second, patients who experience chiropractic adjustments not only tolerate them well, but think of them in such a positive and beneficial way, that they often try to "adjust" themselves at home (which we then must gently but MAJORLY discourage). On the contrary, I don't seem to find a large population of people who develop the desire to give themselves injections or surgery at home, no matter how needed the procedure may be. And if this were not evidence enough, lets look at an industry who's wallet is at stake when evaluating these risks... Malpractice Insurance Companies. They openly tell us that, of all the different types of doctors, it is the chiropractor, that has, by far, the lowest-risk practices. In fact, chiropractors enjoy the lowest malpractice insurance rates of ALL the health care disciplines!

We have Hollywood to thank for our irrational fear of the fragility of our necks. How many action movies have you seen that show the apparent ease with which a "ninja warrior" or mafia thug goes around casually, and almost effortlessly, eliminating all those who would dare oppose him with a quick twist of the head. Ha! Give your body and bone structure a liiiiiiittle more credit than that. Food for thought... The average boxer hits with a force of about 800-1,000 lbs across someone's chin. Notice that, in most cases, this does not break the neck. Now, compare that to a chiropractic adjustment which is, at most, 70-80 lbs. God made your body strong... don't underestimate it. :)

Ok... lets think about this rationally. Consider the following ABSOLUTELY TRUE statement: Some people have strokes directly after eating pizza. What was your first reaction to this statement? This question is the first step needed to make a rational assessment of the risks of eating pizza. The second question you want to ask is: How many is people is "some"? If one out of every 1,000 people stroke after eating pizza, then Papa John's Pizza everywhere would be closing down until this epidemic could be stopped. However, if that number was closer to 1 out of every 2-3,000,000 people, the fear level would significantly drop. Everyone knows that there is a risk of choking on a pepperoni, but the love of pizza causes patrons to flock to these restaurants anyway. Why? Because everyone who eats pizza casually accepts the small level of risk in order to enjoy their favorite Italian dish.

Now... lets look at this ABSOLUTELY TRUE statement: Some patients have strokes after receiving a cervical spine adjustment. What was your first reaction to this statement? And again, the next question: How many is some? As people have started looking at the "risk of stroke" statistics a little closer, they are seeing that, as a group, people under regular chiropractic care, appear to have a slightly LOWER risk of stroke than an equivalent group of those not under chiropractic care! WOW!

I will close with this quote from NCMIC (malpractice insurance company) and statistics:

"On analysis, Spinal Manipulative Therapy (SMT) as delivered by chiropractors is one of the most conservative, least invasive and safest of procedures in the provision of heal care services. The risks of SMT pale when compared to known medical risks. Chiropractors, by their training and skill in SMT and special emphasis on the spine, are the best positioned to deliver this mode of health care to the public."

• 99% of strokes occur within the BRAIN
• 1% of strokes occur in the neck

Research is showing that 1 : 5,850,000 chiropractic adjustments MAY cause stroke... here are some relative numbers:

• Being struck by lightening 1 : 700,000
• Drowning in a bathtub 1 : 818,051
• Fatal fall down stairs 1 180,188
• Accidental suffocation in bed 1 : 565,700

I would say this myth is officially... BUSTED!

The "Flip-Flop" Hop

Are Flip Flops Bad for Your Back and Feet?
For those who don’t know what flip flops are, they are the flat soled sandals that make a “flip-flopping” sound when you walk. Over the years, flip flops have increased in popularity, so the question of “are flip flops bad for my back and feet?” has been asked.

If you want my honest answer... Flip flops are terrible for your back and feet! Flip flops lack support for the medial arch (the arch that runs from the inside of your foot to the outside) and the longitudinal arch (arch from the toes to the heel). They do not properly handle the forces that are applied during the weight acceptance phase of gait, this is the phase when your foot contacts the ground.

The improper distribution of forces may cause muscle strains, ligament sprains, or other soft tissue injury. For example, the lack of support may change your gait leading to an over stretching of the plantar fascia (the tissue that supports the arch of the foot). This may cause heel pain or even a heel spur. The altered gait may also lead to improper weight acceptance leading to ankle, knee, hip, and low back challenges later on.

I understand the ease and simplicity of slipping on this type of shoe in the summer. IF YOU MUST WEAR FLIP FLOPS... I would suggest a brand like Croc or Okabashi. They have a slight arch support, which is better than their lacking competitors.

Over all, when choosing your summer footwear, please choose your footwear with your back and feet in mind.

How am I? I'm spine and dandy! Thanks for asking...

These are before and after X-rays of a scoliosis patient who underwent chiropractic treatment. Wow... what a difference!

We have the honor of conducting all of the scoliosis screenings for Wilson County’s 6th graders twice a year. I am always surprised to find out how many people know so little about this debilitating condition. Scoliosis is a lateral curvature of the spine. It seems so simple in definition, but the effects of this condition can be severe and even fatal.

All of the systems of your body are controlled by your brain. Your brain sends the signals to the organs through your spinal cord and into your nerves. When the spine is curved or twisted in an abnormal manner, it causes swelling in the tissue around the spine. The result: putting pressure on the nerves and inhibiting nerve function. I think it can best be illustrated with a story…

One day I bought a car that I was intending to fix up. It didn’t run yet, so I parked it to the side of the driveway in the yard. Over the next few weeks, my mother started noticing that her rose garden was turning brown and dying. I told her I would take a look at it, and upon closer inspection, realized that my car was parked on the garden hose that supplied water to her roses. Oops! It took a bit of finagling, but I was able to free the hose from under the car. Within the week the roses were vibrant in color once again. Mom thought I was the “rose whisperer” or something! (Of course I didn’t tell her any different…) The point is, the problem was never with the roses… it was in the water supply TO the roses. Many times, people think their problem lies with their sinuses, kidneys, or lungs; but if they would just move the car off the hose, everything would be normal again. This principal applies not just to scoliosis, but in every spinal condition. But you understand the point I am making.

How do I know if I or my child has scoliosis?

The best way to know if you or your child has scoliosis is to be checked by a chiropractor. Most chiropractors will do free scoliosis screenings on children 0-14. Scoliosis will typically begin to show up in boys ages 0-8 (0-1st Grade), and in girls by ages 8-12 (4th-7th Grade). These are just a guideline; remember, it is never too early to have your child checked for scoliosis.

Can Chiropractic help scoliosis?

There have been SEVERAL cases of scoliosis treated by chiropractors that have yielded great results. It is like anything though; some are better candidates than others. Possibly the biggest determining factor in the overall effectiveness of treatment is the age of the patient. When a patient is younger, it increases the likelihood of more dramatic results. Why? Simple. While the spine is still growing and developing, it is more susceptible to training and correcting. You can retrain the spine with much less effort.

Now, just because the patient is older, does NOT mean that there is nothing that can be done. Chiropractic has shown great success in both treatment AND management of this condition. Chiropractic is a GREAT alternative to pain medicine and a great supplement to physical therapy. Chiropractic has saved thousands of patients from back surgery. The wonderful thing about chiropractic is that it is restorative, preventative, drug free, noninvasive, and has no side effects!

I think a quote from Robert Frances Kennedy says it best- “There are those who look at things and ask why… I dream of things that never were, and ask why not?”

People look at chiropractic as a strange and foreign thing and ask “Why would I go to a chiropractor?” When the question should really be “Why WOULDN’T I go to a chiropractor?!”

I wouldn’t trust my spine to anyone else, and here is why…

Minimum Required Hours

Chiropractic College vs Medical School

Anatomy/Embryology: 456 vs 215
Physiology: 243 vs 174
Pathology: 296 vs 507
Chemistry/Biochemistry: 161 vs 100
Microbiology: 145 vs 145
Diagnosis: 408 vs 113
Neurology: 149 vs 171
Psychology/Psychiatry: 56 vs 323
Obstetrics & Gynecology: 66 vs 284
X-ray: 271 vs 13
Orthopedics: 168 vs 2

Total Hours for Degree: 2,419 vs 2,047