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The Office Built With You in Mind

by Dr. Willemin

At Align Chiropractic we do a lot of things differently; our current patients already know this. We built our office procedures with our patients in mind. We are truly a family business, and we know that most offices don’t seem to actually consider what patients want, but rather force them into office routines that make receiving quality care a challenge. We have never wanted to be ‘just another doctor’s office,’ but rather we built Align Chiropractic to feel like a family friendly hangout.

What is the first thing you do in most offices? Yep – wait. And the second? You got it – wait some more. Newsflash – no one likes waiting! At our office, the goal is zero waiting time. Really. Zero. In fact, our waiting room isn’t so much a place to wait as it is for children to enjoy some play time. The only people who really use the waiting room are the children who tag along with their parents. Don’t worry, they don’t mind. In the morning they will have instant playmates with my own kids or an afternoon visit complete with kid friendly entertainment. We have a large collection of toys, games, and activities, including: a kid-sized kitchenette, cars and ramps, board games, coloring books, and if all of that still isn’t enough we have streaming services on TV and are happy to put on a favorite show or movie. You won’t have to battle or feel stressed with your children at our office, except maybe when it’s time to leave! On the rare occasion you do have to wait, we will keep that wait time under 10 minutes. We know that your time is important, and so we do everything we can to let you keep as much of it as you can.

Another way that we try to make you and your family comfortable is our free beverage and snack station. Did you book one of our 7:30 am appointments or want an afternoon pick me up? We’ve got you covered with both coffee and tea. We also have more kid friendly options like hot chocolate, juice, and water. More than just thirsty? We have an array of healthy snacks ready to go too. All drinks and snacks can be enjoyed in the office and are also easy to grab for the road. Between no wait time, and our free beverages, you could sub out your morning coffee stop for an adjustment and still be to work on time.

While our office is very kid friendly, we also know that not everyone is looking for the noise and chaos that tends to follow wherever kids go. Don’t worry, we are open until 7pm three nights a week. These later hours seem to be ideal for patients who are looking for a quieter, kid free experience.

Okay, we get it, time isn’t the only thing you have in limited supply. Money also has to be managed. Health insurance costs a lot, and so most people want to utilize theirs. To help patients get the most of their insurance, we participate with most insurances and even take the time to verify and explain your benefits to you. We then will explore your options to make sure our care is as cost effective as possible for you. If you don’t have insurance or your insurance doesn’t provide a lot of beneficial coverage, we offer several affordable cash options. If your whole family is looking for care, we even have family plans available to help keep your family and wallet healthy.

Our office was set up with family in mind. We wanted to create an office environment that ditches the uptight feeling of most offices and instead feels more like visiting family. So whether the appointment is for you, your entire clan, or some combination in between, our office is setup to get you what you really want – back to your life.

Sugar Ain’t So Sweet

by Dr. Willemin

TL;DR – Eating too much sugar is bad for you, especially added sugars. Simple diet tweaks can cut a lot of sugar from your diet and reduce your risk of a number of health conditions.

When we hear the word sugar, most people think of things like ice cream, cookies, cakes, candy, etc. What about bread? French Fries? Spaghetti Sauce? In the American diet we eat a lot of sugar, and it often isn’t as obvious as it seems. We are going to take a look at a diet that most people would consider to be fairly healthy, and see how much sugar is actually lurking there.

As with all of my blog posts, I like to explain why we even care about the topic. Well to put it simply, too much sugar is hard on your body. Sugar has been linked in studies to a variety of conditions including cancer, heart disease, Type 2 diabetes, and obesity. (1-5) Remember 2 seconds ago when I mentioned that Type 2 diabetes was associated with excessive sugar intake? Well it gets worse from that. Type 2 diabetes was associated with decreased cognitive function and accelerated aging of the brain. Meaning that excessive sugar intake can lead to mental decline; making it more difficult to learn new things and recall memories. (6) While all of those things sound unpleasant enough, it turns out sugar also causes inflammation. Which means that chronic inflammatory conditions like arthritis (among many others) can be made worse by excessive sugar intake.(7)

Unfortunately, Americans consume a lot of sugar:

Meal Food Grams of Sugar Calories
Breakfast 1 Cup Raisin Bran 18 185
½ Cup 1% Milk 6 51
1 Cup Coffee with 1 Sugar Packet 4 15
Morning Snack 1 Medium Apple 19 95
Lunch Turkey Sandwich* 4 214
15 Baked BBQ Potato Chips 3 120
1 Can of Coca-Cola 39 150
Afternoon Snack 1 Chocolate Chip Cookie** 14 120
1 Cup Coffee with 1 Sugar Packet 4 15
Dinner 1 Cup Zucchini Noodles 3 33
½ cup Prego Sauce 10 70
1 Piece Garlic Toast 2 80
Evening Snack 1 Cup Fruit Salad 14 124
Miscellaneous 2 Wint-O-Green Lifesavers 7 30

*Turkey Sandwich = 2 slices whole wheat bread, slice of cheddar cheese, lettuce, tomato, 4 thin cut slices of turkey, mustard

**Chocolate Chip Cookie is from https://amyshealthybaking.com

Now most people would think of this as a pretty good day of eating. I didn’t get any fast food. The only real indulgences were the cookie and the can of soda. Well, the total grams of sugar? Drumroll….147 grams! This diet also, only included 1320 calories…yikes! What the heck is going on? What if you substituted a cup of chocolate ice cream instead of fruit salad at night? Add 20 grams of sugar and 162 more calories. What if that afternoon coffee was a second soda? That’s 35 more grams of sugar and 135 more calories. The scariest part if you’re doing the math is that even with those things, we are still only at 1617 calories, while being at 202 grams of sugar! The average American male eats 1000 more calories a day than that (8) – how many more grams of sugar do you think they are adding?

So why are we so hooked on sugar? Well research suggests that sugar can actually be addictive. Sugar can actually change the way your brain works on a neurochemical level and can lead to behaviors of addiction – Bingeing, withdrawal, craving, and cross-sensitization. (9) Dopamine is a chemical in our brain which is a major part of our reward system – meaning it gives us a feeling of pleasure. Well sugar, actually causes the release of dopamine, and so quite literally, it gives us pleasure to eat it. Unfortunately, the more sugar we eat, the less intense the pleasure effect becomes, so we crave more sugar to get the same pleasure result. (10)

What can we do? The answer is actually fairly simple, but simple doesn’t mean easy. Eat more whole foods. Here is another example of a day of eating:

 

Meal Food Grams of Sugar Calories
Breakfast 1 Cup of Oatmeal with 2 teaspoons of sugar and cinnamon 8 330
1 Cup of Coffee 0 0
Morning Snack 1 Cup Raspberries 5 65
1 String Cheese 0 80
Lunch Turkey Sandwich 4 214
¼ Cup Almonds 2 200
1 Glass Iced Tea with 2 Sugar Packets 8 30
Afternoon Snack 1 Biscotti 9 110
1 Cup of Coffee 0 0
Dinner 1 Cup Zucchini Noodles 3 33
1 Diced Tomato 3 25
1 Tablespoon Olive Oil 0 100
1 Tablespoon Parmesan Cheese 0 22
1 Garden Salad With Grilled Chicken and Italian Dressing 3 164
Evening Snack 1 Cup Strawberries 7 49
Miscellaneous Mouthwash 2X 0 0

 

The totals for this day worth of eating – 52 grams of sugar and 1422 calories. That is 65% less sugar!

Now the take away from this article definitely is NOT to use artificial sweeteners. While they do reduce calories and sugar, it turns out they create the exact same problems, and sometimes even increase your risk. They have been shown to be linked with obesity, high blood pressure, heart disease, and even type 2 diabetes. (11-12) The goal is to show that sugar hides in some seemingly innocent foods like raisin bran; and sometimes it isn’t hiding, but we underestimate the amount, such as soda. By switching to things like tea and homemade oatmeal, we can control the amount of sugar. You will be surprised at how much less sugar it takes to make something taste sweet enough when you are doing it yourself. Want a little self test? When you are home take a teaspoon and a plate. Then scoop out a teaspoon for every 4 grams of sugar in whatever food you are looking at eating, and decide if the pile of sugar in front of you seems like an appropriate amount to eat. This visual can really help you understand how much sugar is lurking in some foods.

Hopefully, you can take this information, make some simple changes to your diet, and reduce your risk of a number of potentially deadly diseases, as well as reducing pain and inflammation. That will definitely make life a little more sweet.

  1. https://www.ncbi.nlm.nih.gov/pubmed/9298574
  2. https://www.ncbi.nlm.nih.gov/pubmed/8123778
  3. https://www.ncbi.nlm.nih.gov/pubmed/23460912
  4. https://www.ncbi.nlm.nih.gov/pubmed/15328324
  5. https://www.ncbi.nlm.nih.gov/pubmed/26376619
  6. http://neuro.hms.harvard.edu/harvard-mahoney-neuroscience-institute/brain-newsletter/and-brain-series/sugar-and-brain
  7. https://www.arthritis.org/living-with-arthritis/arthritis-diet/foods-to-avoid-limit/food-ingredients-and-inflammation-2.php
  8. https://www.livestrong.com/article/327754-how-many-calories-does-the-average-american-eat-daily/
  9. https://www.sciencedirect.com/science/article/pii/S0149763407000589
  10. https://www.npr.org/sections/thesalt/2014/01/15/262741403/why-sugar-makes-us-feel-so-good
  11. https://www.sciencedaily.com/releases/2017/07/170717091043.htm
  12. https://www.theguardian.com/society/2017/sep/14/artificial-sweeteners-raise-risk-of-type-2-diabetes-study-suggests

 

Migraines and Structural Chiropractic

by Dr. Willemin

TL;DR – Research shows that Structural Chiropractic care is really safe and really effective for migraines.

Your head is pounding, and just the lights in the room make it worse. You feel nauseated and even a whisper sounds like a megaphone pressed up against your ear. Yep…you have a migraine.

To put it bluntly – migraines suck. Let’s take a peek at the numbers. In America alone, there are 38 million people who suffer from migraines. Almost 1 in 5 women get migraines. Nine out of Ten people with migraines have missed work, with 59% reporting their work was cut in half! Migraines cost between $5.6 and $17.2 BILLION in productivity EVERY YEAR in the United States. (1)

Now, most of the people reading this, already know what a migraine is, because they are here because they have them. In case you are just reading because you want to learn something new, let’s get a quick overview of what exactly is a migraine. Migraines are severe headaches with specific symptoms. A migraine has four stages. Stage One: Prodrome Phase – the time preceding the migraine which typically has indicators such as food cravings, irritability, drowsiness, among others Stage Two: Aura Phase – this is typically a visual disturbance, but can also manifest as another sensory issue. Stage Three: Attack Phase – this is the acute phase of a migraine that can last from 4-72 hours. Finally, Stage Four: Postdrome Phase – this is the typically the 1 to 2 days following a migraine in which a person is recovering from the Attack Phase and is characterized by feeling drained or fatigued. (2)

Migraine diagnoses are not as clear cut as a positive or negative blood test or imaging scan. Rather, a migraine diagnosis comes from a combination of a patient’s history, symptoms and examination findings. (3) Unfortunately, not all migraines manifest the same way. Some migraine sufferers don’t have auras, or any distinct Prodrome Phase. This can make a migraine diagnosis a drawn out affair while symptoms are monitored, various testing is performed, and sometimes multiple medications are experimented with.

(Let’s take a second here to post this disclaimer – I am NOT a medical doctor. I am NOT making any recommendations FOR OR AGAINST medical treatments. For medical advice consult a medical doctor)

Some good news…sort of…Imitrex™ (Sumatriptan Succinate) has been shown in studies to be generally effective for migraine symptoms, and typically works within about 2 hours of taking it. The less great news is overuse can cause – you guessed it – headaches. The side effects of the medication are not pleasant either. Pain or tightness in the chest, jaw, throat, or neck; feeling of pressure or heaviness in your body; numbness/tingling in your fingers and toes; feeling hot or cold in your hands and feet; and feeling weak, drowsy, or tired are all COMMON side effects. In fact, feeling drowsy is so common that the medication warns against performing any task that requires you to be fully alert. (4) Hmm..the medication sounds almost as debilitating at the condition itself! Don’t misunderstand me – I’m not criticizing the medicine, the people using it, or the doctors prescribing it. Migraines really are horrible events and getting relief is a good thing. The question though, is this the only option?

I’m so glad you asked! No – there is preventative migraine medication. Prevention sounds great, but there are a few qualifiers first. The official recommendation to be considered for migraine prevention is having frequent attacks – meaning more than 1 per week (3). While this still applies to 2-3 million people, that leaves 35-36 million people out of luck (1). I am going to use this time to repeat the previous disclaimer – I am NOT a medical doctor and I am NOT making any recommendations FOR OR AGAINST medical treatments. For medical advice consult a medical doctor. Okay, now that I have made that perfectly clear I will give you a brief table regarding preventative medications for migraines.

Types of Medications Medication Class Side Effects
Blood Pressure Medication Beta Blockers Fatigue, Depression, Nausea, Insomnia, Dizziness
Blood Pressure Medication Calcium Channel Blockers Weight gain, Constipation, Dizziness, Low BP
Antidepressant Tricyclic Antidepressant Weight gain, Dry mouth, Sedation, Decreased libido
Antidepressant SSRI/SSNRI Weight gain or loss, decreased libido
Anticonvulsant Anticonvulsant Weight gain or loss, Sedation, Skin rash
Serotonin Antagonist Serotonin Antagonist Blood vessel spasm, Abdominal scarring (very rare)

 

The way that these drugs are used for migraine prevention can range from a single medication to a combination of 3 or more. (3)

Now what…are there any other options? The answer is definitely yes – let’s talk about Structural Chiropractic Correction. (If you need some background information on what Structural Chiropractic Correction is suggest you read this.)

So let’s start with the most basic question – do people even go to chiropractors for migraines? The article, “Evidence-based guidelines for the chiropractic treatment of adults with headaches” found that chiropractic is both a safe and effective treatment for migraines (as well other types of headaches) (6) A survey found that many chiropractors even carry what is known as a Heavy Migraine Caseload. (7) If you suffer from migraines and you aren’t getting adjusted, you are missing out on a well established treatment which has been shown to be both safe and effective.

Okay, so we know that the medication options for migraines have been shown to be pretty effective, but they have some less than desirable side effects. What could I expect for side effects with a chiropractic approach? Well, the news is…pretty good actually. A study focused entirely on the sides effects of chiropractic adjustment and migraine sufferers found that the most common side effect was local tenderness after the adjustment, with the second most common side effect being tiredness the day of the adjustment. The study also found that no serious or severe side effects were observed! (8)

Okay, so we have seen that a lot of people see chiropractors for migraines and the side effects are pretty minimal, so how effective is the treatment? The answer here is also pretty good. One study focusing on the structural realignment of the top bone in a person’s neck (C1) was associated with decreased migraine frequency, improved quality of life scores, and reduced migraine related disability! (9) Another study comparing medicinal interventions, chiropractic, and sham treatments found that the chiropractic adjustment group did better than the medicinal group at 3, 6, and 12 month follow-ups following intervention. Also migraine duration and intensity were reduced more with chiropractic adjustment. (10)

So for a quick recap, we can see that there are a lot of people who suffer from migraines and a few different treatment options for those people. One treatment option that offers reduced frequency, duration, and intensity of migraines, while having minimal side effects – none of which were described as serious or severe is chiropractic care. So, then why is this article about Structural Chiropractic Correction and not just chiropractic care? Well that answer lies in yet another study. The study examined x-ray findings and people with tension-type headaches aka cervicogenic and migraines. The results were pretty overwhelming – 97% had a significant x-ray finding! In fact, 9 out of 10 women in the study had a significant reduced, absent, or reversed curve in their neck. (11) That is a pretty great example of why Structural Chiropractic Correction is what we choose to focus on at our office. Changes to the structure of your spine are often associated with significant and and debilitating symptoms. Getting rid of pain is great, but changing the structure allows the body to actually return to normal biomechanics and physiological function, and still gets rid of the pain along the way.

  1. https://migraine.com/migraine-statistics/
  2. https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/multimedia/migraine-aura/vid-20084707
  3. https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207
  4. https://migraine.com/migraine-treatment/imitrex/
  5. https://americanmigrainefoundation.org/understanding-migraine/preventive-treatments/
  6. https://www.ncbi.nlm.nih.gov/pubmed/21640251
  7. https://www.ncbi.nlm.nih.gov/pubmed/29202816
  8. https://www.ncbi.nlm.nih.gov/pubmed/28324697
  9. https://www.ncbi.nlm.nih.gov/pubmed/26783523
  10. https://www.ncbi.nlm.nih.gov/pubmed/27696633
  11. https://www.ncbi.nlm.nih.gov/pubmed/1342581

Structural Chiropractic is a Golfer’s Best Friend

by Dr. Willemin

TL;DR: Golf requires your body to be able to coordinate complex movements and puts stress on your body. Structural chiropractic helps with that.

Stop! Wait! When is the last time you stood up from your desk!? Has it been more than 15 minutes? Okay, here is what I want you to do. Before you keep reading, stand up, reach as high as you can and stretch. Then lean back as far as you can. Then I want you to put your arms up and squeeze your shoulder blades together. Don’t worry…I’ll wait…

Did you do it? Really? Second chance…go ahead.

Great! I’m glad you that you did that. Anyone who knows me, knows that I’m a research guy. I read a lot of it. I belong to a research group and I’ve even published research (you can read the summary here). Something I find gets supported more and more with every piece of research I read is that, a better spinal structure will facilitate better function. Now what does all this have to do with golf? Everything.

First we will start with the more obvious – injuries. According to Dr. Tom LaFountain, director of chiropractic services for the PGA, about 80% of the golf related injuries involve the lower back. (1) Golfing requires complex movements that put a lot of strain on the lower back due to the rapid rotation of the trunk and the force generated by swinging the club. This means if your back is operating less than optimally it has a good chance to become injured. It’s not just backs that get hurt either. Based on compiled statistics 19% of the injuries for the PGA were associated with the neck, 7% the shoulder and 6% the elbow, wrist, or forearm. (1) If handled properly, these injuries don’t have to sideline you for an entire season, or worse yet, permanently. Additionally, chiropractic patients have been shown to have better long term results. Follow-ups for patients 1 year after receiving either chiropractic care, medication, or acupuncture showed that those who received chiropractic care showed sustained improvement in 5 of 7 criteria compared to 1 of 7 criteria for acupuncture or medication. (2) Structural Chiropractic typically involves special equipment such as laser therapy, spinal decompression, traction, and/or repetitive motion therapy.  This allows all aspects of an injury – soft tissue, bony structures, and affected nerves to be addressed for maximum healing.

Another reason a lot of golfers use chiropractic care is to improve performance. Most people don’t really think about the fact that just because their body isn’t actively hurting doesn’t mean that it’s working very well either. Pain is only one type of response to an injury. Lost flexibility, reduced balance, lost muscle strength, among many other things, are common problems often chalked up to aging, but they don’t have to be. The real reason we have these issues is that our body simply isn’t coordinating optimally. An example of this is that a properly aligned thoracic spine is associated with better lung function (3). The brain and the body coordinate function via the spinal cord, which is housed in the spinal column. Spinal alignment isn’t associated with just pain, it is relevant to all body functions. Nearly three-quarters of all PGA tour golfers use chiropractic. (1) The reason the number is so high is because they rely on their body to be operating at a peak level all year round. Chiropractic care has also been demonstrated to have a significant impact on range of motion (4) an essential part of being a top level golfer.

The last reason so many golfers are seeing chiropractors is longevity. Changes to the spinal structure affect normal physiology. One study demonstrated that different types of compressive loads caused different types of degeneration. (5) This indicates that if you put a repetitive type stress, like say oh swinging a golf club 1000+ times a day, you can cause parts of your spine to wear down faster. A structurally sound joint will reduce the stresses created by these activities. Less friction and inflammation, as well as more normal spinal loading, helps to prevent the degenerative changes which can sideline golf careers permanently.

Why should I care if I’m not a profession golfer, or what if you aren’t a golfer at all? Well, the benefits still apply. We all put repetitive stresses on our body. Whether it is sitting in the same chair at work, carrying the same heavy purse, or just a product of our normal habits, our body is constantly undergoing and adapting to stress. Structural Correction reduces the impact of that stress on your body and promotes healthy long term function as well.

Sources:

  1. http://www.chiroweb.com/archives/26/15/02.html
  2. http://www.chiro.org/research/ABSTRACTS/Medication_Acupuncture_and_Spinal_Manipulation_Follow_up.shtml
  3. https://www.ncbi.nlm.nih.gov/pubmed/27341855
  4. https://www.ncbi.nlm.nih.gov/pubmed/28731832
  5. https://www.ncbi.nlm.nih.gov/pubmed/29770581/

Anterior Head Syndrome and Low Back Pain

by Dr. Willemin 0 Comments

Everything we do at Align Chiropractic has a purpose and reason. Today we want to shed some light on why we always analyze the entire spine for structural shifts, and address the shifts wherever they occur, even if some regions of the spine are pain-free.

 

Anterior Head Syndrome (AHS) is a growing problem in the modern world. A syndrome is classified as “a group of symptoms that consistently occur together or a condition characterized by a set of associated symptoms.” (1) AHS is a set of symptoms associated with anterior or “forward” displacement of the head relative to the rest of the spinal column. This is a common result of a structural shift in the cervical spine (the neck). While there are many aspects of this syndrome that we could explore today we are going to explore a less commonly explored aspect, which is LOW back pain.

 

The average head weighs between 8-12 pounds. (2) When the structure of the cervical spine is altered, and there is a reduction or reversal of the cervical lordosis (normal curve), the weight of the head gets shifted. This leads to a number of biomechanical changes in the spine. These changes actually compound dysfunction in the low back. Correction of the structural shifts which cause AHS have been shown to actually improve low back pain and lumbosacral radiculopathy (radiating leg pain). Research indicates that addressing AHS, when present, in conjunction with lumbar spine correction leads to improved outcomes.(3)

 

As you can see, it isn’t always just the low back that is structurally shifted, when you are suffering from low back pain. Maybe if you have unresolved low back pain, it is because you haven’t address the entire issue.

TL;DR – Having a structural neck issue can be a factor in low back pain, even if your neck is pain free.

 

 

1) https://www.google.com/search?q=definition+of+a+syndrome&ie=utf-8&oe=utf-8

 

2) Goldstein, Jonathan P. Goldstein Helmet Study. Biker’s Rights. May-June 2006.

 

3) http://www.ncbi.nlm.nih.gov/m/pubmed/25704221/?i=4&from=lumbar+lordosis+nerve+root

6 Steps to Permanent Diet Changes

by Dr. Willemin 0 Comments

There is so much information about how to lose weight floating around on the internet that it is easy to get lost and confused. I recommend a very simple approach to start, which can be refined as you go, versus a drastic change that is nearly impossible to maintain. This feeds into a lot of yo-yo dieting, which actually wreaks havoc on your body. For more information regarding that, read this (Yo-Yo Dieting and Heart Risk). Rather than trying to trim down 10 pounds for the beach, instead think of some lifestyle diet changes that can easily be made permanent.

Step 1 – Figure out your current lifestyle. How much do you currently eat? How active are you currently? Take a week and record exactly what you ate and exactly how active you were. Don’t try and make any changes yet, just keep a record. You will probably be tempted during this time to start eating a little healthier, but right now you are just trying to get an honest assessment.

Step 2 – This can be combined with Step 1, or just done at the end of the first week. Now it’s time to do some calculations. You need to find out how many calories you eat per day on average and how much time you spend being active. Be diligent and as honest as possible. If you ate out, most restaurants have nutrition information available, but if you are somewhere that doesn’t provide that information, check a similar meal at another restaurant. There are websites all over to help with this. They will give you a calorie count for almost any food item, can calculate your basal metabolic rate (BMR), and calculate how many calories you burned while active. Try to be as accurate as possible.

Step 3 – Find out how much you are supposed to be eating. Weight loss, gain, and maintenance is (almost) as simple as calories eaten compared to calories burned. While there are ways to tweak this, to start I just recommend finding out how much you should be eating to maintain your ideal weight. Once you know how much you currently eat and burn, you have to ask yourself a few questions. Can you restrict your diet to only eating the amount of calories needed to maintain your ideal weight at your current activity level? Be honest, because it will help you in the long run. If you can’t then you will need to incorporate a gradual step down approach. If you can, great, you are almost ready to go – skip to Step 5.

Step 4 – Set a realistic goal of how much you can restrict your diet. If you need to be at 2000 calories per day, but you are currently eating 3000, then it’s unlikely you can make that jump directly. If you think you can only cut 100 calories, then start there. If it is 250, then make that your goal. The next step is to start eating your reduced calories. Each month re-evaluate, and reduce your calories an additional amount. Continue this process until you get to the right amount of calories for your body and lifestyle. Don’t try to cut extra calories either. If your ideal weight requires 2000 calories, stick with 2000, don’t aim for 1600. Eating less than you need for your ideal weight will lead to burnout and can have undesired health effects.

Step 5 – Adapt to your lifestyle. Now that you are conscious of what you are eating and how active you are, feel free to add in more activity to try to burn some extra calories while you are getting down to your ideal weight. Here is the trick though, don’t try to add more activity than you are ready to handle and don’t count the extra calories burned towards your nutritional lifestyle change. This way if you don’t stick with the extra spin class per week, it won’t affect your overall weight management. Also, during this phase don’t be too hard on yourself. Did you go over on calories one day? Don’t fret, go right back to your appropriate calories the next day. Be aware of how much you went over and think about how many days of normal eating it will take to cancel out those extra calories. Did you skip a workout? No problem, since you are focusing on an improved diet, the weight loss should continue regardless of gym days. Plan for events. Are you going out to eat, or have a party to attend? Try and restrict your calories earlier in the day so you can indulge. If you want to have a snack in the evening, try cutting some calories from your lunch to leave room for that. At this point in the process, you should be figuring out what works for you and what you can consistently do. Don’t avoid foods you love, even if they are bad for you, just plan for them through the rest of your daily diet. Be aware of how portions affect calorie count too. Maybe you love having juice in the morning. Keep the juice, but try drinking 4 ounces instead of 8 or 12. You might find you’re just as satisfied if you mix even less with some water. Experiment and find what works for you.

Step 6 – During this process, if you have consistently eaten the appropriate amount of calories, you will have lost weight until you hit your ideal weight. The reduced calories will assure you of it. It may have been a long process, weeks, months, even more than a year depending on where you started. The time frame isn’t important, because, as always, we focus on long term lifestyle changes, not short term improvements that are unsustainable. At this point, you probably have a pretty good idea of what portions and foods work for you. Now the goal is to ease away from having a strict calorie count each day and work towards just eating those foods in those portions regularly. Monitor yourself, if you start to creep up in your weight, then you probably aren’t being honest in what and how much you are eating.

Bonus — Remember this is a lifestyle change. This isn’t a program that you follow and complete, it ultimately should be a process that you continue to re-work and refine throughout your entire life. There is no exact approach that works for everyone, so be willing to try a number of things until you settle on what is most effective for you. Maybe you are prone to a mid morning snack, then you need to make your breakfast a little more protein heavy to keep you feeling full until lunch. Maybe if you want a nighttime snack while you unwind with your favorite TV show, you will need to trim your dinner down a little to allow for the right amount of calories. Figure out what works for you. While you are improving the amount you eat, you can start improving what you eat. As you become more calorie-aware you will start realizing how many calories some foods pack, or conversely how few calories some things pack. To get even more benefits from this process, you can start refining your diet to healthier foods and improve the quality of the food you are eating.

Warning — You might initially feel tempted to try to “maximize” your calories by eating the low calorie, low fat, fat free, or diet alternatives of foods. I highly encourage you to avoid this practice. For one, these products often use fillers that can have adverse health effects. ( See Diet Soda Intake and Metabolic Disruption) More directly relevant to this article is that these products are actually linked to long term weight gain (See Fueling The Obesity Epidemic). What I have found is that I get and stay full off of a smaller portion of the non-diet version of a food than the diet version. This helps lower my overall calorie intake throughout a day.

1. https://www.ncbi.nlm.nih.gov/pubmed/19151203: Diet Soda Intake and Metabolic Disruption

2. https://www.ncbi.nlm.nih.gov/pubmed/18535548: Fueling The Obesity Epidemic

Why Structural Care for Low Back Pain?

by Dr. Willemin 0 Comments

People are continuing to experience low back pain at an incredibly high rate. Current statistics show that 8 out of 10 Americans will experience low back pain at some point. (1) If that weren’t bad enough, low back pain doesn’t seem to really have a preference regarding who it affects. The CDC reports that of people who have experienced low back pain in the past three months there is less than a 4% difference between males and females. A common misconception is that low back pain is a problem that develops as we get older, but 1 in 5 people aged 18-24 reported having low back pain. (2) So it isn’t surprising that people are looking for an answer.

So what are the options? Over-the-counter drugs? Prescription drugs? Surgery? Physical therapy? Chiropractic? Something else? Each approach has pros and cons. Let’s dive a bit deeper into each and see what might be the right choice for you.

Medication – Short term prescription pain medication demonstrated modest relief of pain, and limited improvement in disability. Long term use of opioids can actually be associated with an increase in disability. Also, most prescription medications did fare any better in relieving low back pain than simple over-the-counter ones. (3) What we can take from this is that while the medications might help for a little while, they don’t seem to provide a good long term solution. With growing concerns regarding addiction and side effects caution has to be used when treating low back pain with narcotics.

Physical Therapy and Traditional Chiropractic – A little over half (54%) of people who saw a chiropractor for their low back pain reported getting effective results. Physical therapists did similarly although slightly worse with 48% reporting their care as fairly or very effective. (1) Unfortunately that still leaves a lot of people still suffering. The initial thought might be that those patients just had more severe cases that needed surgery. Let’s take a look.

Surgery – University of California, Irvine, School of Medicine clinical professor of orthopedic surgery, Charles Rosen, M.D., was quoted saying “An enormous number of back surgeries don’t give patients long-term relief.” He even went as far as to say, “”Maybe 5 percent of patients with back pain need surgery.” Another study drew the conclusion that, “This Lumbar fusion for the diagnoses of disc degeneration, disc herniation, and/or radiculopathy in a WC setting is associated with significant increase in disability, opiate use, prolonged work loss, and poor [Return To Work] status.” This conclusion came after the study showed that only 26% of people returned to work 2 years following a spinal fusion whereas 67% were able to return to work if they did not have surgery. (4)

So what’s left? Well at Align Chiropractic we feel a different approach, the structural approach, is our best chance for a positive outcome. We address the underlying structural issues that cause the cascade of events that lead to low back pain, disc herniations and/or degeneration, or symptoms down the leg. We take an in-depth analysis of the patient before us, and then address the structural shifts to create our best outcomes. Research shows that structural rehabilitation of the spine has more evidence supporting it than traditional chiropractic. (5) By incorporating treatments designed to not only improve the objective measurements of the spinal column, but also to facilitate healing and restructuring of the associated soft tissues (discs, muscles etc) we see success in much higher numbers than the reported 54%. We have invested heavily into the techniques and equipment that have been shown to have the best outcomes. We offer spinal decompression therapy, which is backed by studies showing resolution of symptoms in 86% of patients who completed decompression therapy, while improvement was shown in 92% of patients. (6). We don’t stop there. We also incorporate Class IV Laser Treatments which have been shown to improve blood flow, improve tissue healing, reduce inflammation, and ultimately reduce pain. (7)(8 )

Our goal is to restore normal structure. With normal structure your body is set up for success allowing for normal, pain-free, function.

1. https://medlineplus.gov/backpain.html

2. https://www.cdc.gov/nchs/data/hus/2014/046.pdf

3. http://www.goodhousekeeping.com/health/a18687/back-pain-surgery/

4. https://www.ncbi.nlm.nih.gov/pubmed/20736894

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1840024/

6. Gionis, Thomas MD; Groteke, Eric DC. Surgical Alternatives: Spinal Decompression. Orthopedic Technology Review. 2003; 6

7. http://www.litecure.com/medical/2014/07/2-studies-that-will-make-you-rethink-laser-therapy/

8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418129/

Structural Care for Pregnancy

by Dr. Willemin 0 Comments

My wife is amazing. No questions, no debates. While there are a plethora of reasons why I say this, I am currently referring specifically to her giving birth to both of our wonderful children. I will avoid straying too far down memory lane, but I want to take a minute to discuss my wife’s experience with pregnancy. For our first child, our daughter, my wife had an uneventful (relatively speaking) pregnancy. She had a lot of the norms – nausea, fatigue, etc, but on the whole things marched along pretty smoothly.

For our son, pregnancy marched along fairly smoothly until we found out that at 38 weeks our son was in the breech position. We had a conversation with our OB that included her telling us that my wife would need a cesarean section, and me informing the OB that before we just agreed to that, there was some structural chiropractic work that I wanted to do with my wife. While the OB agreed, she clearly didn’t understand the purpose or even the goal. For the next week my wife and I employed a rigorous structural correction plan. I addressed shifts in the bony structures and spent a lot of time working on the soft tissues as well. The goal of the structural care was focused on allowing my wife’s pelvis to achieve a normal position which would remove a secondary condition known as intrauterine constraint, and allow our son to achieve the normal position for delivery. At our follow-up appointment ultrasound confirmed that our son was no longer breech, and could be delivered without a cesarean section, which for us was terrific news.

Now let me make a few quick, but essential, points here. First, I did not, do not, will not ever treat to turn a breech baby. There is a medical maneuver for that called an External Cephalic Version (ECV). It is where a medical doctor attempts to turn the baby manually into a head down position.(1) The goal of structural care is to create normal structure which facilitates normal function. Second, I am in no way criticizing or disparaging any woman who has had, or will have, a cesarean section. The procedure can be a life saving intervention for the mother, for the baby, or for both. For my wife, she wanted to avoid a cesarean section if possible and was happy to be able to do that.

So now that you have our backstory, let me dive further into why structural chiropractic care during pregnancy is so effective.

Ultimately the main reason we chose to utilize structural chiropractic care for my wife’s scenario is that the Webster Technique has been shown to be much more successful than ECV. With structural chiropractic care demonstrating an 82% effective rate in research (2) and ECV showing less than a 56% success rate in 2016 according to statistics from the CDC. Additionally, there are some drawbacks to ECV which made my wife uncomfortable. While the risk associated with ECV is small, 1 in 286 results in the need for emergency delivery, typically via cesarean section. Other complications such as cord prolapse, vaginal bleeding, and water breaking are infrequent, but associated with the maneuver. (3)

Using structural care during pregnancy is not just for a breech presentation of the baby either. Common complaints like low back pain and sciatica are also associated with the structural shifts that naturally occur during pregnancy. The mechanism of structural shifts is pretty simple. In basic terms the fetus grows in the woman’s uterus it expands, which in turn pushes and strains everything in that area. These shifts result in changes to normal movements – think of things like the late pregnancy “waddle”. All of this is occurring while the woman is carrying the additional weight of pregnancy. This is why structural focused care during pregnancy can be so helpful – it helps to compensate for the inevitable changes of pregnancy. Research also supports that chiropractic care is very safe during pregnancy. (4) In fact evidence exists which shows that getting manipulative therapy during pregnancy is associated with improved labor and delivery outcomes. (5) This indicates that structural care can be beneficial during pregnancy even without a secondary complaint.

At Align Chiropractic, we have specialized equipment to help pregnant women – tables with drop away abdominal pieces, tables that raise and lower to make getting on and off the table easier, gentle adjusting equipment for women that do not want or cannot physically handle manual adjustments, soft tissue tools used to address tight ligaments and muscles. If you have questions, I would be happy to sit down and have a consultation with you. As always, at our office a consultation is a conversation, not a commitment.

1. https://www.acog.org/Patients/FAQs/If-Your-Baby-Is-Breech

2. https://www.ncbi.nlm.nih.gov/pubmed/12183701

3. https://evidencebasedbirth.com/what-is-the-evidence-for-using-an-external-cephalic-version-to-turn-a-breech-baby/

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647084/

5. King H.H., Tettambel M.A., Lockwood M.D., Johnson K.H., Arsenault D.A., Quist R. Osteopathic manipulative treatment in prenatal care: a retrospective case control design study. J Am Osteopath Assoc. 2003;103(12):577–582.

Quick Fitness Test – Plank

by Dr. Willemin 0 Comments

TL;DR: You should be able to hold a spine neutral plank position for 2 minutes. Train by a combination of short intervals and longer holds.

We are going to spend a few blogs going over some basic fitness tests to see where you fall on the spectrum and help identify how you can improve. Today’s blog will discuss plank.

There is a lot of debate and discussion regarding the risks and benefits of plank. In order to dive into the topic we first have to have a baseline understanding of what the plank exercise actually is. The basic plank is when your toes and forearms are on the floor and you are supporting your body and head in a neutral spine (straight line) looking down at the floor.

What’s not to like?

I’ve read articles that discuss the pressure put on the lumbar spine (low back) and the risk of costochondritis (inflammation of the cartilage between the ribs). In one article, Dr. Michael Durtnall, a chiropractor in London, was even quoted saying, “Planks are for the super-fit and athletes, not for soft, desk types to go bananas with once a week.” (1) I don’t agree. While I would agree with the sentiment that it is not a good approach to go wild with plank once a week; I would say the same is true for almost any exercise, especially when first starting. The statement implies though that working at a desk is mutually exclusive of being fit or an athlete. I know a lot of people who are active athletes in a variety of sports that work desk jobs. I myself play pickup basketball when I can. I have participated in flag football leagues, kickball leagues, and play tennis regularly when the weather permits. The goal with any exercise is to work up gradually. The risk of injury with plank is substantially lower than with many exercises since there is no motion and there are no additional weights being used. I do agree with the sentiment out there that just trying to exercise to overcome low back pain is not a good approach. Having said that, not doing an exercise because of a current injury doesn’t make the exercise inherently bad. If I had a broken leg I wouldn’t be doing squats, but that doesn’t mean squats are bad (in fact I Love Squats)

What’s the good news then?

The good news is that there is good evidence that planks are pretty beneficial. You see it isn’t actual strength that seems to be important with your core, but rather your core endurance. In the research article, “Core Stability Training for Injury Prevention” by Bliven et al. (2) Planks can help train core endurance which may help reduce certain injury risk. Stuart McGill published in the June 2015 issue of the Journal of Strength and Conditioning Research “…an isometric training approach was superior in terms of enhancing core stiffness. This is important since increased core stiffness enhances load bearing ability, arrests painful vertebral micromovements, and enhances ballistic distal limb movement.” (3) Think of it like this – if you compared it to holding a weight at arm’s length in front of you, it isn’t about how heavy the weight is, but how long you can hold it. Also, one of my favorite things about plank is it is NOT a massive time consuming exercise. This means it is easy to incorporate on a daily basis. Now there is a bit of debate regarding how much is enough/too much. Top End Sports lays out a guide in which they state that excellent core strength is the ability to hold the plank position for over 6 minutes! (4) If you’ve ever tried plank you know that is a LONG time, and fortunately, most exercise experts would disagree. An article published in Women’s Health reads, “Albert Matheny, R.D., C.S.C.S, co-founder of SoHo Strength Lab and advisor to Promix Nutrition, says you can plank daily, but the length you should hold a plank can vary from 10 seconds to one minute.” (5) Men’s Health contributor and strength coach Dan Johns feels strongly that anything over two minutes is a waste of time, but not being able to hold a plank for two minutes is a problem.

The Test

I agree with Johns, the benchmark is two minutes. To perform the test get into the plank position with a time directly in front of your face, or with a partner timing you. If you have appropriate core endurance then you should be able to hold a perfect form plank for 2 minutes. This doesn’t mean it won’t be hard. You might shake, you might hate every second, but if you can hold a neutral spine while in the plank position for 2 minutes then your core endurance should be adequate. If you can’t then you need to get better. Going over 2 minutes doesn’t really indicate anything better in terms of injury prevention or overall fitness.

How to Train

McGill recommends training in repetitions of 10 seconds (6), while Matheny recommends simply holding the position until your form breaks down. I recommend both. To give an analogy to running, if you’re training for a marathon, don’t only run sprints. If you’re trying to make your body as fit as possible, don’t only run long distances. All of the exercises we discuss are designed to promote healthy and normal function. Our goal isn’t just to be able to hold a plank for two minutes but to actually improve the function of our core so that we reduce injury risk and promote wellness. If you alternate days between training intervals and longer holds, or want to mix both together on the same day, you will make positive steps with either approach. If you really want to maximize your training though try using plank variations like side bridge or one foot planks. Your body is dynamic and your training should reflect that by challenging your body in a controlled manner to improve overall fitness.

1. http://www.dailymail.co.uk/femail/article-3030983/The-ultra-competitive-exercise-fad-ruin-health-called-planking-suddenly-sweeping-gyms-Pilates-classes.html

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3806175/

3. http://journals.lww.com/nsca-jscr/Abstract/2015/06000/Effect_of_Long_term_Isometric_Training_on.8.aspx

4. http://www.topendsports.com/testing/tests/plank.htm

5. https://www.womenshealthmag.com/fitness/how-long-to-hold-plank

6. https://www.menshealth.com/fitness/truth-about-extreme-planking

Quick Fitness Test – Sit Rising Test

by Dr. Willemin 0 Comments

TL;DR – You should be able to go from standing to sitting on the floor and back to standing without using anything to help you up or down. The older you are, the more it matters.

The Test

Okay, I’m sure you are all masters of the 2 minute plank now. If not, maybe it’s because you didn’t read this. It is time to take a look at our second quick fitness test. The Sit Rising Test (SRT). The test is very simple. Go from standing to sitting cross legged, and then from sitting back to standing. The goal is to perform the movements WITHOUT losing your balance or using anything to stabilize yourself (i.e. putting your hand or knee on the ground). If you can’t picture what I’m saying watch this https://youtu.be/1tdtHWURId0 video. Remember I said simple, not easy. Scoring is straightforward as well, for every body part you need to use to brace yourself, you lose a point, and if you’re wobbly you lose a half point. A perfect score is 10 (5 points for the standing-to-sitting portion and 5 points for the sitting-to-standing portion). The benchmark is a score of 8 or better. Some voices in health and fitness feel there are some concerns that pre-existing injuries to the hips, knees, and ankles, or bone fragility are good cause to avoid performing this test. While I certainly encourage everyone to exercise caution, I don’t believe that this test has to be avoided. I encourage people to aim for an honest assessment. What that means is that if you need to use your hand on the ground, then use it. You can test your hip, knee, and ankle flexibility simply by trying to get into a cross legged position from an already seated position. If you have bone fragility issues to the point that just sitting down might break them, then you should be addressing this with a doctor.

Uh-Oh, I didn’t score an 8 or higher

Being able to do the SRT with a score of 8 or better is an indicator of good musculoskeletal health. If your score was less than this, it means you need to improve. This movement series will test hip, knee, and ankle flexibility, lower body strength, and core stability. A great way to start improving those things are with squats. Read this earlier post about why I love squats and really recommend adding them to your routine. At Align Chiropractic we are focused on improving the underlying structural issues that may be occuring in your musculoskeletal system – a low score is an indicator that you might have a structural problem holding you back. Also, don’t try and rush into a perfect score. Take your time making small, but steady, improvements, and then try the test again after giving yourself adequate time to improve. Note where you have difficulties and look for specific improvements in those areas.

Why Do We Care?

While the Sit Rising Test has some detractors, according to a study in the European Journal of Preventive Cardiology, the test is a good predictor of musculoskeletal fitness. The study showed SRT actually was a good predictor of all-cause mortality in 51-80 year olds. The study did a 6 year follow up on participants and found that there was a strong relationship for death and a lower score. The higher your score the lower the risk of death. (1) This means that at the 6 year follow up people with lower scores were more likely to have died than those with higher scores regardless of the specific cause of death. Now further study is certainly warranted, but this isn’t the first study to associate musculoskeletal health and mortality rates. The Journal of the American Geriatrics Society found that a hyperkyphotic posture (anterior head posture) was also a significant predictor of mortality in older persons. (2) Clearly your musculoskeletal health matters, and it isn’t just about aches and pains.

http://journals.sagepub.com/doi/abs/10.1177/2047487312471759

http://cdn2.perfectpatients.com/childsites/uploads/219/files/PosturePredictsMortalityinOlderCommunity.pdf