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March 2019
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  • Getting Rid of Back Pain

    Doctors of chiropractic spend years in chiropractic college learning to manipulate the spine, but that’s certainly not all they learn. Chiropractors are effective at relieving back pain because they know that long-term solutions come from taking a well-rounded approach to dealing with the problem.

    A study involving 147 patients (101 of whom were classified as “disabled” from car accidents or work-related back injuries) provides evidence of the effectiveness of this approach to managing back pain. Patients participated in a four-phase rehabilitation program consisting of:

    1) chiropractic treatments, including spinal adjustments, ultrasound therapy, and TENS (electrical stimulation of the muscles), along with cardiovascular exercises;

    2) isometric strength training;

    3) resistance weight training; and

    4) education on back pain, including strategies for coping with pain, relaxation techniques, etc.

    After nine weeks of rehabilitation, patients reported decreases in pain and disability compared with pre-rehabilitation measurements. Strength, flexibility and range of motion were also higher, and most significantly, 91 of the 101 disabled patients were able to return to work.

    So if back pain’s got you down, get up and take a trip to your doctor of chiropractic. You’ll get a comprehensive, caring approach that’s sure to help you get back on your feet.


    Guerriero RC, Rawani M, Gray E, et al. A retrospective study of the effectiveness of physical rehabilitation of low back pain patients in a multidisciplinary setting. Journal of the Canadian Chiropractic Association, June 1999: Vol. 43, No. 2, pp89-103.

    5 Ways to Survive the Worst Allergy Season Ever

    By Editorial Staff

    Spring is in the air – literally, in the form of massive pollen levels that are causing an historic spike in cases of seasonal allergy, also known as allergic rhinitis.

    In fact, health experts are calling this the worst allergy season on record, which means the tactics you overlooked last year to survive the sneezing, coughing, runny nose, itchy eyes and various other symptoms may require real attention this time around. Bad news for spring-lovers who can’t wait to emerge from their winter cocoons and enjoy the outdoors. After all, who wants to smell the flowers when doing so causes you to feel miserable?

    If you’re an allergy sufferer who’s used to “getting away” with minimal attention to allergy avoidance, this is definitely not the year to push the envelope. With an early spring and record pollen levels, you could be asking for trouble – big trouble. Here are five ways to minimize your risk of succumbing to seasonal allergies this year:

    1. Pick your spots: One of the best ways to minimize your exposure to allergens such as pollen is to make smart choices. For example, pollen levels tend to be highest in the morning or when it hasn’t rained in awhile. And let’s not get started on wind, which can not only circulate pollen, but also tends to cause allergy-like symptoms – a bad combination that can ruin your day.

    2. Keep it out: Unless you’ve got a garden in your living room, the good news about pollen is that it’s outside, which means you can take a few simple steps to keep it there. For starters, keep windows closed whenever possible (especially if it’s windy). If you’ve been out, change your clothes once you get in the house, and try not to repeat-wear clothing. If it’s been a particularly bad day in terms of pollen and/or you’ve spent most or all of the day outdoors, you may want to throw your clothes directly into the washer. And speaking of that garden in your living room, avoid bringing flowers into the house – unless putting a romantic gesture on display is worth the allergy symptoms that may accompany it.

    3. Seek shade: The eyes are often the hardest hit by allergy symptoms. No one wants to spend their day rubbing watery, itchy, dry, red eyes, and trust us, it doesn’t look good when you’re making that big presentation in the boardroom. Two tips: 1) Wear sunglasses whenever you’re outside during allergy season. (This is also a good idea because with spring comes sunnier skies, putting your eyes at risk for sun damage if they aren’t protected.) 2) Carry saline drops to keep your eyes moist throughout the day, which will help when pollen, dust, etc., inevitably attack your field of vision.

    4. Clean up: It’s amazing how many health issues can be minimized with the simple act of washing your hands, and when it comes to seasonal allergies, it’s a great recommendation. During allergy season, it becomes even more important because pollen and other irritants transfer easily from your hands to your face / mouth if you’re not careful (much like germs that cause the common cold).

    5. Eat smart: Research suggests vitamin C, which is found in a variety of fruits and vegetables, in addition to being available in supplement form, provides an antihistamine benefit that may help minimize allergy symptoms. (Histamine is released from cells as part of an allergic reaction.) Probiotics or “healthy bacteria,” found in yogurt and increasingly added to a number of food products, also may reduce allergic symptoms caused by exposure to pollen. And don’t forget that in general, a balanced diet high in antioxidants and other immune-boosting compounds helps your body defend whenever it’s attacked – even by allergens.

    Exercise Your Right to Change Up Your Workout

    By Editorial Staff
    To Your Health
    March, 2013 (Vol. 07, Issue 03)

    You’ve been working out for the past three months and you’re feeling great. You’re losing pounds, dropping inches off your waistline, and toning and tightening muscles you didn’t even know you had – and that thought you’d forgotten them.

    Then you hit the proverbial workout wall and your enthusiasm starts to go downhill. Every workout feels the same, you don’t seem to be making any strength or muscle gains, and the scale’s stuck at the same place it was last week – and the week before that.

    Your body – and mind – are constantly adjusting to the demands placed upon them. If you do the same thing over and over without variation, eventually it becomes routine; and routine is always a recipe for workout disaster. In exercise terminology, it’s known as plateauing – the point at which your workouts fail to be effective beyond “maintaining” your current level of fitness.

    The solution is a simple one: vary your workouts. By mixing things up periodically, you keep your body guessing, which means it’s always working hard to “figure out” the stresses you’re placing on it. From a mental perspective, variation will also keep you interested, engaged and enthusiastic, looking forward to the next workout, rather than the “same old” workout. Let’s review a few simple exercise variations that can take a basic exercise and give it a fresh new look:

    exercise Push-Up Positions: Push-ups are a fundamental body-weight exercise that can help tone and tighten your entire upper body, particularly your chest, but after awhile, it may feel like you’re repeating yourself. One easy fix is to vary position during the exercise. You can change the position of your hands (inside shoulder width, which will work the triceps muscle of the arms more; or outside shoulder width, focusing more on the outer pectoral / chest muscles). You can also vary from a flat-floor push-up to a raised push-up (placing your hands on a chair, bench, table, etc., to focus on the lower pecs, or placing them on the floor with your feet elevated on a chair, table, etc., to focus on the upper pecs). Finally, try changing your hand position while doing standard push-ups: complete one push-up, then move your right hand to the right a foot or so, follow with your left, then do another push-up; repeat to the right, and then return to your original position in increments, doing a push-up each step of the way. (Essentially, you’re doing push-ups while “walking” with your hands across the floor, which will stress your muscles differently than standard push-ups.)

    Arm Angles: The biceps curl is another fundamental exercise that can get old over time. Here are a few variations to spice things up:
    1.Reverse curls: Instead of the traditional curl, reverse your grip with dumbbells or a barbell so your palms are facing down, now up. Now do a curl from the thighs to the shoulders, as you would with a standard curl. It may seem like the same move, but you’re actually working the outside of the arms and the forearms more than usual – plus it’s not the same curl you’ve been doing for the past three months (or more).

    2.Another great variation on the biceps curl is commonly called “7′s,” although you can choose any number of repetitions depending on your fitness goals and ability. To do this one, start with the dumbbells / barbells at your thighs (standard starting position), but for the first third of your repetitions, only curl the weight to your sternum (until your forearms are perpendicular with your biceps). For the second third, start at the sternum and curl the weight to its upper end point, returning to the sternum on each rep. Finally, complete your last third of the repetitions by doing full curls from thighs to shoulders and back. Trust us, this will leave your muscles burning – and responding, rather than stagnating.

    Leg Lifters: Lift your legs out of their doldrums is as easy as varying the position of your feet while doing the traditional squat. Instead of pointing your toes forward (the traditional position), point them out (the “sumo squat”) to put more emphasis on the inner thighs, and point them in to work the outer thighs more. You can also work your legs and glutes in a totally different way with jump squats (body-weight only, of course), side squats (leaning to one side and bending only the knee on that side; also known as a lateral squat), and even squat holds (holding your body in the squat position and squeezing your legs / glutes for 5-10 seconds or more).

    Keep in mind that with these and other exercises, variations may work better (and be safer) with body weight only versus weights (particularly the squat variations). And always remember to use proper form when performing these and other exercises; that means keeping your back straight, raising and lowering your body / the weights in a smooth, controlled manner, and stopping if you get dizzy or lightheaded. Talk to your doctor for more information.

    Aerobic Exercise Programming for Patients With Metabolic Syndrome

    By K. Jeffrey Miller, DC, DABCO

    Metabolic syndrome is a multifaceted condition that requires a multifaceted approach to treatment. The syndrome is made up of five conditions; hypertension, diabetes, hypercholesterolemia, hyperlipidemia and obesity. Individually, these conditions are significant health problems; together, their effect can be devastating.

    Fortunately, there are commonalities among these conditions. This makes it possible for individual treatments to have an effect on more than one condition in the syndrome. One such treatment is exercise. Exercise aimed at weight loss and reducing obesity has a positive effect on diabetes, hypertension, hyperlipidemia and hypercholesterolemia. Each of these conditions is easier to control when body weight is reduced. This makes exercise one of the most important components of the treatment regimen for metabolic syndrome.

    Most health care providers understand the benefits of exercise, and often suggest patients exercise and lose weight. However, minimal (if any) instructions are typically provided with this directive. In all fairness to the doctor giving the weight-loss directive, exercise programming is not a subject taught or emphasized in school. This means there is a gap to bridge for clinicians treating patients with metabolic syndrome.

    A bridge for the gap is offered here through instruction in aerobic exercise programming. Aerobic training is the easiest type of exercise to begin, and has the greatest effect on weight loss and controlling obesity. Other fitness components, such as flexibility, strength training, etc., can be added in once an aerobic base has been established.


    Regardless of the patient’s physical status at the beginning of a program, a thorough physical examination is necessary. The examination should include heart, lung and blood pressure assessment. An ECG and general lab work should also be performed in order to clear the way for an aerobic conditioning plan.

    Pulse rate, body weight and circumferential measurements of the neck, arms, waist, hips and thighs should also be recorded. The waist-to-hip ratio should be calculated from waist and hip measurements. (Table 1) These baseline numbers will serve as the reference for improvement throughout the program.

    Table 1: Calculating and Interpreting Waist-to-Hip Ratio
    Waist measurement: circumference of the body at the waist, measured midway between the lowest ribs and the crest of the ilium in inches
    Hip measurement: circumference of the body at the widest point of the hips (greater trochanter area) in inches
    Waist-to-hip ratio: The waist measurement is then divided by the hip measurement. The resulting number for men should be less than .90; the resulting number for women should be less than .80

    Mode of Exercise
    When most people think of aerobic exercise, they picture aerobic dance classes. There are many other choices. Table 2 lists several types of aerobic exercise readily available to most patients.

    Frequency / Rest
    Some modes of aerobic exercise can be performed daily. Walking is the best example. It is low impact and requires minimal training or equipment. Other modes of exercise cannot be performed daily and require a lower frequency. Running is the best example. It is high impact and requires more training. Days of exercise must be mixed with days of rest.

    Strenuous aerobic exercise can be performed every other day or in patterns, such as two days of exercise followed by a day of rest, or three days of exercise followed by a day of rest. Exercise can also be recommended as a number of sessions per week. The patient can be instructed to exercise at least five days a week, with the patient selecting the days that best fit their weekly schedule.

    Table 2: Modes of Aerobic Exercise
    Aerobic dance classes
    Cycling (road)
    Cycling (stationary)
    Dancing (multiple types)
    Elliptical trainers
    Jumping rope
    Rowing (boat)
    Rowing (machine)
    Running (road)
    Running (treadmill)
    Ski machines
    Stair climbing (actual stairs)
    Stair climbing (step machine)
    Walking (outdoors)
    Walk / run intervals
    Walking (the mall / track)
    Walking (treadmill)
    Water aerobics

    Patients who are also involved in other types of exercise can alternate days between those exercises and aerobic exercise. The alternation of activities provides a degree of rest for the body, even if some form of exercise is performed daily by altering activities and body regions exercised.

    Exercise frequency must also be planned beyond weekly sessions. The number of weeks the patient should exercise before the frequency and overall exercise program are reassessed must be considered from the start. Reassessment should occur in four- to 12-week intervals depending upon the patient’s condition and goals. Patients who are just beginning a program or who are returning from an injury should be reassessed frequently (4-6 weeks). Patients who have been exercising for longer periods and are in better shape do not require reassessment as frequently (6-12 weeks).

    Duration / Distance
    The length of an exercise session can be measured in time or distance. Time is the most practical method. Walking 20 minutes sounds better than walking 1mile. This is more encouraging and seems more attainable to the patient, especially the novice exerciser.

    Since schedules and daily activities are tracked by time, it is easier for patients to plan exercise based on time. This is especially important for patients who are not used to exercising. Patients know immediately how to plan for 30 minutes of exercise, but may not know initially how long it may take them to walk a mile or bike 5 miles.

    Tracking time is also more practical when aerobic equipment does not have the capability to track distance, the tracking mechanism is broken or the mode of exercise does not result in measurable displacement (water aerobics, jumping rope).

    Exercise Intensity
    There are two simple rules for determining appropriate intensity. The rule for determining minimal intensity is that the patient must be sweating within the first 10 minutes of exercise. If the patient is not sweating at this point, the intensity is too low. The rule for determining maximal intensity is that the patient must be able to carry on a conversation while exercising. If the patient cannot converse readily, the intensity is too high.

    Table 3: Determining Maximum Heart Rate for Aerobic Exercise
    Determining the maximum heart rate for a 40-year-old male with a resting heart rate of 70 and an exercise goal of weight reduction and fat burning is accomplished as follows:
    Resting heart rate: 70 beats per minute (bpm)
    Maximum heart rate: Patient’s age subtracted from 220 (220-40) = 180 bpm
    Resting heart rate subtracted from maximum heart rate (180 – 70) = 110
    To find the heart rate required to burn fat, multiply 100 x .70 (70 percent) =77
    The number based on the goal-percentage is then added to the resting heart rate: 77 + 70 = 147 bpm

    Thus, the target heart rate during exercise for the patient in question is 147 bpm

    An additional method for determining intensity is monitoring target heart rate. Monitoring target heart rate helps assure the patient that their exercise goals are being met. To determine a patient’s target heart rate, subtract the patient’s age from 220. Then subtract the patient’s resting heart rate from this number.

    Once the above number is determined, the exercise goal can be considered. To burn fat, the number is usually multiplied by 60-70 percent. To build endurance and stamina, the number is usually multiplied by 80 percent. Then add the patient’s resting heart rate to determine the final number. (Table 3)

    The final step in aerobic exercise is to keep track of activity and progress. The patient should record the dates and duration of each exercise session. The record will later serve as a reminder to the patient of how far they have progressed, and it will help the doctor track patient compliance and progress.

    While these suggestions are intended to help the doctor address metabolic syndrome through aerobic exercise, the method of exercise programming recommended here can apply to almost any patient. For a sample travel card to assist with exercise programming and record-keeping, visit my website,

    ◾Byrns CD, Wild SH. The Metabolic Syndrome and Primary Care. Wiley; Hoboken, NJ, 2007.
    ◾American Council on Exercise. ACE Personal Trainer Manual, American Council on Exercise; San Diego, CA, 1997.
    ◾Baechle TR, Earle RW. Essentials of Strength Training and Conditioning, 3rd Edition. National Strength and Conditioning Association; Lincoln, NE, 2008.
    ◾Bryant CX, Franklin BA, Conviser JM. Exercise Testing and Program Design: A Fitness Professional’s Handbook. Healthy Learning; Monterey, CA, 2002.

    5 Simple Food Substitutions to Improve Your Heart Health

    By Editorial Staff

    Heart health is a significant topic these days for two simple reasons: First, increasing evidence suggests that our poor dietary choices – particularly the Standard American Diet (SAD), characterized by heavy intake of processed, fatty, calorie-laden, fiber- and nutrient-deficient foods – puts us at major risk for heart disease; and second, evidence also suggests wise dietary choices can protect the heart from disease, keeping it healthy as we age.

    Case in point: A recent study that examined the heart-health benefits of the Mediterranean diet. According to study findings, people at higher-than-normal risk for cardiovascular disease reduced their risk simply by consuming a diet high in whole grains, nuts, seeds, olive oil, fruits and vegetables, and fish, and low in dairy, red meat, processed meats and sugary foods.

    Specifically, eating the Mediterranean diet supplemented with extra olive oil or extra mixed nuts reduced study participants’ risk of suffering a heart attack or stroke, or dying of cardiovascular disease, by nearly 30 percent compared to a control group, whose only dietary modifications were based on a general recommendation to reduce dietary fat intake. Results were similar when the two Mediterranean diets were combined and compared to the control diet.

    Here are five easy ways to follow the principles of the Mediterranean diet and improve your heart health starting today, courtesy of the Mayo Clinic (
    1.Think plant-based meals: fruits and vegetables, whole grains, legumes (beans) and nuts / seeds.
    2.Instead of adding salt to your favorite meals, substitute herbs and spices to give your meals punch without the sodium content.
    3.Eat no more than 1-2 servings of red meat per month, and eat at least two servings of poultry and fish (preferably wild, not farmed) a week.
    4.Replace butter with “good” oils (olive, canola, etc.), which are high in monounsaturated fat, helping clear cholesterol from the body.
    5.Limit dairy intake and choose low-fat / fat-free options when it comes to milk, cheese and yogurt. That way, you can enjoy some of the health benefits of dairy (calcium, protein, healthy bacteria) without the high fat / cholesterol.

    The key principles of the Mediterranean diet make perfect sense considering what we know about food intake and health, and they’re all great for your heart – and by the way, great for your entire body. To learn more about the Mediterranean diet and how a healthy diet can benefit not only heart health, but also weight loss and an overall healthy lifestyle, talk to your doctor.