The almighty bench press.

I would like to preface this post by saying I neglected my shoulder problems too long and caused irreversible damage and I’m paying for it now. Thus, I’ve made it one of my missions to become one of the most knowledgeable doctors on non-surgical treatment of the shoulder. If you read anything that is incorrect please let me know. I hope this information will enlighten you.

Why the shoulder pain?

First, there is a huge list of reasons why your shoulder is hurting while bench pressing, too many to list. However, I will discuss a few potential causes. The forced horizontal adduction of the bench press puts an abnormally large load on the acromioclavicular joint (AC joint) causing pain. The AC amplifies the range of motion of the humerus yet lacks structural support. Another reason for frequent injury. Excessive weight also causes the glenohumeral (GH) joint to become a weight-bearing joint. These forces can lead to premature degeneration of the shoulder complex. The bench also pins down your shoulder blades. You’ve seen the guy benching with his rear in the air, not so good. This places excessive stress to their thoracic spine, possibly exacerbating or creating back pain, and immobilizing the scapulothoracic complex. Fluid scapular motion and a strong rotator cuff are key to a healthy shoulder. So what happens if your shoulder blades can’t work in harmony with the rest of your arm? Excessive motion about the AC and GH joint, leading to pain and/or instability.

More on the rotator cuff.

Many gym junkies rip out 30 minutes on the bench and go home, neglecting the rotator cuff (RTC). You could quit benching for two weeks, strengthen the RTCs and see an increase in your max. The RTC is vital for shoulder stability and strength. The rotator cuff is a set of four muscles; the supraspinatus, infraspinatus, teres minor and subscapularis. Most people have no idea what the rotator cuff actually is, so you’re ahead of the game. A few sources indicate that your RTC strength should be 9.8% of your one rep bench max. Not sure how much validation there is behind that number but its worth mentioning.

Fixing the pain.

I give props to everyone in the gym, but some of the routines I see are only contributing to bad shoulders. There are plenty of great RTC strengthening programs/exercises, but if you really want to fix your shoulder consult with a sports doctor. Remember I mentioned the huge list of possible reasons why your shoulder hurts? They’ve memorized it and know it. Each person is different, that is why it’s key to have a thorough evaluation to identify any pathologies, muscle weaknesses and supply a comprehensive strengthening package. A doctor certified in Active Release Technique (ART) is the best route to go. Almost every profession sports team in the U.S. has an ART doctor. No idea what this is? Watch the video below. Or visit this link: http://www.activerelease.com/

Conclusions.
I’m not saying everyone should skip the bench, but if you keep hurting yourself doing it stop and fix the problem. Strengthen your RTCs, try free weights if its pain free and if you can afford it, get an ART and/or a sports medicine doc to evaluate you. Lastly educate yourself, I highly suggest the Buchberger-12 it’s a Rotator cuff and Scapular Strengthening Program designed by Dale Buchberger D.C., P.T. and CSCS.

Other exercises to consider limiting or cutting out of your program:
1. Lat pull downs behind the neck.
2. Military press.
3. Upright rows.
4. Empty can exercises.


*Don’t hurt yourself, consult with your doctor to see what you should and shouldn’t be doing.

What is Active Release Technique? Watch and find out.

US Army General Rebecca Halstead

In honor of Veterans Day, watch this video of US Army General Rebecca Halstead discussing why chiropractic care is essential in ensuring our troops in Afghanistan are battle ready.

New D.C.? Go electronic for cheap.

To all my fellow D.C. friends,
Our generation of health care providers must migrate towards electronic note taking; the government will soon require it and start penalizing offices in 2015 that don’t. Plus, if you're like me you're not entering any penmanship contests soon . Thus, I have done a little research to find a solution for POOR D.C. graduates. I was recently talking to a new graduate about an electronic health care records company called future health. He got my attention when I heard I didn’t need $15,000 to start. The basic program is around $25/month then you add “apps” as you need them. I haven’t actually used this program in a working clinic, but have downloaded it for a free 3 month trial. They do NOT collect any credit card information, so if you hate it then uninstall with no consequences. I attached an introduction video for your convenience. If anyone has actually been using this software in practice I would love to hear your thoughts. I have no affiliation with this company.

Poppin' Bottles

As an alternative health care provider to be, I’m constantly surrounded by the world of supplementation. I’ve attended many health seminars with various supplementation companies represented. To be quite frank many of them are flat out garbage. Money talks and it shows. I believe there is a time and place for supplementation, however, we have been trained that the answer lies in a capsule or powder. In my opinion, our focus/efforts should be turned toward shopping, cooking and eating habits. Diet and exercise can go a long way to cure disease. Start the change this week! I’m not meaning throw out all your food and start growing everything in your backyard. Make the change slowly, buy one “new” fruit or vegetable each time you shop this month and buy one less unhealthy item. I grew up in a family where eggs, bacon and pancakes were the well rounded breakfast. It took me years to escape the trap and to shed the pounds. No ideas? Buy a handful of Kiwi fruit and throw it in with your cereal or yogurt. They are cheap and chalked full of Vitamin C. If you are still reading this, thanks, and please spend 30 seconds to respond to my questionnaire in the upper right corner of this page.

ElliptiGO. No more stationary elliptical workouts.

We all understand the benefits of the low impact cardiovascular machine. It’s a great way to sweat and keep your knees edema free, but how many hours have you been on the elliptical bored out of your mind? The new ElliptiGO bike might just be the solution to this problem. It’s a hybrid between a traditional bike and an elliptical. The ElliptiGO was created by a former cyclist and Ironman triathlete that found traditional biking uncomfortable and elliptical workouts in the gym boring. The ElliptiGO has 8 speeds and according to their website and customer reviews they are very easy to ride, including hill climbs. The only down side to the product is that it costs a little over $2,000. However, there are demo locations around the U.S. as well as a 60-day money back guarantee. It’s worth checking out.

http://www.elliptigo.com/

Exercise physiology: Clinical Application

Understanding exercise physiology on a microscopic level allows the practitioner to make clinical decisions macroscopically. This knowledge can be used in a number of different clinical settings. The knowledge has led to the use of muscle energy techniques such as Hold-Relax, Contract-Relax, and Hold-Relax with agonist contraction. The chiropractic school (University of Western States) teaches and recommends this treatment in their curriculum. Knowing that calcium is key to muscle function and that CoQ10 is a crucial component of the electron transport chain for aerobic energy (ATP) production may lead us to make diet or supplemental recommendations based on the patients needs. We can tailor our rehabilitation programs based on which muscle fiber types our patient needs to focus on. The 60 year old with low back pain may benefit more from slower concentric, eccentric and isometric contractions of core stabilizers than ballistic exercises that increase type II fibers. (As a side note it’s important to know that eccentric muscle contractions place the most amount of stress on the muscle. This can be used for training purposes or in the clinic for orthopedic evaluation of muscles.) It may be useful to tell the 60 year old that reduced pain or incidence of low back pain episodes doesn’t mean exercise can be stopped. Educating the patient on continually working these muscle groups to allow long-term stabilization is important in the clinical setting. The more ballistic activity would benefit the sprinter more than it would the marathon runner. This knowledge allows us to select specific types of programs to optimize the patient’s health and performance.

In summary, understanding exercise physiology can allow us to make specific physical activity recommendations based on our patient’s specific needs. The understanding of the body’s energy systems and biochemical needs allow us to aid the patient in their dietary needs. The marathon runner may need to supply his/her body with the proper nutrition’s to optimize their physiological potential before and after an event. Finally, the information can allow the practitioner to make clinical treatment decisions. This is evident with the muscle energy techniques utilized by many health professionals. In a sense, knowing exercise physiology boils down to making physical activity, diet and treatment recommendations in the clinical setting. Exercise physiology is a rapidly evolving field that is becoming increasingly important in the delivery of health care especially for the sports chiropractor.

Want to read what your doctor is writing about you?

Would you be more inclined to find a new doctor if you saw his/her charts notes about you? A new pilot study is being conducted and is coined "opennotes." The study will determine if readily accessible medical chart notes will improve the efficiency of your doctor visits. Would you like to know if your doctor believes you are in denial? Or if he/she believes you have a psychological disorder that need further evaluation? Right now you have the capability of requesting your medical records, yet, this system will allow easier access and lower costs. Read all about it below.

http://myopennotes.org/

FISH FACTS

Pictured is a Blue Marlin I caught this summer while fishing in Baja. I need to give a big thanks to the De Smet family for taking me there and showing me how its done. The fish weighed over 200lbs and was 8.5 feet long. If you've been concerned about including fish into your summer diet here are a few tips to help you decide.

Most of us know that a healthy diet should include fish and that fish contain good fats that keep our hearts healthy. It’s true, fish consumption reduces the risk of heart disease and stroke by reducing blood clots and inflammation, improving blood vessel elasticity, lowering blood pressure and improving cholesterol. Here are other benefits of consuming fish that you may not be aware of:

• The fatty acids found in fish encourage the healthy development of vision and brain function in infants whose mothers diet include fish while pregnant or nursing. A report also commented that consuming fish while pregnant appears to decrease the risk of delivering pre-term babies. If you are concerned about methyl mercury consumption refer to the decision pathway for consumer guidance here: http://www.iom.edu/~/media/Files/Report%20Files/2006/Seafood-Choices-Balancing-Benefits-and-Risks/11762_SeafoodChoicesFactSheet.pdf




• A new study by the University of Southern Denmark demonstrated that individuals who consume a moderate amount of fish had significantly lower hospital utilization and better self-reported health than those who don’t regularly eat fish.

• Another study by Harvard found that regular fish consumption reduced overall mortality by 17%.

• One systematic review revealed some evidence of neuroprotective properties against dementia. The overall evidence favors the role of omega-3 fatty acids in slowing cognitive decline in the elderly individual without dementia, but not for prevention of dementia.

• There are also reports of reduced depression and improved blood sugar regulation in those managing diabetes. Fish contain a high source of protein and unlike red meats it contains little saturated fats.

• For more information visit: Food and Drug Administration
Food Safety Information Line
888/SAFE-FOOD
http://www.fda.gov

The Subluxation?

A classmate of mine wanted me to define a "subluxation" for him. I did a little research and found a few explaination to clear up the term that is thrown around by many chiropractors. I tend to agree with explaination #1. It's an alteration of normal functioning joints. I tend not to believe that these cannot be found on x-ray. However, plain film is a very useful tool to the chiropractor for many conditions. Rather it is the training of our hands and understanding of human anatomy that allows us to find abnormal joint motion. I hope this helps!

The following are pulled from a couple chiropractic websites. I tend to agree with explaination #1.

Explaination #1
Q: What is a Subluxation?
A: In Orthopedic terms, a "luxation" is the same as a dislocation, and so, orthopedically speaking, a sub-luxation is a "below" a dislocation, where the two sides of a joint, or articulation have not fully lost contact. Chiropractic uses a subtler definition of Subluxation: a Chiropractic Subluxation is a partial loss of proper joint articulation, with corresponding alterations in range of motion, alteration of normal biomechanics, and local tissue changes such as soreness, stiffness, and swelling.
Q: How can Chiropractic help these so called "subluxations"?
A: Chiropractic employs a High Velocity, Low Amplitude impulse, called an "Adjustment" to normalize proper joint mechanics. While many Chiropractors talk about "Alignment", what we are really talking about is function. Joints can become "fixated", where they do not have full range of motion. When we adjust 'fixated' joints, they are allowed to regain their normal biomechanical, histological, and neurologic function. Since the vertebrae encase the spinal cord and provide means for spinal nerves to reach out to all areas of the body, to whatever degree the improper biomechanical alignment of the vertebrae may irritate the nervous system, restoring proper function of these vertebral segments can serve to decrease neurogenic discomfort.

Explaination #2
What are vertebral subluxations?
A vertebral subluxation is the result of spinal bones with improper motion or position affecting nerve communications between your brain and your body.
sub = less than | luxation = dislocation
A vertebral subluxation is a stress response. Muscles go into spasm. Spinal bones lock up. And adjacent nerves are choked or chafed. This interferes with the control and regulation of your body. This garbles communications between the brain and parts of your body.



Distorted nerve communications can be an underlying cause of many health problems beyond just headaches and back pain. For example. Interfere with nerve impulses going to or from your stomach: stomach problems.
Your nervous system controls every cell, tissue, organ and system of your body. These nerve impulses travel through your spine. So having a spine free of vertebral subluxation is essential for optimal health.
Only a chiropractic examination can detect vertebral subluxations. And only chiropractic adjustments can reduce their effect to your nervous system, naturally.
Find out if you have vertebral subluxations before they become more serious and more difficult to correct.

HIGH BLOOD PRESSURE and CoQ10

What is coenzyme Q10? It is a fat soluble compound found in almost every cell that makes energy. The reason I bring this over the counter (OTC) compound up is due to its ability to lower blood pressure. I have recently done some searching through scientific articles that show CoQ10 can reduce systolic blood pressure by 11mmHg and diastolic blood pressure by 7mmHg. These numbers are taken from the Cochrane review, a well respected organization that summarizes many studies and lays down the facts. This could be of great benefit to those who have high blood pressure, yet, wish to remain drug free. I read another article that had an average reduction of nearly 17mmHg (systolic BP), this is a huge reduction. Always keep in mind that errors happen in studies and you always have to be curious about results, however, many studies have shown positive results with little to no side effects in hundreds of people.

Two weeks ago I decided to quit taking my prescription medication and start taking Coq10 instead. I have also added 2000IUs of Vitamin D (I was already taking 2000IUs). I’ll let you know the results in a month or so. CoQ10 is an OTC that anyone can purchase. Below is a link to more information about one of the articles:

http://www.inspiredliving.com/heart-cardio/coQ10-high-blood-pressure.htm

Questions about health and wellness?

Let me know about your health and wellness question! If you have any questions regarding chiropractic, exercise, nutrition, food, or any related topics please ask me and I'll post a blog about it. Thanks for visiting and have a good day.

Acai Berries and Berry Juice

I’ve recently seen several advertisements for acai berry juice or a juice concoction with acai berry added in it. It lead me to do a little digging for the facts. Some sites are claiming it to be the new wonder weight loss fruit. There are ads on the net that claim to dramatically shed pounds with no exercise or changing what you eat. If it sounds too good to be true it probably is. Some sources say they have tried a “free” trial of the juice, yet, the “trial” never ends and they have to end up canceling their credit card to stop the charges. All I have to say is be careful and do a little research before you make an impulse purchase.

Although, not everything is bad about this fruit. It is a fruit right. Here is an excerpt from WebMDs website that I found useful: “Can acai berries boost weight loss?
“Scientists are learning more about the functional power of superfoods, such as the acai berry. Although acai is touted in some weight loss products, few studies have tested the benefit of acai in promoting weight loss.
For now, plenty of research supports eating a diet rich in antioxidants. There’s no doubt that berries and other fruits are a key part of any healthy diet promoting weight loss. The jury’s still out on whether there is something special about acai’s ability to shed excess pounds.”

Here is the link to read the full article:
http://www.webmd.com/diet/guide/acai-berries-and-acai-berry-juice-what-are-the-health-benefits

MISSION: SUPER BABY CANNER

I found out a couple weeks ago that my good friends Jake Canner and Lindsey are going to be parents in less than nine months. Concurrently, I’ve been taking a class in Chiropractic College on Obstetrics wondering when I was going to use some of this information. Thus, I’m relying some of the information that I have learned to help guide you to a healthier pregnancy. (This is not meant to be the end all, be all. These are simply some tips to help. You should always listen to your doctor and consult with him/her if you are thinking of changing something.)


TIP 1:
Do your vitamins have an adequate source of Vitamin D? Recent research has suggested that Vitamin D contributes to improving pregnancy outcomes, such as decreasing the risk of pre-eclampsia (high blood pressure), improving gestation length, birth weight and infant bone mineralization to name a few. For Lindsey’s health one study in the American Society for Clinical Nutrition suggests that maternal Vitamin D deficiency in early pregnancy is significantly associated with an elevated risk for gestational diabetes mellitus (GDM). There is still a lot to be learned about this powerful vitamin so it’s not suggested that you go to GNC and buy mega doses, yet, a good multi should have at least 400IU’s.


TIP 2:
News about CAFFEINE. Recent studies have shown that women who consume greater than 200mg of caffeine daily are at significant risk for miscarriage prior to 20 weeks. To put this into perspective one large coffee has up to 100mg of caffeine. A good substitute is green tea; there are only 30mg/ cup.


Tip 3:
Why should I drink a minimum of 2-3 L of water a day? Water accounts for 75% of newborns weight and is essential for ALL activities of body function. Dehydration decreases amniotic fluid volume and increases preterm uterine contractions. Carry a water bottle with you to work or at the gym.


Tip 4:
Speaking of the gym, is there really much benefit to working out while I’m pregnant? One study suggests infant’s mothers who exercises for at least 30 minutes three times a week had HIGHER IQ’s, better coordination and lower levels of body fat. AKA Super Baby Canner.


Tip 5:
Why am I getting sick? Pregnancy nausea usually happens in up to 80% of newly pregnant women. Lindsey- most women start experiencing morning sickness between 4 and 6 weeks. The nausea usually ends around the 14th to 16th week when the hCG levels start to decrease. There are prescription medication that are reserved for severe sickness, yet, one of the natural ways for battling pregnancy induced nausea is B6 supplementation. B6 around 50mg daily has been shown to help with pregnancy induced nausea.


Tip 6:
Can chiropractic care help me?

During your pregnancy the body goes through an amazing transformation. The average women gains 25 to 35 pounds, placing a tremendous amount of stress on the spine. In addition, your baby may press against your back placing added stress to joints and nerves. As you progress in your pregnancy your center of gravity shifts forward. This posture places stress on the discs between your vertebrae; which can create pain. This is very common as 50-90% of pregnant women experience some type of back pain during their pregnancy. The body attempts to compensate by releasing hormones that loosen ligaments that are attached to the pelvis. However, even these natural changes can result in posture imbalances. Chiropractic care can help you during your pregnancy in several ways:



· By restoring normal motion of the spine and pelvis.

· By relieving pain.

· By increasing your endurance.

· By promoting healthy self care.

· By helping you return to normal activities after birth.

· By reducing the time of labor.

Interested in white water rafting this summer?

Every summer I work for a company called Oregon River Experience. If you are interested in taking a wild river trip this summer I highly recommend this company. Do one thing a day that challenges you!

http://www.oregonriver.com/

Fenzian link

http://www.fenziansport.com/

Have you heard of Fenzian?

Today I had the pleasure of observing Dr. Espinoza D.C. in North Plains, Oregon. During this time I watched him use a product I have never seen to alleviate pain arising from a wide range of medical conditions. The product is called Fenzian. The system works by delivering biphasic electrical impulses through the surface of the skin.

The device picks up signal variations from different areas of the skin surface which arise from underlying physical disturbances. The practitioner uses a variety of techniques on these sites, including brushing the skin with the device or holding it in place, to alleviate pain.

http://www.fenziansport.com/ This link will take you to the products site for more information. If you have any personal experience with this product let me know! Thanks for you time and have a great day!

Lunch Time Lecture By Alex Vasquez N.D. D.C. soon to be D.O.

Today I went to a lecture by Dr. Vasquez on Chiropractic Management of Chronic Hypertension. Dr. Vasquez is a sensation individual who started his professional career at Western States Chiropractic College, got his D.C., then went to N.D. school in Washington and is now just finishing up his D.O. degree. Not sure how he's financing all those loans but what an accomplishment.

He pointed out that hypertension is the number one diagnosis and accounts for 11 million patient visits per year. Most of the research and treatment of hypertension has been with prescription drugs. Dr. Vasquez outlined an evidence based approach to alternative ways at battling high blood pressure. He talking about the integration of diet, exercise, vitamin D (huge topic right now), CoQ10 and spinal manipulation to regulate blood pressure safely and cost effectively.

Dr. Vasquez has written an entire book on this http://www.optimalhealthresearch.com/ . Here you will find the link to the book and other good information on this topic.

I also recommend reading this article on Vitamin D

http://www.optimalhealthresearch.com/cholecalciferol.html, I found it a very useful and has most of the up to date information regarding benefits and dosing. Thanks.