Health Risk Assessment

Baby Boomers and Beyond

The maturing individual has specific needs, which we address with a great deal of understanding and individualized care.

The Ageing Spine

As we age, it is likely that we will experience tissue deterioration. The tissues of the spine are of particular interest because the spine carries a great deal of stress through years of physical activity, and even prolonged sitting. Although every one of us will experience the natural deterioration process, the speed at which this occurs can differ from one person to another.

The intervertebral disc

Health Risk Assessment Portland - Intervertebral disc image

Between each vertebrae, or bone in the spine, is a gel-filled disc, called the intervertebral disc. These discs most commonly experience the effects of tissue deterioration. Discs typically remain strong and healthy through our normal torso movements, which draw nutrients and fluids into the discs and flush waste products away from the spine. As we age, discs may become affected by natural stiffening, which makes them less accepting of the influx of nutrients and fluids, resulting in dehydration. This dehydration can be seen as a loss of height, due to decreased space between two vertebrae. Dehydrated discs under pressure may begin to bulge, causing discomfort and a limited range of motion. Intervertebral discs, in their arthritic changes, lead to a change in spinal biomechanics that should be treated in order to slow the deterioration.

Facet joint and vertebral body arthritis

Health Risk Assessment Portland - Face joints image

Within the vertebral bodies and the facet joints, calcium buildup may occur through the natural deposit of this mineral and its subsequent ossification. As calcium ossifies in these areas, stiffness occurs. Your chiropractor can see the presence of calcium in x-ray films, identifying the cause of neck or back pain and stiffness. Sometimes, affected vertebral bodies and facet joints may lead to shooting pain like sciatica, often felt down the backs of the legs. The sensations from calcification may be the direct result of irritation to the nerve roots or bony compression. If untreated, these seemingly minor compressions can lead to serious spinal issues.

Chiropractic treatments can help

Chiropractic care of the spine maintains proper motion, which is essential to the ongoing health of joints, discs, and soft tissues. With regular chiropractic care, the stress associated with deterioration is minimized, and spinal biomechanics, in which nutrients are absorbed, are optimized. The better the spine is maintained with effective care, the longer it will function properly. Just like a vehicle or trusted appliance, a breakdown can occur without proper maintenance.

Chiropractic Care

Millions of aging adults retain control over their quality of life each year with the help of a trusted chiropractor. Chiropractic treatments can increase the general quality of a person’s life by improving flexibility and strength, enhancing function and mobility, increasing balance, and eliminating acute and chronic pain.

There are many aspects to chiropractic care, including direct adjustments of the spine and extremities, physical therapy and soft tissue treatments. Many people do not realize that a chiropractor will also provide valuable counsel on exercise and fitness, as well as diet and nutrition. At HealthSource Chiropractic & Progressive Rehab, our goal is to help our patients enjoy life to the fullest!

The importance of chiropractic care for the mature adult

Older adults experience dramatic changes in the spine as the years progress. The discs, muscles, ligaments, joints, and tissues of the spine, become less flexible, less capable of withstanding stressors, and generally weaker with age. The result of degeneration in the spine, or spinal arthritis, is persistent pain, a tendency toward injury, and an increase in healing time from seemingly minor injuries.

Your chiropractor provides specialized care with understanding and a focus on the aging spine, including potential abnormalities. At HealthSource Chiropractic & Progressive Rehab, the implementation of a gentle, non-invasive chiropractic care plan can minimize pain, improve mobility and flexibility, and slow the degeneration process.

Treatments that focus on eliminating pain and other symptoms tend to be short-lived and mostly ineffective for long-term improvement. Chiropractic treatments require a team effort between doctor and patient, but provide truly effective, long-lasting benefit with commitment to care.

The benefits of chiropractic care for the older adult

There are numerous benefits of chiropractic care, including:

Relief from back and neck pain, headaches, and other uncomfortable symptoms
Decrease in muscle spasms and stiffness
Increased range of movement and mobility
Better coordination and balance
Improved energy
Healthier joints
Optimized tissue healing
Decrease in joint pain and arthritic pain
Decreased inflammation in muscles and other tissues
Slowed progression of spinal degeneration
Decreased spinal stress
Decreased risk of injuries from falls
Improved sense of wellbeing

Studies show the benefits of chiropractic care for older adults

A study of 414 participants with an average age of 80 discovered a number of significant findings when comparing individuals under the care of a chiropractor with individuals not receiving chiropractic care.

87 percent of chiropractic patients reported feeling in good or excellent health, as opposed to only 68 percent of non-chiropractic individuals.
32 percent of non-chiropractic individuals felt their health was poor, as opposed to only 13 percent of those receiving chiropractic care.
44 percent of chiropractic patients reported arthritic symptoms, versus 66 percent of non-chiropractic patients.
Chiropractic patients would more frequently engage in strenuous exercise.
3 years post-study, no more than 5 percent of chiropractic patients resided in nursing homes, whereas a whopping 48 percent of non-chiropractic patients did.
3 years post-study, 26 percent of patients who received chiropractic care required hospitalization, versus 48 percent of non-chiropractic patients.

Coulter, PhD et al. Chiropractic and Care for the Elderly. Top Clin Chiro 1996;3(2):46-55.

What chiropractic can do for you

Chiropractic care can increase the range of motion

We rely on a wide range of motions to perform many of our daily activities. For some, increasing their range of motions means regaining the ability to crouch down to speak to or pick up a grandchild. For others, increased range of motion allows better enjoyment of activities like golf or bowling.

For decades, chiropractors have been helping people just like you reach their goals through increased range of motion. The improvement from chiropractic care can often be felt after the very first treatment, as well as each subsequent adjustment. This is one reason chiropractors have become an invaluable part of professional athletic teams.

Chiropractic care reduces the severity and frequency of head, neck, and back pain

Chiropractic care has been shown to be one of the safest and most effective forms of treatment for most head, neck, and back complaints. The reason for this is that most of the uncomfortable symptoms occurring in these areas are caused by soft tissue abnormalities in the spine – conditions that chiropractic physicians have been specifically trained to address.

Chiropractic care improves coordination and balance

With age comes a natural decrease in coordination and balance. Research has identified the receptors responsible for balance and coordination as those located in the joints of the neck, or the upper cervical spine. Injury to the cervical spine, and these receptors, inhibit proper balance and coordination.

According to Dr. Caranasos, MD:
“Mechanoreceptors in cervical facet joints provide major input regarding the position of the head in relation to the body. With aging, mild defects impair mechanoreceptors function. Loss of proprioception can also involve the legs, especially with diabetes. With decreased proprioception, body positioning in space is impeded and the patient becomes reliant on vision to know the location of a limb. To compensate for the loss of proprioception in the legs, the feet are kept wider apart than usual. Steps become irregular and uneven in length. As impairment increases, the patient becomes unable to compensate. With severe loss of proprioception, the patient is unable to get up from a chair or rise after a fall without assistance.”
Caranasos, MD, Isreal, MD. Gait Disorders in the Elderly. Hospital Practice. 1991; June 15:67-94.

According to Dr. Guyton, MD:
The Textbook of Medical Physiology supports this data, stating that vital data needed for proper equilibrium originates in the “joint receptors of the neck.”
Guyton, MD. Textbook of Medical Physiology. 9th edition. WB Saunders, Philadelphia 1996;714.

Chiropractic care that stimulates the joint receptors located in the upper cervical spine has been shown to restore better balance and coordination. It is thought that this stimulation normalizes joint receptor functioning.

Chiropractic care decreases fall injuries and other injuries

A highly detrimental, yet sadly very prevalent event for the elderly is fall injury. The CDC reports that 90 percent of the 850,000 annual bone fractures occur in individuals aged 65 or older.

The risk of fall injuries and other injuries can be decreased with regular chiropractic care because the function of cervical joint receptors is normalized, improving coordination and balance. Chiropractic care also includes stretching and exercises that increase coordination and balance, as well as mobility, flexibility, and strength. The nutritional counseling provided by a chiropractor can increase energy and the individual’s general sense of wellbeing.

Chiropractic care nourishes the joints and decreases arthritis of the spinal joints

Joint movement facilitates the nourishment of the spinal facet joints and spinal discs, as well as the elimination of waste from the joints. Lack of movement can lead to scar tissues and adhesions of spinal joints.

With regular chiropractic care, the motion of spinal joints and surrounding joints is improved, and nutrients are drawn into the discs through proper movement. This nourishment and waste-elimination keeps joints healthier longer, decreasing the risk of arthritis.

Chiropractic care optimizes biomechanics, decreasing degeneration in joints and tissues

When the spine is not in proper alignment, excessive wear occurs. This is similar to wear on car tires due to improper alignment. We only get one spine, and we want to maximize the “mileage” we can get from it. With chiropractic care, the stress placed on the spine is reduced due to optimal biomechanics. The result is a healthier, more flexible spine.

Chiropractic care optimizes health and wellbeing

Life is more enjoyable when we are free to engage in the activities that bring us pleasure such as playing with grandchildren, gardening, or golfing. Pain and stiffness, however, can impede our ability to do the things we have always loved to do, or those things we would love to try. Chiropractic care has been shown to not only increase flexibility and eliminate pain, but also to greatly improve a person’s quality of life.

You deserve to live your life to the fullest. Call our Portland office today to learn how we can help you do just that.

Back Pain

Amongst aging individuals, one of the most common complaints is back pain, otherwise called arthritic back pain. This type of pain is usually the result of the accumulative stress of uncorrected spinal injuries, however minor. However, due to the potential for more serious conditions in the older population, it is recommended that back pain be addressed with more comprehensive testing that rules out problems such as infection or spinal compression.

The elderly patient, back pain, and chiropractic care

Chiropractic medicine is considered a holistic approach to health and wellness. The chiropractor seeks to discover the underlying cause of pain and other symptoms, and treat the source. Understanding the individual goals of each patient helps us design the most suitable treatment plan. Combining the patient’s goals with his or her underlying problem and its contributing factors equates to an optimal outcome using a care plan tailored to the individual. Diagnostic testing is also performed to rule out conditions such as infection, fracture, and cancer.

Chiropractic care utilizes natural, safe, non-invasive methods to aid in the body’s own healing capabilities rather than surgery or drugs. This level of holistic care may include lifestyle modification, nutritional counseling, stretching and exercise programs, soft tissue treatments, physical therapy exercises, and spinal manipulation. Any combined therapies are focused on the underlying cause of unpleasant symptoms, resulting in significant long-term improvement and optimal wellness.

The elderly, back pain, and medicine

Chiropractors are not in the business of “bad mouthing” conventional medicine or medical practitioners. Our view is simply different. Medical doctors are not extensively or specifically trained to understand the workings of the spine in the same way as chiropractic physicians. Many lack the experience or even the confidence to treat back pain effectively.

It was discovered, in the “Practitioner Self-confidence and Patient Outcomes in Acute Low Back Pain” study, that chiropractors scored significantly higher in the area of self-confidence in treating low back pain than physicians.

1. Arch Fam Med. 1998;7:223-228

Prolonged rest, prescription medications such as ibuprofen or aspirin, and a no exercise are the most common inclusions in the medical treatment plan for low back pain. The issue with using rest and drugs to address back pain is that sensations are simply decreased while the true issue is not addressed. This would be the same thing as busting the light that warns you you’re low on gas instead of filling the tank.

a) In several studies, bed rest has actually been identified as detrimental, decreasing the patients overall capacity by as much as 7 percent each day, while offering the potential improvement of only 1 percent per day of rest,

i) Mechanical loading and early motion stimulate the production of new collagen fibers, which leads to the diffusion of synovial fluid and improved blood flow to the spinal discs,

ii) The prescription of pain relievers and anti-inflammatory medication simply mask uncomfortable symptoms. They do not increase function or slow the progression of disease. Even more alarming, one study determined that several NSAIDs, such as ibuprofen and aspirin, could actually block the natural healing process of joint cartilage. Further, the long term use of NSAID medication may lead to the rapid deterioration of joints, a condition called “Analgesic Atropy.”

Nelson, DC. Top Clin Chiro 1994;1(4):20-29
Gottlieb MS, DC. JMPT 1997; 20(6):400-414

Head and Neck Pain

Head and neck pain are not quite as common as back pain in the older adult, but still pose problems as we age. Stiffness and pain in the head and neck may naturally result as a cumulative effect of degenerative changes in the tissues of the spine. Additionally, the older adult may experience balance problems or even dizziness because of these changes.

The elderly, neck and head pain, and chiropractic care

The Chiropractor’s holistic approach to patient care keeps an eye on the whole being. Chiropractors want to help their patients achieve their individual health goals, and do so by first discussing them in a comprehensive consultation. Goals are then considered when evaluation of the patient’s current condition is performed. Additionally, a care plan will address the various factors that have contributed to the current condition. A careful evaluation seeks to rule out potentially serious problems like infection and tumors.

The chiropractic approach to neck and head pain does not rely on drugs or surgical procedures. Instead, natural, non-invasive techniques aid the body in healing itself. To address head and neck pain, a chiropractor will adjust the spine into proper alignment, and may prescribe physical therapy treatments and exercises or soft tissue therapy, recommend specific lifestyle modifications, and provide nutritional counseling. This combination of natural therapies leads to excellent long-term effects due to optimized health and wellness. Treatments designed simply to relieve symptoms are not only short-lived, but also highly inefficient at producing optimal results.

The elderly, head and neck pain, and medicine

The chiropractic approach to treating pain differs greatly from traditional medicine. This difference is largely in part in education. Whereas medicine seeks to reduce symptoms, chiropractors are specifically educated to understand the mechanics of the spine and the various symptoms that arise from misalignment.

In a study on practitioner self-confidence and patient outcomes, chiropractors’ scores of self-confidence in treating back pain were much higher than conventional medical practitioners.

1) Arch Fam Med. 1998;7:223-228

Most medical physicians prescribe extended periods of rest, no exercise, and prescription drugs such as anti-inflammatories, or NSAIDs. Common prescriptions include ibuprofen and aspirin, which decrease inflammation and diminish pain. What his approach lacks is the identification, or even the consideration of an underlying problem. Though pain may be decreased, the cause of pain is not corrected.

a) In several studies, the detriment of bed rest has been confirmed, with patients losing 3 – 7 percent of their overall capacity by the day. Improvement with bed rest measured only 1 percent per day,

b) resuming motion and normal mechanical load early led to collagen stimulation within damaged tissues, and an infusion of synovial fluid and blood flow for enhanced healing,

c) pain killers and anti-inflammatory medications are designed to diminish pain and inflammation, not to increase function. In a recent study, medications such as aspirin and ibuprofen were noted as inhibiting to the natural healing process, rather than aiding it. Moreover, the long-term use of such medications has been shown to cause deterioration of joints, called “Analgesic Arthropathy.”

Nelson, DC. Top Clin Chiro 1994;1(4):20-29
Gottlieb MS, DC. JMPT 1997; 20(6):400-414

Children and Infants

Chiropractors regularly care for the unique needs of infants, children, and teens, as well as adults. At HealthSource Chiropractic & Progressive Rehab, we understand that raising a healthy family is important, and know that the habits formed early in life have a lasting impact. Likewise, the lack of good habits will affect a child as he or she grows into adulthood.

Browse our various children’s topics for more information on the growing spine and chiropractic care for early spinal problems.

Chiropractic Care

Every day in our country, thousands of children from infants to teens benefit from chiropractic treatment. This form of health care is designed for far more than adult back pain, providing an effective source of health and wellness for every member of the family.

While chiropractic care is beneficial for the effective, non-invasive treatment of obvious pain such as headaches, and for “chiropractically responsive” problems such as scoliosis, the care we provide is capable of much more. The conditions that children often suffer from, ranging from colic to asthma to ear infections, have all been shown to improve with chiropractic treatment.

The chiropractic approach to the management of health conditions sees the entire system. This holistic approach incorporates, as needed, various therapeutic methods, such as spinal adjustments, soft tissue therapies and physical therapy, nutritional guidance, and lifestyle modifications. In the experienced hands of your trusted chiropractor, your child’s health is attended to with great care.

We offer effective, non-invasive treatments to help your family enjoy health and wellbeing. If you have questions after browsing our various topics, please contact our Portland office for more information about our services.

The Growing Spine

Spinal length and growth

Forty percent of an infant’s total length is devoted to the spine; the same is true for adults. The difference between infants and adults comes down to total length, not percentage. In an infant, the spine measures only about 9.6 inches. During the first year of life, the spine grows by 50 percent. In the subsequent four years, the spine grows to reach a length of about 20.4 inches, or 51cm. Between the ages of 5 and 10, another 10cm is added, and 15 to 20cm more during the teenage years.

Spinal curve development

At birth, the spine looks like the letter “C.” As the infant develops and learns to raise his or her head, this curve shifts to “lordosis,” or a reversed “C.” Around the age of 6 months, when standing and seating posture develops, the lower back also develops a “C” curvature.

Spinal trauma

Small traumas to the spine occur from the birth experience, during which the infant’s body has a very small area from which to enter the world. During some deliveries, unnatural forces are used to facilitate the process and minimize discomfort for mother and child. This intervention, although designed for patient comfort, can cause mild injuries to the spine, specifically to the neck area.

As an infant develops, learning to lift his or her head, to walk, and balance, the recurrent falls, and the bumps that occur provoke further minor injuries. These injuries add up over the years as a child develops, all while the spine is still growing at a rapid pace.

What is the point?

Obviously, the spine is susceptible to a number of injuries, both minor and major, from the time we are born, and throughout our lives. It is for this reason that chiropractors love treating patients of all ages. There is no minimum age requirement when it comes to caring for the health of the spine. Due to the speed the spine grows and children’s penchant for bumping, jumping, and generally being active, chiropractic care during childhood is wise.

Monitoring spinal health

Children visit their dentist to monitor the health of their teeth, and they visit their primary care doctor to monitor development. Receiving spinal evaluations are equally important to the health and wellbeing of the average child. The spine plays an important role in many of the general functions of the body. Professional spinal care is gentle and non-invasive, and we believe it to have a wonderful impact on the growing child, as well as the adult patient. If your child’s spine has not been checked, we invite you to contact our Portland office to schedule a visit.

Childhood Scoliosis

Definition

Scoliosis is a spinal condition in which there is a lateral deviation, meaning the spine curves sideways. Although this condition is sometimes discovered in adults, scoliosis is most often detected in children and adolescents.

Prevalence

Four percent of children between the ages of 10 and 14 have noticeable scoliosis. Of those with this condition, between 60 and 80 percent are girls. Typically, the progression of scoliosis stops once the spine has fully matured. However, some adults continue to experience the progression of a lateral curvature.

Types of scoliosis

Infantile scoliosis is detected between birth and age three. This type is more commonly identified in boys. Infantile scoliosis has a high rate of resolution: between 74 and 97 percent. In rare instances, this type of scoliosis can become severe, although this is not common in our country.
Juvenile scoliosis is detected between the ages of three and about ten, when puberty begins. Because this type of scoliosis has the potential to progress, the beneficial practice is to monitor with x-rays every three to six months. Progression of scoliosis without proper treatment can lead to deformity of the spine and cardiovascular compromise.
Adolescent scoliosis is detected in the teen years, and commonly has no known cause. In the same way as juvenile scoliosis, consistent monitoring is beneficial in cases of adolescent scoliosis as a way to prevent the progression to severe problems.

Diagnosis

Detecting an abnormal curve in the spine can be difficult, even for a trained eye. For that reason, the first indication of scoliosis may be unevenness in the height of one shoulder compared to the other or noticeable imbalance in how clothes hang from the body. Complaints of chronic fatigue, discomfort, ache, or back pain may indicate a problem. Such complaints, however, may not begin until the muscles and ligaments around the spine reach a chronic state of irritation.

Complications

In most cases, the progression of scoliosis ceases once the spine has fully matured, there is a risk that progression will continue past maturity. If the lateral curvature of the spine becomes very severe, the heart may become compromised. Ultimately, severe scoliosis can be disabling or even fatal.

Treatment

In the child patient, scoliosis treatment may consist of:

1) Ongoing monitoring of the curvature, measured in degrees

2) Chiropractic treatments to adjust the spine, minimize stress, improve biomechanics, and facilitate normal nervous system function

3) Physical therapy stretches and exercises to strengthen the muscles on the appropriate side of the spine while increasing flexibility in muscles pulled on the concave side

4) Physical therapy and soft tissue treatments to provide symptomatic relief

The goal of chiropractic treatment for scoliosis is to prevent the progression of an abnormal curvature and to eliminate uncomfortable symptoms of the condition. Untreated, scoliosis can lead to cardiovascular problems and disability.

Sports and Fitness in the Child

Regular physical activity in the way of play and sports provide fun entertainment for children and teens and, more importantly, promotes healthy lifestyle habits and improves their general state of health and wellness.

The risk of heart disease is cut by exercise and health education in childhood

Recent research points to health education and vigorous exercise in childhood as a beneficial precursor to lower blood cholesterol, as well as a decreased risk of heart disease, in adulthood.

The study responsible for these findings is a part of the ongoing Cardiovascular Health in Children study in North Carolina. This study, in which researchers are learning how to improve childhood and adult heart and lung health, followed 600 middle school students from three different North Carolina counties.

One researcher in the study noted most adults in our country were far more active as children than children today. Many parents do not realize how little physical activity occurs in the school setting.

The study was conducted in four groups. One group received classroom health education as well as physical activity. One received only one of these areas. One received the other, and the final group received no education and no physical activity. Of those who received physical activity, three days a week provided vigorous, non-sport activity. Classroom training included topics such as blood pressure, smoking, fitness, and nutrition.

Before and after completing the program, the fat levels in the blood of participants were measured. In the combined group receiving both education and physical exercise, there was an average of 10.6 milligrams per deciliter drop in total cholesterol, and an 8.7-milligram per deciliter drop in LDL.

Researchers concluded that combining physical activity with a program for education and attitude produced effective improvement in the lipid profiles of this group of adolescent participants. The importance of this particular study is that it is the first of its kind to study adolescents, not children, or adults.

1. American Heart Association Conference, Santa Fe, New Mexico - March 19, 1998.

Diet and Nutrition in the Child

Dietary considerations

Caloric Requirements

According to experts, the most advantageous diet for infants up to age one is breast milk. Before the age of one, cow’s milk not in the form of infant formula is not recommended due to the potential for allergic reaction and bleeding in the gastrointestinal tract. Cow’s milk also does not contain sufficient nutrients in the form of fatty acids and vitamins for the growing infant. If an infant is fed formula, this should account for only one-third of the daily caloric intake.

Recommendations for daily caloric intake:
i. Infants: 80-140 kcal/kg/day
ii. Children: 40-90 kcal/kg/day
iii. Adolescents: 30-50 kcal/kg/day

1. Barnes L. Infant feeding: formulas, solids. Pediatric Clin North Am 1985;32:355-362.
2. The use of cow's milk in infancy. Pediatrics 1992;89:1105-1109.

Fruits, vegetables, and children

Studies show that American children do not eat sufficient amounts of fruits and vegetables on a daily basis. The food consumption of 168 preschool-aged children was recorded during a one-week study. Not one child’s intake met the recommendation of five daily fruit and vegetable servings. Researchers discovered that most children attained a mere two servings of fruit, and less than one-half of a serving of vegetables each day. Of the fruit servings, half of the total was consumed as juice, which according to experts can cause diarrhea, failure to thrive, growth failure, and an increased risk of obesity.

The low intake of fruits and vegetables was associated with insufficient levels of vitamin A and C, as well as dietary fiber. On the other hand, low intake of fruits and vegetables also led to higher intake of saturated fats and total fats.

Research has shown that eating the recommended amounts of fruits and vegetables can dramatically decrease the risk of various types of cancer. Researchers encourage parents to make sure children have an expansive variety of fruits and vegetables available to them, and to teach good habits through acting as a role model.

1. Journal of the American College of Nutrition 1998;17:371-378.

The truth about fruit juice and other popular drinks

As previously stated, fruit juices pose certain risks to a growing child. The problem with many fruit and other types of juice is that they contain excessive amounts of simple sugars while also being low in fiber, fat, protein, and carbohydrates. Store-bought juices are typically also deficient in vitamins and minerals, potentially leading to:

Bloating and diarrhea due to poor digestion of sorbitol and fructose
Insufficient daily caloric intake if juice takes the place of calorie and nutrient dense foods
Nutritional deficiency due to “empty calories”
Dietary imbalance if a variety of foods is not consumed

Experts recommend that, rather than giving full strength juice, parents add a few tablespoons of juice to children’s water. It is also important to note that the consumption of juice before bed increases the risk of dental caries.

1. Smith MM, Lifshitz F. Excess fruit juice consumption as a contributing factor in nonorganic failure to thrive. Pediatrics 1994;93:271-277.

Food allergies and intolerance

Infants and children commonly experience food allergies and intolerances. The foods most commonly linked to allergies or intolerance include:

Dairy products
Soy products
Nuts
Yeast and wheat
Citrus fruits
Fish and pork
Various food additives

Food allergies or intolerance may show up in the form of skin problems such as hives or eczema, wheezing, sneezing, runny nose, asthma, failure to thrive, vomiting, and diarrhea. Determining which food is at the core of an allergic response or intolerance can be challenging. Experts recommend that one new food be introduced to a child at a time. This way, a food intolerance can be more easily identified.

Cow’s milk is the source of the majority of food-related allergies and symptoms, especially in children younger than twelve months. Cow’s milk can be exchanged for rice milk or soymilk.

Breast-feeding vs. formula

Experts encourage new mothers to recognize the significant role of breast milk in the health of their growing infant. Several studies have linked breast milk with improved health and a lower incidence of infection and disease.

Breast feeding and infant illness – In a recent study, researchers determined that infant illnesses such as respiratory tract infections, ear infections, pneumonia, and gastrointestinal disorders were significantly lower in breast-fed infants. A group of 977 infants was followed for the two-year period of one study, in which mothers were encouraged to breast feed. This encouragement resulted in an increase in breast-feeding from 16.4 percent to 54.6 percent, and a subsequent decrease (33%) in pneumonia in the first twelve months of life. There was also a 15 percent decrease in gastroenteritis among study infants.

Researchers believe the findings of this study are indicative of the protective power of breast milk against common infantile illnesses. Breast feeding for the first year of life, or longer, is recommended by the American Academy of Pediatrics.

1. Pediatrics 1998;101:837-844.

Breast milk for the premature infant – Breast milk is believed to contain several compounds that boost immunity and give the growing infant a “jump start” to combat infections. In a study of 212 preterm and low birth weight babies, one group was fed breast milk and the other formula. After making necessary adjustments to address varying factors, researchers identified a 57 percent decrease in the chances of infection in the breast-fed group of infants. It was also discovered that mothers whose infants were born prematurely had higher concentrations of many of the agents that aid in immune function in their breast milk.

The American Academy of Pediatrics has consistently advocated breast-feeding as the primary practice during the first year of life. In 1997, the recommendation extended to include premature infants.

1. Pediatrics Electronic Pages 1998;102:e38.

Breast milk decreases instances of diarrhea – Infants and small children tend to experience an increased instance of diarrhea. Severe diarrhea, or the presence of other symptoms, should be evaluated by a physician. In many cases, supplementation with approved, natural intestinal flora can efficiently treat diarrhea. Natural immunity may also be increased by feeding an infant bovine colostrum.

Breast milk decreases middle ear infections – Chiropractic care has been shown an effective treatment for middle ear infections. Nutrition plays a role in the development of middle ear infections in children, with breast-fed infants experiencing far fewer ear infections than their counterparts. One study found that just 4 months of breast-feeding reduced the instance of ear infection by 50 percent compared with bottle-fed infants. This second group also experienced twice as many recurrent ear infections as the breast-fed group.

1. Duncan B, Ey J, Holberg CJ, Wright AL, et al. Exclusive breast-feeding for at least 4 months protects against otitis media. Pediatrics 1993;91:867-872.

Breast-feeding and the development of the intellect – Researchers found, in studying a group of 229 infants, that those who were breast fed consistently achieved higher scores on psychomotor skills tests.

1. Temboury MC, Otero A, Polanco I, Arribas E. Influence of breast-feeding on the infant's intellectual development. J Pediatric Gastroenterology Nutrition 1994;18:32-36.

Childhood obesity

Obesity is the condition of weighing 20 percent or beyond ideal body weight. In the last thirty years, America has witnessed a significant rise in the rate of childhood obesity. Research shows that obese children are more likely to experience obesity in adulthood, increasing the risk of health conditions that affect wellbeing. Due to the immense self-discipline required to overcome obesity, this condition is incredibly difficult to treat. It is important to prevent childhood obesity and seek effective treatment immediately should obesity develop.

Preventing obesity in children begins with good role models. Parents who engage in regular activity with their children and provide healthy food choices teach children the importance of nutrition and exercise. If childhood obesity becomes evident, parents are encouraged to seek the counsel of a skilled nutrition and fitness expert.

Nutritional supplements for children

Iron

The American Academy of Pediatrics advises mothers to breast-feed their infants for a period of one year. Infants younger than twelve months should not be fed cow’s milk, as this can cause iron deficiency. However, too much iron can increase bacterial growth during active infection, retard the growth process, and inhibit the absorption of other essential minerals.

Vitamin A

Most infant formulas contain added vitamin A. This supplement, made as a liquid, can also be given if deficiency is identified. Research suggests that a dose of 100,000 IU in infants younger than 12 months, and a dose of 200,000 in children aged 12 months or older reduces the risk of fatality from measles. In a Brazilian study, vitamin A was also identified as a beneficial treatment for severe diarrhea.

1. Butler JC, Havens PL, Sowell AL, et.al. Measles severity and serum retinol (vitamin A) concentration among children in the United States. Pediatrics 1993;91:1176-1181.
2. Barreto ML, Santos LM, Assis AM, et. al. Effect of vitamin A supplementation on diarrhea and acute lower-respiratory tract infections in young children in Brazil. Lancet 1994;322(Jul 23):228-231.

B vitamins

Infants receive vitamin B through breast milk. Therefore, if Mom is deficient, baby may be as well. For mothers deficient in vitamin B, a common trait of those who do not eat meat, supplementation is beneficial.

Vitamin D

Vitamin D deficiency may occur in mothers who do not eat meat or who do not get adequate exposure to the sun. Deficiency in vitamin D may be corrected with supplementation. Infants usually receive vitamin D, along with vitamin K, at birth.

Vitamin K

Vitamin K deficiency may occur in some infants, such as those with disorders that affect absorption of nutrients. Deficiency of this vitamin can lead to hemorrhagic disease, which causes unexpected bleeding. Most infants receive an intramuscular dose of vitamin K at birth.

Zinc

If a breastfeeding mother has a zinc deficiency, or there is an uptake problem within the mother’s mammary glands, an infant may be zinc deficient. Premature babies and those with malabsorption issues may also be deficient. Breast feeding mothers who are not zinc deficient tend to have infants with adequate levels. Zinc deficiency may cause:

Poor growth
Diarrhea
Persistent candida, or diaper rash
Irritability
Baldness, or alopecia
Anorexia

Treating common ailments

Asthma

Approximately 5 million American children are affected by asthma, a condition that can be potentially fatal. Symptoms of asthma include shortness of breath, coughing, and wheezing, with the severity and frequency of “attacks” varying widely from one person to another. There are several factors at play in asthma, including:

Muscle spasms in the airway
Swelling in the mucosa of the airway
Excessive secretions of mucus
Injury in the airway

Asthma sufferers may experience some relief of symptoms with chiropractic care. In a study, about thirty asthma patients received either real chiropractic adjustments, or “fake” adjustments, for a four-week period. During this time, no measurable difference in lung function was recorded in either group. However, patients receiving real chiropractic adjustments measured a 34 percent decrease in complaints. Though further research is required, patients of chiropractic medicine tend to report excellent results from regular care.

1. Neilsen NH, Bronfort G, Bendix T, Madsen F, Weeke B. Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial. Clin Exp Allergy 1995;25:80-88.

ADHD, Attention Deficit Hyperactivity Disorder

ADHD is a condition commonly diagnosed in young males. Characteristics of the ADHD patient include impulsivity, restlessness, inattention that is inappropriate for the given stage of development, and, in some, hyperactivity. Because hyperactivity is somewhat common in children, especially young males, there is a propensity to misdiagnose a youngster with ADHD, exposing the child to undue medication as a form of behavior control. The common medication to treat ADHD is Ritalin, a drug associated with:

Disrupted sleep patterns
Sadness and depression
Stomach pain
Headache
Decreased appetite
Slowed growth
Rise in blood pressure

An official cause of ADHD has yet to be determined. Chiropractic researchers hypothesize, however, that misalignment in the spine, called subluxation, may lead to hyperactivity in the autonomic nervous system, either causing or worsening ADHD. In a small-scale study, children with ADHD seemed to benefit from chiropractic care.

1. The Merck Manual. 16th ed. 1992.
2. Giesen JM, Center DB, Leach RA. An evaluation of chiropractic manipulation as a treatment of hyperactivity in children. J Manipulative Physiol Ther 1989;12:353-363.

Back pain

In a study of almost 1200 school-aged children, more than half were found to have back pain. Active adolescents who engaged in sporting activities showed the highest instance, due to excessive stress on the spine. Children and adolescents, like adults, respond well to chiropractic care for back pain. Chiropractic care offers effective, safe treatments that focus on the root cause of discomfort.

1. Troussier B, Davoine P, deGaudemaris R, Fauconnier J, Phelip X. Back pain in school children: a study among 1178 pupils. Scan J Rehabil Med 1994;26:143-146.

Headache

According to a study found in Headache, more than fifty percent of seven-year-old schoolchildren experienced headaches in a six-month period. In a study comparing chiropractic care for the treatment of headaches with amitriptyline, a common prescription medication, chiropractic adjustments were shown to provide significant reduction in the frequency and intensity of headaches. Chiropractic patients experienced a decreased need to use medication for headache relief. Additionally, over 80 percent of amitriptyline patients experienced side effects.

1. Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV. Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. J Manipulative Ther 1995;18:148-154.

Heel pain

Chronic pain in the heel is often the result of “severs disease.” This condition, often identified in children aged 8 to 13, is the result of chronic strain where the Achilles tendon attaches to the calcaneus. The focus of chiropractic care is to improve biomechanics and release any locked joints with gentle manipulation, exercise, and stretching.

Colic in infants

Infants affected by colic often cry violently for no apparent reason, and tend to experience severe flatulence, or gas. Colic typically develops in the first month of life, and resolves spontaneously after a few months. In a Danish study, 94 percent of 316 infants who received chiropractic care experienced a reduction in colic.

1. Klougart, Nilsson N, Jacobsen. Infantile colic treated by chiropractors: a prospective study of 316 cases. J Manipulative Physiol Ther 1989;12:281-288.

Knee pain

Two common conditions cause knee pain in young patients: chondromalacia patella and Osgood-Schlatter disease. Chondromalacia patella results in deep knee pain, which may be exacerbated by going up or down stairs, or by keeping the knee in a flexed state for too long. Chiropractic care, in its improvement of biomechanics and its reduction of stress on the spine and various other joints, is an excellent treatment for this condition.

Osgood-Schlatter disease leads to swelling, tenderness, and pain below the knee is due to the kneecap tendon pulling away from its attachment in the tibia. With therapeutic exercise, stretching, and manual chiropractic therapies, this condition is effectively treated. Tendon stress may also be minimized with a special support.

Otitis media

Otitis media is the scientific term for middle ear infection. This infection typically occurs because of infection in the upper respiratory system. Middle ear infection can occur in people of all ages, but is most commonly seen in youngsters between aged three or younger. Symptoms of inner ear infection include severe ear pain and fever. Patients may also experience diarrhea, nausea, and vomiting. If sudden, significant hearing loss, fever and chills, dizziness, or persistent headache occurs, immediate medical attention is needed. Standard medical treatment for otitis media is to clear infection with antibiotics. This protocol, however, is becoming more and more ineffective. Studies also suggest that the use of antibiotics actually sets a patient up for recurring infection.

Studies on the effectiveness of chiropractic care for the treatment of otitis media have returned promising results, with many children benefitting greatly from this care. One study followed five children under the age of five who had no resolution of otitis media within six months of conventional pediatric care. These children received gentle chiropractic adjustments of the cervical spine, or neck, as well as lymphatic massage. Within 3 days, the first patient experienced resolution of otitis media, and the others followed shortly. The last patient’s infection resolved within 8 weeks of regular chiropractic treatment. Each patient, however, required five or fewer chiropractic treatments to end infection, confirmed with examination using an otoscope and the elimination of fever.

When the cervical spine, or neck, is not in proper alignment, neurological compromise and muscle spasms occur. These conditions are believed to inhibit proper drainage from deep inside the ear. When drainage is insufficient, bacteria collect and flourish, causing infection. When the cervical spine is corrected, the middle ear drains efficiently and instances of otitis media decrease significantly.

1. The Merck Manual. 16th ed. 1992.
2. Fysh PN. Chronic Recurrent Otitis Media: Case Series of Five Patients with Recommendations for Case Management. J Clin Chiro Ped 1996;2:66-78.

Scoliosis

For more information on scoliosis, visit our Scoliosis section.

Scheuermann’s disease

Most commonly seen in adolescent males, Scheuermann’s disease leads to chronic back pain and a posture in which the shoulders are rounded. In Scheuermann’s disease, vertebral surfaces sustain small injuries that lead to a wedge shape in those located in the mid-back area. With regular chiropractic care, stress on the spine is reduced and biomechanics improved, resulting in decreased discomfort. Treating Scheuermann’s disease is an important proactive step in minimizing the risk of osteoarthritis in adulthood.

Spondylolisthesis

This term refers to a vertebra that sits forward compared to others. This “slipping” typically occurs in the lower back. Spondylolisthesis does not typically cause noticeable symptoms. The importance of recognizing an out-of-place vertebra is to avoid overloading the spine through sports like football or weight lifting while the spine is still maturing. Identification of this condition, and its severity, is accomplished with x-rays.

Ergonomics

Ergonomics is the scientific approach to developing everyday equipment and laying out work strategies and workstations in such a way as to protect the human form. The focus of this applied science is the reduction of emotional and physical stress and the prevention of workplace injury.

It is up to us as individuals to recognize the limitations of our own body. Injury can occur in even the best-planned ergonomic environment if excessive stress or repetitive stressors affect the body.

The Right Chair

Millions of people experience neck and back pain because of prolonged sitting. However, sitting is a fact for many of us. A specific posture should be maintained when sitting. This includes bent knees, a straight back, and centering of the head over the shoulders. While the spinal muscles may feel relaxed when we slouch forward, this posture actually causes the spinal ligaments to stretch too much. The result is neck and back pain along with other problems. Our recommendation to our patients is to keep the spine “neutral” at all times.

Choosing the right chair

The backrest of the ideal chair will incline slightly backwards. This incline will decrease the pressure on spinal discs and relax the muscles around the spine.

Lumbar support is important, and it can be added to a chair if it is not built in. Support for the lower back preserves natural curvature for ideal posture.

Armrests reduce stress on the shoulders and trapezius muscles by supporting the arms. The height of armrests should be low enough to fit beneath desks or tables while high enough to provide physical comfort.

Seat height should allow you to sit back and still have your feet touch the floor. If a chair does not meet this criteria, a footrest can be situated to accommodate height.

The seat angle should be such that comfort is achieved and the spine remains neutral. This neutral positioning may be achieved with a forward tilt, which extends the lower back.

Ergonomically speaking, it is also important to:

Maintain awareness of posture, mainly neutrality of the spine, so that slouching does not occur
Stretch regularly
Get up and move around frequently throughout the day
Use proper tools and equipment in a workspace where prolonged sitting is necessary

Adjusting Your Monitor

Several eye, neck, and back problems can be prevented by finding the most suitable monitor height for every computer you regularly use. When improperly positioned, a monitor can cause irritation to the muscles of the neck. Perpetual strain on muscles to view a poorly positioned monitor can also lead to alterations in functional spinal curvature, and can cause eyestrain and even migraines.

Monitor distance – The distance you sit from your monitor will depend on the screen size. Monitors that are 17 inches should be at least 20 inches away from the eyes to prevent eyestrain. Smaller monitors may be situated closer, and larger monitors a greater distance away from eyes.

Monitor height – The height of your monitor is important to the reduction of neck and upper back strain. To find your ideal height, sit in front of your monitor using correct posture. With your eyes closed, find your ideal neutral spine position in which your back is relaxed but upright, and your head is centered over the shoulders. When you open your eyes, notice where your eyes focus. This is where the center of your screen should be positioned.

Monitor settings – A monitor may be adjusted to the ideal brightness, contrast, and resolution, displaying content in such a way that the eyes do not have to strain to read. Settings can be adjusted based on the size of screen, the background, the lighting within your work area, your own vision, and the distance from which you read your screen.

Lighting and glare – Inadequate or ill-positioned lighting can make it difficult to view your computer screen comfortably. Moving lighting, adjusting the settings on your monitor, closing blinds, moving the monitor, changing the background color, and placing an anti-glare screen over the monitor are all solutions to improve the way you view your monitor.

Telephone Techniques

Individuals who spend extended periods using the telephone are at an increased risk of chronic pain in the neck, shoulders, and upper back. With proper habits and equipment, stress on the spine is reduced and the risk of discomfort significantly decreased.

Location of your telephone – You should be able to reach the telephone easily in your workstation without stretching, bending, or twisting.

Shoulder rests – Shoulder rest extensions easily attach to the telephone receiver, allowing the user to speak hands-free. However, it is necessary to tilt the head to one side in order to hold the receiver in place, even with a shoulder rest, resulting in stress to the supportive tissues in the neck. An alternative to a shoulder rest is a headset.

Using the speaker – Maximum flexibility is achieved with the use of a speakerphone. However, privacy and clarity may be affected using this technique. A headset provides the clarity and privacy needed for many phone conversations while protecting the natural structure of the neck.

Headsets – With a headset, the highest degree of versatility is achieved. Headsets maintain proper ergonomics while allowing the speaker to move about freely.

Writing materials – To ensure proper body position can be maintained while on the phone, it is beneficial to keep a pen and paper in a location where notes can be easily jotted down.

Workstation Setup

There are several benefits to the properly designed workspace, including increased morale and greater productivity. Ergonomics in the workspace also decreases the risk of repetitive stress injuries. Workstation setup is different for every individual because the ideal workspace is designed around the individual’s body type. When setting up the workstation, it is beneficial to consider various factors.

Space – The workspace needs to provide sufficient space in which all tasks can be comfortably accomplished. When space is insufficient, it is difficult to reach peak performance, and emotional stress may occur.

Layout – To ensure all tasks can be comfortably performed, a general floor plan that includes furniture, equipment, and accessory placement should be drawn. Items that are frequently used should be positioned to minimize twisting and strain.

Equipment – The various pieces of equipment regularly used in the workspace should be ergonomically designed to facilitate proper performance. Compatibility among equipment is also important. Lighting should be sufficient without causing a glare on computer monitors, chairs should fit beneath tables and desks, and computer monitors should be positioned for comfortable reading. Additionally, the insertion of discs into a computer should be accomplished without having to bend over beneath the desks.

Accessories – Workstations can be fully organized with the inclusion of headsets, document holders, and other accessories.

Mini-Breaks and Stretching

The effects of work stress can be diminished with small breaks taken throughout the workday. In addition to providing a mini mental-vacation, periodic breaks help to reduce the tension that develops when sitting or standing for prolonged periods. Moving around and performing specific stretches every thirty to forty minutes alleviates tension and reduces physical and emotional tension.

The exercises on this page are designed for those who work in a seated position. Each stretch should achieve a position in which a comfortable stretch is felt. Performed a few times a day, every day, these stretches can keep the body healthy and happy. Each stretch can be held for 15-30 seconds. Depending on how much time is available, stretches may be performed a few times a day.

Important note: Stretches and exercises should be performed with the recommendation of a licensed health care provider. If discomfort or pain occurs during a stretch or exercise, this practice should be stopped and medical attention received. The exercises and stretches outlined on this website are intended for patients of our Portland practice who have been advised to use them.

Basic neck stretches

The anterior neck is stretched by extending the head backwards and looking upwards. To achieve the best stretch, the mouth should be allowed to open as the head is extended. This stretch can be performed while sitting or standing.
Beginning with a neutral spine, head over shoulders; tilt the head to one side. The stretch will be felt on the opposite side of the neck. Repeat this stretch on the other side. For additional stretching, place gentle pressure on the head with a hand.
The posterior cervical muscles can be stretched by dropping the head forward, towards the chest. A greater stretch may be achieved by placing gentle pressure on the head with a hand.

Lateral torso stretch – The torso can be stretched by sitting in a chair and holding the left armrest with the right hand. Rotate the torso to the left until a comfortable stretch is achieved. Repeat on the opposite side.

Anterior torso stretch – While sitting or standing, place interconnected hands behind your head, lean back slightly and squeeze shoulder blades together.

Posterior torso stretch – While sitting toward the front edge of a chair, place your feet as far apart as necessary and lean forward from the hips. Tight back and hamstring muscles will feel this gentle stretch.

Performing these and other stretches throughout the day can minimize muscle tension.

Lifting Techniques

Learning proper lifting techniques can minimize stress on the back and decrease the risk of injury.

The squat lift is ideal when lifting most objects. Bending the knees while keeping the back relatively straight may initially feel a bit unnatural, but this posture significantly decreases stress on the lower back. The squat lift should be performed with a wide stance with feet shoulder width or farther apart. The object being lifted should be held closely.

Not every person can easily bend his or her knees. In the instance that knees cannot be fully bent, it may be necessary to bend the spine slightly. Heavy objects should not be lifted in this manner, and even lighter objects should be held very close to the torso in order to minimize stress on the spine.

The Golden Rule when it comes to lifting objects is to hold objects as closely as possible.

Heavy and repetitive lifting – Individuals who regularly lift heavy objects or lift many objects throughout the day are at an increased risk of spinal injury even when proper lifting techniques are used. Heavy objects should be lifted with assistance whenever possible. When many objects must be lifted throughout the day, care should be taken to allow the spine to rest so that fatigue does not lead to injury.

Fitness and Exercise Programs

Welcome to fitness and exercise programs!

Individuals of all ages benefit greatly from regular physical exercise. Unfortunately, only 40 percent of all Americans meet the recommendation for physical activity. Even worse, one quarter of Americans fail to engage in physical activity at all. Although there are several studies that show exercise as a main source of increased energy, the primary reason given for lack of exercise is low energy or tiredness.

Several resistance programs for beginners and intermediate exercisers are included here to help you start or spice up your current exercise routine.

Resistance training utilizes resistance in the way of nautilus equipment or free weights. This resistance increases the tone and strength of muscles and sometimes size as well. Many people think of resistance training as an activity for bodybuilders who want to gain muscle size. The truth is resistance training keeps the body fit, healthy, and strong. This form of exercise also works the cardiovascular system when the duration of rest between sets is minimized. Engaging in resistance training in this way exercises the most important of our muscles, the heart!

Note: It is important to consult us or another health care practitioner before engaging in an exercise or fitness routine, especially if a pre-existing health condition exists.

There are numerous benefits to exercise, including:

Cardiovascular health

Increased HDL
Decreased LDL
Improved heart health and strength
Increased oxygen uptake (V02 max)

Emotional health

Lowered stress
Reduction in anxiety
Improved sense of wellbeing
Increased self-confidence

Disease prevention

Reduced chance of fall injuries in older adults
Reduced instance of illness and disease
Effective prevention of diabetes

Weight management

Reduced body fat
Obesity prevention

Gains in size and strength

Increase in speed
Increased strength
Improved overall physical performance
Increase in muscle tone

Quality of life and improved function in the elderly

Extension of life
Increased mobility leads to greater independence in the elderly individual

Pregnancy

Facilitates timely delivery
Decrease in the risk of miscarriage

Midsection Training Program

For many people, the main fitness complaint is a flabby midsection. Toning the abdominals does not have to be impossible. With a consistent focus on diet and a few targeted exercises, it is possible to achieve that flat tummy you want.

Introduction

In the middle of the body is an area that reveals your normal diet and exercise habits. Most of us desire a tight, flat midsection, but few ever achieve this goal. In this section, we will provide detailed workout information to help you tone and tighten your midsection.

Lose the fat

In order to achieve toned abdominal muscles, it is first necessary to address any excess body fat in the midsection. There are many diets in existence to aid you in this initial step, as well as tips such as:

Eat several smaller meals each day rather than fewer, larger meals
Trade soda (even diet) and juice for at least 8 glasses of bottled or filtered water each day
Maintain protein intake at about 40 percent of daily calories, and limit fat to 20 percent
Avoid carbohydrates in the form of pasta and bread, eating mostly fruits and vegetables as a source of carbs

Target exercises

The three exercises included in this section are designed for the upper and lower abdominal muscles, as well as the obliques and the lateral muscles. Between the three exercises, the entire abdominal area receives the necessary attention for toning. With the cable crunches exercise, the upper region is toned. Knee rock backs focus more on the lower midsection, and alternating side crunches work the obliques, or sides.

Exercise sequence

Maximum benefit is gained when we exercise for short bursts of high intensity, also called high intensity interval training. For this reason, we recommend performing each of the listed exercises one after the other. Rest for 1 to 2 minutes and then repeat each exercise in another “giant set.” Take another 1 to 2 minute break and perform the last set. Within a fifteen-minute window, the entire workout is done. This workout can be performed twice a week. See our weekly workout routine schedule at the bottom of this page for more details.

Exercise 1 - Cable Crunches

Cable crunches are a weight resistance exercise, the only one in the midsection workout. This exercise requires the use of a cable pulley machine and a rope handle, set to a high starting point. With hands together at the top of the head, hold the rope handle firmly. Facing the weight stack, get into a kneeling position on the floor, hands still against the top of the head. To work abdominals, bend forward from the upper midsection, progressing until elbows are one-third of the way to the floor. Bending should occur near the sternum, not at the waist. Bending from the waist will work the hip flexors more than the abdominals. When leaning, pay close attention to contracting the abdominal muscles. Perform 15 repetitions at a comfortable weight. For the last few repetitions, increase weight to achieve a comfortable muscle burn.

Exercise 2 - Knee Rock-Backs

Knee rock-backs work the lower abdominal muscles. Begin by lying on your back on a clean mat or floor, knees bent. Hands go beneath the buttocks, palms against the floor. Roll the lower body upwards, bringing the knees to the chest, focusing on tightening the abdominal muscles. Lower back should lift slightly off the floor. Achieve the necessary back support by keeping arms and hands flat. Slowly return to the starting position in a controlled motion. Perform this movement 15 – 25 times.

Exercise 3 - Alternating Side Crunches

Crunches of any kind are very popular. The important note about crunches is the speed is key. Many people move so quickly through their “crunch” movements that they actually minimize the impact of the exercise because they gain too much momentum. Remember, when performing crunch exercises, slow movements reap the greatest benefit.

To perform alternating side crunches and work the obliques, lie on the floor or an abdominal bench. Place calves on a chair or bench so that a 90-degree angle is made at the hips and at the knees. Place hands behind the neck for support, interlacing the fingers. Slowly raise the upper body, beginning with the shoulders, from the floor. Gradually lift the upper back and right hip as you twist toward your left, bringing the right elbow left, toward the knee. Elbow and knee do not need to come together. The only area completely lifted off the floor will be the shoulders, stopping at the shoulder blades. Once the shoulder blades are lifted, contract the abdominal muscles and hold, counting to two. Perform the number of repetitions that achieve a comfortable burn. This will vary from person to person.

When you are performing abdominal side crunches, focus on supporting the neck so that the neck muscles do not flex. If you have neck problems or find that holding your hands behind your neck is not fully comfortable, you can try positioning hands differently. With arms crossed over the chest, the palm of each hand is placed on the opposing shoulder. This position can minimize the stress on neck muscles.

Tips

Do sit-ups rather than crunches, sit-ups work the hip flexors and they stress the neck and lower back unnecessarily.
Move in slow, controlled motions, squeezing for a count of two at the end of each repetition.
Make healthy diet choices that will complement the effort you put into working out.

Weekly Workout Schedule:

Day 1 - Chest & Biceps
Day 2 - Shoulders & Traps & Abs
Day 3 - Back & Triceps
Day 4 - Legs & Abs

Arm Training Program

With an effective training program and a healthy diet, it is possible to tone “wings” and build muscle.

Introduction

Today, men and women alike see the benefit in sporting toned, muscular arms. To what degree you build your muscles is completely up to you. Fit individuals share an appreciation for the physique they have achieved through commitment and hard work. During warm weather months, you will be glad you put focus into arm exercises such as those listed in this section.

All you need to tone and build arm muscles is commitment to a few minutes of high intensity resistance training, after which muscles are given time to recuperate. The arm exercises we have included here provide maximum benefit in a short period.

Sets and repetitions

The best practice for smaller muscles like the biceps and triceps is to perform four sets of no more than three exercises in each of these two muscles. Warm up is also important, and takes place in the way of one or two “warm up” sets using lighter weight for about 15 repetitions. For the first set of exercises, a comfortable weight should be used to allow 15 repetitions. In each subsequent set, weight will be comfortably increased, and the number of repetitions decreased. For instance, in set two you will perform 12 repetitions, set three 10, and in set four 8. Each subsequent repetition should be challenging, but doable. The weight used for these exercises will vary from one person to another. The typical range is 10 to 20 pounds.

Biceps

Our biceps enable us to flex our elbows. These muscles also work in unison with back muscles in several different movements. For this reason, back exercises should be performed carefully after a challenging bicep workout, and biceps should not be worked the same day as a back workout. Due to the size of biceps, it is beneficial to limit workouts to 2 to 3 exercises so that burnout does not occur. If the smaller muscles develop burnout, their growth may be slowed or it may not occur at all.

Exercise 1 - Standing Barbell Curls

Standing barbell curls are a powerful tool to enhance the performance of bicep muscles. This exercise has been popular for decades, and for good reason . . . it gets results! When performing barbell curls choose an appropriate weight and stand with “soft knees,” which are slightly bent. Holding barbell with straight arms, lift bar to chest using slow movement.

Exercise 2 - Preacher Barbell Curls

The preacher bench is a nautilus machine that isolates bicep muscles while keeping the body anchored against the negative force during repetitions. Motions should be controlled and constant, not too fast.

Exercise 3 - Single Arm Cable Curls

Using a cable system and the appropriate pulley handle for comfort, face the weight stack and hold the pulley in one hand, arm straight extended as if shaking someone’s hand. This 45-degree angle is natural to the bicep muscle. From here, curl upward in a slow, controlled movement.

Triceps

Tricep development has become increasingly popular amongst women, as well as men. While men may desire bulk in the various muscles of the arms, women tend to perform tricep exercises as a way to minimize the appearance of “wings.” The tricep muscle is actually larger than the bicep, and has three separate heads, which is what leads to its distinct shape.

Exercise 1 - Lying Triceps Extensions

Lying triceps extensions may be called French Curls, or even “Skull Crushers” due to the unique position required. For the safest performance of this exercise, beginners should work with a spotter who can ensure proper biomechanics. Lighter weight should also be used for easy management. During his exercise, it is important to keep the upper arm, from shoulder to elbow, perpendicular to the torso, keeping the elbows in. Due to the stress on wrists, wrist straps may be used to prevent strain.

Exercise 2 - Triceps Cable Pushdowns

This is one of the most efficient triceps exercises, and one of the most popular. Pushdowns are most comfortable when an inverted V bar is used. The form of this bar helps keep the wrists neutral and decreases the risk of injury.

Exercise 3 - Triceps Flat Bench Pushups

This type of pushup exercise is a traditional triceps dip. The difference is that weight is placed on the thighs in order to increase resistance. To maintain proper form, focus on keeping the elbows in and move slowly, never locking elbows in the straight position.

Maximize gains with the following important points:

Maintain proper form with a focus on biceps/triceps isolation. Form can be compromised when too much weight is applied or movements are too quick. Slow movements in proper form, with a focus on squeezing the isolated muscle, will produce the best result with minimal risk of injury.
Remember to keep elbows soft, not locked, and keep moving. This maintains excellent blood flow throughout the exercise and minimizes the risk of injury.
Maintain healthy eating habits that include adequate protein, fat, and carbohydrate consumption. To improve health along with muscle structure, supplementation is also recommended.

Weekly Workout Schedule:

Day 1 - Chest & Biceps
Day 2 - Shoulders & Traps & Abs
Day 3 - Back & Triceps
Day 4 - Legs & Abs

Back Training Program

Though you may not “feel” the burn of training back muscles, developing this area is important to overall physical function.

Introduction

Back muscles are not readily seen, however, the overall development of upper body physique relies on also working the muscles of the back. This area forms the most complex, and largest, muscle group of the upper body. The back muscles aid in virtually all pulling movements and many lifting movements as well. For this reason alone, it is important to keep back muscles in shape.

The back muscles

When thinking of back muscles, we most commonly think of the “lats,” or the latissimus dorsi. There are several other important muscles in the back that facilitate proper movements, including four rotator cuff muscles, the rhomboids, the posterior deltoid muscles, and the trapezius. To develop this large, complex grouping of muscles successfully takes balanced training.

A balanced approach

The various muscles in the back work together to accomplish the movements we perform daily. However, each muscle has its own unique trajectory. Therefore, a balanced training routine will include various approaches. Since the upper back muscles aid in pulling motions performed with the upper arms and shoulders, the comprehensive back workout will include such motions from different starting positions. The three exercises here accomplish this goal. In front pull-ups/pull-downs, the upper arm is over the head in starting position. Cable rows begin with the upper arm pointing forward, and dumbbell rows starting position has the upper arm hanging downward. Through these various starting points, all angles of the targeted muscles are put to work. The last exercise of this routine is designed to work the muscles of the lower back and does not incorporate pulling movements or the arms.

Pitfalls

What happens with many people performing back exercises is that there is very little “feel” with the movements. Therefore, more weight is added in order to feel the burn. The problem with adding weight to back exercises is that the biceps become involved, and stimulation to the back is actually reduced. Instead of racking up weight, practicing mindfulness is more effective at achieving injury-free results. When performing these exercises, focus should be on the contractions of back muscles, not on the arms.

Warm-up

The back exercise routine, like others, should begin with a 5 minute warm up that includes stretching. The back muscles can be stretched by holding onto a ledge or chair, bending the knees, and leaning backwards. Another way to stretch out the back muscles is to use weight resistance. Using a heavily weighted cable pull-down machine, grasp the bar while seated and hold for thirty seconds, letting the resistance elongate the back. After stretching, perform one or two warm-up sets of the listed exercises.

Exercises

Exercise one - Front pull-ups or pull-downs

These exercises focus on the lats, effectively building mass in the back. Steady gains can be maintained by switching between the two exercises, and by using various grip widths. Three sets of pull-ups should be performed to failure. For pull-downs, four sets of 8-12 reps should be performed. The focus of pull-downs is to bring the elbows back and down, squeezing the shoulder blades. To minimize biceps involvement, grip the bar with palms outward. To minimize stress on the back, keep spine straight, not arched, and move slowly.

Exercise two - Seated cable rows

Seated cable rows are excellent for developing the lats, the mid and lower trapezoids, and the rhomboids. Four sets of 8-12 repetitions should be performed. Seated at the cable row machine, knees should be bent slightly. Arms are extended forward, and back is slightly arched. The movement desired is the pulling back of the elbow, while squeezing the shoulder blades together. Throughout the exercise, the torso needs to be perpendicular to the seat, and focus should be on the back muscles.

Exercise three - Dumbbell rows

Dumbbell rows, performed in a standing position, target the middle to lower traps and the middle to lower lats. Standing with bended knees, with right foot forward, left foot back; hold a dumbbell in the left hand. Lean forward to a 90-degree angle and, with the left hand, support your body on a flat bench. The arm that holds the dumbbell should have the hand towards the floor. Begin movement by pulling the elbow of the left hand upwards and squeezing the shoulder blade inward toward the spine. As the elbow comes up, a 90-degree angle is created, with the upper arm in line with the torso. During four sets of 8-12 reps, the focus should be on the back muscles.

Exercise 4 – Hyperextensions

Most fitness centers have a piece of equipment designed for hyperextension exercises. This bench will have padding for the ankles as well as the pelvic area. Leaning forward on the flat pad, position the backs of the ankles against the padding near the floor. Cross arms across the chest and lean forward until the angle between the torso and the thighs is about 120 degrees. From this position, pull the torso up until parallel to the floor. Be careful not to extend too far, hyperextension really isn’t the goal of this muscle building exercise. Keeping the back slightly arched and moving slowly, the lower back gains strength. A word of caution . . . hyperextensions can irritate existing back problems. Individuals with a history of low back problems or an existing concern should not perform this exercise until evaluated by their chiropractor.

Tips

Remain focused only on back muscles throughout each exercise. The use of heavy weights is not necessary to get a good workout.
Maintain a slight arch in the back and pulled-back shoulders. Do not hunch.
Do not use heavy weight for bent-over rows, or any other type of heavy resistance, especially when the back is extended backwards. A back injury is not only painful, but sets you back in your fitness goals!

Weekly Workout Schedule:

Day 1 - Chest & Biceps
Day 2 - Shoulders & Traps & Abs
Day 3 - Back & Triceps
Day 4 - Legs & Abs

Chest Training Program

In order to accomplish noticeable results and avoid imbalances or injury, planning chest exercise is necessary.

Introduction

So far, we have discussed how to develop visible areas such as the midsection and the arms. It makes sense to move right into the other highly visible area, the chest. Proper development of the pectoral muscles requires specific methods and targeted exercise to accomplish the ideal shape. Additionally, where each exercise fits into the overall routine is important. If only one type of exercise is performed, imbalance in pectoral muscles can occur. The most common deficiency is noticed in the upper pectoral region, commonly seen in individuals who either do not perform incline presses or who leave them for last, when chest muscles are fatigued.

The Pectoralis muscle

Originating in the sternum and upper six ribs, the pectoralis muscle spans the mid-clavicle, or collarbone, and attaches to the lateral lip of the greater tubercle of the humerus. Why does it matter to know this? Because it helps you to understand how the pecs aid in certain movements. For instance, the pectoralis muscle is what pulls the upper arms and elbows inward, assists with rotations of the upper arm, and helps the upper arm flex forward.

The pectoralis muscle has three distinct regions that may be developed using specific exercise. Training the upper, middle, and lower areas of this muscle leads to optimal results, beginning with the weakest area, which is, for most, the upper pectoral region.

Sets and repetitions

Like other areas of the body, the chest is worked in three targeted exercises, each focusing on a particular region. Our routine is designed to start with the upper chest in an incline bench press, moving into a decline bench press and ending with flat bench flies. Before getting into the routine, a five-minute stretching session should be performed. With a 5-10 pound weight in each hand, lie on a flat bench with arms extended outwards. Let them dip towards the floor, opening up the chest. After stretching, 1 – 2 sets of warm-up exercises should be performed to prepare muscles for heavier weight. After warming up, 4 sets of these three exercises begin with 12 repetitions, then 10, then 8, then 6. With each set, weight is increased while reps are decreased. Weight should be sufficient to create a burn without causing fatigue.

Exercises

Exercise one - Incline Bench Press

The incline bench press develops what, for many of us, is the weakest region - the upper chest. Because the upper chest is typically weaker, we want to maximize our available power to develop this area. Movements should be full, slow, and controlled. During upward movements, focus should be primarily on squeezing chest muscles.

Exercise two - Decline Bench Press

In the declined position, the lower chest is developed. Additionally, the triceps get a good workout with this exercise, so it is important to keep the focus on chest muscles. To avoid strain, elbows should be kept “soft,” which prevents locking.

Exercise three - Flat Dumbbell Flys

Dumbbell flys are a great ending to a tough chest workout. This exercise isolates the pectoralis muscles through the adduction, or pulling in, of extended arms. Lying flat on a bench, palms facing forward and appropriate weight in hand extend arms forward, above the chest. Elbows should be soft. Using slow movement, lower extended arms towards the floor, keeping a slight flex in the elbow at all times. Before arms lock out, stop the downward motion and squeeze pectoralis muscles to return arms to their forward extension. Throughout this entire motion, focus on squeezing pecs together, as if holding an object with them.

Discussion

As you work through this routine, you will notice that the middle chest gets quite the workout. This is because the mid-region is activated in all three exercises. You will also notice that we do not recommend either dumbbells or barbell for these exercises. This is because the greatest amount of efficiency actually comes from alternating between the two every month or two, or whenever you want to maximize gains. The use of both dumbbells and barbells is the best way to achieve excellent results in any area of the body. It is important to note that barbells are best used when a workout partner is available to spot you so that you don’t find yourself stuck beneath a heavy weight. Safety first!

Maximize pectoralis gains with these tips:

Maintain focus on chest muscles throughout every movement, consciously minimizing biceps involvement.
Perform full movements without overdoing it. You want to feel a good stretch but, especially with heavier weight, don’t want joints to lock in a position that will strain the joints, ligaments, and supporting tissues.
Can’t make it to the gym? Perform push-ups! In a bind, push-ups provide a decent chest workout, but they do not replace a full workout with the three listed exercises.
“Maxing out” or moving to a heavier weight should ONLY be done when a spotter is available! Attempting either without a spotter, especially with a barbell, could lead to serious injury.

Weekly Workout Schedule:

Day 1 - Chest & Biceps
Day 2 - Shoulders & Traps & Abs
Day 3 - Back & Triceps
Day 4 - Legs & Abs

Women's Weight Training Program

Introduction

The female weight lifter deserves a routine designed for her specific needs. The routine we have posted looks very similar to that which a man may perform, for one simple reason: the physiology between the male and female body is almost identical, with the primary differences occurring in the reproductive systems of each. The female weight lifter, different from a male, will typically not develop the same degree of size and strength as a male lifter due to simple genetics. Specifically, the female body does not have the same hormones to induce these characteristics.

Before moving on, it is important to address a common misconception about weight lifting and the female body. Strength training exercises may tone and tighten muscles, but they will not necessarily result in the rapid and large growth of muscles to a point of looking “muscle bound.” With a well-designed program, the female weight lifter can quickly achieve her desired result.

For those who wish to “downsize,” weight lifting is an ideal way to reduce the waist and other areas, creating a leaner physique. Working against the resistance of weight, muscles tone and tighten quickly, achieving this goal.

This result is noticed in those who regularly work their abdominal muscles. Even if the overall fat content in the midsection remains stable, waist size decreases as the abs become tighter. The implementation of a moderately intense resistance routine also provides a decent cardiovascular workout, aiding in the overall fat burning process. This added burn is especially effective when only a minute or less of rest takes place in between sets. Finally, the body changes that occur with weight lifting do so in part because the additional muscle mass requires more energy to exist, thus increasing the total calories the body burns at rest. Whether you want to add a bit of muscular bulk, tone and tighten, lean out, or simply improve your overall health, weight training is an ideal path to get there.

To begin a new routine takes planning. We must discuss which exercises to do, how repetitions and sets of each, and how many days to work out each week. It is also beneficial to discuss nutrition as it relates to muscle building, even if bulk is not desired, and any other factors that will improve or inhibit the ultimate desired effect.

Repetitions

Repetitions, the number of times an exercise is performed, depends on what you wish to achieve from your workout routine. For example, as few as 4 to 6 repetitions of a given exercise may be performed in a set to maximize muscle gains and overall strength. Women seeking to achieve moderate gains, but not desiring extensive muscle growth, on the other hand, will typically perform 8 to 12 repetitions. If “just” toning is desired, 12 to 15 reps per set are ideal.

Sets

Female weight lifting experts recommend 3 to 4 sets of each exercise in a balanced routine. This recommendation is based on the personal experience of hundreds of reputable female athletes recorded over twenty years. From these women’s experiences, it has been determined that less than 3 sets of a given exercise produce very minimal results. More than 4 sets, on the other hand, can lead to burnout through excessive strain, increasing the risk of injury.

Weights

Determining your ideal weight is as simple as experimenting, keeping in mind the number of repetitions you will perform. Weight should be comfortably challenging, allowing you to complete the chosen number of reps without being too easy. Remember; use a spotter when first beginning, or when increasing weight.

Workout Schedule

How often and what days you perform your weight lifting routine is dependent on your work, family, and social obligations. Optimal results, however, are achieved when the main body parts are worked out at least once a week. A 3 or 4 day workout schedule seems to be ideal for most people, allowing a few days of rest, or days in which makeup workouts can be performed, if necessary. Rest is an important component of weight training, as muscles need time to recuperate and grow. With a 3 or 4 day workout schedule, clumping days together is advantageous for several reasons. The days you work out are completely up to you. What is important is the order in which the different areas of the body are worked out. For instance, your leg workout should be on the same workout day each week.

A typical weight training routine will last 45 minutes to an hour. This includes the warm up portion of the workout, and exercises for one major and one smaller body part. Each area worked out takes 15 to 25 minutes, depending on the number of exercises devoted to the given body part. No single body part should be exercised for more than 30 minutes. These suggestions are intended to maximize success in the gym while minimizing the risk of burnout or injury.

Warm up

If you want to get the most out of weight training, it is important to reduce the risk of injury with a proper warm up. Muscles need to be gradually introduced to their normal workout weight. A warm up routine will include a few minutes of basic stretching that focuses on each of the muscle groups that will be worked out. Each stretch should be held for 30 seconds or more, with no bouncing. Total stretch time is typically about five minutes. After stretching, two sets of a light weight exercise should be performed, including about 20 repetitions in each set. Through stretching and warm up sets, the muscles are primed to handle their normal workout weight.

Exercises

The number of exercises performed in each area of the body will depend on the size of the muscle groups or individual muscles being worked out. Smaller areas such as the triceps respond quite nicely with only two exercises, whereas larger muscle groups require three to four in order to achieve maximum gains.

Choosing exercises is extremely important, and relatively easy. Men and women have been weight lifting for decades, and several choice exercises have been proven long ago. Exercise trends may come and go, but there are numerous exercises that we know to be highly effective in producing the desired outcome while, for the most part, allowing the body to remain in a neutral position. Such exercises are included in this section.

Workout 1

Chest

8-12 or 12-15 repetitions of each of the three chest exercises can be performed in 3 or 4 sets. Dumbbell flat bench press – Ideal for full chest development, this exercise begins lying flat on the back, weights held centered on the chest. Push weights upwards, fully extending the arms. Return to starting position.

Dumbbell incline bench press – This upper chest exercise begins with a slight incline on the incline bench, weights held over the shoulders. Press upwards, extending arms fully. Return to starting position.

Flat bench dumbbell flys – Isolating the pec muscles, this exercise begins lying flat on the bench, arms out to the sides, parallel to the floor. Elbows should be soft, or slightly bent. Squeezing the pec muscles together, bring fully extended arms together. Palms should be facing each other. Return to starting position.

Tips:

Keep back flat against the bench during chest exercises. Feet can be placed on the end of the bench to aid this posture.
With each movement, focus on contracting the pec muscles.

Biceps

3-4 sets of 8-12 or 12-15 reps may be performed.

Dumbbell standing curls – Standing upright, hold weights with hands by thighs, palms facing in. As weights are slowly curled up, the wrist will rotate so that, when the arm is fully flexed, the palms will face upwards. Throughout movements, the upper arm remains near the torso.

Dumbbell preacher curls – This exercise may be performed using a special bench or a nautilus machine. Beginning with arms at a near full extension, bring weights up towards the chest. To reduce the risk of injury, keep elbows slightly bent at all times.

Tips:

Pay close attention to wrist position during curls, never allowing a backward extension.
Lift a weight that allows you to perform each movement comfortably. You never want to “throw” the weight up or use momentum as this decreases effectiveness and increases the risk of injury.

Workout 2

Back

Perform 8-12 or 12-15 reps of each exercise for 3 or 4 sets.

Wide/Close grip cable pull – Using the cable pull, attach the bar to the low point near the weight stack. Facing the weight stack, grip the bar with hands shoulder width apart, arms extended fully. Squeezing the shoulder blades together, bring the bar up to the chest area, and slowing return to starting position.

Seated cable rows – Sitting on the bench facing the weight stack, keep back straight and grip the handle. Squeeze shoulder blades together, bringing the handle to the abdomen. Hold for a count of two and return to starting position. It is important not to lean forward when performing this exercise, as this places pressure on the lower back.

Hyper-extensions – A great lower back exercise, hyper-extensions are performed on a special bench. The backs of the ankles are placed against the padded bar, keeping them in place. Lean hips against the padded base, and place hands to the side of your head. Lean forward to about a 60-degree angle. Slowly extend upwards, focusing on the lower back muscles, until the torso is parallel to the floor. It is not necessary to lift beyond this point. In fact, hyper-extending can cause injury. Caution: Hyper-extensions may not be appropriate for individuals who have had a lower back injury or problem. Consult your health care provider before performing this exercise.

Triceps

Perform 8-12 or 12-15 repetitions of each exercise for 3 – 4 sets

Standing cable pushdowns – This popular exercise is also one of the most effective. Standing facing the weight stack, push the handle downwards until arms are fully extended towards the floor. Throughout the movement, upper arms remain by your side. Return to starting position.

Seated machine pushdowns – Many gyms have a piece of equipment for this exercise. If one does not exist at your gym, the assisted pull-up machine can be used for dips, as well. Begin gripping handles of the machine with arms extended back, elbows bent. Push handles down until the elbows are extended, return to starting position.

Workout 3

Shoulders

Perform 8-12 or 12-15 repetitions of each exercise for 3 – 4 sets

Dumbbell seated presses – This exercise should be performed on a bench with a back so that the back is not hyper-extended during movements. With back against the backrest, hold weights at shoulder level, elbows out to the side. Slowly press weights upward, over the head, until arms are fully extended. Return to starting position.

Dumbbell side laterals – In standing position, hold weights at sides, palms facing in. With arms straight, elbows slightly bent, lift weights out to the side to about shoulder level.

Standing dumbbell shrugs – To work the trapezius muscles, stand with arms at sides, palms facing inward. Lift shoulders up in a shrug motion and return to starting position. Elbows and back should be kept straight throughout movement.

Legs

Perform 8-12 or 12-15 repetitions of each exercise for 3 – 4 sets

Leg presses or squats – These two exercises may be performed interchangeably, as each provides the upper leg with an excellent workout. Weighted squats begin with lifting the bar off the rack with the help of a spotter. Once the bar is comfortably on shoulders, get into a wide stance, with feet slightly outside of the shoulders. Squatting down, the head should remain looking forward and the back straight. Squat until upper legs are parallel to the floor, butt back. From the heel, press back up to starting position. The butt should not move too far backwards, nor should you lean forward to complete movement. This puts stress on the lower back. Leg presses are performed on a machine. With feet shoulder width apart on the platform, back against the backrest, bring the knees down close to the chest. Push the weighted platform out until legs are almost fully extended. Return to starting position.

Machine leg extensions – Seated at the extension machine with feet beneath roller pads, raise feet by squeezing quadriceps. Legs should be almost fully extended forward. Hold briefly and return to starting position.

Machine leg curls – Isolate the hamstring muscles lying face down on the curl machine. The backs of the ankles will be positioned beneath the roller pads. The kneecaps should be just off the edge of the bench. With comfortable weight, curl legs, bringing the feet towards the buttocks. Hold briefly and return to starting position, keeping knees slightly bent. Standing calf raises – Almost all weight lifters perform this basic exercise. Standing on the balls of your feet with back straight, raise heels as high as possible, squeezing calves. Most gyms have a machine for weighted calf raises.

Summing up

The exercises listed in this section are just a few of many that can be performed. It is fine to experiment with other effective exercises after confirming their safety and efficiency. In addition, it is important to increase weight periodically so that new muscle growth is consistent. Weight increases should take place gradually so that muscles are not overloaded but also do not become lazy. Switching up your workout routine to include barbells, will keep the body guessing and changing in all the right ways.

Weight Training for the Aging

The aging individual gains a number of positive benefits when regular exercise is performed, some of which aid in slowing the progress of aging or even reversing some of the common complaints that occur with age.

Introduction

There may be no literal fountain of youth, but aging individuals are discovering there are significant health and wellness benefits that come with resistance training. Research has shown resistance training to be a positive force in individuals even into their nineties. One study smashes the idea that an aging adult cannot engage in weight training successfully or safely. The study, found in the New England Journal of Medicine, followed 100 men and women in their eighties and nineties who would be described as “frail.” Each participant had one or more chronic illnesses, heart disease, and arthritis. After weight training for a period of 10 weeks, the mean strength of the group had increased to 120 percent. Who says grandma and grandpa can’t keep up their physique?

Generally, adults aged 20 to 30 enjoy maximum strength and muscle mass. Beginning about the age of thirty, muscle mass and size progressively decline. To slow or recover from such loss, weight training is ideal. Many older adults have been able to surpass the vigor of their youth by implementing their own resistance training routine. In addition to keeping muscles strong and lean, weight training increases flexibility and bone density, raises the metabolic rate, positively affects the cardiovascular system, builds strong connective tissues, and improves energy and vitality. Essentially, the very things we stand to lose with age can be preserved with a good workout regimen and a healthy diet.

Getting started

Safety is a priority when implementing a new workout routine. Individuals over the age of forty, as well as those who take medications, have been rather inactive, or who have a known health condition should have a consultation with their chiropractor or family physician before starting resistance training.

Reality check

As much as we may be in touch with our younger self, it is important to remember that your body is very likely not what it used to be. Many individuals have learned this the hard way, after joining a weekend sporting league after years of inactivity, or suddenly beginning a new workout routine, only to sustain an injury the first day on the field or at the gym. With age comes a decreased ability to handle physical stress, even that which may be good for us. What you were able to do even ten years ago may not be achievable right out of the gate at this time. Give yourself a break and take it slow. In time, you will reap the benefits of your new workouts.

Train smart, not hard

Ok, resistance training can be challenging, even hard, but this does not mean that jumping right into a heavy weight is appropriate. Allow yourself to begin with a comfortable weight, and take the necessary time to let your muscles recuperate as recommended. These steps will truly help you maximize gains, and will provide a dose of protection against unwanted injury.

The workout

The routine in this section addresses each of the major muscle groups. In this four-day workout week, each muscle group will be worked out one time. You may work out whatever days suit your schedule, as long as rest days remain between workouts. Also, please remember to comply with your physician’s guidelines or restrictions as you work on becoming your healthiest, fittest self.

General guidelines

Your exercise routine does not begin with loading up the weight bar; it begins with a good stretch and warm up. Stretching the major muscles groups for five minutes goes a long way in preventing injury. The warm up before your actual routine will include 1 or 2 sets of exercise using half of your normal workout weight. After stretching and the warm-up, muscles are primed and ready for training.

Determining your ideal workout weight comes with experimentation. The goal is to achieve safe movements while still stimulating the muscles. When using barbells, it is important to work out with a partner who can ensure you do not become trapped beneath a heavy bar. Sometimes, a muscle can power out, or fail, unexpectedly if it has not been active for some time. As muscles grow in size and strength, you will find that your normal weight feels lighter and lighter. This means it is time to increase the weight used.

If weight lifting is new to you, or it has been 3 months or longer since you have engaged in resistance training, begin your new regimen with 2 sets of each exercise. Each month, an additional set can be added until you are completing 4 sets of each exercise.

All it takes to achieve your goals for muscle growth and strength is commitment and some patience. Choose a weight that allows you to complete all of the recommended repetitions while providing sufficient stimulation to the muscle or muscle group. The last few reps will be more challenging than the first, but should not be exceedingly difficult. In between sets, rest for 60-90 seconds.

Cardiovascular exercise

Cardiovascular exercise is included in workouts 1 through 3, so that the heart is trained along with other muscles. Cardiovascular exercises can be completed using a number of different pieces of equipment. Excellent choices include the treadmill, stationary bike, or stair-stepper. If you have been relatively inactive for some time, cardiovascular exercise should be only 10 minutes per workout for a few weeks. Every few weeks, this type of exercise can be increased by 2 to 5 minutes until 30 minutes can be comfortably performed. Again, cardiovascular exercise should be in line with recommendations or restrictions from your physician.

The workout

Workout 1:

Chest – 2-4 sets each:
- incline presses
- decline presses
Shoulders – 2-4 sets each
- Shoulder presses
- Lateral raises
Up to 30 minutes of cardiovascular exercise

Workout 2:

Back – 2-4 sets each:
- Cable pull-downs
- Seated cable rows
Traps and Abs – 2-4 sets each
- Dumbbell shrugs
- Crunches
Up to 30 minutes of cardiovascular exercise

Workout 3:

Biceps – 2-4 sets each:
- Barbell curls
- Dumbbell curls
Triceps – 2-4 sets each:
- Close grip presses
- Cable pulldowns
Up to 30 minutes cardiovascular exercise

Workout 4

Legs – 2-4 sets each:
- Leg presses
- Leg extensions
- Leg curls
Calves and Abs – 2-4 sets each:
- Calf raises
- Crunches

Tips for injury prevention:

If you feel unsure about weight training, work with a qualified personal trainer until you gain confidence and experience. Personal trainers assist individuals in the achievement of their fitness goals, providing motivation and much-needed support during workouts.
Listen to what your body tells you. Muscle soreness may be common when first beginning a weight-training regimen. Sharp pains, painful joints, or other abnormal feelings, however, could indicate a potentially serious problem and warrant evaluation by your chiropractor or physician.
Remember the other beneficial facets of health, including diet, rest, healthy posture, a healthy spine, a positive attitude, and supplementation as needed.

Home Exercises and Stretches

The exercises and stretches found in this section are intended solely for our active patients for whom they have been specifically prescribed. If you have been prescribed stretches/exercises by your practitioner in our office, these must be performed in the exact manner demonstrated in our office.

Inactive patients or those who are not under the care of this office may view the information in this section, but do not have authorization to perform the stretches/exercises within. Note: Attempting to perform exercises/stretches that have not been prescribed and demonstrated to you can worsen an existing condition or result in serious injury. Please do not attempt to perform these stretches/exercises without specific prescription.

Back Exercises and Stretches

Range of Motion Flexion Stretch Back Extension Trunk Rotation Lateral Flexion		Standard Stretches Buttocks Calf Groin Hamstring Hip Flexors (Quads) Iliotibial Band (ITB) Piriformis Tensor Fasciae Latae (TFL)
Standard Exercises Hip Abduction Hip Adduction Hip Flexion Hip Extension Lunges Wall Squats Abdominal Crunches Oblique Crunches Leg Lifts		Stabilization Exercises Standard Bridge Dead Bug Cat Pose On All Fours Prone Extension Prone Press-ups

Range of motion: Flexion

Flexion Stretch

Position:

This stretch can be performed from a standing or seated position, with legs about shoulder width apart.

Movement:

From erect standing position, bend forward from the waist, reaching towards the floor, until the back and backs of legs feel a comfortable stretch. Hold for the specified count before returning to upright stance.

From the seated position, bend forward at the waist and lean between the legs, arms outstretched. Feel a mild stretch in the back and backs of legs as you hold for the specified count.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

IMPORTANT: If pain, numbness, tingling, or any other abnormal sensations occur during this or other stretches/exercises, stop and contact our office right away. The stretches/exercises in this section are intended for the sole use of active patients for whom they have been prescribed. Though others are permitted to view this information, they should not perform them, and have no permission to do so. Performance of the exercises/stretches found here may worsen an existing problem or result in serious injury.

Range of motion: Extension

Back Extension

Position:

This extension may be performed from a standing or kneeling position, hands on hips.

Movement:

Lean slightly backwards, slowly arching the low back. The chest will stick out and a nice stretch will be felt in the mid and low back. Hold position for the prescribed count.

Important Tips:

Individuals who are dizzy easily should use the kneeling position for this stretch.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Range of motion: Trunk rotation

Position:

You may stand or sit to perform this stretch.

Movement:

From a standing position, rotate the torso to the left, maintaining a forward-facing position in the pelvic. Hold for the specified count and return to starting position. Rotate to the right in the same way. Hold for specified count, and return to starting position.

If performed while seated, grasp the left arm of your chair with your right hand, pulling the torso to the left. Hold for the specified count and return to starting position. Next, grasp the right arm of your chair with your left hand, pulling the torso to the right. Hold for the specified count.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Soleus stretch – Bend back leg slightly as you lean forward towards the wall and bend the front knee. Feel a gentle stretch in the rear leg. Hold for specified count. Perform same stretch on opposite calf.

Gastrocnemius stretch – Keep back leg straight as you lean forward towards the wall and bend the front knee. The calf of the rear leg will gently stretch. Hold for specified count. Perform same stretch on opposite calf.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Standard Stretches: Groin

Position:

This stretch may be performed while seated on the floor or lying on your back (supine). The bottoms of feet should be together, knees out.

Movement:

From a seated position with feet together, knees to the sides, press the elbows down on the knees pushing them towards the floor. A gentle stretch will occur in the inner thigh. Hold position for the specified count.

In the supine position, place the soles of feet together, knees to the sides. Allow gravity to pull knees downward, stretching the inner thigh. Hold for the specified count.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Standard Stretches: Hamstring

Position:

This stretch may be performed from a seated or supine (on back) position.

Movement:

From a seated position, lean back slightly while holding the sides of the chair. Tighten the abdominal muscles and squeeze the buttocks to keep spine neutral. Raise feet to a height of 6-12 inches and hold for specified count before returning to starting position. Perform the prescribed number of repetitions.

On hands and knees, tuck the chin to the chest and contract abdominal muscles while arching the back upwards. Hold for specified count. Then, bring the head up to look upwards and let the abdominals hang towards the floor, achieving a reverse arch. Hold for the specified count.

Lying face down on the floor, place palms of hands on the floor near shoulders. Keeping the legs and pelvis flat against the floor, slowly push upwards, extending the torso. Keep the back and buttocks relaxed through this movement. If necessary for comfort, push off the floor with elbows instead of hands. Hold for specified count before returning to starting position.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Neck Exercises and Stretches

Flexion

Stretch

Hand Assisted

Exercises

Active Range of Motion
Gravity Resistance
Hand Resistance
Pillow Resistance

Extension

Stretch

Hand Assisted

Exercises

Active Range of Motion
Gravity Resistance
Hand Resistance
Pillow Resistance

Lateral Flexion

Stretch

Hand Assisted

Exercises

Active Range of Motion
Gravity Resistance
Hand Resistance
Pillow Resistance

Rotation

Stretch

Hand Assisted

Exercises

Active Range of Motion
Hand Resistance

Flexion

Stretch

Hand assisted:

Position:

Standing or seated.

Movement:

Tuck your chin towards your chest in a slow, controlled motion. To increase the stretch, gently press on the top of the head with one hand. This stretch will be felt in the neck and the back. Hold for specified count before relaxing. Repeat as prescribed.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Extension

Stretch

Hand assisted:

Position:

Standing or seated.

Movement:

While seated or standing, slowly look upwards, controlling the motion as your head tilts back. If comfortable, increase the stretch by gently applying pressure to the top of the head. Hold for specified count and repetitions.

Important Tip:

Individuals with balance problems or dizziness should sit while performing this stretch.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Neck exercises - Flexion

With a pillow between head and the wall, lean forehead into the pillow.

Movement:

The goal of this flexion is to contract the muscles at the front of the neck while keeping the head in a fixed position. Leaning into the pillow with the forehead, push gently until a comfortable contraction of the anterior neck muscles is reached. Hold for specified count before relaxing.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Neck Exercises – Extension

Extension exercise: Active range of motion

Position:

Standing or seated.

Movement:

While standing or seated, slowly look upwards, letting head tilt back. Hold for specified count and repetitions.

From a standing or lying position, gently press the back of the head into the pillow, increasing pressure until a comfortable contraction is reached. Hold for specified count before relaxing.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Lateral flexion

Stretch

Hand-assisted

Position:

Sit in a chair and grasp one side for support. With the other hand, apply gentle pressure to the side of the head.

Movement:

Hold right hand to right ear while seated comfortably. Slowly tilt the head to the right side, applying gentle resistance with the right hand. You will feel a gentle contraction in the left side of the neck. Hold this position for the specified count before returning to starting position. Perform the same movement in the opposite direction. Repeat as prescribed.

Slowly press head into the pillow, feeling the resistance of the wall. Increase pressure until a comfortable contraction is felt in the lateral neck muscles. Hold for the specified count before relaxing. Switch sides and repeat movement.

Important Tip:

Individuals with dizziness or balance problems should perform this exercise from the seated position.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Place a hand on the side of the head, applying gentle pressure as you turn toward the hand. There should be enough resistance to keep the head from visibly turning without causing a strain on neck muscles. Increase pressure until a comfortable contraction is achieved. Hold for specified count before relaxing. Repeat in the opposite direction. Important Note: This exercise should be performed in a seated position if you have balance problems or easily become dizzy.

*See your individualized exercise prescription for the recommended number of repetitions and sets.

Posture

Proper posture is an important part of protecting the body from excessive stress and injury. Posture is involved in the development of problems like neck and back pain or persistent headaches. This is because, when posture is poor, the ligaments and other structures that support the spine are overstretched and overworked.

Minimal effort is required to maintain proper posture, and the payoff is well worth it. Implementing proper postural habits means a reduced risk of spinal stress and, subsequently, a decreased chance of chronic pain and spinal degeneration.

Seated Posture

Proper seated posture

Ideally, we would be able to get up and move around frequently; prolonged sitting is a primary cause of neck and back pain. However, for many, sitting for long periods is necessary for some reason.

Proper seated posture includes a straight back and bent knees. The head should be centered over the torso, not in a forward, slouched position. There may be times when slouching simply feels more comfortable due to the relaxation of back muscles. However, this posture causes the spinal ligaments to stretch too far, resulting in neck and back pain, among other issues. The straight back/bent knees/centered head posture keeps the spine in “neutral” position. This is what we encourage our patients to maintain at all times.

Seat backrest – Your ideal seat backrest will have a slight backwards incline, which will decrease the stress on the spine and its individual discs.

Lumbar support – The low back needs support to keep it properly arched when seated. Many chairs have built-in lumbar support. If yours does not, supports may be purchased and placed into any chair you regularly use. Lumbar supports can even be used in the car.

Armrests – Properly positioned arms are important to reduce stress on the shoulders and trapezius muscles. Armrests should be able to fit beneath a desk or table, but remain high enough to feel comfortable.

Seat height – When seated, you should be able to sit all the way back and have your feet flat on the floor. If a seat height cannot be lowered to allow for this, a footrest may be used.

Seat angle – The seat angle should be set to a position that allows the spine to remain neutral. Neutral spine is usually achieved nicely with a forward-tilted seat angle.

To maintain proper seated posture, it is also important to:

Be mindful of posture, making a concentrated effort to avoid slouching.
Get up from your seat frequently and stretch.
Design an ergonomic workspace in which all frequently used accessories and equipment can be comfortably reached.

Standing Posture

Proper standing posture

We spend a good deal of time standing, and yet most of us do not consciously think about how to stand properly. In fact, many people do not realize the significant impact standing posture has on the back and the neck.

These general guidelines for standing will help you reduce the stress on the body and keep your back healthy and comfortable:

Keep the spine straight, not slouched to one side or the other
Avoid leaning backwards or slouching forward
Center the head over the shoulders by keeping the chin up
Stand with feet a little less than shoulder width apart
Slightly bend the knees
As often as possible, wear comfortable, flat-heeled shoes
Move around or sit down periodically to prevent fatigue and tension

Lying Posture

Proper lying posture

We spent about one-third of our lives lying down. Whether this is on the floor or sofa, or in bed, there is a proper way to lie down in order to reduce stress on the body. For some individuals, modifications to lying posture are necessary to avoid aggravating or causing pain.

Lying face down

Lying on your stomach for longer periods can place too much stress on the lower back. This position also requires excessive neck rotation, increasing the risk of arm paresthesias, dizziness, headaches, back pain, and neck pain. If you must lie on your stomach for some time, reduce stress on the back by bending one leg and the same-side arm so that 90-degree angles are created at the elbow and shoulder.

Lying face up

Most people can comfortably lie on their back. For those who have back pain or problems, placing a pillow beneath the knees can improve comfort and reduce stress on the lower back muscles. Some individuals place a towel or small pillow under the lower back area to support the spine’s natural curvature.

Lying on your side

The side position is favorable both for individuals who have back problems and for those whose spine is pain-free. It is important when lying on your side is to support the head and neck properly with an appropriate pillow. Pillow size should allow the head and neck to lie in line with the spine, not too high or too low. A pillow may be placed between the knees to keep the hips and lower back from twisting towards the mattress. The woman whose waist is smaller than her hips may find that a comfortable position is achieved by placing a pillow beneath the waist area. This keeps the spine from bending sideways.

Choosing the appropriate pillow

The right pillow makes all the difference when it comes to comfort and quality sleep, especially for individuals who have struggled with chronic headaches or neck and back problems. The pillow should support the head and neck in line with the spine. Cervical pillows are designed to achieve the neutral position, but should be chosen carefully. Many of the more inexpensive pillows (less than $20) are too rigid to accommodate the natural head and neck contours. Spending a little more on a quality pillow is worth the investment, considering how much use it will get.

Pregnancy

Throughout her pregnancy, a woman experiences a number of new sensations. She may feel excited, but may also have mixed feelings about the changes occurring in her body, which are significant. Pregnancy may also elicit questions.

The links in this section contain information on the various basic and complex pregnancy questions. We wish you a smooth and uncomplicated pregnancy and a healthy, happy baby.

Chiropractic Care

Studies have shown the benefits of routine chiropractic care for the mother-to-be. Both during and after pregnancy, chiropractic care keeps the body feeling good by reducing physical stress on the spine and joints.

Biomechanical and neuromuscular changes in pregnancy

Numerous biomechanical and neuromuscular issues are common with pregnancy. These problems respond quite well to non-invasive, gentle chiropractic treatments:

Muscles and ligaments relax with the production of the hormone relaxin
- This can lead to misalignment of joints and the spine
Weight gain
- Greater stress on pelvic and spinal ligaments
- Greater demand on the pelvic and spinal muscles, leading to fatigue
- An increase in the curve of the lower and mid back further increases stress on muscles and ligaments
- Increased stress on joints leads to misalignments
Weight distribution
- Greater stress on pelvic and spinal ligaments
- Greater demand on the pelvic and spinal muscles, leading to fatigue
- An increase in the curve of the lower and mid back further increases stress on muscles and ligaments
- Increased stress on joints leads to misalignments

The changes that occur in weight and weight distribution primarily affect the ligaments of the spine and pelvis, joints, surrounding muscles, and other supporting tissues. Through these changes, the biomechanics and curvature of the spine are altered, and increased strain occurs. The result of these stressors may be discomfort and pain.

Chiropractic care for biomechanical and neuromuscular problems

The biomechanical, ligamentous, and muscular stresses that naturally occur during pregnancy can result in uncomfortable symptoms. Fortunately, they may be safely treated with gentle chiropractic treatments using very specific techniques designed for the pregnant body.

Gentle spinal adjustments designed for the mother-to-by optimize biomechanics while decreasing fixations and misalignments of the spinal vertebrae.
- Helps to maintain healthy posture/position in the pelvis
- Improves general comfort by reducing pelvic and spinal stress
- Labor complications may be minimized when functional biomechanics is retained through chiropractic care
Therapeutic stretches and exercises for pregnancy
- Maintain a strong, balanced, pain-free spinal structure
- Help to maintain correct, neutral spinal position throughout various body changes
- Help the mother-to-be remain mobile and active
Working the soft tissues with soft tissue mobilization, trigger point work, massage, etc.
- Maintain flexible, relaxed muscles
- Reduces instances of aches and pains
- Reduces stress on the spine
Nutritional counseling specifically designed for the mother-to-be
- Maximizes baby’s health
- Helps Mom maintain her energy throughout pregnancy
- Aids in the prevention of neural tube defect, as well as other
- Enables Mom to handle better handle stress
General information on pregnancy and childbirth
- Mom has resources for all of her pregnancy questions
- Mom’s health may be improved
- The birthing process is optimized
- Baby’s health is enhanced

Frequently Asked Questions

Is it safe to have chiropractic adjustments during pregnancy?

Both Mom and fetus are safe under the care of their skilled chiropractor. Due to the increased release of the relaxin hormone during pregnancy, a chiropractor can use very gentle pressure in the correction of subluxations. The positions in which adjustments take place are also designed specifically for the pregnant body.

How frequently should I see my chiropractor throughout my pregnancy?

How often visits take place during a non-complicated pregnancy will vary from weekly to monthly. How often you see your chiropractor will largely depend on your particular concerns.

Scientific studies on chiropractic in pregnancy

Low back pain in pregnancy

In a study of lower back pain in pregnancy, researchers noted that the sacroiliac joints in the pelvis were the root cause of most instances of low back pain. This is believed to be brought on by specific changes in the biomechanics of the pelvis coupled with dramatic hormonal changes. 7 out of 10 women in this study received relief from low back pain with chiropractic manipulation.

1. Bery G, Hammar M, Moller-Nielsen J et al. Obstet and Gynecol, 72:71-75, 1988.

Textbook on Chiropractic & Pregnancy

Statistics from the office of renowned “chiropractic pediatrician” Dr. J. Fallon show that the average labor time is reduced in those who received regular chiropractic care during pregnancy. The reduction for first-time mothers was 25%. Subsequent births experienced a 33% shorter labor time.

1. Fallon J. International Chiropractic Association. 1994 - Arlington, Virginia.

Italian study on chiropractic & pregnancy

In ninety out of 120 participants of this Italian study, postpartum pain was reduced with chiropractic treatments.

Back Pain

Factors behind back pain in pregnancy

One of the most common soft tissue complaints amongst pregnant women is back pain. There are several factors involved here:

In response to excess relaxin, ligament laxity increases
Weight increases in the front of the body
Poor posture and body mechanics
Enlargement within the ribcage leads to subluxations in ribs
Mechanical pressure impinges nerves and blood vessels

Because of these various factors, spinal biomechanics become altered, soft tissue pain can develop, muscle spasms may occur, and vertebral subluxations may cause pain. Each of these conditions may be successfully treated with gentle chiropractic care.

Chiropractic Treatments

Spinal adjustments

Using safe, effective, non-invasive spinal adjustments, chiropractors manage pregnancy-related abnormalities in soft tissues. Chiropractic adjustments treat problems in the joints, ligaments, and muscles of the arms and legs, the pelvis, and the neck and back. They reduce muscle tension and spasms, reduce pain that comes from the pelvic and spinal regions, correct biomechanical issues, and allow the nervous system to work efficiently. This type of care is a safe way to improve the pregnancy experience successfully.

Soft tissue work

There are several reasons for the muscles achiness and fatigue of pregnancy. Chiropractors use a variety of soft tissue therapies such as massage, soft tissue mobilization, and trigger point therapy to maintain healthy function and relaxation within muscles.

Exercises and stretches

The pregnant body can remain mobile, strong, and flexible with therapeutic exercises and stretches. Chiropractors prescribe specific exercises and stretches to pregnant patients to aid in handling the increased physical demands that result from increased weight and the change in weight distribution. The more strength and flexibility that can be achieved, the more successful and comfortable pregnancy will be.

Postural practices and proper body mechanics

As a result of imbalanced weight distribution, improper biomechanical and postural habits tend to occur in pregnancy. These poor habits add to the natural stress on the pelvic and spinal regions, increasing irritation to soft tissues and often resulting in bouts of discomfort or pain. Chiropractic doctors teach their patients how to stand, sit, and lie in ways that support the spine. Learning these habits helps the mother-to-be maintain optimal function and minimal discomfort throughout pregnancy. See recommended postures below.

Orthopedic supports

Orthopedic supports such as orthotics for the feet or pregnancy orthopedic belts may be beneficial as the body continually changes through pregnancy.

Proper postures for the pregnant body

Proper Posture	Improper Posture
Keep the head centered over shoulders with chin up	Head and chin are in a downward position, with ears out of line with shoulders
Shoulders are slightly back and up	Shoulders are rolled slightly forward
Back is kept slightly straight by contracting abdominal muscles. No hyperextension	The pelvis tilts forward under relaxed abdominal muscles
Slightly bent knees reduces stress on the low back	Straight, locked knees place undue stress on the back
A wide stance centers weight on the feet	Weight is dispersed to the insides of feet, rather than centered

Prenatal Care

The Birthing Plan

During the prenatal period is when a birthing plan is designed. This plan is a written outline of the mother’s desires for the prenatal, birth, and postpartum periods. Each aspect of the birthing plan should be as specific and detailed as possible to achieve the desired outcome. Some of the points contained in a birthing plan include:

Caregiver
- Obstetrician
- Licensed nurse-midwife
- Occupational midwife
Complementary practitioners
- Pediatrician
- Chiropractor
- Acupuncturist
- Massage therapist
Birth setting
- Hospital
- Birthing center
- Home
Prenatal care
- Purpose of visits
- Frequency of various therapies
Prenatal testing
- Alfa-feto protein testing to rule out neural tube defects
- Amniocentesis
- CV sampling
- Non-stress test
- Various blood tests
- Ultrasound with licensed ultrasonographer
Pregnancy activity level
- In-home work
- Office or professional work
- Exercise
- Other family members
How mom feels about:
- Anesthesia during labor and delivery
- Childbirth classes
- Nursing
- C-section delivery, or vaginal birth after previous C-section
- Special testing if past the age of 30
Labor
- When do you want to leave for the hospital?
- How long do you want to labor before intervention?
- Might pitocin be necessary?
- How much monitoring will occur during labor?
- Will there be an IV of fluids or medication?
- What positions might you consider?
- How much mobility will be allowed?
- Up to what point can you eat?
- Might you need a C-section?
- Would you deliver vaginally in the instance of breech positioning?
Medications
- Anesthesia
- Epidural
- IV
Birth
- Who can be present (family, siblings)?
- Can your labor partner be present at all times?
- How long can pushing continue?
- What signs may indicate the necessity for C-section?
- Is it possible to hold the baby immediately after birth, before weighing?
- Will the doctor or midwife be present the entire time?
- How often does the doctor perform episiotomy?
Postpartum
- Will the baby remain in your room?
- Who can visit?
- What is the baby fed immediately after delivery?
- Can nursing begin immediately?
- Which pediatrician will assess the baby?
- How often will the baby be assessed?
- How long must you remain in the hospital after a vaginal birth?
- How long must you remain in the hospital after C-section?
- What types of services are available if there are complications or the baby needs special care?

1. Fallon J. TextBook on Chiropractic & Pregnancy. International Chiropractic Association. 1994 - Arlington, Virginia.

Chiropractic adjustments

Routine chiropractic care is immensely beneficial during pregnancy and the postpartum period. Spinal adjustments minimize the effects of excessive laxity in ligaments and the uneven distribution of additional weight, keeping the spine and pelvic region healthy and optimally functional.

Diet and nutrition

The health of a pregnant woman and her fetus benefit greatly from healthy eating habits and supplementation as needed. One of the services offered by chiropractic doctors is nutritional counseling, taking the confusion out of this aspect of pregnancy. In addition to making healthy dietary choices, mothers-to-be are advised to supplement the necessary vitamins and minerals, such as folic acid, to achieve optimal health and minimize the risk of neural tube defects.

Pregnancy diet and exercise require close attention in order to normalize metabolic homeostasis. During this time, an extra 300 calories is required each day.

Physical activity/exercise program

In most cases, maintaining mild to moderate physical activity throughout pregnancy is more than safe, it is very beneficial.

Kegel exercises

Kegel muscles are intended to preserve muscular tone in the pelvic floor. The muscles in this region are integral to pregnancy, labor, and delivery. Kegels should begin early in pregnancy, and be continued throughout. This practice will enable pelvic muscles to handle the bodily changes that occur during labor. Healthy pelvic muscles are also less likely to tear during delivery or develop hemorrhoids.

To perform Kegel exercises, simply contract and hold the muscles of the pelvic floor. These are the muscles used during urination.

Pregnancy exercise a safe practice

According to a study published in the American Journal of Obstetrics and Gynecology, women who regularly exercised before pregnancy could continue their practice with no negative impact to their pregnancy or to the growing fetus. The published study concluded that, judging by birth weight and ease of delivery, the healthy, well-conditioned woman can remain physically active throughout pregnancy with no adverse effects.

In the study, 42 women engaged in moderate to high-intensity strength, interval, and endurance exercise six days a week throughout pregnancy and for six weeks after delivery. Each participant had been physically active before becoming pregnant.

Results of this study included findings that women who exercised put on more weight and delivered earlier when pregnant with girls. No participants in either group, those who exercised moderately or those who performed high intensity work, experienced differences in terms of infant health, birth weight, or labor.

1. American Journal of Obstetrics and Gynecology 1998;178:280-286.

Exercise and miscarriage prevention

A study published in Epidemiology reports that healthy women who exercise during pregnancy are 40 percent less likely to miscarry a chromosomally normal fetus than their non-exercising counterparts. In this study, 346 women who had miscarried were interviewed regarding exercise and other pregnancy habits. From these interviews, it was determined that exercise such as aerobics, jogging, and swimming lead to a reduced risk of miscarriage of a fetus with normal chromosomes. Interestingly, physical activities such as working outside the home, taking care of other children, or housework did not produce a protective effect. Researchers believe the protective effect comes from the sustained activity of exercise. Other activities noted tend to be sporadic. Of the interviewed women, only 25 percent exercised while pregnant.

1. Epidemiology 1999;10:6-7, 73-75.

Athletes in pregnancy

In a case report published in The Lancet, A 33-year-old distance runner pregnant with twins maintained intense exercise throughout her pregnancy and experienced no complications with delivery. For the duration of her pregnancy, this woman ran about 66 miles each week, maintaining an exercising heart rate of 130-140 bpm. She continued this level of exercise until three days prior to labor. Researchers covering this case report cautioned women who were not active before pregnancy to be far more cautious with their pregnancy exercise.

1. The Lancet 1998;351:1182

Soft tissue work

Soft tissue mobilization, working the trigger points, and massage are all considered soft tissue work. Using various techniques, chiropractors help their pregnant patients maintain flexible, relaxed muscles, decreasing common muscle aches and pains.

Fetal Development

Stages of fetal development

Conception

Joining together, the sperm and the female ovum form a zygote in the fertilization process
Balanced hormones and a normal cycle lead to a healthy pregnancy
Gametes are normal
Fallopian tube health and ovum conduction prevents ectopic pregnancy
A well-positioned, healthy uterus receives implantation

Development of the embryo

1 ½ weeks

Embryo is fully formed

2nd week

Primitive streak

3rd week

Development of central nervous system and heart begins.
Heartbeat occurs.

4th week

1" long mass exists, containing embryo, chorion, etc.
3/8" long embryo inside the mass weighs less than a gram.
Limb buds, early eyes, outpouching from the brain.

5th week

Lips and nose begin to form.
Cerebral spinal fluid flow occurs through brain vesicles aligned with lumen of spinal cord.
Five components of the brain develop.

8th week

Development of major organs.
Embryo reaches about 4 grams in weight, 1" length
Hands and feet are formed.
Extreme reactivity to environment occurs.
Testosterone is produced in the testes.
Male embryo develops masculine traits; female does not

12th week

Embryo reaches about 2 oz., 3 ½"
Fingers and toes are visible
Well-established placenta outweighs embryo
Embryonic stage ends

Development of the fetus

14th-16th weeks

Brain development allows fetus to make irregular breathing movements, swallow, and suck

16th week

Fetus weighs about 6 oz., measures about 6 inches
Nasal septum and palate are completely closed
Heartbeat can be heard
Sex can be distinguished
Meconium forms in intestines

20th week

Fetus reaches approx. 10 oz., measures about 8 inches
Fine hair called lanugo covers entire body
Vernix Caseosa, containing antimicrobial substances as well as sebaceous material, is secreted by the fetus
Audible fetal heart beat: 120-160 bpm

24th week

Fetus weighs approx. 1.5 lbs., measures about 12 inches
Although maturing, fetus is not viable until 28 weeks

28th week

Viable, the fetus could survive outside of the womb if lungs functional
If born at this time, survival rate is 10-20 percent.
Weight is approximately 2.5 lbs. Fetus measures about 14 inches
Breech position persists until week 32

32nd week

Survival rate increases to 50% if born at this time
Head should not point downward
Approximate weight is 3.5 lbs., length is 16 inches
Red, wrinkly skin
Vernix increases while hair covering decreases

30th-34th week

Fetus and placenta are the same size

36th week

Fetus measures about 18 inches and weighs approximately 5.5 lbs.
94 percent chance of survival if born now
Fingernails cover the nail bed
Time to begin watching your weight

40th week

At full term, fetus weighs approximately 7 lbs., measures about 20 inches
Very little hair covering remains, vernix has increased substantially
Maturity best indicated by length

Complications

Potential pregnancy complications

Bell's Palsy

Bell’s Palsy is a painless condition in which the function of facial muscles becomes impaired. Affected individuals may not be able to purse the lips, close the eyes, or lower the eyebrows. In some, a loss of taste also occurs in the front two-thirds of the tongue, and pain may occur behind the ear. While no exact cause of Bell’s Palsy has been identified, a common theory is that vertebral subluxations play at least some small role in development.

A pregnant woman is three times more likely to experience Bell’s Palsy due to the increase in water retention during pregnancy and the work of facial muscles during delivery when ligamentous laxity is significant. Typically occurring in the 3rd trimester, the general presentation of this condition is waking with the inability to use muscles on one side of the face properly.

Most often, the symptoms of Bell’s Palsy improve over several weeks or months. In several studies, chiropractic care has been shown effective at producing favorable results.

Brachial neuralgia

From the cervical spine, the brachial plexus descends down each arm. The brachial plexus is a collection of nerves, which are responsible for motor and sensory innervation. Brachial neuralgia is a condition in which, due to hormonal variations, portions of the plexus may become irritated or impinged, causing radiating pain down the arm. Neck stiffness and pain may also be present. Chiropractic spinal adjustments eliminate stress on the cervical spine and can therefore effectively reduce the symptoms of this condition.

Breast cancer

The instances of breast cancer in younger women are increasing, with approximately 1 in 3,000 pregnant women facing this diagnosis. As such, breast examinations are vitally important prior to pregnancy, as well as soon after pregnancy occurs. If breast cancer is present, this will enable the establishment of a baseline.

Carpal tunnel syndrome

This condition, which is most often linked to repetitive wrist movements, can become a concern in pregnancy. The increased risk of median nerve impingement during pregnancy comes from hormone-related water retention. Symptoms of carpal tunnel syndrome include a general ache in the wrist and forearm area, as well as tingling or numbness in the hand and fingers. Inflammation that leads to carpal tunnel syndrome can be alleviated by chiropractic adjustments to the wrist and cervical areas. Symptoms have also been shown to respond favorably to supplementation with vitamin B6.

Coccydynia

At the end of the spine is the coccyx bone. We know this as the tailbone. Coccydynia is a term used to describe general pain in the tailbone area, or coccyx. Discomfort or pain in this region tends to become more prevalent in the last trimester due to the size and position of the baby. Adjustments to the coccyx can be performed by a doctor of chiropractic medicine.

Ectopic pregnancy

Ectopic pregnancy is one in which the fertilized ovum implants and begins to develop outside the uterus, usually in one of the fallopian tubes. These tubes are not expansive, and can burst as the embryo continues to develop. Symptoms of ectopic pregnancy include sharp pains or cramping in the lower abdomen. Vaginal bleeding may also occur. Ectopic pregnancy is very serious due to the potential for acute internal hemorrhaging, which could be fatal.

Risk factors of ectopic pregnancy include:

Use of an IUD prior to pregnancy
Abnormalities of fallopian tubes
Prior infection in the tubal or pelvic regions (as with some STDs)

Headaches

During pregnancy, the most common type of headache is a tension headache. This type of headache is typically the result of poor biomechanics, and responds quite well to chiropractic treatments. Fortunately, for the women who tend towards migraines, the hormones released during pregnancy counteract the typical migraine process, actually decreasing the risk of migraines for this time.

Intercostal neuralgia

During pregnancy, hormonal changes cause the various joints and ligaments to relax. This includes the joints in the rib area. At the same time, increased weight puts added stress on the rib cage. This combination can lead to irritation in the nerves that run between the ribs, the intercostal area, and rib subluxations. Gentle adjustment of the rib heads restores proper position and alleviates the irritation to nerves.

Meralgia paresthetica

The numbness and tingling that develop in the side of the upper thigh are the result of pressure against the femoral cutaneous nerve, the one responsible for sensations in the skin of this area. Added pressure comes from increased weight in the front of the body coupled with the increase in the curve of the lower back. Chiropractic care can successful alleviate this condition.

Sciatic neuralgia

As pressure on the nerves of the lower back increases, impingement may occur. When the nerves of the lower back are under too much pressure, symptoms like back and leg pain occur. Sciatica “pain” like tingling or numbness radiates down the buttock and leg or legs. Sciatica neuralgia may also result from vertebral subluxations, irritation to the lumbar facet joints, lumbar disc syndrome, or dysfunction in the sacroiliac joint. Due to the directness of treatment, chiropractic adjustments are ideal for the elimination of sciatica.

Risks of birth defects from drugs and other substances

During pregnancy, and even the time leading up to pregnancy, it is important that a woman strictly avoid the consumption of any drugs that may increase the risk of complications or birth defects. In the first weeks, while the embryo is beginning to develop, its lungs and heart are extremely sensitive to toxins like alcohol and drugs. However, other substances may also be detrimental to the growing embryo.

Adverse effects may occur with the consumption of:

Aspartame, a common artificial sweetener
Aspirin
Antibiotics
Antihistamines
Antidepressant medication
Accutane, a common acne medication
Antiepileptic medication
Caffeine
Cardiovascular medications
Tobacco
Recreational drugs such as marijuana or heroin

Toxemia – Eclampsia

There is no known cause to this potentially fatal condition that can develop during the second half of pregnancy. A common theory is that toxemia of pregnancy occurs when nutrition is severely lacking. The early stage of eclampsia, pre-eclampsia, may be detected through protein in the urine, high blood pressure, and, sometimes, excessive edema, which is swelling. Eclampsia may lead to several dangerous conditions, such as:

Tubal and kidney necrosis, or death
Uremia, or renal failure
Liver failure
Cerebral/subarachnoid hemorrhage
Epilepsy
Placental necrosis, or death of the placental tissues

Birthing process complications

Insufficient power

For labor to progress smoothly, it is essential that coordinated contractions are coupled with sufficient power. Weak contractions, or those that do not follow a set pattern, may lead to exhaustion in the mother. Ultimately, fetal distress may develop due to insufficient power or uncoordinated contractions, causing harm or necessitating a C-section. Some of the reasons contractions may be poor include:

Annular detachment
Edematous cervix
Rigid cervix
Bandl’s ring, which is constricted
Colicky uterus
Disordered uterine action

Passage obstruction

Obstructions within the cervix, uterus, or pelvis can lead to birthing complications. Common obstructions may be:

A flattened (android) pelvis with male-like tendencies
Subluxations
Fractures
Cysts
Tumors
Physiological conditions such as rickets, tuberculosis, or degenerative joint disease

Malpositioning

An uncomplicated birth requires the fetus to be in proper position. Common malpositions include: Breech presentation – When a baby is breech, his or her buttock or feet are presented first, rather than the head. 1 in 40 births are breech presentation, a malposition that can lead to serious complications such as:

Uterine rupture
Cord prolapse
Premature placental rupture
Genital edema
Disruption to internal organs
Clavicle fracture
Hip dislocation
Shoulder dislocation
Neck dislocation
Intracranial bleeding

Upside-down presentation – Approximately 13 percent of births involve this type of presentation, sometimes called “sunny-side up.” Failure to turn or turning too late may lead to a “cone head” appearance, and will result in “back labor.” With regular chiropractic care, the risk of upside-down presentation can be reduced.

Face presentation – Approximately every 3,000 births is a face presentation, in which the baby’s neck is extended and the face presents first. This type of presentation may occur due to fetal neck spasms, anencephaly, multiple fetuses, a flat pelvis, or a lax uterus. The stress of a face presentation on a newborn will typically lead to subluxation in the cervical spine. Gentle chiropractic adjustments by a chiropractor experienced with newborns greatly improves the potential for proper spinal growth.

Shoulder presentation – “shoulder first” deliveries occur in every few hundred births. This type of presentation may be due to:

A highly mobile pelvis
Unusual fetal shape
Sub-septae uterus
Mother has delivered more than three times in the past
Placental malposition causes placenta praevia, where a part of the uterus appears first
Hydramnios, excessive amniotic fluid
Twins

Delivery with forceps

Forceps-assisted delivery may occur if mother or baby is in distress, or the labor does not occur as planned. This type of delivery is carried out only when necessary due to the potential problems of forceps use, which include:

Birth marks
Brachial plexus damage
Induced torticollis, or asymmetry of the neck
Skull fracture

Cesarean section

For some time, C-section deliveries were quite popular. The current recommendation by experts is that C-section delivery occurs only when extreme distress develops in mother or baby. This recommendation is made because the surgical procedure is highly invasive, and places undue stress on the baby. Instances in which C-section may be appropriate include:

Lack of labor progression
Maternal distress
Fetal distress
Placenta praevia due to malposition of the placenta

Birthing Process

From conception to birth, an average of 38 weeks, or 266 days passes. Though physicians estimate a “due date,” only 5% of births actually occur on this date.

The 4 stages of labor:

Stage 1 – from first contractions to the full dilation of the cervix
Stage 2 – from full dilation of cervix to delivery of baby
Stage 3 – from delivery of baby to release of placenta
Stage 4 – from release of placenta to recovery after birth

Stage 1: The onset of labor to full dilation of cervix

Labor begins with the onset of uterine contractions, leading to the full dilation of the cervix, which is about 4 inches. The duration of Stage 1 is different for every woman, dependent on factors such as where the birthing process takes place (i.e. home or hospital), medications used at this time, labor induction, patients of the delivering practitioner (doctor or midwife), and condition and health of mother and fetus, and the number of previous pregnancies.

Stage 2: Full dilation to delivery of baby

Once the cervix has dilated fully, the baby is usually born within about an hour as uterine contractions increase in strength and frequency. During Stage 2 is when the urge to push occurs. For the baby, a number of passive movements occur, including flexion of the head, followed by internal rotation, neck extension, external rotation, and, finally, crowning, in which the baby’s head becomes visible.

Stage 3: Delivery of baby to release of placenta

This stage typically completes in the 10-minute period after the baby is delivered. If the placenta resists expulsion, gentle uterine massage is recommended for encouragement. The placenta should not be pulled or tugged, and should be examined after expulsion to ensure none remains inside the uterus. The retention of any part of the placenta within the uterus can cause potentially fatal hemorrhage in the mother.

Stage 4: Release of placenta to recovery after birth

After the placenta has been expelled, consistent monitoring occurs to ensure no complications or undue bleeding are experienced.

Postpartum

Caring for mother

Following delivery, the body continues to experience a great many changes as joints and bones shift, tissues return to normal size, and hormones regain normal levels. Throughout the many months of pregnancy, various stressful events occur, all of which recover exceptionally well with proper care. With chiropractic adjustments, the period in which recovery occurs can be shortened, and proper spinal and pelvic biomechanics can be restored so that future health and pregnancies are optimal.

Caring for baby

For the baby, the birthing experience is a traumatic. The birthing process involves the baby squeezing through an opening much smaller than its size, potentially causing injury undetectable to an untrained eye. Chiropractors have the training and experience to evaluate the spine and detect minor injuries that may be sustained during the birth process. When vertebral subluxations are detected and corrected, the risk of developmental problems later is reduced.

Weight loss

Weight gain, for many, is the most unwelcome change to occur in pregnancy. For some, returning to pre-pregnancy weight, or near it, seems to be a natural transition. However, this is not necessarily every woman’s experience. Implementing healthy eating habits and engaging in exercise is not only good for the mother’s physical health and weight, but also keeps energy up and helps her handle the psychological demands now placed on her. Many chiropractors provide nutritional counseling as a part of a balanced treatment program.

Nutritional requirements of the baby

To breast feed or bottle-feed

New mothers are encouraged to recognize the positive impact of breast-feeding when it comes to infant health. Numerous studies confirm the significance of breast feeding, showing a greater level of health amongst breast-fed babies as compared to those who are fed formula. Within the breast-fed group is a far lower rate of illness from disease and infection.

Breast feeding and infant illnesses

Common illnesses including ear infections, infections of the respiratory tract, gastrointestinal disorders, and pneumonia are all decreased among breast-fed infants. One study, in which mothers were encouraged, via a community service program, to breast-feed their infants, showed an increase of breast-feeding from 16.4 percent to 54.6 percent. Instances of pneumonia within the first 12 months were reduced 33 percent, and gastroenteritis experienced a 15 percent reduction. Researchers believe that these results indicate the protective value of breast milk or the breastfeeding process. The American Academy of Pediatrics encourages breastfeeding for first year of life, longer if both mother and infant prefer.

1. Pediatrics 1998;101:837-844.

How the premature infant benefits from breastfeeding

Breast milk, suggested by research, seems to contain several compounds, which aid the infant in building a strong immune system, allowing him or her to better combat infections. Researchers in one study of breast-fed preterm infants detected far fewer infections within this group. Within a group of 212 preterm infants weighing less than 3 pounds, some were fed breast milk and others formula. Making adjustments for varying factors, researchers were able to determine the breast-fed infants experienced a 57% decrease in the risk of infection. In addition, a comparison of the components of preterm mothers’ breast milk to that of full-term mothers showed that those who delivered early had a higher concentration of immune system agents than their full-term counterparts.

The American Academy of Pediatrics has promoted breast-feeding for full-term newborn infants for many years. The inclusion of premature infants occurred in 1997.

1. Pediatrics Electronic Pages 1998;102:e38.

Iron

In order to prevent iron deficiency, breast-feeding should continue for a period of twelve months after birth. In the first twelve months, cow’s milk should not be fed. The majority of baby formulas are supplemented with iron so that deficiency does not occur.

Vitamin A

Another addition found in many baby formulas is vitamin A, which comes in liquid form. If there is a suspected vitamin A deficiency, children under one year may be supplemented with a 100,000 IU dose. Children age 1 and older can be supplemented with a 200,00 IU dose. Vitamin A supplementation, if a deficiency exists, reduces that risk of measles-related death and, as suggested by a Brazilian study, provides relief from severe diarrhea.

1. Butler JC, Havens PL, Sowell AL, et.al. Measles severity and serum retinol (vitamin A) concentration among children in the United States. Pediatrics 1993;91:1176-1181.

2. Barreto ML, Santos LM, Assis AM, et. al. Effect of vitamin A supplementation on diarrhea and acute lower-respiratory tract infections in young children in Brazil. Lancet 1994;322(Jul 23):228-231.

Vitamin B

B vitamins are received in-utero, as well as through breast milk. If a deficiency exists in the mother, the fetus or baby may also become deficient. Deficiency, which is more prevalent with vegetarians or vegans, may be corrected with supplementation.

Vitamin D

Mothers who do not get sufficient sun exposure or who are vegetarian may have a vitamin D deficiency. Mothers and infants may both be given supplements of this vital vitamin. Breastfeeding mothers, as well, are encouraged to sit in the sunshine for 15 minutes a day to increase levels of vitamin D naturally.

Vitamin K

Vitamin K, which is administered via injection at birth, may be lacking in infants affected by some types of malabsorption disorders. Deficiency in vitamin K can be an underlying cause of sudden bleeding (hemorrhagic disease).

Zinc

Zinc deficiency is commonly seen in pre-term infants and those who experience malabsorption. This condition may also occur in an infant if mother has zinc deficiency, or if there is an uptake problem within the mother’s mammary glands. In mothers who are not deficient in Zinc, breastfed babies tend to have sufficient levels. Deficiency may present as anorexia, diarrhea, candida or diaper rash, irritability, stunted growth, or alopecia (baldness).

The Spine

Health Risk Assessment Portland - Spine Views

When you understand the various intricacies of the spine, you can also understand the point behind chiropractic therapies, and the reasons why such therapies are so successful in treating various conditions.

Within the complex structure of the spine lie various nerves, joints, ligaments, and muscles. These components may become irritated or may sustain injury via a number of factors, many of which are everyday stressors. Stressors like poor nutrition, lack of exercise, mental stress, bad posture, repetitive motions, and extended sitting can have a cumulative effect on the spine and its components.

Chiropractic physicians provide safe, effective, and speedy relief from a great many spinal concerns.

Spinal Column

Health Risk Assessment Portland - Spine Regions

24 vertebrae and the sacral bone make up the vertebral, or spinal, column. In addition to providing protection to the nervous system, the vertebrae also support the body and aid in mobility.

There are four areas of the spinal column, each very distinct, containing a particular number of bones in specific structural shape. These areas include the sacral bone, lumbar spine, thoracic spine, and the cervical spine. Each area of the spine achieves its rigidity or flexibility, as needed, through the structure unique to its region.

If we were to view the spine from the back, it would appear to be straight up and down. In side view, however, we see that there are actually four areas of curvature. The lumbar (lower back) and the cervical (neck) regions each have a “C” shape. The other areas, the sacral and thoracic regions, are shaped in a reverse “C.” It is through these curvatures that the body functions with proper biomechanics and stresses that can lead to discomfort and degeneration are reduced.

Chiropractors are physicians who have been trained to expert level in the evaluation and rehabilitation of the spine. Your chiropractor can identify minute spinal abnormalities. With chiropractic care, biomechanical stresses, inflammation, and pain are reduced. At the same time, health and overall quality of life are improved.

Chiropractic training and education is the only area of health care devoted to the identification and rehabilitation of disorders and problems of the spine.

Vertebrae

The spinal vertebrae

The spine is comprised of two dozen bones called vertebrae. Each is an individual functioning unit. As a collective unit, however, vertebrae work together to facilitate the various motions of the torso. Vertebrae are connected and interrelated via two facet joints and spinal discs. Vertebrae are also attached to ligaments and muscles in order to prevent movement.

As stated, one of the functions of the spinal column is to protect the nervous system, to which the spinal cord is a vital component. The spinal cord runs through the spine via the spinal canal, which is a hollow area located on the back of each vertebra. At each level of the spine, “nerve roots” leave the spinal cord and exit the spinal column through small openings called intervertebral foramen (IVF). It is in this area where nerve irritation most commonly occurs.

The misalignment or fixation of one vertebra in relation to its neighbor is called vertebral subluxation. This condition can limit range of motion, such as how far you can bend. Subluxations may also lead to muscle spasms or generalized pain, and may produce nerve interference or irritation via inflammatory biochemicals or mechanical pressure.

Chiropractic doctors are those who have been specifically educated and trained to identify and treat the slightest spinal abnormalities.

Discs

The intervertebral discs

Health Risk Assessment Portland - Disc Image

The discs that reside in between each of the vertebra in the spinal column could be described as nature’s “shock absorbers.” The intervertebral discs account for the majority of low back pain because they are the structures to sustain injury most frequently.

Disc structure

A spinal disc could be likened to a jelly doughnut due to the nucleus pulposus, a gel-like substance at the disc’s core. Around the nucleus is the annulus fibrosis, a collection of dense, fibrocartilagenous fibers that keep the nucleus in place.

Causes of disc injury

A disc may become injured if a tear or tears occur in the annular fibers. Within these fibers, there are no nerves to signal pain, which is why discs can become injured without the knowledge of the injured party.

Annular disc tears may occur due to:

Extended exposure to vibration (jackhammer operator or truck driver)
Improper techniques for lifting
Poor ergonomics in the workspace
Poor posture
Sitting for extended periods
Uncorrected spinal misalignments

Factors increasing the risk of disc injury include:

Inactive lifestyle
Obesity
Smoking
Poor nutrition

Types of disc injuries

The three common disc injuries are annular fiber tears, herniation, and disc bulge. Annular fiber tears are relatively minor because the nuclear material remains contained within the disc.

A disc herniation may occur if an annular tear extends from the inner area, near the nucleus, to the outermost region of the fiber collective. This injury allows nuclear material to escape its capsule. Outside of the disc, this material may reach the nerves of the spine and even the spinal cord.

Bulging discs are those in which hydration is lacking within the nucleus. This type of injury is more common amongst aging adults and those who sit for extended periods. Like a herniated disc, a bulging disc may impinge spinal nerves or reach the spinal cord.

Symptoms of disc injury

The presentation of disc injury symptoms is dependent on the location of tears and the extent of spinal nerve or cord involvement.

Inner annular tears typically produce no pain due to the lack of pain receptors in this area. Tears that extend to the outermost fibers may cause generalized pain that ranges from mild to excruciating. For instance, impingement due to an injured lumbar disc may cause generalized pain along with muscle spasms. If several smaller tears were to join to form one larger tear through the entire annulus, nuclear substance may escape from its capsule. If contact occurs with spinal nerves or the spinal cord, the lower extremities may become weak or experience tingling or numbness. Although rare, loss of bladder and bowel control has occurred. In such an instance, immediate medical attention is necessary to prevent permanent effects.

Treating disc injuries

Chiropractic care has been proven quite effective in the treatment of disc injuries. The success of chiropractic treatments lies in the fact that dysfunctional segments of the spine are corrected. The use of muscle relaxants, anti-inflammatory medication, and pain-reducers only mask the problem that persists without specific correction. When sensations of pain are merely masked, further injury becomes a real risk.

With chiropractic care comes the safe, fast relief from disc injuries. What’s best is that, when spinal abnormalities are corrected, results are long lasting. Chiropractic treatments are designed to restore spinal health by improving function and restoring alignment, the very factors that either prevent or lead to disc injury.

Doctors of chiropractic medicine are experts in the maintenance of spinal function through proper alignment, each of which is important in managing spinal stresses. With the proper management of spinal stresses comes a reduced risk of injury and accelerated degeneration of the discs.

Facet Joints

The facet joints

Many experts in spinal function believe the primary source of spinal discomfort and pain to be the facet joints.

At each vertebral level are two sets of facet joints, each set is responsible for articulating the vertebra to its neighboring vertebra. While the spinal discs are responsible for absorbing the force of movements, the facet joints allow vertebrae to move in relation to one another.

Due to body weight and the performance of general motion while preventing extreme movements, the facet joints carry a constant load. These joints or their fibers may become irritated or injured if excessive or repetitive motions, such as extension or rotation, are performed. Physical stress on the facet joints may also come from poor postural habits or abnormal biomechanics of the spine, thus posing an increased risk of degeneration due to wear and tear.

Facet joint stresses and abnormalities, along with other abnormalities of the spine, can be detected and treated by a chiropractic doctor. Treating such conditions leads to improved spinal health and physical comfort.

Muscles & Ligaments

The muscles and ligaments of the spine

Health Risk Assessment Portland - Spine Muscles

Attached to the vertebrae, the pelvis, and the ribs are the muscles and ligaments of the spinal region. These muscles and ligaments facilitate proper movements in the trunkal area, such as twisting or rotating, bending from side to side, and bending forward and backward. Injury to these muscles or ligaments may occur gradually or suddenly if a muscle is asked to perform beyond its capacity or excessive motion is performed.

The normal balance of the spine is upset by the presence of a strain or sprain to the spinal muscles and ligaments due to the significant alteration of alignment and biomechanics. Such alterations increase the risk of injury and degeneration in the various components of the spine, including the nerves, vertebrae, facet joints, and discs.

Through specific adjustments and rehabilitation, chiropractic doctors improve spinal health and decrease the risk of spinal imbalance. Only when the spinal muscle and ligaments are healthy is it possible to achieve proper alignment and biomechanics.

Sacroiliac Joints

Health Risk Assessment Portland - Pelvis Joints

The sacroiliac joint is another area of the spine in which a great many stresses may occur. Pain in the lower back or even in the lower extremities may occur if the actual joint surfaces or their supporting ligaments become irritated.

The two sacroiliac joints of the body are formed through the connection of two ilium bones and the sacrum, both within the pelvis. Similar to the structures in the rest of the spine, the sacroiliac joints may sustain injury via poor posture, repetition of certain movements, or direct trauma.

If the sacroiliac joints become injured or irritated, pain may develop in the lower back and may, extend down the backs of the legs. It is also common for pain to occur in the hip, knee, or ankle and foot because of increased stress on joints that occurs with improper pelvic biomechanics.

Sacroiliac problems tend to be common in pregnant women due to various hormonal factors and the physical effect of added weight. Chiropractic care is an essential part of the pregnancy plan as gentle adjustments minimize stresses on the pelvis and spine. In a study found in Obstetrics and Gynecology, it was noted that chiropractic adjustments successfully alleviated sacroiliac pain in 7 out of 10 women.

One way to identify misalignment in the pelvic region is to look at leg lengths. While lying flat on a bed or other surface, have someone compare the length of legs by observing the position of the bottoms of heels. Discrepancy between leg lengths indicates that misalignment may exist in the lower back or the pelvis.

Chiropractors may gently adjust the ilium and sacrum to restore and normalize biomechanics and sacroiliac joint positioning.

Nervous System

Control over all of the organs, tissues, and cells of the body lies within the nervous system. It is through nerves that our thoughts and cognitive skills are achieved. The endocrine system, immune system, lungs, and heart, as well, are all controlled by nerves. Essentially, the nervous system sustains life, health, and healing after an injury has been sustained.

Many people do not recognize the correlation between the spine and the nervous system, and may be surprised to learn that the nervous system is protected within the spinal column. Aside from facilitating torso movements, the primary function of the spinal column is to protect the spinal cord and its nerve roots. Were the spinal cord not encased within the components of the spine, any small injury could have devastating effects.

The spinal column makes the ideal pathway for the spinal cord and nerve roots to enter the body. This begins at the base of the brain, with the spinal cord descending downward through the hollow area of the spinal column. At each vertebral level is a small opening called an intervertebral foramen, or IVF, which nerve roots travel through after splitting from the spinal cord. The location of these IVFs makes nerve impingement possible if spinal disc injury occurs, if a disc becomes herniated or bulges, if vertebral subluxation occurs, an arthritic bony growth develops, or if inflammatory biochemicals are released in nearby tissues.

Irritation or interference of a nerve scrambles the messages and impulses that travel from the brain to the body. In some instances, only a slight alteration of signals occurs. Sometimes, however, a message or impulse is kept from its destination. The domino effect of miscommunication or failed communication is felt when the organ, tissue, or cells that depend on the impinged nerves lose their own effectiveness in completing their designated tasks, and health is impacted. In the end, the deterioration of affected tissues leads to dysfunction and disease.

In this model of disease, it is easier to understand why so many individuals who receive chiropractic care have experienced drastic improvement in various conditions not immediately associated with the spine. Some of the conditions in which improvements have been noted include low energy, menstrual pains, asthma, ear infections, ulcers, and dizziness, and these are just a few of many. While chiropractors do not claim that their treatments can eliminate every condition, it is clear that chiropractic patients often experience phenomenal results.

When nerve interference and irritation are corrected by addressing spinal abnormalities like vertebral fixations or misalignments, the body can function as intended. Only chiropractors are educated and trained to identify and treat such spinal problems.