When the snow starts to fly, your trusty shovel is often the only thing between you and a day spent snowed in. If used improperly, however, that same shovel could leave you with a painful (and maybe even debilitating) injury. Statistics from emergency room and primary care visits provide plenty of evidence that it happens to lots of people every year. That said, it is certainly possible to remove snow from your sidewalk and driveway safely. Here are a few techniques that will help you reduce your risk of snow shoveling injuries.
How to Reduce Your Risk of Snow Shoveling Injuries
The first thing to do when facing the cold is to make sure your body is nice and warm – warmed up, that is. Snow shoveling is an aerobic activity, so it’s wise to treat it the same way you would a jog or a swim. Walk briskly for five minutes, do 100 jumping jacks, or simply march in place. Stretch your lower back, hamstrings, and arms to make sure they’re limber and flexible. Your chiropractor can show you specific stretches that will help get your muscles and joints in shoveling shape.
Next, consider your tools. Having the right ergonomic shovel is a great help when it comes to removing stress on the spine. Choose a shovel that has a curved handle for better ergonomics. A shovel with a small, plastic blade limits the amount of weight you’ll end up lifting, reducing the risk of strain and injuries. Choose your clothing carefully as well. Good quality boots with plenty of traction will keep your feet warm and dry while reducing the risk of slipping.
Once you’re prepared, it’s time to shovel. Push the snow to the side rather than lifting it whenever possible. When you do have to lift, the key word is “straight.” Face the snow straight on, with your hips square. Bend at the knees, take on a small load, and lift with your legs while tightening your stomach muscles. Keep your back straight: don’t twist to toss the snow to the side. Instead, move your feet.
Proper pacing is another effective way to avoid injuries. If you are dealing with a foot of snow, don’t try to get all of it in a single scoop. Instead, remove it in layers from the top a few inches at a time. Take a break every fifteen minutes, or if you start to feel overworked. Stretch your arms, switch out your gloves or hat if they’ve gotten soaked, and remember to drink plenty of water.
The number one way to avoid shoveling injuries is to let something (or someone) else do the work. A snow blower is a great investment if you live in a snowy area or have lots of ground to cover. If you suffer from back pain or have a previous injury, consider hiring someone else to do the job.
If you tend to have back pain after shoveling, consider checking in with a chiropractor about it. Your chiropractor can help you identify areas where your technique could be changed for better safety and effectiveness. He or she can also suggest specific exercises and stretches that will improve your core strength and flexibility. With a little caution and know-how, you and your shovel can handle any winter challenge that comes your way.
Measuring the amount of pain being experienced by a patient is an essential part of chiropractic assessment prior to treatment. However, unlike objective measures such as the degree of spinal curvature or the range of joint movement, the amount of pain cannot be determined directly, but is instead inferred from the patient themselves or from signs usually associated with it. These two methods—patient self-reporting and inference by examination—are the basic tools chiropractors will use to assess a patient’s pain level.
While the degree of discomfort reported by a patient is an important guide, the subjective experience of pain means that each person will have a different level at which they call pain mild, moderate or extreme. Likewise, patients will all have varying degrees of verbal and physical reactions to different levels of soreness. Taken together, however, self-reporting and examination provide a combination of evidence which can be used to determine pain levels with a reasonable degree of accuracy.
Most chiropractors treating a patient will use an assessment form that asks about the kind of problem that the patient is currently experiencing and the amount of pain it is causing. A basic diagram of the body may also be used to mark locations and levels of pain. Further questions, either in the form of a questionnaire or through a patient interview, may be asked to ascertain the frequency of pain and the nature of movements and activities that may trigger pain or worsen it.
The level of perceived discomfort is often assessed using a pain scale in which the patient is asked to assign a figure to their experience such as from 0 (no pain) to 10 (extreme pain). Although such a scale will be subjective, most patients demonstrate a good deal of internal consistency when it comes to reporting relative pain levels. This means that patient-reporting using this type of pain scale can be useful in determining whether a condition is responding to treatment over time or getting worse, as well as in determining how pain levels fluctuate over the course of a day or in response to certain kinds of activity. In addition to the simple pain scale, there are several specially designed questionnaires that are also used to assess the degree of pain and disability associated with spinal injuries, such as the Quebec Back Pain Disability Scale.
Chiropractic assessment of a patient actually begins the moment the patient walks in the door. A skilled chiropractor can tell much about a condition and how much pain someone is in by their overall posture, how they walk, facial expressions of discomfort and involuntary verbalization. While being examined, palpation and movement of problem areas will often give rise to further articulation and tensing against painful movement, which provide further clues both to the location and degree of soreness. A chiropractor may use pain scales during the examination so that patients can communicate in a more focused way how much a certain movement or palpation hurts. Marking these pain levels on a chart provides a baseline measurement that a chiropractor can use to judge the effectiveness of treatment over time.
Although pain measurement is only one method of assessing both the degree of injury and success of treatment, it is an important one. Pain is both a clear sign that something is wrong and an impediment to normal daily activity. In contrast, a reduction in pain following chiropractic therapy increases feelings of wellbeing and provides subjective evidence of improvement. For the chiropractor too, this is an essential indication that they are doing something right. Together with other signs such as increased strength, range of movement and endurance, reduced pain is a welcome indicator that a patient is making progress.
For some people, whiplash symptoms can be so minor that they go away within a couple days. For others, the symptoms can become varied and chronic, ranging from severe pain to cognitive and emotional problems.
Whiplash symptoms might manifest immediately following the acceleration-deceleration accident, or they can take a few hours or days to appear. Oftentimes the exact underlying cause remains unknown for some whiplash symptoms despite today’s best diagnostic techniques. Due to the potentially high number and varied complexity of whiplash symptoms, they are sometimes collectively referred to as whiplash-associated disorders.
Common Whiplash Symptoms
Some of the most common symptoms of whiplash include:
- Neck pain. The pain could range anywhere from mild to severe. It might be located in one spot or general area, or it could also radiate down the shoulder into the arm and/or hand. Typically, neck pain from whiplash is caused by ligament sprains or muscle strains, but it can also be caused by injuries to discs, nerves, joints, and/or bones.
- Neck stiffness or reduced range of motion. Reduced neck mobility could be from pain, tightening of a muscle, or a mechanical problem, such as with a joint.
- Headache. A neck muscle tightening, or a nerve or joint of the cervical spine becoming irritated could cause headaches.
- Neck instability. This whiplash symptom commonly results from stretched or torn soft tissues, such as ligaments. Although, it could also be caused by a fracture.
- Shoulder and/or upper back pain. If the neck’s soft tissues, such as muscles or ligaments, are torn or strained during whiplash, then sometimes that pain can also be referred to other soft tissues in the upper back and shoulders.
- Radiating tingling, weakness, or numbness. Sometimes whiplash can cause one of the neck’s spinal nerve roots to become compressed or inflamed, which can lead to cervical radiculopathy symptoms of tingling, weakness, and/or numbness radiating down the shoulder, arm, hand, and/or fingers. Typically, cervical radiculopathy is only felt on one side of the body, but in rare cases, it can be felt on both sides if more than one nerve root is affected.
Anywhere from just one whiplash symptom all the way up to numerous symptoms can present at once. Symptoms can also come and go at various times.
Other Whiplash Symptoms and Associated Disorders
Other whiplash-associated disorders can include:
- Dizziness. Whiplash-related dizziness could be from neck instability or even a concussion (mild traumatic brain injury).
- Vision problems. Blurry vision or other visual deficits could result from any number of causes, including concussion or damage to a nerve. A vision problem could also contribute to dizziness.
- Emotional changes. A person might become more irritable, anxious, or even depressed. It can be hard to know if these changes are due to a concussion, post-traumatic stress syndrome, pain from the neck injury, or stress from the accident’s aftermath which could include litigation, financial worries, and/or the involvement of loved ones who were also injured.
- Ringing in ears. Also called tinnitus, this ringing or buzzing in one or both ears can range from intermittent and minor to constant and highly distracting. Any number of problems from whiplash could lead to tinnitus, such as an injury to the part of the brain that controls hearing, nerve or vascular damage, jaw injury, or even stress.
- Trouble getting good sleep. A person might find it difficult to fall asleep or stay asleep. These problems with sleeping well and waking refreshed could be due to various whiplash-related factors, such as pain, stress, or concussion.
- Fatigue. Lack of energy could be related to difficulty sleeping, depression, stress, pain, concussion, or various other causes.
- Memory and/or concentration problems. It’s possible for someone to develop cognitive symptoms after a whiplash injury. These troubles could involve difficulty with memory or thinking. Sometimes these symptoms start shortly after the injury, or they might not show up until hours or days later. Cognitive problems could be from a brain injury, or perhaps they could be related to various types of stress.
- Challenges with chewing, swallowing, or speaking. Sometimes trauma to muscles around the jaw can cause chewing or yawning to be painful.
- Difficulty swallowing. Injury to the larynx or esophagus could make swallowing painful or more difficult.
This article was written by Zinovy Meyler, DO and is shared from the following website: https://www.spine-health.com/conditions/neck-pain/whiplash-symptoms-and-associated-disorders
Are the bad ergonomics of your workplace causing you chronic back or neck pain? If so, you’re not alone. Work-related musculoskeletal disorders (WRMSDs) are one of the leading causes of occupational injuries and disability throughout the world. In the United States, WRMSDs cause over 647,000 days of lost work every year and result in workman’s compensation claims costing anywhere from $45 billion to $60 billion. They also account for 34% of all work-related injuries and illnesses. Examples of WRMSDs include chronic back and neck pain, carpal tunnel syndrome, sprains, and hernias. While you might assume that these types of injuries are the result of unrelated incidents or isolated situations playing out in many different environments across the country on any given day, there is actually a pattern. Many of them are caused by badly designed workplaces.
This pattern became evident in a study recently published in the Journal of Back and Musculoskeletal Rehabilitation. The researchers wanted to analyze the postures of workers in a high-tech medical laboratory to determine the prevalence of work-related musculoskeletal disorders and to investigate the relationship of these musculoskeletal disorders to workers’ individual factors, their work characteristics, and their working postures.
They gathered data from the medical lab technicians, using the Nordic Musculoskeletal Questionnaire (NMQ, a standardized scale for measuring musculoskeletal disorders and occupational health), the Visual Analogue Scale (VAS, a type of self-reporting measurement), and RULA (Rapid Upper Limb Assessment, a self-reported scale by which workers assess the postures that most accurately reflect their working positions). They then assessed the positions that the technicians’ lab workstations and equipment forced them to adopt for long periods of time each day and compared them with the technicians’ medical problems.
What they found was that poor lab workstation design was causing musculoskeletal problems in 73.3% of the workers. The poorer their posture was on the VAS and RULA scales, the more musculoskeletal problems they had. In addition, there was a significant difference between pre-work and post-shift reports of neck, lower back, and knee pain. In summation, the workplace design was definitely causing the WRMSDs.
There is a very real possibility that your own workplace is just as likely to put you at an increased risk of developing musculoskeletal disorders. Symptoms of WRMSDs are not limited to back and neck pain—they also include joint discomfort, muscle tightening and swelling, stiffness, and feelings of numbness or “pins and needles.”
If you or your fellow workers have noticed such symptoms, you should report them to your employer and expect that they will take steps to correct any problem-causing ergonomics. In the interim, you can take some steps on your own to protect yourself from WRMSDs. You don’t have to sit at a desk that is too high or low or in a chair that puts you in an uncomfortable and unhealthy position. Modern desks and their accompanying desk chairs have controls that can be used to lower or raise them. The same applies to computers or other equipment you use every day—you can put your monitor on top of some books so that it’s more in your line of sight or make other changes to help make your workspace more ergonomic. A good place to start looking for tips on how to improve the ergonomics of your office workspace is the Occupational Safety & Health Administration Computer Workstations guide. OSHA also has similar guides for other types of work environments.
Chiropractors know that adjustments are good for your general health. Millions of satisfied patients cannot be wrong. But what do chiropractors know that the rest of us do not?
They know the nervous system is the one system in the body that directly affects every other system. This is because nerves conduct sensory information from every part of the body and then delivers this information to the brain. Once there, the brain analyzes the information to determine what the body needs to maintain a healthy state. So the health of this system is paramount to the good health of the rest of the body.
Chiropractors recognize that misalignment in the spine can interfere with proper nervous system function. More specifically, chiropractors study the effects of vertebral subluxations – conditions of the spine where align- ment and/or movement patterns of the vertebrae are abnormal. When this occurs, imbalances cause irritation and inflammation. In turn this can cause interference with information that is transmitted along nerves and spinal cord. Chiropractors are the only health care professionals specifically trained to locate and correct spinal subluxations.
This is the principal reason why chiropractors should be called wellness doctors. Every time a chiropractor corrects a vertebral subluxation, the positive effects are felt in multiple systems simultaneously.
Where’s the Proof?
For decades, scientific research has focused on the use of chiropractic adjustments for low back pain, neck pain and headaches. In fact, there is now clear evidence to recommend chiropractors as the go-to professionals for spinal pain syndromes. However, with the rising popularity of wellness-based philosophies focused on non-traditional approaches to health, chiropractors are being asked to justify their role.
The traditional medical model of symptom-based healthcare is rapidly waning. We no longer feel we have to be sick to call upon a health professional for advice. Instead, we are focusing more on the detrimental effects stress has on our bodies, and the therapies that address the mind-body connection are getting much more attention.
In a recent report from the Center for Disease Control, the four most popular forms of alternative and complementary medicine were listed as: natural products, deep breathing, meditation and chiropractic!
People are casting their votes with their healthcare dollars and chiropractors are taking a leadership role in this new wellness model. As a profession whose core philosophy is about the optimization of the brain-body communication network, chiropractic can be viewed as a therapy with an emphasis on whole body health and wellness
Research is catching up to what chiropractors have known for years. In a recent study that reviewed all the available research to date, investigators found that “chiropractic adjustments, often for the purpose of correcting vertebral subluxation, confer measurable health benefits to people regardless of the presence or absence of symptoms.” More people are seeking what chiropractic offers: optimization of health and an improved quality of life, with a spine free of vertebral subluxations!
In a multi-nation study involving hundreds of chiropractors and thousands of chiropractic patients, researchers sought to measure the incidence of non-musculoskeletal responses to chiropractic therapy. What they found was that a number of patients experienced systemic benefits from their chiropractic treatments whether or not they mentioned any symptoms in these areas at the onset of care. The most common benefits reported in this study were breathing (27%), digestion (26%) and circulation (21%).
In yet another ground-breaking study, chiropractic adjustments were shown to actually decrease blood pressure, one of the leading causes for preventable death in North America (in relation to the incidence of heart-attacks and strokes). The study stood up to medical scrutiny and showed unequivocally that vertebral subluxations – of the upper cervical vertebra in this case – can be detrimental to the health of the individual, and not just a pain in the neck.
From these research results, chiropractors clearly have a greater role in your health and wellness than just treating sore backs. Chiropractic care should be considered an invaluable tool for you to not only help you feel well, but to also help you be well.
References and sources:
1. Dagenais S, Gay RE, Tricco AC, Freeman MD & Mayer JM. NASS Contemporary Concepts in Spine Care: Spinal Manipulation Therapy for Acute Low Back Pain. Spine Journal 2010 (Oct.); 10(10): 918-940.
2. Bronfort G, Assendelft WJJ, Evans R, Haas M & Bouter L. Efficacy of Spinal Manipulation for Chronic Headache: A Systematic Review. J Manipulative Physiol Ther 2001 (Sept.); 24(7): 457-466
3. Thiel HW & Bolton JE. Predic- tors For Immediate and Global Responses to Chiropractic Manipulation of the Cervical Spine. J Manipulative Physiol Ther 2008 (Mar.); 31(3): 172-183.
4. Barnes PM, Bloom B, Nahin R. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. CDC National Health Statistics Report #12. December 10, 2008.
5. Hannon SM. Objective Physiologic Changes and Associated Health Benefits of Chiro- practic Adjustments in Asymptom- atic Subjects: A Review of the Literature. J Vertebral Subluxation Research 2004 (Apr.): 1-9.
6. Leboeuf-Yde C, Pedersen EN, Bryner P, Cosman D, Hayek R, Meeker WC, Shaik J, Terrazas O, Tucker J & Walsh M. Self-reported Nonmusculoskeletal Responses to Chiropractic Intervention: A Multi- nation Survey. J Manipulative Physiol Ther 2005 (Jun.); 28(5): 294-302.
7. Bakris G, Dickholtz M, Meyer PM, Kravitz G, Avery E, Miller M, Brown J, Woodfield C & Bell B. Atlas Vertebra Realignment and Achievement of Arterial Pressure Goal in Hypertensive Patients: A Pilot Study. Journal of Human Hypertension 2007 (May); 21(5): 347-352.
Palpation is the most frequently used diagnostic technique in chiropractic care and is a clinical cornerstone of most physicians’ practice. It is a manual, non-invasive method of determining where a patient has structural or functional problems in the body.
In palpation, chiropractors use their hands and their detailed knowledge of anatomy to effectively see what is happening in the spine and its supporting structures, such as the muscles, tendons and ligaments. As your chiropractor palpates your spine, he or she will look for subluxations in your vertebrae, which are misalignments that may be causing pressure on spinal nerves, or other abnormalities that may be causing problems in your musculoskeletal system.
There are essentially two forms of palpation—static and motion. As the name suggests, in static palpation the patient remains still while the chiropractor palpates the spine and tissues to identify any misaligned vertebrae, protruding disks, and areas of pain or inflammation. In motion palpation however, the patients joints are mobilized, bending and flexing under the expert eye and hand of the chiropractor. He or she will move various joints through different planes, observing the patient’s range of motion and where a joint may “lock up.” They will also measure the patient’s amount of flexibility, muscle strength, stiffness, reflexes and general neurological function.
Palpation may be used at every visit to your chiropractor so they can quickly determine whether your condition has improved or not since your last visit and they can see which areas need the most care and attention. Based on what your chiropractor finds during palpation, he or she may then order additional diagnostic tests—an x-ray, MRI or CT scan, for example—to get a more detailed view of your condition.
Your chiropractor will also perform a visual examination to detect any swelling or abnormal curvature of the spine, and will observe your gait to see the coordination of your head, neck and pelvis as you move. They will also take a full medical history and ask about the location, frequency and severity of any present and past conditions.
Based on all these diagnostic tools, your chiropractor can better determine the type and frequency of treatment necessary to resolve your condition in a way that is holistic, drug-free and non-invasive. Palpation is simply another tool in the chiropractor’s arsenal of techniques to keep you moving well and pain-free.
With all of the snowy weather we have had, you may need your back palpated! Be sure to schedule an appointment with Dr. Oblander by calling 406-652-3553.
While we’ve all seen the old banana peel skit, slips and trips in the real world are no laughing matter. Simply falling to the floor or pavement from an upright position causes a great many serious injuries—and even deaths—each year. No one really knows for certain how many falls could actually be prevented, but the topic is of growing interest to a wide variety of people, from public health officials, designers, architects and community planners to business owners, workplace supervisors and employees. Senior citizens are perhaps the most at risk. The U.S. Centers for Disease Control and Prevention (CDC) presents several statistics that highlight this point:
- One out of three older adults (those aged 65 or older) falls each year, but less than half talk to their healthcare providers about it.
- Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, or head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
- Among older adults, falls are the leading cause of both fatal and nonfatal injuries. In 2010, about 21,700 older adults died from unintentional fall injuries. Over 95% of hip fractures are caused by falls. In 2010, there were 258,000 hip fractures.
- Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.
- In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized. In 2010, the direct medical cost of falls, adjusted for inflation, was $30 billion.
Walking is a very complex activity, and science has only recently begun to understand the biomechanics involved. Shirley Wang wrote in a recent Wall Street Journal article, “Scientists are finding that maintaining stability and balance with each step we take requires complex coordination of foot placement, arm movement, trunk angle and neck and head motion.” At the same time, researchers are also learning how other factors like sloping, uneven or slippery surfaces and obstructions come into play. There are many variables to consider. Even when the body’s movements are perfectly coordinated, small things about environment can still foil our best efforts to remain upright.
We know from nervous system studies that the body is capable of reacting within milliseconds. Science has shown that a person’s balance is maintained by simultaneous feedback from the body’s visual system, proprioceptive system and inner ear. If one of these systems becomes less efficient or fails altogether, then the other two can usually compensate to keep us balanced. If two fail, then balance becomes far more difficult. Aging frequently leads to poorer eyesight and troubles with the inner ear, so it’s small wonder that seniors are more likely to fall.
Canadian researchers at Simon Fraser University used video cameras in a long-term care facility to see if seniors were right about “tripping” or “slipping” being the reasons for their falls. What they found was surprising. Tripping actually accounted for only 20% of events. The nearly 3-year study of 227 falls involving 130 people showed that the single largest cause (41%) was from improper weight shifting, such as leaning over too far. This seems to indicate a failure in the seniors’ proprioceptive system.
There are a few ways you can help to prevent slips and falls. Be sure to keep walkways clear of clutter, and consider adding non-skid material to flooring—especially to floors that are more likely to become wet. Maintaining your strength helps too. Upper body strength is particularly important for catching yourself before or during a fall. Even when there’s nothing to grab onto, having the sort of upper body strength that helps you to do push-ups can soften the blow to more sensitive parts of the body. Reaching out with hands and flexing elbows upon impact can slow the fall or stop it altogether. The late Jack LaLanne, fitness guru, was still doing fingertip pushups at age 93. Don’t say it can’t be done!
Balance requires that every part of the body works well together. Dr. Oblander can help you maintain this balance by ensuring you have a healthy spine and nervous system. He can also recommend specific exercises that maintain or increase your upper body strength. So if you or someone you care about is interested in avoiding slips and falls, we can help you take advantage of the latest research! Just call or visit our office today: 406-652-3553!