Maintenance vs Pain Relief Care

I’ve been talking to a number of patients about this lately, so I thought it would be a good idea to share my thoughts on this. There are 2 camps of people who use chiropractic care—those who wait until they are hurting to come in, and those who come in proactively around a once a month.

Maybe I shouldn’t admit this, but I used to be someone who only came in when I was hurting. I wasn’t going to waste my money on treatment I didn’t need; I would rather use it to go skiing or golfing. This worked for me until my 30s. In my 30s my back pain, which was definitely helped by chiropractic care, seemed to occur around twice a year (snow shovelling and spring activity). It would take about 6 visits each time to clear up. I realized that I was coming in around 12 times a year—what the maintenance program was recommending anyway—it just wasn’t once a month.

Around this tipping point, life also became a little more complicated (you know…wife, kids, more yard work…) and my free time was rare. It seemed that my back flare-ups tended to occur on golf days and ski days. I was getting frustrated. So, I started getting adjustments at the once-a-month schedule and, low and behold, my recreation time was no longer interrupted! And on an even brighter note, over the year my back became stronger. Over the next 5 years small improvements added up, so I can confidently say that my back is stronger in my 40s than it was in my 20s. The adjustments became more than pain relief. It was about constantly taking stress off my spine so that my neck and back continued to heal over the long term. Now, looking back at a 10+ year journey, I can tell you that my back is stronger, less prone to injury, quicker to heal after injury, and it did not take many more adjustments than if I had only focused on pain relief.

The goal I have for myself, as well as for my patients, is to keep our backs and necks strong so we can be physically active in our 80s and 90s. This is achieved a lot more easily if we conduct maintenance care as opposed to only patchwork repair periodically. I don’t want anyone to miss a golf game, a ski day, or whatever physical activity a person loves because their back is too sore. Maintenance care works!

Written by Dr. James Mayne, DC

Arise Chiropractic, Vernon, BC

Dr. E’s Immune-Boosting Salsa & Hummus

Salsa

  • 4 medium tomatoes
  • Small handful of cilantro
  • 2-4 cloves of garlic, depending on how much you love your fellow man
  • Hot pepper of your choosing, depending on masochistic tendencies. I add one jalapeno (minimum), but I have also used one serrano, which is quite a bit hotter. Or, if you are feeling frisky, go for one habanero—what the heck. 2-3 Thai chilies also bring a nice kick.
  • 1/3 of a red onion, or more if you enjoy dreadful halitosis
  • Orange juice from ½ freshly squeezed orange balances out the chilies’ heat
  • Freshly squeezed lime juice
  • Salt and pepper to taste
  • In a food processor, carefully pulse contents below to bring salsa to your level of preferred coarseness. I like it a bit coarser, not overly pulverized.

Hummus

  • I large can chick peas
  • 1-2 cloves garlic (I know, I am a garlic fiend)
  • 1 tsp cumin powder
  • ¼ cup olive oil
  • 3-4 Tbsp sesame paste (tahini paste)
  • Freshly Squeezed lemon juice
  • Salt and pepper to taste
  • Process in food processor on high, adding a small amount of water, until hummus is blended to desired      consistency.

And there you have it—an immune-boosting snack sure to save your life and kill others around you.

Side note: Cilantro can help remove heavy metals and neurotoxins from your body as it is considered a chelating agent.  Lycopene, found in tomatoes, is an antioxidant & cancer-preventing phytonutrient.  Garlic helps lower cholesterol and regulates blood pressure, among so many other things.  And onions are a form of birth control (kidding!!).

By Dr. Elliot Lysyk, DC

Arise Chiropractic, Vernon BC

Knee, Ankle & Foot

The lower extremity has a significant impact on your ability to move within your world. A series of moving links (hip, knee and ankle joints) work cooperatively in dynamic and static states. This capacity affords us the opportunity to proficiently move, perform and pursue our passion in life. An understanding of these articulations, muscles, joints and their biomechanics should help in sustaining our quest to stay healthy and active!

Specialized sensory receptors in the body (muscles, tendons ligaments and joints) have a proprioceptive function, meaning they relay positional or spatial awareness to your brain in order to maintain upright balance. This is accomplished through a constant stream of information flowing from our body into our spine and up into our brain. Neuropathways, or somatic sensory circuits, create a sense of self as we move our body parts through space and time.

Joints

The knee joint is the largest, most complex joint in the body designed for stability. It is a modified “hinge” joint that flexes and extends with very little rotation or twisting. Stability is dependent on a complex network of thick, strong ligaments inside and outside the joint. Mobility must exist above and below the knee joint in the hip and ankle joint. If the hips are tight and stiff, the knee joint is vulnerable to excessive motion that can create wear and tear. The patella (also known as the knee cap) is the largest “sesamoid” bone in the body and glides between the two round surfaces on the femur bone with knee flexion/extension. On top of the tibia bone sits two shock-absorbing pads, called the menisci, which help to deepen the knee joint surface area in a figure-eight-like pattern. This meniscus pattern shares connections with the cruciate ligaments and assists in guiding the small amount of rotation in the knee.

The foot and ankle are key focal points of support for total body weight forces. Every day we endure concentrated forces of stress through the ankle, which acts as a shock absorber and distributes those forces into the foot. The ankle joint consists of two primary hinge-type joints, the talocrural and subtalar joints. While upright and in gravity, these joints are constantly adapting to the accommodations necessary to stand, walk, run or jump. The fibula and tibia bones from above, and the talus bone from below, form the talocrural joint, which is a hinge joint. The talus and calcaneus make up the subtalar joint. These complex movements in the human frame require intricate and subtle relationships governed by neuromuscular reflexes, provided by our nerves, spinal cord, and brain.

Ligaments

Medial Collateral Ligament (MCL): A superficial, long and flat ligament between the medial epicondyle of the femur and the tibia (4 – 7 cm); stabilizes the inside of the knee joint; resists excessive external rotation and abduction.

Medial Capsular Ligament (MCL): Deep, thick, and attaches to the medial meniscus; shares fibers of the joint capsule; resists inward or valgus stress and medial rotation; stabilizes anterior-posterior movement assisting the anterior cruciate ligament.

Lateral Collateral Ligament (LCL): A strong cord-like ligament attaching from the lateral epicondyle of the femur to the top or superior head of the fibula; does not attach to the meniscus; resists outward or external rotation of the femur on the tibia; not injured as much as the MCL due to its lack of meniscal attachment.

Anterior Cruciate Ligament (ACL): A strong intra-articular ligament that runs front-to-back (anterior to posterior); fibers are taut with straight leg; prevents the femur from moving backwards or posteriorly on the tibia.

Posterior Cruciate Ligament (PCL): An intra-articular ligament that attaches back-to-front (posterior to anterior); prevents forward movement of the tibia relative to the femur and internal rotation of the tibia

Patellar Ligament: Common tendon of quadriceps muscle inserts on tibial tuberosity

Muscles

Quadriceps: The largest muscle mass in the body: Rectus Femoris, Vastus Lateralis, Vastus Medialis, Vastus Intermedius. Its action is extension of the knee, flexion of hip (Rectus Femoris only), and tracking of Patella (Vastus Lateralis and Medialis)

Sartorius: A flexor and external rotator of hip joint and flexor of knee joint, and the longest muscle in the body

Hamstrings: Semimembranosus, Semitendinosus & Biceps Femoris. Its action is flexion of the knee, extension of hip, deceleration of leg, stability functions with knee extension

Popliteus: Small muscle that flexes the tibia and rotates it medially

Iliotibial (IT) Band: Tendinous extension of the tensor fasciae latae and gluteus maximus Gastrocnemius. The two heads (lateral and medial) insert above knee; common tendon (Achilles) insets on the calcaneus; influences knee flexion and ankle plantar flexion.

Range of Motion

Standing with both feet on the floor (Closed Kinetic Chain) with a straight or “locked knee” creates zero degrees of flexion due to ligaments, meniscus and joint capsule being tight and at maximum tension. As the knee moves into flexion, the knee “unlocks” and the femoral head and lateral condyle externally rotate slightly and the medial condyle glides or translates in the first 15-20 degrees. Rotational movement is greatest between 45-90 of knee flexion. Knee flexion (120-150 degrees) and extension or hyperextension (5-10 degrees).

Ligaments

Medial Collateral or “Deltoid” Ligament: A thick, strong triangular ligament on the medial side of ankle; from the medial malleolus above, it fans out and inserts on three ankle bones (navicular, calcaneus, talus)

Lateral collateral ligament: Three distinct ligaments (calcaneofibular, anterior/ posterior talofibular) and considerably weaker than its medial counterpart; prone to ankle “inversion” sprains

Muscles

Anterior Leg: Tibialis Anterior, Extensor Digitorium Longus, Extensor Hallucis Longus (Anterior Shin Splints)

Posterior Leg: Tibialis Posterior, Flexor Digitorum Longus, Flexor Hallucis Longus, (Posterior Shin Splints), Plantaris, Triceps Surae, Gastrocnemius (superficial and soleus/deep)

Lateral Leg: Peroneal Tertius, Peroneal Longus, Peroneal Brevis

Foot (Dorsal): Extensor Digitorum Brevis, Extensor Hallucis Brevis, Interossei

Foot (Plantar): Abductor Hallucis, Abductor Digiti Minimi, Flexor Digitorum Brevis, Quadratus Plantae, Lumbricles, Flexor Hallucis Brevis, Adductor Hallucis, Flexor Digiti Minimi Brevis, Interossei

Range of Motion

Talocrural Joint: Dorsiflexion (20-30 degrees); Plantarflexion (40-50 degrees)

Subtalar Joint: Supination or Inversion (20 degrees); Pronation or Eversion (10 degrees)

Ankle & Foot Arches

The 3 arches in the foot create support with a suspension-like capacity. The talus bone is considered the “keystone” of support in the arch of the foot. It gives us information for our balance and posture. It allows us to move with precision and power when activities demand it. Strengthening the arches must happen over time and with understanding of proper biomechanics. The 3 arches of the foot are: Medial Longitudinal Arch, Lateral Longitudinal Arch, Transverse Arch.

Squat Test

Perform a squat 5-6 times with good, upright posture (looking straight ahead, feet hip-width and parallel, using a postural grid in the background for reference. You can also take a video or picture (front and lateral views) to check for the structural dysfunctions that may occur below.

  1. Knees move inward of ankles. Right or Left
  2. Inside arch of foot collapses (pronation/Inversion) Right or Left
  3. Foot rotates laterally: Right or Left
  4. Spine flexes forward/dowel angles forward. More than 30 degrees? Y / N
  5. Pelvis shifts or translates: Right or Left
  6. Heels lift off floor: Yes / No
  7. Toes grip floor for balance: Yes / No

Key considerations while performing the squat:

  1. Knees should align vertically above ankles
  2. Inside or medial arch should be maintained. If arch flattens or pronates, this can stretch the soft tissues (plantar fascia/aponeurosis), leading to plantar fascitis or achilles tendonitis
  3. Feet should stay pointing straight ahead and not flare out
  4. Poor flexibility through the ankle and hip joints creates imbalance posteriorly and the upper body will counter-balance by leaning forward respectively.
  5. Asymmetry through old injuries or poor postural habits over the years causes the pelvis to shift laterally or side-to-side, compensating to maintain stability
  6. Tight calf muscles limit the ankle joint in dorsiflex (see #4). When stability is compromised due to body weight moving forward, intrinsic foot muscles have to work hard to resist falling forward and losing balance.

Written by Dr. Deane Studer, DC

Arise Chiropractic, Vernon

Hey, I Put Some New Shoes on and Suddenly Everything’s Right…

Earlier this summer I went for a long run on a sunny day, just after a rainfall. I had just bought an amazing new pair of running shoes.

It’s so easy to focus on the painful areas in your body when you’re running—your toes hurt, your midsole pinches, you feel that twang in your knee and the dull ache in your back. But on this day, I made it a point to bring my meditation practice into the run. Instead of letting my mind get pulled down the rabbit hole of thoughts—reliving old conversations, planning for the future, or having my mind’s attention land on the aching of my unconditioned legs–I simply held my focus on my lungs. I focused on filling them up, and on the feeling of air in my nose and mouth with each breath. I completely let go of my attention on my footfall, or anything to do with my legs at all. I held my head higher than usual, focusing my eyes on the distance and not on the road before me.

I began to feel buoyed up, almost floating, from my chest upwards. Each breath made me rise higher, expanding upwards from the top of my chest. The pain disappeared in my legs. They moved effortlessly, and my feet kind of took over, requiring no conscious attention whatsoever. All of this created an expansive feeling, like I was floating with the air, connected to my surroundings, instead of feeling the shock and thump of each footfall impact.

This is the same expansive, boundary-less experience that I often come across in meditation, where no thoughts are arising, and, even if they do, my mind is the silent witness to those thoughts. I see them from afar, as if they are a simple story line that floats along, disconnected from who I really am.  When in this state, it’s impossible to feel ‘stressed out.’ One is also less likely to feel any kind of pain, and, again, even if you do, it’s as though the pain is not who you are—it’s disconnected from you, unattached, but tolerable, and not necessarily ‘bad.’

Today, I married up my love of meditation with running. This is a whole new way of running for me. But then again, maybe it was just the new shoes.

7 Steps to Runner’s Zen

  • Focus your attention on the simple feeling of air rushing past your nostrils or through your mouth when breathing in. Count One.
  • Breathe out. Count Two.
  • If any thought arises in your mind to steal your attention, simply recognize it, and let it pass, and move back to your breath.
  • Don’t count your steps if you are running. Disregard your legs and feet altogether.
  • Focus only on counting your breaths, feeling your nostrils, and the expansive feeling in your chest when breathing in.
  • When breathing in, expand your lungs deeply, allowing this to pull you higher so you feel you are rising with each breath.
  • See how many breaths you can count before a thought steals your attention.

Enjoy your run, friends!

Written by Dr. Elliot Lysyk, DC

Arise Chiropractic, Vernon BC

Slackline Your Way to Better Balance

Dr. E demonstrates his newfound love of slacklining.

I took up slacklining last summer. My first attempt produced what I call “Elvis Leg,” where even the slightest foot pressure on the line caused my leg to shake uncontrollably. It seemed impossible, like there was no way I would ever achieve the steadiness of the slackliners I had seen practising at the beach days before.

Yet I kept at it, hoisting myself onto the line and falling off, over and over again.

Eventually, my body stabilized over my wobbly foot, and there I was—steady on the line, eyes focused far in front of me, overcome with an exhilarating feeling of balance, like the only thing in the world was the line and my body hanging in space.

I practised in 15-minute intervals a couple of times each week, and by about week four I was able to balance myself slowly along, shakily, inching forward about 25 feet before falling off. After that, I was able to turn myself around, and even move backwards.

And just like that, I was hooked.

The Benefits of Slacklining

Aside from the feelings of exhilaration and accomplishment, slacklining offers some pretty amazing health benefits.

  1. Focused attention & mindfulness ~ a rarity in this era of smartphones, devices and endless distractions.
  2. Balance ~ Try doing a yoga tree pose before slacklining, and then do one afterwards.  You’ll suddenly feel much more stable and balanced, because your body has “clicked in” to its alignment.  You’ll probably even be able to do it with your eyes closed.  Trust me.
  3. And my favourite, Kinesthesia ~ Slacklining promotes an increased awareness of your body in space. It enhances nerve-firing patterns in the ankle, knee and hip joints, which is incredibly healthy for the joints and the brain.

Inspiration

Try watching Man on Wire, a 2008 documentary about Philippe Petit’s famous (and illegal) tightrope high wire routine performed between the World Trade Towers in 1974.  It’s astounding!

How to Get Started

It’s easy! I bought my slacklining kit at True Outdoors in Vernon for about $80. It’s easy to set up and can be done anywhere. All you need are two sturdy trees, a dash of patience, and my favourite trait: tenacity.

By Dr. Elliot Lysyk, DC

The Progression of Low Back Pain

Approximately 70% of the people that come in to the clinic complain of low back pain. Low back pain can take many forms, but, in general, long-standing low back pain follows a typical plot line.

I will often hear from a patient that their low back has been bothering them, on and off, for years. It bothers them after gardening, shovelling the driveway, sports, or a similar physical activity. They will report that it is happening more frequently and lasting longer.

Now, this explanation may seem self-evident, but please allow me to explain the situation as we chiropractors see it.

The reason the low back hurts following activity is because the back is not functioning properly. There are 5 lumbar vertebrae and 2 sacro-iliac (SI) joints that must move in harmony for optimal low back movement.

The initial trauma to the back/pelvis usually starts in childhood. Anyone who has children has seen them fall off the monkey bars, wipe out on a bike, or fall on their backside skating. These little accidents initially sprain the back and pelvis and affect its movement pattern. Next we add a lifetime of ski wipeouts, car accidents, icy parking lot slips, and we get a back and pelvis with repeated small-scale trauma.

Then we sit. We sit at work, in the car; we sit to eat and watch TV. This sitting loads up the back and tightens the hip, leg and back muscles.

Now, instead of vertebrae and SI joints working in harmony when we are active, one or two of the joints do most of the movement and get sore. As the years add up, these overworked joints can become worn and arthritic. The situation builds over time. The problem becomes chronic and then even small activities can strain the back, until finally we are frustrated enough to do something about it.

This is the role of chiropractic care. We assess the level of damage to the low back, and depending on the severity of the situation, come up with a plan to get the lumbar spine and SI joints moving again in harmony. This will reduce pain, but, just as importantly, allow the low back to tolerate activity again, giving us another hike, another day skiing, another day in the garden. We have seen that the more a body moves, the longer it lasts and the more enjoyment we can get out of life.

Like I said, this is a long-term build-up, but the sooner we tackle the problem the better chance we have of making a difference. If this sounds familiar, please come in and have a physical exam and assessment. We would love to help you become more active.

Written by Dr. James Mayne, DC

Bungee Jump Your Way to the Present

I grip the handles of a bridge and peer 160 ft. down into a rocky, raging river. A stranger pokes me in the back, urging me to lean out as far as possible. I stare into the abyss, gulp deeply, and, when I hear my cue (“5-4-3-2-1…Go!”), I jump.

Just before slamming into the turbulent current, the rubbery cord catches my fall and whips me around. I release a “man-roar” of complete exhilaration.

This describes my recent experience bungee jumping in Whistler, BC—one of my many attempts at capturing the ‘aliveness’ that comes with fear. There is nothing like total fear and trust having coffee together on a sunny day. The billions of nerve fibers in my body were all screaming not to jump…and yet overcoming that resistance made me feel incredibly vital and alive.

Feeling truly present and in the moment can often mean coming to terms with fear, where any illusion of security is taken away. I definitely wasn’t thinking about taxes, the real estate market, or my to-do list. And that, my friends, is present-moment consciousness at its best!

Written by Dr. Elliot Lysyk, DC

Do you have an i-Hunch?

Did you know that forward head posture is the cause of many headaches, neck pain, and shoulder strain? This is when your neck slopes forward and downward in a hunched position.

With the increase in screen time, and all the sitting we do, there has never been a more crucial time to address poor posture. All day long people crane their necks sharply down or forward, peering at their phones—150 times per day on average!

Long-term poor posture leads to poor spinal health and degenerative joint conditions. If your head feels too heavy, you feel tired or foggy a lot, and you feel pain in your head, neck, upper back, or shoulders, you likely have poor alignment.

May is Posture Month. Make it a focus to check your posture and spinal alignment health by a qualified Chiropractor. We’re here to help you feel your best!

By Dr. Elliot Lysyk, DC

Arise Wellness Center, Vernon BC

What’s Our “Why”? Providing Drug-Free Healthcare Options

A wellness revolution is unfolding. Everyone is talking about improving their health, losing weight, eating organic, doing yoga, sleeping adequately, and wanting more energy to keep up with the kids, play golf, and meet the day’s demands pain-free.

People are seeking better options for their healthcare. They want natural solutions to their health issues. They’re tired of taking medications; they’re tired of thinking that surgery is the only option. They’re tired of side-effects and hearing alarming stories about the widespread opioid crisis. They want to prevent illness and disease and feel well.

Arise Wellness Centre was created to play a part in this demand.  This is our “Why,” our mission.

We are a large team of talented health professionals sharing the goal of enhancing our community’s well-being, naturally. We have helped thousands of people since opening in 2009, and our team has grown significantly to meet your demands.

The future of health care is patient-centered. This means that people have several health professionals helping them now; they have health teams. It’s common now for patients to simultaneously see a chiropractor, naturopath, counselor, and family doctor. As a result, t’s becoming increasingly important to ensure strong communication between all health professionals – including medical doctors. We aim to encourage this communication, and we feel that if we uphold the highest professional standards, we can break down the walls separating different health professions, so that you, the patient, can enjoy a team approach to your health.

Dr. Elliot Lysyk, DC

Arise Wellness Center, Vernon, BC

Ramping up into Spring

The sun is finally shining, we can go outside in just a shirt, the snow is off the ground and that means spring chores are here! For most of us this is a wonderful season, getting to yard work and getting the garden ready. We charge into the crisp air and sunshine, work the weekend away, hike and exercise. And then our bodies start speaking to us…stiff necks, sore backs, sciatic pain. Maybe we got a little soft over the winter months.

I am as keen as the next person to get out and put in a 10-hour day in the yard, but most of us are not ready for that yet. And while I love seeing all of my patients who didn’t need me as much in the winter, I like seeing them without severe discomfort from overdoing it in the yard.

So let’s talk about simple tips to get the body ready for spring.

First up, stretch before and after yard work. Simple stretches like touching your toes, bending side to side, and gentle twists from side to side can warm up both the neck and low back. We all have collected our favorite stretches over the years, so doing this before and after yard work is a great way to get started.

Next, limit activities. Any time we are doing one activity for more than 20-30 minutes we can create strains in unconditioned muscles. Having a plan like raking for 20 minutes, then pruning for 20 minutes, then weeding/tidying for 20 minutes breaks up an hour and creates less stress on the body. Also, it is important to check in with yourself every hour to determine if it is time to quit for the day or continue on. There is always something that is “almost finished” but somehow 2 more hours go by before we head in. There is always tomorrow or next weekend.

Third, build up slowly. Whether it is exercise or chores, we have to build up our bodies and muscles before we are ready to go full on. Generally we want to add time to our spring walking/running/yard work in small increments until we are up to our full activity level. Putting this into perspective, if at the beginning of the spring season you can handle 2 hours of waking/running/yard work a day before you start to get sore, the next day/weekend add 15-30 minutes. Then increase from there. This may not work for all activities perfectly, but gradual increases in activity from day to day or week to week will limit the severity of strains when they occur.

And despite all of this pre-thought and planning many of us still manage to overdo it on a weekend and start our week off with neck pain or low back pain and sciatica. When that occurs we are here to help. I am blessed to work with fantastic chiropractors who can put me back together if I overdo it. So hopefully you have a wonderful spring and stay strong and healthy, but if you need a little help to get the body in spring shape, please call and let us help.

Written by Dr. James Mayne, DC