Dr Lauren Hilliar

Category: Health and Wellness

  • Chiropractor meets CrossFit.

    Chiropractor meets CrossFit.

    The new year approaches and you might be setting some goals when it comes to fitness. Looking to spice it up and really challenge yourself alongside some really fun and motivated humans? Ever tried CrossFit? Oh no, I can’t do CrossFit for x, y, z reasons. Sound familiar?

    As a medical practitioner, what are my thoughts on this “cult” as some may say, or this ridiculous type of intense training? It is one thing as a chiropractor to treat cross-fitters, but to be one myself? Through personal observation, I do believe that some healthcare practitioners have a dig at CrossFit, and I have had a few patients present to me saying “my last practitioner told me to stop CrossFit,” however, their ailments weren’t even CrossFit related. Huh? I guess I’m giving myself permission to scrutinize this topic and unpack my point of view because I use to be on the fence about this “CrossFit thing” a few years ago BEFORE I had even tried it. We all make up preconceived ideas about something by what we read on the internet (including ranting blogs that have no research foundations), or by someone else’s experience, whether good or bad. All these opinions dictate our outlook on something without ever being exposed to it correctly.

    All experiences are relative. 

    So, this is my outlook of CrossFit based on the research I’ve been exposed to, and this is MY experience as a crossfitting chiropractor. I encourage you to take a moment and read on (it’s lengthy), but I do believe you’ll really learn something and gain some insight into one of the world’s fastest growing sports, and maybe even sign up and give it a try in the New Year.

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    So what is CrossFit actually? Let’s break it down for a better understanding because I don’t believe that the word “cult” should be used as a substitute for an individual’s lack of understanding of why a group of people are eager to workout together. CrossFit is high-intensity interval training coupled with resistance training, elements of powerlifting, and gymnastics. It is constantly varied, high-intensity, functional movement that aims to prepare the body for the unknown and the unknowable (Glassman, 2007). It incorporates a lot of what is already practiced in various sports or training programs, from rowing, swimming, running to squats, deadlifts, snatches and so much more; the difference: the high-intensity methods utilised (Smith et al., 2013). Basically in summary, ‘our specialty is not specializing’ (Glassman, 2007). I personally like to think of CrossFit as the kingpin of all cross-training, hence the term ‘CROSSfit’. You never do the same thing or combination of movements twice, unless you walk in, quickly peer across to the board and it reads some female name like Fran, Grace, or Annie. You know how hurricanes are named after females? Well, that gives you an indication of the havoc that is about to unfold when the countdown begins, 3…2…1… But let’s continue with the research. 

    Breaking down the definitions further, CrossFit is focused around “constantly varied, functional movements”. These are movements involving universal motor recruitment patterns, performed in a wave of contraction from core to extremity and they are compound movements, i.e. multi-joint. Basically, the best type of joint movement when performed correctly (I will get to the technique later). This type of training involves gymnastics which increases strength, suppleness, and agility (Adamson, 2007), as well as power and weightlifting. Hedrick and Wada (2008) stated that the greater skill complexity required for weightlifting exercises facilitates the development of a broader physical abilities spectrum, which is transferred to improvements in athletic performance. Furthermore, they went on to explain the numerous benefits of weightlifting including the following: Biomechanical, neuromuscular, fiber adaptions and benefits; increased lean body mass; neuroendocrine adaptions; improved balance, coordination, flexibility, and kinesthetic awareness. 

    So all this, yet CrossFit has some sort of negative stigma attached to it especially amongst healthcare practitioners. Well, it wouldn’t be fair-minded if I sat here writing about all the good stuff from a biased perspective. How about I unpack the stereotypes and “negative implications” for you; the poor technique, the overuse, the crazy intensity, and the rhabdomyolysis. Heard these attached to the word CrossFit before? Most certainly. 

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    Yes, CrossFit is high intensity which often means that movements are completed against time and frequently with heavy weights in many reps and sets. Generally, this leads to a state of fatigue, and accompanied with this, improper technique. But most certainly NOT always. Heavy lifting does require great technical skill and form due to high spinal loads (Hedrick and Wada, 2008). Therefore improper technique holds great risk for injury development, particularly to the low back ranging from strains to herniated discs (Lavallee and Balam, 2010). “You see, exactly my problem with CrossFit. Too much emphasis on getting through the workouts in a set time and not enough focus on form and technique.” Yup, I’m sure some of you were thinking along these lines. That’s okay, I use to say this too, and to some extent, still do.

    And then there is rhabdomyolysis. Rhabdomyolysis is the rapid breakdown and destruction of skeletal (moving) muscle resulting from intense athletic activity (medicine.net, 2018). The injured muscle cells subsequently leak into the circulation and cause electrolyte abnormalities and acidosis (Rathi, 2014). Insert a great deal of muscle pain, weakness, and potential hospitalisation. Sounds extreme right? However, in 2005, Glassman reported 5 cases of CrossFit induced rhabdomyolysis, FIVE, all of which made a recovery and returned to CrossFit training. Another study in 2013 (Hak, Hodzovic and Hickey) looked at the prevalence of injuries during CrossFit training where no cases of rhabdomyolysis were reported. CrossFit can be intense, yes, but so are a lot of other sports and activities. The overall risk is minimal especially if the individual understands their body limitations. 

    Now that I’ve laid out the scrutiny of the negative, I have some rhetorical questions for you. Is there any sport that is injury-free? If CrossFit is so heedless, then why do most strength and conditioning coaches, as well as Biokineticists incorporate these exact movement standards into their patient/client training programs? If you’ve been to most regular gyms lately (not CrossFit affiliated), they have a “workout of the day (WOD)” presented for regular gym-goers to challenge themselves, or training classes structured around a very similar, if not identical program design. Is this not CrossFit? Hmmm…

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    EVERY sport has flaws, and every sport has a risk of injury. Injuries are expected at any competitive level. We CANNOT prevent injury. There is no way to guarantee that. People get hurt. Accidents happen. Even the most prepared athletes can experience injury. But we CAN reduce the risk of injury by making our bodies better at adapting to stress and load. Now when it comes to CrossFit, how does one manage and reduce injury risk? Well, this is where all my negatives were disintegrated. Being part of an affiliated CrossFit box, with certified CrossFit coaches, providing high-quality program design, and implementing good technique patterns – injuries are not as common as I originally thought.

    Qualified coaches ensure that members need to be set up for functionality and success; there is injury surveillance and introspective input of how much is too much when it comes to fatigue and potential technique issues. Yes, we spoke about lifting heavy weights for many reps and sets, and the fact that fatigue sets in leading to improper technique. Thankfully CrossFit is diverse and this is not always the case, and actually never has to be either. CrossFit can be scaled meaning it can be adapted to be less intense based on a persons abilities and the presence of any incorrect movement patterns or injuries. You DO NOT HAVE to lift heavy weights. You do not have to walk on your hands or climb a rope. The beauty of CrossFit is adaptation. I read an article where one healthcare practitioner said, “There is no way inexperienced people doing this are not going to get hurt.” Yes, that is what experienced, certified CrossFit coaches are for and why people are encouraged to do CrossFit at affiliated CrossFit boxes, not regular gyms. I am inexperienced at rock climbing, hence if I rock climb without adequate guidance, I am sure I’ll come off second best. This makes logical sense. Coaches are there to guide you accordingly in this array of challenging movements. If you can’t perform a regular bodyweight squat with proper technique, you shouldn’t be using a loaded barbell, simple. But that is also not ONLY the coach’s responsibility, it is YOURS too. Get good at moving your body WELL before you move it fast and under too much load. We also have a level of responsibility when it comes to training.

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    The human body can be pushed to do UNBELIEVABLE things and CrossFit provides a platform for that to unfold. The magnitude of skill required is complex enough to humble you in one way or another. CrossFit embodies its own language from WOD, AMRAP, EMOM, RFT, The Open, bear complex, RX, scaled to Sally Up. It encourages sweat, commitment, accountability, and hard work, and it is a gathering place for like-minded individuals to be challenged, whilst having a good time. You won’t only come into the gym for training, you will enter into a fitness family. Yes, you can get injured but that is not CrossFits’ fault and it is not the coach’s fault either, that is called personal responsibility! We all have physical boundaries and limits, know them well, and be aware of them.

    If you want to take the CrossFit thing too far, that’s your choice. Trust me, your EGO will get you injured a lot quicker than CrossFit will.

    We cannot demonize a particular sport. There are MULTIPLE factors that accumulate to produce stress and injury. Don’t blame CrossFit or even regular gym for a shoulder injury when you’ve been dancing your way around poor movement patterns, poor posture, and strength imbalances for ages. 

    This is not me promoting CrossFit from the comfort of my computer screen, this is me giving you my experience from both sides of the fence, and providing you with the information you need to drastically alter your perspective. CrossFit may not be for everyone, but I doubt that’s because of your body type, as some will say, and I truly hope it isn’t because you were too proud to try. 

    The next time we find ourselves criticising something based on preconceived ideas gathered from the internet, whether it’s CrossFit or any other form of exercise or sport, let’s think again and rather experience it firsthand for ourselves, then make your decision.

    This is me, the CossFitting chiropractor, who would rather condition my body to be functionally prepared for the unknown and unknowable, than be efficient at a single joint static movement or just for the sake of trying to “look” good. 

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    Photo’s by Nick Beswick, Daniel Osch, and Tyrone Harris.

  • Sabotaging your postural health.

    Sabotaging your postural health.

    We all seem to say, “Ah I know I have bad posture,” I hear this in my practice every single day without fail. We recognise it, but we aren’t willing to do anything about it. Initially, I never understood this, if something is wrong, why don’t we try to fix it? Especially if it can be detrimental? But then as each year in practice clocked by, I have come to these conclusions:

    1. We don’t fix it because we don’t truly understand the detrimental effects of poor posture, “it can’t be all that bad, right?” Wrong. 
    2. We don’t focus on correcting it now because “that’s a problem for 10 years time.” You are potentially correct about this – it WILL be a problem in 10 years’ time.
    3. If we want to try to fix our posture, it must be fixed TODAY. “Don’t give me the effort. I don’t have time for that.” Well, you didn’t develop bad posture overnight, therefore we cannot restore good posture overnight either. 
    4. “It just costs too much to seek care to address it.” The reality is, the pain killers will cost more, or the reduced quality of life, or even the potential surgery.

    Truth is, we can make all these points valid. Life is busy, and we think that the absence of pain is the true measure of how well we’re functioning. No pain, therefore no dysfunction, and good health right? Unfortunately, this isn’t the case.

    “Health is not about how you feel, it is about how well you’re functioning.”

    The physical feeling of a disease or niggle may have spent ages manifesting and you weren’t even aware of it. Here’s a simple example; in as many as 50% of cases of cardiovascular disease, the first symptom is either a heart attack or death – that is a pretty alarming fact. We may feel fine, but our bodies may not be functioning effectively. This refers to the physical feeling of poor postural health too. 

    But then, on the other hand, we do get pain as a complication of poor posture. “Pain is a request for change. Change in what? Your habits and behaviours. Pain is ultimately a cry for behavioural change.” What most don’t realize is that a lot has happened between the point of no pain to pain, and therefore it is not a quick fix. Just like getting stronger in the gym, or running a marathon, or even developing skills in a new job position. You didn’t just go from start to finish, there was a PROCESS in between.

    So with all that said, where do we even start? Well, start small, and just be consistent. Any change in your postural behaviours can have a massive physiological response in your body. So if A is poor postural habits and B is improved postural health, there is a process that happens to arrive at B. We want B as an outcome, now the task is getting there. No amount of therapy is going to last for long if poor lifestyle habits and postural behaviours are not changed.

    “We cannot get well in the same environment we become ill.“

    To help you start making those small changes, here are a few things to think about that might be sabotaging your postural health on a daily basis:

    1. Slouching during transportation is an easy habit to fall into. Make a conscious effort to sit up straight when commuting. Ladies, be careful with ponytails that cause your head to protrude forward from the headrest. Studies have further shown that vibrations from engines can actually relax and sedate your muscles leading to increased slouching – be aware!
    2. Holding your phone between your shoulder and your ear is a no-go: Try earphones, hands-free or correct speaker settings to minimize a compromised neck posture. 
    3. It is important to take regular breaks from your computer screen and have a good ergonomic setup. Prolonged sitting with no movement and incorrect monitor positioning is detrimental to your posture in its entirety. Remember, “you cannot offset 10 hours of sitting every day with a 1-hour workout.”
    4. Straining at the computer screen: if this is you, it is time to schedule an appointment with your optometrist. 
    5. Carrying everything on one shoulder, especially heavy bags: This causes an increased lean to one side and can have drastic long-term effects. Switch up the shoulders, and decrease the load of your bag/s. 
    6. Ladies, avoid wearing excessively tight bra straps on the shoulders. If you have a fuller bust size, it can significantly affect the pull on the thoracic spine (mid-back), please ensure you invest in good, supportive bras.
    7. Wearing high heels: The spine begins to sway unnaturally, the Achilles tendon shortens, there is increased pressure on the knees and low back. When sitting, remove the shoes, stretch the calf muscles, and try alternate high heels with supportive footwear ladies. 
    8. Bending forward with your back: Not only when lifting things daily, but whilst applying make-up, picking up kids, leaning over a cot, etc. Bend from the hips, drop a knee to the floor, and/or keep your spine in a neutral posture. 
    9. Uncross your legs when you sit, and gentlemen – stop sitting on your wallet: this promotes a pelvic tilt and can result in back pain. 
    10. Sleeping prone (on your tummy) might be your favourite but sometimes it isn’t the best sleeping posture: Your spine is not in its neutral position and you increase stress on certain spinal curvatures, especially your neck and low back. If you “have to” sleep prone, place a thin pillow under your head and under your stomach. Better yet, invest in a supportive memory foam pillow and sleep on your back or side-lying.
    11. Reading your phone or a book on your lap: Constant looking down (neck flexion) is only making your forward head posture worse, and this contributes to increased pressure on your spine. Text neck is a real diagnosis nowadays. Lift up your phone or book in front of you, or find a surface to comfortably rest either on. 
    12. Not moving your body regularly: We know this to be obvious. Our bodies require movement in order to retain good muscle function, and for joints to stay mobile and functional. Think of a padlock on an old gate that hasn’t been opened in years – that padlock would be stiff and very very difficult to unlock. This is what happens to your joints if you have poor movement patterns; and pertaining to your muscles – If you don’t use it, you’ll lose it. Get moving every single day in some shape or form where the body is challenged through a healthy range of motion. 

    It all starts with AWARENESS. I always tell my patients that just because you have poor posture, doesn’t mean you WILL get pain, or you WILL get degenerative changes, but it can most certainly contribute to both. And as the spine becomes more compromised, so tensions arise and compensatory patterns set in. Do not allow your first appearance of pain to now kickstart you into doing something about it. Start changing small things now, and be consistent about this change. Your body will thank you later. 

    Remember: PROACTIVE HEALTH IS MUCH BETTER THAN REACTIVE CARE.

    Points are taken from research done by The Business Insider.

  • It’s that time of the year again… STRESS!

    It’s that time of the year again… STRESS!

    Final reports. Exams. Kids’ Christmas concerts. Work deadlines. Laptop at work, at home, and in bed. Final functions. Year-end goals still to be achieved. And even recovering from the Rugby World Cup anxiety – sheesh! Quite frankly – all of the chaos! This time of the year is such a joy, yet at the same time, there comes that final push and the accumulation of simply everything.

    With so much on the go, we start sleeping slightly less or get less good quality sleep; our weekly exercise regime decreases; we skip meals and/or our nutrient-dense meals get replaced with convenience foods on the go; our alcohol and caffeine intake increases; we spend less time engaging with loved ones or just talking about our days; we leave the office later than usual, and the pressure and stress build exponentially. Sound familiar?

    So why is this important to recognize? The concept of ADAPTATION is central to health and chiropractic care. If we give it some thought, the body adapts to survive daily. We encounter a virus, our body shuts it down. We eat food, and our body extracts nutrients and expels toxins and waste products. We get a fever, our body takes care of it. So when the body is unable to adapt adequately to both internal and external stresses, it becomes easier for illness and injury to develop and thrive. And STRESS is a major OBSTRUCTION to adaptation. As chiropractors, we focus on supporting the neurological and physiological systems within the body to ensure there are minimal obstructions to adaptation. Subluxations in the spine = trigger stress responses by releasing stress hormones.

    Ever got sick when you’ve been under a lot of increased stress? Or tie your shoelace and your back went into spasm? If you’d like to read why this can happen, I am going to leave you with this article below, written by Beckenham & Sevenoaks Chiropractic Clinics because they just sum up “Stress, Lifestyle and the Nervous System” brilliantly. If you wish to stop reading here, then I’ll leave you with this: Identify and manage your stress so you can awaken your body to heal itself adequately. As tough as it may be during this time 1) Get enough quality sleep, 2) Eat regular, nutrient-dense meals, 3) Keep exercising, even if it’s 15 minutes, 4) Do not sit for extended hours behind your computer at night, 5) De-stress psychologically, however that looks for you, 6) Stay hydrated, 7) Take time out for yourself, 8) Prioritize quality time with friends and family, 9) Spend less time scrolling on your phone, and 10) Get adjusted!

    And a bonus point: Focus on your BLESSINGS and wake up with a grateful heart every morning. Shift your perspective during this busy time.

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    “Stress, Lifestyle, and the Nervous System.” Written by, Beckenham & Sevenoaks Chiropractic Clinics

    In this post, we’re going to look at how your nervous system adapts to stress, and how you can use that knowledge to improve your overall health.

    Most patients expect us to ask about their pain, and questions about their occupation and exercise habits don’t seem too unusual either. But many don’t expect us to ask about their wider health and lifestyle – questions about diet, sleep habits, alcohol and caffeine intake for example.

    As we mentioned last time, 3 types of stress affect the nervous system: physical stress, biochemical stress, and psychological stress. Each individual stress will usually cause the body to respond in a specific way – such as fever from an infection, or back pain from poor posture. However, all stresses also trigger a generalized stress response, and the effects of multiple smaller stresses combine to increase this general response. This is known as “General Adaptation Syndrome”, a term coined in the 1930s by the physician Hans Seyle. He described 3 phases of the stress response: alarm, resistance, and exhaustion.

    During the alarm phase, our bodies prepare to respond to stress. This is commonly known as the “fight or flight” response, where adrenaline, cortisol, and other “stress hormones” are released. Blood pressure increases, blood flow is diverted to muscles, and we feel we are on “high alert”. This situation isn’t sustainable for very long, so if the stress persists we move on to phase 2 – resistance. Here we compensate to reduce or repair the effects of the stressor and try to restore things back to normal. If it’s an infection, we mount an immune response. If it’s a work deadline, we stay late at the office.

    However, this has its limits – if the stressor continues beyond our nervous system’s ability to adapt, we begin to struggle. Our energy supplies are depleted, and we can’t keep up with the demands of adapting to the threat. We become less able to adjust to other stresses and are vulnerable to illness and injury. The nervous system struggles to regulate our normal physiology and goes into “defense mode”. Common effects include muscle tension, aching, and stiffness. However, long-term stress can have more widespread effects, such as increasing pain sensitivity and inflammation and decreasing circulation and muscle strength.

    We can often cope for quite a long time in this state, but at the cost of a reduced ability to respond to other stresses – essentially reduced health. Our nervous system can only tolerate so much stress at one time. This is called our “Generalised Adaptive Potential”, or Stress Threshold. This is also a pretty good definition of health – our ability to resist additional stresses. Some stress is unavoidable, and we have evolved to cope with it to a degree. But when we go over our Stress Threshold, it pushes our body and nervous system to phase 3 – exhaustion. We’ve all spent short periods here – think of the “run down” feeling you get when recovering from the flu. If the stresses are removed (you fought off the virus), things calm down and you recover.

    But what if the stress isn’t removed, or not enough is removed? What if you’re still coping with an aggressive boss, or partying heavily every weekend? This is the real danger, where stress can have more severe long-term consequences.

    The problem with constantly exceeding your stress threshold is that over time this causes it to lower. You become less able to adapt to stress in the future, even if you can recover from the original problem. Previous stresses that weren’t so bad now take a greater toll on your health. The danger here is the potential for a downward spiral as the nervous system becomes more easily overloaded and then less able to cope.

    This graph illustrates the nervous system’s response to stress:

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    1. “Everyday stresses” – It’s below the threshold, so you manage without being too aware of it.
    2. Short-term high stress (e.g. flu) – Slight reduction in the stress threshold, but it recovers quickly.
    3. Long-term high stress – Big reduction in the stress threshold.
    4. Exhaustion – “Everyday stresses” now exceed the stress threshold, so it is unable to recover as easily.

    So what can we do? We have to be realistic – there will always be some stress on the body, and some stresses are not easily removed. This is okay as long as we stay safely below the threshold. The trick is to identify stressors that can be removed or reduced and work on those. Chiropractic treatment is very effective at both reducing the stress on the nervous system and increasing the stress threshold, but making changes to your lifestyle is just as important.

    Looking for other stresses you can reduce will help you stay below the threshold so that your nervous system can recover more easily. Once you’re safely below your threshold, we can work to increase the threshold itself: for example, specific exercise can help strengthen joints and muscles to improve their ability to adapt to stress in the future. It can also help you plan for the future – if a stressful event is on the horizon, you can prepare by removing other stressors beforehand. If you have a busy month at work approaching, taking time to prioritize sleep, eating well, and doing a little exercise will improve your ability to cope with it.

    Big love,

    Doc Lol x

    Inspiring you to Move. Heal. Excel.

  • A week, or even a day without a headache would be great, thanks!

    A week, or even a day without a headache would be great, thanks!

    In the Global Burden of Disease study, headaches were the second most prevalent disorder in the world (Lancet, 2016). If you’re reading this and you’re surrounded by people, take a look around you; 1 in 5 people are affected by tension-type headaches (Stephens et al., 2016) in particular, and that one might be you, or your friend, or a family member. 

    If the stats aren’t frightening enough, individuals who get regular headaches think it’s normal, or they just live with it or have medication in every corner just waiting for the next headache to strike. HEADACHES ARE NOT AN ASPIRIN DEFICIENCY. I deal with this almost daily in my practice. Stories of patients suffering from headaches for years. Stories beginning with “I’ve tried everything.” And the only solution they were given after numerous tests? Medication. We’ve been fed this lie that the only way to fix or manage headaches is through the constant misuse and abuse of medications. If the prescription works so well, why do we keep refilling it? Did you actually know that certain medications are responsible for headaches? (Discussed later). 

    I must say, I really struggled to compile this blog post. Headaches can be exceptionally complicated, and it is truly impossible to cover even a tenth of the information, and despite a staggering amount of research, the underlying etiology is not always well understood. I am going to attempt to shed some light on understanding the type of headache you may have, what could be some triggering factors to consider and what you can potentially do to limit the intensity and frequency of your headaches.

    First things first, a headache is not just a headache, the complexities are way greater than that, and headaches can be multi-faceted. There are numerous different classifications and presentations, and understanding your headache may help treat it successfully. Let’s take a look at the International Classification of Headache Disorders (https://ichd-3.org/) in order for you to first understand that headaches can be extensively diverse.

    PRIMARY HEADACHES: Are disorders by themselves. They are caused by independent pathomechanisms and not by other disorders. 

    • Migraine (with or without aura)
    • Tension-Type Headache (TTH)
    • Cluster Headache (and other trigeminal autonomic cephalalgias)
    • Other primary headaches

    SECONDARY HEADACHES: Develop as a secondary symptom due to another disorder that is known to cause headaches. 

    • Headache attributed to head and/or neck trauma
    • Headache attributed to cranial or cervical vascular disorder
    • Headache attributed to non-vascular intracranial disorder
    • Headache attributed to a substance or its withdrawal 
    • Headache attributed to infection
    • Headache attributed to disorder of homeostasis 
    • Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structures
    • Headache attributed to psychiatric disorder

    CRANIAL NEURALGIAS AND FACIAL PAINS: This refers to neuropathic pain of the head that is caused by a lesion or disease of the somatosensory nervous system. They are characterised by pain in the distribution of the nerve/s. 

    • Cranial neuralgias and central causes of facial pain
    • Other headache, cranial neuralgia central, or primary facial pain

    As you can see, the types of headaches one can experience are extremely diverse and numerous questions need to be asked within a case history in order to correctly establish a list of differential diagnoses. The information I gather should help me ascertain whether this is a headache I can successfully treat, or if it needs either further investigation or urgent referral. Some classifications need to be handled by neurologists, but for the most part, according to studies, primary care practitioners are the ones who should be ideally handling headaches.

    As much as I want to dive into the details of how each headache presents, I don’t think it’s helpful, it’s like Dr. Google. Allow a professional to diagnose your headache for you. What I personally think is more beneficial to you is understanding potential triggering factors and tips to help reduce your headache attacks. I am going to unpack some triggering factors more than others based on questions individuals have specifically asked me and I hope it helps to explain how these things can trigger your headache attacks. 

    TRIGGERING FACTORS

    We need to understand that triggering factors can be physical, psychological and/or environmental. 

    [ Sleep ] 

    • 50% of individuals who have Tension-type headaches (TTH) and migraines suffer from insomnia (Fernandez-de-las Penas et al., 2017). 
    • Sleep disturbances, insomnia, and poor sleep quality are associated with a higher frequency and intensity of headache attacks (Fernandez-de-las Penas et al., 2017). 
    • Data suggests that roughly 50% of patients that suffer from sleep apnea, and 80% of those with narcolepsy also have headaches (Williams, 2010). 

    So what is the connection between sleep and headaches? There are numerous connections, however, I will attempt to explain in a short, less anatomical description. There are two main hormones that are important for sleep. Serotonin is the brain chemical that regulates the sleep/wake cycle, whereas melatonin is responsible for healthy sleep. Serotonin is synthesized by the pineal gland to produce melatonin. During our REM sleep, serotonin is shut off, and melatonin secretion is decreased. If we have an irregular or delayed secretion of melatonin, it can result in sleep disturbances and poor sleep quality. This decreased secretion is seen in individuals suffering from Cluster type headaches or menstrual migraines (Williams, 2010).  Furthermore, poor sleep posture can have a direct effect on the natural curvature of the spine which stresses our joints and increases tension in the musculature.

    [ Sex ] 

    • Significant sex differences exist in migraine and other headache-related disorders (Peterlin et al.,2011). 
    • Migraine occurs in both sexes, but predominantly affects women, with a cumulative lifetime prevalence of 43% in women and 18 % in men (Stewart et al., 2008). 

    Amongst the potential causes of this are fluctuations of sex hormones, particularly oestrogen levels, genetic factors, exposure to environmental stressors, as well as differences in the response to stress and pain perception (Peterlin et al., 2011). Olsen (2014) noted that hormonal fluctuations can be responsible for triggering menstrual migraines, and interestingly enough research has further shown that women experience an improvement in migraine frequency and/or severity during pregnancy and menopause.

    Furthermore, ladies, if you have spent years taking the contraceptive pill and you suffer from headaches, please note the time frame for when the headaches started and when you commenced taking the pill. There are a wide array of contraceptive pills and sometimes what works for one, does not work for another. The pill can have a significant effect on your hormones, and based on what I have seen in practice, it is usually a more negative effect. Please consult your doctor regarding more information on this.

    [ Medication rebound (overuse) and side effects ] 

    • Medication rebound headaches affect 1 – 2% of the global population (Munksgaard et al., 2014).

    It doesn’t seem like much, but if you do the math, the statistic is quite high especially when we expect the medication to do the opposite. Medication side effects are a common, sneaky cause of headaches, and the biggest culprit causing this: your simple analgesics, pain-killers. These simple analgesics can offer some relief for the occasional headache, however, when we take them more regularly, they trigger rebound headaches. How? Well, they pre-empt the production of your body’s own pain-fighting molecules and endorphin production, for instance, will decrease (Ingraham, 2019). So when you eventually cease taking these medications, you are left in a state of rebound pain. 

    Other medications that can cause rebound headaches include Triptans, ergotamine medications, and Opioids (tramadol, codeine).

    [ Food triggers ] 

    • Aspartame and sucralose – artificial sweeteners found in chewing gums and diet beverages 
    • Tyramine – an amino acid found mainly in cheese and yoghurt can trigger migraines and vertigo symptoms
    • Chocolate
    • Alcohol
    • High sugar intake 
    • Gluten/wheat

    Dietary triggers are quite controversial and what works for one, may not work for the other. But it is important to take note of some of the above foods that are migraine-causing. Research also notes that those that suffer from Irritable Bowel Syndrome (IBS) are statistically more likely to suffer from migraines (Aydinlar et al., 2013) which can support food triggers promoting an inflammatory response.  

    [ Caffeine ] 

    Coffee can be both a friend and a foe. If you experience frequent attacks or chronic migraines, or pain increases when you drink caffeinated coffee or other drinks, caffeine is probably a foe for you. It will cause overall irritation and possibly trigger migraine attacks and/or inflammation.

    [ Posture and related work ergonomics ]  

    Often my patients state that their headaches are aggravated during the day as work stress and demand increases. As I’ve written in a previous blog, “Beware of the chair” (https://kinetichealth.co.za/2018/11/12/beware-of-the-chair/), the average person now spends 9.3 hours per day sitting down, that is more than we spend sleeping each day (average 7.7 hours). The reality is, most of our jobs and productivity is centered around staring at a computer for large parts of the day, with poor work station setups, and we truly aren’t safeguarding our spinal health. Computer professionals and enthusiasts often suffer from a combination of symptoms, with a higher prevalence of musculoskeletal pain noted in the neck, shoulders, upper extremities and low back amongst computer users.

    Prolonged sitting lends itself to a forward flexed position of the head and neck. And the result of this? Complaints of pain in the upper back and neck, altered postural patterns and those annoying tension headaches. Anyone nodding their heads in agreement? One must remember that neck muscles start at the bottom of the shoulder blades and span up to the base of the skull. Here’s a little perspective as to why a forward flexed head position is detrimental. In the neutral position, the head weighs approximately 4-5kgs. As our head starts to flex (bend) forward whilst constantly looking down at a computer, the head can weigh up to 27kgs (at 60-degree flexion). And naturally, such a drastic increase in pressure results in the acceleration of spinal degeneration. Accompanying this, the muscles at the back of the neck (especially the sub-occipitals) are then stretched and undergo a large amount of strain to keep the head from falling further forward. This forward flexed posture also inhibits the muscles in the front of the neck creating a further muscle imbalance.

    [ Physical activity ] 

    There are two sides to physical activity – a lack of and too much. When reading the research on this, there were many inconsistencies as to whether or not physical activity triggers or reduces headache attacks but based on what I have personally seen in practice, a lack of physical activity can trigger headaches particularly TTH. This lack of movement subsequently increases stress levels, promotes further tension and can promote other psychological triggers. On the other side of the spectrum, too much strenuous activity can also be a triggering factor, more so for headaches of migraine nature. This can be due to the over-exertion causing swelling in the blood vessels of the head, neck, and scalp.

    [ Anxiety and stress ] 

    These are both potent drivers of headaches (Martin, 2016). These triggering factors can produce physical pain through an increase in tension resulting in TTH, or furthermore can indirectly cause other triggering factors such as high blood pressure, inflamed arteries, tissue damage, etc, which leads to secondary headaches. 

    [Bruxism/teeth grinding] 

    According to the Bruxism Association in the UK, people who grind or clench their teeth, both during the day and/or whilst sleeping, are three times more likely to experience headaches (Mathew, 2017). Bruxism can further contribute to tender jaw muscles, TMJ (temporomandibular joint) pain or a stiff neck. 

    HELPFUL TIPS

    All the below suggestions are the simplest factors that you can address that can potentially make a difference to your headaches. They might not be the ultimate solution but I hope they can provide some guidance in kicking those headaches to the curb, and increasing your quality of life. 

    1. Keep a headache diary. This is the first piece of advice I give my patients, especially those unsure of their headaches and what triggers them. Keep a simple diary and document the details of your headache attack – what did you eat? How much sleep did you get? Have you done any physical activity? Have you been exposed to high levels of stress? Is your menstrual cycle about to begin? Etc etc. This helps to provide greater insight into understanding your headaches and triggering factors. I have truly seen great results with patients that have done so. 
    2. Consult your doctor regarding current medications, the contraceptive pill and avoiding rebound.
    3. Seek chiropractic care. There is so much explanation to this but in short – there are numerous research studies that show the following are associated with headaches, particularly TTH and cervicogenic headaches: 1) decreased cervical (neck) and thoracic (midback) range of motion, 2) muscle tightness, 3) Active myofascial trigger points, 4) painful upper cervical joint dysfunction (Ferracini, 2017; Espí-López and Gómez-Conesa, 2014; Couto et al., 2013; Zito et al., 2006). Furthermore, besides physical treatment in the form of manipulation, mobilization, dry needling, soft tissue therapies, stretching, etc, a chiropractor can focus on postural awareness and correction, as well as approach your headache from a holistic standpoint. 
    4. Physical activity. General, healthy levels of physical activity is a no brainer solution for a lot of painful problems. In general, exercise is a great stress outlet, it promotes better sleeping habits and improves our overall mood. This is mainly driven by the increase in serotonin levels, which we have covered previously.  
    5. Caffeine. For others, caffeine may be a friend and it is often administered in the treatment of headaches and occasional migraine attacks. How is caffeine even remotely helpful? It acts to constrict blood vessels and speeds everything up, in particular, the effects of other medications taken with it. Furthermore, caffeine helps to blunt the effect of adenosine – a natural, powerful vasodilator that controls cerebral and meningeal blood flow (basically the flow of blood around your brain), and it is often present in higher amounts during a migraine attack. As mentioned in the triggering factors section, if you a chronic headache sufferer, caffeine probably remains a foe to you.  
    6. Food. This is where a headache diary can really help. Take note of potential food triggers and then begin a process of omitting select foods. Please note, do not omit all food triggers at once. It will be very difficult to pinpoint the actual trigger, start with one food type at a time.
    7. Nutrients. There are FIVE nutrients that can help reduce headache attacks. Magnesium. Riboflavin (Vitamin B2). Coenzyme Q10. Ginger. Feverfew. Ensure you have sufficient intake of Vitamin B and Magnesium in your daily dietary intake, as a decrease in these nutrients can result in many symptoms that trigger headaches such as, anxiety, irritability, and insomnia.
    8. Upgrade your eyewear and/or get your eyes checked. You’ll be surprised how much eye strain and computer glare can be responsible for increased tension in the suboccipital muscles of the neck, triggering headaches. Consult your optometrist.
    9. Invest in a good pillow to ensure quality sleep with supported posture.
    10. Reduce screen time before bed to subsequently reduce being bombarded by EMFs which affects our body’s ability to produce melatonin. 
    11. Improve computer and/or work station ergonomics. Please see my blog “Beware of the chair” to read some information regarding correct work ergonomics. 
    12. If you suffer from bruxism, consult your dentist about a mouthguard or other possible solutions.
    13. Avoid tight hats, helmets, swimming googles, constricting bra straps, tight ponytails and cradling a telephone between your ear and shoulder.
    14. Be careful with heat. I know we all love the feeling of heat instead of cold therapy, however, in the case of headaches, prolonged heat application stimulates vasodilation and increases tissue blood flow (Charkoudian, 2010) which can contribute to a congested feeling which may aggravate attacks. My suggestion, experiment with what works for you and utilize that which causes soothing of your headaches. 
    15. Self-massage and stretching. This can serve as a great home therapy when presenting with TTH and cervicogenic headaches. Run through a couple of gentle, cervical stretches and grab a tennis ball and release the muscles at the back of your head and neck (see image below). 
    tennis ball neck nbzncl

    Phew, I know that is a lot to take in but I hope you can take away some useful information from this, and that it can potentially help to reduce the intensity and frequency of your headaches in some way. However, please note, if you are suffering from headaches, especially chronic ones, please seek professional help, do not play Dr. Google. 

    Big love,

    Doc Lol x

    Inspiring you to Move. Heal. Excel.

  • The Big C…omrades! And 5 other “C’s” that might help you.

    The Big C…omrades! And 5 other “C’s” that might help you.

    It is that time of the year again, an influx of runners in my office, increasing the mileage as Comrades qualifiers approach and the month of June draws closer. As promised from my last blog “Sportsmen or women? This read is for you” I want to dive into different sports focuses over the next few months, with the Comrades Marathon being my first event of choice.

    Based on my own private practice experience, which I know is only 3.5 years, this is my feedback, advice and hopefully helpful tips for you thus far, together with some input from some of my patients. Please note, this is just my broad-spectrum analysis. I am fully aware that during your Comrades’ journey you will receive advice from a hundred different people but FIND WHAT WORKS FOR YOU. These are just points to be aware of and to consider. And with that said, don’t read this and then go change everything, that in itself can lead to disaster. If these tips are helpful, start making the necessary changes over time.

    [ CROSS TRAINING ]

    The biggest ‘error’ I have personally noted is patients dropping every other activity just to increase running mileage. “I can’t surf anymore because I need to run instead.” “I don’t want to strength train because it makes me too bulky for Comrades.” Like I’ve quoted before, the best way to prevent injury is by staying diverse with your movement demands! We need to work through a wide range of physical literacy challenges in order for different systems and tissues to be stressed without being overstressed. Yes, I understand that you need running mileage, but what is the point of all the mileage if you develop a stress fracture or medial tibial stress syndrome? Running is a LINEAR sport, but the forces applied during running are not just sagittal or in a straight line. If you don’t incorporate movements that make you stronger in the frontal and transverse planes, you may just end up with an ITB (iliotibial band) syndrome. 

    Balance practice, core endurance, and strength training will drastically reduce your chances of developing running injuries, especially whilst training for ultra-marathon distances. Why balance practice? Running is one foot at a time, and you are constantly changing loads, therefore this is a skill we need to develop and possess. Why core endurance? Most issues that occur deep into a run stem from hip and core stability mechanisms fatiguing. Why strength training? It really helps to have strong, activated gluteal and lower limb muscles. Resistance is key to ensuring that our joints can handle the repetitive stress from km’s of running. Did you know that running can create forces up to 3x your body weight with each foot strike? Your Achilles tendon, for example, is loaded 3.4x your body weight during walking but 7.7x your body weight when running. And this resistance training doesn’t refer to light weights and high reps. Another reason why lower body strength and trunk control (core) is important is that the majority of runners are heel strikers. Research shows that rearfoot striking increases stress on the body to a much greater degree than those who are mid, to forefoot strikers. The stronger you are, the harder you are to hurt. 

    Photo 17

    [ CONDITIONING ]

    If your friends dare you to do the Comrades marathon in a couple of months and you’ve never run more than 10km’s, maybe not the wisest decision you’ll ever make. Conditioning is of vital importance for reducing injury risk. As discussed above, running subjects the body to an increased, repetitive load with every foot strike. Be smart and realistic about your goals. Just because someone believes you can do the Comrades, doesn’t mean you have to enter the upcoming one and prove you can achieve it. It is a 90KM ROAD ULTRA MARATHON. Yes you might complete it, but at what cost? We all know there are some super humans that beat all the odds, run a dozen Comrades marathons with minimal preparation and still manage to avoid injuries or knee surgery, but those individuals are few and far beyond. 

    So what do I mean by conditioning? According to the Britannica Encyclopaedia, “conditioning, in physiology, is a behavioral process whereby a response becomes more frequent or more predictable in a given environment as a result of reinforcement, with reinforcement typically being a stimulus or reward for a desired response.” So, if Comrades is your goal (and by that I mean a successful Comrades as injury-free as possible), then get a few half marathons under your belt first. Once you’ve done that, allow the mileage to climb again and then get very comfortable with doing a marathon, or two. And I don’t mean this happens all in a few months. Comrades is not running away (yes I know what I did there), you have plenty of years ahead to prep for an event of this magnitude. And besides, research shows that peak running performance occurs later in your 30s and/or with the correct conditioning over the years. With that said, if you are very conditioned in the marathon department, this is great, however, when picking your qualifier marathon, don’t pick 4. Too many people exert themselves 110% over a few marathons, instead of strategically planning for one or two. You cannot always expect your body to show up for that many marathons. 

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    [ CORRECT EATING – NUTRITION ]

    I decided to consult the beautiful Mariella Sawyer for this section, a top South African triathlete and dietician (e-mail her at hello@mariella.co.za for more information). Her pointers include:

    • Everyone is an individual and different things/food work for different people so stick with what YOU know. 
    • Race intensity influences how well your body can digest food. The higher the intensity, the less blood goes to your gut, meaning that digestion becomes a lot more difficult. This is why easily digestible carbs such as gels are often the go-to for those racing at higher intensities. 
    • Hydration is key! Electrolytes are important and dehydration is often the cause of cramps, stomach stitches, nausea, vomiting and a decline in performance. 
    • PRACTICE MAKES PERFECT! Practice your race-day nutrition during long runs and figure out what works best for you. 
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    [ CONSERVATIVE CARE ]

    Of the thousands of individuals that run the Comrades Marathon, I always wonder how many see a chiropractor or get regular sports massages during their training, 10% maybe? And I don’t mean visits to either due to running injuries, I am just referring to maintenance care, maybe more like 5%? I always think it’s fascinating that when our shoes reach a certain mileage and are worn out (which happens pretty quickly when training for an ultra-marathon), we get new ones. In most cases, not because they are causing injuries, but because we have come to terms with the level of wear and tear they are exposed too. We do this, yet we fail to get our bodies treated regularly during this time. I am sure our bodies are the ones withstanding the constant impact of the weekly increased running mileage. Respect your body during this time, its training to achieve a huge goal. 

    Book a sports massage TODAY if you haven’t had one. Flush out those toxins, give the body some TLC and celebrate it for all the efforts it has achieved thus far. If you haven’t seen a chiropractor, make an appointment with one TODAY too. “But why do I have to see a chiropractor if I don’t have any reason too?” Well, why do you service your car every 15 000kms if there’s nothing wrong with it? Here are a few pointers taken from my previous blog regarding the benefits of chiropractic care for you.

    Chiropractic care improves movement, on a spinal and joint level, as well as overall body movement. Imagine training for the comrades with ankles that don’t move properly? That directly affects the whole gait cycle and can lead to numerous lower limb enthesopathies, like ITB syndrome and shin splints. 

    Better Balance and heightened body awareness. Chiropractic care restores balance to the entire body through correcting nervous system disturbances and allowing signals to flow freely between the brain and the body. Upper cervical adjustments have a direct influence on the brain stem. Do you know what the function of the brainstem is? It controls the flow of messages between the brain and the rest of the body and also controls basic body functions such as breathing, heart rate, swallowing, blood pressure, consciousness, whether one is awake or sleepy, and maintains healthy brain function and balance/coordination.

    Increased flexibility. When joints and spinal bones are in proper alignment, you are able to manoeuvre with ease. 

    These benefits, therefore, contribute greatly to preventing injury, relieving body stress inflicted by strenuous training regimes, increases strength and enhancing performance. Seeking chiropractic care is not only about injuries, but it’s also about body function and overall optimal performance. 

    Photo 32 683x1024 1

    [ CELEBRATE ]

    And finally, celebrate the small victories. Celebrate the fact that you are training for an ULTRA MARATHON, and that fact the most of you have probably already successfully completed one, or multiple Comrades marathons. This is a massive achievement and you should be proud of yourself. Too often we fail to celebrate the things we achieve, the things we are capable of conquering, the goals we keep knocking out the park. Too often we forget that many people aren’t able and well enough to achieve something of this caliber, despite deeply desiring too. “Health is a crown that the healthy wear on their heads, but only the sick can see it.” 

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    If you want some more perspective, here are a few patient testimonies for you.

    Emari

    “There will be times in the race where you feel great especially at the start but hang back. Then there will be times in the middle where you will feel like the finish line is incredibly far away and all you can think about is how much everything hurts. But then you will see someone you know or you have a snack or you walk for a bit and you will eventually start feeling a bit better, just hang in, you will get there. 

    On the up run, I felt so ill in the first half and couldn’t eat anything and could only drink water. I got to halfway and wanted to cry, it just seemed so far, but I had a rehydrate and just kept going only drinking water and what I felt I could stomach. I took some walk breaks and eventually felt better and was able to start eating again in the second half and my latest km of the whole race was the last one because I couldn’t believe I was actually finishing. Once I got to the top of Polly shorts, I knew I would make it. 

    The down run is much more of a mental battle about the distance. Running over 90kms in mentally insane. I got to 60kms and it felt impossible that I still had another third of the race to do. But because there is quite a bit of downhill in the last part, you just have to keep moving forward, and running into Durban is amazing! So much support and you are running home. Best advice – lots of vaseline and remember to take in the experience instead of just focusing on the time on the clock.”

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    Sam

    Everyone is different, you will get so much advice on pacing, nutrition, etc, but no one knows your body better than you, listen to it. You will hit a wall or two and you will get over it. Your mind is powerful and if you can get over the wall, you will finish the race (if you have put in the work). Find inspiration from your surroundings – there are some boring bits and long hauls – look around and find distractions, take part in traditions and talk to people around you, even if you get nothing back, encouraging someone else may be the encouragement you need. 

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    Nicole

    My Comrades marathon journey in 2018 started as a daunting experience, stepping into the unknown and venturing into a sport and distance I know very little about. The best advice I received was to listen to one person’s advice and stick to one training plan. Thanks to my coach, Glen Gore, I was able to follow a manageable training plan and get as much advice from him as I wanted, as often as I wanted it. Throughout my 5 month build-up to Comrades, I did no other training besides running and swimming. I was incredibly conscious of the amount of physical work I was putting my body through so I made sure I booked a chiropractic appointment with Dr. Bezuidenhout every second week and sometimes every week depending on my training load. Due to the fact that I have a physical job where I am sometimes on my feet for up to 9 hours a day, I was very aware of the load I was placing on my legs. I didn’t do any form of gym or weight training during my 5 month training period, so I relied on swimming as my cross-training. It definitely helped massively with recovery, with getting rid of lactic acid after big runs, kept my core and upper body strong and gave me an opportunity to rest my legs. Being in the water also has a massage effect, so swims helped me to feel relaxed and physically relieved after running, at no extra expense. Although I have been injury-prone my whole life, I did not get injured once throughout all of my Comrades training and I suffered from no pain or injuries on race day. If I can give one piece of advice, it’s the advice I received – choose one plan and stick to it. 

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    Big love,

    Doc Lol x

  • Sportsman or woman? This read is for you.

    Sportsman or woman? This read is for you.

    As healthcare practitioners, we generally find our niche, and by that I mean the favorite ailments we love to treat, or the focus we attract. Some chiropractors choose pediatrics, or pediatrics chooses them. Same with geriatrics, postural correction, sports injuries, or animals (yes there are chiropractors who work on animals, racehorses for example).

    For me, I think I’ve attracted the sportsmen and women, why? Probably because it’s been apart of my life forever, and continues to be. It’s one of my communities, and it is something I’m so passionate about. From swimming and underwater hockey to cycling, running and CrossFit, at different performance levels, with the occasional involvement and enjoyment of a large range of other activities. I generally find that patients want a practitioner they can relate too, someone who understands the sporting struggle, the hard work, the injuries, the brick walls, the “I can’t afford to rest” and so many other factors. Well, I know I do. 

    In the next couple of months, I am going to be unpacking different sports or major events based on my practice experience, whether that be young swimmers with the goal of making the Olympics, runners participating in a 5 km fun run or the Comrades Marathon, athletes prepping for Warrior races, etc. So if this kinda talk interests you, stay tuned over the next few months. But to set the foundation for these forthcoming blogs lets focus on the well being of sportsmen and women in general and why chiropractic care should form part of your preparation just as much as the training itself. And by the term “sportsmen/women” I do not mean exclusively a professional athlete that is being paid to compete, I am using it as a loose term for any individual training religiously towards a goal or event. 

    Sean Atkins, Exercise Physiologist said, “I would estimate that at least 90% of world-class athletes use Chiropractic care on a regular basis to prevent injuries and to improve their performance.” Well, let us have a small look. 

    • Tom Brady, American Football Player, “As long as I see a chiropractor, I feel like I’m one step ahead of the game.”
    • Tiger Woods, American Professional Golfer, “I’ve been going to chiropractors for as long as I can remember. It’s as important to my training as practicing my swing.” 
    • Floyd Patterson, former American Professional Boxer and World Heavyweight Champion (1956 – 1962), “I have to have a series of chiropractic adjustments before I go into the ring. I found that going to a chiropractor three times a week helps my performance. The majority of boxers go to chiropractors to get that extra edge.”
    • Arnold Schwarzenegger, former Professional Bodybuilder, when asked about his personal training, he talked about his chiropractic treatment, “This is how I found out the best way to use chiropractors, not only after injuries but also before injury.”

    So there are numerous famous athletes that utilise chiropractic care to enhance their game. But what about the everyday heroes and sportsmen and women that walk into my practice regularly? Can we better relate to them? What do they have to say?

    IMG 3122
    • Comrades runner and provincial triathlete seeing a chiropractor every two weeks to ensure she is as injury free and well maintained as possible.
    • National High Jump athlete who “traveled with a chiropractor for weekly competitions, working his chiropractic magic at every session we had.” 
    • The CrossFit athlete receiving maintenance care to improve ankle and hip mobility in order to squat more efficiently.
    • National Paddler receiving chiropractic adjustments prior to surf-ski races to keep any niggles at bay and to ensure paddling efficiency and optimum performance.
    • Cyclist preparing for KZN and SA road cycling champs receiving chiropractic adjustments “to increase power output on the bike, which isn’t a perception, it is a defined reading.”
    • Competitive swimmers receiving “regular care to maintain a high intensity in training and peak performance whilst racing.”
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    One patient of mine wrote this in a review, “As an individual who is involved in a numerous amount of sports, I have learned but one thing when I have decided to skip on my chiropractic appointments; chiropractic support is not a necessity but an absolute essential part of the training and healing process.”

    With all that said, if you’re training towards a sporting goal, however big or small, chiropractic care has an important role to play in your training. 

    So what are the benefits of overall wellness and chiropractic care to sportsmen or women? I am going to unpack this slightly differently, and I hope you will understand why by the end of the blog, because as a chiropractor, I personally believe in a holistic approach to care, especially when treating athletes, which ultimately means I consider the FIVE PILLARS OF HEALTH. Sleep/rest. Nutrition. Mental/Attitude. Movement. Spinal/Nervous System. My attention is focused more specifically on one pillar (naturally the nervous system), but I address and pay attention to all pillars because, in order to function and race at your optimum, you need a good balance of all five. One car wheel doesn’t perform its function without the other three working in unison. 

    5 Pillars of Health

    To begin, as sportsmen and women, we are ALWAYS looking for the next best thing to enhance our performance and get ahead of our components and opposition. Have you tried Hydrotherapy? What about that athlete, he’s on a Ketogenic diet and look how well he’s performing. Have to tried ice bathing after every session? Maybe you should train in an altitude chamber? Have you tried genetic testing? Everyone needs to find what works for them, and yes, these things can all aid performance, however, I will share this disclaimer: Get your FIVE PILLARS OF HEALTH aligned first. Let’s go. 

    [ SLEEP/REST ]

    Every night when we sleep, our metabolism changes and our cells go into rebuild mode. They do this to repair the damage that has occurred during the day, as well as to flush out any toxins that have accumulated. You are all putting your body through huge amounts of stress each day on the bike, on the road, in the gym, in the pool, etc. We are not super humans even if we think we are. 

    How many of you spend your time before bed on your cell phones or iPads? Well, believe it or not, this bombards you with EMFs which affect our body’s ability to produce melatonin – a hormone that is necessary for proper sleep. 

    Insufficient sleep = impaired repairing of cells and a build-up of toxins. 

    ONE OF THE BEST PERFORMANCE ENHANCERS IS SLEEP! 

    You can’t expect to train at your optimum if your body hasn’t received the recovery it needs. With that said, it is not only sleeping, this includes RESTING and giving your body time to rebuild from numerous hard training sessions. Overtraining is a thing, it isn’t just some myth. 

    [ NUTRITION ]

    Aha! 

    You know that saying – you are what you eat – well there is a lot of truth to that. What we eat every day is going to determine the health and energy of our cells and how efficiently our metabolic pathways work. 

    I always like to relate to the food you eat to fuel for a car. High-quality fuel = high energy cells. Low-quality fuel in the form of processed foods etc = low functioning of the cells. 

    I treat so many sportsmen and women that are not eating well but are expecting the results. When I take a case history and ask, “So how are your eating habits? Do you eat well for your training?” Um… it’s either a guilty smile that follows or “ah that’s nice wallpaper.” Please ladies and gents, see a dietician if you are unsure how to fuel yourself adequately, get a good eating plan that is specific to YOU. Just because Sally functions well as a vegan, doesn’t mean you will. Be smart. 

    [ MENTAL ]

    Now, this is crucial in the sport you do. 

    This is not only your mental capacity, its the relationship you have with those around you. 

    People close to us have a tremendous effect on our health, positively, negatively or both. This, however, works both ways – you also play a role in adding value to those around you, especially close training partners.

    Sport is a relational healthy mindset, just as much as an individual mindset. I find that many sporting individuals that I treat are actually seeing a sports psychologist regularly and there is nothing wrong with this! Especially if you’re a professional or competitive athlete, the stress that comes with performance is high and can be mentally challenging, and struggling in this area can have a massive impact on external performance. 

    [ MOVEMENT ]

    Yes as sportsmen and women, you’re active. Well done. For my patients that don’t exercise, I encourage movement of any sort, but in your case, I’m not talking about going for your training runs or your scheduled 180km cycle. In your case, it’s movement specific to avoid injuries and ensure stability and strength. 

    The best way to prevent injury is by staying diverse with your movement demands. 

    This is the perfect summary of a great quote from Boo Schexnayder on the topic of preventing injuries: 

    The ides is that the human body was designed to be a Swiss Army knife of movement with the capability of sprinting, jumping, lifting heavy things, moving with fluid motion, and feats of endurance. Focusing on just a few of these elements for your “exercise” would simply be a mistake. By working through a wide range of physical literacy challenges, different systems and tissues are stressed without being overstressed. This results in more resilient tissues and less injury. So have your primary focus but supplement or break up programming with components of physical literacy that are neglected by the “meat and potatoes” of your program. 

    The number of athletes I see that have a weak core, um… insert emoji facepalm to the face. If you are serious about your goals and want to achieve some superb results, please see a Biokineticist, you will not be disappointed. CORE: GET GOOD AT BEING STILL SO YOU CAN BE EFFICIENT WHEN YOU’RE MOVING FAST. 

    Photo 15 1

    [ NERVOUS SYSTEM ]

    Which brings me to this. So what are the reasons why sportsmen and women get adjusted and receive chiropractic care?

    • Well, firstly it is non-invasive and DRUG-FREE. We do not prescribe medication to try to fix niggles or prevent injuries, nor do we give medication to enhance performance. We simply look to the neuromusculoskeletal system, because that is where it all begins. 
    • Heightened body awareness. Training towards a goal requires a lot more activity and participation, and for some sports that further requires higher levels of impact on the body. Chiropractic adjustments restore function to the body and nervous system. 
    • Chiropractic care improves movement, on a spinal and joint level, as well as overall body movement. Imagine training for the comrades with ankles that don’t move properly? That directly affects the whole gait cycle and can lead to numerous lower limb enthesopathies. 
    • Better Balance. Chiropractic care restores balance to the entire body through correcting nervous system disturbances and allowing signals to flow freely between the brain and the body. Upper cervical adjustments have a direct influence on the brain stem. Do you know what the function of the brainstem is? It controls the flow of messages between the brain and the rest of the body and also controls basic body functions such as breathing, heart rate, swallowing, blood pressure, consciousness, whether one is awake or sleepy, and maintains healthy brain function and balance/coordination.
    • Increased flexibility. When joints and spinal bones are in proper alignment, you are able to maneuver with ease. This is crucial to athletes. 

    All the above benefits, therefore, contribute greatly to preventing injury, relieving body stress inflicted by strenuous training regimes, increases strength and enhancing performance. Seeking chiropractic care is not only about injuries, but it’s also about body function and overall optimal performance. 

    What are you truly missing out on? 

    Focus on ensuring that these five pillars are standing strong and I can assure you that achieving your sporting goals will be that much easier and much more enjoyable. 

    As always, 

    Inspiring you to Move. Heal. Excel.

    Big love,

    Doc Lol x 

  • BEWARE of the CHAIR.

    BEWARE of the CHAIR.

    Did you know that the average person now spends 9.3 hours per day sitting down? That is more than we spend sleeping each day (average of 7.7 hours). In fact, I’m sure 90% of you are reading this sitting down (with a strained posture I might add). “Yes, obviously Doc Lol,” however, you’ve probably been sitting for more than an hour without taking a break. The reality is, in this day and age, sitting is an integral part of our lives. Most of our jobs and productivity is centered around staring at a computer for large parts of the day. And as demands increase, this translates to further evenings spent behind a computer too, in combination with a lack of activity, movement and rest. This month I’ve decided to write on this concept of “beware of the chair” – something I deal with every day in practice and I hope to provide some great insight as to why prolonged sitting can be harmful, how chiropractic care can help, as well as practical ways to “maximise” your sitting positively, reduce discomfort and safeguard your spinal health.

    x ray of bad posture

    Every day most of us are seated at our computers and working hard; our lives are demanding and we have deadlines to meet, daily. It is unavoidable. The reality with sitting is that you may not necessarily experience the detrimental effects now at the moment, but bad postural habits that stem from prolonged sitting and computer use can ultimately cause damage in years to come. Computer professionals and enthusiasts often suffer from a combination of symptoms. Research indicates that there is a high prevalence of musculoskeletal pain in the neck, shoulders, upper extremities and low back amongst computer users. It can’t be that bad, can it? Well, let’s unpack this further. There are a few simple negatives first, these being: 

    • We know that sitting has a strong impact on your metabolism and weight gain, and excessive weight is shown to be a risk factor in the degenerative process of the lumbar spine joints and intervertebral discs. 
    • Uninterrupted sitting is deleteriously associated with blood pressure and markers of homeostasis. 
    • As soon as you sit, electrical activity to the leg muscles shuts off, calorie-burning drops and enzymes that help break down fat drop by 90%.

    But then there are other more significant factors which I’d like to focus on: 

    • Due to the length of time and nature of sitting, compression of the low back (referred to as lumbar region) is very common. Your lumbar intervertebral discs (those spongy shock absorbers between each vertebra) are loaded three times more in the sitting position as opposed to when standing. Most of us do not engage our deep abdominal muscles (argh yes those core muscles) or our psoas muscles (commonly known as our hip flexors) whilst sitting, resulting in this increased lumbar disc compression, as well as an increase in our lumbar lordosis (normal curvature of the low back). Furthermore, when we sit for prolonged periods, some muscles shorten and some lengthen. As the brain accommodates to this change in posture, it chooses which muscles become neurologically active and underactive to conform with the new movement pattern. Iliacus and hip flexor muscles = overwork, whilst lumbar multifidi and back extensors = under work. This results in low back pain.
    • Prolonged sitting lends itself to a “text neck” or a forward flexed position of the head and neck. And the result of this? Complaints of pain in the upper back and neck, altered postural patterns and those annoying tension headaches. Anyone nodding their heads in agreement? One must remember that neck muscles start at the bottom of the shoulder blades and span up to the base of the skull. Here’s a little perspective as to why a forward flexed head position is detrimental. In the neutral position, the head weighs approximately 4-5kgs. As our head starts to flex (bend) forward whilst constantly looking down at a computer, the head can weigh up to 27kgs (at 60-degree flexion). TWENTY-SEVEN kilograms. And naturally, such a drastic increase in pressure results in the acceleration of spinal degeneration. Accompanying this, the muscles at the back of the neck are then stretched and undergo a large amount of strain to keep the head from falling further forward. This forward flexed posture also inhibits the muscles in the front of the neck creating a further muscle imbalance. Hello, headaches. If I wanted to continue… forward rolled shoulder position, shortened pectoral muscles and an increased thoracic kyphosis further adding to the array of problems and complaints. But I shall stop there. 
    text neck

    The reality is, our bodies are exposed to this increased musculoskeletal strain every day especially if we remain unaware of our poor desk habits. This strain translates into long term detrimental effects on our spinal health and it’s not long before we get to the point of saying, “ah these headaches are the normal tension pain from work stress,” or “I’ve had numbness and tingling in my hands for a decent amount of time.” When did daily discomfort or pain become so normal and acceptable? I struggle to believe we are okay with that. For me, I am not only concerned about the ‘now’ and the discomfort you may feel today; I am also concerned about the state of your physical and spinal health in years to come. So what can you do to limit these detrimental effects of prolonged sitting and computer use? Before we dive in, do your own little self ergonomic evaluation first so you become aware of your current situation. 

    • Does your chair promote good posture and core activation? 
    • Is it comfortable and at the right height for your desk? Are your feet placed firmly and comfortably on the floor?
    • When seated, is the weight of your arms supported at all times? 
    • Is your monitor placed directly in front of you? And is it at a safe distance away from your eyes to avoid straining (at arm’s length)? 
    • Is your monitor at eye level? 
    • Are your keyboard and mouse close enough to prevent excessive reaching? 
    • Is the office aircon placed correctly within the office to avoid blowing cold air directly onto your neck and upper back? 
    • When talking on your cellphone or work telephone receiver, is it held correctly with one hand to the ear in order to avoid jamming the telephone between your ear and shoulder? 

    If you answered yes to all the above questions, you’re off to a good start. These questions give you a good indication as to whether or not your workspace ergonomics are contributing negatively to your daily musculoskeletal strain. With the simple groundwork in place, here are a few more important things to implement: Take intermittent short breaks. Sitting needs to be interrupted. It takes about a minute or two to stand up, walk around, do a quick stretch and then return to your desk. Set a reminder on your phone if you have too. At least every 60-90 minutes, until you get into the firm habit of giving yourself a break from the computer screen and seated position. Trust me, your spine will thank you later. And surprisingly enough, you think you’re being more productive by slaving away for hours without taking a break, that is a myth. Research repetitively shows that there is reduced fatigue and improved cognitive ability when taking regular breaks from prolonged sitting. Movement is your friend.  

    Following on from this, if you can afford it and if your office space supports it, get a sit-to-stand desk, or work standing up for part of the day. This relieves that sitting position and can ultimately assist in maintaining a better posture for longer periods of time. Furthermore, remember all those factors from the beginning of this blog? Well, your lumbar intervertebral discs aren’t excessively loaded or compressed as much, deep abdominal and psoas muscles actually have a chance to activate adequately which results in maintaining normal lumbar lordosis and reducing the predisposition to low back pain. Working in the standing position further prevents you from looking up and down, assuming your monitor is at eye level, and this helps to alleviate the strain placed on the muscles at the back of the skull. Removing this strain will reduce the risk of imbalance between the neck extensors and flexors. If the sit-to-stand desk is not an option (I mean, not many have the cash dollar for that), then invest in a better chair. And better doesn’t necessarily mean more expensive. I often say to my patients, get a pilates exercise/swiss ball (the correct size for your height). They are relatively inexpensive and trust me if you aren’t maintaining the correct posture whilst sitting on it, I am sure you’ll be falling over more than sitting. Using a Pilates exercise ball is massively beneficial as it helps to absorb the increased spinal load, it provides a softer cushion for the gluteal (bum) region and if you ask anyone of my patients who have used one, it definitely makes you activate and utilise the deep abdominal muscles to stabilise your spine. It practically forces you to be seated in the upright position.

    Better yet, invest in a FitChair. I’ll allow a patient review to speak for itself.  “As I work within a corporate environment I find I spend more time sitting at work then I do standing or even sleeping in my bed. After suffering frequently with upper back pain and slouching, I decided to invest in a FitChair for work. Because hey, spending more time sitting at work then sleeping in my bed at home – it was a worthwhile investment. I have been using it for a few months now and I have seen and felt amazing results. I no longer slough, my posture has improved, my back and stomach muscles have strengthened, and I haven’t experienced much back pain since. To be honest, if you’re considering buying one, I do warn you that for the first week your abs feel like they are working and you will feel a bit tired, but after that it is super comfy. When I travel for work, my other work colleagues jump at the opportunity to use my chair. I couldn’t think of using another chair again.” – Casey Nielson

    PHOTO 2018 10 30 18 33 59 768x1024 1
    A picture is worth a thousand words. Casey using her FitChair at work.

    Which brings me to the final point, seek chiropractic care, for many reasons. Ergonomic advice. Postural assessment. Education on, and correction of posture. To remove spinal dysfunction and restore joint mobility. To reduce strain and tension. To alleviate discomfort and musculoskeletal pain. To safeguard your spinal health. And, and, and! I could unpack every single one of these statements, but promoting chiropractic care is not the main point here. It’s as simple as: “low back pain and neck pain are the leading causes of missed work” and “on average we sit more than we sleep nowadays.” You cannot neglect this alarming information. 

    According to the ongoing conversations I have outside of practice, as well as my general observation of individuals postures (it’s a habit as a chiropractor), it seems that we are well aware of our incorrect or strained postures but not enough for it to motivate us to do something about it. And I think it’s because we are under the false impression that it is not detrimental. It kinda is, but not really. Or, we know it’s detrimental but it’s just too much effort to actively work at improving it. Yes, it does require effort, not just for one week, persistent effort in actual fact, but I can guarantee you’ll wish you preserved your health when your future self is on the brink of spinal surgery due to degenerative processes, or you’re living in a state of 7/10 pain rating and consider this the norm. I know I sound harsh or like the bearer of bad news, that’s not my intention. My intention is to make you realise that your wellness and health is wealth; it’s worth fighting for. And it’s in the smallest investments and simplest changes that we can achieve that. 

    “Being proactive about your health will result in less time, money and pain to keep you injury-free.” – Dr Dunaway. (Article is written from a combination of my experiences and the various research I have read over time, hence collective knowledge with no specific reference to particular articles).

    Big love,

    Doc Lol x

    Inspiring you to Move. Heal. Excel.

  • The preservation of health is easier than the cure for disease.

    The preservation of health is easier than the cure for disease.

    To my patients, and others reading, a warm hello to you all. Being the first blog, it was quite difficult to decide what to write on because the topics seem endless. Which one to pick? I’ve kinda been racking my brain a bit. But I thought I’d keep it pretty simple, set the foundation straight and focus this chat on what this profession is actually about, how I apply this to my practice, and how it can have a positive impact on YOU. 

    I often hear people say, I don’t need to see a chiropractor because I’m not in any pain. For me… insert cringing emoji face. Is our level of functionality depicted by our level of pain? This is like saying, “Just because I’m skinny, I’m healthy! (Currently digesting a McDonald’s burger – not me).” I don’t believe this to be true. I think this misconception has developed because it’s been constantly drilled into us that we only see a doctor or healthcare professional when we are sick or injured. Yes, in some cases this can be true, agreed; however, for example, you don’t only need to visit a Biokineticist once you’re recovering from surgery. What about prehab? Postural correction before the onset of pain or potential need for surgical intervention? Strength and conditioning for an athlete? Pain is certainly not the only reason for chiropractic care either.

    BJ Palmer had this to say, “The preservation of health is easier than the cure for disease.” However, in order to truly understand what the ‘preservation of health’ actually looks like, I think there is one important thing we need to actually grasp about what HEALTH is: “Health is not about how you feel, it is about how well your body is functioning.” The physical feeling of a disease or niggle may have spent ages manifesting and you weren’t even aware of it. Chiropractic care aside (I’ll get to this in more detail), here’s a simple example; in as many as 50% of cases of cardiovascular disease, the first symptom is either a heart attack or death – that is a pretty alarming fact. We may feel fine, but our bodies may not be functioning effectively. As the world advances, our bodies undertake increased stress levels and we develop this attitude that we are invincible, we can handle it. “Argh I’ll start eating healthy next week Monday (New week, new goals right?); I don’t have time to exercise because work is too hectic; Yes I have bad posture… so? I will see the chiropractor when I get to a 10/10 pain rating or when my pain killers run out.” Sound familiar? But the reality is, this all has a direct effect on the homeostasis of our bodies. And this is where chiropractic comes in. 

    We are neuromuscular skeletal doctors – we believe in achieving a healthy spine and nervous system because the nervous system controls and coordinates every organ and cell in the body. We influence the system that runs ALL other systems in the body. Therefore, it is absolutely crucial that it is functioning correctly. We can identify subluxations that rob the body’s ability to focus, think, organize and heal; and provide chiropractic adjustments to help restore motion into the areas of the spine, as well as reestablish homeostasis (proper function) to the nervous system. Furthermore, pertaining to me in particular, those individuals who are my patients will know that my approach to chiropractic care is further reinforced by taking interest in one’s lifestyle – I spend a fair amount of time diving into exercise regimes, proper diet, sleep patterns, and any other factors that can affect a healthy lifestyle. I have a passion for the holistic approach to chiropractic practice because I do believe that all factors have an impact on how well we are functioning. My take in a nutshell: Combining chiropractic adjustments, soft tissue therapy, education, and patient relationships. When we move well, we can heal, and hence excel in more ways than we think.  

    So, ultimately chiropractic care is about allowing your body to heal itself, to function and move at its optimum. So the next time you get that physical feeling or niggle that whispers to you, don’t ignore it. Be proactive and listen to your body and you won’t have to hear it scream. I read an article that gave me a great perspective regarding the onset of back pain, and it has shaped how I like to educate my patients on this topic and help them to better understand the preservation of health. “Back problems are rarely the result of a singular incident, but rather the culmination of several smaller traumas. Think of it like boxing. The knockout blow only becomes so devastating because it was set up by all the other punches before it.” 

    I hope this has provided some insight into what I do and what this profession is all about from my perspective. And if you’re reading this line, congratulations on reading the entire blog post (unless you just skipped to the end haha). 

    A massive thank you to all those that have entrusted me to look after them from a chiropractic perspective, I value every one of my patients dearly. 

    Remember, 

    Move. Heal. Excel. 

    Big love, 

    Doc Lol x