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Prevent Joint Injuries with proper movement

6/29/2016

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Human joints come in many shapes and sizes and allow us to move and carry out normal activities of daily living. Without joints, we would be rigid and immobile. But they are also often injured, causing pain and discomfort. The most commonly injured joints are the knees, shoulders, ankles and spine. Approximately 30 million doctor visits a year are due to knee and shoulder injuries alone. Some 150 million to 200 million cases of back pain send people to the doctor every year—and many of those are related to joint injuries.

How do joints work?
Joints are designed to withstand the loads placed on them and provide a full range of motion. Each joint is made up of at least two surfaces that touch each other and allow for movement. These include ball-and-socket joints such as the hip; hinge joints such as the knee and elbow; and gliding joints, such as those in the spine.

The bones that make up the joint allow movement, but it is the muscles that pull the bones that produce the movement. Muscles are attached to bones by structures called tendons. Tendons must be both strong to facilitate movement and compliant to prevent damage to the muscle tissues. Ligaments, which are stiff structures that connect bones, help to prevent excessive movement.

Muscles, tendons, and ligaments are attached around each joint at very specific positions, with joint surfaces shaped in exact dimensions. Fluid within most of the joints lubricates the joint surfaces to reduce friction and allow for lifelong use.

How do I keep joints in good shape?
The movements that you perform on a daily basis are critical to long-term joint health, as are proper nutrition, a healthy exercise regimen, and a healthy lifestyle. Proper lifting is also important. Moving a joint through its full range of motion serves several important purposes. Joints are not supplied directly with blood as are other organs within the body, so the saying “If you don’t use it, you’ll lose it” applies to joint function. Most joints in the body are lined with cartilage—a firm but pliable tissue that covers the surfaces of the bones that make up the joint. Cartilage within a joint is nourished by synovial fluid, which is “forced” into the joint cartilage through a process called imbibition.  The pressure within the joint providing nourishment to the cartilage occurs only when joint movement happens. And this is why movement is critical to joint health. Grinding of bone on bone without a cartilage covering leads to degenerative joint disease, tearing up the bones and creating cysts, bone spurs, and excess bone production.

A spinal disc is made up of two parts: a larger, outermost, more ligament-like portion called the annulus fibrosus and an inner gelatinous portion called the nucleus pulposus. These two structures are primarily fluid- or water-based and they also rely on movement and imbibition for their nourishment. Therefore, movement in the spine is also critical to the health of the spinal joints.

Proper diet and nutrition also contribute to joint health by providing the joints with enough healthy nutrients for long-term stability and resistance to wear and tear.  A healthy lifestyle, one that is free from tobacco products and other toxins, helps to ensure proper blood supply to tissues surrounding joints and speeds up healing of joint injuries when they occur.

How are joints injured?

Most of the injuries to joints occur because abnormal stresses are placed on a normal joint. A joint can be injured acutely from a single traumatic event…Other joint injuries are called repetitive-stress injuries or cumulative-trauma disorders. These injuries occur when relatively small abnormal stresses are repeatedly placed on normal joints. The stresses placed on joints by poor posture, poor joint position during the performance of a task, and/or poor workstation ergonomics make these joints more likely to be injured.

How can I prevent repetitive stress injuries?

There are three basic principles that are especially important when considering the impact of proper joint movement:

1. When lifting an object, be sure that the largest muscles in the area perform the task. The larger the muscle or muscle group utilized for lifting, the less the stress placed on smaller, more vulnerable muscles and the joint itself.

2. During any activities, you should be able to comfortably assume several different postures, to avoid staying in one posture for extended periods. Muscles will fatigue and joints are more likely to be injured when you hold a particular posture, especially a poor one, such as staying partially bent forward at the waist.

3. When performing tasks, keep the joints that are being used either in their neutral posture or approximately halfway into the range of motion. Working with your joints at the extremes of their ranges of motion for prolonged periods places abnormal stresses on those joints and can result in repetitive-stress injuries.

source:  Copied from JACA Online Healthy Living Fact Sheet May/June 2009
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What do I do to stay properly hydrated?

6/29/2016

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We really don’t know the exact answer to this question because fluid requirements vary from person to person—and from day to day. For example, infants need more liquids than adults because their bodies maintain a higher water content and their systems do not provide water balance that’s as good as what’s found in adults’ bodies. The general guidelines for hydration are: 

  • Numerous studies investigating water balance have demonstrated that the minimal water requirements of inactive adults who live in normal temperate climates are approximately 1 to 3.1 liters (or 34 to 105.4 oz.) a day. This amount should adequately replace estimated minimum respiratory, urinary, fecal, and insensible water losses. 

  • A general guide for replacing water loss is 1 liter (34 ounces) of fluid for every kilogram (2.2 pounds) lost, or 2 cups (16 ounces) for every pound lost.

  • In more physically active individuals, the amount of water intake necessary to maintain proper hydration varies between 2 to 16 liters per day, depending on the activity and the individual. Physically active individuals are not necessarily athletes. Farm workers, heavy laborers, and the like naturally have higher needs for water.

  • If you are planning a strenuous physical activity, drink approximately 2 to 3 cups of cold water 2 hours before activity. Drink 1 cup approximately 10-15 minutes before the activity or during your warm-up. During the activity, drink 3 to 4 cups of water every hour of activity, or 1 cup every 15 to 20 minutes. After the activity, you should rapidly replace the fluids that you lost within 2 hours. You should drink approximately 16-24 ounces of water for every pound lost during the activity. 

  • Cool beverages of 50-60 degrees are the best forms of fluid for the body. If an activity lasts longer than 1 hour, a sports drink is often recommended. 

  • Fluids with salt (e.g., sodium, potassium) are beneficial because they increase thirst. The salt also helps replace what’s lost through sweat. If you choose a sports drink, it should contain no more than 7% of carbohydrates per serving. 

  • Avoid fruit juices, carbohydrate gels, sodas, alcohol, and high-sugar sports drinks. These may dehydrate the body further by stimulating excessive urine production and/or decreasing your overall beneficial fluid intake.

source: JACA Healthy Living Fact Sheet April 2006
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Keeping Correct Posture

6/29/2016

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How do I sit properly?
• Keep your feet on the floor or on a footrest, if they don't reach the floor.
• Don't cross your legs. Your ankles should be in front of your knees.
• Keep a small gap between the back of your knees and the front of your seat.
• Your knees should be at or below the level of your hips. 
• Adjust the backrest of your chair to support your low- and mid-back or use a back support.
• Relax your shoulders and keep your forearms parallel to the ground.
• Avoid sitting in the same position for long periods of time. 


How do I stand properly? 
• Bear your weight primarily on the balls of your feet. 
• Keep your knees slightly bent. 
• Keep your feet about shoulder-width apart.
• Let your arms hang naturally down the sides of the body. 
• Stand straight and tall with your shoulders pulled backward.
• Tuck your stomach in.
• Keep your head level-your earlobes should be in line with your shoulders. Do  not push your head forward, backward, or to the side.
• Shift your weight from your toes to your heels, or one foot to the other, if you have to stand for a long time. 


What is the proper lying position?
• Find the mattress that is right for you. While a firm mattress is generally recommended, some people find that softer mattresses reduce their back pain. Your comfort is important.
• Sleep with a pillow. Special pillows are available to help with postural problems resulting from a poor sleeping position.
• Avoid sleeping on your stomach.
• Sleeping on your side or back is more often helpful for back pain.
• If you sleep on your side, place a pillow between your legs.
• If you sleep on your back, keep a pillow under your knees.

Source: Copied from JACA Healthy Living Fact Sheet May/June 2006
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Vitamin D

6/29/2016

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Vitamin D is a nutrient generated by the body through exposure to the rays of the sun. It can also be found in some foods. Vitamin D plays an important role in building strong bones by helping the body absorb calcium from food and supplements. People who get too little vitamin D may develop soft, thin and brittle bones.

Vitamin D is found in cells throughout the body and is vital for many other health functions, as well. It participates in the nerve and muscle function, as well as in the function of the immune system and in the reduction of inflammation.

How can I get vitamin D?

The body makes vitamin D when skin is directly exposed to the sun outdoors. During the warmest months, for example, 5 to 30 minutes of exposure between 10 AM and 3 PM several times a week to the face, arms, legs, or back without sunscreen may be enough to produce sufficient vitamin D. However, excessive exposure to the sun increases the risk of skin cancer. When out in the sun, wear protective clothing and apply sunscreen with a sun protection factor of 8 or more. Cloudy days, shade, and having dark-colored skin cut down on the amount of vitamin D the skin makes. People who avoid the sun, who cover their bodies with sunscreen or clothing, or who live in the northern half of the United States during the winter months should include good sources of vitamin D in their diets or take a supplement. Vitamin D is found in supplements in two different forms: D2 (ergocalciferol) and D3 (cholecalciferol). Both increase vitamin D in the blood, but the D3 form may do it better and keep levels raised for a longer time.

Vitamin D in American diets is found mostly in fortified foods:

• Fatty fish such as salmon and tuna, as well as fish liver oils, are among the best sources.
• Beef liver, cheese, egg yolks and some mushrooms provide small amounts.
• Almost all of the U.S. milk supply is fortified with 400 IU of vitamin D per quart. But foods made from milk, like cheese and ice cream, are usually not fortified.
• Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt, margarine, and soy beverages. Check the labels for more information.

 Am I getting enough vitamin D?

The amount of vitamin D required depends on your age. Average daily recommended amounts for different ages are listed below in International Units (IU):

Children and most adults 200 IU
Adults 51–70 years 400 IU
Adults 71 years and older 600 IU
Pregnant and lactating women 200 IU 

Measuring blood levels of 25-hydroxyvitamin D is the best test to check the levels of vitamin D in the body. In general, levels below 15 nanograms per milliliter (ng/mL) are inadequate, and levels above 200 ng/mL are too high. Some nutrition experts think a blood level of at least 30 ng/mL is best for overall good health. By these measures, some Americans are vitamin D deficient and almost no one has levels that are too high.
 
What precautions do I need to take with vitamin D?

When amounts of vitamin D in the blood become too high, it can lead to toxicity--
nausea, vomiting, poor appetite, constipation, weakness and weight loss. In addition, by raising blood levels of calcium, too much vitamin D can cause confusion, disorientation and problems with heart rhythm. Excess vitamin D can also damage the kidneys. The safe upper limit for vitamin D is 1,000 IU/day for infants and 2,000 IU for children and adults. Vitamin D toxicity almost always occurs from overuse of supplements. Excessive sun exposure doesn't cause vitamin D poisoning because the body limits the amount of this vitamin it produces. Like most dietary supplements, vitamin D may interact or interfere with other medicines or supplements. Tell your health care providers about any dietary supplements and medicines you take.

Source: Copied from JACA Healthy Living Fact Sheet May/June 2010
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Headaches: Facts and How to Avoid Them

6/29/2016

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Picture
Alarming facts about headaches:
-9 out of 10 Americans suffer from a headache at some point in their life
-45 million Americans suffer from recurrent headaches, while 28 million of those suffer from migraines.
-The most frequent type of headache is known as a tension type headache, occurring when the muscles in the back of the neck get tight or go into spasm.
Common Headache Triggers:
-Caffeine withdrawal
-Caffeine-Alcohol and Dehydration
-Smoking
-Tight pony tails, hair bands, or hats pulling on hair
-Slouched or improper neck posture
-Warm weather
-Strong scents
-Excessive salt
-Skipping meals
-Chocolate
-Nuts (peanuts, brazil nuts, and even coconuts)
 -Allergies (pet, grass, mold, weeds, food, etc…)

Migraine Triggers:
-Tyramine rich foods:Bananas, Grapes, Raisins, Prunes, Plums, Oranges, Avocadoes, Dried Fruit, Eggplant, Figs, Pineapples, Soy, Tofu, Sauerkraut, Aged Cheeses (asiago, romano, parmesan, aged cheddar, etc…) 
-Foods seasoned with monosodium glutamate (MSG):  Seasoned potato chips/many processed foods with added seasoning
-Nitrate containing foods:  Processed meats, hotdogs, etc…
-Over sleeping or not getting enough sleep
-Oral Contraceptives
-Alcohol/Red Wine/ Any of the common headache triggers listed above 
Ways to reduce headaches:
-Avoid the triggers
-Acupuncture
-Chiropractic care
-Biofeedback
-Stress reduction techniques
-Deep breathing techniques
-Fish Oil
-Vitamin B12
-Get the same amount of sleep each night (6 to 8 hours)
-Several over the counter medications

Sources:"Foods Containing Tyramine." Wikipedia, the Free Encyclopedia. Web. 16 July 2010. http://en.wikipedia.org/wiki/Foods_containing_tyramine."Alternative Migraine and Headache Treatments." WebMD - Better Information. Better Health. Web. 16 July 2010.http://www.webmd.com/migraines-headaches/stop-frequent-migraines-5/remedies.
"Headaches and Migraines Center: Treatments, Causes, Types (Cluster, Tension, Chronic, Sinus, and More )." WebMD - Better Information. Better Health. Web. 16 July 2010. http://www.webmd.com/migraines-headaches/default.htm.
"Headache and Migraine Causes Slideshow: 12 Surprising Headache Triggers & Tips for Relief." WebMD - Better Information. Better Health. Web. 16 July 2010. <http://www.webmd.com/migraines-headaches/slideshow-surprising-headache-triggers>.
 

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Calcium Supplementation and Osteoporosis

6/29/2016

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The proper amount of calcium is vital to your health:
National Institute of Health Recommendations:
Teens:   1300mg per day
Adults <50 y/o:   1000mg
Adults >50 y/o:   1,200mg
The main reason for the increased dosage in teens is due to the desire to help them avoid osteoporosis later in life.  It is also important for Women to be mindful of their Calcium intake.  Bones are made of calcium, and many females do not get the recommended dosage of calcium through their diets alone.  This may lead to osteoporosis later in life which can lead to fractures, and pain. 
Calcium is absorbed in the small intestine when we have an acidic gastric pH.  This level of acidic pH is generated normally after meals.  Interestingly enough, popular antacids claim to give you calcium in every dose.  However, these antacids work by raising the pH in your stomach and small intestine, thereby limiting the amount of calcium you are able to absorb.  The same is true of other antacids including the popular proton pump inhibitors containing omeprazole “Prilosec”, or lansoprazole “Prevacid®.”  The Journal of The American Medical Association found “the risk of hip fracture was significantly increased among prescribed long term high dose proton pump inhibitors.”  This study appears to reveal the link between proton pump inhibitors and osteoporosis later in life, so be careful with what you are giving to your children.
Adding a Calcium supplement to your diet may help lower the risk of osteoporosis later in life.  If you or your children are not getting enough calcium through the foods you eat, you should consider taking a calcium supplement.  I recommend the cheapest form of calcium available, which is calcium carbonate.  Your body will only absorb about 500mg of calcium at one time, so depending on the amount of calcium you are getting from your diet, I advise taking about 500mg twice a day.  Another important fact to remember is that Vitamin D is needed for proper calcium absorption.  Sunlight produces Vitamin D naturally in your body, so I recommend getting 15 minutes of sunlight each day.  Too much Calcium has been linked to the development of kidney stones; however, so limit your intake to 1000-1500mg/day.

Citations:

Yang, Yu-Xiao, James Lewis, Solomon Epstein, and David Metz. "JAMA -- Long-term Proton Pump Inhibitor Therapy and Risk of Hip Fracture, December 27, 2006, Yang Et Al. 296 (24): 2947." JAMA, the Journal of the American Medical Association, a Weekly Peer-reviewed Medical Journal Published by AMA. Web. 10 June 2010. http://jama.ama-assn.org/cgi/content/full/296/24/2947. 

Shaw, Gina. "Understanding Calcium: Supplements, Calcium Carbonate, Calcium Citrate, and More." WebMD - Better Information. Better Health. Web. 10 June 2010. http://www.webmd.com/osteoporosis/features/calcium-supplements-pills.
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Sports Injuries: Sprains and Strains

6/29/2016

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Ankle sprains most often involve tears of one or more of the ligaments along the outside of the ankle.  Knee ligaments can also be torn.
An acute twisting or overextension of a joint can lead to tears of muscles and tendons, called “strains,” and tears of ligaments result in “sprains.”  These tears range from mild to severe.
In mild injuries, just a few fibers are torn or stretched.  Severe injuries, where there is a tear through the fill thickness of the structure, frequently require surgical intervention.
The intervertebral disc, a ligament between the vertebrae of the spine that works as a shock absorber, can also be torn, resulting in a disc bulge and/or herniation.
Source:  Copied from ACAnews – August 2010, article by Lawrence H. Wyatt, DC, DACBR, FICC 
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    Dr. Joe Glenn, DC, MS

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