Seminar Schedule and Chiropractic Educational Products by Dr. Malik Slosberg

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This weekend, I will be at SFO attending one of my favorite seminars presented by Dr. Malik Slosberg. I have found that this post-graduate seminar is always packed full of valuable information that helps me understand the biomechanics and physiology of chiropractic care.

The seminar reviews the very latest chiropractic research in a practical, yet inspiringway, so clinicians can integrate the newest information into daily practice and improvepatient compliance, education and outcomes

Attendees will learn: how to use the abundance of current information on adjustmentsand exercise to change the natural history of chronic problems; how to improve patientfunction, performance, satisfaction, self-efficacy, and neuromotor control; and how todocument patient progress using patient self-reports and objective physicalperformance tests. This dynamic presentation is filled with colorful computer graphics, illustrations and data charts that will captivate doctors’ attention.

Source: Seminar Schedule and Chiropractic Educational Products by Dr. Malik Slosberg

Would You be a Volunteer Crash Test Dummy?

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Road and Track ran an interesting story where they sent one of their writers to Las Vegas to volunteer to be a crash test dummy. After trying to arrange a crash test conducted by auto manufacturers and Insurance Institute for Highway Safety (IIHS), who rejected their request based on ethical grounds, they finally found a group called the Collision Safety Institute (CSI). The CSI does their own independent crash tests to measure certain parameters for insurance purposes and law enforcement.

The writer, John Krewson, is seen in this video:

That is a crash between a 2007 Crown Victoria taxi and a Subaru WRX STI. The Crown Vic was going 40 mph at the point of impact, and the Subaru’s force sensor measured 100g’s of force at the a-pillar. Even with all of this force, the author was left with only aches and pains over the next couple of weeks.

Pretty crazy to put yourself through that, but there are a couple of things that make this different than a car crash that you might have been in. For starters, these guys had mouth guards in, and they were definitely braced for impact. Many of my patients who I see in the clinic are not braced for the collision. When you are caught unaware, you have less muscle strain, and more ligament sprain. Ligament sprains take a much longer time to heal.

Second, these guys are doing the hitting; they aren’t the “target” vehicle. When you are being hit, you have a lot less deceleration or acceleration time to cushion you from the blow. As the article points out, the G-force on the Subaru was 100g’s! That would be pretty concussive, if not fatal. When you are rear-ended, it’s not as bad as you have more crumple zone in the rear of your car, but it still affects the facet joints in the back of your spine, and it will still likely catch you off guard. Also, in a rear-ender, you don’t have a lot of space between your body and the car’s seat. Some car seats break away to absorb impact, other’s don’t.

This reminds me of other experiments done where there were some insurance adjustors who volunteered to be in a low impact, rear-end collision. When they were asked if any part of their body hit the back of the head restraint, or if their head whipped forward, they said “no”. But, when they rolled the video, they were shocked to see how much their heads pitched back and forth in slow motion.

Thankfully, cars are getting a lot safer. The Road and Track article says that we are essentially living in an era of Peak Safety. All cars sold today are safe. You’ll have a very hard time going to a car dealership and finding an unsafe car nowadays.

Todd

Source Road and Track I Was a Human Crash-Test Dummy

San Francisco Trigger Point Therapy Workshop

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On tuesday evening, March 10, I will be leading a trigger point therapy workshop at Rincon Chiropractic.

This will be a workshop where we will pair off and take a hands-on approach to caring for your trigger points with either the help of a partner, or for yourself.

To prepare, I’ve been watching Youtube videos on the subject.Above it the first one, and one that I thought had excellent animation. It’s a great overview of trigger point therapy, and it even goes into the sarcomeres of the muscles and how they are at the center of your trigger point.

This next one is one that I had to cut short because it was intolerable. The lady was reading from a script, and she was going over very dry anatomy. Not a good combination. Here’s the video, but I find it hard to recommend.

Still, I guess it’s a nice niche to brand yourself as an expert of a trigger point therapist.

Here’s a guy who started a niche about back pain. It looks like he even wrote a book about it. He uses a device in the video that he sells. It has knobs that dig into his glute muscles. You may not need a special device; I have been to plenty of rehab seminars where they use lacrosse balls or baseballs to dig into the trigger points in the glutes and piriformis muscles.

Here’s a doc who gives helpful advice on treating your own trigger points. Along with a slow, sustained ischemic press, you can also do a myofascial release by raising the arms up and down, and you can even give it a wiggle by oscillating your body by pushing with your feet. He goes over the distinction between active and latent trigger points.

Up next I saw this video who is a “certified trigger point therapist.” Good for him. He does give some good advice for self care:

  1. Keep your targeted muscle relaxed.
  2. When putting pressure on your trigger point, only take the pain up to a medium setting. Do 5-6 on a 1-10 scale.
  3. Put pressure on the muscles, not on joints. For example, when you roll on your legs, don’t be rolling the back of your knees. You have arteries and veins there, and nerves that you can irritate.
  4. Gently stretch the muscles after you treat them.

 

Does chiropractic care help with neck pain with pinched nerves?

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When your neck becomes arthritic and painful, the bones and inflamed soft tissue can compress the nerves that travel through the neck and down the arms. This is called osteoarthritis and degenerative joint disease (DJD). More specific to the bones in the spine, this is called degenerative disc disease (DDD). When you have degenerative disc disease and it presses on a nerve, it is called a radiculopathy, and it will cause pain that travels down the arm, tingling in the fingertips or arm, and numbness in the fingertips or arm. If a radiculopathy gets bad enough, it can cause the muscles to shut down, and this can be a surgical case, rather than a chiropractic case.

But before it becomes a surgical problem, can chiropractic care fix it?

A paper published in the journal Clinical Rehabilitation took a good look at the current published evidence to find out. They noted that cervical radiculopathy is often treated by conservative methods. These conservative methods include non-steroidal-anti-inflammatory drugs (NSAIDS), oral steroids, computerized cervical traction (decompression), manual therapy, cervical collar.

NSAIDs are a very common for the common person to use. It’s available over the counter, and you can buy as many as you want for very cheap. The problem with NSAIDS is that they tear up your stomach–they can cause ulcers. NSAIDS are actually a very common cause of illness or death in around the world. NSAID use has been associated with ulcers, serious cardiovascular events, hypertension, acute renal failure, and worsening of previous heart failure. Use them sparingly.

Cervical collars use to to be used more commonly for neck pain, but in the past couple of decades, you don’t see them being used anymore. This is because the supportive collar can make you dependant on it to move through your life. It can make the muscles in your neck shrink. And worse, this kind of brace can reinforce your pain avoiding behavior, rather than confronting the painful area with better function. It’s pretty well-known in chiropractic and physiotherapy that we should use cervical collars sparingly.

Because more and more people are using spinal manipulation around the world, these reviewers are in China, they wanted to take a critical look at how it works. They recognize that when you have your neck adjusted, it provides pain relief accompanied by an audible pop. They surmise that within the joint, there is a gapping in the facet joints and a reflex relaxation of the supporting muscles of the spine. This allows better circulation in the soft tissue in the joints and supportive ligaments in the spine, and it accelerates your body’s ability to heal itself.

These researches looked at over 2500 articles to find out what research was available for neck pain, radiculopathy, and manipulation. They sorted through them and only found 3 studies that met their exact criteria. They found that the three studies were of “moderate” quality. What this is is an understated way of saying that the studies were really good. They’re not gold standard, but they were very well designed. All three studies were randomized controlled trials. Some people in the studies got the treatment, and some got no treatment, and the patient’s outcomes were compared.

What they found was that in all three studies, the patients with pinched nerves improved compared to the patients that had no treatment or computer traction. Spinal manipulation works better than traction. Not only does cervical manipulation work better than other forms of treatment, but it has an immediate effect with treatment. Getting adjusted gives you an immediate, palpable improvement in the way you feel. You feel like pressure is released immediately.

In summary, this review is similar to the guidelines published by the North American Spine Society. The NASS guidelines are evidence-based reviews that give spine doctors a roadmap for treatment when they have patients with certain conditions. For patients with low-back radiculopathy, they recommend spinal manipulation by chiropractors as the first course of care. Spinal manipulation has positive evidence in support of it, while certain medications have no evidence, or evidence against their use. There is no evidence in support of exercise or stretching techniques for treating a pinched nerve. Only chiropractic adjustments show improvement for lumbar spine radiculopathy. This study shows the same for the neck.

Todd Lloyd, DC
chiropractor in San Francisco.

Even Harvard Medical School recommends chiropractic care for pain relief.

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In an undated article from Harvard Health Publications, Harvard Medical School recommends that you try chiropractic care to restore your body’s alignment, and thus help you with your pain relief.

[pullquote cite=”Harvard Health Publications” type=”left”]Chiropractors try to correct the body’s alignment to relieve pain and improve function and to help the body heal itself.[/pullquote]

They say, “While the mainstay of chiropractic is spinal manipulation, chiropractic care now includes a wide variety of other treatments, including manual or manipulative therapies, postural and exercise education, ergonomic training (how to walk, sit, and stand to limit back strain), nutritional consultation, and even ultrasound and laser therapies. In addition, chiropractors today often work in conjunction with primary care doctors, pain experts, and surgeons to treat patients with pain.

“Most research on chiropractic has focused on spinal manipulation for back pain. Chiropractic treatment for many other problems—including other musculoskeletal pain, headaches, asthma, carpal tunnel syndrome, and fibromyalgia—has also been studied. A recent review concluded that chiropractic spinal manipulation may be helpful for back pain, migraine, neck pain, and whiplash.”

I’d say that is a pretty good endorsement, and that’s exactly why I chose to become a doctor of chiropractic.

Todd Lloyd, DC
chiropractor in San Francisco

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Should your kids lift weights?

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It’s well known that part of an adult’s healthy lifestyle includes lifting heavy weights. you lift heavy things, and your muscles become healthier. Your posture improves. You feel better. You look better. You become more fit. Lifting weights can help prevent chronic degenerative diseases of aging, and it can prevent the most disabling conditions that working adults face, namely, depression, back pain, and other body aches.

You should be lifting weights, but what about your kids?

It turns out that your kids should be lifting and playing too. Here is a well-done set of guidelines published by Canadian Sport for Life. They say that being active helps kids understand the rules of play, the ethics of sport, and can make them more well-rounded. Kids should be engaged in a wide-variety of sports, and not just specialize on one. The exception to this rule of no specialization is certain sports such as gymnastics or diving.

So, part of this having a wide variety of activity includes weight lifting. The Well Blog at the NYTimes says that lifting weights for kids is essential. It turns out that kids as young as 6 years of age can build muscle strength when they lift. Especially on a consistent basis, but kids won’t add bulk like adults do.

Muscle strength training in kids tends to make existing muscle fibers more efficient. When your kids lift, their nerves can recruit more muscle fibers as they do so. Their nerves and muscles become more efficient, and they become stronger.

Kids grow more both physiologically and psychologically when they lift. just like you, when they lift, they notice that they become stronger. They feel good about themselves. Kids get in touch with their genetic primal selves. They become freed from the their imprisoned lives in front of a classroom or in front of a glowing computer screen.

By strength training, kids become conditioned to become stronger and less likely to become injured. They can go out into the playground and the real world and their bodies can take care of themselves. Between the ages of 7-12 is a very important time in a kid’s growth where they benefit the most from strength training. And, at this age, you don’t need special weights or weight machines. Kids can do body-weight exercises like pushups and jump-squats and they will gain.

Todd Lloyd, DC

Excellent shoulder examination

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I ran across this video the other day of an orthopedic surgeon doing a shoulder examination. I thought this guy presented it so well, that I had to share it.

Dr. Hawkins of the Steadman Hawkins Clinic starts out by talking about how the usual shoulder exam goes straight to the point. If you are talking to a patient, and the patient’s history of injury points to a labrum tear, then you would just go straight to labrum tear tests. If you have an elderly patient with an obvious rotator cuff rupture, then you wouldn’t do all of the shoulder tests. You would just confirm the obvious injury.

This video talks about a comprehensive shoulder examination. This involves inspection, palpation, range of motion testing, neurological testing, and orthopedic testing.

Starting with inspection, you take a look at the patient and notice the standing anatomy of the shoulder. Look for any scapular winging, muscle wasting. Inspect and palpate the supraspinatus and infraspinatus. Run along the top of the trapezius, deltoid, clavical. Down at the throacic outlet, there is a depression just proximal to the AC joint that surgeons use for labrum tear surguries. This is called the neviaser portal.

Todd Lloyd, DC

The Bay Area’s tech scene is the reason why I love The City

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This is the reason why I love practicing in San Francisco’s South of Market neighborhood: The tech scene. Every day I get to rub elbows with people involved in multi-billion dollar companies as well as lean tech startups.

This morning as I was walking to the office on Howard Street, I was listening to the excellent Tim Ferriss Podcast where he was interviewing Matt Mullenweg, who is the founder of WordPress. In the passage in the video above, Matt talks about the competitive tech scene, and how it’s actually to his advantage to have software engineers all over the world as they are in high-demand in San Francisco.

It was a great podcast, and was a nice follow-up to Tim’s recent Arnold Schwarzenegger podcast.

Todd Lloyd, DC

Here are five reasons you need to use a rebounder.

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You might be wondering what a rebounder can do for you. I had the same question when I was looking for one last year. Purchasing my rebounder has been one of the best investments in my health. Not only to I get to start the day out with a fun workout, but I arrive at work feeling more energetic and focused.jump sport

When I was looking at what type of rebounder to buy, I was faced with multiple decisions from $30 el cheapos to the flagship bellicon, which can cost between $499.00-$1050.00. I started to research obsessively on what to buy, even going to sporting good stores to try them out. you might be familiar with the cheap ones with the metal springs, and you might even think you are safe settling for these, but you consider stepping up to something that you will enjoy more. I have found that the cheap steel spring-based mini trampolines are noisy, and, more importantly, are rough on your joints. The bellicon, which I invested my hard-earned money on, is very smooth to jump on. With its bungee cords, It’s completely silent. More importantly, it has a comfortable yet stimulating bounce to it. If paying $800 for a bellicon is a little rich for you, you could also consider a Jump Sport. I consider the Jump Sport a really good rebounder, and is a lot less expensive.

There are several different exercises that you can do on your rebounder. You are able to use hand weights while bouncing, which has helped tone my arms. You can bounce to videos, or just turn on some good music and bounce while doing jumping jacks, which can be very engaging for you. You could also get into a moment of zen as you are bouncing on it while meditating.

Here are some of the heath benefits that you will enjoy while rebounding.

Rebounding is a great full-body detox as up and down movement helps the lymphatic system detox.

When you bounce, your body’s lymphatic system is being pumped around your muscles and through your whole body. Your lymphatic system is responsible for carrying fluids from in and around your cells back into your blood. Along the way, your lymph fluid gets filtered in your lymph nodes. As a matter of fact, a lot of people report that they feel achy and they get headaches after bouncing on their rebounders for the first time. They say that is is because your body is flushing toxins through your lymph system.

You’ll have an increased immune system

That brings us to your immune system. As you flush toxins through your lymphatic system, it allows more freely flowing lymph fluid through your cells, accelerating your body’s immune attack.

You’ll see a less cellulite

As your lymph system and your muscles tone, then you’ll soon start to see that your thighs and butt are smoother.

You will notice that your overall body is more tone

And your body will start taking shape. I have noticed a lot more definition in my legs, and ever since I started bounding for fun on my bellicon, I can see my abs.

You’ll enjoy this exercise

I promise you will feel like a kid when you are “exercising” on this rebounder. How do I know? Because every time my daughter or step-son see it, they naturally want to bounce on it. You will want to too. It’s the one piece of exercise equipment that consistently gets used multiple times per day.

Felicia Abernethy-Lloyd

 

Cut your migraine medications in half with this simple procedure.

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15 years ago, some researchers had some took a large group of people who were suffering from migraine headaches. Only, this group of people weren’t just people who happen to have an occasional bad day.

If you suffer from headaches, picture this: You have a migraine headache twice a week, and when this migraine happens, you are disabled from doing anything for a full 24 hours. They’re severe. They give you brain fog. You have to retreat to a dark, quiet place because if you don’t, the pounding in your head grows worse and worse. You might feel nauseous. You might feel like vomiting. With this kind of migraine headache, you certainly can’t work. There’s no way you can concentrate with this kind of brain fog and pain going on. You think of calling in sick, but your job is in danger because you’ve used up your sick time too muck already this year.

The group that these researchers were following were taking on average 20 pills per month each to either reduce their pain, or to prevent more migraines from happening. It’s my feeling that it’s okay to take a pain killer once in a while, for occasional pain, but when it becomes long-term use, this is a dangerous situation for you to be in.

About 12% of us over 15 years old experience migraine headaches. Migraines are responsible for $17 Billion in healthcare costs every year in the United States.

If you have migraine headaches, you might be experiencing an aura. An aura is some kind of neurological disturbance that happens before (prodrome), during, or after a migraine headache. You might experience visual distrubances, or feel numbness one side of your body. You could have trouble speaking, or have other kinds of weaknesses during an aura. An aura usually happens on one side of your body or one half of your field of vision. They say that when you have a prodrome that comes before a migraine, you have a “cortical spreading depression” where the blood flow to the brain becomes temporarily starved. The starved blood flow spreads slowly across the surface of your brain, and the brain has a temporary spontaneous excitation of the neurons in the same area. When there’s a spreading depression across your occipital cortex, for example, neurons for you vision. This makes the flashy, zig zaggy lights that travel across your field of view.

So, these researchers followed this group of migraine sufferers for 2 months with their regular treatment involving popping 20 pills a month. After 2 months, they started giving them chiropractic care, fixing their upper neck. They continued keeping a diary of their migraines, and at the end of the 2 months of treatment, they stopped the chiropractic care and tracked them for another 2 months.

At the end of the 6 months of following these patients around, here’s what they say you can expect with chiropractic care if you have migraines.

  1. You’ll have fewer episodes of migraine headaches
  2. When you get them, they will be shorter.
  3. You’ll be taking about half the medications that you were taking before.

When the study was done, they found that the people in the study dropped their medication use from 21 pills a month to about 10. If you think about this from both a personal level and at a public health level, this is tremendously important. In your personal life, when you take fewer medications, Your liver and kidneys will suffer less damage.

All it takes for you to enjoy these benefits is a trip to your local chiropractor.

Todd Lloyd, DC
chiropractor in San Francisco.