04.04.12

Sitting straight ‘bad for backs’?

Posted in Spinal Hygiene at 4:23 PM by Dr. Greathouse

seating positions

Sitting up straight is not the best position for office workers, a study has suggested.

Scottish and Canadian researchers used a new form of magnetic resonance imaging (MRI) to show it places an unnecessary strain on your back.

They told the Radiological Society of North America that the best position in which to sit at your desk is leaning back, at about 135 degrees.

Experts said sitting was known to contribute to lower back pain.

Data from the British Chiropractic Association says 32% of the population spends more than 10 hours a day seated.

Half do not leave their desks, even to have lunch.

Two thirds of people also sit down at home when they get home from work.

Spinal angles

The research was carried out at Woodend Hospital in Aberdeen.

Twenty two volunteers with healthy backs were scanned using a positional MRI machine, which allows patients the freedom to move – so they can sit or stand – during the test.

Traditional scanners mean patients have to lie flat, which may mask causes of pain that stem from different movements or postures.

In this study, the patients assumed three different sitting positions: a slouching position, in which the body is hunched forward as if they were leaning over a desk or a video game console, an upright 90-degree sitting position; and a “relaxed” position where they leaned back at 135 degrees while their feet remained on the floor.

The researchers then took measurements of spinal angles and spinal disk height and movement across the different positions.

Spinal disk movement occurs when weight-bearing strain is placed on the spine, causing the disk to move out of place.

Disk movement was found to be most pronounced with a 90-degree upright sitting posture.

It was least pronounced with the 135-degree posture, suggesting less strain is placed on the spinal disks and associated muscles and tendons in a more relaxed sitting position.

The “slouch” position revealed a reduction in spinal disk height, signifying a high rate of wear and tear on the lowest two spinal levels.

When they looked at all test results, the researchers said the 135-degree position was the best for backs, and say this is how people should sit.

‘Tendency to slide’

Dr Waseem Bashir of the Department of Radiology and Diagnostic Imaging at the University of Alberta Hospital, Canada, who led the study, said: “Sitting in a sound anatomic position is essential, since the strain put on the spine and its associated ligaments over time can lead to pain, deformity and chronic illness.”

Rishi Loatey of the British Chiropractic Association said: “One in three people suffer from lower back pain and to sit for long periods of time certainly contributes to this, as our bodies are not designed to be so sedentary.”

Levent Caglar from the charity BackCare, added: “In general, opening up the angle between the trunk and the thighs in a seated posture is a good idea and it will improve the shape of the spine, making it more like the natural S-shape in a standing posture.

“As to what is the best angle between thigh and torso when seated, reclining at 135 degrees can make sitting more difficult as there is a tendency to slide off the seat: 120 degrees or less may be better.”

07.27.11

Is Chiropractic Care Essential to Child’s Spinal Development?

Posted in Back Facts (spine), Chiropractic, Spinal Hygiene, Truths About Back & Neck Pain at 12:22 PM by Dr. Greathouse

Growing Up Right

Why Chiropractic care is essential to your child’s spinal development.

See article: http://toyourhealth.com/mpacms/tyh/article.php?id=1450

Is chiropractic really essential to spinal development? Of course the answer is unequivocally no. I can say that without reservation because there’s no data to support such a statement. As far as aligning the spine goes, well, we can’t support that statement either.

This is the kind of stuff that chafes my tuchus. Don’t get me wrong, there’s some good stuff in this article. Kids can benefit from chiropractic care just as adults do and we can educate on the importance of good posture, body mechanics and ergonomics.  But don’t promulgate such innuendo as; chiropractic care is essential to your child’s spinal development.

If your child complains of back or neck pain a chiropractor is qualified to assess, differentially diagnose and treat them. Some chiropractors will go a step further and tell you they can treat other ailments other than musculoskeletal problems and there is some anecdotal evidence of that. That’s OK as long as you are made aware of the anecdotal level of evidence and you are still willing to try it.

Most pediatricians will not recommend chiropractic care, likely because they have no clue as to what we do. What they likely do hear from their patient’s parents is all sorts of healing claims and of course that doesn’t sit well with them either. Chiropractors can help a lot of folks out there but the MD gets too much hyperbole feedback from their patients about chiropractic care claims and simply writes us off much of the time.

For good spinal health and development, in my opinion, children must be taught good spinal hygiene (mobility maintenance – posture – body mechanics – ergonomics) early on, just like dental hygiene training.

07.14.11

Posture & Pain

Posted in Spinal Hygiene, Uncategorized at 9:55 AM by Dr. Greathouse

The article below discusses the psychosocial element of posture pain. Let me assure you there’s a direct cause & effect associate with the mechanics of poor posture as well.  Be mindful of your posture!

Public release date: 12-Jul-2011

Contact: Amy Blumenthal: amyblume@marshall.usc.edu, 213-740-5552, University of Southern California

Your mother was right: Study shows good posture makes you tougher

Study co-authored by USC Marshall professor examines the link between posture, effectiveness and pain tolerance

Mothers have been telling their children to stop slouching for ages. It turns out that mom was onto something and that poor posture not only makes a bad impression, but can actually make you physically weaker. According to a study by Scott Wiltermuth, assistant professor of management organization at the USC Marshall School of Business, and Vanessa K. Bohns, postdoctoral fellow at the J.L. Rotman School of Management at the University of Toronto, adopting dominant versus submissive postures actually decreases your sensitivity to pain.

The study, “It Hurts When I Do This (or You Do That)” published in the Journal of Experimental Social Psychology, found that by simply adopting more dominant poses, people feel more powerful, in control and able to tolerate more distress. Out of the individuals studied, those who used the most dominant posture were able to comfortably handle more pain than those assigned a more neutral or submissive stance.

Wiltermuth and Bohns also expanded on previous research that shows the posture of a person with whom you interact will affect your pose and behavior. In this case, Wiltermuth and Bohns found that those adopting submissive pose in response to their partner’s dominant pose showed a lower threshold for pain.

IMPLICATIONS

Fake it until you make it

While most people will crawl up into a ball when they are in pain, Bohn’s and Wiltermuth’s research suggests that one should do the opposite. In fact, their research suggests that curling up into a ball may make the experience more painful because it will make you feel like you have no control over your circumstances, which may in turn intensify your anticipation of the pain. Instead, try sitting or standing up straight, pushing your chest out and expanding your body. These behaviors can help create a sense of power and control that may in turn make the procedure more tolerable. Based on previous research, adopting a powerful, expansive posture rather than constricting your body, may also lead to elevated testosterone, which is associated with increased pain tolerance, and decreased cortisol, which may make the experience less stressful.

Keeping Your Chin Up Might Really Work to Manage Emotional Pain

While prior research shows that individuals have used pain relievers to address emotional pain, it is possible that assuming dominant postures may make remembering a breakup or some distressing emotional event less painful.

05.05.11

What’s the Safest Way To Lift?

Posted in Spinal Hygiene at 10:37 AM by Dr. Greathouse


Here’s a new study that supports what many chiropractors, including myself, teach individuals to avoid to prevent back pain.

The study identified specific muscle activation or lack there-of during different types of lifts. What was found was that if you stoop or bend at the waist, in combination with a twist, key muscles that stabilize the spinal joints actually turn off. It’s theorized that once those muscles are deactivated you become more prone to injuring yourself during that maneuver.

So, to avoid that predisposing scenario, it’s recommended that you keep the object that you are lifting or about to lift directly in front of you or simply don’t twist with a bend at the waist!

Take note that “about to lift” in the paragraph above is underlined. Historically, many individuals report injuring their backs by simply bending & twisting before the actual lift. Two thirds of your body weight sits above the last vertebrae, so your own body weight loads the spine as well.

Stooping or bending at the waist is biomechanically unsound and so it’s recommended you bend at the hips & knees, and only slightly flex the spine whenever possible. If actually lifting, keep the load as close to the body as possible.

Stooping

The stress associated with leaning forward (stooping), is compounded by reaching. Add a twist and the stress/load increases more. Add a lift with that, even a small object, and the load compounds even further.

Bend with Twist

Many injuries occur at busy periods and we become less aware of what we are doing.

Always be mindful of your movements and posture.

Be Kind to Your Spine

Dr. Greathouse

02.28.11

Low Back Injury Prevention Tips

Posted in Spinal Hygiene at 1:34 PM by Dr. Greathouse

  1. Avoid lifting over head & shoulders.
  2. Avoid low lifts, especially off the ground.
  3. Stay mentally alert, (morning, lunch & end of shift).
  4. Get help moving or lifting bulky objects.
  5. 35 lb. begins high risk for back injury with repetitive lifting for females.
  6. 50 lb. begins high risk for back injury with repetitive lifting for males.
  7. When lifting any object, assess its size and weight first, establish a firm footing, prepare for the lift, bend at the back only slightly, bend at the knees, keep the load as close to the body as possible, avoid any turning or twisting with the lift, lift with the legs, keep the stomach muscles tight, and lift with a slow and smooth movement.
  8. Materials stored at least 20 inches off the ground reduced strain of the back by 50%.
  9. Use handling aids such as dollies and lift hoists for heavy items.
  10. With a load (carrying) avoid twisting the trunk of the body.
  11. Avoid reaching the over 16 inches with any job activity, especially lifting.
  12. Avoid prolonged bending or long periods of standing.
  13. Take breaks from sitting every 15 minutes.
  14. Pushing is better than pulling.
  15. Adjust just your work surface height to avoid bending.
  16. Make sure your work space is adequate.
  17. Make sure the lighting is adequate.
  18. Remember that injury occurs lowering objects as well as lifting.
  19. Reduce frequency of repetitive action of any body part.
  20. *Avoid sitting with an unsupported back if possible (no slump).
  21. Make sure you warm up before any physical activity, no matter how insignificant that might seem.


02.25.11

A Practical Guide to Reduce Problems Associated With Sitting

Posted in Spinal Hygiene at 3:34 PM by Dr. Greathouse

Common Problems Associated With Sitting
Low back pain, neck pain, headache, eye strain, headaches, shoulder and arm pain, wrist, hand and finger pain or symptoms, leg and foot symptoms, tired achy muscles and fatigue.
Practical Techniques To Reduce Stress
1.     **Take breaks, reverse posture and move at least every 20 minutes. Tissue integrity begins to weaken after about 15 to 20 minutes of load/stress from prolonged position.     Although this happens on a microscopic scale, the effect is cumulative over time and predisposes one to injury.
2.     *Avoid slumping; the use of a lumbar support pillow or a rolled towel adds significant low back support. Prolonged slumping is thought to produce disc protrusion, ligament and muscle fatigue.
3.     Prolonged positioning reduces circulation, thus, movement breaks re-circulate blood flow to the tissues.
4.     Forearm to upper arm angle is best maintained at 75 — 90 degrees.
5.     A footrest is required when the feet cannot be firmly placed on the floor.
6.     Thigh and trunk (body) angle should be at 90 degrees.
7.     Knee angle should be at 90 degrees.
8.     Make use of your swivel chair; avoid twisting your back when turning.
9.     Practice relaxation & movement techniques during a break.
10.  Computer screens are best situated 14 to 30 inches in distance from the face.
11.  The center of the computer monitor should be most comfortable at chin level.
12.  Materials on your desk, which are used at high frequency intervals, should be placed for easy access.
13.  Bracing a telephone between head and shoulder is a common cause of neck problems and should be avoided.
14.  Direct light from a window or lamp can cause visual interference/screen glare producing eyestrain.  Glare screens can reduce this problem.
15.  Too much heat from the sun through a window or too much cold from the AC can cause discomfort and muscular reactions.
16.  Excessive room noise can be stressful.  Modular room dividers can be very helpful at reducing this problem.
17.  Frequently changing your field vision will reduce eyestrain.
18.  Bifocal glasses requiring backward head tilting can precipitate neck pain.
19.  Leaning forward with an unsupported back will produce back pain.
20.  Constant one-sided twisting or leaning will produce muscular and spinal imbalance leading to pain and stiffness.
21.  Source documents should be at the same level as the screen if possible.
22.  A neutral wrist angle is best to avoid hand & wrist problems.
23.  Avoid resting your wrist on sharp edges.
24.  Your keyboard should be adjusted to compensate for wrist comfort.
25.  Your seat pan angle should be adjusted or changed to reduce pressure on your thighs.
26.  Sitting on a wallet will produce imbalance, poor circulation and sciatic nerve compression.
27.  Headaches are frequently produced from neck strain and/or eyestrain.
28.  Practice mini-breaks with desk exercises.
29.  Your desk chair should have adjusting capabilities for both vertical and horizontal changes for better back support.

02.22.11

Tune-ups

Posted in Spinal Hygiene, Uncategorized at 2:10 PM by Dr. Greathouse

Tune-Ups

Are Regular Interval Visits Good for You?

You Be The Judge

Dr. James E. Greathouse

What are tune-ups? A chiropractic tune-up may also be called palliative care, or wellness care, but in general it’s interval care on a regular basis, of variable frequency to work out the kinks that may be developing in your spine.

Supportive care is provided for those who, for various reasons, have recurrent problems and require care in order to prevent condition worsening.

This is a controversial subject within chiropractic as well as among lay people and other health care disciplines.

For a theoretical rational of why these tune-ups may actually be beneficial please see information below.

Spinal Problems Are Common If you haven’t experienced a back or neck problem yet, chances are you still will at some point. If you have suffered a back or neck problem, studies show you are likely to experience recurrent problems. The highest rate of incidence occurs between 30 and 50 years old, and typically does not involve a significant traumatic event. These are just a few statistical facts.

While chiropractic care isn’t the only effective way to treat spinal problems and it isn’t the end all to management; manual therapy may be a helpful component to prevention and management of problems once they do occur.

Ongoing Problems More Common Than Conventional Wisdom Reports: von Korff based his skepticism of low back pain’s benign natural history on his report that 69% of recent and 82% of non-recent onset patients were still experiencing back pain one year later (146). He later published that 33% of those contacted one year after their low back pain onset were still experiencing back pain with at least moderate intensity, 15% were still having severe back pain, and 25% continue to report substantial activity limitations (147).

In 1998, Croft et al. reported the results of interviews with 490 low back pain patients 3, 6, and 12 months after seeking care for their low back pain. (35) His results were similar to von Korff’s. Only 21% had completely recovered at 3 months. Interestingly however, just as in the 1996 Dillane study, 90% had stopped consulting with their doctors by three months, further discrediting care seeking as a surrogate for recovering. Even at 12 months, 75% of those surveyed indicated they were still not fully functional or without symptoms. A number of other studies also challenge the overly optimistic view of low back pain’s natural history. (26, 113, 142)

These data would seem to be a more accurate reflection of these patients natural history and also clearly portray a far less benign natural history than what guidelines continue to report.

Recoveries Followed by Recurrences Are Common: The second important characteristic of low back pain, and where there’s little controversy, is that it commonly recurs in the form of episodes; as many as 75% who experience their 1st episode of low back pain have a recurrence. (77, 119, 142) 
Croft: “the message from the figures is that, in any one year, recurrences, exacerbations, and persistence dominate the experience of low back pain in the community.” (35) 
Both Croft and van Korff’s data indicates that recurrent episodes often progressively worsen. (35, 147)

Waxman et al. conducted a three-year population based survey concluding that recurrent low back pain is “a mutable (variable) problem with acute episodes blending into longer periods resulting in more disability as time progresses.” (153) “Most persistent disabling back pain is preceded by episodes that, although they may resolve completely, may also increase in severity and duration overtime.”

Family physicians do notice this trend as well. A survey indicated there was nearly universal agreement as to the high rate of recurrences that commonly worsen overtime. (54)

Possible Contributing Factors To Spinal Pain

Sedentary or Inactive Lifestyles Lead to Spinal Stiffness: 
Experimental studies indicate that fixated (immobilized) joints eventually show signs of microscopic adhesions that limit flexibility and extensibility of the tissues. These fibrotic (scar) changes occur in the absence of trauma/injury. These changes result in a related loss of water (dehydration) necessary to lubricate the tissues. Furthermore, because movement affects the orientation of regular ongoing collagen synthesis, the collagen in the immobilized joints was found to be laid down in a more haphazard “Haystack” arrangement (non-conducive to movement). This orientation restricts tissue (and joint) mobility further by adhering to existing collagen fibers. (Maxey; Magnusson, Rehabilitation 2001, p 5)

Annotation: Although these studies are based on fixating joints, it’s reasonable to deduce, that over time, people who are more sedentary or do not regularly stretch or move the spine and maintain an active lifestyle will be prone to similar loss of joint mobility.

Spinal Stiffness & Degeneration Are Common Age Related Problems

It has been documented that the human spine shows signs of degeneration as early as four years old. This degeneration process continues in a linear pattern with varying degrees of severity, until death. It has been maintained that by age 30, there is no lumbar disc that does not show age related degenerative changes. (Ombregt, Bisschop & Veer: A System of Orthopedic Medicine; p729)

The spine stiffens as we age (Grieve).

Age related degeneration is not only due to inactivity but also from microtrauma (normal wear & tear) and repair, many times coupled with episodic, excessive, cumulative & repetitive stress and overload injury. Connective tissues do not regenerate if damaged, but are replaced by inferior fibrous scar tissue. (Evans 1980; Hardy 1989). Scar tissue is less flexible. 

The Stiffening Process is Slow and Insidious 
(Commentary) It’s likely that as gradual degeneration occurs and build-up of scar tissue takes place, the joints gradually become stiffer and joint movement is gradually reduced (hypomobility); which is a form of joint dysfunction.

As the process advances, it may become more evident on x-ray in the form of degenerative changes; ligament calcification and thinning joint spaces. It also becomes more self evident as stiffness and achiness is experienced.

The literature clearly recognizes that degenerative arthritis is a non-inflammatory process and commonly a non-painful, age related process. For example, it’s not uncommon for an individual to experience a painful back or neck, see a doctor, have x-rays taken, and discover that they have moderate to advanced degenerative arthritic changes, but never had prior episodes of pain.

Although a non-inflammatory condition, the stiffness of the tissues probably predisposes one to strains and sprains, which does lead to inflammation and pain to varying degrees.

Muscle Response

In stiffened joints, receptors (nerves that sense movement) can cause both abnormal facilitation (tightness) and inhibition (relaxation/weakness) of muscles (Liebenson, page 19). Thus, stiffened joints can potentially create muscle imbalances, which can lead to inappropriate or abnormal muscle responses to movement. Commentary: When muscular imbalance and joint dysfunction take place, strains and sprains are probably more likely to occur.

Supplementing With Hands On Joint Movement Possibly a Key Component

A key dynamic to getting things moving again is the passive (hands-on) component of spinal joint mobilization.

This is evidenced by x-ray stress studies, whereby it is demonstrated that when actively moving the spine, as in stretching or normal movement, the hypomobile (stiff) segments do not move. Consequently, actively stretching may not ensure all segments are re-establishing movement.

Passive forms of joint movement (hands-on), augments the movement that active stretching fails to achieve, ensuring that the hypomobile (stiff) segments are encouraged to regain movement and joint nourishment.

Remobilization: After repeated mobilizations, these joints gradually return to some degree of normalcy. (Maxey; Magnusson) Rehabilitation 2001, p 5)

Avert Back Problem With Spinal Hygiene

By combining passive joint and soft tissue mobility work (hands on manual therapy), on regular intervals, as well as regular active spinal movement exercises, it may be possible to preserve & improve joint and soft tissue mobility. Thus, in theory, this reduces the chances for acute episodes of pain or injury. In a sense, it’s very similar to dental hygiene.

Your Involvement Is Necessary

Regular active spinal movement exercise, as well as improved postural and body mechanic behaviors, continue to be a necessary continuum for optimal spinal joint and soft tissue health to maintain gains from passive procedures and to reduce the effects of daily stress on the joints. A more active lifestyle is necessary as well. Remember, moderation is a key!

You’ll Be Pleasantly Pleased With The Results!

You will be pleasantly pleased with how much better you feel after passive joint movement has been performed, especially when you are just feeling a little achy and stiff!

Our tune-ups typically include 10 minutes of moist heat, passive manual therapy, including muscle work; so it’s  much like a mini-massage with the extra component of spinal joint mobilization. Typically, these visits are very relaxing and relieving of aches & stiffness. A real feel good experience that likely helps preserve and improve joint & soft tissue flexibility and mobility.

“An ounce of Prevention”

02.21.11

Choosing The Right Mattress

Posted in Spinal Hygiene at 5:50 PM by Dr. Greathouse

Because we spend an average of one third of our lifetime lying down or on a mattress, that’s on average 24 years, choosing a good mattress probably is important.  If we are not comfortable when we sleep obviously we do not get adequate and necessary rest.  Poor mattress design does produce musculoskeletal aches and pains, therefore  proper support is important.  Unfortunately there isn’t a lot of study on this topic.  Most medical references with regard to bedding is directed at reducing bedsores.

It is estimated that about half the population has experienced sleep difficulties.  Ergonomic study indicates that maintaining a natural shape of the spine while sleeping is important.  One study indicated that a regular bed versus an orthopedic mattress made no difference in sleep quality.  Air mattresses do provide better sleep quality than futon mattresses.  Another study suggested that our bodies just needed time to adjust to different sleep surfaces, and thus the complaints by travelers sleeping in different beds.  How hard or soft the mattress was did make a difference as it related to low back pain, soft was better.

There are three basic factors to look for in choosing a mattress.  First, choose a quality mattress that’s going to hold up over time.  The second thing to look for is a soft overlay, which is the top support surface of the mattress.  This is important because it reduces the amount of pressure on uneven body surfaces, conforms better to your body contours, allows for maintaining the natural shape of your spine and reduces restriction of circulation on pressure points.  The bed should also be firm under the overlay, so as to restrict sagging.  Sagging mattresses do not support the natural shape of the spine, therefore, placing more stress or load on ligaments, tendons and muscles.  This of course is more likely to produce aches and pains.

Additionally, there are other factors to consider. It’s important to provide yourself with a large sleep surface area.  We all toss in turn throughout the night and if this is restricted, prolonged load and reduced circulation occurs resulting in poor sleep quality or aches and pains.  A mattress should be designed to minimize the transfer movement from one sleeping partner to another and it  should have a perimeter edge support.

There’s a multitude of brands and types of beds that meet these requirements. The rest is up to you in finding the best buy for your money.

02.17.11

Tight Muscles & Stiff Joints

Posted in Spinal Hygiene at 2:13 PM by Dr. Greathouse

Science of  Flexibility (Alter) 1988

In patient care I’m often asked, “what’s causing the problem”? Back and neck problems are rarely the result of a single factor but rather multiple factors over time. Below is an explanation of how problems might develop.

What Makes Muscles Tight?

Science of  Flexibility (Alter) 1988 (page 5 — 6)

Prolonged muscular tension result in several negative effects.

  • Excessive muscular tension tends to decrease sensory awareness.
  • It also wastes energy; a contracting muscle requires more energy than a relaxed muscle, thus fatigues quicker with normal use.
  • Habitually tense muscles cut off  circulation, reducing blood supply resulting in lack of oxygen, essential nutrients and causes toxic waste products to accumulate in the cells. A source of discomfort and fatigue.
  • This process predisposes one to fatigue, aches, even pain.
  • When a muscle stays partially contracted, an abnormal state of shortening called contracture develops.  Contracture and chronic muscle tension not only shorten the muscle, but also make the muscle less supple, weaker, and unable to take the shock and stress of various types of movement.

Common activities of daily living that contribute to this process are; prolonged sitting, standing and poor sleep or recumbent positions.

Muscle contraction limits joint mobility.

Effects of Immobilization on Connective Tissue

Science of  Flexibility (Alter) 1988 (Page 54 – 55)

When joints are immobilized for a length of time, the connective tissue elements of the capsules, ligaments, tendons, muscles, and fascia lose their extensibility / flexibility.  Connective tissues will come in contact with each other and eventually stick, thereby encouraging the formation of abnormal cross-linking (adhesions). The joints become stiffer.

Commentary

Based on the above simple concepts you might better understand some of the mechanisms involved with back and neck pain. Tight muscles and stiff joints produce aches and pains as well as predisposing one to injury with increased use or even normal use in many instances.

You should not only understand these effects, but also where tension comes from, and some of the additional implications of muscle contracture.  Muscle contracture is not “muscle spasm”, and is called by other similar names such as muscle over-activity, muscle hypertonicity or hypertonic muscles, trigger points etc.

Muscles become tense for many reasons, probably the most common reasons are poor posture and emotional stress.  Sitting, standing and even lying with poor posture places tension or load on muscles.  When a muscle is loaded, it naturally resists the load by contracting just enough to overcome the demand.  Over time, no matter how seemingly insignificant, the effects of tension (load), as described above, come into play.  Eventually, the contracture or overactive response becomes learned behavior and the muscle stays contracted, even when the load is removed.

Muscles are our movement organs and therefore effect joints.  Without joints and muscles there’s no movement.  The joints & muscles communicate neurologically.  A tight muscle adversely affects joint mobility by restricting movement and causing off axis movement.

The partially immobilized joint and surrounding connective tissues adapt to this hypomobile state.

As indicated above, immobilized tissues lose extensibility.  The dense connective tissues ligaments, joint capsules etc. shorten.  This creates adaptive joint stiffness or what is commonly called articular (joint) dysfunction. Articular dysfunction not only harms the joint but also adversely affects the muscle as well.

Ironically, the neurologic sensors in the joints called mechanoreceptors can reflexively react to the stiffness and aberrant movement by signaling the muscles to respond or contract, thus further perpetuating the problem.

As you can imagine, in this state, the joints and muscles are very susceptible to injury.  Back and neck problems are very common and this process is probably a major contributing factor.  By the time you seek care for a problem, in many instances, this process has probably already established itself.  Many, if not most, patients experience strains and sprains of the back or neck because of pre-existing tight muscles and joints.  Just the right movement, twist or even prolonged positioning places a demand tissues that  have lower tolerance levels, thus injury or damage occurs.

The second component to this issue is the additional poor adaptation to injury with post trauma muscle spasm and scar tissue formation.

Manage the problem with joint mobilization, massage and exercise.

Prevent recurrent problems with good posture, frequent breaks, stress management and exercise.

Dr. James E. Greathouse Jr.

Chiropractic Physician

12.08.10

A Practical Guide to Reduce Problems Associated With Sitting

Posted in Spinal Hygiene at 9:22 PM by Dr. Greathouse

Common Problems Associated With Sitting

Low back pain, neck pain, headache, eye strain, headaches, shoulder and arm pain, wrist, hand and finger pain or symptoms, leg and foot symptoms, tired achy muscles and fatigue.
Practical Techniques To Reduce Stress1.     **Take breaks, reverse posture and move at least every 20 minutes. Tissue integrity begins to weaken after about 15 to 20 minutes of load/stress from prolonged position.  Although this happens on a microscopic scale, the effect is cumulative over time and predisposes one to injury. 2.     *Avoid slumping; the use of a lumbar support pillow or a rolled towel adds significant low back support.3.     Prolonged positioning reduces circulation, thus, movement breaks re-circulate blood flow to the tissues.4.     Forearm to upper arm angle is best maintained at 75 — 90 degrees.5.     A footrest is required when the feet cannot be firmly placed on the floor.6.     Thigh and trunk (body) angle should be at 90 degrees.7.     Knee angle should be at 90 degrees.8.     Make use of your swivel chair; avoid twisting your back when turning.9.     Practice relaxation & movement techniques during a break.10.  Computer screens are best situated 14 to 30 inches in distance from the face.11.  The center of the computer monitor should be most comfortable at chin level.12.  Materials on your desk, which are used at high frequency intervals, should be placed for easy access.13.  Bracing a telephone between head and shoulder is a common cause of neck problems and should be avoided.14.  Direct light from a window or lamp can cause visual interference/screen glare producing eyestrain.  Glare screens can reduce this problem.15.  Too much heat from the sun through a window or too much cold from the AC can cause discomfort and muscular reactions.16.  Excessive room noise can be stressful.  Modular room dividers can be very helpful at reducing this problem.17.  Frequently changing your field vision will reduce eyestrain.18.  Bifocal glasses requiring backward head tilting can precipitate neck pain.19.  Leaning forward with an unsupported back will produce back pain.20.  Constant one-sided twisting or leaning will produce muscular and spinal imbalance leading to pain and stiffness.21.  Source documents should be at the same level as the screen if possible. 22.  A neutral wrist angle is best to avoid hand & wrist problems.23.  Avoid resting your wrist on sharp edges.24.  Your keyboard should be adjusted to compensate for wrist comfort.  25.  Your seat pan angle should be adjusted or changed to reduce pressure on your thighs.26.  Sitting on a wallet will produce imbalance, poor circulation and sciatic nerve compression.27.  Headaches are frequently produced from neck strain and/or eyestrain.28.  Practice mini-breaks with desk exercises.29.  Your desk chair should have adjusting capabilities for both vertical and horizontal changes for better back support.