In this issue, we discuss how to stay active, despite some challenges with aging and we go into depth about Lower Cross Syndrome, what it is and why it creates low back or leg pain, as well as some exercises. We also provide some updates on our clinic staff!
In this issue:
- Masks Optional in Clinic
- Aging: How to Stay Active When It Hurts to Do So – abridged by Dr. Eric Lee
- Lumbar Cross Syndrome – LCS – abridged by Dr. Rick Lee
- Staff Update – Certifications, Weddings & Scholarships
- **11 Day SHRED** for Spring Season
– Dr. Rick, Dr. Eric & the Staff @ Bridlewood Chiropractic Centre
As our society is starting to open up again after the last three years of COVID, we have changed some of the protocols at the clinic. The main one being that masks are now optional for our clients while in the clinic. We continue to wipe tables down and our staff wear masks, but we feel that we are in a safer time to relax this protocol without increasing the risk or jeopardizing people’s safety. We continue to provide masks for those who would like to utilize one during their visit.
We will still require that people adhere to the COVID screening questions and if in doubt, please re-schedule your apppointment to another date. At this time, everyone has been considerate and we have not encountered any problems with our guidelines up to this time.
AGING: HOW TO STAY ACTIVE WHEN IT HURTS TO DO SO
From Ontario Chiropractic Association Website abridged by Dr. Eric Lee
Stay Active While Aging — Even with Osteoarthritis
Aging, obesity, and chronic health conditions such as osteoarthritis can lead to limited mobility and strength that can contribute to problems in your musculoskeletal (MSK) system, which includes your spine, muscles and joints. Women are more at risk. According to a report prepared for the World Health Organization (WHO) Report on Aging and Health (2015), OA, osteoporosis and sarcopenia (muscle loss) affect millions and can lead to very serious outcomes, such as falls that shorten lifespans.
An Integrated Approach to Health Care
“We’re living longer but not necessarily healthier,” says Dr. John Antoniou, an orthopedic surgeon and former president of the Canadian Orthopaedic Association.
More collaboration between health care professionals can help Canadians with these conditions get healthier. For example, an integrated approach between a medical doctor and a chiropractor can help older patients stay active while aging. The medical doctor supports their chronic health conditions and a chiropractor helps manage their spine, muscle and joint conditions. This approach can positively impact their chronic health conditions.
Exercise also impacts health. One 2018 review study found that among more than 2,300 people with chronic knee and hip pain from OA, exercise helped with pain and function.
A Complex Interplay
For most people, MSK problems start with mild symptoms, such as joint pain, stiffness and swelling seen in early OA. Discomfort can cause you to limit activity, leading to weaker muscles. You lose more range of motion and things start to increasingly hurt. You can begin using muscles and joints wrong, which makes it worse. At this point, people may stop exercising and begin limiting their everyday activities too.
“A sedentary lifestyle tends to lead to a lot of chronic diseases, including cardiovascular disease and diabetes,” says Ed Ziemann, former vice-president of education programs and services for the Arthritis Society. It triggers balance problems, which put you at risk of falls. Meanwhile, when people have multiple conditions, they must juggle a wide range of medications and all their potential side effects.
Being physically active can turn things around for those with MSK conditions, but only one in five Canadian seniors get the recommended 150 minutes of activity per week.
Getting the Right Exercise
It has to be the right exercise: controlled movements that build strength and range of motion. A combination of activities such as swimming, cardio, weight-bearing exercises and low-impact aerobics can be effective.
For those whose range of motion is limited, yoga and Pilates can be helpful, along with further support from chiropractic, massage therapy and physiotherapy. Most people will benefit from prescribed exercise therapy which can include stretching, strengthening, postural awareness, balance training and neuromuscular exercise.
Pushing Through the Discomfort
Exercise as therapy can be a challenge for those who instinctively stop moving once they have mild pain. They need to push through discomfort, but stop when they feel true pain. Guidance from health care professionals on “hurt versus harm” can make sure exercise is healing, not hurting. If you are someone who doesn’t enjoy traditional exercise, such as going to the gym, focus on doing everyday life activities such as walking, gardening, or lower impact sports such as golf.
The right activity for the right person can make a big difference. With OA, for example, you won’t reverse the damage that’s occurred, but it’ll maintain the function that’s still there. Exercise can also help slow the rate of bone loss in osteoporosis and can cause some reversal of muscle mass loss. With less pain, stronger muscles and better balance, people find they can do much more to stay active while aging.
Age-Related Spine, Muscle and Joint Conditions
The most common type of arthritis affects 4.6 million people. According to the Arthritis Society, it’s a progressive disease of the whole joint, which over time leads to the breakdown of joint cartilage and underlying bone. Severe OA may lead to hip- and knee-replacement surgeries.
Our bones decline in density as we age, starting at age 30, and if bone mass gets dangerously low, it’s called osteoporosis. The higher you get your bone mass up before 30, the lower the risk of getting osteoporosis later. The condition affects two million Canadians, and many only get diagnosed after breaking a bone.
Muscles naturally get weaker as we get older, but underlying conditions or inactivity can lead to this condition, which involves serious muscle loss and weakness. In Canada, it affects about 12 per cent of women and seven per cent of men between the ages of 60 and 69. One 2012 study, published by the U.S. National Centre for Biotechnology Information (NCBI), found patients with sarcopenia were more than three times more likely to be at risk of falls.
LOWER CROSS SYNDROME
From Medical News Today Website, October 2020 by Jenna Fletcher & Dr. Angela Bell, MD, FACP abridged by Dr. Rick Lee
Last year we covered Upper Crossed Syndrome, today we will review the other half called what else…. The Lower Crossed Syndrome (LCS) of course!
LCS gets its name from the cross pattern of affected muscle groups and there is an imbalance of the strength of the muscles around the pelvis.
According to the National Academy of Sports Medicine (NASM), LCS is one of the most common compensatory patterns in the body. In other words, the body adds a new movement in an attempt to make up for a lack of movement or strength in one area of the body.
In this case, weakened muscles include the abdominal muscles and the gluteus maximus, which is the largest muscle in the buttocks. People with LCS typically also have tightened hip flexors and lumbar erector spinae — the group of muscles running from the base of the skull to the hip.
In many people with LCS, the tightened muscles pull the pelvis out of its normal alignment.
The abdominals and gluteus maximus typically offer a counterpull and keep the pelvis in line. However, weakness in these muscles allows the additional pull from the hip flexors and lumbar erector spinae to change the person’s posture and movement patterns.
To compensate for these issues, the person’s lower back arches, and their pelvis tilts forward.
Other people may notice different changes in their posture, depending on the affected muscles.
The most common cause of LCS is a sedentary lifestyle. Sitting for prolonged periods can cause an imbalance between the muscles to develop.
Another potential cause is overtraining certain parts of the body while undertraining others. For instance, if a person strengthens their hip flexors and back without focusing on their glutes and abdominals, this could lead to an imbalance.
Several muscle groups can potentially cause LCS when they become weakened or tight.
Muscles that can become weakened include the:
- gluteus medius, which is on the outer surface of a person’s pelvis
- transversus abdominis, which is on either side of the abdominal wall
- gluteus maximus, which is in the buttocks
- posterior tibialis, which is in the lower leg
- internal oblique, which is on either side of the abdominal wall
- anterior tibialis, which is on the outside of the tibia bone
Muscle groups that can become tight and contribute to LCS include the:
- erector spinae, which is a group of muscles that run the length of the spine
- latissimus dorsi, which are a pair of muscles covering the lower back
- adductor complex, which is around the thigh
- hip flexor complex, which comprises hip muscles
- soleus, which is a broad muscle in the lower calf
- gastrocnemius, which is the chief muscle in the calf
LCS can affect both posture and movement.
A person may not be able to stretch fully or correctly. Doing so may also cause aches and pains in the body.
According to the American College of Osteopathic Family Physicians, LCS can cause two types of posture: type A and type B.
Both postures feature:
- Hyperkyphosis: This is the curvature of the spine that causes the top of a person’s back to appear more rounded.
- Hyperlordosis: This is a condition where there is excessive curvature of the lower back.
If the pain is severe, apply cold packs or heat to the affected area depending upon the type of pain. General rule of thumb: if a dull ache or sharp pain, apply cold, if it is a stiffness, use heat.
Avoid taking medications for extended periods to treat lower back pain, particularly if you are taking other medications.
The goal of treatment is to correct the person’s posture through retraining the muscle groups responsible for the imbalance. Once a person corrects the imbalance, their posture and movement should return to normal. As Chiropractors, we help to mobilize the joints and muscles that have been compromised and lost their normal mobility due to the compensatory imblanaces.
Discuss an exact exercise program to follow to help treat LCS.
THERAPY AND EXERCISE:
1. Relaxing the muscles
First, a person should relax the muscles.
To do this, they can use a foam roller and slowly roll parts of the body, such as the quads and inner thighs, over it. Once a person finds a tender spot, they should hold the position for 30 seconds.
2. Lengthening and static stretching
The next step is to strengthen and lengthen the muscles.
At this stage, a person should get into a static stretch and hold the position for 30 seconds. Below is the iliopsoas stretch.
The Glute Bridge and Bird Dog Exercises are some exercises to strengthen glutes and part of your core muscles.
This pic shows a yoga variation:
- Begin in a kneeling position with the back in line with the buttocks and knees.
- Place one leg in front with the knee bent, the foot resting flat on the ground, and the toes facing forward.
- Lean forward slightly into a lunge position until there is a gentle stretch in the hip flexor. You can stay more upright or lean down onto some blocks for a deeper stretch.
- Hold the stretch for 15-30 seconds and then repeat using the other leg
To perform bridge:
- Lie flat on the back with the knees bent and the feet flat on the floor. Keep the heels a few inches away from the buttocks. Extend the arms out straight toward the feet.
- Keeping the shoulders on the floor, lift the pelvis into the air, forming a straight line with the knees, pelvis, and shoulders.
- Hold the position for a couple of seconds before lowering the body. Perform 10–15 repetitions.
Quadruped Opposite Arm & Hip Extensions/ Bird Dog Exercise
To perform this move, a person should take the following steps:
- Start on all fours with the hands under the shoulders, the knees under the hips, and the neck in line with the spine.
- Stretch out the right arm and left leg, resting the hand and foot against the ground.
- Once balanced, raise the outstretched right arm and left leg until they are both parallel with the back.
- A person should hold this before returning to the starting position and carrying out repetitions.
Congratulations to Dr. Eric Lee for completing the Contemporary Medical Acupuncture Certification through McMaster University in November 2022!
He uses this modality to complement his treatments for joint and muscle challenges. Feel free to ask how it may help your condition.
By now most of you know that Larissa had retired in April 2022 to help raise her first grandson and also prepare for her daughter’s wedding for 2023, which is happening next month.
There is also another wedding date, coming up soon in May, and this is for Yasmine! She joined our staff in July 2020 as we were resuming practice from COVID. She has been here more recently on Saturdays working with Dr. Eric and now she’ll be moving to Portland, Oregon in July with her new partner.
Congratulations Yasmine & David and thank you for the care that you provided for all of our clients and keeping the docs in check!
When Yasmine went on to a full time opportunity last summer, Aiden stepped in to help us during the weekdays. By now, you know that after graduating from Mary Ward CI, he took a gap year to hone his pitching skills over the winter in order to showcase his talent for U.S. college teams.
We just wanted to share that he has accepted a scholarship offer from Indian Hills College in Iowa, which is one of the top junior college baseball teams in the U.S.
Congratulations Aiden and we look forward to checking in on your progress later this season!
**11 Day Spring Shred**
On Monday March 20th, we start an 11 day program that helps to kick-start some new health & lifestyle habits. We do this every quarter and help people transition some of those ideas into their regular lifestyle habits.
We run this through a private FB Group to provide support and share information.
We also do this on an individual basis over a 30 day program that isn’t quite as intense, so you can start when the time is ready for you. If you’d like more information, please contact Dr. Rick.