2…..The Effect of Exercise on the Prevention of Low Back Pain
3…..Glutes & Bladder Incontinence
4…..4 Simple Exercises to Get your Glutes Fired Up
5…..Upper Cross Syndrome (Hunchback Posture)
6.….What is a Custom Orthotic & Runner’s Knee
7..…Challenges with your Health & Nutritional Foundation?
8…..Website http://www.bridlewoodchiropractic.ca & Clinic Hours and Services
CHIROPRACTIC 101 – by Dr. Rick Lee
It’s official, summer solstice just passed and we are into the season now. Spring was wet, cold and late, but for Raptors Fans, it was an amazing Spring run for the NBA World Champions. As of this writing, we still do not know where Kawhi will end up, however there are many signs that he will stay in Toronto.
Recently, we have hired or shall I say re-hired a front desk staff. Judy Cardinali had worked with us when we were downstairs in the mall some 23 years ago sharing space with the dentists. She did not follow us upstairs and had stopped working to help raise her grandchildren. She now has time to get back into some part time work and began with us at the end of April. I know some of you will remember her and for the more recent clients, who started with us 16 years ago or less (LOL), please welcome her back.
On the subject of people returning, Fiona Caldwell who was our resident Registered Massage Therapist for 11 years before Desmond Fan, has come back to work on Saturday mornings once a month. Des is here during the week of course, but Fiona is filling in one Saturday each month. We thought it might be more convenient for people who have scheduling challenges during the weekdays. Please ask Larissa or Judy to book an appointment time.
This summer, Larissa and I along with our sibs and parents are embarking on a trip to San Francisco to visit the burial site of our grandfather (Dad’s side) and uncle. We have many cousins there who we had met during a cross country drive through the States when were in our teens and they were all older than us. My Dad was the youngest in his family of six kids, so he is the Dr. Raymond of the family and his oldest brother passed away awhile ago. We are visiting Alcatraz and seeing some of my cousins there who are now all in their 60’s. Hmmm, that last sentence did not come out very well. No, they are not imprisoned, but living in the SF/Oakland area. The Alcatraz visit is a separate tourist thing we’ll be doing 😉
Final bit of news is that we are moving….again! After 30 years in the Mall, less 8 months during a project location change, we will be moving out of the mall. We received a notice in May, but things were not finalized with the possible renovations. Sadly, they were just finalized last week, so we have to the end of September. There is no room in the mall and many of the other tenants in this long hallway are in a similar situation. I am trying to keep the clinic close to our current location, so we will let you know when we know. If you have intel of places that have vacancies, please let us know.
THE EFFECT OF EXERCISE ON THE PREVENTION OF LOW BACK PAIN – by Dr. Eric Lee
Low back pain is a major public health problem worldwide affecting people of all ages. Most people will experience low back pain at some point in their lifetime, with two-thirds having a recurrence. Low back pain is the leading cause of disability, activity limitation and workplace absence in most parts of the world.
In 2017, a systematic review was conducted on the effect of exercise on the prevention of low back pain. A systematic review is when the current published research on a topic is collected, evaluated, and summarized. The various studies included different combinations of the following and their effect on low back pain:
- Stretching exercises for the spinal muscles
- Strengthening exercises
- Aerobic fitness
- Endurance and coordination exercises
- Neuromuscular exercise to improve participants’ control of movement in the lower back and enhance trunk muscular endurance and spinal stability
- Posture and balance exercises
The length of the studies ranged from 3 weeks to 2 years.
The researchers were able to conclude from these studies that strengthening the spinal muscles in combination with stretching or aerobic exercise can reduce the subsequent occurrence of low back pain by ~30% with lowering of pain intensity and associated disability in occupational and similar populations.
The main conclusion was that a combination of strengthening and stretching/aerobic exercise, performed 2-3 times per week, can reasonably be recommended for the prevention of low back pain in the general population.
- Shiri R, Coggon D, Falah-Hassani K. Exercise for the Prevention of Low Back Pain: Systematic Review and Meta-Analysis of Controlled Trials. Am J Epidemiol. 2017 Oct 19. doi: 10.1093/aje/kwx337. [Epub ahead of print]
- Steffens D, Maher CG, Pereira LS, et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med 2016;176(2):199-208.
- Vassilaki M, Hurwitz E. Perspectives on Pain in the Low Back and Neck: Global Burden, Epidemiology, and Management. Hawai’i Journal of Medicine & Public Health 2014;73(4):122-126.
GLUTES & BLADDER INCONTINENCE – by Dr. Rick Lee with contributing article by Dr. Christiane Northrup
I saw an article that claimed Squat Exercises (strengthens glutes) were the answer to bladder incontinence and this was new to me because I had always learned that the go-to-exercises for bladder incontinence were always “Kegels” (series of exercises that get the pelvic floor musculature to become more taut) to help with this issue. The idea was that the pelvic floor muscles were weakened or overstretched after say pregnancy and many women as a result suffered from urinary incontinence or “leaking” when they coughed, sneezed or even laughed.
I wanted more biomechanical evidence that squats were the missing link beyond Kegel exercises. My digging around led to this great article by Dr. Christiane Northrup, who is a leading authority in the field of women’s health and wellness. She is a board-certified OB/GYN physician and graduated from Dartmouth Medical School. I learned a bit more about this condition and what can or cannot cause it, read on!
Here is her article “Liberated from Incontinence” – by Dr. Christiane Northrup, MD
I overheard two women discussing urinary incontinence in the ladies room. One complained that coughing caused her to pee her pants. The other was upset because she leaks a little urine when she exercises. Unable to keep myself from responding to what I consider a woman’s health emergency, I said, “I’m a gynecologist. And in order to prevent this kind of urinary problem, you have to develop strong buttocks muscles and get in touch with your pelvic floor. I recommend peeing in the shower.” They were a little offended by my brash advice.
About one in four women suffers from urinary incontinence, the involuntary loss of urine when sneezing, coughing, or laughing. And even more have what’s called “urgency incontinence” when the urge to urinate is so strong that you fear you won’t get to the bathroom in time. Urinary problems in women are epidemic. In fact, the number one reason why older women have to go to nursing homes is…drum roll…urinary incontinence!
Did you know that the average woman suffers in silence for an average of seven years before she finally brings it up with her healthcare practitioner? When she does, usually she is told one of two things: take a drug or do Kegel exercises. The drugs stop “urge incontinence” by blocking some of the nerve endings on the bladder’s main emptying muscle (the detrusor). When the muscle is less irritated, it’s less likely to contract involuntarily—and cause you to lose urine at an inconvenient time. These drugs have bothersome side effects, though, like dry mouth. And besides, like so much of modern medicine, they don’t really cure anything. They just mask the symptoms.
The Kegels strengthen the PC (pubococcygeous) muscle, which closes the sphincters of the pelvic floor and stops the flow of urine. Kegels are a step in the right direction. But they don’t address the function of the entire pelvic floor—they strengthen only one muscle. A strong, rigid muscle isn’t necessarily a functional, strong, flexible muscle. That’s where the squats in the shower come in.
When you squat to urinate as opposed to sitting up straight on the toilet, you automatically engage your butt muscles. And your pelvic floor naturally stretches and tones. Moreover, because your urethra is now pointed straight down all you have to do is relax for urine to flow out easily—as opposed to sitting up straight and having to strain to empty your bladder. The same thing is true with moving your bowels.
Before going on, I want to bust a popular myth that childbirth results in urinary incontinence. This is not true. Many teenage girls have incontinence. And so do nuns who have never had children. Yes, childbirth—especially when conducted without knowing how to push correctly—may weaken the pelvic floor for a time. But that is reversible.
So what do I recommend if you have urinary incontinence or are worried about it?
- See a women’s health physical therapist who specializes in the pelvic floor. This relatively new specialty uses Pilates and other exercises to assist you in reclaiming a healthy and functional pelvic floor. The pelvic floor is all the muscles and tissue between your pubic bone and tailbone, and it holds in your bowels, bladder, and genital organs. When this part of your body isn’t strong or toned, your organs tend to fall out! That’s known as a prolapse. Prolapses can often be treated well with physical therapy alone. You don’t always need surgery.
- When you sit on the toilet, put your elbows on your knees so that you are in a squatting position. Notice how much easier it is to empty your bladder or bowels. Better yet, get a stool and put it under your feet so that your body is comfortably seated in a squatting position.
- Strengthen your core. I have done Pilates for 15 years and can attest to its ability to strengthen one’s pelvic floor.
- Read The Bathroom Key: Put an End to Incontinenceby Kathryn Kassai and Kim Perelli or go to www.thebathroomkey.com for more resources.
As a quick summary to her article: there is value in doing proper Kegel exercises related to the pelvic floor, however add squat exercises (and more exercises in the next article) to strengthen your butt muscles. Finally place yourself into an ergonomically favoured squat for a more complete emptying of your bladder or bowels.
4 SIMPLE EXERCISES TO GET YOUR GLUTES FIRED UP! – by Cassie Dionne, Physical Therapist
Your glutes are an incredibly important muscle group for many reasons, including preventing injury, improving performance, and helping you fit nicely into your jeans.
This is why I want to show you some of the best exercises you can do to get your glutes properly fired up and working for you. These will help you move better, feel better, and kick your training up a notch.
Most People Can’t Properly Fire Their Glutes
Almost every one of the people I see in my clinic has at least one muscle group that isn’t functioning properly. Very often, one of these muscle groups is the glutes. Many of these people can’t even properly fire their glutes without first undergoing some teaching or activation, on one or both sides.
“Even when people train hard every day, if they spend the majority of the remainder of the day sitting down, then they are simply not using their glutes.
And I’m not talking your average desk-worker who exercises once in a while. I’m talking your five-times-a-week fitness enthusiasts, your elite-level athletes, your weekend warriors, and their sedentary friends alike.
Why Are the Glutes So Inactive?
There are many potential reasons, but I am going to keep it simple and give you just two. The first and most common reason people suffer from underactive glutes or “glute amnesia” is due to lifestyle. Even when people train hard every day, if they spend the majority of the remainder of the day sitting down, then they are simply not using their glutes. And remember the old saying – if you don’t use it, you lose it. Unfortunately, this is just what happens with your glutes.
Another common reason I see glutes that aren’t working properly is due to injury. Often an injury happens that changes the mechanics and motor programming of a person’s body. This can lead to some muscle groups becoming overactive, while others become underactive (think: compensation). This can alter things for a long time without the person even knowing it.
Enter Glute Activation
Simply put, glute activation is waking up your glutes. It makes the connection from your brain to your muscle and gets the muscle fired up and ready to do some work. Glute activation should be done prior to your workout, but it can also be done as an active rest between sets. And trust me when I say that doing some glute activation prior to your squats, lunges, and deadlifts will result in an excellent glute workout!
“Simply put, glute activation is waking up your glutes. It makes the connection from your brain to your muscle and gets the muscle fired up and ready to do some work.”
So, how do you go about activating them prior to your workout for the best results? Here are four glute activation exercises I regularly use with my athletes.
The Modified Clamshell
I’m sure you’ve seen the clamshell before. It is a fan-fave when it comes to glute activation and glute med strengthening. However, at our studio we don’t love how this movement is typically taught.
Modified clamshell – top knee on the ground
Modified clamshell – top knee off the ground
We’ve found the traditional way the clamshell is taught ends up leading to the athletes overusing their hip flexors and not feeling the exercise where they should. In other words, it usually just cements in already poor movement patterns. This is why we always teach a modified version.
To do this modified clamshell:
- Lie on your side with your head resting comfortably.
- Your bottom leg should be straight, with your top hip bent up to ninety degrees and your top foot resting behind your bottom knee. Your hips should be forward, and should remain in this forward position throughout the entire movement to come.
- Squeeze your glutes and lift your knee off the ground, keeping your top foot rested on your bottom knee (make sure your hips don’t roll back because they most certainly will try to do so).
- You should feel this exercise approximately where your jeans pocket would be. If you feel it here, you’re doing it right!
“We’ve found the traditional way the clamshell is taught ends up leading to the athletes overusing their hip flexors and not feeling the exercise where they should.”
The Glute Bridge
This is a great, functional exercise, and one I have written about in the past. The basic glute bridge is simple, just lay on your back with your knees bent, lifting your hips in the air. This is an excellent starting point, but most of you will quickly need to move on to more challenging variations to really get your glutes fired up. Check out my two favorites:
The Cook Bridge/Cook Hip Lift – Developed by physical therapist Gray Cook, this exercise eliminates lumbar spine movement, forcing the work to happen at the glutes. To do this movement:
- Get into the bridge position.
- Place a tennis ball below your bottom rib on one side, and hug the same knee to your chest, pinning the ball down with your thigh.
- Holding onto this position, lift your hips in the air, and repeat. You’ve just done the Cook Bridge!
Glute Bridge With March – This one forces you to engage all of your stabilizer muscles. To do the glute bridge with march:
- Get in to the bridge position and lift your hips in the air.
- At this top position, and without allowing any movement at your hips, slowly lift one leg off the ground and hold for two seconds.
- Put it down and lift the opposite leg.
- Repeat this about twenty times, ensuring your hips remain stable throughout the entire exercise.
Glute bridge with march
Mini Band Walks
Mini bands are becoming more popular and with good reason. They are a great way to get the glutes geared up for a workout. The best way to do them? Put the mini band around your feet – yes, your feet – and walk laterally, trying to move your upper body as little as possible. This is usually a pretty fail-safe way of getting a burn in that pocket muscle.
Slider Reverse Lunge
The slider reverse lunge is simple to perform and doesn’t need much in the way of instructions. Simply grab a Valslide, or a similar tool that will allow you to move smoothly across the ground. Put the slide under one foot, and use that foot to slide into a reverse lunge, and then return to standing. Try doing this exercise after one of the ones above, and just wait until you feel the burn!
UPPER CROSSED SYNDROME (HUNCHBACK POSTURE) – by Dr. Rick Lee (abridged article from Jeremy Etheir)
Hunchback posture is becoming more prominent nowadays due to increase technology use and time spent sedentary. But this hunched posture (also known as upper crossed syndrome, rounded shoulder posture, or kyphosis) isn’t something that should simply be ignored because it can increase your risk of injury in the gym and negatively affect your strength in key lifts like overhead pressing movements and the bench press.
Here are some corrective exercises for bad posture. Although most people have an idea as to how to fix hunchback posture, they don’t perform the right exercises nor do they perform the right exercises in the right fashion in order to strengthen the weakened muscles and lengthen the tightened ones. The main muscles that cause round shoulder posture by pulling the shoulders forward are overactive front deltoids, pecs, and upper traps. Equally as important are muscles that are weakened and no longer pull your back into its upright position, which are most commonly the lower traps and rhomboids. Perform the exercises (wall angels or wall slides, prone Y’s, foam rolling, shoulder dislocations) daily with correct form, and you will start to see a huge difference in terms of fixing your bad posture.
WHAT IS A CUSTOM ORTHOTIC? – by Dr. Rick Lee
A custom orthotic is a device designed to align the foot and ankle into the most anatomically efficient position. They look like insoles, but are biomechanical medical appliances that are custom made to correct your specific foot imbalance. Custom orthotics work on your feet much like glasses work on your eyes – they reduce stress and strain on your body by bringing your feet back into proper alignment. The plastic body of the custom orthotic helps to re-align the foot by redirecting and reducing certain motion that takes place during the gait cycle. They fit into your shoes as comfortably as an insole – and they have the advantage of having been made from precise imprints of your feet.
CONDITION: RUNNER’S KNEE
Runner’s Knee is a general term referring to pain around the front of a runner’s knee.
If the pain is anteromedial in location, the source of the problem may be over-pronation. The internal rotation of the tibia associated with over-pronation, may cause the knee to fall into a functional valgus orientation during the stance phase of gait. This in turn will compromise the ligaments on the medial aspect of the knee. Furthermore, the abnormal motion will result in abnormal pressures behind the patella, leading to a more specific knee malady referred to as chondromalacia patella.
A properly fitted custom orthotic and exercises can help to quickly remedy this common biomechanical problem. Please ask us if you are a candidate for custom orthotics.
CHALLENGES WITH YOUR HEALTH AND NUTRITIONAL FOUNDATION? – by Dr. Rick Lee
Are you living your best version of yourself and your level of health? Many people first consider their aches and pains and then look at their current body composition (lean muscle : fat ratio). Did you know that much of it goes hand in hand? Body and joint inflammation occur in acidic body environments and added visceral and subcutaneous fat can contribute to larger stresses on joints. Much of it is what you feed yourself on a regular basis. Remember we always talk about what you do 75-80% of the time, will determine your health. What you eat has such a large impact on the building blocks of your cells, which make up your body. It’s like the old adage, do you want your home built out of straw or bricks? The quality and ratio of the macronutrients, Protein, Carbohydrates and Fats along with the micronutrients of Vitamins and Minerals will determine if your body cells are great or made of crap.
Eating healthy is difficult for many people who lead busy lives, are not nutritionists or do not have personal chefs. I have used the Isagenix program for my personal lifestyle, so it takes a lot of the guesswork from what I am having and it gives me a great foundation of nutrients for that 80%, which allows me flexibility with my other food choices.
If this is you, feel free to ask us about starting you on the program that comes with coaching and there is a 30-day money back guarantee if you are not satisfied. Nothing to lose and only better health to gain!
This is a BEFORE & AFTER picture of one of our clients at the clinic. Judy had a remarkable change not only in her body composition, but also in her mood and energy. Real People, Real Results.
If you’re reading this newsletter online, then of course this is NOT news, however for those who want to find out more about our clinic and what we do, this is a great reference. It is also good for those who have family members or friends who want to learn more about what Chiropractic is and what it is not. Look us up on the web and our current newsletter along with future newsletters, all will be available online.
CLINIC HOURS & SERVICES
Dr. Rick & Dr. Eric
Monday 2:00 pm – 6:00 pm
Tuesday 2:00 pm – 6:00 pm (by appointment)
Wednesday 10:00 am – 12:00 pm 3:00 pm – 6:00 pm
Thursday 2:00 pm – 6:00 pm (by appointment)
Friday 10:00 am – 12:00 pm
Saturday 9:00 am – 12:00 pm
Desmond Fan, RMT & Fiona Caldwell, RMT
Please call Larissa at 416-756-3833 to arrange an appointment. Des is available during the weekdays and Fiona is available one Saturday morning per month.
We also offer customized orthotics, therapeutic massage, acupuncture, computerized nerve scans and health & wellness workshops