Everett Chiropractic Center Blog

July 2, 2019

9 Benefits of Tai Chi: Neil Rosiak (elder tai chi brother)

Tai Chi benefits: 9 reasons why you should be practicing Tai Chi Chuan

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June 25, 2019

Twelve Tips for Healthy Sleep

These are from Why We Sleep, by Matthew Walker, PhD. He got them from NIH Magazine Plus (Internet) [I edited some of it… they were wordy]

  1. Stick to a sleep schedule. Go to bed and wake up at the same time each day.
  2. Exercise is great, but not too late in the day. … not later than two to three hours before your bedtime.
  3. Avoid caffeine and nicotine. Caffeine can ‘take as long as eight hours to wear off.’
  4. Avoid alcoholic drinks before bed. (He talks about sedation not being the same as sleeping.)
  5. Avoid large meals and beverages late at night.
  6. If possible, avoid medications that delay or disrupt your sleep. Some can be taken at a different time of the day.
  7. Don’t take naps after 3 p.m. Naps can make up for lost sleep but late afternoon naps can make it harder to fall asleep at night. (Naps are good. He did a whole section on that, but too late not so good.)
  8. Relax before bed.
  9. Take a hot bath before bed. (There is a whole chapter on temperature and getting to sleep quick – important and simple to implement.)
  10. Dark bedroom, cool bedroom, gadget-free bedroom. He offers tricks.
  11. Have the right sunlight exposure – get bright sun in the morning, early part of the day; turn down the lights as bedtime approaches.
  12. Don’t lie in bed awake. He says get up and do something relaxing if lying in bed awake for more then twenty minutes makes you feel anxious or worried. I say breathe and ‘follow your breath’. (Mentally ‘notice’ your breath and keep you mind on that one thing. Look at the Blog Posts on breath and breathing  to fill in the details. Essentially, you will be meditating; and asleep before you know it.

June 1, 2019

Seth Godin Clearing Things Up

Justifying mediocre work

The list of reasons is nearly endless.

We need all of them to explain the shortcuts, phone-ins and half-work that we’re surrounded by.

All of them are pretty good reasons too. We’re in a hurry, the system is unfair, the market demands it, no one will notice, it’s not my job, I was handed a lousy spec, the materials are second-rate, the market won’t pay for quality, competition is cutthroat, my boss is a jerk, it’s actually pretty good, no one appreciates the good stuff anyway…

On the other hand, there’s only one way to justify work that’s better than it needs to be: Because you cared enough.

May 30, 2019

“Beyond Measure” – A Book Review

Beyond Measure (2015), by Vicki Abeles and Grace Rubinstein, is about rescuing an “over scheduled, over tested, underestimated generation”. It followed a documentary, also done by the author, called “Race to Nowhere.”

The issues of the current generation trying to become adults spills over into the conversations we have with patients – and their kids (they are all patients:-).

I had no idea the magnitude of the problem. Yes, we have – for years – talked about the heavy back packs; and now, of course we talk about “text neck”. That is the tip of the iceberg.

I would say that if you have school-aged kids, or will have, or they or their parents are in your life at all, this would be a book for you. It is well written, and though the authors spend a lot of print on the problem – details meant to convince and compel, which I do not need, but you may.

Here I would just like to share quotes that struck me.

“nature-deficit disorder” on page 79 – it becomes a health issue very quickly.

Meaningless (school work) leaving the kids with no sense of purpose. “Change the system not just the symptoms”. (They do a great job of getting to cause.)

“deep learning is as much about the process as it is about the product.

Become a “Rat Racer in Recovery” page 197. They do this a lot – it helps with retention:-)

“An act of cultural defiance” breaking old habit and familiar patterns – in maintaining balance – referring to digital detox.

“Define success with wellness at the core.” There is an idea that I can get behind!

In reclaiming a runaway schedule: ask what matter most (to yourself, and the kids – ask them the question).

Peace has to precede wellness – first measure of successful parenting – who they are verse what they do.

Focus on real connection

School work should be done at school.

“There is more than one path to a meaningful life.”

This whole book is about “project-based learning” as an alternative to what kids experience currently.

“Frustrated beyond function”

“A problem shrouded in silence a decade ago.”

“Childhood is not a race: say ‘no, it’s not a race'”.

“The most important lessons and qualities can not be measured – insisting on measuring them will never lead kids to thrive.”

Chapter 8, First Be Well – “The deliberate promotion of children’s wellbeing”, “Beyond healthy – strive toward happy”, Prevention: social and emotional learning; positive psychology (University of Pennsylvania, Martin Seligman); and… mindfulness (See 2014 cover of TIME magazine)

The coordinator of mental health services and outreach at Harvard started offering mindfulness classes in student dorms and found it to be the “single most effective tool” he’s encountered in his work so far.” Page 198

This hits home for me, of course, as a Tai Chi instructor, both at the local Community College, and a local gym. Mindfulness, relaxation, and developing both external and internal awareness, is at the very heart of Tai Chi.

I would like to end with a quote from the front cover of the book: “America. This is your wake-up call. With both heart and smarts, Vicki Abeles showcases the courageous communities that are rejecting the childhood rat race and reclaiming health and learning. Our kids really need us to listen.” – MARIE SHRIVER

May 29, 2019

The Big Three

Scroll down a ways and you will find a Post for each of the Big Three exercises…

Start here: https://doctordilday.wordpress.com/2015/07/

May 26, 2019

Tai Chi is a Martial Art: It Fights Stress – Now Popular with Millennials

https://www.cnn.com/2017/09/05/health/tai-chi-millennials/index.html?fbclid=IwAR37xA1Niy-OYAFEh5gTt-Fk218wXHPK5RBK82LJGIhQgTs8IzY9XmAEM1s

May 23, 2019

For Tai Chu Students: Paul Silfverstråle

Here is the newest offering by Swedish tai chi elder brother,  Paul Silfverstråle.

May 21, 2019

The Context of “Exercise” – The Dreaded Re-injury

If the subject is back pain, the consensus among many of the ‘experts’ is that the “natural history” of back pain is a series of episodes: the #1 predictor of back is…? Answer: you have had back pain in the past. Ask any athlete that has been around for a few decades and they will tell you that old injuries tend to re-visit and re-occur – we call them relapses if they re-occur within a reasonably close time to relief of symptoms.

So if an old injury is a weak link, what can you do? Well, make the weak links as strong as they can possibly be. If structural stability is compromised, emphasize muscular stability way beyond what would otherwise be considered adequate.

But, it is going to happen (re-injury that is). Then what? You have to start the cycle over again, from the start, and go through each phase as carefully and mindfully as you did the first time. For us, and for most professionals in the business, patients’ injuries were never properly rehabilitated. As soon as symptoms were relieved, either the doctor or the patient discharged themselves from care, and went on as if they were back to “normal.” If exercises ever were seriously discussed, or done, they are dropped (how we got to this series in the first place); and how to maintain progress, or continue progress, never gets discussed: the patient is not there to discuss it.

The re-injury itself may or may not have been avoidable – remember Safety First! But the entire focus of this series is that a full and proper recovery, followed by mindful and correct use of the body, will ensure the fewest and least dramatic episodes in the future. In my case I had regular back pain episodes for 15 years. After I figured out what I just shared here, it was more than 15 years without a single episode – and really only one in the past 20-plus years.

Apply the principles described in this series of Posts, in the absence of symptoms, and you have prevention. Imagine that!

May 20, 2019

The Context of “Exercise” – The Recovery Phase

First there was when to stop.

Then Relief Care context.

Then Rehab, the transition.

Then “core” stabilization or strengthening.

I kind of backed into this series of Posts inadvertently. Initially, I wanted to address some of the issues that could come up in the consideration of why or why not to do an exercise – when to stop doing it.

But, years ago, I did want to do a series on this cycle (injury-relief-rehab-recovery-reinjury). I began with the story about my own back injury and how I progressed to full recovery. (It took 15 years and had almost nothing to do with any of the health care professionals I came in contact with – the rehab and recovery phases didn’t that is.)

So why is it necessary to talk about recovery at all: you are ‘recovered’ after all. Well, in a word: relapse. In the tissues of a significant injury, aging is going to take place faster than in the surrounding, uninjured tissues. That injured spot is a weak link. Now might be the time to take a more global look. To find out if there are other weaknesses that need to be balanced out. Finally, the phrase, “I just want to ‘get in shape'” makes sense. This part is about your longer term future. The point I would make here is the same one I have made all along: what you do should be guided by why you are doing it. Elsewhere (all over) this Blog I have written about setting goals, assessing where you are now, “progressing” in steps to where you want to be. That is all covered. Use the search box on this Blog, using whatever key words seem appropriate, to find a list of Posts. (Start with “progressions” to get started.) Here, too, there are all kinds of ‘normals’ that can guide you into exercises that will give you meaningful benefits safely. And normal is a worthy goal: most people are far from it. It will keep you healthy. How you get there is a journey. And you know about journeys… they all start with a single step:-)

If you need help, let me know.

May 18, 2019

The Context of “Exercise” – Rehab Phase “Core Strengthening”

First there was when to stop.

Then Relief Care context.

Then Rehab, the transition.

Now, finally, strengthening the ‘core’ muscles. To begin, there are the following four assumptions: (1) you are pretty much out of pain, (2) you are in adjustment, pretty much, (3) there is little to no pain with palpation during visits to the office, and (4) you do know how to move properly and can demonstrate that.

You can argue whether stretching hamstrings belongs in the Rehab or the Relief phase, but when it comes to core strengthening exercises, failing to factor in the above assumptions can come at a cost.

All of these ‘phases’ overlap in real life. That is where it becomes and ‘Art’.

If you are following the research, then strengthening the core begins with “The Big 3”. These are tried and true exercises that work. They have been studied enough to know that as a way of strengthening, they will work. The Big 3 amounts to abdominal strengthening (ala Stuart McGill if you are absolutely on the straight and narrow). (Personally, this is where I make sure that the Reverse Back Crunch is in place, effective and not painful, then I move patients into the McGill stomach exercise. Second, is the Bird Dog – on the hand and knees, then one arm and the other leg extended. (Like everything else here, we could spend all day talking about the Bird Dog – technique is everything!) Third is the Side Plank: a tough exercise, one which I always give last and bite into carefully. Here too, bracing (but this time the shoulder as well as the trunk) is critical to correctly doing the exercise. Don’t use anything that I have put in a Blog Post as instructions on how to do an exercise: get professional instruction from someone who knows what they are doing.

Strengthening can then proceed, typically, to the repetitive squat, lunge, one-legged standing, and eventually, the gym ball exercises that involve back muscle endurance.

One nice thing about many of these exercises is that they double as balance tests, or tests of what a normal. So if you fail the test, you know that you need to do the exercise – and you have not fully rehabilitated your back.

A reasonable time doing all of these exercises (at least to test), without pain, is the evidence that you have rehabilitated a back pain episode to the point where you can think about “going to the gym to get in shape”.

May 15, 2019

The Context of “Exercise” – Relief Phase of Chiropractic Care

The other day I wrote about when, and why to stop doing an exercise.

There I mentioned the Relief-Rehab-Recovery-Reinjury cycle. What I really wanted to talk about was the context of any given exercise, within each of the phases of care in the cycle. (It should go without saying that as a chiropractor, I offer a chiropractic perspective. A good reason for me to write it and a good reason, maybe, for you to read it: you might not get it anywhere else.)

That said, it also needs to be said that the chiropractic overall goal of care is to promote health (toward normal – a measurable normal). It bears reminding that we are the ones who have been talking about addressing the cause and not just the symptoms – for 124 years! Yes, patients are focused on the feeling. And, yes, we need to honor and respect that. And we need to deal with the pain (usually it is pain). But in keeping with our primary focus (health promotion), we also attempt to educate and increase awareness of function. Enough about all of that for now.

Speaking of symptoms, the Relief Phase of care is all about relieving them. That is where ice is recommended. We chiropractors find the joints that don’t move (subluxations) and we move them (adjustments). But that is not all we do. To the extent that pain allows, we begin the process of restoring function beyond just moving joints that were not previously moving (or not properly moving).

Keeping in mind that everything we recommend is a test: and the feedback from the patient after trying it is measure: Did they do it (a measure of compliance)? Did it increase, decrease, or have no effect on the symptoms, and what does that mean in terms of continuing, discontinuing, or modifying it.

In the Relief Phase, exercises such as bracing are described and discussed. Coughing engages those muscles and a patient can try that to find out how it feels. They also become aware of which muscles are involved, and begin to get acquainted with those muscles. This stiffening of the spine is an important feature of many important motions a patient is expected to do, usually, in there work. Bracing is also enhanced, and much else is learned, by an exercise called the Reverse Back Crunch (see Pain Free, by Peter Egosque, 1997 – a good book, a great exercise). While they are still in pain, this may be relieving. They can do it while they are on ice. It trains the abdominal muscles. All the while it is also increasing awareness and the patient is gaining control.

This has turned into 400 plus words already so I will do Rehab Phase and Recovery Phase exercises in additional Posts, but here, in the Relief Phase, proper moving technique (biomechanics) are also discussed. How to bend and lift, get up off the ground, and sometimes how to push and/or pull, are important movements patients often have to do all day every day at work. If they are doing them poorly, then relief and recovery are much harder to accomplish. If they begin to do them well, it is another opportunity for epiphanies as a patient becomes aware and gains control. They feel stronger and more stable, and they are less likely to get hurt again.

That is a start on the exercises in the Relief Phase of care. Does knowing the context help? It does help patients.

May 13, 2019

When can I stop doing this exercise?

A question almost no patient ever asked. (They just stop. They have lots of reasons to stop; and not enough reasons not to.) There are times to stop an exercise (progressions or a relapse comes to mind). But a better question to ask first is: “Why am I doing this exercise?”

If you think of each exercise as a solution to a problem, or answer to a question, that will help. Reasons for doing an exercise differ whether in Relief Care, Rehabilitation, or in Recovery. As the reasons for doing an exercise go away, so can the exercise. If the reason remains, so should the exercise.

Here are two examples from the Relief phase of care: the Cat/Camel and Bracing. At some point the Cat/Camel will become unnecessary – a patient will move on to more demanding exercises that incorporate all the benefits of the Cat/Camel but also have additional benefits. Until there is a relapse or re-injury there is no serious need to continue doing it – no prohibition against it, just no real need.

Bracing is different. It is supposed to be a natural, unconscious, normal, part of movement – especially movement that involves exertion. For most it is a forgotten art. So, we use bracing to stabilize the lower back in the Relief phase (if bracing does not hurt). By consciously training bracing a person gets good at it. Eventually, if they first consciously practice, it will become the second nature part of movement that it was always suppose to be. You never stop doing it, you just stop having to think about it.

So before you stop doing an exercise, ask why you were doing it in the first place. And if you do not know, ask.

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