Articles for the Month of September 2013

Friends, Family, and Faster Healing

Guess what this post is! It’s Post #100! The blog is just a little over 2 years old now and we have finally reached the triple digits. Because of this I’m going to step away from the chiropractic and nutrition for a minute and talk about something completely different today.

One of the questions on my intake forms as a doctor is “Do you have close friends and/or family?” It’s down there in the lifestyle section with questions about smoking and drinking and occupation. When people come across that one they often give me a weird look and ask me why that matters. Well, it really does matter in physical health as well as mental health.

Having someone around to check in on you is the most obvious benefit. Someone to keep you on track with your health goals and maybe work towards them with you. Moral support is great for getting where you want to and healing but on top of that research has repeatedly shown that people with a healthy social life and support network heal faster. Crazy, I know.

Our emotions play a role in our healing and we humans are social creatures. So when we have a social environment we feel safe in we are generally happier and calmer, which allows our bodies to heal faster. I don’t know the exact science behind WHY this happens but the research is out there. A positive outlook has been linked with better prognosis for patients with chronic conditions for a long time.

Similarly, research has shown that people who are happier have a measurably higher pain tolerance than those who are sad or depressed. So a social life and support network to keep you happy will also keep you healthy. Pets can have this effect on healing times, too. Research suggests that animals in the house decrease healing time and actually decrease the frequency of becoming sick as well. This may be due to the fact that pets make us be more active and clean more frequently, so it’s kind of like living with a hairy (or feathered) physiotherapist in your house.

So whether it is coming home to snuggle up to your loved one on the couch or just grabbing a coffee with a friend, make sure that you have a positive social support system in place for the next time you get hurt. Go ahead, grab the next friend you see, give them a big hug and say, “Thanks for making me healthy!”

Thanks for reading,
Dr. Ben

What Are B Vitamins?

In our current nutritional culture Vitamins are kind of a mystery category and people don’t generally know what they are other than these miracle nutrients we need for some undisclosed reason. The B Vitamins are a good example of this. Previously we talked about Vitamin C and one of its lesser known roles in the body. Today I would like to clear up some of the mystery around our B Vitamins and show you just how great they are.

The B Vitamins are a group of vitamins rather than a single molecule like Vitamin D or C. They were originally thought to be a single molecule but later discovered to be multiple molecules with similar actions from similar foods. When this was discovered there were even more chemicals listed under the Vitamin B flag but many were discovered to not fit the definition of a vitamin and so there are holes in the numbers associated with the current list of B Vitamins. In general, B Vitamins are small molecules that are absolutely essential to the daily grind of a human cell.

Let’s take a second and break down what a cell is and how it works in our bodies. We tend to think of cells are these static little balls that are squished together into organs and bones and someone magically function together. Well, the function of an organ actually comes from the functions within each cell. Different organs have different structures to their cells and this can alter their functions but every cell in our body has a core of basic functions that are essential to their existence. These basic functions are how cells maintain their structure, process the energy they need to function, and repair their DNA. This is where B Vitamins have their biggest impact.

All cellular functions are based in chemical reactions like breaking apart or fusing together molecules. These processes can be either very simple or pretty complicated. The simple ones can occur on their own but the complicated ones require the help of other molecules to make sure the reaction is controlled and goes according to plan. B Vitamins are these molecules, called “Catalysts” which exert a controlling force on these chemical reactions.

Some of the more specific roles that B vitamins take on include energy release (the break down of absorbed nutrients into usable energy) and the creation of red blood cells. Folic acid (vitamin B9) has been firmly linked to the development of the neural tube (the part of the fetus that becomes the spinal cord, the surrounding layers of tissue, and the boney spine) and is highly recommended for anyone who is thinking of becoming pregnant or already is.

Niacin (Vitamin B3) has created some mixed results in the research over the years as a potential therapy for those with high cholesterol levels. This has sparked a lot of debate in the medical community over the use of vitamins vs pharmaceuticals (that’s a conspiracy theory for another time though).

Some research exists connecting B Vitamins, specifically Folaic acid and B12 (“Cobalamin”), supplementation with improvements in memory and mood. This and increased energy are the main reasons I suggest B Vitamins to almost all of my patients.

Our B Vitamins can be found in both animal products and those dark green leafy veggies that I’m always talking about. As in so many things with nutrition variety is the key. It is possible to lead a vegetarian and/or vegan lifestyle while still receive healthy doses of our B vitamins but it does take planning and work. As always, please consult a professional before taking or ceasing a supplemental regimen.

So that is the general story of our Vitamin B’s. It’s just a peak through the door but I hope that it gives you a better appreciation for these essential nutrients. They are everywhere in our lives and effect so much.

Thanks for reading,
Dr. Ben

How Low Can You Go? – Water and the Body

I’ve mentioned it before as part of other topics but I wanted to take some time this week to about water. Water is such a common thing in our lives that we tend not to think about it but I would go so far as to say that it is the single most important nutrient in our diet. All the processes in our body, from copying DNA for cell replication to contracting a muscle to walk forward, are chemical reactions and all of these chemical reactions take place in water. In chemistry terms water is acting as the “solvent”.

In this way water plays a passive role in every single thing that happens inside of us. Water is also actively used in many different tasks throughout the body such as filtration of the blood through the kidneys. Water is pumped out of the arteries into the kidneys and then, depending on the needs of the body, a certain amount is brought back into the veins so that it is not wasted. For example, if we have a high concentration of sodium in our blood we will push more water out and reabsorb less back in so that we can excrete that sodium. If we are dehydrated then our body will try to retain as much water it can as the sacrifice of threes filtration processes. This means that if we do not have enough water in the day then we end up keeping some chemicals in our blood that should be filtered out and some that should be kept end up being lost. Good hydration will ensure proper filtration of our blood and avoid build-up of chemicals that can lead to problems later on.

The liver, as most people know, is the processing plan of the entire body. It detoxifies us, creates essential hormones and chemicals, and manages the level of fat in our blood. It is a very busy place. Every cell of the liver is continually working to make our body perfect. This means that the liver cells have a lot of chemical reactions going on all the time and that means they need water. In a dehydrated state these chemical reactions will slow down (not drastically but still some) and just like a factory that is working at only part of its potential, the liver will not be able to keep up with the demand placed upon it. This is not to say that simple dehydration will lead to jaundice but hormones will be slower to respond, blood toxicity will increase slightly, and fat levels in our blood will be higher than appropriate. None of these will cause immediate signs or symptoms but over time they will cause problems. Regular water breaks will help to keep our body functioning at peak performance.

Water and our level of hydration is directly related to our energy levels as well. This is because of our blood. The volume of our blood is dependent on our level of hydration as water is needed throughout the body and does not stay concentrated in our cardiovascular system. We are not talking about changes like the tides here, just minor fluctuations in the overall system, but these fluctuations are enough to make a noticeable difference. Our oxygen is carried throughout the body in the blood and its transference from the lungs to the blood and from the blood to the tissues is based on concentration. So when there is a decrease in blood volume the amount of oxygen needed to reach maximum concentration decreases as well. This means that there is less oxygen that is making it to our muscles and brain. Again, this is not a drastic decrease but definitely enough to make us feel drained and tired and decreases our mental focus. Also, it increases the likelihood of getting a headaches and sore muscles. Staying hydrated can save us a lot of pain in the end and make being active much easier without as many aches and pains.

Probably the most commonly thought of use of water in the body is sweating. Sweat is designed to help us maintain an appropriate core temperature by releasing heat. It is one of the very few water based processes in our body that is not cut back on when we are dehydrated. This makes it even more important to stay hydrated on hot days when we are sweating more. Drinking good amounts of water throughout the day will help to ensure that we don’t become dehydrated through the regular functions of our own body.

Water also plays several important roles in our digestion. First of all it moistens the food and allows it to be chewed and squished into the soft ball it needs to be to reach the stomach where the acids can digest it. As the food reaches the intestines water is very important as it allows the digested particles to move around and get absorbed by the intestinal walls. In the large intestine water is absorbed into the body as we need it. So in a dehydrated state we will absorb more water from our feces. This leads to hard and dry poop which is much harder to pass and can make you strain just to get some relief. Drinking water regularly can help to alleviate some constipation and make those uncomfortable moments much easier.

Drinking water throughout the day will also keep our stomach walls stretched which will trigger the release of the hormone called “ghrelin” (the “I’m full” signal) which will help to decrease the amount that we snack on during the day. So water can even help us to lose weight!

Many people struggle for a “hydrated” look to their skin and so try all kinds of creams and ointments to achieve it but they generally ignore one big factor. Skin is an organ of our body just like any other but in the grand scheme of things it is significantly less important than any of the other ones. So long as the skin is intact and keeping the outside world out then it’s fine. This means that the body will shunt resources away from the skin to keep other organs working. So really to have a “hydrated” look on the outside we need to be hydrated on the inside. Always having a glass of water on hand (not just sitting there but actually drinking it) will go a long way towards the look we all want of healthy skin.

So you don’t have to remember all of these details and mechanisms that we’ve been talking about today. All you really need to know is that your body doesn’t work without water. So drink up! It’s one of the best things we can do for our health.

Making sure that there is always a glass of water within reach is a good way to start getting enough water in our day. If it is there we will think about it more and drink more. As a rule of thumb it is a good idea to drink enough water that your urine is consistently a very light yellow colour or clear.

Thanks for reading,
Dr. Ben

Winging It: Scapular Instability

In the past we have talked about the importance of our posture and our rotator cuff muscles but we really haven’t talked about how they are connected yet. Pretty much everyone can identify their shoulder blade (“Scapula”) but can you say what it is for? It’s a weird flat bone that sits on your upper back and just kind of floats there, but everything in the body has a purpose (except for those wonderful vestigial organs like the appendix). The scapula’s purpose is to act as an anchor to the arm. It holds the ends of the rotator cuff muscles as well as the Biceps, Triceps, and the Deltoid muscles. Now what is the most important aspect of an anchor? That’s right! Stability! Just like our core muscles, our shoulder blades should remain rock solid when we need them but still have some mobility to adapt to changes in arm movement and pressures.

So how can a flat bone be both stable and mobile at the same time? The scapula sits on top of the rib cage with a connection to the collar bone (“Clavicle”) at the front. This connection should not provide mechanical support but only act as a guide for the position of the scapula relative to the rest of the body. The stability of the shoulder blade comes from the muscles that surround it. These “Scapular Stabilizers” pull the boney plate in different directions and lock it down thus allowing it to remain stationary while the prime movers of the arm (Deltoid, Biceps, and Triceps) use it as their anchor.

Posterior (Back) Shoulder Bony Anatomy

Posterior (Back) Shoulder Bony Anatomy

 

Anterior (Front) Shoulder Bony Anatomy

Anterior (Front) Shoulder Bony Anatomy

These Scapular Stabilizers consist of the Trapezius (Upper, Middle, and Lower), Rhomboids (Major and Minor), and Serratus Anterior muscles. Both Rhomboid muscles as well as the Middle Trapezius help to pull the scapula in towards the spine while the Upper Trapezius muscle pulls the scapula up and the Lower Trapezius pull it down and in. The Serratus Anterior opposes muscles by pulling the scapula out and forwards towards the front of the ribs. There are other muscles that attach to the scapula and help to stabilize it but these are the major actors on this stage.

We’re discussing these muscles and their role in shoulder function today because we do not use them correctly. If we were properly stabilizing our shoulder blades they would remain firmly pressed to the back of our ribs but the most common postural pattern in the Western World does not do this. Generally we are slouching forward which rolls our shoulder blades out and forward, around our rib cage. This position puts a lot of mechanical pressure on the joint with the clavicle and causes the Upper Trapezius to bear the weight of the shoulder and arm. Through maintenance of this position the Lower and Middle Traps, the Rhomboids, and the Serratus Anterior all weaken from lack of use and are not able to act upon the scapula as they should. When this happens it is called a “Winging Scapula” because the inner edge of the shoulder blade pops away from the ribs and sticks out like a wing and it means that our scapula cannot provide the stability it needs to. Scapular instability leads to increased risk of injury to the shoulder and arm, specifically the rotator cuff muscles and the Acromioclavicular joint (the joint now under pressure between the scapula and the clavicle).

Winging Scapula

If you have been reading my blog for any amount of time you know that I am all about preventing injuries and reducing the risks we expose ourselves too. So to get out of this problematic position we need to retrain our muscles to hold the shoulder blades in place. There are two fairly simple exercises that can accomplish this. The first we’ve talked about before and I call it the “Pocket Push”. The second is demonstrated very well in the video. The sound is a not great so use some headphones or watch it in a quiet space to hear all the details.

No matter how much some of us might wish for wings to fly, a Winging Scapula is not going to help at all. Tuck in those flat little bones and sit up. It will do your body a world of good.

Thanks for reading,
Dr. Ben