What Is Diabetes?

(Originally posted on bcotoronto.com on May 16th, 2013)

This week is the 4th Annual Diabetes Blog Week so I thought that it would be apropos for me to throw my hat into the ring even though I am not a diabetic myself. So I’m not going to talk about living with diabetes or the emotional struggle involved. For stories like that I would recommend my good friend Ilana Lucas’ blog Diaturgy where her amazing writing talent will have you laughing and crying with every post.

For my part, I’m going to try to do what I (try to) do best: Educate. We’re going to dive deep into what diabetes is so that those of us lucky enough to not have this condition can understand a little more of what it is to live with it.

In a nutshell, Diabetes is our body’s inability to regulate our blood sugar levels. This leads to complications throughout the body which we will get into in a bit. There are two types of diabetes. Type 1 is where the pancreas is unable to produce the insulin necessary to control blood sugar. This can happen because of genetics or environmental exposure to some kind of toxins and usually develops prior to birth or around puberty but can develop later in life. Type 2 is where the body’s regulatory systems which trigger insulin production and release become deficient. This generally develops because of frequent spikes in blood sugar and consistent over production of the hormones associated with decreasing hunger signals.

People living with Diabetes need to constantly measure their blood sugar levels by pricking their finger with a needle and testing a drop of blood. Type 1 Diabetics will also need to inject themselves with insulin to regulate blood sugar after meals. Type 2 Diabetics can monitor their blood sugar levels and manage them through diet and activity without the need for injections.

So far this just sounds unpleasant but not a huge problem right? Well, this is where the picture gets a little darker. To those of us living without diabetes, a dip in blood sugar brings on lethargy and hunger and a spike causes a little bit of mania and maybe the jitters. For someone living with diabetes a low or high blood sugar level can be life threatening.

Insulin is required to push glucose across the cell membrane and into our cells for use. So when we don’t have the insulin to perform this essential component of life glucose builds up in the blood and our cells need to look for alternative energy sources. Muscles begin to breakdown protein which creates urea (a toxic chemical) that needs to be filtered out by our kidneys. Also if glucose is not being pushed into our cells it is staying in the blood and so ends up being filtered out by the kidneys as well. This leads to a drop in blood volume as water is pushed into the urine in the filtration process. A drop in blood volume like this is bad for the brain and causes stupor and confusion. To add to all of this fat is being utilized as an energy source by the body and the processing of fat into usable energy by the liver produces something called Ketones which as toxic if they build up. The build up of Ketones and the drop in blood volume can lead to coma and possibly death. This whole process does not take long to occur.

The other side of the coin is when there is not enough glucose in the blood which is very bad because our brains can only use glucose as an energy source and nothing else. So without sufficient glucose our brain starts to shut down and can lead to coma and death.

So keeping a regulated blood sugar level is very important and very difficult. Our blood sugar fluctuates wildly throughout any given day depending on our needs. This is not a big deal and kept in check by our bodies for people without diabetes but those living with this condition it is a daily struggle. Even a diabetic with well controlled blood sugar can have spikes and dips sometimes.

There are long term consequences to blood sugar levels that are uncontrolled as well. With higher levels of glucose circulating in the blood (not high enough to cause a coma as we talked about before) the glucose ends up sticking to things, mainly the red blood cells (used as a measure of ~3 month blood sugar stability, “A1c”) and the walls of the arteries and veins. This process is called, “Glycosylation” and it causes the tissues it happens to become stiff. This is not a huge problem for the red blood cells but is an issue for the blood vessels which need to respond to different situations by expanding and contracting. This stiffening causes them to be more susceptible to damage which is where the long term consequences come in.

Damage to the walls of the blood vessels increase the risk of the development arterial plaquing which leads to heart disease. Glycosylation has also been shown to lead to the development of Macular Degeneration (a disease of the retinas leading to blindness) as well as putting strain on the kidneys and the filtration of the blood.

Glycosylation can also happen to the nerves of the body which can cause pain along those nerves and can lead to the loss of all sensation along that nerve. This is generally associated with areas of heavy glycosylation in the blood vessels and so a decrease in oxygen reaching these areas of the body (generally the feet and hands) and so the degeneration and death of these tissues. This degeneration is not reversible (although there is some interesting leads in laser therapy to prove this wrong) and the tissue will need to be amputated.

Diabetics also have a higher risk of being diagnosed with cancer because tumors feed off of glucose hungrily. So when tumors are very small and have a chance of dying off on their own due to lack of nutrients they have no end of nutrients in the blood of people living with diabetes because they do not require insulin to grab the glucose up out of the blood while the cells around them are still waiting for the insulin to feed them.

So now you have a little more knowledge about what this condition entails and the burden it can be. A little understanding can go a long way. Diabetes is not something to be feared or shunned. It is a physiological process that can be influenced by our activities and habits. The people I know who have diabetes are some of the strongest characters I have ever met. They struggle and strive to conquer this mountain daily.

Thanks for reading,
Dr. Ben

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What Is Arthritis?

(Originally posted on bcotoronto.com on May 9th, 2013)

Arthritis is an extremely common condition. It affects people young and old everywhere across the world but did you know that there are different kinds of arthritis?

In general, arthritis is a degeneration of the joints in the body for any reason. First, this leads to painful movement and use of the joints. Then it progresses to instability of the joints involved, which causes the body to try to lock down that joint to avoid injury. This last part involves the over growth of bone to fuse the joint.

The most common form of arthritis is called, “Osteoarthritis” and it is the breakdown of cartilage within the joints through various reasons. There are several others which all involve varying degrees of autoimmune disease progression which we will not explore in depth today. These conditions include “Rheumatoid Arthritis” and “Psoriatic Arthritis” among others which are fairly uncommon.

Last week we touched on the idea of nutritional deficiencies leading to arthritis, specifically Vitamin C. Not many other deficiencies will lead to collagen breakdown as protein is the main component of collagen and we would notice that deficiency long before the development of arthritis.

There are many other causes of arthritis such as improper wear and tear of the cartilage through misalignment of the joints, which causes pressures to be applied to the cartilage unevenly. Our posture plays a huge role in this. Cartilage gets its nutrition like a sponge. You need to wring it out to remove the old water (waste products of cartilage cell metabolism) and let it expand again to bring in new water (the nutrients carried from our blood). Movement is how we squeeze and refresh our cartilage, so our sedentary lifestyles in North America actually lead to higher risk of arthritis even though our cartilage is being “used” less. Also, even if we are marathon runners, our joints can sometimes become “stuck” and not move properly. This can be the misalignment of joints we touched on earlier or from muscular spasms that do not allow movement. Whatever the reason, this immobility of the joint decreases our ability to bring nutrients to the cartilage of that joint and increases our risk of degeneration.

There are other things in life that increase the risk of degeneration of a joint such as previous dislocations, direct injury to the joint, or a broken bone that is close to or specifically involves the joint. Our bodies can even attack the cartilage in what is called an “Autoimmune” disease which is the case with Rheumatoid and Psoriatic Arthritis but that’s a story for another time.

In the case of an autoimmune disease medication and supervision by an MD is required but for other forms of arthritis a conservative approach may be tried. Most people with arthritis protect the painful joint but this the absolute opposite of what you want. Movement will help to beat the pain of arthritis as well as bring the nutrients to the remaining cartilage to help keep it healthy and strong. Chiropractic adjustments will help to get those immobile joint moving again and manage the pain of arthritic joints. Hydration is key to maintain lubricated joints and healthy cartilage. All three of these treatments also do wonders for preventing degeneration of the joints in the first place as can improved posture. Acupuncture also is an excellent way to manage the pain of arthritis and in trying to prevent further degeneration.

There is a supplement called Glucosamine which is a natural substance that our bodies are able to make on their own which is the form of glucose (sugar) which the cartilage can use. As a supplement it is delivered to the body in the cartilage friendly form already and so goes directly there but it can still trigger an insulin spike so diabetics should consult their doctor before starting to take glucosamine. The research on glucosamine has had mixed results but the balance is tipping towards the benefit of the supplement and its potential to protect and possibly stimulate the cartilage to grow.

So as you may be able to tell, there is a lot that we can do to help prevent the degeneration of our joints. Arthritis does not need to be as prevalent or as devastating as it currently is in our society. Remember, an ounce of prevention is worth a pound of cure.

Thanks for reading,
Dr. Ben

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Vitamin C and the Modern Day Scurvy

(Originally posted on bcotoronto.com on May 2nd, 2013)

We all know that Vitamin C is an essential antioxidant in our bodies but, like Vitamin D, it has so many more uses. Today we are going to discuss one such role Vitamin C plays and explore its implications.

Collagen is a protein that is ubiquitous throughout the body. It is the main component of our connective tissues which make up all the ligaments, strips of fibre holding our organs in place, blood vessel walls, and layers of tissue under our skin anchoring it to the structures underneath. It also makes up a large part of our cartilage and our bones before they harden.

Vitamin C is the key catalyst in the production and maintenance of collagen. This is actually how that age old disease Scurvy works. A lack of Vitamin C in the sailors’ diets lead to a breakdown of collagen which cased the teeth to fall out (the gums are almost completely collagen) and the blood vessels to weaken and break. Of course, it is extremely rare to find cases of Scurvy in the Western World now but a lot of the population does not get enough Vitamin C. This is what’s called a “Subclinical Deficiency” and it can go unnoticed until bad things start happening.

In Subclinical Vitamin C deficiency we find cases of gum recession, easy bruising, and joint laxity. Now don’t jump to the conclusion that all cases of these conditions are caused by Vitamin C, each has many factors that can influence it. In this case we are talking about Vitamin C though so let’s not get side tracked. With a subclinical deficiency collagen is being broken down more quickly than it can be replaced and this leads to certain unhealthy situations. Cartilage will wear away faster and our blood vessels will become weakened.

With cartilage maintenance impaired this puts us in greater risk for developing arthritis which can be managed but not reverse once it has started.

The collagen in our blood vessels is extremely important because that provides the stability needed to withstand the pressures of the pumping blood. The weakened blood vessels can burst which causes the easy bruising but more importantly puts us in great risk of aneurysms and strokes.

So are you getting enough Vitamin C in your life? Vitamin C can be found in all the citrus fruits as well as almost all brightly coloured veggies (peppers, radishes, etc.) and, of course, our favourite dark green leafy vegetables. Make sure you are getting the nutrients you need in quantities that are sufficient.

Thanks for reading,
Dr. Ben

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Signs of a Heart Attack

(Originally posted on bcotoronto.com on April 25th, 2013)

Like in last week’s post on Stroke I would like to take some time and discuss another important event where timely care is extremely important. A Heart Attack. Most people know that chest and left arm pain are the symptoms of a heart attack but there is definitely more to the picture than that.

These symptoms are often described as a warm or burning pain in the chest and arm. They are also associated with a feeling of pressure on or around the chest, often described as, “an elephant sitting on my chest”. This pressure can be accompanied or preceded by shortness of breath and sometimes light headedness. Some people will lose consciousness with a heart attack due to this.

As I said, this is the most typical picture of a heart attack presented to us as the general public but there are different ways for it to show up. The most common way for a heart attack to present itself is in the pressure I described above or as a vague discomfort in the mid or left chest.

The main sign to look for is a new pain or sensation in the chest or a change in a usual pattern.

Other symptoms that are not as chest centric can occur during a heart attack such as nausea and vomiting, cold sweats, dizziness, and left sided neck and jaw pain. In women, especially over 40-50, some heart attacks have been noted as pain between the shoulder blades.

All new pain and symptoms should be checked out by a healthcare professional but some do not require immediate care. If you think that you or someone else is having a heart attack be sure to call 911 as soon as you can. A speedy response can make all the difference in the world in situations like this.

The general rule of thumb is call 911 when in doubt but here are some handy tips if you can’t quite tell if you or someone else is in trouble. Many of the above symptoms can be caused by other conditions that are significantly less life threatening but almost all of these can be localized to a specific point of origin. So if you can literally put your finger on a point and say, “This is where my pain is from!” then it is most likely not a heart attack. The pain associated with a heart attack is generally widespread and vague in nature. That being said if you have a number of these symptoms all together then that definitely raises your risk and you should seek help immediately.

I hope all picked up something from this or that this is all old, well known information for you. The more you know the better you will be able to help either yourself or someone else in an emergency.

Thanks for reading,
Dr. Ben

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Signs of a Stroke

(Originally posted on bcotoronto.com on April 18th, 2013)

Stroke is an extremely important topic in chiropractic and so it is incredibly important that chiropractors know how to identify a stroke when it is in progress. It is also important for you as the general public to be able to identify a potential stroke because the sooner someone suffering from a stroke is taken to a hospital, the better their prognosis will be.

There are some commonly known tools for identifying strokes out there but I would like to repeat them here because everyone should know them. They are easy to remember because they start with the same three letters as Stroke. STR.

S stands for Smile. A stroke almost always affects one side of the brain and so on side of the face will experience weakness in the muscles that allow us to for expressions. A person suffering from a stroke will have a lop-sided smile or even a smile on one side and a drooped, limp lower lip on the other.

T stands for Talk. As the person you suspect of having a stroke to speak to you. It doesn’t matter what they say just that they are trying to form words. The muscles of the tongue are mirrored down the middle and like the muscles of the face one side gets its nerve supply from one side of the brain and the other side gets it from the other. Add this on to the already weak lips and you can’t form words properly. It will sound as if the person is slurring their sentences.

R is for Raising Your Arms. Like the muscles of the face and the tongue, the muscles of the body are mirrored down the middle and each side gets their nerves from one half of the brain. So shrugging their shoulders or raising their arms above their head would be difficult on one side for someone having a stroke. This is, of course, assuming that they could perform this task previously.

So those are the three common “Public Education” signs of stroke that people usually know because they are posted in your office first aid room or all over the internet in chain e-mails. The one other symptom that people generally know about is numbness along one side of the body but this can’t really be tested in an observable way.

There is a lot more to a stroke than just these signs and symptoms. I would like to walk you through a little bit so that you will be able to identify more of these signs and help people get to the proper care they need.

The brain is very organized and so different functions are located in different, distinct areas. So when a stroke happens, only the areas that immediately surround the bleeding artery or vein will be affected. While muscle control is the most common area to be effected it is by far not the only one. In some cases people are still able to speak clearly and move without difficulty.

In general, one of the signs that doctors look for in identifying a possible stroke is patients complaining of the “Worst Headache of their Life”. Of course, this statement is prone to exaggeration so you need to be careful not to jump to conclusions on this one. If you are concerned, ask them to clarify.

During a stroke essential senses can be compromised like balance, vision, smell, or hearing. Generally this means an increase signal from these senses rather than a loss of sense such as blurred vision or seeing auras, smelling a scent that is not there, or a ringing in the ears. Any one of these alone could be a number of different things but probably not a stroke, although they should still be evaluated by a doctor. When in combination they become truly concerning.

Nausea & vomiting are also commonly associated with conditions influencing the brain. When these symptoms occur without provocation always take that person to the emergency room.

So if you think that someone near you or even yourself is experiencing a stroke, start with the STR questions and then add to them with what you have learned here today.

Thanks for reading,
Dr. Ben

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Chiropractic Poster

(Originally posted on bcotoronto.com on April 11th, 2013)

So this week has been kind of busy for me. I’ve been running around getting ready to start with my first Corporate client and one of the tasks I have been working away on is a poster for presentations and health fairs. So I thought I would share with you my work.

Enjoy (click to enjoy the full sized pdf, approximately 24 x 30 inches)

Health Fair Poster – Reformat

All the pictures (with the obvious exception of my handiwork) are from Ontario Chiropractic Association material intended for use by members of the association.

Thanks for reading,
Dr. Ben

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What Is A Hamstring?

(Originally posted on bcotoronto.com on Mar 27th, 2013)

Concluding the theme of March: Anatomy and Ergonomics, we will be discussing Hamstrings and their important role in the body. The hamstrings are a group of large muscles that run down the back of the leg from the bottom of the pelvis to the knee. They are the primary knee flexors and help our gluteus muscles with hip extension. The Hamstrings include the Biceps Femoris, Semimembranosus, and Semitendonosus.

Biceps FemorisSemitendinosusSemimembranosus

So why are they so important? Well, as I said before they are the primary movers in knee flexion which is an incredibly important movement. Just try walking or jumping without bending your knees. Even sitting for that matter would be difficult. Needless to say we use our Hamstrings every single day to move around so any injury to these muscles will significantly impact our activities during the day.

Hamstring strains are very common among athletes but also among the general population through slipping on ice or missing the curb of the sidewalk. Improper stretching or not stretching at all before exercising is also an extremely common way to injure your hamstrings. So we need to ask, why is this muscle group so easily strained? It is because the Hamstrings are chronically tight and short in the average population.

When a muscle is tight it does not have the ability to react properly and smoothly to changes that are force upon it. With respect to a slow, gradual change this is not a problem but fast changes, like missing a step or running without a warm-up, can strain the muscle. Muscles can be tight for two main reasons; overuse (as with Tennis Elbow or rotator cuff injuries) and postural pressures.

In the case of chronically tight Hamstrings postural pressures are generally the cause, unless you are an athlete but even then they can be part of the contributing factors. The Hamstrings cross two joints, the hip and the knee and just like our hip flexors, if we keep the muscles shortened for a long period of time they will think that length is the appropriate default. Sitting for long periods of time, where the knees a bent, will shorten the Hamstrings. Add to this leaning back into the chair which rolls the top of your pelvis back and brings the bottom forward and you have an even shorter muscle.

Standing posture is also important in Hamstring health. Slouching causes the low back to bow backwards and rolls the top of the pelvis back and the bottom forward and down, once again causing the Hamstrings the shorten.

As with any other muscle, the key to healthy Hamstrings is stretching, proper posture, and keeping moving. There are lots of ways to stretch the Hamstrings but these generally reaching down and touching your toes which many people find uncomfortable and difficult. So I’m going to share with you a different stretch that is a little easier for those of us, myself included, who are not all that athletic.

Lie on your back on a flat surface that you can comfortably stretch out on. Take a bath towel and fold it along the width to make it thinner but still the same length. Hook one heel in the middle of the towel and grab the ends of the towel in your hands. Pull your leg up, flexing and the hip and keeping your knee straight, until you feel the stretch along the back of your leg. Hold firmly onto the towel with both hands and resist as you push your heel into the towel as if trying to bring your heel back down to the floor. Your foot should not move during this push. Maintain the pressure for the length of 3 big belly breaths. Relax the pressure from your leg and gently pull your leg further up with the towel until you meet tension and feel the stretch in the back of the leg again. Hold this stretch for a count of 3 big belly breaths then push into the towel again. After 3 belly breaths of pushing relax and pull your leg towards you more. Repeat this process one more time until you have pushed and stretched 3 times each. After this push your heel back into the floor one last time and only resist this pressure with the towel half as much as you had before. This should allow your foot to slowly come back to the surface you are on. If you feel your Hamstrings are tight do this every morning for each leg and see the difference it will make.

So remember. Sit up straight, move often, and stretch daily.

Thanks for reading,
Dr. Ben

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What Is A Knee Cap?

(Originally posted on bcotoronto.com on Mar 21st, 2013)

Our knee cap (“Patella”) is a funny little bone. It is what is called a “Sesamoid” bone which means that it is a bone suspended within a tendon of a muscle. These sesamoid bones develop in areas where tendons rub over bones as they are stretched by the movement of a joint. They take the pressure and friction off of the tendon and for a joint with the bone they are against instead. This is what the patella does with the Quadriceps muscle and the Femur. The back side of the patella is covered in cartilage just like the any other joint and glides through a depression in the Femur called the “Patella Groove”.

Anterior Knee Bony AnatomyLateral Knee Bony Anatomy

Just like any other point, the Patellar-Femoral joint is susceptible outside pressures and because it is not held securely by ligaments these pressures can lead to significant dysfunction. This can lead to a condition called Patellar Tracking Syndrome (PTS). This is most commonly caused by an imbalance in the quadriceps muscles which pull the patella up through its groove as the knee straightens. The muscles of the quadriceps attach to the patella from three different angles and so if one side pulls harder than the other the Patella will be guided out of the groove.

Anterior Knee - The Quadriceps Muscles

Sit in a chair and keep an eye on your knee cap as you slowly straighten your knee. If the patella moves to one side of the other this indicates an imbalance in the strength of the quadriceps. If left unchecked this deviation in movement can cause extra wear and tear on the cartilage underneath the patella and eventually lead to arthritis and pain.

Before reaching the point of full-blown arthritis the cartilage may become inflamed to the point of causing pain and swelling beneath the patella. This is called Subpatellar Chondritis and can cause a significant amount of grief and get in the way of our activities.

So what can we do about this? Well, the most common muscular imbalance in the quadriceps is a weakness in the Vastus Medialis Obliqus (VMO) which causes a lateral (towards to outer side of our leg) shift in the patella out of its groove. The VMO is important in the last little bit of knee extension and so to strengthen it we take it through this activity.

Sit on a flat raised surface like a chair or bed and straighten your knee as much as you can (if you can bend your knee backwards, only extend the knee to be straight and not more). Bend your knee approximately 5o then slowly extend your knee to be straight again. Repeat this 5-10 times at least once a day. This will help to strengthen the VMO and balance out the side-to-side pull on the patella.

It is possible to have an imbalance in muscular strength in the quadriceps due to other reasons like injuries to nerves and scar formation, in which case significantly more therapy and care is needed and exactly how much should be determined by your healthcare professional. We can also injure our patella directly in other ways, but why not do a little work now to prevent the injuries we can?

Thanks for reading,
Dr. Ben

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What Is A Pulled Groin?

(Originally posted on bcotoronto.com on Mar 14th, 2013)

Continuing our look at the hip, we will be discussing “Pulled Groin” injuries this week. Of course you are now asking, “What does the groin have to do with this hip Dr. Ben?” Well, that’s what we are here to explore. In sports it is incredibly common to hear about an athlete with a Pulled Groin injury but who runs or skates or jumps with their groin? This misrepresentative nomenclature comes from the pain associated with the injury.

A “Groin Injury” is actually a simple strained muscle of the inner thigh. This strain occurs high up the thigh where the muscle attaches to the pelvis on a region called the “Ischiopubic Ramus”, which as you can see in the picture below, is very close to the genitals. This proximity leads to a lot of referred pain into the groin, specifically the testicles and the labia in men and women respectively. Thus the name.

The Pelvis and Femoral HeadsThe muscles involved are a group called the Adductors and two muscles called the Gracilis and the Pectineus. There are three Adductor muscles called the Adductor Magnus, the Adductor Longus, and the Adductor Brevis. Do you remember the Thigh Master from those commercials in the 90’s (it’s actually still around)? These are the muscles that it was targeting.

The Adductor Brevis and Gracilis MusclesThe Adductor Longus and Pectineus The Adductor Magnus Muscle

So if this is just a simple strained muscle what does that mean for healing this kind of injury? Well, initially we should take it easy and ice the injured area. This will help to reduce the inflammation and swelling. After approximately a day and a half we should switch this up and use heat to relax the tight muscle and increase the blood flow in the area. As well, we should lightly stretch the muscle. This will help to get the muscle to relax as well as increase its ability to contract properly again.

The first stretch we should attempt is a butterfly stretch. Sitting upright on a flat surface (a soft surface like a pillow or mattress might be easier when first trying this stretch), place the bottoms of your feet against each other. Let your knees lower towards the floor and put a light downward pressure on them. Hold this position for several deep belly breaths and then release the pressure on your knees and raise them up again. Repeat this stretch 2-3 times in a set and do 2-3 sets in a day. The closer your feet are to your pelvis, the greater the stretch will be so start with your feet farther out and work them in until you find where your comfortable spot is.

The second stretch is a side lunge. This stretch should not be attempted until we are well on the road to recovery as use of the adductors is necessary to get out of the stretching position and this will hurt a lot if tried too early into recovery. So when you feel like you can manage it stand with your feet flat on the floor and standing straight in a neutral posture. Keep the foot of your injured leg on the floor and with the opposite foot take a large step out to the side. Bend the knee of the uninjured leg and lower your body weight over that leg. This should put you in a position where your injured leg is sticking straight out to the side and the rest of your body is squatting over your other leg. Hold this position for several deep belly breaths and then raise yourself back up to a standing position by straightening your knee and bringing the foot you stepped out with back in. Repeat this stretch 2-3 times in a set and do 2-3 sets in a day.

If you are an athlete you can generally introduce strength training into your recovery when you can perform these stretches without pain.

Thanks for reading,
Dr. Ben

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What Is A Hip Flexor?

(Originally posted on bcotoronto.com on Mar 7th, 2013)

One of our most important areas of movement is our hips. They are the main powerhouse movers while walking, working in conjunction with all the thigh muscles (which really involve the hip anyway). Everyone knows about the Gluteus muscles and even a few of the other big movers that make up our bums, but how many people can name what lies on the other side of the hip joint and helps us swing our leg forward?

This main mover is called the Iliopsoas (“Ill – eo – so – as”) muscle. It is made up of two muscle bodies coming together into a common tendon. They are the Iliacus and the Psoas muscles. The Iliacus muscle is a broad, flat muscle that attaches to the upper rim of the pelvis and sits on the inside surface of the pelvic bowl. This ends up making it look like a big fan and gives it the ability to pull on the femur (thigh bone) from many different angles.

The Iliacus MuscleThe Psoas muscle is actually two thick bands of muscle fibres (Psoas Major and Psoas Minor but we’re just going to refer to it as a single Psoas muscle for the ease of the description) that attach to the sides of the lumbar vertebrae. Its length and girth allows these two bands to pull on the femur with quite a bit of strength.

The Psoas MuscleAs the Iliopsoas, these two muscles work together to flex the hip joint and bring the leg forward. They are important in walking, running, sitting, swimming, and really any activity that requires the use of our legs. This grouping of “Hip Flexors” is one of the “Prime Movers” in our body which are responsible for making the large movements of our limbs and body as a whole.

This Hip Flexors are important for another reason too in this day and age. As a society, we sit much more than is good for us. The body, when in any posture for long periods of time, will adapt to that position as the default. This means that when we sit all day and our hips are flexed at a 90 degree angle, the Iliopsoas is shortened and our brains make that new length the default position for the muscle. So when we stand up again, we straighten out our hip joints but the Iliopsoas is no longer long enough and so this pulls our pelvis and lumbar spine forwards.

This creates an over extension of the lumbar spine which pushes the joints that the back of the spine together potentially causing low back pain and decreasing the size of the holes where nerves leave the lumbar spine potentially causing nerve pain that may travel into the leg. More commonly, the Iliopsoas will be a source of pain itself which can cause pain in the low back, pelvis, and genitals.

None of these situations are pleasant and there are two simple things that we can do to make sure they don’t happen; move and stretch. Get up from your desk every 15-20 minutes and stretch your hips and low back (and while you’re at it your shoulders and neck too) and walk around a little bit. This stimulation will keep the blood flowing through the body of the muscle and keep it limber and the appropriate length.

Remember. An ounce of prevention is worth a pound of cure.

Thanks for reading,
Dr. Ben

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