With spring upon us and summer quickly approaching, it’s time to dust off your bike and get ready for some good rides. What better time to get on the bike than during National Bike to Work Week!
To keep you out of pain, we wanted to bring light some key points you can check to make sure you fit your bike well.
First, the seat height. When sitting on your bike with the pedals in top/ bottom position, a good rule of thumb is to have the knee of your extended leg near but not exceeding a straight 180? angle. Because there are a few inches of clearance between the pedal, in the down, and the ground, you should not be able to plant your foot onto the ground when coming to a stop. You may be able to prop yourself up on a pointed toe, but if you are able to stand without coming forward out of the seat, either your seat is too low or your bike is all around too small for you. Also, if your hips bounce from left to right as you ride, your seat is too high.
Second, the distance between the seat and the handlebars. When sitting on the bike with the line between your pedals horizontal (one foot forward one back), your front shin should be perpendicular to the ground. If your seat is too far forward or backward, you may experience pain, discomfort, and unnecessary exhaustion.
Third, the angle of the seat. As with a chair, if you sit on a surface that is tilted forward, you will continually feel pushed forward and potentially slide. And vice versa, if your seat is tilted back, you won’t have the ability to get the power you need to propel yourself. Try to set the seat as close to level/ parallel to the ground as possible.
And forth, the seat’s size and material. When I started riding bikes in my adult life, I was using a pretty narrow and firm seat. It was so uncomfortable, I wondered if I would ever be able to walk normal after that. The pain decreased with use, but then my (now) husband got me a padded covering for my seat. It seriously made all the difference for me. My advice to you, simply choose the size and firmness according to your own liking.
As we thought through topics that would be most helpful to share with our patients, one of the first that we identified was sitting at your desk/ computer without getting neck or upper back pain. Sounds simple enough, right? I’m guessing, though, that a good number of you (and your coworkers, family, and friends) experience pain caused by this very reason.
Maintaining correct posture is a great habit to develop as it contributes to your health, general well-being and quality of life. Think of the bony anatomy of a healthy body and you should generally notice alignment and symmetry. The (front/ back) curvature of a healthy spine should remain close to neutral through most of your day whether you are sitting, standing, working, playing, or even sleeping.
When standing in good posture, your ear, shoulder, hip, and heel should remain in the same plum line. When you sitting or even squat or bend to get something off the floor, your feet will come out of that line, but the ear, shoulder, and hip should remain in the same line.
In the video below, Katie deomonstrates the proper sitting posture:
Our bodies were not created to sit in one static position for long periods of time, but for the majority of our culture, this is hard to avoid. Our bodies were created to be regularly active so when we force ourselves to sit stagnant for hours on end, certain parts of your body will be placed in great stress. Whether it is your job or lifestyle that calls you to be in this position, it is easy to sit lazy and slump into a forward bent. When we slip out of good posture and into one big “C-shape” curve from head to tail-bone, the muscles along the length of the spine beg you to sit up right… and your body communicates to you through pain.
As you begin feeling that pain, raise your chin up to the sky, open your chest, and stretch extending back. Refrain from tucking your chin and flexing forward as that can easily exacerbate the strain.
If your job or lifestyle does call you to sit for many hours a day, take a few seconds every half hour or hour to do a few simple extension exercises. When you’re done with your day of sitting, choose to take a quick walk to get your body moving and blood flowing. And while you are sitting, here are some key tips to think of so reduce pain:
Use a seat that supports your back (low back especially) and creates just over a 90 degree angle between your trunk and your thighs.
Allow the top of the monitor to be at or slightly below eye level
If your screen creates a glare, you may find yourself straining to see what is on the computer and a screen cover would be a good investment.
Place your monitor a little more than an arms distance in front of you.
Allow feet to rest flat on the floor. If your legs are not long enough for that, create a footrest out of some books or a box.
If typing from a document, place it on a stand at eye height near the computer screen.
Only use a wrist-rest while resting, not typing, to reduce risk of impinging the nerves and tendons in your wrist. Maintain straight wrists in relation to forearms.
Keep shoulders relaxed down and elbows at an appropriate angle to keep your wrists straight.
Keep body, monitor, and keyboard in the same plane to decrease rotation.
Avoid propping up your keyboard on its retractable feet. Although it’s easier to see the keys, it forces you to strain your wrist.
Use a stable work station that won’t bounce or move around.
Take frequent breaks throughout your day!!.
In addition to the postural keys, we recommend a few items that can aid in decreasing pain and increasing healthy posture. The first is very simple. I’ve been giving each of our new patients a few stickers to take with them (if you need some, just ask) so that they can be put in strategic places… places that you spend a good amount of time in or places that you recognize being in when your pain presents. When you see the sticker, it should act as a reminder to sit up tweak some of those postural points, to drink more water, to bring your ears in line with your shoulders, or to do anything else that you are having trouble remembering to do.
One product we sell here at Compass that works to retrain the shoulder muscles to pull back into form. The Str8nUp is a spandex band in the infinity shape that hugs your shoulders wraps around your upper back. It is a rigid brace but rather it gently reminds the shoulders where they should stay. For more information you check out the video.
A third item that can help with good posture is the disc-o-sit. This is a air-filled disc that when sat on creates the feeling of sitting on an exercise ball. On it, you will initiate your core and hip muscles more than if on a static chair. Going further than that, you can do intentional exercises on it throughout your day. Here is my video showing ways to use the disc-o-sit.
Finally, we have a product called the McKenzie Roll. This pillow-like roll comes with a strap that keeps the roll on whatever chair you are using. Seeing that it is so light and small, it can easily be moved from your car to home to the office! When used correctly, the McKenzie Roll pushes forward on the low spine and causes you to sit with the lumbar spine neutral.
I know it can be overwhelming to make all these changes at once, so this month, identify a few areas that need to be modified and begin to make healthy changes. If you become confused or overwhelmed, feel free to email our staff with questions. We would love to help.
I can tell you that I’ve heard this phrase “I’m moving like an old woman” uttered on my adjusting tables more than once, but this 86 year old German gymnast challenges the idea that we have to move slower as we age.
I have thought of health in many different ways throughout my life. Now that I have kids and have more seriously started to plan for my future I have a renewed perspective regarding my health. I realize that my health not only affects the way that I feel, but the quality of life for my family and those who depend on me.
Health is an investment, much life retirement savings. Many people put off saving for retirement because “now is not a good time” and find themselves unable to retire due to poor planning. I see this with health all the time. We know what we need to do, but we keep waiting for a good time. Unfortunately time doesn’t wait for us and before long we realize that we have a lot of catching up to do.
I remember an interview that I heard with Adrian Fenty, who at the time was the Mayor of Washington D.C and known as the countries fittest Mayor. The interviewer asked Adrian how a busy man like himself could time time for exercise and he responded by saying that he views exercise like any other essential part of his day. To Adrian exercising is no different than eating and breathing, activities that are a daily necessity.
I encourage you to take those small steps now toward good health as they will pay dividends in the years to come. This video is inspiring to me and I hope that it will inspire you also.
In this video, Stuart McGill, researcher from the University of Waterloo and one of the foremost experts on back pain discusses how doing crunches can damage the back and lead to back injuries. He also gives alternatives to the typical crunch.
Personally I have seen a number of people who have hurt themselves while doing crunches and instruct my patients to modify their workouts.
In this video we see a clip from one an NFl game where a chiropractor is adjusting one of the team members on the sidelines during a game.
Every NFL team has a Chiropractor on staff and many NFL players credit Chiropractic for keeping them on the field. Jerry Rice is huge proponent of Chiropractic care as you can see in the second video.
This month, we are investigating Iliotibial Band Syndrome or more commonly know IT Band Syndrome or ITB Syndrome.
How do you know if you have IT Band Syndrome?
Those with ITB syndrome typically experience pain on the outside of the knee, increased pain with repetitive knee motions, increased pain with walking or running uphill, walking stairs or increased pain at the hip on the outer thigh.
What causes IT Band Syndrome?
The iliotibial band (IT Band or ITB) is an extension of the band (a long tendon) that extends down from a hip muscle called the tensor fascia lata (TFL). Starting at the hip, extending along the side of the thigh and attaching just below the front side of the knee, the ITB has a big impact on both joints.
Those with a lack of flexibility of the TFL/ ITB muscle, bowlegged or people with foot problems may be predisposed to chronic ITB syndrome.
What causes lack of flexibility in the ITB?
There is not a one size fits all answer to this question. The most common reason for tightness in the ITB is compensation for weak Glute muscles, particularly a muscle called theGluteus Medius (Glute Med). The Glute Med can become inactive or weak for a number of reasons; two of the most common are restriction in the hip joint and ankle problems (sprains and weak arches).
When the Glute Med stops firing properly, the TFL will work overtime to pick up the slack and essentially doing a job that is wasn’t designed to do. As with any overused muscle (or person), it becomes irritated. The irritation from repetitive knee flexion and extension causes inflammation and stiffness to occur especially in activities such as running and biking.
How do we treat ITB Syndrome?
Our first job is to get you out of pain and once we accomplished that we need to correct the patterns that brought this problem about. There are a number of therapies that we utilize to relieve tension in the ITB. See the following videos for explanations of these therapies.
This video demonstrates using the Fuzion tool on the ITB/TFL
In this video we look at multiple uses of the foam roller including the stretching of the ITB.
This video shows a wall stretch for the TFL/ITB
Our next step is to correct the patterns and muscle imbalances. There are a number of compensatory patterns that can lead to ITB Syndrome, but we will cover the treatment of the most common which is Glute Med insufficiency. Glute Med insufficiency will lead to instability in the hips which can be seen below in this video.
When we see hip instability like we do in this video we know that we have Gluteus Medius insufficiency which we can remedy a number of ways. Our two favorite exercises for this muscle are called “clamshells” and “speed skaters.” You can see examples of these exercises below.
Because the tight tendon rubs against the thigh bone and pulls tight on the knee, inflammation of this area will lead to pain, which also needs to be addressed. To reduce the inflammation, it is important to fill your diet with foods that have anti-inflammatory agents. Here is a recipe that includes a number of anti-inflammatory herbs and spices: Yellow Thai Curry.
This month’s newsletter, we focused on iliotibial band syndrome (ITB Syndrome), and seeing that it causes such inflammation, I wanted to think of a recipe that would include the most anti-inflammatory spices in it. Twelve spices with very high anti-inflammatory properties are: ginger, turmeric, black pepper, cinnamon, rosemary, basil, cardamom, chives, cilantro, cloves, garlic, and parsley. Mmm! I just love flavor! So it works out well for me to eat these foods… I hope you do too! The first type of meal that came to my mind that includes a number of these spices was… curry.
The word curry means ‘sauce’ and has immense popularity in Thai, Indian, and Japanese cuisine. This blend of spices varies depending on the cook and can be individualized to your own taste. If you are not so sure about trying curry, rest assured, I used to be as well until a few years ago. I was on a trip in New Zealand, and a friend from India convinced me to try Indian curry… it was love at first bite! I have now tried other types of curries, really enjoy them, and even try to make it. I have found that I particularly enjoy most Thai curries as they typically have a hint of sweet and spicy. This yellow curry recipe is a classic Thai dish that can easily be adapted to the flavor profile you prefer and the veggies you have on hand. My recipe includes chicken, but it can very easily be made vegetarian, or vegan. Remember to let veggies be the main show (as this is where most of the nutrition you need is) and the meat be a side. Let me know what you think!
Ingredients:
1 stalk fresh lemongrass
4 cloves garlic
1 thumb-size piece of ginger, minced
1 small onion
½ – 1 tsp. dried crushed chili, depending on heat desired
¾ tsp. turmeric
1 tsp ground coriander
1 tsp ground cumin
¼ tsp cinnamon
1/3 tsp white pepper
2 Tbsp soy sauce or Bragg liquid aminos
1 Tbsp lime juice
2 Tbsp brown sugar
1 can coconut milk
1 cup chicken or vegetable stock
3 chicken breasts, cut in roughly 1 inch cubes
2-3 potatoes (can mix sweet and white potatoes), cut in roughly 1 inch cubes
1 can chickpeas, drained and rinsed
½ – 1 can diced tomato, depending on preferred taste
handful fresh Thai basil
Preparation:
Preheat oven to 375 degrees.
Peel off and discard the outer woody layers of the lemongrass and place cut the stalk about 5 inches from the bottom. Place that in a blender or food processor (the greener top of the stalk is too tough to eat but can be used in potpourri or tea). To the lemongrass, add garlic, ginger, onion, chili, turmeric, coriander, cumin, cinnamon, white pepper, soy sauce, lime juice, brown sugar, and coconut milk. Blend until a fragrant, even sauce is made.
Pour sauce to a 9×13 casserole dish. Add the chicken stock and stir to combine. Mix in chicken, potatoes, and chickpeas. Cover and bake for 45 minutes. Remove from oven and add tomatoes, then cover and return to oven for 15-20 more minutes.
Remove from oven and check the chicken. If the meat is tender and juices run clear, the dish is cooked. If not, stir and return to oven for another 10 minutes.
Top with a handful of lightly-chopped Thai basil, serve with rice, and enjoy…mmmm!
Flu influenza spreads around the world in seasonal epidemics which slows down our busy lives and results in 250,000 and 500,000 deaths every year! Typically occurring between October–March (for our area), the flu outbreak typically coincides with flu vaccinations being pushed at us from all angles. I’ve always been a bit skeptical about getting the flu vaccination and have often gotten sick from the shot. After doing a bit of research, a key vitamin (one of our favorite here at Compass) has proven to be more effective than the flu shot.
Flu shots were originally recommended only for the elderly and youngest children, but each year, the recommended age range grows. Though those groups are at more risk, the flu shot shouldn’t be the only strategy recommended against the flu. In fact, there is a lack of evidence for it being beneficial, receiving the vaccination poses great risk to the consumer, and you might not even be protected from the correct strain of flu! Because there are so many strains of the virus, officials must select the 3 strains they think are most likely to circulate. The vaccines are then grown in fertilized chicken eggs for up to eight months. Formaldehyde (a known cancer-causing agent) is used to inactivate the virus. Aluminum (a neurotoxin that may play a role in Alzheimer’s disease) is added to promote an antibody response. Other additives in the flu vaccine include Triton X-100 (a detergent), Polysorbate 80, carbolic acid, ethylene glycol (antifreeze), gelatin, and various antibiotics that some are allergic to! I was stunned when I saw this list of chemicals!
In an article titled Avoid Flu Shots, Take Vitamin D, by Dr. Donald Miller, he states that there is some evidence that flu shots have caused Alzheimer’s and the mercury levels in the vaccination has also been implicated as a cause of Autism. In addition, he states that “Three serious, acknowledged adverse reactions to the flu vaccine are joint inflammation and arthritis, anaphylactic shock (and other life-threatening allergic reactions), and Guillain-Barré syndrome.” Guillian- Barré syndrome is a paralytic autoimmune disease. It is rare that something as severe as these reactions would happen to you, but I would rather risk getting the flu or using something else much more trustworthy than risking Alzheimer’s, arthritis, paralysis, or other reactions!
So what is a recommended, healthy, and safe alternative to the flu shot? Vitamin D. As the sun shines down on you, UVB rays interact with the skin, and particles of a cholesterol derivative open to form vitamin D! Amazing, isn’t it?! Vitamin D regulates many processes in your body, acts as an antiviral, makes natural antibiotics, and keeps inflammation down. In twenty minutes of sun exposure for a fair skinned person (more for those with darker skin), 20,000 IU of vitamin D are produced at which the body stops synthesizing it for the day.
Depending on what you read, daily vitamin dosage recommendations can range from under 1,000 IU to over 20,000 IU. Personally I feel that 5,000 units per day is sufficient unless you’re fighting off an infection in which case I recommend 15,000-20,000 IU. There have been no cases of Vitamin D toxicity in the literature and Vitamin D can be found in prescription form with up to 50,000 IU.
In the winter months sun can be hard to come by especially when you’re covered head to toe. If you are unable to get in the sun each day, look to supplements or foods rich in vitamin D, including wild Alaskan salmon and mackerel. For a list of foods high is Vitamin D click here.
