Monday, November 30, 2015

How The Cold Weather Can Have An Impact On Your Muscles And Tendons

Canadian Chiropractic Association

You may find that as the weather gets colder, you may experience more aches and pains, and even feel like your muscles are stiffer. This is even more evident for workers who work outside in the winter, or individuals with certain ailments. The cold weather can increase the risk of suffering from MSK injuries and can even increase the intensity of certain MSK conditions.

How Can the Cold Weather Impact Us?

If you live with an arthritic condition you might find that your symptoms may be exacerbated by cold weather conditions, which can keep you away from doing the activities you enjoy. Conditions like rheumatoid arthritis and osteoarthritis may not react well to sudden weather or atmospheric changes, which may worsen symptoms1.
Even without any specific conditions, most of us are very aware of how our bodies feel and move when we are cold – we may move slower and walk around when our muscles are tense and stiff. This can result in soreness that we may not experience otherwise. For those who work outside, be conscious of your working conditions. Feeling warm, safe and comfortable is important as heavy lifting and overexertion can increase risk of injury in colder temperatures2.
Here are a few things that can be done to prevent stiffness and MSK-related injuries during the winter months3:
  • Maintain an active lifestyle – make sure you are doing some form of physical activity to exercise your muscles and joints
  • Dress warmly – wear proper clothing to keep your body warm and protected from the cold
  • Wear proper boots that are waterproof and warm, and have good threads to prevent falls
  • Wear a warm hat (keeping your head warm reduces the amount of body heat that escapes from your head).
  • Do not stay out in the cold for too long (if you work outside, move indoor during your breaks if possible).
The winter months shouldn’t keep you from doing the things you love, or keep you indoors in pain. Keep active and dress warmly, and you may be able to minimize the aches and pains of the season. Your chiropractor can also help you manage your condition-related pain during the winter months, and help you prevent MSK conditions if you work outdoors.

1. Irish, “Cold and damp Weather,”
2. BC Government and Service Employees’ Union, “Workplace Guidelines for the Prevention of Musculoskeletal Injuries,”
3. Centres for Disease Control and Prevention, Cold Stress,

Tuesday, November 24, 2015

Muscle And Joint Injury First Aid

By Dr. John A. Papa, DC, FCCPOR(C)

Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  This can cause pain, stiffness, and swelling in a joint or muscle, leading to injuries known as sprains, strains, and contusions.  Initial conservative management and first aid of such injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation) outlined below.
PROTECTION:  Immobilize the injured area to protect from further injury.  This can be accomplished with the use of an elastic wrap, brace, splint or sling.  Walking aids such as crutches or a cane can be useful to help you get around.
REST:  To ensure proper healing, rest the injured area and avoid activities that cause pain.  Do not restrict all activities completely.  Other regions of your body can still be used.  This will help prevent physical de-conditioning.  An attempt should be made to return to regular or modified activities as soon as possible provided it does not put you at risk for further injury.
ICE:  Ice cubes, frozen vegetable bags, or commercial ice/gel packs are examples of cold sources that can be molded or applied to an injury site immediately.  Icing will help to reduce pain, swelling, and inflammation in the injured tissues.  Ice application should not exceed 10 to 20 minutes at a time.  Allow for skin temperature to return to normal before ice is reapplied.  This cycle can be repeated as often as necessary within the first 24 to 72 hours.  Ice should never be applied directly over the skin for a prolonged period of time as this can damage the skin.  A wet towel can safely be used as a barrier between the ice and skin and acts as an excellent conductor of cold.  Do not apply ice to blisters, open cuts, or sores.  Individuals hypersensitive to cold and those who have circulation problems should avoid ice.
COMPRESSION:  Compress the injured area with an elastic tensor bandage.  This will help decrease swelling.  Do not wrap the bandage too tightly as to cut off circulation.  You should not feel an increase in pain with compression.
ELEVATION:  Elevate the injured area (whenever possible) above the level of the heart, especially at night.  Gravity helps reduce swelling by draining excess fluid.
You should seek immediate medical care under the following circumstances:  a popping sound heard during the injury accompanied by a feeling of joint instability or inability to weight bear; obvious evidence or suspicion of a broken bone, fracture or joint dislocation; or injuries at risk for infection.
By using the P.R.I.C.E. principle after an injury, you can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  In the event that you suffer from ongoing muscle and joint pain following an injury, you should contact a licensed health professional who can diagnose your condition and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance.  For more information, visit
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Friday, November 20, 2015

Fun Activities For The Fall Season

Canadian Chiropractic Association

When it gets colder we tend to move our activities indoors, which in some cases can decrease our activity level. Rather than letting yourself get into a slump during the fall and winter seasons, embrace fun activities as the weather begins to cool down.
As we have mentioned before, it’s very important to maintain an active lifestyle to help prevent MSK conditions. Staying active will allow your body to manage everyday activities such as gardening or raking leaves, which require a certain level of endurance over a period of time.
There are many things you can do in the fall to maintain your active lifestyle and have fun while you do it! To help you out, we’ve come up with a few ideas to help get you moving outdoors.

A Fall Hike

Take advantage of the beautiful bright fall foliage. Check out your city or provincial website to find local walking trails for you to explore! Whether you go alone, or with a friend, hiking is a great way to stay active in the fall months and perfect for enjoying the outdoors.

A Day at the Orchard

Get your family or a few friends together and enjoy this popular fall activity. Between walking through the orchard and reaching for the perfect apple, you will enjoy some active rest to keep you moving. Enjoy the fresh crisp air and extend your visit by going for a walking tour of the orchard.

Checking Out Local Museums and Art Galleries

On the chillier days that make you want to stay indoors, try checking out a local museum. Exploring new exhibits is a nice way to get out and enjoy this season despite the shift in weather. Have some company join you to learn something new and have an adventure filled with art and history!

Daily Walks in Your Neighborhood

Since we would rather stay indoors when the weather is cold, starting a routine that encourages you to go outdoors each day can help you build-in activity in your routine and is a perfect opportunity to meet new neighbours. Waking up for a walk around your neighborhood is a great way to get an active start on your day.
Make sure to remain mindful of your activity levels during this season. Remember that staying active not only helps to prevent MSK conditions, it’s also a great energy booster that will benefit your health. Staying active is an important part of a healthy lifestyle and keeping a healthy spine.

Tuesday, November 17, 2015

Low Back Pain: Facts And Fiction

By Dr. Greg Lusk, DC

As you can imagine conversations around low back pain are quite common in the office of a chiropractor.  While we are trained to diagnose and treat muscle and joint related conditions throughout the entire body, pain in the low back area is the most frequent complaint bringing patients through the door.  In addition to any therapy we can provide, education plays an integral role in helping clients understand what may have contributed to their pain, what structure(s) may be causing it, what needs to be done to resolve it, and finally what should be kept in mind as they aim to prevent a recurrence.  That being said, patients often have some misinformed beliefs about low back pain that need to be addressed as these beliefs can have a real influence on how they feel and how easily they may recover.

Belief #1

It’s important to know exactly what tissue is causing the low back pain.  There’s no arguing the fact that this would be nice to know but research does not support our ability to determine this in the majority of cases.  Once serious causes have been ruled out, which can largely be done with a good patient history, the many tests we have to stress different structures in the back are not good at isolating the cause.  Even when there is imaging (i.e. x-ray, MRI) that shows an abnormality it’s often not definitive what the source of pain is.  Instead, we have to take all clinical information into account, decide a course of action, and evaluate the outcome of that trial.  As a result, "Mechanical Low Back Pain" is often the best diagnosis available, in all its vagueness.

Belief #2

Imaging, such as x-ray or MRI, is needed early for proper diagnosis and treatment.  There are definite indications for imaging, such as suspicion of fracture or cancer, but serious causes of low back pain account for less than 5% of all cases.  Also, if low back pain is accompanied by progressive neurological changes in the legs or is not responding to an appropriate trial of care, imaging becomes warranted.  However, most low back pain does not present this way.  Unfortunately, getting imaging done early can have a negative effect by identifying and attributing value to abnormalities that are not clinically relevant.  In extreme cases, this may result in unnecessary surgery but the far more common negative effect is the patient’s belief that the finding is important and “bad”.  Research repeatedly shows that a high percentage of healthy, pain free individuals have abnormal low back findings with imaging so it’s vital to make sure they’re clinically relevant, not just present.

Belief #3

The severity of back pain correlates to the amount of tissue damage present or the degree of injury.  With respect to back pain this simply is not the case.  Pain is a very complicated phenomenon that is affected by many things including, but not limited to, tissue damage, previous injury history, perception of threat to daily activities (i.e. fear), and ideas of what may have occurred.  It is not uncommon to see a client in severe pain be remarkably improved in a few days, which far exceeds the rate of normal tissue healing.  Therefore, tissue injury cannot be the only factor at play.

Being an informed patient not only assists recovery but may also help prevent the undesired development of chronic pain.  This article is for general information purposes only and is not to be taken as professional medical advice

Thursday, November 12, 2015

How to Stay Active At Home When the Days Get Shorter

Canadian Chiropractic Association

During this time of year, days are getting progressively shorter and we may start to feel a little more pressed for time. Most of us already struggle finding time to stay active, which can take a toll on our overall health and the health of our spines. Staying active and mobile is important to keeping our spine healthy, and decreasing overall tension and stress which can also help prevent MSK conditions. As little as fifteen minutes to a half hour of activity a day can help prevent MSK conditions.

When you feel short on time as the daylight shortens, here are some ways you can stay active at home.


This is one of our favourite ways to stay active. The Fit-in-15 program was developed by Canada’s Doctors of Chiropractic, recognizing the difficulty in scheduling physical activity in your daily routine. It allows you to quickly build a 15-minute workout plan to target muscle strength, flexibility and cardiovascular health. Designed for simple, practical use, Fit-in-15 will help you stay motivated and active from home!

Schedule Your Workout

Sometimes even the perception of shorter days can leave us feeling anxious and stressed about missing out on activities you enjoy – like your workout. If you constantly feel like you are too pressed for time for physical activity, try scheduling it into your day as though it were a meeting you can’t miss. Use the Straighten Up Canada app and set reminders to complete your exercises.

Working out at Home

If you don’t feel like heading out into the cold or darkness to get your workout, try some resistance training at home  or follow along to a workout video. Introduce simple, scalable and easy to do activities to your day, such as push-ups, sit-ups and lunges1. These exercises are easy to do since they rely on your own body weight and do not require the use of equipment. You may also find a variety of workout videos on YouTube or popular fitness sites if you do not have the means to purchase a program at home.

Weekly Chores

Being indoors makes it easier for us to fall complacent to sedentary activities such as watching TV or using the computer. A great way to stay regularly active at home is to commit to a schedule of daily chores broken down in 15-30 minute segments. Instead of investing hours during the weekend, consider breaking down tasks into smaller, more manageable routines that could also provide you the opportunity for daily exercise. These could include any chores or duties around the home like vacuuming, doing laundry, or mopping2. Committing to your chores on a consistent basis will keep you physically active even when the weather discourages us to venture outside.
Staying active can become a challenge as the days get shorter and the lack of exposure to daylight drains our energy. Yet, daily activity can be an important factor to re-energizing the body and the mind, while preventing MSK conditions.
For more tips on how to stay active at home during the fall and winter months, visit your local chiropractor.

Monday, November 9, 2015

Treatment And Prevention Of Whiplash Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

The unique forces generated during a motor vehicle collision (MVC) cause more than 100,000 whiplash cases in Canada each year.  This article will specifically focus on the treatment and prevention of whiplash injuries.

The term WAD (Whiplash Associated Disorder) is used to describe a range of injuries that can be attributed to whiplash.  This may include:  neck pain, whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.

WAD Grades 1 and 2 represent the majority of whiplash cases and are amendable to conservative management.  Early treatment and consultation can greatly improve the recovery process and prevent future complications and chronic pain.  Effective treatment strategies may include: pain controlling modalities such as electrotherapy and acupuncture to help facilitate and promote activity and functioning; manual and soft tissue therapy to assist in the healing of injured tissues; education on how to safely re-integrate into activities of daily living; and rehabilitative exercises that may include range of motion, flexibility, strengthening, and balance/coordination training.  An independent home exercise program should also be provided.

The goal of treatment is to get the injured individual back on their feet and up to their normal level of activity.  The majority of people with WAD Grades 1 and 2 experience no significant disruption to their normal activities of daily living.  Some may experience a temporary disruption to their normal activities, but usually improve after a few days or weeks.  Occasionally, symptoms may persist over a longer period of time.  A return to normal activities of daily living may be assisted by active treatment and rehabilitative exercise prescription as described above.

Included below are some tips that may help prevent a MVC and/or whiplash injury (courtesy of the Alberta College and Association of Chiropractors):

1.    Drive defensively.  Always anticipate the actions of other drivers.

2.    Wear your seatbelt at all times.

3.    Make sure your headrest is positioned properly, that is, the top of the headrest should be no lower than the top of your ear.  If more than one driver uses the car, remind each other to always check the headrest height.

4.    Never operate cell phones or other electronic equipment while driving.

5.    When road conditions are poor (i.e. icy, wet, dark, or crowded), slow down accordingly.

6.    Be sure your car is always in good working order, particularly your brakes, tail lights, headlights, and directional signals.

7.   Engage in regular physical activity consisting of cardiovascular, strength, and flexibility training.  This will help keep your body strong and offer some protection in the event your are involved in a MVC.

If a whiplash injury is interfering with your activities of daily living, consider chiropractic care.  A chiropractor can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for you.  For more information, visit

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Tuesday, November 3, 2015

Understanding Whiplash Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

Whiplash is a common injury that can be experienced following a motor vehicle collision (MVC).  There are more than 100,000 whiplash cases in Canada each year.  The unique forces generated during these collisions can stress biological tissues and result in pain and decreased functioning for those affected.  This article provides a review of whiplash specifically focusing on the mechanics of injury, the associated symptoms, and general guidelines for the evaluation of any accompanying injuries.

Although rear-end collisions are the most commonly reported mechanism of whiplash injury, an injury may also occur following side and head-on collisions.  The forces generated from these types of impacts thrust the head (and to a lesser extent the entire body) back and forth, much like a snapping whip.  Injury results because the body is unable to compensate adequately for the speed of head and torso movement from the acceleration forces generated at the time of impact.  This will put stretch, compressive and shear stresses on biological tissues such as muscles, ligaments, joints and nerves.  As a result, this can generate pain symptoms, and affect range of motion, strength, coordination, and balance. The onset of whiplash symptoms may immediately follow a MVC or may gradually develop over the first 24-72 hours.  A later onset of symptoms does not necessarily indicate a more serious injury.

Neck pain is frequently associated with whiplash injuries.  However, the whiplash mechanism may also cause injury and symptoms that include: whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.  The term WAD (Whiplash Associated Disorder) encompasses all of these potential symptoms and is commonly used to grade the degree of injury present.  Of the four Grades of WAD, Grades 1 and 2 represent the majority of whiplash cases.

Evaluation of whiplash injuries should include a proper medical history, along with a physical examination consisting of inspection, palpation for tenderness, range of motion, strength, neurological, orthopaedic and functional testing.  Signs of serious injury, such as fracture, are usually evident in early assessments and may require further diagnostic testing such as x-ray, CT scan, or MRI.  Chiropractors are healthcare professionals skilled in the diagnosis and treatment of whiplash injuries and are commonly involved in the management of WAD.

When an individual sustains a whiplash injury, injured tissues can become stiff and weak when they are not used, which can further exacerbate pain symptoms.  Therefore, a return to daily activities after whiplash injury is extremely important for successful healing as extended rest may prolong recovery.  Healing and a return to daily activities may be facilitated with active treatment and rehabilitative exercise prescription.  Join us next time when we specifically take a closer look at the treatment and prevention of whiplash injuries.  For more information, visit

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.