Monday, May 30, 2016

How To Choose The Right Mattress

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

Choosing the right mattress can go a long way in determining the quality of your sleep.  Using a mattress that does not provide adequate support and comfort can also be a significant source of muscle and joint pain, especially in the shoulder, back, and hip regions.

The right mattress is usually defined as any mattress that helps a person sleep well, so that they wake up feeling rested and without pain and stiffness.  However, there is no single best mattress for everyone as there are a variety of factors that go into choosing the right mattress.

Below are some useful tips that can help you find the mattress that's right for you:

·        Consider how your mattress is made.  Mattress support is determined by the internal architecture of the mattress.  This can include innerspring coil mattresses (most common), memory foam, latex, and air mattresses.  Each offer different degrees of support and comfort.  Some manufacturers also include additional padding on top of the mattress for extra comfort, but this may not be necessary for all individuals.

·        Sleep experts recommend replacing your mattress on average every 8-10 years or sooner.  Look for visible sagging and/or material breakdown as a sign to replace your mattress.  Over time, mattresses collect dust mites and other germs that can exacerbate allergies and impact sleep.  In addition, our bodies change over time and an old mattress that had originally been comfortable may no longer be providing the comfort and support it once did.

·        Your physical health and your mattress.  Sleeping with painful conditions such as osteoarthritis, hip bursitis, and degenerative disc disease can be minimized by choosing the right mattress.  You can also incorporate additional sleep positioning tips to get the most comfort out of your mattress.

·        Try before you buy.  Lay on a variety of mattresses (i.e. firm, medium, pillow top) for at least 10-15 minutes in several simulated sleep positions to get a sense of how the mattress feels.

·        Shop at stores that specialize in mattresses.  These stores will offer a diverse range of choices and other important factors such as manufacturer and comfort warranties.

·        The right mattress achieves a balance between comfort and support.  A mattress that is too firm may cause pain in pressure points such as the hips.  A mattress that is too soft may not offer enough support and cause pain and stiffness.  Most people do well with a medium-firm mattress.  However, at the end of the day, a person's overall comfort level will determine which mattress is right for them.

If you experience muscle and joint pain that is causing difficulty with your sleep, you should contact a licensed health professional who deals in the diagnosis and treatment of these conditions.  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, May 24, 2016

Stretches & Exercises For Knitting Pain & Strains

The Ontario Chiropractic Association recently partnered with Knitted Bliss to educate knitters on stretches & exercises that can be used to reduce pain caused poor posture and repetitive strain. Check it out!
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Wednesday, May 18, 2016

Taking Care Of Your Feet

By Dr. John A. Papa, DC, FCCPOR(C)
The feet are an individual’s contact points with the ground, so how they support the rest of the body is critical.  Our feet have nearly 100 individual working parts, which all have to function together when we stand, walk, run and jump to provide proper stability and balance.
When a small problem develops in our feet, the subtle changes in the way we move can cause a chain reaction of adjustments in our posture and walking mechanics.  This can lead to symptoms such as: localized foot pain, arch and heel pain, along with ankle, knee, hip, and back pain.
Protecting your feet and choosing proper footwear can go a long way in preventing injury and pain.  Below are some helpful tips that can ensure your feet are protected and functioning to the best of their ability.
·        Choose footwear that is appropriate for your foot type.  For example, people with low arches, called pronators, will need a shoe that provides some degree of stability.  A shoe with good cushioning is important for people with high arches, called supinators.
·        Select a footwear store with knowledgeable staff who can provide advice on the shoe that best suits your activity, body structure and type of foot.  Shop in the afternoon or evening, as your feet tend to accumulate fluid and swell throughout the day.  What may have been comfortable earlier in the day could now feel tight later in the day.
·        Remember that not all shoes are created equally.  The same shoe sizes can have different fits depending on the manufacturer.  Be sure to try several sizes to find the most comfortable shoe.
·        Avoid buying shoes that you feel need a break-in period.  Shoes should be comfortable from the first time you put them on.
·        Don't cheap out on your shoes!  Better quality shoes may cost more but will pay off in terms of support and sturdiness.  A mid-priced shoe may offer the best value.
·        Do not hesitate to replace footwear after excessive wear as it may not be providing you with proper support and stability.
·        Consider custom orthotics to help support your feet.  Orthotics are mechanical aids that fit into your shoes as comfortably as an insole and work on your feet much like glasses work on your eyes – they decrease stress and strain on your body by bringing your feet into proper alignment.  This helps rebalance your feet and reduces pain and discomfort by enhancing your body’s natural movements.
·        Remember to exercise regularly and try to maintain a healthy weight.  Extra weight adds extra stress on your feet, knees, hips, and back.
In the event that you suffer a muscle or joint injury related to your feet that does not subside, you should contact a licensed health professional.  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, May 13, 2016

Clarifying "Shin Splints"

By Dr. Greg Lusk, DC

With warmer temperatures we will notice an emergence of outdoor running enthusiasts.  Unfortunately for some, the efforts towards a more regular fitness habit will be plagued by the development of lower leg pain that may force a hiatus.  Lower leg pain experienced while running, but not exclusive to running, is often broadly referred to as "shin splints"; however, there are a few distinct conditions that you may experience in the lower leg (i.e. shin), each having its own possible causative factors and relieving strategies.
True shin splints are known as Medial Tibial Stress Syndrome (MTSS).  The location of pain is the inner (medial) border of your shin (tibia), typically over a broad area, and develops over time.  It is common in newbie runners or when running volume is increased too rapidly without ample time for your body to adapt.  Hard running surfaces and hill running are also potential aggravating factors.  Pain is initially felt after a run or the next morning as the tissues start healing.  Calf muscles which attach along this edge can become irritated.  The bone itself is subjected to more stress as well and can be a contributing source of discomfort.  Over-pronating or having a high arch with a more rigid foot often results in suboptimal loading mechanics which may also play a role.  As such, it is important to wear shoes with the appropriate amount of motion control for your feet and orthotics may be a consideration for some.  Relative rest with cross training (i.e. doing a different activity that doesn't cause pain), treatment to manage pain and inflammation, and then a gradual resumption of running is usually successful in managing this complaint.
If the pain does persist despite treatment and appropriate rest, or it becomes localized to a small area along the bone, a tibial stress fracture diagnosis should be considered.  Also, unlike MTSS, symptoms may be better in the morning after a period of rest.  X-rays often miss a stress fracture so a bone scan may be necessary to find the "hot spot" where the fracture is located.  A prolonged period of rest, which may still involve cross training, is necessary for the fracture to heal.
Another area in the lower leg where runners may experience "shin splints" is the upper, outer portion of the front of the shin.  Pain here typically comes on during a run and forces you to stop running, but then resolves quickly over time.  This scenario is descriptive of Chronic Exertional Compartment Syndrome (CECS).  Muscles in this part of the leg are surrounded by a dense, inelastic tissue called fascia.  With exercise, the muscles become engorged with blood and expand in a confined space determined by the fascia.  If your body cannot clear the extra fluid quickly enough the pressure in the tissues increases and results in pain.  This is not to be confused  with the medical emergency of Acute Compartment Syndrome where pressures increase due to bleeding as a result of a trauma and are not relieved with rest.  Gradually progressing your running volume and/or adopting a more forefoot running style, which uses the muscles in this area of the leg less, may be effective in managing this condition.
So, as you head out in the nice weather to be active, wear good shoes and progress your activity level gradually.  After all, as with most healthy habits, the desired results are achieved only if the change is regular and sustainable.
This article is for general information purposes only and is not to be taken as professional medical advice.

Monday, May 9, 2016

The Physical Strain Of Sitting

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

From smart phones to computers to video games, modern technology has significantly influenced our daily postural habits and caused us to sit more often and for longer periods of time than ever before.  As a result, our increased exposure to sitting has contributed to rising levels of inactivity, and chronic ailments such as headaches, neck pain, and back pain.

People who sit for prolonged periods of time may adopt a poor posture that includes losing the natural hollow of the low back, rounding or slouching of the upper back and shoulders, and a forward head poking position.  This can eventually lead to painful symptoms as these less than ideal positions put cumulative compression, stretch, and shear forces on spinal tissues such as joints and discs.

The cumulative effects of sitting are often offset by the body’s ability to compensate.  However, even in the absence of pain, these compensatory changes may begin a vicious cycle of unbalanced motion, muscle and joint stress, and secondary areas of discomfort.

Structural changes can also result from poor or prolonged sitting habits.  For example, aside from providing anatomical support, ligaments also function as neurological sense organs to the spine and influence reflexes that help muscles fire.  When an individual is exposed to prolonged sitting postures, they load their spinal ligaments which results in a delayed reflex action of muscles.  As a result, when this individual moves, the muscles may not fire quickly enough to protect the spine and this can lead to episodes of neck and back pain.  This is known as the biomechanical principle of CREEP, which stands for Continuous or Repetitive Elongation of the Elastic Properties of tissue.

Scientific research has also identified changes in muscle tissue associated with inactivity and prolonged sitting.  Over time, muscle tissue will accumulate fatty infiltrations that make it weaker and less capable of providing support for physical activity.

Below are some useful tips that can help overcome the physical strain of sitting:

1.    Proper posture is key:  Make sure weight is evenly distributed, your shoulders are not rounding forward, and you are not slouching.  A lumbar support can also be used to help maintain the natural hollow of your low back and proper spinal alignment.  Even slight slouching to the side, backward, or forward can put undesirable forces on biological tissues.
2.    Take a break from sitting:  Take 10 to 30 second stretch or posture breaks every 20 to 40 minutes.  Some activities such as computer work, talking on the phone, and business meetings can also be done while standing.

3.   Consider ergonomics:  The use of a properly designed workstation, along with ergonomic tools and assistive devices can help maintain mechanically advantageous positions while working in a seated position.

4.    Engage in regular physical activity and exercise:  Exercise strengthens our muscles and joints, while inactivity and poor posture weakens them.  Regular exercise can help overcome the effects of cumulative spinal forces, compensation, CREEP, and fatty infiltrations associated with poor posture and prolonged sitting.

Sitting can undeniably cause real physical change and breakdown in the body.  Chiropractors are well positioned to effectively evaluate and treat the effects of poor posture and prolonged sitting.  This may include symptomatic treatment, the prescription of appropriate exercises, and ergonomic advice 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.

Tuesday, May 3, 2016

Understanding Sciatica

By Dr. John A. Papa, DC, FCCPOR(C)
The sciatic nerve is the longest nerve in the human body.  It is made up of five separate nerve roots originating from the low back region on each side, and runs from your pelvis through your buttock and hip area and down the back of each leg.  It controls many of the muscles in your legs and provides feeling to your thighs, lower legs and feet.
"Sciatica" is a common term used to describe any type of pain/symptom that radiates into the leg.  "True sciatica" occurs when there is a mechanical and/or inflammatory irritation directly affecting any component of the sciatic nerve.  This differs from “referred” pain/symptoms which can arise from a bone, joint or muscle that can send pain/symptoms into the leg.
True sciatic symptoms may be felt almost anywhere along the nerve pathway.  These symptoms can radiate from the low back region, into the hip or buttock, and down the leg, into the calf, and even the toes.  The symptoms can vary widely and may include:  a cramping or achy feeling, tightness, burning or a sharp electric shock sensation, numbness, tingling, and leg muscle weakness.  The symptoms may start gradually and intensify over time.  Activities such as bending forward or to the side, walking, prolonged sitting or standing, and even coughing or sneezing may aggravate sciatica.
Below is a brief summary of three common causes of true sciatica:
1.    Spinal disc herniation/bulge – Spinal discs separate and cushion lumbar vertebra.  Repetitive and cumulative loads or a single heavy load has the potential to cause a disc bulge or herniation, thereby causing a mechanical and/or inflammatory irritation of the nerve root(s).  This most commonly occurs in adults aged 20-50.
2.    Degeneration and Osteoarthritis – The normal aging process causes lumbar disc degeneration, osteoarthritis of lumbar joints, and occasionally vertebral slippage.  The consequence of these processes is that mechanical irritation from bony spurs and vertebrae along with inflammation can cause symptoms of sciatica.  This most commonly occurs in adults over 50.
3.    Lumbar spinal stenosis – This condition causes sciatica due to narrowing of the spinal canal and/or nerve pathways.  This puts pressure on the spinal cord or nerve roots and causes neurovascular irritation.  This most commonly occurs in adults over 60.  It is usually secondary to degeneration and osteoarthritis.
Other causes of true sciatica include: direct irritation of the sciatic nerve by the piriformis muscle; direct trauma or injury to the sciatic nerve or nerve roots; and postural and mechanical changes associated with pregnancy.  Some common causes of sciatic-like symptoms or referred pain include: muscular trigger points and ligament sprains from the low back, hip, gluteal and pelvic regions; sacroiliac joint dysfunction; and arthritic low back, hip and knee joints.
Sciatica is a set of symptoms of a problem, rather than a diagnosis for what is irritating the nerve and causing the pain.  This is an important point to consider because the treatment for sciatica will often be different depending on the underlying cause of the symptoms.  Therefore, it is important to obtain an accurate diagnosis.  A proper medical history, along with physical examination consisting of range of motion, strength, neurological and orthopaedic testing, along with diagnostic imaging (if necessary) should be performed to aid in the diagnosis.  It is extremely important to rule out rare causes of sciatic symptoms such as spinal tumors and infections.  Individuals with a loss of bowel or bladder control may be experiencing cauda equina syndrome and should be referred for emergency care.
When sciatica strikes, there are conservative treatment options available.  These may include: mechanical traction, spinal manipulation and mobilization, soft tissue techniques, acupuncture, ice/heat application, electrotherapy, and rehabilitative exercise. A qualified health professional can determine the cause of your sciatica 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.