Wednesday, December 27, 2017

Protecting Your Back During The Winter Season

By Dr. John A. Papa, DC, FCCPOR(C)
The winter season is upon us and extra precaution must be taken as snow removal and icy walking surfaces can contribute to an increased risk of back injuries.  Included below are some useful tips that can be followed to help keep your back healthy and injury free this winter season.
1.    Warm up:  Prepare your body for physical activity by stimulating the joints and muscles, and increasing blood circulation.  Climbing stairs, marching on the spot, or going for a quick walk around the block can serve as excellent warm-up activities in five to ten minutes.  Follow this with some gentle stretches and exercises for the back.
2.    Push, don’t lift:  Push the snow to one side and avoid lifting.  If you must lift, keep the shovel close to your body and avoid twisting and turning by positioning yourself to lift and throw straight at the snow pile.  Be sure to lift slowly and smoothly and do not jerk with your lifts.
3.    Hinge the hips, bend the knees, keep the back straight and brace:  Use your hips, knees, legs and arm muscles to do the pushing and lifting while keeping your back straight.  Maintaining the natural and neutral curves of your back is important, as this is its strongest and most secure position.  Contracting and bracing your abdominal muscles during lifting improves spinal stability and decreases the chance of injury.
4.    Use the right shovel:  Use a lightweight, non-stick, push-style shovel.  Separate your hands as much as possible on the shovel handle for better leverage against the weight of the snow.
5.    Dress for the job:  Wear warm clothing to protect yourself against the elements.  Shoes and boots with solid treads and soles can help minimize the risk of awkward twisting, slips and falls.
6.    Don’t let the snow pile up:  Removing small amounts of snow on a frequent basis is less strenuous in the long run.
7.    Watch the ice:  Caution should be exercised around icy walkways and slippery surfaces.  Intermittent thaws and subsequent freezing can give way to ice build-up under foot increasing the risk of back twisting, slips and falls.  Coarse sand or ice salt can help give your walkways and driveways more traction.
8.    Take a break:  Know your physical limits.  If you feel tired or short of breath, stop and take a rest.  Make a habit to rest for a moment every 10 or 15 minutes during shoveling.  This is especially important if the snow is wet and heavy.  Stop shoveling immediately if you feel chest or back pain.
In the event that you suffer a back injury that does not subside, you should contact a licensed health professional who deals in the diagnosis and treatment of back pain.  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.

Saturday, December 23, 2017

Happy Holidays!

Canadian Chiropractic Association

It’s the time of year for family and friends, food and good cheer. However, for a lot of people, the season can be hectic, stressful and exhausting. Your to-do list may be long, and you may feel anxious about completing it in time. But, are you taking care of yourself while you hurtle around preparing for the Season? Canada’s chiropractors want you to have a joyful holiday, so we’ve put together a few tips that we hope will help keep you healthy and happy throughout this busy season.

Lift Right

The holidays usually involve lifting and lugging scads of groceries and parcels. If possible, ask a friend or family member to help you carry on your merry cheer! If no one is available, consider making several trips and carrying smaller loads to prevent the risk of injury. Also, visit our Lift Right page for tips on how to prevent injury while lifting.

Take a Break

Do you enjoy entertaining during the holidays? Carolers at the door, a house full of people, children running around? That can involve a lot of cooking and cleaning, decorating and preparations. Make sure to take frequent breaks and keep hydrated. Set a timer every hour or so, have a glass of water and sit for a few minutes. For tips on getting a good night’s sleep, browse through our Good Night’s Sleep page.

Ask for Help

Being present and enjoying the company of your friends and family is what is of utmost importance. Even during the holidays, no one expects you to be a super-human. Excessive expectations and stress can heighten your risk for injury and illness. Instead, ask your friends and family for help and everyone will be merrier for it! You can also read about some useful Energy Boosters here.

Stay Active

The holidays are a time when we are surrounded by temptations. One key strategy to manage and cope is to keep moving and stay active! Winter offers a multitude of fun family activities including skating in the park or a brisk trek around the block. Activity will keep you energized during the day and help you sleep at night. Before you hit the ice or go tobogganing, make sure you warm up first! Here are some great stretches for hockey and running.

Drink Responsibly

Trips, slips and falls account for many injuries in the winter months. However, drinking can also add to the risk of falls. Moderation is the key! Here are some good strategies from the Canadian Centre for Substance Abuse.
  • Set limits for yourself and stick to them.
  • Drink slowly.
  • Have no more than 2 drinks in any 3 hours.
  • For every drink of alcohol, have one non-alcoholic drink.
  • Eat before and while you are drinking.
  • Always consider your age, body weight and health problems that might suggest lower limits.



Here’s to safe, healthy and happy holidays for all Canadians!

Monday, December 18, 2017

I've Got This Feeling, Inside My Hands?

By Dr. R. Greg Lusk, DC

My recent DIY project of replacing the flooring on the main level of my house has made me keenly aware of the nerves that run down our arms. I'm well underway, nearly done in fact, but at some point after the demolition part of the project I began waking up in the morning with partial hand numbness. Looking down while pulling out thousands of staples that secured the quarter inch plywood sub-floor, beneath the vinyl I removed, may have had something to do with it. The numbness would go away easily at first with a change of position but then it became more persistent. Recently, it was accompanied by a burning sensation and a deep ache that drove me out of bed at 5 AM. That was the final straw that made me consult with a colleague for some treatment.
I've experienced these sort of symptoms previously, often preceded by increased, repetitive physical work. Some of you may be able to relate. Now, if they don't go away with some rest, treatment may be considered and paying attention to your symptoms can help your therapist identify the area(s) of your body that need treatment. For instance, location of symptoms is quite informative as three separate nerves provide sensation to your hand. Also, are symptoms felt above the wrist, elbow, or shoulder, or is there even neck discomfort? All nerves down the arms ultimately stem off the spinal cord at the level of the lower neck and upper back so that area could be the ultimate source of symptoms. Alternatively, a nerve can become irritated, or entrapped we call it, by soft tissues (i.e. muscles, fascia, ligaments, tendons) somewhere along its path as it makes its way down the arm. What's important to realize is that where you feel symptoms in the arm or hand may not be where your problems lie. Let's look at sensation of the hand to illustrate this.

As mentioned, three nerves supply the skin of the hand with feeling - the median, ulnar, and radial nerves. Looking at your hand with the palm up, the median nerve covers the palm side of your thumb, index, middle, and the half of your ring finger that is closest to your middle finger. This is the nerve that passes through the carpal tunnel so carpal tunnel syndrome involves pain or altered sensation in this area. However, this nerve also runs down the front of your arm and forearm and may become irritated by other soft tissues there (e.g. the biceps muscle/tendon). The ulnar nerve supplies the other half of the ring finger and the pinky, on both the palm side and back of the hand. It does not go through the carpal tunnel but runs down the inside of the forearm from the elbow, where it can commonly get compressed if you lean on your "funny bone". The last nerve is the radial, which runs down the back of the arm and forearm, providing back of the hand sensation to most of the thumb, index, middle, and the half of the ring finger closest to the middle finger. Clearly, these nerves all have different paths to the hand and different tissues to examine for possible involvement. This is in addition to their ultimate origin, the neck, as well as muscles around the neck (e.g. scalenes) and the chest (i.e. pec muscles) which they pass through or under en route to the hand.

So, if you have symptoms in your arm or hand that are not resolving on their own, pay attention to some of these specifics. The details will aid your therapist in providing an accurate diagnosis, intervention, and hopefully timely relief of your symptoms. This article is for general information purposes only and is not to be taken as professional medical advice.

Friday, December 15, 2017

Holiday Gift Certificates

Give the gift of Health & Wellness this holiday season.
Purchase a gift certificate from the New Hamburg Wellness Centre.
Perfect for everyone on your Christmas list!

Tuesday, December 12, 2017

How To Choose The Right Pillow

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

A good night’s sleep is important for maintaining good health and optimal functioning, and choosing the right pillow can make all the difference in the world when it comes to how well you sleep.  Using a pillow that is the wrong size and fit can be a significant source of neck and back pain.  In some cases, incorrect head and neck positioning can also affect breathing and cause snoring, which can hinder sleep.

The right pillow will help support the head, neck, and shoulders, keeping them in alignment, and thereby minimize stress and strain on muscles and joints.  As a result, this will also create a feeling of comfort and increase the likelihood of a restful sleep.

There is no one best pillow for everyone as there are a variety of factors that go into choosing the right pillow.  Below are some useful tips that can help you find the pillow that's right for you:

·        Consider your sleeping position.  Back sleepers should choose a pillow that is not too firm or too high.  The pillow should keep the chin in a natural resting position, and support the head and neck so they are aligned with the upper back and spine.  Side sleepers should opt for a firm pillow that supports the neck in a neutral position.  The pillow should hold the head high enough to ensure that the spine is aligned.  Stomach sleepers should choose a soft or flat pillow so the neck isn’t turned or tilted at an uncomfortable angle.

·        Choose a size of pillow suitable for your body size or frame.  The pillow should cover the entire back of the neck and mold to one's individual shape to alleviate any pressure points.

·        Try out a variety of pillows.  Most pillows are packaged in a plastic wrapper so you can lay it on a display bed in the store and put your head on it.  Visit a store that has a wide range of pillow options to find the one that best meets your needs.

·        A hypoallergenic pillow is a must if you suffer from allergies, but it is also a good choice for anyone.

·        Replace your pillow every 12-18 months.  Pillows will wear over time by losing their shape and ability to provide proper alignment and support.

If you experience pain and discomfort at night or have difficulty falling asleep, consider visiting a  chiropractor.  Chiropractors are trained to treat muscle and joint problems that can interfere with a restful night's sleep.  They can also offer nutritional and lifestyle advice that can help improve sleep quality.  For more information, visit  The author credits the Alberta and Ontario Chiropractic Associations in the preparation of this educational information for use by its members and the public.
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.

Monday, December 4, 2017

The Health Benefits Of Strength Training

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

Strength training is exercise that uses weights or resistance to strengthen and enhance a muscle’s ability to contract and do work.  Below are some of the numerous health benefits of strength training.

1. Strength training plays a key role in body composition and weight management.  Simply put, strength training burns calories, improves body composition by building lean muscle tissue, and thereby reduces fat stores in the body.

2. Strength training reduces the risk of cardiovascular disease.  Heart disease risk is lower when the body is leaner and less fat.  Other associated benefits include decreased cholesterol levels and lowered resting blood pressure.  Strength training will also help improve glucose metabolism.  Poor glucose metabolism is strongly associated with adult onset diabetes.

3.    Strength training stimulates bone mineral density development and reduces the rate of bone loss.  This is crucial at younger ages for maximizing bone density.  It is also important in older individuals looking to prevent or slow down the bone-thinning disease osteoporosis as it decreases the likelihood of fractures and morbidity related to fractures.

4.  Building muscle through strength training is helpful for recovering from and preventing injury as it helps improve overall strength, endurance, stamina, flexibility, balance and coordination.
5.   Strength training can be beneficial for those suffering from arthritis.  Studies in older men and women with moderate to severe arthritis have shown that a strength training program can help general physical performance with everyday activities, and improve clinical signs and symptoms of the disease resulting in decreased pain and disability.

Below are some useful tips that can help individuals get safely started on a strength training program:

·     Strength training exercises can be accomplished with conventional weight-training equipment, hand-held "free weights", and resistance bands/tubing.  An individual can also use their own body weight while performing push-ups, pull-ups, dips, stair climbing, lunges, and wall squats.

·      Modest benefits from strength training can be seen with two to three training sessions a week lasting just 15 to 20 minutes each.  A resistance level heavy enough to tire your muscles after about 8 to 12 repetitions is sufficient.  When you can easily do 12 or more repetitions of a certain exercise, increase the weight or resistance.  Rest at least one full day between exercising each specific muscle group.

·       Always perform strength training in a safe manner with proper technique and stop if you feel pain.  Although mild muscle soreness is normal, sharp pain and sore or swollen joints are signs that you’ve overdone it and that your program/activity needs to be modified.

A lifetime of regular strength training exercise is ideal, but it is never too late to start!  If you are over 35, have been sedentary for some time, or have a specific health condition or limitation, consult with a knowledgeable health care provider before beginning any new exercise program.  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 28, 2017

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 into 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 from a qualified health professional.

When sciatica strikes, there are conservative treatment options available.  These may include: mechanical traction, spinal manipulation and mobilization, soft tissue techniques, laser therapy, 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.

Monday, November 20, 2017

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.

Monday, November 13, 2017

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.