This past week at Boulder Peak, and the latest edition of Denver Chiropractic Center’s 1-Page Health News

This past week the staff from Denver Chiropractic Centers all over the state. Dr. Hyman was up in Beaver Creek training for Xterra Beaver Creek on July 14. While biking, he ran into a bear under lift 11. There’s a little snippet of video posted on our blog: http://www.denverback.com/?p=861

Dr. Stripling and Keri were up working hard leading the Active Release treatment team at the Boulder Peak Triathlon this weekend. Here’s a picture from the brief window when Dr. Hyman stopped by:

And here’s the 1-Page Health News for You…

Mental Attitude: Immune Against Alzheimer’s? Researchers discovered the best marker associated with memory is a gene called CCR2. This gene showed immune system activity against beta-amyloid, thought to be the main substance that causes Alzheimer’s disease. According to Dr. Lorna Harries, “Identification of a key player in the interface between immune function and cognitive ability may help us to gain a better understanding of the disease processes involved in Alzheimer’s disease and related disorders.” National Institute on Aging, June 2012

Health Alert: Cancer Rates Expected To Increase! Cancer incidence is expected to increase more than 75% by the year 2030 in developed countries, and over 90% in developing nations. Countries must take action to combat the projected increases in cancer rates via primary prevention strategies such as healthier lifestyles, early detection, and effective treatment programs. Lancet Oncology, June 2012

Diet: Snacking On Raisins. Eating raisins as an after-school snack prevents excessive calorie intake and increases the feeling of fullness as compared to other commonly consumed snacks. Grapes, potato chips and cookies resulted in approximately 56%, 70% and 108% higher calorie intake compared to raisins, respectively. The cumulative calorie intake (breakfast + morning snack + lunch + after-school snack) was 10-19% lower in children who ate raisins as an after school snack when compared to children who consumed other snacks. Canadian Nutrition Society, May 2012

Exercise: Exercise and Cancer. Researchers are working toward proving that daily yoga or 20 minutes of walking will likely extend a cancer patient’s survival. In 15 years, doctors have gone from being afraid to recommend exercise to cancer patients to having enough data that shows it is safe and effective, particularly for relief of treatment side effects. American Society of Clinical Oncology Annual Meeting, June 2012

Active Release: A whole lot of nerve? Your nervous system runs and controls every aspect of your body. For example, there are 45 miles of nerves in your skin alone. Nerves throughout your body can become trapped in muscles, causing symptoms from headaches to carpal tunnel to sciatica to tingling in the toes. Active Release can take pressure off of nerves and fix problems. Gray’s Anatomy / Active Release Techniques

Wellness/Prevention: Early Stress? Children who experience intense and lasting stressful events in their lives score lower on tests of the spatial working memory and have more trouble on tests of short-term memory. Journal of Neuroscience, June 2012

Quote: “Remember to perform random acts of kindness.” ~ From the film Pay It Forward, released in 2000

Confessions of a barefoot failure


Me & Bobby McGee. Trying to solve the problem.

In early 2010, I drank the barefoot running Kool Aid. I’ve written about that part of the story before, but I’ll briefly review it for those of you who may not remember.

After reading the book Born to Run, I decided to start running barefoot on my treadmill. I felt good, so I bought some “Barefoot Shoes”. My knee pain went away, I started telling all of you to try it, blah, blah, blah. I tried to go from running as a heel striker to running as a mid-foot striker. It worked for about a year. And then some new injuries set in.

Last week (as I sit writing this) I spent Friday at my 1st grader’s field day. For those of you who don’t know, it’s like a kiddie Olympics held outside at school on a nice spring day. The kids do all sorts of things, like tug-of-war, throw the ball as far as you can, and a round-the–bases relay race.

The round-bases-race was interesting, because I got to watch kid after kid after kid run. As a student of running mechanics, it was quite enlightening.

After observing about 30 kids, I can tell you that only about 1 in thirty kids is a heel-striker. They’re almost all mid-foot strikers, and their feet are quick – touch down, pull up. They all looked smooth and efficient.

So why do the people who gather data on such matters say that about 75% of adult runners are heel strikers*? What happens? Should we all be mid-foot striking or do what comes naturally?(*reference- Foot Strike Patterns of Runners At the 15-Km Point During An Elite-Level Half Marathon HASEGAWA, HIROSHI; YAMAUCHI, TAKESHI; KRAEMER, WILLIAM J. Journal of Strength and Conditioning Research, August 2007 – Vol. 21 – Issue 3.)

The answer? I have no idea.

So I decided to go see expert running coach Bobby McGee for a 90 minute mechanics evaluation / lesson. Here’s what Bobby had to say (paraphrasing):

“For most runners, unless they want to be elite runners, it doesn’t make any sense at all to try to force a style of running. If you’re a heel striker, don’t try to force yourself to be a mid foot striker. If you are strong enough to run barefoot, great. But if you’re not, it’s a disaster waiting to happen.”

The conclusion – be who you are, and work to optimize the mechanics that you’re used to. So instead of forcing yourself out heel striking, work with it. Remember, we’re all individuals, and your unique running style is just that- yours. Don’t go changing for the sake of change. Like I did.

For the record, Bobby spent more time working on what my upper body was doing than he spent on my lower body. This made a huge difference. He also told me that my feet were not strong enough for running in so-called barefoot shoes. So there you go, I’m a barefoot failure. If you are serious about running, you might want to go spend 90 minutes with Bobby. He’s brilliant.

This week’s 1-Page Health News

Mental Attitude: Sleep Tight? Children with excessive daytime sleepiness (EDS), despite little indication of short sleep from traditional measurements, were more likely to experience problems with learning, attention/hyperactivity and conduct than children without EDS. Obesity, symptoms of inattention, depression, anxiety, and asthma have been found to contribute to EDS. Penn State, May 2012

Health Alert: Obesity Projections! At current projections, 42% of the US population will be obese by 2030, with 11% categorized as severely obese. Severe obesity is defined as a body mass index over 40 or roughly 100 pounds overweight. $550 billion could be saved in the next 20 years just by keeping obesity rates at the current level! American Journal of Preventive Medicine, May 2012

Exercise: Cancer and Exercise. Physical activity is linked to lower rates of breast and colon cancer deaths. Exercise helps moderate insulin levels, reduce inflammation and possibly improve the immune response. Even though direct effects of physical activity on cancer are not definitely proven, given that physical activity is generally safe, improves quality of life for cancer patients, and has numerous other health benefits, adequate physical activity should be a standard part of cancer care. Journal of the National Cancer Institute, May 2012

Active Release: We frequently have patients referred to us from other chiropractors to treat some of the tougher problems that they can’t help. We’re always happy to work with other chiropractors’ patients, and respect the good work that these other docs do. Some of the more common conditions that other chiros refer include hip pain, sciatica, and rotator cuff problems. We use Active Release Techniques to treat the muscles, tendons, ligaments, and even the nerves that may be involved in these kinds of problems. Do you know someone who needs our help?

Wellness/Prevention: Commutes Risk Health. Individuals with the longest commutes are least likely to report frequently engaging in moderate to vigorous exercise, and most likely to show risk factors for poorer cardiovascular and metabolic health. Commuting more than 10 miles to work is linked with high blood pressure. American Journal of Preventive Medicine, June 2012

Quote: “Inaction, save as a measure of recuperation between bursts of activity, is painful and dangerous to the healthy organism. Only the dying can be really idle.” ~ H. L. Mencken

The Truth About Yoga & This Week’s 1-page Health News

This article ran in the NY Times, and ended up all over the internet. We thought it was important to give you our thoughts, since a lot of people are still asking us about it (it is amazing how much power the popular press has).

Levitt D. How Yoga Can Wreck Your Body. New York Times. Article adapted from “The Science of Yoga: The Risks and Rewards,” by William J. Broad, Published: January 5, 2012.

“According to Glen Black, a prominent yoga teacher of nearly 4 decades, a number of factors have converged to heighten the risk of practicing yoga. The biggest is the demographic shift in those who study it. Indian practitioners typically squatted & sat cross-legged in daily life, and yoga poses, were an outgrowth of these postures. Now urbanites who sit in chairs all day, walk into a studio a couple of times a week & strain to twist themselves into ever-more-difficult postures despite their lack of flexibility & other physical problems. Many come to yoga as a gentle alternative to vigorous sports or for rehabilitation for injuries. But yoga’s popularity — ~ 20 million practitioners in 2011 — means that there’s an abundance of teachers who lack the deeper training necessary to recognize when students are headed toward injury.

Black has come to believe that the vast majority of people should give up yoga altogether. It’s simply too likely to cause harm. Black notes that not just students but celebrated teachers too, injure themselves in droves because most have underlying physical weaknesses or problems that make serious injury all but inevitable. “Today many schools of yoga are just about pushing people,” Black said. Normally, the neck can extend 75◦, flex 40◦, laterally bend 45◦, & rotate ~50◦. Yoga practitioners typically move the vertebrae much farther. An intermediate students can easily turn their necks 90◦— nearly twice the normal rotation. In the shoulder stand, hyperflexion of the neck is encouraged. Iyengar emphasized in the shoulder stand tt the trunk & head should form a right angle with neck neck maximally flexed. In cobra pose, the head should extend as far back as possible. Extreme motions of the head and neck, can injure vertebral arteries, resulting in vertebrobasilar artery strokes & brain damage. A growing body of medical evidence supports the contention that, for many people, a number of commonly taught yoga poses are inherently risky.

Reports of yoga injuries have been published in some of the world’s most respected journals —Neurology, British Medical Journal, & JAMA. In 2009, Columbia University published a worldwide survey of yoga teachers, therapists & doctors. The survey’s central question — What are the most serious yoga-related injuries seen? —The largest number of injuries (231) centered on the low back. Other sites, in declining prevalence: shoulder (219), knee (174) & neck (110). Then came stroke.

Among devotees, yoga is described as a nearly miraculous agent of renewal and healing. They celebrate its abilities to calm, cure, energize & strengthen. And much of this appears to be true: yoga can lower blood pressure, make chemicals that act as antidepressants, even improve one’s sex life. But the yoga community long remained silent about its potential to inflict pain. Timothy McCall, MD & medical editor of Yoga Journal, called the headstand too dangerous for general yoga classes. He notes that the inversion may contribute to thoracic outlet syndrome, degenerative arthritis of the cervical spine & retinal tears.”

Commentary:

Here’s our take (Dr. Hyman & Dr. Stripling): In our combined 17 years of seeing patients, we have seen maybe 5 injuries from yoga, with most of those being strains of muscles. We’ve seen far more injuries from sneezing, sleeping and gardening. The truth is there is far more benefit to yoga than risk, especially if you take out the headstands. It’s annoying when the popular press finds some extreme position and warns us all that a popular activity is bad for you. Most of the time it’s just Chicken Little screaming that the sky is falling.

Here is our regularly scheduled Weekly1-Page Health News

Mental Attitude: No Emails? Being cut off from work email significantly reduces stress and improves focus. Heart rate monitors were attached to computer users in an office setting, while software sensors detected how often they switched windows. People who read email changed screens twice as often and were in a steady “high alert” state. Those removed from email for five days reported feeling better able to do their jobs and stay on task, with fewer stressful and time- wasting interruptions. UC Irvine and US Army, May 2012

Health Alert: Misusing Prescription Drugs At A Young Age! The peak risk for misusing prescription pain relievers occurs in mid-adolescence, specifically about 16 years old and earlier. Clinicians and public health professionals are prescribing more pain relievers, and research suggests an increased misuse of these drugs and increased rates of overdose deaths. Each year, 1 in 60 young people (between 12-21 years old) begin using prescription pain relievers outside the boundaries of what their doctor intended. Journal of the American Medical Association, May 2012

Diet: How Much Protein Do I Need? For healthy adults, an estimator used for MINIMUM daily protein intake is 0.36 grams per 1 pound of body weight. Formula = 0.36 grams/pound of body weight. For example, if you weigh 155 lbs, you should consume 56 grams of protein per day (155lbs x .36g/lbs = 56g). Institute of Medicine, 2002 (Note- those of you who train hard, plan on doubling that).

Exercise: Jogging For Life. Jogging 1-2.5 hr/week increases the life expectancy of men by 6.2 years and women by 5.6 years. Jogging improves oxygen uptake, increases insulin sensitivity, improves lipid profiles (raising HDL and lowering triglycerides), lowers blood pressure, reduces platelet aggregation, increases fibrinolytic activity, improves cardiac function, bone density, immune function, reduces inflammation markers, prevents obesity, and improves psychological function. EuroPRevent2012 Meeting, May 2012

Wellness/Prevention: Zinc About It! People regularly taking oral zinc may experience shorter common cold symptoms than those who do not. Higher doses appeared to have a better effect, but taking zinc for just 2-3 days seemed to have no impact at all. Common adverse events associated with zinc supplements are nausea and a bad taste.

Canadian Medical Association Journal, May 2012

Quote: “Everything comes to him who hustles while he waits.” ~ Thomas A. Edison

Dr. Glenn Hyman’s Race Schedule, 2012

I know a lot of you have been wondering, “Which races is Glenn Hyman from Denver Chiropractic Center doing this year?”

July 8 – Boulder Peak Olympic (road)

July 14 – Xterra Beaver Creek (Sprint Distance, trust me it’s plenty)

August 4- Xterra Inidan Peaks (In the middle of co-leading the ART treatment team for the Boulder Ironman 70.3)

August 26 – Xterra Lory (Horsetooth Reservoir, CO)

How’d the staff do at Elephant Rock? & this week’s 1-Page Health News.

First off, I (Glenn) want to start by wishing my parents a happy 45th wedding anniversary. 45 years!?! That’s incredible.

And yes- Miss Keri & Dr. Stripling both did the Elephant Rock ride yesterday…

Miss Keri: 34 miles in 2:30.

Dr. Stripling: 100 miles in 7:49.

Me? I set the record for eating Bon Bons and watching paint dry in my back yard. 3 boxes in under 10 minutes. Just kidding. I’m cramming for Xterra Curt Gowdy on June 24th (off road triathlon). I rode, ran and swam yesterday. Then I mowed the lawn.

Here’s this week’s 1-Page Health News…

Mental Attitude: Facebook Addiction? According to Dr. Cecilie Schou Andreassen, some users of Facebook have developed a dependency to the social networking site. “Facebook Addiction” is more common among young people who are anxious and socially insecure, probably because those who are anxious find it easier to communicate via social media than face-to-face. Psychological Reports, May 2012 Health Alert: Infection and Cancer. Each year, 16.1% of the 12.7 million total new cancer cases in the world are due to infections that are largely preventable or treatable. Most of these cancer-causing infections were of the gut, liver, cervix and uterus. The Lancet Oncology, May 2012

Diet: Black Pepper and Fat. Black pepper has been used for centuries in traditional Eastern medicine to treat gastrointestinal distress, pain, inflammation and other disorders. A new study found that Piperin, the pungent-tasting substance that gives black pepper its characteristic taste, can block the formation of new fat cells. Journal of Agricultural and Food Chemistry, May 2012

Exercise: Strong Bones! Osteoporosis affects more than 200 million people worldwide, yet many are unaware they are at risk. The disease has been called the silent epidemic because bone loss occurs without symptoms and the disease is often first diagnosed after a fracture. Osteoporosis is more common in women, but men also develop it, usually after age 65. Young men who play volleyball, basketball or other load-bearing sports for 4 hours a week or more may gain protection from developing osteoporosis later in life. Men who increased their load-bearing activity from age 19-24 not only developed more bone, but also had larger bones compared to men who were sedentary during the same period. Bigger bones with more mass are thought to offer a shield against osteoporosis. Journal of Bone and Mineral Research, May 2012

Chiropractic: “I came to the point where I wanted an adjustment every day. I believe in Chiropractic.” ~ Evander Holyfield, 4x World Heavyweight Boxing Champion Wellness/Prevention: Ancient Remedy Slows Prostate Problems. Caffeic acid phenethyl ester, or CAPE, is a compound isolated from honeybee hive propolis, the resin used by bees to patch up holes in hives. If you feed CAPE to mice with prostate tumors, their tumors will stop growing. After several weeks, if you stop the treatment, the tumors will begin to grow again at their original pace. Cancer Prevention Research, May 2012

Quote: “Earth provides enough to satisfy every man’s need, but not every man’s greed.” ~ Gandhi

Neck Pain – which treatment works best?

Neck Pain:  Manipulation vs. Mobilization – What’s Better?

Does mobilization (MOB) get less, the same, or better results when compared to spinal manipulative therapy (SMT)? To answer this question, let’s first discuss the difference between the two treatment approaches.

Mobilization (MOB) of the spine can be “technically” defined as a “low velocity, low amplitude” force applied to the tissues of the cervical spine (or any joint of the body, but we’ll focus on the cervical region). This means a slow, rhythmic movement is applied to a joint using various methods such as figure 8, side to side, front to back and /or combinations of any of these movements. In the neck, gentle to firm manual traction or pulling, when applied to the cervical spine, stretches the joint and disk spaces and can be included during MOB.

Spinal Manipulative Therapy (SMT) can be defined as a “high velocity, low amplitude” type of force applied to joint which is often accompanied by a audible release or “crack,” which is the release of gas (nitrogen, oxygen, and carbon dioxide).

Some joints “cavitate” or “crack” while others are less likely to release the gas. Studies that date back to the 1940s report an immediate improvement in a joint’s range of motion occurs when the joint cavitates. Many people instinctively stretch their own neck to the point of release, which typically, “…feels good.” This can become a habit and usually is not a big problem. However, in some cases, it can lead to joint hypermobility and ligament laxity.

As a rule, if only a gentle stretch is required to produce the cavitation/crack, it’s typically “safe” verses the person who uses higher levels of force by grabbing their own head and twisting it beyond the normal tissue stretch boundaries. The later is more likely to result in damage to the ligaments (tissue that strongly holds bone to bone) and therefore, should be avoided.

Since SMT is usually applied in a very specific location (where the joint is fixated or “stuck”, or, partially displaced), it’s obviously BEST to utilize chiropractic, as we chiropractors do this many times a day (for years or even decades) and we know where to apply it and can judge the amount of force to utilize, especially the neck where there are many delicate structures.

Back to the question: Which is better, MOB or SMT? Or, are they equals in the quest of rid of neck pain? A recent study of over 100 patients with “mechanical neck pain” (strain/sprain)  showed that those who received SMT had a significantly better response than the MOB group as measured by a pain scale, a disability scale and 2 tests that measure function!

In our clinic (Denver Chiropractic Center) we’ve found that the best approach uses BOTH. Mobilization in the form of Active Release Technique combined with safe and gentle (never forced) adjustments – also known as spinal manipulation – get better results in a shorter time frame.

Call us at 303.300.0424 if you want to get rid of your neck pain. We’re here to help.

My Crossfit Level 1 Trainer Course & This Week’s 1-Page Health News…

I (Glenn) woke up early on Mother’s Day, emptied the dishwasher, woke the kids up to give Meredith her gift, and promptly abandoned them for Day 2 of the CrossFit Level 1 trainer’s certification course. I’m not going to lie, I felt bad about it. But in addition to that espresso machine, Meredith got herself a live-in CrossFit trainer to put her through the paces.

While I’m still fully interested in an participating in Xterra Triahtlons, there’s no denying that CrossFit is on to something: train all 10 aspects of fitness – strength, endurance, stamina, power, speed, flexibility, agility, balance, coordination, and accuracy. Using “Constantly Varied Functional Movements Done at High Intensity” is how CrossFit gets you there.

Anyway, I’m working out the details, but I’ll be doing some CrossFit classes in the near future. We’re in talks with Colorado Kettlebell Club to use their space, which is about 1 mile from our office. We’re looking at weeknights at 5 PM and 6 PM. So if you’re interested, keep an eye out for more info.

And here’s this week’s 1-Page Health News…

Mental Attitude: Dementia. The number of people globally with dementia is set to rise from its current 35.6 million, to 65 million by 2030 and 115 million by 2050. Currently, $604 billion are spent each year worldwide on treating and caring for individuals with dementia. This toll includes the provision of health and social care, as well as loss of income of the dementia patients and their caregivers, as many caregivers have to give up their jobs to look after a person with dementia. World Health Organization, April 2012

Health Alert: America’s Obesity Epidemic. The scope of the obesity epidemic in the US has been greatly underestimated. Researchers found that the Body Mass Index (BMI) substantially under-diagnoses obesity when compared to the Dual Energy X-ray Absorptiometry (DXA) scan, a direct simultaneous measure of body fat, muscle mass, and bone density. The study found 39% of Americans who are classified as overweight based on BMI are actually obese as measured by DXA. The BMI is an insensitive measure of obesity, prone to under-diagnosis, while direct fat measurements are superior because they show distribution of body fat. PLoS ONE, April 2012 Diet: How Should You Take It? For reversing damage and promoting repair to cartilage, the supplements Chondroitin Sulfate and Glucosamine have been shown to be more effective if taken together, as the mixture of the two allows them to act synergistically. Osteoarthritis Cartilage, 2006

Exercise: Caffeine & Exercise? According to a 14-week study conducted on mice, caffeine and exercise may cut the risk of developing skin cancers caused by sun exposure. Researchers found 62% fewer non-melanoma skin tumors and the size of tumors reduced by 85% in the caffeine and exercise group when compared to the control group (no caffeine, no exercise). The results of the caffeine and exercise group also exceeded the other two groups in the study (caffeine, no exercise and exercise, no caffeine). American Association for Cancer Research Annual Meeting, April 2012

Wellness/Prevention: Still Smoke? 7,000(!) chemicals and chemical compounds are present in tobacco and tobacco smoke, including 93 HPHCs (harmful and potentially harmful constituents). Food and Drug Administration, April 2012

Quote: “I look to the future because that’s where I’m spending the rest of my life.” ~ George Burns

Low Back Pain or Hip Arthritis: Which One is it? How the Active Release doctors at Denver Chiropractic Center can help you

Low back pain (LBP) can have many causes. Our job is to identify the main pain generator(s) and manage the patient accordingly. This requires a careful history, examination, and a short trial of treatment with conservative methods, like Active Release Techniques Soft Tissue Treatment.

When first presenting for care, the patient tells us about their complaint in the history portion of our evaluation. Here, we not only ask about the main reason for their appointment or, what’s bothering them now but also their past history. We also discuss old injuries such as slips and falls, sports injuries that date back to high school, motor vehicle induced injuries, as well as family history (we ask if family members have or have had low back trouble since it’s been reported that there is a genetic link identified for osteoarthritis).

We also inquire about the patient’s current activity level and how well those activates are tolerated, often using tools completed by the patient that can be scored and compared periodically during care to track the benefits of treatment. When we finally return to the primary complaint history, we ask about the location, mechanism of injury, notable changes in the course of the condition, the onset date, pain related activities that increase or decrease pain, the quality of pain, radiation patterns, severity levels (such as a 0-10 scale), and timing issues such as, worse in the mornings vs. evenings.

When patients say, “…I have low back pain,” they may point to anywhere between the lower rib cage and their hip area. In other words, everyone interprets where their low back is located differently. So, when differentiating between low back pain and hip pain, one would think that the patient would either point to their low back or their hip, right? Well, where does hip osteoarthritis usually hurt? That’s what makes it so hard! The pain location can vary and move around in the same patient anywhere in the pelvic region including the groin (which is common), to the side of the pelvis, to the buttocks, the sacrum and in the low back.

To make it even more challenging, degenerative or injured disks in the lower lumbar spine can refer pain directly into the hip area and also create localized low back pain. In fact, patients often have BOTH conditions simultaneously. Usually, during examination, we move the hip in the socket and feel for reduced motion and watch for pain patterns in certain positions. When comparing the two sides, we both can feel, “…a difference between the two.”

The osteoarthritic (OA) hip is comparably more tight and painful with rotation movements. For example, the patient is seated with their leg crossed, trying to touch their knee to their opposite shoulder. In the OA hip patient, they may only be able to get it half way there compared to the other side and often complain of groin pain. The “ultimate test” is the x-ray that reveals the loss of the joint space – the “cartilage interval” – which narrows on the OA hip side.

How often is hip OA found? In a recent article, after reviewing 2000 patient files and 1000 x-rays of patients 40 years or older, 19% (~1 out of 5) demonstrated x-ray findings of hip OA. THAT’S A LOT!  At Denver Chiropractic Center, management of hip OA includes mobilization, manipulation, stretching the muscles surrounding the hip joint with Active Release Techniques, exercise/stretch instruction, nutritional strategies and others. If/when the time comes, we will help set up a referral to the orthopedic surgeon for joint replacement, as any “quarterback” of your care should.

In our experience, using Active Release Techniques to manages the soft tissues (muscles, tendons) that are associated with the hip joint –and there are a lot of them – is the best option to both manage the pain and stiffness in the hip joint.

It all starts with the initial exam. To schedule yours (or schedule one for someone that you care about), call us at 303.300.0424.