So…You made a New Years resolution to get in shape and lose weight. Did you keep it? How far did you get? Well, maybe you just made some easily fixed mistakes. Since graduate school I’ve worked in numerous doctor’s offices, all of which provided some sort of general health and fitness counseling. The two greatest mistakes people make when getting into an exercise or weight loss program are that they make it too hard or too complicated. Now I know you have heard this before but I promise to provide real examples and real help before the end of this article.
First, if your resolution was to get into shape, you need to decide what you want to be shapely! Are we talking about your general health or are we talking about your thighs? For example, many of our patients want to be in “better shape” and by that they mean a healthy heart and better over-all endurance for their daily activities. If you want to trim down, I’ll address that a little later. If health and fitness is your goal, you need to find an activity that will cause you to reach your target heart rate (pulse rate) for 20 minutes three times a week. For the regular guy or gal that is all you need to do and your cardiovascular health will improve. You will feel better and you will enjoy all the benefits of better health. To figure out your target heart rate (beats per minute) you subtract your age from 220 and multiply it by 0.7. Take your pulse as you exercise and see how close you get. If you do not reach your target pulse/heart rate right away don’t worry about it. The most important aspect of this exercise is that you do it. Even if you don’t reach your target the first month, don’t worry about it. I would even go so far as to say don’t schedule more than 20 minutes even if you reach your target heart rate and find it very easy. The thing that makes us motivated to get into shape is many times fleeting. It’s the person who sticks with the moderate activity for the longest time who will reap the greatest benefits. If the activity of your choice consumes too much time you will eventually have to reschedule it as life’s other priorities take over. If you do too much your gonna hurt! And probably the most important aspect of doing any physical exercise--you have to make your workout fun. What is enjoyable is different for everyone so think about what will work for you. Do something you like. Lets face it, if you wind up thinking of your workout as a chore you won’t stick with it very long. I personally enjoy jogging by picturesque bodies of water, but “to each their own.”
Did that resolution include weight loss? I’m going to give you a somewhat simple formula to design your own weight loss program. Please forgive me for not referencing any celebrity testimonials or pushing any prepackaged foods. If you want to lose body fat you simply have to expend more energy than you consume. This is not an oversimplification, it’s a scientific fact. You use energy to breath, keep your heart beating, and blink, all of this is defined as your BMR (basal metabolic rate). You use energy to walk, talk, and type as well and that’s referred to as your Voluntary Muscular Activity. The foods you consume are simply a fuel source and so are those love handles. To figure out your BMR: (and I’m sorry about the math)
Basal Metabolism: Use the factor 1.0 kcalories per kilogram of body weight per hour for men, or 0.9 for women.
1. Change pounds to kilograms: ________ lbs (divided by) / 2.2lbs/kg = _______ kg.
2. Multiply weight in kilograms by the BMR factor: _______ kg (multiplied by) x 1 kcal/kg/hr = _______ kcal/hr
3. Multiply the kcalories used in one hour by the hours in a day: _______kcal/hr x 24 hr/day = __________ kcal/day = Energy needed for BMR.
Then you need to decide about how much energy you burn off during a normal day. Be honest!
Voluntary Muscular Activity: The following figures are crude approximation based on the amount of muscular work a person typically performs in a day. To select the one appropriate for you, remember to think in terms of the amount of muscular work performed; don’t confuse busy with being active.
1. For sedentary (mostly sitting) activity (a Typist), add 40 to 50 percent of the BMR.
2. For light activity (a Teacher), add 55 to 65 percent.
3. For moderate activity (a Nurse), add 65 to 70 percent.
4. For heavy work (a Roofer), add 75 to 100 percent or more.
An Example:1,632 kcal/day x 50% (Secretary) = 816 kcal/day Then add this to the BMR.1,632 kcal/day + 816 kcal/day = 2,448 kcal/day. _______ kcal/day x _______% = __________kcal/day + _______ kcal/day = _________ kcal/day
Did you do this right?
Example: 172lbs man (teacher) close to 3,095.99kcal/day
150lbs woman (typist) close to 2,209.09kcal/day
This final figure will tell you what you can consume calorie wise to break even and maintain your particular weight. If you consume a little less you should loose weight, you consume a little more you should gain. In a practical sense any diet will have to include some calorie counting. You are going to have to read a lot of labels, which can be tedious at first. However, you will be much better off knowing what you’re really eating! The choice of foods should be roughly 30 percent or less calories from fat, 35 percent of calories from carbohydrates, and 35 percent of calories from proteins. This is what the experts suggest as a healthy balance. Fad diets are great but if you actually read the books almost all of them suggest a healthy balanced diet when you reach your target weight. I suggest you start off the right way and stick with it. The best way to get started is eat to maintain your current weight by the formula and see if you feel satisfied. If you are hungry all the time, you estimated your activity level wrong or your math is off. And remember, you are setting yourself up for failure if you try to loose too much too fast. When you shed a lot of weight fast your body thinks your starving and you will rebound if you slip up. It is my experience that if patients try to start an exercise program and a diet at the same time they also fail. It takes a lot of discipline for either and most of us can’t do it for very long, myself included. When you increase your activity level your gonna get hungry, hungry, hungry. Do I think it is a good idea to shed those extra pounds and exercise regularly? Yes. I am just saying it is very hard to start both when you have been doing neither.
This brings us back to the original question I had of your resolution. What did you want to be shapely? Unfortunately, you can do sit-ups until you have the abdominal muscles of Arnold but if you are not expending enough energy to reduce your fat stores you will still have a gut. What you will have is strong tone abs under a layer of soft tissue fat. Which is completely normal, its how our bodies are designed. The principle is the same no matter what part of the body we’re talking about. So figure out your real goal and proceed with a passion. If something doesn’t feel right or you have any hesitations go see your doctor. Physicians and therapists are impressed by people who want to take charge of their own health. If you have any physical ailments, if your no spring chicken, or if you are more than 30lbs over weight, you should consult your doctor before starting any weight loss or exercise program.
Dr. Kevin S. Steele, D.C.
If you’re looking for a safe bet, bet that at some time in your life you’re going to have a least one episode of debilitating back pain. Back pain is actually as common as headaches in the adult population. It is estimated that 80% of the adult population in our country will experience some form of low back pain in their life time (Tribune media services, 91-92-93). Would you believe that nearly half of the people reading this article have back pain right now? The prevalence of low back pain in the USA in any given month, is 41.7% in females, and 34.5% in males (Spine 1995;20:1889-1894). It is a huge problem that costs us millions of dollars in lost wages and endless personal grief. Even our federal government has issued guidelines to the healthcare community for the treatment of this “epidemic!” But as I see it, all these back aches are not the real problem. In fact, the majority of people who experience one episode of uncomplicated low back pain heal completely on their own. That’s right, the pain just goes away like a headache. The real problem is getting out the information people need to avoid serious back problems. But how do you know when your one episode of back pain is more than just a passing annoyance? A quick, easy reference is as follows:
Acute low back pain can be generally divided into three practical categories. The first, is low back pain that starts after a recognizable incident, is not severe, goes away after only a few days, and does not preclude you from doing your normal daily activities. What’s severe? Well, as a general guideline you can say that anything over a 6 on a 0 to 10 scale is severe (0 being no pain at all, and 10 being the worst pain imaginable). If you have back pain that falls into the first category it will likely be self-limiting and not require a trip to the doctor. The second category, is comprised of any back pain that does not fit into the first category. Any back pain that you would deem severe, does not go away in a few days, keeps you from your normal routine, or that comes on for what seems like no reason, warrants a trip to a health care provider. In addition, any back pain that comes with radiating/shooting pain or numbness down a leg should be added to this category. In many cases this second type of low back pain is also self-limiting, but it is generally recommended that your health care provider eliminate any serious underlining medical problems with a good physical examination. The third category is comprised of any low back pain that is associated with an inability to control your bowel or bladder, or comes with extreme leg weakness, a high fever, abdominal pain, or numbness in the groin or rectal area. If you have any of these symptoms with your back pain you should go to the emergency room right away!
If you do end up having to go see your health care provider what can you expect? What will happen at the doctor’s office? Your health care provider will ask you about your symptoms in detail. He or she will ask you about the history of the injury and your general health history. They will also give you a physical exam. It is important to check out if any other more serious medical illness is causing your back pain. Assuming there is not any serious medical problems to worry about, there are a variety of treatments that help relieve low back pain!
Medicine: Medicine often helps low back symptoms. The type depends on the severity of the symptoms, your allergies, the strength of your stomach lining, and so on. But generally, over-the-counter strength medicines such as acetaminophen, aspirin, or ibuprofen are prescribed. Stronger medications are prescribed for more severe symptoms.
Heat & Ice: Low back injuries can be treated just like sports injuries when it comes to the application of heat or ice. The first 48 to 72 hours after the symptoms start one should apply ice for 5 to 10 minutes at a time repeatedly. (Never apply ice directly to the skin) After 48 to 72 hours one can apply heat (hot packs/warm showers/hot tub) in the same manor.
Spinal Manipulation: This treatment (using the hands to apply force to the back to mobilize poorly aligned or “locked up” vertebrae) has been shown to help elevate low back pain. It should only be preformed by a professional with experience in manipulation.
Physiotherapy: Physiotherapy is the term used to describe treatments from a variety of machines designed to reduce pain and swelling in joints or muscles. Some examples include, TENS (transcutaneous electrical nerve stimulation), Low volt current, Interferential current, and Ultrasound. These treatments should only be applied by a professional, with training in physiotherapy modalities.
Massage: Massage has been shown to help reduce the muscle spasms that come with low back pain.
Exercise: Most health care professionals suggest you avoid any strenuous exercise when you have acute low back pain. Although, mild stretching can also help reduce the muscle spasms that come with low back pain.
What kinds of things can I do to help my back pain? There are many little tricks you can employ to help alleviate your back pain!
- Wear comfortable, low-heeled shoes.
- Make sure your work surface is at a comfortable height for you.
- Use a chair with a good lower back support that may recline slightly.
- If you must sit for long periods of time, try resting your feet on the floor or on a low stool, whichever is more comfortable.
- If you must stand for long periods of time, try resting one foot on a low stool.
- If you must drive long distances, try using a pillow or rolled-up towel behind the small of your back. Also, be sure to stop often and walk around for a few minutes.
- If you have trouble sleeping, try sleeping on your back with a pillow under your knees, or sleep on your side with your knees bent and a pillow between your knees.
- And, the single best thing you can do for your back, is stay in shape! Healthy backs heal faster!
Dr. Kevin S. Steele, D.C.
Running, like walking, seems like a series of simple movements at first glance. Yet a careful analysis reveals the act of running to be a very complex task. A trained eye can break down the simple act of running into nine definable parts, and that’s just for one leg. Then adding all the sequenced muscle actions and joint movements together demonstrate the coordinated teamwork required for any speedy locomotion. When any one of the parts that comprise the whole process becomes off balance, injuries can and do happen.
Runner's knee, also known as Chondromalacia, is a common condition causing knee pain. The pain can develop close to the kneecap, under the kneecap, at the front of the knee, or on the side of the knee. The pain tends to be gradual in its onset, increasing over weeks or months. The problem arises when the cartilage under the kneecap starts to wear away. The inner surfaces of the knee joint becomes rough, and tell tale signs may include a grinding sound when the knee is bent. Why does this happen? There are quite a few possible scenarios. More common causes of Runner’s knee include the following:
1. Not warming up properly before you begin to run.
2. Lack of flexibility in your quadriceps and or hamstrings.
3. Weakness in your quadriceps.
4. Running on a sloping road or hill.
5. Poor initial contact of your foot on to the ground.
6. Running to much early in your training sessions.
7. Running to hard early in your training sessions.
Prevention of Runner’s knee can be simple. First, address the following: Stay flexible. Begin and end each exercise session with slow static stretching of the quadriceps, hamstrings, groin, calf, and low back muscles. Press slowly into your stretch, never bounce when stretching! Maintain a well-balanced exercise program that focuses on strength and endurance. Don’t be a weekend warrior. Start out slowly and work up your endurance or distance. Train your whole body, not just your legs. You can’t forget about your belly and your back muscles. Muscles above your waist help provide stability for your hips and pelvis. Your hips determine how your whole lower extremity will hit the ground and so on. Avoid deep knee bends and bicycling against a heavy resistance. This can just be tremendously hard on your knees. Be fitted with a running shoe that fits your foot correctly. Shoes are a runner’s most important piece of equipment and should be chosen wisely. There are several running shoes on the market that focus on different aspects of ones foot and the way it makes initial contact with the running surface. Each runner has his or her own unique stride and I recommend that each runner be fitted by a professional for a proper fit. Avoid running on sloped or camber surfaces. This will avoid putting too much stress or strain on to lateral aspects of the knee and lower leg. Avoid running on cement. Cement is a hard surface that will increase the impact shock on the knee joint. It is best to pick a softer surface. Running in the sand or on the beach is also not recommended because it can cause excessive pronation, ankle turning over, or stretching of the Achilles tendon. Pronation or a loose Achilles tendon can lead to ankle sprains. Experts recommend running on a track or a firm gravel surface.
Again, Runner’s knee can be prevented if you take some simple precautions. Nevertheless, if symptoms arise or persist, seek help from a professional. Use your body as a guide. If you feel pain, it is your body’s way of telling you that something is wrong. “Listen to your body--work with it, not against it”. If you catch the problem early, you can prevent further damage from occurring. The earlier you diagnosis Chondromalacia or Runner’s knee the easier it is to rehabilitate. A licensed physical therapist can lead you to recovery. A physical therapist can develop an exercise specific program focusing on your deficits and problem areas.
1. Roy Stephen, Irvin Richard: Sports Medicine: Prevention, evaluation, management, and rehabilitation. Englewood Cliffs NJ, Prentice Hall, 1993.
2. Holt D: Running Dialogue. Chondromalacia (Runners Knee) and Iliotibial Band Syndrome…Knee injury advice. 2000.
Dr. Kevin S. Steele, D.C.
Want to have FUN and do something good for your back? There’s lots of good evidence now-a-days that we, as practitioners, have been pushing the wrong kinds of exercise! It used to be the goal of rehabilitation to get the Patient to increase their range of motion and strength, and let’em go. Patients and training clients went home with lots of stretching and repetitious exercises. We all know how long it takes until you loose interest in that kind of exercise. Newer research is indicating that although range of motion and strength is good, something called Proprioception is also extremely important. Our Proprioceptive ability is the ability of our muscles, tendons, and joints to transmit information about their position to our brains. In English, its our ability to be coordinated and balanced. Exercise for coordinating your back can be fun and easy. But, let me give you an example of why it is so important. Let’s say you’re a lawyer. The majority of your day is spent in front of a computer or at a desk. Your functional range of motion is small. It is not all that important for you to be able to touch the bottoms of your feet to the back of your head! The amount of stretching and bending you do is minimal and you can accomplish it easily. So why would it be that simply bending over to pick up a pen would “throw your back out?” Simple, poor Proprioception and balance! Backs with coordinated muscles rarely “go out!” Balanced joints surrounded by coordinated muscle do not catch wrong and cause pain. They react quicker when we take a wrong step or try to rapidly move beyond our normal activities. What I’m getting at here, is that a coordinated back is more important than one with a huge range of motion, for people who do normal activities. One of the easiest ways to coordinate your back is doing simple exercises on an Exercise Ball. There are very easy exercises for beginners and challenging exercises for the more adventurous.
Salters Creek is offering Exercise Ball (Proprioceptive) training. The exercises are great for toning up as well! Dr. Kevin S. Steele, D.C.
Help, "I've fallen and I can't get up", a phrase made humorous by poorly acted TV commercials, but it happens for real more often than you think. As most medical professionals know, the probability that you will experience a bout of low back pain is extremely high. For example, the prevalence of low back pain in the USA in any given month, is 41.7% in females, and 34.5% in males (Spine 1995;20:1889-1894). These statistics taken as they are, produce a certain anxiety in most, myself included. And lets face it, the percentage given for males is probably conservative as men are notorious for denying any pain they can't successfully treat themselves.
It is estimated that 80% of the adult population in our country will experience some form of low back pain in their life time (Tribune media services, 91-92-93). So odds being what they are, what's to be done when it happens to you? First and foremost, many bouts of low back pain resolve on their own. Simple muscle pain can be treated with over-the-counter medications which include aspirin and ibuprofen, please always take as directed. In addition, basic first-aid such as cold compresses or ice packs are indicated for the first 48 hours. It is generally recommended that if you experience any pain or unusual stiffness after this 48 hour period you should seek an appointment with a medical professional. Should you have any symptoms that include pain, numbness, or tingling into an extremity you should seek professional help despite being within the first 48 hours or after. Any bowl or bladder incontinence constitutes a medical emergency and requires a trip to the emergency room.
Danger signs aside, if you do end up having to go to the doctor what can you expect? What should you look for? Any Physical therapist, Chiropractic physician, or Medical doctor should and will perform a through examination. They should give you a diagnosis and set up a treatment plan. This plan will include some therapy aimed at controlling the acute aspects of pain and inflammation in your spine. These treatments might be anti-inflammatory medications, physiotherapy (electrical machines or ultrasound), or ice to name but a few. When pain and inflammation are under control some form of rehabilitation should be undertaken. It is now widely accepted that simply killing the pain so that an individual feels comfortable enough to re-injure themselves does them a disservice. Even though we all avoid it, rehabilitation exercises to restore flexibility, coordination, and strength is always prudent. If a conservative course of treatment does not sufficiently improve the symptoms of your injury a referral to a specialist such as a orthopedist may be made.
If you have any questions concerning a low back problem or any musculoskeletal ailment please do not hesitate to call. My partner, Dr. Karyn Lewis, or I would be happy to speak with you.
Dr. Kevin S. Steele, D.C.
Did you know that one of the best things you can do for your body has nothing to do with diet or exercise? It’s relatively inexpensive, requires almost no effort at all, and feels great. Therapeutic Massage has been used successfully to treat everything from serious aliments to simple boredom. You may be surprised to learn the variety of benefits one can derive from simply allowing a professional to knead your sore and tired muscles. Possibly the best therapeutic benefit from massage is an increase in circulation. It has been said that Massage cleans the body from the inside. Everyone builds toxins and waste in their bodies. Every time we contract a muscle, cells in our body have to produce energy. A byproduct of energy is waste, and the waste is deposited in our tissues. Our muscles have a process for dispelling this chemical waste but massage greatly enhances the body’s ability to accomplish this. Additional toxins deposited in our tissues come from stress, the foods we eat, the things we drink, and our environment. Muscle injury or spasm also creates toxins by blocking oxygen and nutrients from these areas. The rhythmic kneading or compression of Massage squeezes out the bad stuff and draws in new blood. This new oxygenated nutrient rich blood promotes healing and the overall health of the muscles and tissues. It helps wash away the wastes and toxins. In fact, if you drink plenty of water after your massage you can increase the speed of this process.
It is for the reasons discussed and many more that massage is used in such a variety of ways. It can be a great compliment to sports and exercise. Massage generates new cell production within muscle tissues, makes them more flexible, and promotes healing. Many seasoned weight lifters use massage to decrease the soreness they know they will have after aggressive workouts. Physical Therapists use massage on athletes to improve their performance and decrease pain.
Massage has been used to control pain since the first caveman hit his finger with a rock and rubbed away the throbbing. Most musculoskeletal pain is associated with swelling. Doctors and Therapists know that decreasing the swelling will help eliminate the pain. Therapeutic massage relieves acute and chronic pain from injury, as well as serious conditions like arthritis, Fibromyalgia, and Parkinson’s Disease. It also works well to alleviate headaches, neck pain, and back pain.
So we know all the physiological gains derived from massage, but what about the thing you can quantify? Let’s face it, there are a lot of treatments that are therapeutically good for us that we never look forward to as much as a good massage. There is something about touch that is difficult to quantify or define. No matter how elaborate your 12-jet hot tub or vibrating Lazy-boy recliner there is no substitute for a real hands on massage. For whatever reason, Massage generates a sense of all over physical and emotional well being. It helps people relax and can be a great way to counteract stress.
Hopefully we have convinced you that massage is beneficial and worth a try. The only real obstacle people have when it comes to massage is there own comfort level. Not everyone is comfortable with new experiences especially if they are being touched. It is our experience that most people are hesitant only because they do not know what to expect. So the following should elevate your anxieties.
What to expect: On your first visit, most Therapists suggest you in come in 10 minutes early to fill out a brief health questionnaire. If you are under a Physician’s care, you should bring in a written approval from your doctor. Eating just before a massage is not recommended. It will make you uncomfortable if your on your stomach to long.
Your comfort is your Therapists priority. You disrobe to your comfort level. You will be covered during the massage, and only the area being massaged will be exposed, then recovered. Most Therapists use a massage cream that is unscented, hypoallergenic, and is designed to leave your skin soft, not greasy. You can always request specific types of oils or creams. You can also request specific types of techniques. In Virginia Therapists have to be certified by the state and are trained in a variety of soft tissue techniques. If you have never had a massage just request Swedish, as it is the most common and most familiar. Remember, any good Therapist will encourage their clients to ask any question or voice any concern. Relax and enjoy your massage. You’ll be hooked!
Dr. Kevin S. Steele, D.C.
Let me tell you a true story about a real man, a man’s man, who happened to be a carpenter. John Doe, lets call him John, had some back pain that had been getting progressively worse for the past six months. He had not been to see a doctor since his last football physical in college. He had never been seriously injured and had never spent a night in the hospital. He finally went to see his family doctor because he developed some blood in his urine. He never admitted the back pain to his doctor. His family physician referred him to a urologist. John’s little problem disappeared the next day and he never went to see the urologist. His back pain was tolerable. Over the next 18 months John continued to have pains in his back but dismissed them as work related. A large man, 6’ 1” and 240 pounds- he continued his daily activity including some heavier construction projects. He continued to ignore his symptoms until the blood returned in his urine. John returned to his family physician with a complaint of low back pain and casually remarked that “oh yea and that blood is still there”. John was convinced to see the urologist who in-turn referred him to a specialist. The specialist removed a tumor from his kidney. John is unfortunately representative of the model male patient. His story is just a little more illustrative of how men make poor health choices. Gentlemen we should be ashamed of ourselves! We are supposed to be the intellectual problem solvers of our species. When it comes to our health we are woefully inadequate compared to our female counterparts. Did you know that most family practices, chiropractors, dentists, and podiatrists see primarily women? This is true of my practice as well. Did you know men make 135 million fewer doctor’s visits a year than women do? A survey taken in 1999 found that about 30 million men hadn’t been to a doctor for a health check-up in the previous year. About 9 million men said they hadn’t seen a doctor in five years. Another survey found that one-third of men in America age 45 to 64 had never had their cholesterol checked. Sadly, because we neglect our health, we pay the consequences. On average, men die seven years before most women. The death rate for heart disease is twice as high for men as it is for women. Lung cancer kills about 95,000 men each year, compared to 65,000 women. Men also have higher death rates from emphysema, accidents, murder, suicide, and alcohol-related conditions.
Are we really that dumb or are we just genetically predispositioned to poor health? It’s not our genes. Unfortunately we are poorly educated consumers. Men know very little about their bodies, they’re too embarrassed to say so, and when they have a problem, they don’t know where to turn for help. Many men think consulting a doctor is an admission of weakness. Any worrying about a health problem that doesn’t land them flat on their backs isn’t manly. Would John Wayne have complained of urinary problems? I don’t think so. Our model man, John, probably learned from a young age to grit his teeth and bare it. The following is a list of commonly used excuses and their possible hidden meanings borrowed from Better Homes and Gardens (probably written by a woman).
|Excuses used by men to dodge the doctor:||The real reason:|
|“I’m too busy”||My co-workers will think I’m weak, lazy, or getting old when I take time from work. It could jeopardize my job.|
|“I don’t trust the doctor”||Do not like giving up control or depending on others.|
|“I don’t want to make a big deal out of it”||I am afraid of bad news, if I ignore the problem it will go away.|
|“I already know what they’ll say”||The doctor might tell me to change my lifestyle.|
|“I can’t talk to my doctor”||I am embarrassed and I will have to admit I don’t know much about this problem.|
So what’s the answer? Men need to realize that the traditional masculine role can be hazardous to their health. Men need to see doctors as allies and become more educated about their health. So what should we be doing and when should we be doing it? This chart should get you started. To use the last column and last chart: assume if you are age 20 to 59 your life expectancy would be 73, if you are age 60 to 69 your life expectancy would be 76, and if you are age 70 to 79 your life expectancy would be 78.
How will this affect my life expectancy?
|20||Regular Physical||Every 5 years.||Screen for major health problems and catch them early enough to help.|
|50||Regular Physical||Every year.||Screen for major health problems and catch them early enough to help.|
|20||Blood pressure screen||Every 2 years.||High blood pressure doubles a person’s risk for heart disease and triples it for stroke. High is pressure that persists over 140/90.||Bp 90/65 to 120/81 add 3 yearsBp 121/82 to 129/85 add 1 yearBp 131/87 to 140/90 subtract 1 year|
|50||Blood pressure screen||Every year.||High blood pressure doubles a person’s risk for heart disease and triples it for stroke. High is pressure that persists over 140/90.||Bp 141/95 to 150/95 subtract 2 yearsBp more than 151/96 subtract 3 years|
|20 & over||Cholesterol screen||Every 5 years after age 20.||High Cholesterol is a major factor for heart disease. Below 200 = good, above 240 = bad.||Less than 160 add 1 year201 to 240 subtract 1 year241 to 280 subtract 2 yearsmore than 280 subtract 3 years|
|50||Stool blood test||Every year.||Early detection of colon cancer. If you have a family history start at age 40.|
|50||Sigmoidoscopy||Every 3 to 5 years.||An inspection of the colon for pre-cancerous polyps.|
|40||PSA blood test||Every year.||A blood test that can be done with a regular physical that screens for prostate problems.|
|35 and younger||Testicular exam||Self exam every month.||Cancer of the testicle is the most common cancer in men between 15 and 35.|
|If you are a cigarette smoker: Never smoked then add 3 years Ex-smoker not smoked for 5 years then add 2 years Ex-smoker not smoked for 3 years then add 2 years Ex-smoker not smoked for 1 year then subtract 1 year Smoke 1 pack per day or less for less than 20 years then subtract 2 years Smoke 1 pack per day or less for more than 20 years then subtract 3 years|
|Do you exercise?: 90 minutes of exercise per day for more than 3 years then add 3 years 60 minutes of exercise per day for more than 3 years then add 2 years 20 minutes of exercise 3 times per week for more than 3 years then add 1 year More than 5 minutes of exercise per day for more than 3 years then subtract a year Less than 5 minutes of exercise per day for more than 3 years then subtract two years If you do not exercise at all then subtract 3 years|
Dr. Kevin S. Steele, D.C.
Your back is a remarkable evolutionary triumph in design that allows for great strength while at the same time housing a delicate conduit for almost every nerve in your body. With the proper conditioning it can withstand a clean-and-jerk weight lifting competition and rugby football game. With the proper neglect it can “go out” picking up your beer from the coffee table. Your back is separated into two major sections. The Thoracic spine or your upper and middle back, and the Lumbar spine your lower back. The Thoracic spine is composed of 12 bones or vertebrae. The Lumbar spine has 5 vertebrae. The vertebrae provide the bony strength of the spine and house your spinal cord. The spinal cord in essence connects your brain to every part of your body. Each nerve that exits your spinal cord does so through a hole between the vertebrae. Between each bony vertebrae there is also a cartilaginous disc or the shock absorber of your spine. The complex layers of ligament and muscle overlying the spine provide additional support and integrity for the structures underneath. This ingenious design allows us to bend and twist with amazing agility and still stand up-right. Problems arise when one or more parts of this complex system fail.
For example, we have all heard someone say they have arthritis in their back. Well, they would actually be unusual if they didn’t. Over time we all develop some degree of Degenerative Joint Disease, which sounds horrible but its not. It’s life. The bones in our spine begin to wear and change shape near the edges or margins around the age of 25. This change in the bone is termed degenerative or arthritic change. This is different from an actual Arthritis, which means an active inflammation of bones and joints. When the vertebrae begin to show signs of degenerative change, the framework of our spines begin to do a progressively poorer job of supporting our back! The same problems arise no matter what is affecting the vertebrae, whether it is a fracture or Osteoporosis (A loss of bone density). When the framework is bad the support is bad. The person can not bend, twist and stand up-right without compromising those delicate nerves underneath. Your body reminds you with Pain! Granted this a vast oversimplification but it illustrates a point. We are mechanical beings that can only perform if the machine is healthy. Unfortunately the back machine breaks down a lot. It is estimated that 80% of the adult population in our country will experience some form of low back pain in their life time (Tribune media services, 91-92-93). The probability that you will experience a bout of low back pain is extremely high. For example, the prevalence of low back pain in the USA in any given month, is 41.7% in females, and 34.5% in males (Spine 1995;20:1889-1894). These statistics taken as they are, produce a certain anxiety in most, myself included. But, keeping the spine healthy is not really difficult.
If you want to keep those vertebrae healthy you have to eat well balanced meals and keep up your intake of Calcium and Vitamin D. For Calcium, you want 1,200 mg/day to age 24 and 800 mg/day as a healthy adult over age 24. For Vitamin D, you want 10ug/day to age 25 and 5ug/day as a healthy adult over age 25. Another important aspect of keeping all your bones healthy is the need for exercise. Believe it or not, your bones do continue to grow after puberty. They do not grow longer, that’s determined by genetics, but they do grow thicker. If you do some form of weight baring exercise on a regular basis you significantly decrease your likely-hood of developing Osteoporosis whether you are male or female. The weight bearing exercise increases the bone’s density and thickness over time.
What about those discs providing shock absorption and flexibility in your spine? You may have heard of someone with a slipped disc or hernitated disc. These are serious injuries requiring medical intervention. These injuries are, in simple terms, what happen when that cartilaginous disc material moves under the presser of our weight. The displaced disc material places pressure on one or more nerves exiting the spinal cord. The symptoms are painful to say the least. The single best thing we can do to help the health of our discs is drink water. The disc needs nutrients as much as any part of the body but it has less direct blood supply as for example a muscle. A dehydrated disc can not perform its functions because it looses elasticity. If you keep yourself well hydrated the disc can bring in the things it needs by osmosis. It makes a huge difference! Would you believe that your discs actually absorb enough water to change your height? If you don’t believe me, measure your height in the morning and then again before you go to bed. The example works better in children than adults but one actually becomes shorter during the day as the weight of our bodies squeeze out the water from our discs.
The last, and maybe most important part of maintaining our back health is maintaining our musculature. The muscles of our back provide a large part of the support of our spines and all of the movement. We can effect great change in the health of our spines and the whole back by simply maintaining muscle tone. Although experts debate how much exercise we need and how much it will save us from back injury, they all agree on one thing. We need it. Most low back exercises are EASY. You do not have to work hard or for hours! For back health most experts just suggest muscle tone not muscle bulk. It is far more important to exercise a little every day than to over do it. For your lower back there are four major groups of muscle you want to work to maintain tone. They are all centered around your pelvic ring. Imagine your pelvic ring as a belt that goes around your waist. If you tighten up your stomach muscles the front of the ring goes up. If you tighten up your low back muscles the back of the ring goes up. If you tighten up your buttocks or hamstrings the back of the ring goes down. If you tighten up the muscles in the front of your thighs the front of the ring goes down. The goal then becomes finding a balance of all of these four muscle groups. You want to be strong enough and flexible enough to move the ring at will. For your upper and central back you want to exercise the trunk of your body and your shoulders. There are many muscles that span both your upper back and your shoulders. To set up a good back exercise program you should really consult a trainer, physical therapist or doctor. Let them know you are not looking to bulk up you just want to maintain muscle tone throughout your back. In one or two sessions you can get the basics for a home program that should take you no more than 20 minutes a day. You will be pleasantly surprised after just a few weeks when you really feel stronger and stand taller. It only takes a few minutes a day to avoid becoming a statistic. If you have questions about back health any member of our staff would be happy to speak with you.
Dr. Kevin S. Steele, D.C.
The causes for headaches are as varied as people’s descriptions of them. A headache, as you know, can be simply an annoyance or a symptom of something much more serious. Fortunately for most of us, a headache is usually just an annoyance and the medical statistics back this up. But, how do you know what kind of headache you’ve got? Well, you have to ask yourself the same questions the doctor would ask. There are six basic questions that help differentiate the kind of headache your having.
1. Location, or where does it hurt?
2. Duration, or how long does it hurt?
3. Frequency, or how often does it hurt?
4. Intensity, or how bad does it hurt?
5. Nature, or how does it hurt? I.e. Throbbing, squeezing, stabbing, so on.
6. And, association, or is your headache associated with any other problem or symptom?
For simplicity’s sake I will use the most common example, the Tension Headache. The vast majority of people who experience headache are having a Tension Headache. As the name suggests, this type of headache is directly or indirectly related to physical or psychological tension. If you have a Tension headache the questions would be answered as follows:
1. The headache feels like it starts around the temples and spreads over the head or starts at the base of the back of the skull and spreads over the top of the head.
2. The headache never lasts more than 10 or 12 hours.
3. The headache is intermittent, in other words it does not come every day.
4. On a scale of 1 to 10 where zero is no pain and 10 is the worst pain imaginable, the pain never exceeds a 5.
5. The pain feels like a dull ache or a squeezing around the head.
6. The headache can’t be associated with an activity, an injury, or a food. It does not come with other symptoms such as nausea, hives, ear pain, neck pain, or anything else.
This is the general outline of the common Tension Headache. It is alleviated easily with over the counter analgesics. But, what you might be disturbed to know is that your tension headache probably would have gone away by itself before your cure kicked in. Research indicates most headaches subside before most over the counter analgesics start working.
Even if your headache did not neatly fall into the outline for a tension headache your headache is most likely still a far cry from life threatening. In fact, the vast majority of headaches are categorized as extracranial and not intracranial. In English, this means they are caused by things outside your head and not in it. For example, stress causes muscle contraction. Have you ever noticed that when your are very agitated you tend to shrug your shoulders. Everyone does it. If you remember to catch yourself you will be surprised how far your shoulders drop when you relax. There are muscles all over one’s head that react the same way, that are just not as easy to relax. Tension in these muscles impedes blood flow and puts pressure on small nerves. The next thing you know, headache. Muscle tightness in the neck and shoulders do the same thing.
Other common non-life threatening headaches include, Migraine, toxic, and Cluster. In a Migraine headache one may experience what is called a prodrome. Although many people claim to have a Migraine headache, they usually do not. The culprit is most likely a rather severe tension headache. The Migraine sufferer often experiences a prodrome or non-headache symptoms usually associated with the Migraine before the headache. The can have a variety of symptoms such as; nausea, vomiting, visual disturbances, light sensitivity, mood changes, or even numbness. The symptoms come on before the headache as a warning of sorts and then the symptoms persist during the headache and usually get more severe. If we were to go through our six questions:
1. The pain can start like that of a tension headache or start on one side of the head.
2. These headaches last about the same amount of time as the tension headache up to 10 or 12 hours.
3. Intermittent, but the sufferer has similar attacks over an extended period of time.
4. The pain can be mild to severe.
5. The pain feels generalized or throbbing.
6. It can be associated with a prodrome.
The general feeling of most professionals is that Migraines are caused by a dilation of arteries in and around the head. Medications that treat Migraine are vasoconstrictors, or decrease this blood flow. Migraines are more prevalent in females.
The Cluster headache is a headache that is severe and behind one eye and may effect one side of the face. If you experienced this type of headache you’d know it. It is felt by most professionals that the causes for this type of headache are similar to that of Migraine and they are treated the same way. Cluster headaches are more prevalent in males.
Toxic headaches are really more of a category of headache. They include headaches caused by infections, alcohol, and poisons. They are all “toxic” to our systems. They can be intracranial, extracranial, or both. They present like a tension headache that keeps getting worse. They are almost always associated with other symptoms and would therefor fail question 6.
The real important thing to remember is the basic outline for a tension headache if you want to eliminate a serious cause of headache. A simple headache should never last longer than 12 hours, never hurt more than a 5 on a scale of 1 to 10, and never be associated with other symptoms. If your headache presents as more severe in any way, see your doctor. He or she will most likely tell you its a bad tension headache after some simple tests to make sure.
Dr. Kevin S. Steele, D.C.
My neck is killing me! My back is killing me, and I did nothing! It doesn’t take a rocket scientist to know why one would hurt after overdoing it at, lets say, the gym. But, it is not uncommon to just hurt at the end of the day for what is seemingly no reason at all. Many of our patients attribute the “out of nowhere pain” to stress. And, yes, stress can contribute to muscle and joint pain but it is usually a more practical culprit. The causes of many of the aches and pains we feel every day can be easily traced back to what we do. If you spend a good portion of the day in front of a computer some easily implemented tricks can keep you from getting sore. The basics: When you are sitting, the pressure on your spine is one-and-a-half times greater than when you are standing. If you slouch over your work or slide down as you sit, you increase the pressure even more. This stretches the ligaments and compresses the disks and nerves in the back. You can reduce the stress in your back and neck by maintaining the normal curves in your spine. Keeping your shoulders straight and centered above your hips helps to distribute your weight evenly. If you sit in a straight-back chair, place a small pillow or rolled towel in the small of your back. You will be surprised that by maintaining the normal curve in your lower back your shoulders and upper back posture will improve naturally. An ergonomically adjustable chair can be adjusted for this curve as well.
There is a whole science dedicated to your posture and your workstation and it is generally referred to as “work station ergonomics” (the science relating to a worker and his/her efficient anatomic work). Now back to the basics:
The easiest way to reduce fatigue on your neck and back is to be properly positioned in front of your workstation. Think 90-degree angles! You should sit so that your feet are flat on the floor and your knees are at 90-degree angles. If you can’t adjust the height of your chair, you can use a phone book underneath your feet. The backs of your knees should be two inches from the front edge of your seat. Your hips should be at 90-degree angles with your spine, with your lower back against some kind of support. To reduce fatigue on your upper back and neck, your elbows should be at 90 degrees. Your work should be placed in front of you such that the tips of your elbows are pointing toward your hips or the first third of your thighs. If you are typing at a computer, your wrists should be close to the neutral position and not flexed up or down. A wrist pad is very helpful. A great way to reduce neck strain is to center your computer screen so it is just slightly below eye-level. Another extremely helpful invention is the document clip. This holds reading material just to the left or right of your screen. Believe it or not, if you type for only one hour from reading material flat on your desk. You may gaze down from the screen to your desk several hundred times. Your mouse should not be so far away from your body that you have to reach for it. Remember your elbow should point to no farther than the first third of you thigh. If you spend a lot of time in front of the computer using the mouse it is generally advised that you switch sides/hands periodically.
Implementing these basic work ergonomics may be awkward at first, however they do not take long to get accustomed to. The reduced tension on your back and neck will make it all worthwhile in the long run. Statistically, 80 percent of us will suffer some kind of low-back pain in our lifetime. It is the most common health complaint experienced by working Americans today, and a condition which costs the economy at least 50 billion dollars every year in lost wages an productivity. The fine-tuning we make to our work habits today can help us have more productive workdays and less pain.
Dr. Kevin S. Steele, D.C