The Safe Scoop on Shoveling:
Here we are, once again the season of cold, sleet and snow has surrounded us. Every year, I see a slew of injuries that involve people’s attempts to shovel pathways through this winter wonderland. Bodies are used to bend and twist, push and lift heavy snow. As a result of this, many suffer shoulder and leg injuries as well as neck and back strains and even more serious, disc injuries.
The U.S. Consumer Product Safety Commission, has reported more than 44,000 people were treated for snow blowing and snow shoveling injuries in 2004.
Snow shoveling by nature is a long lever movement coupled with bending at the waist. It is well known that bending and lifting, as well as twisting combines the perfect cocktail for injury.
Shoveling is further complicated by repetition of movement and slow body fatigue while carrying out the task, in cold weather.
Tips for Shoveling safe:
Cardiovascular health is important, if you have a heart condition, check with the Cardiologist before undertaking aerobic activity, especially in cold weather.
Dress according to conditions, keep the body hydrated and warm so that the muscles maintain themselves flexible. This will limit injury. 5 minutes of warm up movements and some leg stretching is healthy. Wear gloves, prevent blisters and potential injuries to the hands from cold weather.
As with most bend activities, try to use the legs more than the back. It is best to push the snow than lifting the snow. Plan where you will store the snow and push into the direction straight ahead
Give yourself plenty of time, don’t rush the job. Smaller amounts of snow moved will save your back and prevent injury. DO NOT THROW SNOW OVER YOURE BACK OR SHOULDERS!!
If you have to lift snow, again bend ant the knees and use your legs to lift. Inevitably legs will get sore. Some gentle stretches after shoveling are also advised.
Avoid repetition of movement. Change it up by changing hand positions on the shovel at certain intervals. For example the lower hand position should be changed every 5 or 10 shovel loads. If twisting is unavoidable, twist direction should be alternated to prevent repetitive strain injuries to the back.
Don’t overdo, remember that this is an aerobic activity, frequent breaks are ok especially if you are an infrequent exerciser.
If you have questions, please feel free to contact me at the office.
Kosta (Dino) Sotos DC DACO
ProMotion Spinal and Sports Rehabilitation. Chiropractic, Physical Therapy, Wellness
Self treatment and prevention of 7 common pains and sprains:
Most of the injuries endured by runners exist because of either mechanical abnormalities or overtraining and trying too fast. Pace is crucial both during a run as well as in building up to run.
The good news is that most running injuries are preventable or controllable with conservative methods to maintain a pain free sport.
1. Runner’s knee
The condition describes a debilitating wearing away of the cartilage in the back of the kneecap because of unbalanced movement. It occurs because of excessive motion at the kneecap while the kinetics of running are experienced. Mechanically the kneecap has forces pulling it in different directions as the knee bends and extends, stabilizing the kneecap with proper exercises as well as balancing the way the foot hits the ground and lands during the run pattern helps to properly transmit movement to the knee and hip. All our joints move in synchronicity, the poor motion in one joint is picked up by another. Many times good examination of the foot and correction of overpronation (flattening) or oversupination (high arches) with a specific type of casted orthotic helps prevent knee injury. Also consulting with a skilled sports doctor can who can introduce stretches and strengthening exercises for the muscles of the knee and thigh balances the kneecap.
2. Stress fractures
Stress reactions or stress fractures to a runner are just what the name implies. During the biomechanics of a run, the impact and dissipation of forces are transmitted ideally through the joints. The energy of impact eventually is absorbed in the muscles and given off as heat energy. If runners have a biomechanical flaw in their structure of their running style, Forces are concentrated into bones that can be irritated and eventually break. We have all heard of someone suffering a runner’s fracture in the toes or metatarsals. Some runners develop pain in the shins just below the kneecap while others develop them at the hip or sacrum. I advise my patients that a stress fracture to these bones is similar imagining an egg slightly swelling. It can happen but the egg shell has to slightly fissure and crack. It compromises the structure and in order to heal, the runner’s mechanics have to be corrected.
3. Iliotibial band syndrome, a.k.a. ITBS
I almost stopped running my first marathon because of ITBS. It is common amongst distance runners and is responsible for 80% of pain in distance running. The IT band in a runner has nothing to do with Information Technology. In a runner it is a fibrous band of tissue connected between the outside of the hip, down to the outside of the thigh and knee. It rubs over the femur at the outside of the knee and becomes inflamed and thickened. The pain can be lancing and sharp with movement and bending. Some biomechanists blame the irritation to be secondary to running on slightly bent surfaces and roads. The downhill leg has repetitive stretch placed on it and gets irritated. Proper stretching and rolling of the IT band as well as corrective foot supports help prevent and correct the condition Runners should avoid increasing mileage abruptly, icing the outside of the knee will tend to calm down the irritation. Also proper stretches in worm up and cool down times should help minimize irritation and pain.
4. Shin splints
Shin splints are common, and for the most part corrected with proper shoe support and improved arch support. Many of us forget that shoes break down. They are made of textiles that wear and deform, quickly. Shin splints are typically experienced in the legs below the knee on the inside of the leg. The cause is commonly improper motion as the foot hits the ground and improper motion as the run/gait pattern happens forces are spread out rather than being absorbed by shoes and joints in the foot. Balancing the foot, supporting the foot with good arch supportive shoes and non deforming shoes is the first step in treatment and prevention. Stretching, icing and balancing the foot and ankle once the condition has occurred The most common type of shin splints happen on the inside of legs. These medial shin splints are a running injury that results from a biomechanical flaw in your foot (which can be made worse by a shoe that doesn’t offer enough support) and/or overtraining. Start with the shoe and good stretches for the gastrocs and soleus muscles in the calves. Ice as needed and the condition should be controlled. If pain becomes chronic or persists, consider coming in for a full biomechanical evaluation.
5. Plantar fasciitis
Similar to IT band syndrome, this is an irritation of the tissue on the base of the foot. The classic presentation is arch pain. The cause can be inherited poor mechanics of the foot or tightness in the muscles in the lower leg and calf. As the foot flattens out, the base of the foot stretches and repetitively gets irritated.
6. Achilles tendonitis
Tight calf muscles and abnormal heel rise during push off leads to inflammation in the tendons that connect the calf muscles to the heel of the foot. As the tendon, called the “Achilles” gets irritated and inflamed, it hurts. Treatment involves proper stretching, balancing and improved foot function.
7. Ankle sprains
The most common type of ankle sprain is an inversion sprain. The cause is classically a misstep on an uneven surface causing the ankle to roll. They are typically graded according to how much injury is suffered in the ligaments of the ankle. They can be mild, managed with rest ice and elevation (RICE) or severe enough needing surgery. The best prevention is watching your step!!
Most injuries to runners are secondary to overtraining. The sport involves basic equipment; the most important is your body. A good mechanical diagnosis, including evaluation of the movement of the foot, knee and hip is important. Slowly building a running program including stretch routine and dynamic exercises to build ankle and foot strength as well as balance is important!
At ProMotion Spinal and Sports Rehabilitation, we evaluate the mechanics of movement through gait analysis and physical examination. Conservative orthopedic treatment options are then determined and applied returning patients to their most optimum ability. We are a privately owned rehabilitation facility that offer one on one management of injuries and have over 15 years of experience treating the communities of the North Shore. If you or someone you know has foot and ankle questions or any other orthopedic question, please contact us. We do offer free phone consultation for injuries or general question. 847-446-5420
With Good Health in Mind
Kosta Sotos DC DACO
ProMotion Spinal and Sports Rehabilitation
300 S. Happ Rd. Northfield IL
Chiropractic, Physical Therapy, Massage, Sports Medicine
BACK PACK ATTACK
Tips on Properly Wearing a Backpack.
Incorrectly wearing a backpack can cause unwanted pressure on the neck and shoulders. The following tips are important in preventing injury to the spine and muscles of young students or older commuters in the workplace:
Shoulder straps should be worn over both shoulders rather than slinging a strap over one shoulder. This double strap position allows for an even distribution of weight symmetrically over the shoulders minimizing injury and pressure to the body.
Loosening the shoulder straps makes it easier to put the backpack on and to take it off, but you should adjust the straps immediately, so it rides high on the back after wearing it so it is not in a “low back position”.
It is easier to carry backpacks slung over one shoulder by using only one strap. The one strap position puts all of the pressure on one side of the upper body leading to postural stresses that should be avoided in growing spines and muscles.
Regularly carrying a backpack on one shoulder may result in bad posture habits and strain the shoulders, back and neck. It may be stylish or easy to wear a backpack slung over one shoulder or riding low on the back, but that can lead to should pain and posture problems according to researchers from the University of San Diego, California School of Medicine. Everyone should take the time to use both straps and position the backpack high on the back, where it won’t sway with each step.
Wearing a backpack low on the back increases the pressure on the shoulders and the lower back and spine. This position may lead to shoulder and lower back strain that can result in lifelong awareness of pain.
Children’s loaded backpacks should weigh no more than 10% of total body weight, according to the American Academy of Orthopedics, overloading the pack puts unwanted strain on growing joints. Many of the kids in schools today carry a quarter of their body weight in the pack.
If the backpack has a waist strap, it should be used. Waist straps distribute the weight load to the hips, relieving shoulder pressure and alleviating body stress.
Loosening the shoulder straps makes it easier to put the backpack on and to take it off, but you should adjust the straps immediately, so it rides high on the back after wearing it so it is not in a “low back position”.
The low back position can lead to a forward postural lean or flexion at the waist. Bending at the waist places pressure on the lower back. It also causes extra pressure on the discs of the spine increasing the chances of causing disc issues.
Contrary to popular belief, it’s not just the weight of the backpack, but how it’s carried. “The pain generated is not just on the back. It includes the pressure on the skin, which causes nerve pain similar to that tingling sensation caused when a leg or arm falls asleep.
Research shows that even in the high back position recommended, pressure built up under the straps and could block blood flow.
One study used 10 healthy children age 12 to 14. When they walked wearing the backpack low on the back, the pressure was significantly higher than when wearing it correctly high on the back. Contact pressure was always higher on the right shoulder, no matter what position it was carried in. The researchers speculated that the youths altered their posture, raising the right shoulder, which could lead to posture problems and pain when made a regular habit.
Backpack Buying Tips:
- Make sure your child’s backpack weighs no more than 15percent of his or her body weight. A heavier backpack will cause your child to stoop forward in an attempt to support the additional weight.
- The backpack should never hang more than 4 inches below the waistline. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking.
- A backpack with individualized compartments helps position the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your child’s back, and try to place the heaviest items closet to the body.
- Bigger is not necessarily better. The more room there is in a backpack, the more your child will carry and the heavier the backpack will be.
- Urge your child to wear both shoulder straps. Lugging the backpack around by one strap can cause a disproportionate shift of weight to one side, leading to neck and muscle spasms, as well as low-back pain.
- Wide, padded straps are very important. Non-padded straps are uncomfortable, and can dig into your child’s shoulders.
- The shoulder straps should be adjustable so the backpack can be fitted to your child’s body. Straps that are too loose can cause the backpack to dangle uncomfortably and cause spinal misalignment and pain.
- If the backpack is still too heavy, talk to your child’s teacher. Ask if your child could leave the heaviest books at school, and bring home only lighter handout materials or workbooks. Ask the teacher for a set of text books to keep at home.
Kosta (Dino) Sotos DC DACO
ProMotion Spinal and Sports Rehabilitation
Over a life time we have all known someone who has twisted his or her ankle improperly stepping either walking or running or playing a sport. Whatever the activity predating the injury somewhere in the foot, a ligament was stretched, torn or ruptured. Further, depending on the resultant laxity, the degree or “grade” of the sprain is determined by a qualified doctor. A ligament connects bones at points that are in motion, better known as joints, without them our skeleton would simply be a bag of bones inside of our skin. Because ligaments are anchoring chords, they are thick and strong, and have almost no blood supply. If things don’t bleed, they really don’t heal well. They are literally tough cords, elastic enough to provide some give and flexibility but strong enough to resist instability. If they are overstretched, they themselves are protected by muscle reflexes, much like the reflex to sneeze when the nose is irritated by pepper.
When someone twists too far, there is a tug on the ligament that can result in a small sprain, or a large rupture. We have all heard that it is better to break it than to sprain it. Building bone is better than building ligaments, and the result is sturdier. Once stretched, ligaments cannot regain their previous shortened length and result at being unstable, even in the smallest sense of our understanding. This increased mobility at the joint allows for excessive wear and tear, known as repetitive micro trauma. Eventually this results in early degenerative changes at the joint or the surrounding joints.
Unstable joints are typically under diagnosed as “simple sprains”, however, over time, ligament laxity can cause years of chronic pain. They become frustrating to both patients and treating practitioners. They set up imbalances in movement that can lead to surrounding joint issues as well. Sometimes we carry these little aches and pains with us all our lives and dismiss them as normal.
A common result of ligament laxity in the adult foot is what we all know as flat foot. Some people experience plantar fasciitis as a result of flat feet. In most cases of flat foot, the heel will roll out, causing the foot to be in a pronated position. Typically, if there is an imbalance in the amount of pronation one suffers in the feet, left to right, other problems can arise, such as knee and hip and back issues. People tend not to relate the feet as the cause, over a lifetime.
Proper evaluation of the feet will assess symmetry and balance of the arches, a good shoe with support is the start, if support is inadequate, supportive custom orthotics are suggested and fitted. With proper support, the foot and ankle are allowed to maintain proper forces of impact and symmetrically balance the strike of the feet as they strike the earth. This further allows for relief in tension and stress.
In everyone, the feet are the foundation of contact to the earth. They propel, absorb and dissipate shock and at the same time allow for movement of the 33 joints and connection of 26 bones.
If injured, timely recovery and proper intervention are keys to good recovery and enhanced performance
At ProMotion Spinal and Sports Rehabilitation, we evaluate the mechanics of movement through gait video analysis and physical examination. Conservative orthopedic treatment options are then determined and applied returning patients to their most optimum ability. We are a privately owned rehabilitation facility that offer one on one management of injuries and have over 15 years of experience treating the communities of the North Shore. If you or someone you know has foot and ankle questions or any other orthopedic question, please contact us. We do offer free phone consultation for injuries or general question. 847-446-5420
With Good Health in Mind.
Kosta Sotos DC DACO
ProMotion Spinal and Sports Rehabilitation
300 S. Happ Rd. Northfield IL
