Christmas time gives us all the opportunity to unwind, relax and catch-up with friends and family. Here at the Llangefni Chiropractic Clinic it's no different, although we've still got another week or so in clinic before we 'break up', and it's bound to be busy with everyone trying to come in and get sorted out this side of the festive period!
However, last week we were all able to get together and had an excellent evening out at local restaurant, Nant-yr-Odyn. It was a chance for us all to have a proper chat, away from the ringing phone and the hubbub of clinic, and to find out what we're all going to be up to over the Christmas break. So often, we barely say hello to each other, let alone have a proper conversation - once the first patient comes in the day just seems to whizz by!
It was also a chance for me to say a very big 'thank you' to all the reception staff. Without them, the clinic really wouldn't function. It has been said on many an occasion that a receptionist can make or break a clinic - they're the ones that speak to potential patients on the phone, and the first person that a patient meets on arriving at the clinic - and these first impressions last! They're also the ones that sit and chat with people when I'm running late, or have to deal with disgruntled patients who can't get an appointment when they want - and they have to put up with me on a busy day! So, it really was a pleasure to be able to express my gratitude to them.
And what about the previous lot?...
Carwyn is a Minister, working in and around Bala, but is also doing hospital chaplaincy between here and Wrexham. He's back and forth all the time, visiting his family here on Anglesey, as well as attending to his parishioners. He pops into clinic every now and then and keeps us entertained with tales of auditioning donkeys for the upcoming Nativity Play.
Evie is a teacher; she has taught English and Geography to at A level standard for several years, but has now specialised further and is working in a school specifically for children with learning difficulties and special needs. She got engaged earlier this year and is planning her wedding for sometime next year, blissfully happy in a little cottage nestled in the Welsh Borders.
Ceri has left Anglesey too; she married Steve, a soldier in the Royal Welsh, in July of this year and has moved with him (and the Regiment) to Wiltshire. She's adapting to life as an Army wife, but is hoping to continue her career in Law, or perhaps Social Work.
Sharon (sorry, no picture!) still helps out in clinic every now and then, but is taking a bit of time to focus on the non-stop project of her house renovation, and is concentrating on becoming a fully qualified Kennel Club trainer.
Hannah still helps out in clinic too, but is now working full-time as a fully qualified care assistant for adults with learning disabilities. She also teaches dance and drama, and helps out with the Rainbows. She's applied to University and hopes to be resuming her studies next autumn.
Olivia is enjoying time at home with her two little rascals - no doubt they're running riot at this time of year, awaiting the arrival of Father Christmas and his reindeer...
I really couldn't function in the Llangefni Chiropractic Clinic without my brilliant receptionists. They're the friendly face that greets people, the reassuring voice on the end of the phone and the competent professional that keep things running smoothly. The loyalty, commitment and friendship that they demonstrate both to the clinic, and to me, is second to none - and for that, I really can't thank them enough! I'm sure you'll share this sentiment...
With spring approaching, the days lengthening and the wintry sun gradually warming up the air, we're beginning to come out of 'hibernation'. We're generally getting a little more active - out into the garden, spring-cleaning, attacking that DIY project in the house, or taking a bit more exercise than we have during what seems to have been a long winter.
Despite our enthusiasm, it's important to take things gently at first, letting the muscles and joints warm up. Every Monday morning, the phone in the clinic rings non-stop, with people who have 'overdone it' in the house or garden at the weekend. Whilst some gentle exercise is generally good for the back, overexertion can cause problems.
Try to ease yourself into it - do some gentle stretches and warm up exercises first (marching on the spot, shrugging the shoulders, circling the arms) to get the blood circulating through the muscles, and pace yourself. Do lots of different jobs, changing your posture and position regularly, rather than concentrating on the one thing for too long. Listen to your body too - if something is niggling or painful, stop and don't be tempted to 'work through the pain' - it is your body telling you something isn't right. If the niggle persists, or worsens, phone the clinic and get advice!
A simple, 3-minute stretching exercise routine is Straighten Up that will keep the body supple and loose if practised regularly.
One of the things I love about my job is the great diversity of people that I see on a daily basis. Not only is it hugely satisfying to have the skills to be able to relieve someone's back or neck pain and watch them put their socks and shoes on and walk out of clinic when they have hobbled in, but I love the contact that I have with so many people from so many different walks of life.
In just one clinic I have had conversations about: holidays to Corfu; walking around Mont Blanc; the political and military situation in Afghanistan and Syria; sheep farming and the lambing season; the possibility of an extra silage harvest this soggy summer; the weather (where would we be without it?!); bereavement; Wimbledon (will Murray get to the finals this year?!); the unflattering cut of the Olympic Torch bearers' outfits; the risk of flying fast jets; the economy and whether Bob Diamond was right to resign; the bitter battle with cancer; diet, lifestyle and exercise regimes; gardening (including a great recipe for Raspberry Vodka!); the horrors and joys of childbirth; scuba diving; local crime and the Police's endeavours to deal with it; fishing; motor bikes and track days; and finally, nuclear fission (honestly!).
It is this interaction with my patients that keeps me going every day. It is my motivation for going to work each morning; not only do I have a responsibility to care for and treat my patients but I look forward to talking with them. It makes me a richer, more balanced person, and for that, I am grateful.
Taller than average? Wonder if tall people really suffer more with their backs? A recent study, published in the journal Spine* shows that tall people are at far greater risk of being hospitalised due to low back problems affecting the intervertebral discs.
*Wahlstrom et al. Risk factors for hospitalisation due to lumbar disc disease. Spine 2012 July 1;37(15):1334-1339
The study compared the incidence of back pain in over 260,000 construction workers over a period of 20 years. They found that taller people (190-199 cm; 6'3"-6'6") were 1.5 times more likely to be hospitalised due to lumbar disc disease than their shorter colleagues (170-179 cm; 5'7"-5'10").
These results are hardly surprising; tools and equipment are typically designed for those of 'average' height and build. Those at either end of the height spectrum find themselves having to use equipment that is not the ideal size for them which can cause extra strain on the spine.
Ideally, people should take time to find equipment that is the right size for them. Longer handled tools, raised worktops, properly adjusted seats and desks can help to prevent back pain. We chiropractors recognise that 'prevention is better than cure' and much of chiropractic care is about giving advice to help prevent back pain in the first place, as well as treating it.
Many of my patients spend a long time each day sat at a desk and I see a direct correlation with the amount of neck and back pain they suffer. Prolonged sitting can be detrimental to the health of the spine, and poor posture can exacerbate this. Not only can poor posture lead to back and neck pain, but it can be related to many 'repetitive strain' type injuries of the wrists, elbows, hands and shoulders.
Have a look at the picture below and see how it compares to your sitting position. Get someone to have a look at you when you're sitting and ask them to help you to adjust your seat accordingly. I've listed a few tips on how to sit properly, and hence minimise those aches and pains:
Feet - your feet need to be flat on the floor to provide a firm stable base for your spine and pelvis. If your legs are dangling it can place stress on your back and the legs will pull you forwards into an incorrect position. If you need to raise your chair up to be at the right height for the desk, use a foot rest (a shoebox will do!) to support them.
Legs - your knees need to be bent and ideally a little below the level of your hips. Using a wedge cushion will help you to achieve this posture; not only is it more comfortable but it helps to maintain the 'lumbar lordosis' - the healthy curve in the base of the spine. Make sure that the edge of the seat doesn't dig into the back of your knees. Don't sit with your legs crossed - this hinders the circulation and will distort the position of the pelvis and low back.
Bottom - Relax into the chair with your bottom right back in the seat, up against the seat back. This will allow the back of the chair to support your spine and improve your posture - ultimately reducing the risk of back pain. Don't perch on the edge of your seat, even for a few minutes, sit back in the chair and move the whole chair closer to the desk.
Back - make sure your whole spine is supported; your low back against the backrest of the chair (many have a 'lumbar roll' which will help) and your upper back should be straight, with your shoulder blades gently resting on the back rest. This will help to minimise upper back pain, neck stiffness and achey shoulders. (If you're a 'little' person and find that you can't sit in the seat with your back and bottom touching the back rest, then you might need to place a cushion behind you.)
Arms - your chair needs to be high enough so that your elbows are slightly bent and gently sloping down to your wrists (check that your feet still touch the floor if you've raised your seat up - if not, find that shoebox!). Your hands should relax gently onto the keyboard with a minimal bend at the wrist; don't rest your weight on your wrists. Incorrect hand and arm position can cause all sorts of problems! Make sure that your computer keyboard, mouse and screen are directly in front of you so you are not twisting the upper back or shoulders, and have them close enough to you so you don't have to stretch.
Head and Neck - make sure that your screen is directly in front of you so you don't have to twist. If you are copying from text then place it in front of you (blutak it to the screen and proof read later!). The monitor needs to be roughly an arms' length away and should be at eye level. This will mean that you don't have to move your head about to see the screen. If the monitor is too high or low then you will have to look either up or down for prolonged periods - this can strain the upper back, neck and shoulder muscles and might cause pain and stiffness. If you find yourself peering at the screen, or leaning forwards to read the text, then maybe get your eyes checked, rather than risking neck pain and headaches.
Keyboard and Mouse - make sure that these are close to your body and that you're not reaching out for them. Over-reaching for the mouse can cause prolonged strain on the whole arm and shoulder and seems to be one of the main causes for work-related upper limb pain. Use wireless ones if you can - it minimises the clutter on the desk and makes the mouse easier to move.
Desk - in order for your arms and wrists to be in the correct position on the keyboard and mouse, your desk should be about level with your tummy button. You might need to raise the height of your chair to achieve this, but don't leave your legs dangling... find your shoebox/foot rest!
Wriggle! - it is important to move about and change position regularly to relieve the pressure and strain on the body. Don't sit for more than 30-40 minutes; get up and walk around for a couple of minutes before sitting back down again (make sure you adopt the correct posture!). I suggest that patients stand up to answer the phone - there are whole offices in Anglesey with people bobbing up and down every five minutes (they're much less stiff and achey!). Remember 'face to face' time - go to see people down the corridor rather than using the internal email - make movement your friend (time away from the tedium of your desk has to be a good thing...!).
Phone - use a headset if you are on the phone for any length of time, particularly if you have to be writing or typing at the same time. Holding the phone under your chin will cause your neck to 'crick' and shoulder muscles to tighten up quickly - more neck and upper back pain!
Laptop Computers - the 'portability' of laptops makes them tempting to use in awkward positions. However, using them on your lap, particularly for more than a few minutes, can cause all sorts of problems - particularly with the neck and upper back. Make sure that you place your laptop on a desk or table, and adapt your sitting position accordingly to mimic a 'proper desk'. Place your laptop on a stand (a wedge of paper will do) to ensure the screen is at the right height, then adjust your seating position to match. As the keyboard is generally more compact on a laptop, it is worth using a wireless keyboard and mouse in order to prevent unnecessary hand and wrist strain. If you are using your laptop as a more permanent 'desktop' then plugging it in to a proper monitor and keyboard on a proper desk will help you to prevent the risk of back and neck pain.
It might seem a pain to have to check your chair and desk - but, believe me, it is definitely more of a pain when your back and neck seize up due to an incorrect position! Spend a bit of time to get it right the once, and make sure you check it (and yourself!) on a daily basis...
Living near an RAF base I get to see a lot of fast-jet pilots with stiff, sore necks and achey backs, the consequence of low-level sorties, 'dog-fighting', and pulling 'g'. Sadly, whilst I see a few 'mavericks', none of my patients quite resemble Tom Cruise (think long-johns, thermals, Snowdonia and rain not board-shorts, sunnies, Miramar and sun!). As patients go, the aircrew guys are perhaps some of the worst - late cancellations when a debrief over-runs, or postponing an appointment when the flying programme changes at the last minute.
However, after watching this awesome film, all is forgiven! You can't help but feel enormously proud and patriotic. Thanks guys. Fly safe :)
And, for those of you left wanting more, here's another one. Just to keep you smiling.
I'm sometimes something of a procrastinator. I dither about making decisions, particularly those bigger ones that might have a lasting effect, either at home, or at the Llangefni Chiropractic Clinic. It's something that I'm sure we all do, but I found a brilliant little snippet that I'm trying to apply to all those unmade decisions:
Ask yourself these three questions:
1. What's the best thing that could happen?
2. What's the worst thing that could happen?
3. What's the most likely thing to happen?
If you can live with the worst thing that could happen, and the most likely thing to happen will help you to achieve the things that you want, then, decision made! Go for it.
However, if the worst thing that could happen is totally unacceptable and the most likely thing to happen isn't going to help much, then again, decision made. Don't do it!
So, for instance, with respect to the recent refurbishment of the Llangefni Chiropractic Clinic.
What's the best thing that could happen? The clinic will be refurbished, quickly and on schedule, with minimal disruption, and will look amazing, be more inviting for patients and a nicer place to work in.
What's the worst thing that could happen? The work will take ages and ages and maybe cause the clinic to be uninhabitable, in which case I'd have to find alternative premises.
What's the most likely thing to happen? The work will over-run a little, be noisy, dusty and disruptive but we'll cope with it, and in the long run the clinic will benefit from the facelift.
Whilst I wasn't actually the one that had to make the decision about the building work, I did ask myself these questions regularly over the past five months when I felt I couldn't put up with any more noise and dust! I'm pleased to report that the building work is now nearly finished, and the Llangefni Chiropractic Clinic is looking an awful lot better...
Being a keen, (though somewhat weather dependent!) runner, I was grateful of the opportunity to spend a few minutes chatting with the members of Cybi Stryders yesterday evening.
The Cybi Stryders are a friendly, Anglesey running club. Based in Holyhead, they meet twice a week on Wednesdays and Sundays. The mid-week meet is for a short 5-6 mile run, usually in Menai Bridge, Holyhead, Bodedern or Llangefni and they go for a longer run on Sunday mornings - Newborough Forest, The Stacks, Rhoscolyn and sometimes even Snowdonia. The club is made up of a friendly bunch of people with mixed ability - slow plodders to faster, more elite competitive runners. Some go along just for the opportunity to go running with a few, like-minded people, whereas others use the club in order to help them train for specific events (some of them are running the Anglesey Half Marathon next weekend).
I went along just to say hello, and also to do a bit of promotion work for the Llangefni Chiropractic Clinic. Most people are well aware that chiropractors treat backs and necks, but there seems to be less understanding that most of us treat all sorts of problems with the other joints around the body. This includes common 'running' problems like plantar fasciitis, Achilles tendonitis, 'runner's knee' and problems with the iliotibial band. Often these specific ailments are related to 'biomechanical' issues elsewhere in the body - problems with the mechanics and movement of the pelvis or low back can upset the way that the hips, knees, ankles and foot function (remember the song 'the knee bone's connected to the thigh bone, the thigh bone's connected to the hip bone...'!?). We chiropractors are trained to treat the whole 'chain' of events in addition to the specific, localised problem and are also able to give the essential rehabilitative advice that will help to speed recovery and prevent future injury.
I enjoyed meeting the club members, and feel motivated to perhaps go along and join in with some of the runs. I'm always grateful of the opportunity to 'spread the word' about chiropractic, although as one of the members quite rightly pointed out, hopefully none of them will be needing to come along and see me in the clinic!
What better way to spend a wet, windy weekend than catching up on paperwork? And that's precisely what I've been doing - wrapped up in a snuggly jumper and armed with a large mug of tea.
People always wonder what I'm up to when I'm not in clinic seeing patients, easing their back ache, stiff neck and sore muscles. Much as I would dearly love to be at home, pottering about the garden, playing with Twiglet (our rabbit) or running on the beach, the job of being a chiropractor and running the Llangefni Chiropractic Clinic seems to be somewhat never ending! Or maybe I'm just inefficient, or perhaps a workaholic?!
One of the more time consuming activities is letter-writing. I like to communicate with each and every patient's GP (with the patient's permission, of course), to ensure that the GP is kept up to date with their chiropractic care. Obviously, there are also occasions when patients will require referral on to another healthcare professional for a second opinion. This letter writing also helps to build inter-professional relationships, and maintain the profile of chiropractic within the wider medical world.
In addition to this there is the work involved with my position on the British Chiropractic Association Council, and the 'business' side of running a chiropractic clinic. Then the ongoing reading to keep up with latest research findings and catching up with old colleagues to discuss useful techniques - or just to have a gossip!
So, that's probably why I'm finally getting around to writing this blog at 11pm, at the end of a productive rainy day. And yes, I did make sure I got up regularly for a wriggle and had a couple of walks, between the showers, for a bit of fresh air and exercise!
Eich Ceiropractydd yng Nghlinig Ceiropracteg Llangefnii