The end of the school holidays and the start of term needn't be such a pain in the neck - or the back.
I walked with my niece to her school the other day and was amazed at the weight of her school bag - not to mention her hockey stick, PE kit, packed lunch - and all the other stuff that she needed for the day. It's not surprising then that back pain is on the increase in our youngsters, but a few simple tips can make the start of term a bit less painful...
• Bag it up - a rucksack really is the best option, as long as your child carries it over both shoulders, with the straps are adjusted so that the bag is held close to their back and heavier items are placed at the top of the rucksack. They'll probably hate you for it now, making them look like a nerdy swot, but they'll thank you for it later in life when they haven't got such a sore back!
• Keep it light - your child should avoid carrying any excess weight in their bag – check it every day to make sure they aren’t carrying any unnecessary items. Encourage the school to provide lockers so that they don't have to carry all their heavy books around all the time.
• Best foot forward - wearing good, soft-soled shoes that are supportive and have a good grip on the ground will make carrying a heavy bag much easier. Ensure shoes laces are tied up properly for support (again, much cooler to have them undone, socks around the ankles - but just remind them that it's much less cool to have a broken ankle!).
• Move around - staying still for a long time is bad for the spine. Limit your child to 40 minutes on their phone, laptop, tablet, and computer or in front of the TV then encourage them to get up and do something else for a while. Hint - Hide the remote control so they have to get up to change channel.
• Keep fit - Regular and frequent exercise is best - the fitter they are, the less likely they are to injure themselves. Drag them out at the weekends or make the most of this late summer sunshine and head out after school. Encourage them to take up a new sport or active hobby. Exercise is good for us grown-ups too - set a good example and get out there! Ditch the car and walk or cycle them to school - and then carry on to work.
These few simple tips can help to make things more comfortable and reduce the risk of back and neck pain. Ultimately, this'll hopefully make for a happier, healthier child (certainly less whingy!).
Have you ever watched an animal as it prepares to settle down for a nap? Or seen what it does on waking? It stretches. OK, so it might have a bit of a wash too, or circle the ground a few times (apparently dogs do this from their 'wild days' when they would flat down a circle of grass to make a comfy bed), but it will always take time to stretch.
This is one of the many things that we humans have forgotten to do as we've evolved, but stretching regularly is really useful - it eases out the joints, loosens the muscles and helps the circulation.
One of my favourite stretches is the Cat Stretch; it's quick and easy to do and loosens up the entire back, stretching out all the long muscles that run parallel to the spine and mobilising all the little joints between each vertebra. I encourage most of my patients to do it every day, morning and evening - those that do generally feeler looser and easier with less stiffness and fewer aches and pains.
The Cat Stretch
Start off on all fours, hands below your shoulders, knees below your hips. Make sure you're evenly balanced, keep your arms straight and strong and draw your belly button in towards you spine so your tummy doesn't 'sag' down to the floor.
Gently arch your back, pushing your rib cage up to the ceiling, tucking your chin to your chest and your bottom underneath you (think of a dog tucking its tail between its legs!). Hold for a count of three, then gently lower back down to the starting position.
Don't be tempted to arch the other way, sagging in the middle and sticking your bottom and head out, as this can over-arch the lower back and jam all the joints together - keep your back flat with your tummy muscles gently supporting your spine.
Repeat this whole sequence 10 times or so, and do it every morning when you're getting up and last thing before bed. It only takes a couple of minutes and will really help to keep the spine healthy - a bit like cleaning your teeth twice a day keeps your teeth healthy!
Sore knees? You can easily do this kneeling on your bed or on a couple of cushions. If it's still too much for your knees then you can do a 'half cat' - stand facing a wall, place your hands on the wall at shoulder height with your knees slightly bent and gently arch your back. Repeat 10 times, morning and evening.
Obviously, if you find this stretch uncomfortable, painful or difficult to do, please be sensible and don't do it! Email me, or give me a call and we can work out what the problem is.
We all know that good posture can not only improve your posture, but improve your overall appearance. We know too that standing up tall, with our tummies in, head held high and shoulders back makes you feel much better and look fantastic - taller, slimmer and generally poised - and can minimise back and neck pain.
Ideally, we'd all have the strength and discipline(!) to maintain our own posture, but finally, help is at hand. M&S and the British Chiropractic Association have joined forces and come up with the 'Perfect Poise' TM range of lingerie, a 3 piece range cleverly designed to support and improve your posture.
“The Perfect Poise TM range of bras, knickers and shapewear has been specifically designed to increase the wearer's awareness of correct posture by supporting them in key areas. The bra and body incorporate a patent pending supportive back panel and seam-free cups for a smooth silhouette.” Paschal Little, Head of Innovation, M&S Lingerie.
The bra and body use hidden back panels to encourage the wearer to keep their shoulders back and the high waisted knickers have an in-built lower back panel which encourages body alignment. They also slim and smooth the tummy to give a more flattened appearance!
Independent trials by M&S showed that 87% of the women who tried the undies felt that the products supported their back and the national press have followed the story - although recent reviews do say that they need to increase the cup-size range (currently 34B - 40E, sizes 8 - 22) to accommodate everyone.
‘"Perfect Poise TM lingerie has been designed with the modern woman in mind. Our contemporary aesthetic combines graphic sheer and opaque panels to create sculpted, sleek pieces which are discreet under clothing.’’ Soozie Jenkinson, Head of Lingerie Design, M&S.
I'm tempted to try them myself but regrettably require something a little smaller(!), but would love feedback from anyone who's tried them...
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.
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...
A debate has been published today in the British Medical Journal (8 June 2012), questioning the safety of neck manipulation. The story has been picked up by a number of national newspapers, and has been discussed on live radio and television programmes. Regrettably, many of these focus on the negative, so often the case with sensationalist journalism. I hope that I will be able to provide a more realistic, accurate and balanced view.
Neck manipulation has been shown to be safe and effective and benefits thousands of people suffering from neck pain and headaches. In fact, the risk of a stroke after treatment is the same whether you see a GP and get a prescription, or see a chiropractor and get your neck adjusted. (http://www.ncbi.nlm.nih.gov/pubmed/18204390)
Manipulation of the neck is at least as effective as other medical treatments and is safer than many of the drugs used to treat similar conditions. (http://www.ncbi.nlm.nih.gov/pubmed/17258728)
The term chiropractic is often mis-used for treatment carried out by non-chiropractors. This leads to over-reporting of incidents blamed on chiropractors, including in the BMJ. In one report of 24 cases attributed to chiropractors, not one was shown to be a chiropractor. (http://chiromt.com/content/14/1/16#B21)
Chiropractors are highly trained in spinal care and manipulation. In one UK study undertaken in 2007, of 50,000 neck treatments reviewed, not one single adverse event was reported. (http://www.ncbi.nlm.nih.gov/pubmed/17906581)
The cherry-picking of poor quality research needlessly raises alarm in patients and does little to help people suffering from neck pain and headaches to choose the most appropriate treatment.
I hope that this has allayed any fears or worries about the safety and efficacy of spinal manipulation when carried out by a trained, professional pair of hands. However, should you have any further concerns or queries - please, just ask!
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.
Ever pulled a sicky? Wonder how many other people do? According to a recent study published by the Office of National Statistics it's quite a lot of us:
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