Patients are always asking me what type of bed or mattress is best for their backs. Up until now, I've been reluctant to recommend a particular make or design - they can often be incredibly expensive and people can get 'sucked in' by the sales pitch - and the best bed for one person may not be the ideal one for someone else. However, the British Chiropractic Association and one of the leading bed manufactures, Sealy Posturepedic, have finally got together to provide some advice...
First, a few facts and figures*: On average, we spend a third of our lives in bed. 58% of the population complain that they wake up feeling stiff and achey - anything but refreshed! 25% of people wouldn't consider changing their mattress - even if it is more than 10 years old. (*BCA and Sealy Posturepedic 2012)
Time for a change? So, when is the right time to consider changing your mattress? Generally, if it is more than 8-10 years old, uncomfortable, torn, discoloured and a bit 'manky' it could do with an update! If you can feel the springs or you feel it is less supportive than before, or you find yourself rolling into your partner, again it could indicate a need for something new. We should wake feeling rested and refreshed, so another indication is if you find it difficult to get comfy, or you wake up feeling stiff and achey in the morning (although it might be worth having a 'check-up' with the chiropractor too as it might be you, not your bed!).
So, what next?
Research it - ask your friends, find out the make and model of a comfy bed that you've slept on (I even phoned up and spoke to the manager of a hotel in Berlin to find out the specifications of a particularly comfy bed!), check out internet forums and blogs...
Choice - choose a reputable retailer that stocks a wide range of brands and mattress 'types' (foam, sprung, pillow-top etc) and make sure you get an informed opinion from an experienced salesman (Sealy Posturepedic have a wide variety of mattress types and do know what they're talking about!).
Try before you buy - Since you're going to be spending a large proportion of your life in bed, it's important to test out each mattress - lie on it for as long as possible, wriggle about, try getting in and out of it, take your other half with you and see how it works for the both of you. If you are a different size and shape from your partner, or you feel them wriggling about during the night, it might be worth getting two separate mattresses, as what suits them might not be right for you.
Go large - go for as big a bed as possible. This will allow you the freedom to move and wriggle about - important, as if you stay in any position for too long you'll stiffen up and put pressure on the joints, even if it feels comfortable initially.
Don't settle for second best - you don't have to spend a fortune, but a better quality mattress will tend to last longer, so may be a more economical option in the long run. A second-hand bed might be tempting - but remember that the springs and fillings will deteriorate with time, and there is the potential 'yuk-factor' of the previous owners' dust-mites and shedded skin cells...
Sleep Easy - make sure you lie in a comfy position, on your side or back, keep moving about, use a mattress 'topper' if you want a softer feel to a firm mattress and stretch gently before you leap out of bed in the morning.
For more advice check out my previous blog, or the BCA's website...
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.
Things are hotting up at the London 2012 Olympics. Only a few more days until the Opening Ceremony...
This week, the doors of the Athletes Village will open. Athletes and their support teams from 204 countries will start arriving. And, for the first time, chiropractors will be there!
Within the Athletes Village is the state of the art Polyclinic. Open 24 hours a day this multidisciplinary clinic is kitted out with some of the most sophisticated equipment in the country and staffed by highly skilled specialists - including, for the first time ever, chiropractors. It is expected that a high proportion of the anticipated 200 competitors visiting the polyclinic each day will be suffering from musculoskeletal injuries - sprains, strains, muscle injuries and joint pains - exactly the sort of problems that we chiropractors excel in treating. So, it is expected that the team of chiropractors are going to be kept busy, providing care from 7am - 11pm every day, with 24 hour emergency 'on-call' cover as well!
The state of the art Polyclinic in the Olympic Village
The team of chiropractors will be working alongside other musculoskeletal healthcare specialists - orthopaedic surgeons, neurologists, sports injury physicians - as well as other core services like dentistry, optometry, and physiotherapy. Together, this team of medical specialists will help to ensure that athletes are in their peak condition for this most important time in their sporting careers.
Richard Brown meets Lord Coe
Richard Brown, chiropractor and President of the British Chiropractic Association is one of the chiropractors who has taken time out of his busy practice and professional schedule to be treating the athletes. He had the opportunity to meet Lord Coe, Chairman of LOCOG, who voiced his support at the presence of chiropractors at the Olympics, and who said that his own career would have been far shorter, had it not been chiropractors.
Hopefully, Richard and the other chiropractors in the Polyclinic will be able to keep the competitors in tip top condition; here's hoping that they enable Jessica Ennis and a few of her fellow competitors to bring home some shiny medals...!
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...
Having spent much of the bank holiday weekend traipsing around furniture stores, I know that buying a bed can be a costly and time consuming exercise! However, since a poor night's rest can cost you precious sleep and precipitate back pain, it's important to get it right.
So, what's the best mattress?
The best mattress is a supportive one - this will differ for each person, depending on their size and shape. What's right for a 10 stone lady might not be right for her 16 stone husband.
And, how do I find the right one?
Ideally, your spine should be straight when you are lying, either on your side or your back. If your mattress sags or bows so will your spine, and this may cause aches and pains. Your neck is a continuation of your spine - and you should aim to keep this straight too when sleeping, so choose a supportive pillow that isn't too high or low (more on pillows at a later date...!)
There are several types of mattress, and again, it comes down to personal preference...
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.
A patient of mine, nearing the end of her treatment and rehabilitation phase, asked what was the quickest and easiest way to get fit. I suggested running. Personally I find it time and cost effective. No expensive gym membership, pricey equipment or time wasted getting there - I can dash home, sling on my trainers (it's worth investing in a decent pair) and can complete a 5 mile run, do some toning exercises, stretch out, shower and change inside an hour. Ok, so I've been doing it for a bit - but an article I read the other day in Runner's World magazine (June 2012 edition) sang the praises of squeezing in even 15 minutes of exercise every other day.
The article highlighted how just 15 minutes of exercise can be beneficial:
Here are a few easy ways to get started, even if you've never run before:
Obviously, running isn't for everyone, and sometimes our bodies limit what we can do. However, you can easily substitute intervals of fast walking/steady walking for the run/walk intervals, and will still see great results. Take it gently to start with, don't get too puffed out (you should still be able to talk!) and listen to any niggles that your body might have. If in doubt - just ask! I'm only a phone-call away...
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