Whiplash Part 2 – What factors make it worse and when do you start to feel it?

Whiplash iStock_neckpain(3)Last newsletter we introduced the topic of Whiplash Injuries – what it is, and what it feels like. This newsletter we cover the various factors that can influence the severity of the injury.

Whiplash injuries are the most common injury to arise out of rear-end collisions, although they can also occur during other activities such as certain sports – most commonly snowboarding (well, perhaps not with this year’s snow conditions!). Nearly 200 rear-end collisions happen each day in British Columbia alone. Whiplash injuries account for more than 65% of all bodily injury claims (Navan et al., 2000).

When do you start to feel the symptoms?

The answer is not that straightforward. We do know that generally the earlier the symptoms occur, the more severe damage tends to be. However, it is common for symptoms to be delayed for days, weeks, or even months after an injury occurs. Unfortunately, this leaves patients believing that they have not been injured when in fact they have. For these reason, it is very important for person involved in a collision to be examined by their doctor as soon as possible following the crash.

Factors that determine the Severity of the Injury:

  • Your position in the car (front seat, back seat, etc.)
  • Your age
  • The length of your neck and weight of your head
  • Whether you were using the seat belts/shoulder harness, headrest positioning
  • If you were prepared for the impact
  • Your head and body position at the moment of impact
  • The make and model of your car along with any special safety features it may be equipped with
  • The size and speed of the vehicle that you were travelling in
  • The size and speed of the vehicle that collided with your vehicle
  • Whether there were subsequent collisions with other vehicles
  • The direction of the impact
  • How soon after the collision that you experienced symptoms
  • Whether your seat back collapsed
  • Your health prior to the collision such as pre-existing injuries or conditions such as arthritis

Numerous studies show that many whiplash victims have a relatively poor outcome without immediate and appropriate treatment. One such study found that 75% of patients with whiplash still suffer from symptoms 6 months after the accident. Experts agree that individuals with any degree of neck complaints following a motor vehicle accident dramatically improve their prognosis if they seek immediate evaluation and appropriate treatment within hours of the accident.

Next Newsletter: How is Whiplash diagnosed? AND What is the best treatment?

Chiropractors are well- known for helping patients overcome the injuries in whiplash – and not just for the relief of pain, but for maximum restoration of lost function. If you’ve been in an accident and think you think you might have whiplash, no matter how minor, schedule a chiropractic appointment. You’ll be glad you did!

~DR. G

Whiplash – What Happens and How? (Part 1)

The topic of Whiplash is a serious issue. There probably is not one injury in Musculoskeletal Medicine that hasn’t been studied and researched more than this topic. This is partly due not only to the significant impact it can have on one’s life – their family, relationships, leisure time activities, and their job, but also the fact that not everyone recovers 100% from this injury. This means it can have a lasting impact on their lives and their finances with the present and ongoing cost managing this injury. This topic will cover the next three emails with three parts:

PWhiplash2art 1:  What is Whiplash? What does it feel like?
Part 2: How soon do you feel it? What are the factors that determine how bad it can be?
Part 3: How do your Diagnose it? What is the most effective Treatment?

This is the first part:

What is Whiplash and how does it happen?

A whiplash neck injury is the involuntary thrust of the head in any direction. The resulting recoil of the head and neck in the opposite direction injures the surrounding and supporting tissues. Symptoms may not start immediately. Often neck soreness may occur, then disappear and be followed later by head, neck and arm symptoms.

The most common cause of Whiplash is automobile collisions. However, a quick jerk, a violent blow to the head or chin, or any kind of fall causing sudden forceful movement of the head and neck is also common. Sports injuries involving collisions or contact such as a tricky fall in football or a wicked cross check in hockey can create a whiplash injury. Diving injuries and snowboard wipeouts frequently cause whiplash.

The forces causing whiplash may result in concussion, bruising or tearing to the soft tissues, and may produce strains, sprains, subluxations (vertebral misalignments), and dislocations. Joint injuries are common, and in severe cases, fractures may occur.

If someone suffers a whiplash injury, what symptoms could they expect to feel, and how soon will they feel them?

Patients with whiplash type injuries commonly have any of the symptoms, which is only a partial list:

  • Neck pain
  • Headaches
  • Fatigue
  • Shoulder pain
  • Anxiety
  • Pain between the shoulder blades
  • Low back pain
  • Sleep disturbances
  • Sensation changes in their arm(s)
  • Arm pain or weakness

Pressure on the spinal nerves as they exit from between the neck vertebrae is a very common cause of many of these symptoms. This may lead to headaches upper back and arm pain, numbness, tingling and burning of the arm/hand.

Other seemingly unrelated symptoms such as:

  • Moodiness/Depression
  • Difficulty swallowing
  • Dizziness t Forgetfulness
  • Blurred Vision
  • Ringing in the ears
  • Jaw/face pain may also be related to the injury

Next Newsletter: How soon do you feel the injuries? And What factors can make the injuries worse?

Chiropractors are well- known for helping patients overcome the injuries in whiplash – and not just for the relief of pain, but for maximum restoration of lost function. If you’ve been in an accident and think you think you might have whiplash, no matter how minor, schedule a chiropractic appointment. You’ll be glad you did!

~DR. G



Is the Glamour Worth the Pain?

High Heels2You’re all dressed up and ready to go out to work. Or a night on the town. Or on a fancy dinner date. And you’re wearing the one accessory that pulls the entire look together – your high heels that give you that long, lean, leggy look. Nice. However, at what cost to your health?

The wearing of high-heeled shoes is a prime example of women inviting foot problems. Doctors of podiatric medicine see no value in high heels (generally defined as pumps with heels of more than two inches). They believe them to be biomechanically and orthopedically unsound, citing medical, postural, and safety faults of such heels.

They know, for example, that high heels may contribute to knee and back problems, disabling injuries in falls, shortened calf muscles, and an awkward, unnatural gait. In time, high heels may cause enough changes in the feet to impair their proper function. Most women admit high heels make their feet hurt, but they tolerate the discomfort in order to look taller, stylish, and more professional. In a Gallup Poll, 37 percent of the women surveyed said they would continue to wear high heels, even though they did not think them comfortable.”

Heels force the thigh muscles to work harder, putting extra strain on the knee joint and tendon that runs from the knee cap to the thigh bone. Compared with walking barefoot, high heels increase the pressure on the inside of the knee by 26 percent. Over time, this increased pressure on the knee can lead to osteoarthritis.”

Osteoarthritis is the most common form of arthritis, and it’s twice as common in women. “The use of heels is a likely reason,” Kerrigan speculates.  “Just wear flats,” Harvard researcher D. Casey Kerrigan, MD, an associate professor of physical medicine and rehabilitation, tells WebMD. “I am strongly against wearing heels at all,” says Kerrigan, who never wears them.” Throw them out,” she says, adding that women shouldn’t be victims of fashion.

And what about back pain? Think about it, high heels tilt your entire foot forward, increasing the normal forward curve of your back and causing your pelvis to tilt forward. Essentially, wearing high heels throws your entire body off its center of gravity and, therefore, off balance. Think of the long-term effect this has on your body if you wear heels to work each day and then go out at night!High Heels9

“According to the American Orthopaedic Foot and Ankle Society, people take an average of 10,000 steps a day. High heels shift the force of each of those steps so that the most pressure ends up on the ball of the foot and on the bones at the base of the toes. (If you wear flats, the entire foot would absorb this impact.) A 3-inch heel — most experts consider a heel “high” at 2 inches or more — creates three to six times more stress on the front of the foot than a shoe with a modest one-inch heel.

As a result, heels can lead to bunions, heel pain, toe deformities, shortened Achilles tendons, and trapped nerves. In fact, women account for about 90% of the nearly 800,000 operations each year for bunions, hammertoes (a permanent deformity of the toe joint in which the toe bends up slightly and then curls downward, resting on its tip), and trapped nerves, and most of these surgeries can be linked back to their high-heeled shoe choice.

The problems can travel upward, too. The ankle, knee, and hip joints can all suffer from your footwear preferences. When you walk in flats, the muscles of the leg and thigh have an opportunity to contract as well as to stretch out. However, when wearing your high-heeled shoes, the foot is held in a downward position as you walk. This keeps the knee, hip, and low back in a somewhat flexed position, which prevents the muscles that cross the backside of these joints to stretch out as they normally would. Over time, this can lead to stiffness, pain, and injury. High heels can also cause lower back strain, because the heel causes your body to pitch forward more than normal, putting excess pressure on the back.”

High Heels3Dr. Gerard Clum, president of Life West College of Chiropractic and spokesperson for the Foundation for Chiropractic Progress, states that the “dangers associated with wearing high heels affect the entire body, particularly the knee, hip, and back. The abnormal weight-bearing and stressful posture induced by high heels can strain both the low back and the neck, not to mention the foot, ankle and knee.”

The Foundation for Chiropractic Progress has issued the following recommendations for women who wear high heels:

• Don’t wear high heels more than two hours a day. If you must wear heels, carry a pair of flat shoes to change into.

• Compromise heel height to less than two inches.

• Walk to work in your running shoes and change into your heels at work.

• If the increase in height is what you are after, try using platforms.

• Choose a shoe with a wider toe box (as opposed to a pointed toe), and one with padding across the ball of the foot. The positioning of the heel should be more towards the back of the heel which adds more stability as opposed to oriented towards the middle of the foot.

• If you are planning to be more active when you are heading out for the night, such as dancing or walking, plan your shoes accordingly.

If you’ve been wearing heels for years, you’ve probably already experienced some of their negative effects such as back or neck pain, joint pain or foot problems, Chiropractic care can certainly help to address some of the detrimental spinal effects of wearing high heels.  But, if you really want to make a difference, then the rest is up to you.

Chiropractors are well- known for helping patients overcome the problems and pain associated with wearing high heels. Start with calling our office to schedule yourself, or someone you know, in for a check up appointment to see what treatment options are available to you. You’ll be glad you did!

Pillow Talk

Quality sleep is an elusive commodity for millions. Statistics indicate that more than 130 million North Americans have trouble sleeping, which can impact your physical and mental health. The complex process of attaining a quality sleep pattern can be compromised by a number of factors that you may or may not have even considered. One such factor is simply the wrong pillow. If you think of the time we spend in contact with our pillow, you would surely be amazed. You might want to think twice before going out and spending more money without getting some real insight on what we are laying our heads down on each night.

The following describes some of the characteristics and considerations when picking a pillow that is right for you.

 What is your sleeping style?

 Your sleeping style isn’t as complicated as it sounds. It is simply the manner in which you normally sleep – how you typically arrange yourself and your body when preparing for sleep. Do you lie on your back, side or your stomach when you sleep? Or, do you toss, turn and change positions frequently during the night? Since pillows are not created equally, different pillows cater to varying styles of sleeping. Understanding how you usually sleep will help you select the best pillow to help you to enjoy restful nights.

If you’re not sure what your sleeping style is, pay attention to the position you are in when you fall asleep, and then again when you wake up. Are you in the same position, or has it changed? The position in which you find yourself most frequently is your sleep style.

A Good Pillow is designed to keep the spine in natural alignment.

The human neck has a slight inward curve called a cervical lordosis which is designed to sustain the weight of the head when upright and provide shock absorbency. It is very important to maintain and support this curve when in a resting position. If the height of the pillow is too high when sleeping sideways or on the back, the neck is bent abnormally forward or to the side, causing muscle strain on the back of the neck and shoulders. This type of position may also cause narrowing of the air pipe, resulting in obstructed breathing, and sometimes snoring, which can hinder sleep. Conversely, if the height of the pillow is too low, the neck muscles can also be strained.

A good pillow will support the skull and neck without applying undue pressure, as it conforms to and supports the exact shape of the sleeper and our normal alignment, thus spreading the weight evenly and uniformly along the vertebrae. Based on the body’s measurements and personal preference, the pillow should maintain a height of 4 to 6 inches, properly supporting the head and neck (and shoulders when lying on back).

A Pillow must feel comfortable.

A large part of what makes a good pillow is personal preference. If the pillow feels comfortable, it is likely to help one relax, get a good night’s sleep, and feel well rested in the morning. The pillow’s surface can also be a source of comfort – some people prefer a pillowcase with a cool, smooth feeling (such as cotton), some prefer warmth (such as flannel), etc.  The softness of the pillow is a personal preference to consider. However, the pillow should not be too soft that it does not provide adequate support.

A Pillow should be a custom fit and adjustable.

To help the pillow conform to various sleep positions, it is best if the pillow can be adjusted to fit the unique shape and curves and sleeping position of the user. A pillow should mold to one’s individual shape and alleviate any pressure points. Many quality pillows will also come in various sizes to accommodate for different size people.

There are many different types of custom designed pillows to choose from and below are a couple of popular types that we recommend and keep in stock at our clinic. For those who are allergy sufferers or concern about the materials, check to make sure the pillow is Hypo-allergenic.

Foam/Polyester Fill Pillows

Foam pillows are typically filled with a synthetic material, most popularly polyester, and makes for a firm, long lasting pillow. Devotees of the foam pillow often scoff at a down or feather pillow, accusing them of being too squishy to be comfortable. Again, this comes down to personal taste, but if you are looking for a very sturdy, firm pillow, you’ll want to investigate the foam pillow.

Memory Foam Pillows

The original and memory foam pillow is made by Tempurpedic. Many companies now produce equal quality memory foam pillows and they have gained in worldwide popularity for its softness and comfort. Memory foam is designed to remember the contours of your body, providing support exactly where your body needs it.

These types of pillows have fans as well as detractors, and again, the choice comes down to a largely personal preference. Memory foam material is certainly very different; the pillow is “squishy” and doesn’t bounce back quickly, but instead holds the shape of your head and neck. When you shift positions, it takes a few seconds for the pillow to rebound and readjust to your new position. The most popular type of memory foam pillow builds in a ridge of neck support, making it great for many back sleepers. Some people absolutely love these pillows, while others have a very hard time getting used to the feel of them.

Pillows for each sleep position.

One’s sleep position will dictate how a custom pillow can be used to provide the appropriate support.  

Using a pillow while sleeping on one’s back. When lying on the back, a pillow should support the natural curvature of the cervical spine, with adequate support under the head, neck, and shoulders. When sleeping on the back, the height of the pillow should be lower than in the sideways position. Placing a pillow or two beneath the knees further alleviates any back strain, and is the gentlest position on the back. 

Using a pillow while sleeping on one’s side. When lying on one’s side, a pillow should support the head and neck such that the spine maintains a straight and natural horizontal line. Weight should be evenly distributed so as not to create unnatural bending or pressure. Some people may prefer placing a small pillow or rolled up towel under their waist while lying on the side for additional support.

Using a pillow while sleeping on one’s stomach. If sleeping or resting on the stomach is preferred, the pillow should be relatively flat, or the head should rest directly on the mattress, so that the head and neck aren’t turned unnaturally to either side. In this position, it is often best to place another relatively flat pillow under the stomach to help the spine keep its natural alignment.

Over time, cotton filled pillows will begin to lose their firmness and no longer support the neck adequately. The pillows that we recommend do not have such a problem and therefore, last a very long time

When using a cervical support pillow, most people experience an increase in sleeping comfort within a couple of days. Other, however, may require up to two weeks before the neck and back muscles adjust.

Chiropractors are well- known for helping patients overcome the problems and pain associated neck problems including making the right pillow recommendations. Start with calling our office to schedule yourself, or someone you know, in for a check up appointment to see what treatment options are available to you. You’ll be glad you did!

You’re Never Too Old To Become Young Again!

When I first graduated from Chiropractic College, my dad with his usual helpful wisdom, suggested to me that I should move to Victoria and set up practice. “There’s lots of retired people there, and seniors love Chiropractors”, he proclaimed.

What is it that seniors know that a lot of their younger counterparts seem to miss? And how exactly does regular chiropractic care help them?

A three year study published in Topics in Clinical Chiropractic in 1996 examined senior citizens over the age of 75 years of age and revealed that seniors who receive regular chiropractic care experienced the following:

  •  Chiropractic patients spend 15% less time in nursing homes and 21% less time in hospitals than the non-chiropractic patients
  • Report “better overall health” on quality of life surveys (87% of seniors under chiropractic care described their health as “excellent” or “good”, compared to only 65% of non-chiropractic patients)
  • Have fewer chronic conditions
  • Were less likely to utilize prescription drugs than non-chiropractic patients
  • Were more likely to exercise vigorously and be active in the community

As the population ages, more people more people are consulting doctors of chiropractic, especially in their later years. As we live longer there are growing concerns about over-medication and the side effects of combining various prescription drugs. Safe natural chiropractic care is growing in popularity.  Restoring proper nerve and spinal function can help improve mobility, vitality, and endurance, and therefore the quality of your life.

Is chiropractic care only good for seniors? As I once heard an investment banker speak about savings plans, “the best time to start saving would have been 20 years ago, but the second best time is now.”  The same goes for your health. Experiencing the health benefits of chiropractic care now will also provide benefits for your enjoyment of your life in your later years.

Most Frequent Benefits Regular Chiropractic Care provides for Seniors

1. Pain Relief

Chiropractic care is one of the most effective and safest forms of health care to treat pain due to spinal related conditions. Chiropractic is so effective because most causes of spinal disorders are related to abnormalities of the spine and the surrounding soft tissue structures.

2. Increased Range of Motion of the Spine and Extremities

Chiropractic care has been shown repeatedly to increase not only the range of motion of the spine but also in the extremities. Increasing a person’s range of motion can positively and drastically affect lives in many ways. For some, an increased range of motion means being able to bend down to pick up their grandchildren. For others, it means they can garden without pain or get an extra 40 yards of distance out of their driver on the golf course. In many cases, an increase in range of motion immediately follows chiropractic adjustments. This is one of the reasons why many top professional sporting teams have team chiropractors.

3. Increased Balance and Coordination

Many problems in balance and coordination in the aging population have been shown to come from injury or degenerative changes to the cervical spine (neck region). Structures known as mechanoreceptors are located in the posterior (back) joints of the cervical spine and are responsible for providing the brain with essential information important for balance and coordination.

4. Decreased Joint Degeneration

A subluxated (misaligned) spine is much like a misaligned wheel on an automobile. This misalignment will cause the spine (and the wheel) to wear out prematurely. Since all moving parts will eventually wear down over time, it is very important to get your spine aligned periodically. Chiropractic care decreases spinal degeneration and other arthritic changes by normalizing the spinal alignment and reducing spinal stress.

5. Increased Health and Well-Being

We commonly ask our patients what changes they notice once they are put of pain. Here are some regular responses we hear every day:

I feel great!

I can sleep through the night!

Now I can play in the garden!

I have so much energy!

Life is worth living now!

Yes, chiropractic is far more than mere pain relief. Feeling good, staying healthy and doing the things that make us happy are what keeps us looking forward to each new day. Regular chiropractic care increase the quality of life and increase health and well-being.

6. Decreased Incidence of Falling

Injuries due to falling are extremely common in the elderly population. According to the Centers for Disease Control and Prevention (CDC), falls are responsible for 90% of the 850,000 bone fractures which occur annually among Americans past the age of 65. Chiropractors reduce the risk of falls by normalizing the mechanoreceptors of the cervical spine by administering chiropractic adjustments. They also prescribe stretching and exercise programs to increase strength, flexibility, mobility, balance and coordination.

Start with calling our office to schedule yourself, or someone you know, in for a check-up appointment to see what treatment options are available to you.

Don’t Be Caught Flat-Footed!

Yaletown Orthotics

Pes Planus is a general medical term used to describe the flat-footed condition. It is also referred to as pesplanovalgus, fallen arches, and over pronation.You may have noticed a family member or friend when they take off their shoes and socks, that their feet may tend to “widen” when standing and bare, as they are no longer supported by a shoe. The medial arch in one or both feet becomes unsupportive, resulting in the affected foot (feet) to be flat, especially during any weight-bearing activity. Adult Pes Planus affects many men and women throughout the world, and can result in foot, ankle, knee, hip, or spinal discomfort as well as increase the chances of injury. This can be corrected with proper foot wear and custom foot orthotics.

What is a “flat foot”?

A true flat foot is very rare with an estimated prevalence of only 1.8% of the adult population. This condition is referred to as rigid pes planus, whereby the foot is completely flat even during non-weight bearing. Rigid pes planus is a pathologic condition and often occurs in conjunction with an underlying disease.

Flexible (or functional) pes planus is a biomechanical problem experienced by a surprisingly high percentage of the population (up to 20% of the population). In this case the arch will appear normal when the person is sitting (i.e. not bearing weight).  However with the person standing upright you will be unable to place an index finger under the arch. The entire bottom of the bare foot is in contact with the floor or ground surface during standing, walking, and other weight bearing activities.

Flexible pes planus can be caused by ligament or tendon laxity, and severe excess subtalar (ankle) joint pronation, which leads to excessive calcaneal (heel bone) eversion during the contact phase of gait. This lack of arch support causes the feet to flatten, creating an unstable position for the ankles, and inward rotation of the knees. This inward rotation can also affect the hip joint, sacroiliac joint, and even change the alignment of the spine. In each of these areas, the resulting improper biomechanics can be silent or commonly result in ankle, knee, hip and lower back pain. I have even seen alignment changes as high as the cervical spine (neck) from improper foot alignment. This is why a proper examination of anyone with spinal, pelvic, hip or knee complaints should always include an assessment of the feet!

If left uncorrected, this condition can lead to other painful foot conditions such as plantar fasciitis (inflammation of the bottom of the feet), hallux valgus (bunions) and arthritic changes to various joints.

Although this condition doesn’t cause pain to everyone with flat feet, it can be a problem during exercise, a change in job environment, or when walking. What the literature tells us about the flat foot and how it relates to pathology is telling. Research has shown that an increase in plantar surface contact area, associated with pes planus can be a risk factor for the development of overuse injuries and increase the risk of injuries in sports.

Pediatric pes planus is a normal condition in infancy. The arch develops gradually during childhood. Thus, pes planus is normal in infants, common in children, and often present in adults. Its prevalence decreases with age. Commonly, by the age of 5-6 years old, children should have developed a visible arch.

How do we determine if you have Flat Feet?

A simple test is to put slide your index finger under the medial arch of your foot. You should be able to slide your finger in to at least the first finger joint.

People with flat feet will often also notice that footwear may be worn unevenly.

Click on the Picture to watch a Video on the FootMaxx System

Click on this Picture to Watch a Video on the FootMaxx System

What’s more important is to see how your flat feet affect your biomechanics. At our office we perform a Digital Gait Analysis. This involves walking across a computerized pressure pad which measures the timing of various important biomechanical markers of your feet in speeds up to 60 frames per second, which is much faster than the human eye. It can show us how various bones move, the pressure in various parts of your feet throughout the gait cycle and the appropriate timing of your feet relative to normal. This will help us to discover any biomechanical abnormalities that may be putting undue stresses on your feet and alignment of your spine such as flat feet. The information obtained can also help us to design custom foot orthotics if necessary.

How do we fix Flat Feet?

Doctors can help patients overcome this painful condition with conservative treatment:

Footmaxx Orthotics

Foot orthotics allow the muscles, tendons and bones of the feet and lower legs to function at their highest potential. When appropriately prescribed, orthotics can decrease pain, not only in the foot, but in other parts of the body such as the knee, hip and lower back. They can also increase stability in an unstable joint, prevent a deformed foot from developing additional problems, correct improper biomechanics and improve overall quality of life. For athletes this can mean improvement in performance and decreasing the chance of injury.

The FootMaxx orthotics that are often prescribed are custom-made for your feet, sport-specific to your activities and designed to accommodate for different shoe types.

Often people will have Extended Health Insurance benefits that cover the cost of orthotics. Please check your individual health benefits package.

To learn more about custom-made foot orthotics, please click on the following link.


Adequate Footwear

Footwear is a major player in treatment for patients with flat feet. Flat footwear such as shoes without arch support and flip flops only add to the problem. People with flat feet should wear spacious footwear that is comfortable and provides adequate support from the foot bed.


If you believe that you, or someone you know, may have flat feet, call the office today to schedule a check-up appointment, and foot examination and find out what treatment options are available to you.

~ Dr. Gertz

The information contained in these newsletters is designed to provide general information and to promote greater health. Every individual should seek the advice of their chiropractor or healthcare provider for diagnosis and advice before changing or adding any product or treatment to their health regime.

Do You Have Text Neck?

The need for chiropractic care has significantly increased with advances in mobile technology and the reality that the public is constantly “connected”. About three years ago I started to notice more and more people coming to my office with similar complaints. They all had neck pain, headaches, shoulder pain, and sometimes numbness or tingling into the arms. In some instances I would walk into the room at the second visit to give my report of findings and review the patient’s x-rays only to find them buried in their blackberry or iPhone, head flexed forward texting and straining to see the screen. “So Doc, tell me, why is my neck so sore?”

At younger and younger ages, I am seeing a reversed cervical (neck) curve with mild degenerative changes. In other words, spinal damage is occurring in patients much too young to be experiencing these bony changes.

In many patients, these hand-held devices are their primary mode of communication. These days, people are constantly “connected” to their hand-held devices whether it is their cell phones, portable video games like Nintendo, e-readers or using apps on their iPhones. A Kaiser Family Foundation survey found that young people 8-18 years old spend in excess of seven-and-a-half hours per day using some form of mobile media. As a result, this younger demographic will surely be presenting to chiropractic offices with more forward head posture (FHP) and subsequent conditions.

Look around you and you will see people with forward head posture using hand-held mobile devices at tables in restaurants, hockey games, red lights in their cars, walking through mall, in line at the grocery store and even sitting in my exam rooms!

Chiropractors frequently conduct screenings to educate the public on the importance of good posture and explain how poor posture negatively affects the body’s ability to function. If a patient has FHP, then they will have rolled shoulders, a concave chest can follow, and often a pelvic tuck. Of course, forward head posture is certainly not a new condition and it is a common reason for visits to chiropractic offices already. Chiropractors have been treating and educating our patients on the dangers of FHP for years, and the health conditions that FHP contributes to are well-researched and documented.

Forward Head Posture (FHP)

Long-term forward neck posture leads to “long-term muscle strain, disc herniations and pinched nerves.” (Mayo Clinic Health Letter, March 2000)

According to Rene Caillet MD, director of the Department of Physical Medicine and Rehabilitation at the University of Southern California, FHP can:

  • Add up to 30 pounds of abnormal leverage on the cervical spine which can pull the entire spine out of alignment
  • Result in a loss of vital capacity of the lungs by as much as 30 percent. This shortness of breath can lead to heart and blood vascular disease.
  • The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation is a common effect of FHP.
  • It can cause an increase in discomfort and pain because proprioceptive signals from the first four cervical vertebrae are a major source of the stimuli which create the body’s pain controlling chemicals (endorphins). With inadequate endorphin production, many otherwise non-painful sensations are experienced as pain. FHP dramatically reduces endorphin production.
  • FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage and early arthritis. (Journal of Spine, 1986)
  • FHP can interfere with various feedback mechanisms of mechanoreceptor, which connect through various brain regions responsible for emotion. Poor posture can contribute to depressive emotions.
  • The ongoing increase weight-bearing of the head to the postural muscles, which are not designed for this degree of stress, can create long term scar tissue formation and increased tissue sensitivity.

While the problems associated with Forward Head Posture have been known for some time, they are cumulative. The sooner you take steps to correct this problem, the healthier and less damage there will be!

Chiropractors are well- known for helping patients overcome the problem of Forward Head posture – and not just for the relief of pain, but for maximum restoration of lost function and alignment. If you spend a significant amount of time texting, or suffer from neck pain or headaches, schedule a chiropractic appointment! You’ll be glad you did!

~ Dr. G

Are Headaches Due to a Deficiency of Aspirin?

Are Headaches Due to a Deficiency of Aspirin?

Shannon, a new patient, was sitting in my office waiting for her first chiropractic check up. As with many first time patients, she was sitting quietly and had a strained worried look on her face, anxiously awaiting her opportunity to discuss her concerns. After we had a chance to discuss her present concern which was an ongoing foot problem, she still had that strained look on her face. This was unlike most patients who become quite relieved after we have had our initial discussion, so I asked if anything else was the matter. “Oh, I am just having a hard time concentrating right now, due to this headache.”  When I asked her how often she suffered from headaches, she responded, “About three times a week. But that’s okay, they’re just the normal ones.”  How often I have heard that! As it turns out, as with many people, these headaches prevented her from truly enjoying many aspects of her life such as time with her daughter, her productivity at work, and even time on vacation! As with many patients, she was just living with these headaches, and she had to consume medication often just to get through her day. Although the medication dulled her headaches, she was starting to suffer an upset stomach at times from the medication and she had begun to worry about the long term side effects of consuming far too much medication. Shannon’s suffering was a typical story I hear on a daily basis of people whose quality of life suffer needlessly because they are not aware that there are effective natural and safe ways of not only reducing the frequency of headaches, but eliminating them all together.

How common is this story? Let’s look at the prevalence of headaches in our society: Prevalence denotes the number of people in a population who have a particular condition at any designated point in time. General population surveys have shown the prevalence of tension-type headaches in Canada to be 37% of females and 21% of males. The prevalence of migraine headaches in Canada is 23% of females and 9% of males.  Headaches are not just limited to adults. In fact, a survey of adolescents have shown 26% of 12- to 13-year olds and 31% of 14- to 15-year olds reported frequent headaches of “about once a week”!

Although there are a number of causes for tension-type headaches, it is commonly understood that muscular tension, stiffness and misalignments of spinal joints can be common causes.

There are many forms of treatment which may help alleviate the symptoms of a headache. These can vary from rest, pharmaceutical medications, to chiropractic care. However, suffering recurrent or chronic headaches can ultimately affect a person’s ability to work or enjoy their leisure time activities with friends and family. That’s no fun! In fact, recurrent headaches have been shown to be a cause of decreased productivity at work, lower income, decreased enjoyment of life and even marital distress.

Chiropractic care has been shown to be an effective natural and drugless treatment for the treatment of chronic and immediate tension headaches. In fact, in some chiropractic practices, up to 35% of patients seen are for headache related complaints. How effective is Chiropractic treatment?

A 1996 Duke University report, entitled “Evidence Report: Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache,” was a meta-analysis of all valid published studies on the topic.  It is the result of more than six years of work from a multidisciplinary panel of experts, including chiropractic researchers and clinicians. Some of the conclusions of this study were as follows:

  • spinal manipulation — a practice performed almost exclusively by chiropractors — is the most effective treatment for cervicogenic headaches, which are those that originate in neck muscles or vertebrae
  • Chiropractic treatment caused far fewer side effects than a commonly prescribed headache medication called amitryptaline. 84% percent of patients taking amitryptaline experienced side effects whereas just 4% of patients getting chiropractic care had side effects
  • medication provided only short-term benefits
  • compared to various soft tissue procedures, a course of chiropractic treatments is shown to produce sustained improvement in headache frequency and severity in the treatment of tension headaches

Four weeks and several treatments later, I saw Shannon waiting in our reception smiling and chatting excitedly with our receptionist about an upcoming family event. Her headaches had dissipated and she was no longer taking any medication. As a result, her energy had increased and she was again enjoying a part of her life that she had forgotten was lost! What a blessing!

If someone you know is suffering from Headaches needlessly, start with calling our office to schedule yourself, or someone you know in for a check up appointment to see what treatment options are available to you.

~ Dr. Gertz

Tips for Preventing Golf Injuries

The American Chiropractic Association suggests these simple measures  to help you avoid back pain or injury and improve your  game:

1. Purchase equipment that fits. Don’t try to adapt your swing to the wrong clubs: A six-footer playing with irons designed for someone five inches shorter is begging for back trouble.

2. For the women in golf: If you have “inherited” your husband’s or significant other’s golf clubs, they might be difficult for you to use. Not only are the clubs often too long, but the shaft is often not flexible enough for a woman’s grip. Women typically play better with clubs that are composed of lighter, more flexible material, such as graphite.

3. For the men in golf: It is a good idea to spend some extra time performing quality stretches-before and after your game-to increase your trunk flexibility. While men are traditionally stronger than women, they usually aren’t as flexible. Men need to improve their flexibility to maintain a more even and consistent swing plane and thus improve the likelihood of more consistent performance.

4. For senior golfers: If you show some signs of arthritis in the hands, consider a larger, more specialized grip for added safety and performance.

5. Take lessons. Learning proper swing technique is critical. At the end of the swing, you want to be standing up straight; the back should not be twisted.

6. Wear orthotics. These custom-made shoe inserts support the arch, absorb shock, and increase coordination. “Studies show custom-made, flexible orthotics can improve the entire body’s balance, stability and coordination, which translates into a smoother swing and reduced fatigue,” While the upper part of a shoe may score style points, what the foot rests on affects your game.

7. Warm up before each round. “Stretching before and after 18 holes is the best way to reduce post-game stiffness and soreness.” Take a brisk walk to get blood flowing to the muscles; then do a set of stretches. To set up a stretching and/or exercise routine, see a doctor of chiropractic or golf pro who can evaluate your areas of tension and flexibility.

8. Pull, don’t carry, your golf bag. Carrying a heavy bag for 18 holes can cause the spine to shrink, leading to disk problems and nerve irritation.

9. Keep your entire body involved. Every third hole, take a few practice swings with the opposite hand to keep your muscles balanced and even out stress on the back.

10. Drink lots of water. Dehydration causes early fatigue, leading you to compensate by adjusting your swing, thus increasing the risk of injury. Don’t smoke or drink alcoholic beverages while golfing, as both cause loss of fluid.

11. Take the “drop.” One bad swing-striking a root or a rock with your club-can damage a wrist. If unsure whether you can get a clean swing, take the drop.

Regular chiropractic care is not just for golfers but for all of us for the treatment AND prevention of injuries. If you value your leisure time activities, consider scheduling a check up appointment to see if chiropractic care can be of benefit to you!
~Dr. Gertz

Golf and Chiropractic – An Essential Combination

Studies show that more than 80 percent of golfers experience back pain or injury at some point while actively playing golf.

In one study of 154 professional golfers, 55% reported a history of low back pain. This pain was of an adequate level to miss at least one tour event, or to play at an unsatisfactory level. Dr. Tom La Fountain is a chiropractor who travels with the PGA tour and regularly provides chiropractic to the pros. Dr. La Fountain reports that up to 85 percent of the injuries on the PGA Tour and Senior Tour relate to the spine, and about 70 to 75 percent of those golfers receive regular chiropractic care. Golfers such as Tiger Woods, Mike Weir, Vijay Singh, and David Duvall have trusted chiropractic for years to help keep them at the top of their game.


“Being a Chiropractic patient has really helped me immensely…lifting weights and seeing a Chiropractor on a regular basis has made me a better golfer. I’ve been going to Chiropractors for as long as I can remember. It’s as important to my training as practicing my swing.”
Tiger Woods

It’s no wonder golfers suffer a lot of back pain. Picture the contortions a golfer’s spine goes through during each and every shot. First, the spine is twisted really far in one direction for the backswing; then, after hesitating for a second, the golfer’s back must suddenly change direction, forcefully twist and bend through the downswing, swinging a driver or three iron at speeds of up to 100 mph, absorb the impact of the golf club hitting an inanimate object, and then continue twisting for the follow-through. This maneuver is then repeated about 70 times (or 180, as the case may be) per game. Once the golfer finally makes his or her way to the green, the golfer is then bent over lining up and standing awkwardly over the ball while trying to sink a putt.

Studies have shown that the chiropractic adjustment can improve the range of motion of spinal joints. No big surprise here. Further, the adjustment can also help to correct improper muscle firing patterns established from previous injuries. What this means to the avid golfer is likely more accuracy, increased muscle efficiency, greater power, and ultimately better performance with less chance of injury. According to Tiger, “Golfers who consistently get it up and down around the green have two things in common: great technique and good posture.” (Golf Digest, February 2001)

Such movement would be hard on even the fittest athlete. That problem is compounded when you consider most golfers are strictly weekend players, mixing this intense activity with long periods of idleness that leave their muscles weak, tight and prone to injury. (This can occur even if the golfer is active in other sports, as the demands on muscles often differ for different activities.) Then, each time the weekend golfer returns to the links and forces these weak or tight muscles into action, it can put excessive stress on the spine and spinal joints resulting in poor spinal joint mechanics. This can decrease power, as well as speed, hand-eye coordination and consistency.

The golf swing isn’t the only aspect of playing the sport that causes golf back pain. There is a lot of walking in golf, even if you take a cart. You have to walk up hills, down hills, and all over the uneven surfaces of the average course. In addition at other times you have to swing and torque your body while positioning yourself on unstable surfaces like hills, tree roots, or sand. Perhaps the worst part of golf for your back though is the simple act of standing. There is a lot of standing around in golf, and just like in everyday life when someone stands they usually shift weight to one side of their body. This tends to tighten muscles on one side while relaxing muscles on the other side.

When a player experiences back pain during a round of golf, their scores suffer and their enjoyment is taken away from the game. There is a higher rate of injury amongst those players with poor flexibility, trunk control, postural control, and improper muscle firing patterns. In addition, back, neck, shoulder and elbow pain will sabotage any golf swing and ruin the golf experience. It shouldn’t be that way and it doesn’t have to. Regular chiropractic treatment can help alleviate golf back pain and injuries and get your game to where it is supposed to be.

Chiropractors can also make nutritional and exercise recommendations such as a specifically designed program of trunk strengthening that emphasizes balance and coordination to help golfers prevent back problems and maintain good spinal health. There are healthy ways to reduce inflammation, so that golfers can avoid over-the-counter painkillers such as ASA or nonsteroidal anti-inflammatory drugs (NSAIDs), which can be harsh on the stomach and can even cause gastrointestinal ulceration. Instead, some foods and natural supplements can provide anti-inflammatory action, while improving overall health. A good example of such a nutritional product is “Natures Relief” manufactured by Adeeva and it is available at the clinic. Ask Kari for more details.

Rehabilitation exercises promote speedier recovery and warm-up exercises can be beneficial before each game. Certain exercises will also help golfers strengthen abdominal muscles to reduce strain on the back muscles. The pros on the PGA Tour know what it takes to play great golf. They also know that being in top physical form reduces injuries and improves performance, which translates into more earnings. The January 2001 issue of Golf Magazine ran an article called Survival of the Fittest in which they contend that physical fitness has become a top priority for many PGA Tour pros. “The PGA Tour has become a sweat shop: Golfers who aren’t physically fit probably can forget about frequent trips to the winner’s circle. Fitness is not only fashionable, it’s an important piece of the professional golf puzzle.”  More detail about what you can do will be found in Part 2 – next week’s article.

Regular chiropractic care is not just for golfers but for all of us for the treatment AND prevention of injuries. If you value your leisure time activities, consider scheduling a check up appointment to see if chiropractic care can be of benefit to you!

~Dr. Gertz