Beginning a successful exercise regimen requires an understanding of how to avoid injury and ensure you are properly prepared for the increased stress that this will play on your body. To take the stress out of your work out, this article will showcase why the engines of locomotion are firmly planted on the ground and why they are so important. 

Foot and Ankle Anatomy 

The human foot is a complex machine consisting of a flexible network of structures including: bones, joints, muscles, tendons and ligaments. Each foot consists of 26 bones, 30 joints and more than 100 muscles/tendons/ligaments all of which work together to provide support, balance and mobility. Sections of the foot are divided into three recognized areas:

• The Forefoot: includes the bones of your toes (phalanges) and the five longer bones that attach to them, called metatarsals.
• The Midfoot: consists of a puzzle-like pyramid of bones that contribute to the arches of the feet. These include three cuneiform bones (meaning wedge-shaped), the cuboid bone (square) and the navicular bone which gets its name from being boat-shaped.
• The Hindfoot: contains structures to form the heel and ankle. The talus bone supports the bones of the lower leg (fibula and tibia) to create the ankle. The calcaneus (heel bone) is the largest bone in the foot.

What many people don’t realize is that each foot also contains three arches, not just one. When functioning properly, they work the same way as a spring, allowing the feet to bear the weight of the body and absorb the shock produced during activities like walking, running and jumping.

• The Medial Longitudinal Arch: Stretches from the ball of the foot (under the big toe) to the heel. This is what most people think of when discussing ‘the arch of the foot’ because it is the highest and most noticeable arch.
• The Lateral Longitudinal Arch: Spans from the ‘ball’ under the pinky toe to the heel. Note that what we think of as the balls of our feet are actually the heads of the metatarsal long bones where they meet the toes. 
• The Anterior Transverse Arch: Crosses the width of the foot from the ball of the foot under the big toe to the ‘ball’ under the pinky toe and represents the arc of the metatarsal heads.

All of these structures form an association of moveable parts that work synergistically. As experts in optimizing joint function and alignment, doctors of chiropractic (DCs) not only address joints in the spine, they also work with the many joints of the upper and lower extremities and have a detailed understanding of the complexities of the foot and its many supporting structures.

Understanding the Kinetic Chain

Feet are the body’s foundation. Our feet provide the groundwork for our upright weight-bearing posture. This makes them a primary influence when we talk about the kinetic chain in the body. ‘Kinetic chain’ is actually an engineering concept used to describe human movement. It refers to the interconnectedness of the body and how our body areas work together, compensate for or affect one another to perform movements. When choosing footwear, the importance of having proper support to promote functional stability for the many joints and arches of the feet cannot be undervalued. 

It has been estimated that every pound of body weight exerts up to three pounds of force that the feet have to absorb when walking. If a person weighs 200 lbs., the force on the feet will be up to 600 lbs. When running, that number grows exponentially with up to seven pounds of force per pound of body weight being exerted which would translate to 1,400 pounds of pressure per footfall for our 200 lb. example. 

Foot and ankle biomechanics influence motion and function throughout our skeletal structure. Improper gait, foot strike or subtle differences in functionality from one foot to the other can all translate stresses up through the knees and into the hips, pelvis and spine. Anyone who has ever broken a toe, been in a leg cast or sprained an ankle will inherently relate to this concept of how a change in gait can cause pain in other areas. However, an injury does not have to be the primary cause of compensatory pain. Pain can also manifest simply from the way you are walking.

Watching your Step

Over-pronation, for example, is a very common finding in patients. It means you are walking more on the inside arch of your foot. Walking this way actually creates an unnatural internal rotation in the lower leg, which when combined with typical joint positions needed to simply walk, translates to stress in the knee joint and has been shown to increase the risk for knee injuries and back pain.

Internal rotation of the lower leg from over-pronation has also been correlated with an increased Q-angle (Q for quadriceps). The Q-angle is a valuable indicator when evaluating biomechanical function in the lower extremity. The assessment of it provides useful information about the alignment of the hips, pelvis, leg and foot. Increased Q-angle measurements have been associated with higher incidence of ACL injuries.

As we continue up the body, we find multiple studies have also linked over-pronation in the foot to unspecified low back pain. In 2017, a randomized controlled trial was published in the journal Archives of Physical Medicine and Rehabilitation which concluded that over 40% of patient participants had a significant reduction in low back pain and an increase in function with a combination of custom foot orthotics and chiropractic care. This exemplifies how much impact a well-functioning foundation can have on our musculoskeletal system as a whole.

Optimum Foot Strike and Support

The way you walk contributes to significant outcomes. Years of improper walking can lead to joint stress, pain, degeneration, spurs, fallen arches, and in the shorter term, can translate to compensation and resulting pain in your ankles, knees, hips and spine. 

Most people will demonstrate a better foot strike when barefoot. This is because the nerves in your feet can feel the ground and adjust the way your steps hit the floor. Being barefoot on the beach isn’t just a daydream, it also takes more effort than walking on a hard surface and strengthens your foot and ankle while you burn more calories!

With shoes, people are more prone to developing bad walking habits such as dragging the feet, heavy impact steps and limiting natural movement in the joints of the foot. Most of us, however, need to wear shoes the majority of our waking hours. Watch the soles of your shoes, if the outer sole wears down unevenly it can be a strong clue that you need to adjust your foot strike/gait. 

To best support your feet, keep the following considerations in mind to help optimize the way that you walk:

• Proper Posture: Stand up straight/shoulders back/head supported by your spine. Do not look down (such as at your feet or your phone), look forward. Feet should be shoulder width apart/chest forward and abdominals/core muscles engaged.
• Foot Strike: Should begin with the heel landing squarely on the floor. As you roll onto the entire ball of your foot the heel should begin to slightly lift and toes should be flexed. The step should spread to each toe, beginning with the small toe hitting the floor and lifting up off the ground as you complete the step. Mindfully watch to see if your step has you rolling inward or outward.
• Gait: Ensure your toes face forward to keep the ankles in a neutral position. If toes are in a ‘V’ outward or inward it creates strain on soft tissues of the ankle and heel.
• Shoe Fit: Ensure that your shoes are supportive for all areas of the foot and that they are flexible and provide ample width. Also note if they are causing blisters. Custom orthotics may be indicated for many patients that require extra support to ensure that foot strike is optimized. 

Urban exercise myths like ‘no pain, no gain’ certainly do not apply to the foot. Your feet should not feel pain during normal walking or with exercise activities. In the chiropractic office, DCs can analyze and advise on your foot strike/gait, evaluate the complexities of the foot and kinetic chain, adjust affected areas to optimize joint function and mobility, offer strengthening exercises and many offices are also equipped to take foot molds and have custom orthotics created for patients that need to augment foot support. 

For more information on the benefits of walking and running read the Next Step Walking Guide and tune into our ‘Adjusted Reality’ podcast interview with elite endurance athlete, author and adventurer, Colin O’Brady, as he discusses the benefits of walking and how shifts in mindset can enhance our time on the trail.      

Embracing a Menopause Mindset

Every single day, millions of women all around the world are experiencing a natural mid-life progression called menopause. Mindsets about it, however, can be very different. In the Western world, for example, the menopause event seems to carry with it a lot of stigma and may be viewed negatively with aspects of aging. Loss of menses and mid-life hormonal changes are treated as a medical event vs. a natural conversion that our bodies were made to undertake. 

In China, the process of menopause is much different, described as a ‘rebirth’; a time when energy that was once used for fertility/child-bearing and rearing can be saved and repurposed. Many other cultures see the process as one of liberation and ‘being set free.’ In Japan, menopause is viewed as an expected stage of life and the term for it, konenki, actually means renewal, season and energy. For many cultures, the time of menopause is one for celebration and postmenopausal women are revered in the community as mentors with experience and wisdom. Embrace menopause with a positive mindset.

Defining the Process

Menopause is a term loosely used to describe the cessation of menses. Though it sounds like a simple instant change, it is actually a multi-stage process. These stages include:

• Perimenopause: The time (often years) leading up to menopause. During this time hormones change/decline and menstrual cycles may become inconsistent. Women may begin to feel side effects of these subtle hormonal shifts such as hot flashes, vaginal dryness, mood changes, sleep issues and menstrual irregularity. 
• Menopause: The body stops producing the hormones that cause your menstrual period. After going without a period for 12 consecutive months, you are medically considered to be in menopause. If you go without a period and after 10 months you get one, it is not official and you begin the count again. After the 12 consecutive month benchmark, you enter postmenopause.
• Postmenopause: Once menopause has occurred, women are in a postmenopausal state for the rest of their lives.

It is important to note that the process of menopause should not be associated with a specific age. It is a change in physiology, and for some women, perimenopause can begin as early as in their 30s. Other women don’t go through the change until their late 40s or 50s. The menopausal experience is a process specific to each individual. Some women breeze through the progression and others may experience symptoms such as: hot flashes, mood issues, urinary/bladder symptoms, vaginal dryness or sleep disruption. Musculoskeletal and joint pain are also correlated with age and hormonal changes.

Doctors of chiropractic (DCs) provide care to support women throughout their lifecycle, from the onset of menses, through child-bearing years and as they work through the natural and expected process of menopause.      

21^st Century Considerations

A core contributor to increased symptoms for menses and menopause is stress.  Stress has been well-documented to worsen menstrual symptoms, to affect fertility during childbearing years, and to contribute to menopausal symptoms. Stress is also a growing concern in our modern world. In the body, it is our adrenal glands that respond to stress. These walnut-sized glands that sit on top of our kidneys are also responsible for producing the precursors for our sex hormones including: estrogens, testosterone (androgens and DHEA) and progesterone. This means that high stress can affect all of these other hormones. Optimal adrenal gland function is needed for a smooth menopausal transition and stress reduction is paramount.

Talking to family members (grandmothers, mother and aunts) can help you get a feel for what your menopausal experience may be like. However, if a 21^st century woman is under significantly higher stress than her relatives (or vice-versa), that could change family correlations.

Common medical interventions for menopausal symptoms, such as Hormone Replacement Therapy (HRT), can include significant risks including: breast cancer, endometrial cancer, blood clots in the legs and lungs, heart disease, strokes and an increased risk of dementia and gallbladder problems. For that reason, women all over the world are opting for more natural approaches to address symptoms.

Reducing stress should be at the top of the list. Chiropractic care has a long history of aiding in the alleviation of many of the symptoms of stress. It been demonstrated that as chiropractic optimizes joint function, it contributes to muscle relaxation and pain relief. Studies have also specifically shown that menstrual pain associated with primary dysmenorrhea may be alleviated through lumbosacral joint care. 

Preventing Conditions of Change

Beyond basic symptoms of hormonal change, it is important for women to take a preventative approach to the more critical conditions associated with aging and preventative actions are the best way to combat those conditions.

Osteoporosis is a primary concern after menopause. This is because women lose bone more rapidly due to decreased hormone levels. Research indicates that up to 20% of bone loss can happen during these stages. More than one in ten women over the age of 60 are affected by osteoporosis worldwide. Bone loss increases the risk of developing osteoporosis and bone fractures. The bones of the hip, wrist and spine are most commonly affected.

Cardiovascular disease is another major concern. Decreased hormones make women more prone to cardiovascular disease complications including heart disease, stroke and heart attack. After menopause, many women also become more sedentary which can lead to higher cholesterol levels and ultimately high blood pressure. 

Your Partner on the Menopause Path

Your doctor of chiropractic (DC) can help you navigate a positive path through menopause by helping you monitor osteoporosis and osteopenia (a precursor to osteoporosis) through a referral for bone mineral testing. DCs can also design a program of specific weight-bearing exercises to help keep bones strong, and recommend nutrition (such as calcium and vitamin D3 which supports the absorption of calcium) that will help promote the foundational needs of bone tissue.

Chiropractic care can also help you get moving with exercise plans, promote healthy eating habits, and aid in smoking cessation (if needed) which are all paramount to preventing heart disease. 

On the symptomatic level, chiropractic can offer relief from joint aches and pains by promoting optimal joint function, provide recommendations for stress reduction techniques and advise on nutrition to support adrenal function and hormonal balance to give you the smoothest menopausal experience possible so that you can enjoy the newfound freedom that comes with the season of postmenopause.

From sitcoms to movie depictions, the chiropractic profession has certainly earned its ‘good sport’ award as we’ve watched actors enact what they believe to be a re-creation of a chiropractic adjustment accompanied by a very loud series of noises.      

In reality, though, one of the most commonly asked questions in a chiropractic office is “What is that sound?” Patients are often inquisitive about the ‘popping’ and ‘cracking’ sounds and different types of chiropractic adjustments that can be utilized.      

Many patients have visualized that chiropractic care is ‘one thing’ and done only one way. They may expect back-wrenching positions like they see with sitcom stereotypes. They may expect loud noises. They may think that just anyone can provide an adjustment. These notions, however, are far removed from the actual patient experience in a chiropractic office.

The Science Behind the Sound

Doctors of chiropractic (DCs) adjust diarthrodial joints. These are freely moveable joints created by two bones surrounded by a joint capsule. The capsule is filled with a lubricant called synovial fluid. Synovial fluid also serves as a source of nutrients for the cells that maintain the joint cartilage. Within its contents, synovial fluid also contains dissolved gases of oxygen, nitrogen and carbon dioxide.  

Facet joints (also called zygapophyseal joints) are synovial joints that are found between vertebral bones along the length of the spine, on both sides and at the top and bottom of each vertebral segment. They allow for the variety of bending, arching and twisting motions that come from our spine. Facet joints are the most common joint type adjusted in the chiropractic office.

The formal term for noise when moving a joint is ‘joint cavitation.’ When a joint capsule is stretched to a point of resistance, it creates pressure within the fluid that causes the exchange of dissolved gases. Recent studies indicate that the process may actually create a cavity within the capsule fluid allowing this to happen. 

DCs will often explain this to first-time patients so they are not alarmed. It’s important for patients to know that their bones are not literally ‘cracking.’  

Patients may ask questions such as:

• Is the sound from bones grinding together?
• Is the popping sound causing damage?
• There was no sound, did the adjustment happen?
• Can I safely adjust myself or have a friend do it?

As we just described, the sound itself is not bones rubbing together. The sound certainly does not indicate damage or we wouldn’t adjust people. The presence of a noise, or lack of it, in no way indicates the success of an adjustment, it is normal and expected should it occur; and lastly, only a trained provider should attempt the procedures.

Types of Adjustments

Despite common lingo about ‘back-cracking,’ chiropractors do not ‘crack’ the spine. A chiropractic adjustment is a safe, controlled force applied to a joint/joints to restore proper function and mobility. 

Adjustments provided by DCs are very precise corrections that address the way a joint has shifted. Unlike popping your knuckles to simply make a noise, DCs examine and palpate the spine to determine the exact joints involved and the x-y-z axis (three-dimensional space) of how they have moved out of alignment. They are then able to issue a gentle controlled adjustment with a precise line of drive applied to the particular joints that are involved.

Chiropractic is not limited to only the spine. DCs also understand the complex anatomy associated with the joints of the extremities: shoulder, elbow, hand, hips, knees and feet. They are specifically trained to evaluate and adjust all areas of the human skeleton.

To accomplish this goal, there are a wide variety of effective techniques that DCs learn and implement. These include popular hands-on techniques or may utilize special tables with pieces that drop away, and/or instruments. Though joint noise does often occur, different types of adjustments will have different levels of cavitation. Many methods will not have any noise at all but they are as equally as effective in correcting joint alignment. There are many named techniques out there, and your DC will pick one or a combination that they feel is best suited to your individual needs. A broad overview and explanation of what you might experience are given here:

Hands-on Techniques: There are a variety of techniques that go by different names to delineate different hands-on manual adjustment methodologies. With some of them, you may lay on a table, with others you may sit in a chair or use a piece of equipment designed for the low back. Your body will be positioned according to what joints are being addressed and which method is being utilized. With these techniques you may be more apt to hear a cavitation noise, however, it is also not unusual for a bone to silently slip into place during the procedure. 

Special Tables: For certain techniques, special tables may be indicated. Some chiropractic tables will maneuver patients from a standing position, and lower them to a position lying face down. These tables are to maintain the weight-bearing position that a patient had standing, and also to make it more convenient for patients that may have trouble maneuvering positions.

Some tables may have moving pieces that the DC will use to facilitate the adjustment. These require less body positioning. Patients will hear the sound of the moving pieces during the adjustment and may feel a slight shift in the position of a table piece. Other tables may have features that move to provide traction and/or bend to address specific spinal joints or spinal areas. 

Instruments: Small hand-held instruments are used by many DCs. They are spring-loaded mechanisms and provide rapid low-force impulses to targeted areas. The goal is to issue rapid impulses in the direction of correction before the muscles have a chance to tense up. The impulses can be calibrated to be extremely light or heavier depending on the patient and region or joint being addressed. Instrument adjusting is less likely to result in cavitation.

Care vs. Comedy

A diarthrodial joint provides the ability for movement but it also limits movement to prevent injury. It isn’t difficult to pop a knuckle and stretch a joint capsule to make a noise, but a well-meaning friend trying to pop your spine (like on a sitcom) could actually over-stretch the capsule or move joints in the wrong direction and cause more harm. This is why only trained professionals should ever attempt to adjust your spine and extremities.

When care is implemented by a trained provider, such as a DC, specific adjusting affords multiple benefits including:  

• The restoration of optimal range of motion.
• The normalization of local nerve function (or even vascular function) for those structures that might be directly impacted.
• The relaxation of muscles adjacent to the joint as they are able to stop ‘protecting’ the joint through spasm and resume their natural position.
• A decrease in inflammation when the stress on the joint capsule is resolved. 
• A decrease in pain through the release of endorphins at the region of care.

As we get joints moving, a chiropractic adjustment is multifold and holds the advantage of not only properly optimizing joint function but also providing patients relief from the many symptoms associated with it.

Balancing the Hype and Harm of High Heels

The appeal of the high heel has spanned centuries, but what is the motivation to strap a 4-inch peg on the back of your foot and try to walk around? Psychological science says that incentives are multi-faceted and can range in a spectrum from utility to vanity and include reasoning such as:

• Wanting to be taller/reach things/feel more powerful in groups.
• The desire to seem more attractive/sexier gait/enhancing the appearance of the calf muscle/the illusion of elongating the legs or looking slimmer.
• Aspiring to be on top of fashion trends/help clothes hang better/status symbol/look more affluent.

Whatever the reason, high heels are big business. The global high heel footwear market is projected to grow by USD $2.39 billon by 2027. But what is the real cost for consumers who regularly buy and wear high heels?

Paying the Physical Price

Each foot is comprised of three arches, 26 bones, 30 joints and more than 100 muscles, tendons and ligaments. When you slip on a pair of heels, the biomechanical changes that occur in the feet and up the kinetic chain are immediate. With gait, changes were found in the rollover function of the foot, ankle, knee joints and lower back. Step length and balance are also compromised which increases the risk for falls, stress fractures and sprain/strain injuries of the ankle.

An increase in heel height forces the foot into more pronounced plantar flexion (pointing the toes toward the ground) which, in turn, affects the knee and the curve in the lower back. Low back and leg pain are common due to compressive forces and as major joints all the way up the kinetic chain become affected from the unnatural shift in heel height. 

In the long term, pain and deformity are very real concerns. When you think of the shape of most high heels, the deformities fit like puzzle pieces as individuals force their feet to adapt to the shape of their shoes:

• Hallux valgus (aka a bunion on the inside of the foot near the big toe) has been noted in heel wearers as is a deformity of the pinky toe creating a similar situation on the outside of the foot. 
• Haglund’s deformity occurs as a lump on the back of the heel(s) near the Achilles tendon attachment which can then lead to pain and bursitis. Since it often develops in people who wear pump-style heels, it is also referred to as ‘pump bump.’
• Wearers are also at higher risk of developing hammer toes, corns, heel spurs, plantar fasciitis, flattened arches, stress fractures, knee damage and low back pain. 

Studies have shown that regular high heel use may compromise muscle efficiency in walking causing wearers to often experience discomfort and muscle fatigue due to structural and functional changes in the muscles of the lower leg. A 2022 study concluded that balance control was affected for regular wearers not only while in the shoes, but also it did not correct itself in a natural barefoot state which is evidence of lasting change.

Because of the stress and wear and tear to the cartilage of joints, osteoarthritis is another concern. High heels cause stress to the entire foot and the change in foot strike translates up the kinetic chain. Knee osteoarthritis in particular has been an ongoing finding due to altered biomechanics.  

In healthcare offices low back pain has also been an ongoing and prevalent finding in women who wear heels. With your toes plantar-flexed, the joint function of the foot is altered, the hips shift forward and your spine has to balance out the weight by overarching backwards, all of these changes start with the unnatural stresses on the foot joints which move all the way up the kinetic chain to the spine.

Tips for Balancing High Heels with Health

It’s clear that high heels are here to stay and you don’t have to give them up altogether. However, there are several strategies that you can take to mitigate the risks involved with wearing them. 

• Choose flexible shoes with a wider toe box.
• Try not to go over two inches. Even a heel as low as 3/4 inch has
  been found to increase the pressure on the forefoot by as much as 22%.
• Select a wider heel base (vs. skinny heels) to disperse weight and increase balance.
• Be mindful of how often you wear heels. Only wear them occasionally/when absolutely necessary. Wear comfortable shoes to and from the office and only put the heels on for meetings, presentations or special occasions.
• Perform exercises to keep the stabilizing muscles of your foot strong and your calf muscles stretched.

Wearers may also find benefit from custom orthotics to maximize the support of the foot while wearing heels. A study published in the Archives of Physical Medicine and Rehabilitation found that 40% of patient participants had increased function and a significant reduction in low back pain through a combination of custom orthotics and chiropractic care. Your doctor of chiropractic (DC) understands the complex structure of the foot and can support healthy foot function through evaluating and adjusting the joints of the foot, knee, hip and low back (up the kinetic chain) to reduce pain and keep joints functioning optimally. DCs can also advise on footwear, demonstrate exercises for foot stability and help you to obtain custom orthotics for your heels so that you can maximize function, balance and strength when wearing them.

Aging Strong: Maximizing Stability to Diminish Fall Risk

The deterioration of skeletal muscle with age (affecting mass, function, strength and stability) has increasingly been referred to as ‘sarcopenia’ and it is one of the most significant causes of functional decline and loss of independence in older adults. 

Muscle mass accounts for up to 60% of body mass. As we grow older, muscle mass decreases approximately 3-8% per decade after the age of 30. After the age of 60, the rate of decline is even higher. In fact, by the eighth decade of life up to 50% of muscle mass may be lost. 

Maintaining strength and stability is paramount to maintaining independence. A meta-analysis from 2020 that included ten studies concluded that sarcopenia was significantly associated with a higher risk of falls among independent community-dwelling older people.

Skeletal muscle not only contributes to our strength and balance, it is a metabolically active tissue that, when diminished, can have profound consequences for older adults on a variety of levels. It is important to note that a decrease in muscle mass is correlative to an increase in fat mass. This change in body composition is also associated with an increased incidence of insulin resistance in the elderly. These changes in our physiology can affect bony density, joint stiffness and have implications for conditions such as type 2 diabetes, obesity, heart disease and osteoporosis.

Complications with COVID-19 

Prolonged quarantines due to COVID-19 created even more of a problem for slips and falls for older adults by facilitating more sedentary lifestyles and severely diminishing normal activity outside of the home. The extended time indoors contributed to a more prevalent decline in muscle mass. Slips and falls were reported as the most common mechanism for hip fracture during the pandemic outbreak.

Studies have revealed that atypical symptoms of COVID-19 also may include: falls, delirium, confusion, dizziness and usual fatigue. Disorientation, loss of strength and dizziness all put older adults at an increased risk for falls. If an otherwise healthy adult becomes dizzy, weak, suffers imbalance or falls down, they should visit their health provider for appropriate testing. 

Movement to Build Strength and Resilience

The first step to avoid fall risk is to get moving. To combat decreasing muscle mass we need to use our muscles. Remember that the tendons from skeletal muscle attach to bones. Muscle work creates resistance to help bones remain dense and become stronger to avoid frailty. Your chiropractor can help guide you through any/all of the exercise types listed here.

A regimen of exercises can help keep muscles strong and flexible which also aids in maintaining good balance. Many Medicare-Advantage Plans and some Medicare Supplement Insurance Plans may include a fitness component. Ask your agent if ‘SilverSneakers’ is part of your benefit and if it is, take advantage of what the program offers at your local gym facility. If this is not available to you, take heart that exercises to keep toned muscles don’t require a gym membership or any elaborate equipment and can be performed at home.

Weight-Bearing Exercises: These are performed on your feet. Gravity exerts a force on your bones while you remain upright. Your muscles and tendons are forced to pull on the bones which then stimulates activity in the bone cells. Examples include activities like: dancing, aerobics, hiking, power-walking, jumping rope or climbing stairs.

Strength/Resistance Training: These are accomplished lifting free-weights or using exercise tubing that you pull to create resistance. To tone muscles use low weight/high repetitions. For resistance strength training utilize higher weights with fewer repetitions to target specific areas that may be prone to fracture. If you don’t have weights, start with soup cans from your pantry. 

• Perform wall push-ups to use your body weight.
• Pick a stair and stabilize with the railing, raise up and down on the balls of your feet to work your lower legs.
• For your core, lay on your back on your bed and hold your straightened legs in the air. Try laying on your back and moving your legs as though you are on a bike. If you can get on your hands and knees on the floor, practice planks. From hands and knees you can also stretch one leg out straight behind you in the air and hold the position, then switch legs to increase balance and engage deep back muscles.

Isometric Training: These are completely static exercises. This means your muscles contract without your joints actually moving. If you suffer from joint pain or need more low-impact styles of exercise, isometrics are a great option to build bone strength and density, they help to build and maintain muscle mass and improve balance and coordination.

Strategies to Avoid Falls

As we age there are a variety of approaches that we can use to avoid falls: 

• Implement a regimen of exercise to stay flexible and maintain muscle strength. 
• Maintain optimum nutrition. Ensure ample Vitamin D3, Calcium, Magnesium to support your muscles and bones. Collagen peptides may also contribute to better bone mineral density. 
• Invest in comfortable shoes with good support. Custom orthotics are an option available at many chiropractor’s offices.
• Always use a shopping cart at stores to enhance stability.
• Ensure you use handrails for all stairs and install them in the bathroom (in the slippery shower and next to the toilet).
• Rise slowly from bed (whether it is morning or during the night to use the restroom). Rising slowly to a seated position and then waiting a moment will give time for blood flow to reach your brain and avoid the dizziness that could occur from getting up too fast.

Chiropractic care can help you stay strong by maintaining proper joint alignment through neuromusculoskeletal care. Doctors of chiropractic (DCs) also can advise on nutritional support for your muscle, bone and joint health, and can demonstrate exercises that can help you optimize muscle strength, proprioception (balance) and bone health to promote resilience and reduce your risks for slips and falls

Contain and Eliminate: Chiropractic’s Scary Past and Promising Future

A Story Unknown by Many

Less than six decades ago, mainstream medicine plotted to completely eradicate the chiropractic profession. Verbiage in documents from the American Medical Association (AMA) utilized the terms ‘contain and eliminate’ to describe their goals of destroying the existence of chiropractic practice.

Just as riveting as a cloak and dagger film, the contain and eliminate campaign was complete with a media conspiracy including high-level personas like the Ann Landers national news column and publications like Consumer Reports that spread lies to the public.  Political angst, threats against chiropractic physicians and a conspiracy informant/mouthpiece called ‘sore throat’ that used a voice synthesizer to communicate with stakeholders, were all part of an elaborate plot to destroy the profession and cheat the public from accessing chiropractic service.

During that time the AMA actually established a ‘Committee on Quackery’ with the specific goal of demolishing the existence of chiropractic care. Colorful and untruthful language like ‘marginal, quackery, deviant, uneducated, cults, rabid dogs’ among other adjectives were used to try to dissuade the public from visiting chiropractic providers who offered effective drug-free health options.

The ongoing antitrust lawsuit that ensued (Wilk vs. AMA) was a fascinating 14-year journey that changed the face of healthcare and ensured the 21^st century health options that we all enjoy today.

Ancient History

The practice of adjusting the spine has been implemented for thousands of years. The earliest known medical text, the Edwin Smith papyrus, describes the ancient Egyptian treatment of bone-related injuries from as early as 4000 BC. There is evidence of tissue work and bone-setting in ancient Asia circa 2700 BC. Most referenced, however, is the Greek physician, philosopher and scholar Hippocrates, who lived from circa 460-370 BC and saw the significance of the spine and its associations with health and disease.

Hippocrates was historically dubbed ‘The Father of Medicine.’ He was the creator of the Hippocratic Oath which retains a standard of timeless morals and values that is expected of new physicians, medical doctors, chiropractors and others, as they recite a pledge that he/she will uphold professional ethical standards that support the best interest of patients. The current modernization of the Oath, the Declaration of Geneva and Lasagna’s Oath are all pledges used by a majority of new health providers and are foundationally based on the philosophies of Hippocrates.

In 1895, the modern profession that we currently call ‘chiropractic,’ historically also called ‘bone-setting,’ was formally founded in the western world by D.D. Palmer. From the root words chiro meaning ‘by hand’ and practik meaning ‘practice of,’ chiropractic understood the significance that Hippocrates and the ancients attributed to the neuromusculoskeletal system.

Though the appearance of the first apothecary in history was in Baghdad in 754 AD, the practice of medicine as we know it today did not see an emergence until after the Industrial Revolution in the 18^th century.  Similarly, the founding of the chiropractic profession in 1895 should have concluded the story of a natural and reasonable transition from an ancient practice into a modern profession.

Sadly, the well-being and choices of patients was not the first priority of all healing arts practitioners. The success of chiropractic in the U.S. turned out to be a long fight for the basic rights of doctors of chiropractic (DCs) to practice as well as a fight for retaining the rights for patients to choose the most appropriate care options for themselves.

Diverging Paths and the Right to Practice

Many events happened in the early 1900’s, including the discovery of penicillin in 1928 by Alexander Fleming which led to the introduction of antibiotics to combat infections. A single-vision focus on new pharmaceutical interventions also led to a profound divergence in health philosophies that should have been working together.

These included a medical/pharmaceutical path that focused on drugs for treatment and a natural path that utilized innate organic approaches to health. Though these systems, in theory, should collaborate synergistically with a focus on the best outcomes for patients, that didn’t happen. The potential for production and money-making shunted big dollars and influential business interests down the pharmaceutical path.

Spanning decades in the early 1900s, hundreds of DCs chose to go to jail, rather than accepting the accusation of ‘practicing medicine without a license’ and paying unjustified fines. DCs were not prescribing medicines, but simply engaging in the care of patients like they always had, optimizing the joint function of the spinal column. Through threats and persecution, DCs continued to practice. D.D. Palmer himself spent 23 days in jail in 1906.

Despite the conflict, the success and popularity of chiropractic care was steadily growing, as were the numbers of doctors of chiropractic, especially in the state of Iowa. Their success logically led DCs to seek recognized legislation for equity with other health professions. At the time this request was seen as a threat  and the Iowa State Medical Society fought vehemently to stop them. Finally in 1913, after long hardships in many states, Kansas was the first state to  establish a chiropractic board and state licensure procedures for doctors of chiropractic. More states swiftly followed their lead.

During this process, the  AMA became intrigued with the state battles. The AMA was striving to recover from debt and was concurrently concerned about a ‘radical socialistic’ political idea called ‘Medicare.’  The natural approach of chiropractic was seen as a competitive danger to the AMA because there was a ratio of 1 to 10 (DCs to MDs) across the country and in states like Iowa, a ratio of 1 to 4 was a disturbing fact for the AMA that caused alarm at the national level and led them to engage in a campaign of slander.

What if you couldn’t visit the healthcare office of your choice?

After decades of defamation toward chiropractic, the injustices of the AMA ultimately led to a lawsuit against them that made history. In 1987, Judge Susan Getzendanner, issued the final ruling that stated, “…the American Medical Association, the American College of Surgeons and the American College of Radiology are found guilty of having conspired to destroy the profession of chiropractic in the United States.”      

Nearly 130 years after the founding of the modern profession and over 30 years after the court victory of Wilk vs. AMA, DCs are widely recognized as primary health providers. In the U.S. today it is estimated that over 70,000 licensed doctors of chiropractic are in service to the public providing a natural approach to care for more  than 35 million Americans (adults and children) annually. According to the U.S. Bureau of Labor Statistics, “…employment for chiropractors continues to swiftly expand and is projected to grow 11% from 2020 to 2030, faster than the average for all occupations.”

Along with the understanding of the basic human rights of patients to choose a treatment path and/or a team of providers to work together in their best interests, it is crucial that patients and new doctors promote care that puts the patient first, remember the powerful history that afforded us our rights and, sadly, be aware of the old prejudices that may still exist in some circles.

The story of the Wilk vs. the AMA lawsuit is profound and made the choices that patients enjoy today possible. Students of chiropractic continue to include the Hippocratic Oath during their traditional ceremonies to exemplify their commitment to individual patients. In modern practice, doctors of chiropractic work synergistically with all other medical disciplines and healing arts to address the individual needs of patients and to help patients reach their healthcare goals, naturally.

The detailed story of ‘Contain and Eliminate’ has been told with a book and webinar series written by individuals who lived, worked and litigated during this ground-breaking case that changed our healthcare system. The story has also been told on the Adjusted Reality Podcast where host, Dr. Sherry McAllister, interviews Dr. Lou Sportelli.

For more information and details about this case and the powerful history of the chiropractic profession please visit: https://www.ncmic.com/resources/webinars/contain-and-eliminate-a-history-of-.

Chiropractic Care Can Help You Work from Home More Comfortably

by Dr. Sherry McAllister, President, Foundation for Chiropractic Progress

American employees now work from home. The ongoing COVID-19 pandemic made the transition to work from home inevitable, but it hasn’t been easy.

Though working from home is great for social distancing and “flattening the curve,” it presents various challenges. Instead of meeting with co-workers face-to-face, you now have to hop on a phone call or Zoom meeting. Team-building activities such as picnics and game days have gone the way of the dinosaur. Not to mention, most promotions and raises have been put on hold.

Working from home affects your physical health, as well. Most office setups feature comfortable, ergonomic furniture meant to support productivity. But if you rarely worked from home prior to the pandemic, you probably had little reason to invest in a home office.

As a result, many workers are conducting business from their kitchen tables, bedrooms or couches. There’s nothing wrong with working from where it’s most convenient, but without a proper setup, you’re much more likely to experience headaches, neuro-musculoskeletal pain and carpal tunnel syndrome.

Can you relate? If so, you may want to schedule an appointment with your doctor of chiropractic.

Doctors of chiropractic earn at least seven years of higher education before receiving their license. This training includes guidance on how to achieve and maintain good posture. Following a comprehensive exam and a discussion of your lifestyle and symptoms, a doctor of chiropractic can develop a custom treatment plan that improves your posture and helps you feel better.

Your doctor of chiropractic can recommend office furniture that’s comfortable and supportive. They can improve your neuro-musculoskeletal health with hands-on spinal adjustments, nutritional advice and drug-free treatments. Throughout treatment, they can tweak your plan as necessary, ensuring you achieve the desired outcome.

If working from home is causing you pain, don’t wait to seek professional help. Your doctor of chiropractic is only a phone call away.