Chronic back pain is debilitating and painful. The body undergoes physiological changes in response to injury, pain and avoidance behaviours. Unfortunately some of these changes prolong pain and create the chronic conditions. People with chronic lower back pain often have weak abdominal and gluteal muscles, altered spinal mechanics, reduced disc lumbar disc height and even changes to the grey matter of their brains. There are main different causes for lower back pain.  A proper history and physical can narrow down the focus in most cases and occasionally further imaging is needed to understand the root of the problem. Luckily most mechanical issues can be improved with chiropractic care. Studies have shown chiropractic care can restore lost disc height and motion to the spine, prescribed exercises can strengthen weak muscles and over time the brain can adapt to the restored function.
Back pain and stiffness is not a normal part of aging and should be addressed in the early stages. Osteoarthritis, wear and tear arthritis, is unavoidable but pain associated with it is not.

Dr. Nelson

Cholesterol is a concern for many people. It is linked to heart disease and a target for many drugs. There are some options to consider for reducing cholesterol beyond and before medication. Simple lifestyle changes can reduce LDL (bad cholesterol) and increase HDL (good cholesterol). Good and bad cholesterol are also misleading terms as both are essential but 'bad cholesterol' is thought to damage arteries through oxidation. It is important to understand the functions of cholesterol. Our bodies produce 75% of our total cholesterol and the other 25% comes from diet. Many hormones and enzymes are synthesized from cholesterol including: CoEnzyme Q10, vitamin D, Aldosterone, Cortisol, Testosterone, Progesterone and Estrogen. Cholesterol is essential for cell membrane health, helping maintain fluidity and strength in every cell. The function of cholesterol that concerns heart disease is lipid(fat) transport in a lipoprotein. Oil and water don't mix, so your body has to transport fat to cells through blood in an emulsified form, the lipoprotein. Cholesterol is attached to fat in the lipoprotein in several forms including HDL and LDL.

One of the many benefits of exercise includes reducing LDL cholesterol levels. Having a higher HDL to LDL level is linked to lower levels of heart disease. Exercise is thought to help the liver excrete LDL through the gallbladder and also convert LDL into HDL. Research suggests that high intensity exercise is more beneficial to positively change cholesterol levels. A great way to get a burst of high intensity exercise is take the stairs instead of the elevator. 

Diet can help cholesterol levels as well, but what to eat can often be misleading. Cholesterol, saturated fats, trans fats, sugar and alcohol are things that deserve your attention. Cholesterol is only found in animal products as plants do not need it for their rigid cell walls. Cholesterol on labels can be misleading because it is not shown to directly influence blood cholesterol levels to a large degree. Your body can slow down its own production if necessary and blood cholesterol that we normally pay attention to is a large complex protein, fat and cholesterol compound that isn't immediately effected by ingestion of pure cholesterol. About 25-33% of the population has difficulty slowing down body production and are susceptible to high cholesterol if diet isn't well maintained. Trans fats have a negative impact on many aspects of health and are best avoided completely. Saturated fats used to be the bad guy, but now there is conflicting research on whether they lead to heart disease, so it is best to limit these but not completely avoid them. Unsaturated fats are the good fats like Omega 3 and 6, they are found in fish, nuts, seeds and vegetable oils. Diets high in refined sugar and alcohol can lead to LDL oxidation, which can damage arteries and lead to cardiovascular disease. Limiting refined sugar and alcohol along with quitting smoking are very positive steps for cardiovascular health.

Liver health is also important for cholesterol levels. Your liver processes sugar, alcohol, drugs (including prescription and over the counter) toxins and many vitamins and minerals. The more you stress your liver the less it can maintain proper cholesterol levels. If you are taking medication it would be a good idea to limit refined sugar and alcohol intake. 

Cholesterol is a complex and necessary system in your body that can do damage if it gets out of control. Exercise, diet and limiting stress on your liver can keep cholesterol in check. It is important to get your levels checked in your 20's if you have a family history of heart disease otherwise after the age of 35.

Dr. Nelson

An good acronym for post injury care is RICE, Rest, Ice, Compress, Elevate. This acronym is the most useful for acute muscle and ligament injuries, eg. sprained ankle or knee or a strained hamstring or quad. It is most effective if you start the process immediately, especially ice.
Rest is important for recovery however there are a few caveats. Resting too much can stiffen joints and prolong rehabilitation, the idea of weeks of bed rest are long gone. Gentle range of motion exercises can speed healing and reduce inflammation. Range of motion exercises can even begin on the same day of injury. Rest in the terms of RICE is really limit pain producing activities, don't do anything to make the injury worse.
Ice sprained joints and strained muscles during the first 48 hours post injury. Leave the ice on for 10 minutes at a time with at least one hour between sessions and limit it to 3-4 times per day. Icing beyond the initial 48 hours can actually slow healing as it limits blood flow.
Compression is one of the most under utilized strategies. Gentle joint compression with a tensor bandage or sleeve can help limit inflammation and can even help move it out of the effected joints. Be careful to not compress to the point of pain.
Elevation is also helpful for extremity injuries. The closer the injury is to your heart the less effective. Elevation helps drain inflammation and effective for wrist and ankle injuries.
Make sure you have your injury assessed for stability and function by a professional. It is important to know what you are dealing with and whether there may need further imaging assessment.

Dr. Nelson

Most of us aren't perfect and fall off our workout routines at some point during the year. Then January rolls around and we want to hit the gym again after an extended hiatus. Most of us also know that this is usually a short lived venture. But why is it? Why do we fail at something that keeps us health and feeling good. There are many reasons of course and you can probably name most of them already: not enough time, too much early and/or loss of ambition, too many people at the gym, too cold/stormy for running, no immediate benefit. The list goes on. One reason that I will focus on is doing too much too early.

Once we commit to going back to our workout routines there is usually excitement involved. Getting back into shape, feeling better and looking great are all motivating. Most people fail in not acknowledging that returning to a workout routine is more of a mental change than a physical challenge. Habits take 3 weeks to form and I would argue longer for something such as a workout because they generally happen every other day. Weekends away or other activities can easily interrupt forming the workout habit. Benefits aren't seen immediately and post workout soreness can be immediate and intense. There can also be a little shame or disappointment as we don't pick up at the same weight that we did in the past. There are techniques to get around these challenges and they vary in strategies.

First of all set goals, short term, long term, specific and general. Include all of these types as they are important for long term adherence. Plan workouts and goals in advance in your physical and/or electronic calendar. Chart your weights, don't go in haphazardly, have a plan for type of exercises, sets, reps and weights. Be kind to yourself. Our bodies change, and they can change back, but its an organic process. Switch things up if you need too, lighter weights, different exercises. Try free weights, machines and body weight exercises until you settle in to the routine you like the best. If your workout patterns change, update your goals. Eat healthy and drink lots of water, you will reach your goals faster and with less soreness. A little trick I use is topical Magnesium oil to stop post exercise muscle soreness, spray it on the muscles you exercise and wash it off 30 minutes later in the shower. Finally, know your distractions. If you make excuses to not workout, what are you doing instead? Watching TV, facebook/instagram/twitter? If you find your patterns you can undo them.

And most of all have a good time.

Dr. Nelson

Magnesium is an important mineral that is often over looked. It is used in over 300 enzymes in the human body. Including every enzyme involved in the energy systems. It is bound to ATP which is the basic currency of energy in our bodies. It's even needed for DNA and RNA synthesis. It is a necessary element for every cell in your body. As a result magnesium deficiency can present in many different ways: muscular symptoms (cramps, spasms, weakness), fatigue, depression,  insomnia, irritability and poor memory. Magnesium is also important in Calcium absorption and utilization, which of course is vital to bone health. It is found in nuts, beans, whole grains and green leafy vegetables. Excessive sugar and alcohol intake can deplete your body of magnesium.

Determining magnesium levels isn't so simple as a large majority is inside bone and cells. Serum levels are tightly controlled at 0.75-0.9 mmol/L by your kidneys. There are a wide variety of supplements that offer differing benefits and drawbacks. Magnesium absorbtion rates tend to be low 20-40% and not all supplements contain the same amount of elemental magnesium. Magnesium oxide is poorly absorbed but high levels of elemental magnesium. Magnesium citrate is absorbed at much higher rates, but the citrate molecule is large compared to magnesium resulting in a smaller portion of elemental magnesium. Large amounts of magnesium citrate can cause diarrhea and is often used as a laxative. Magnesium glycinate, taurate and threonate are forms of magnesium bond to amino acids (proteins). Magnesium taurate is beneficial for heart function as the taurine is known to enhance heart contractions. Magnesium threonate is a new form that is supposed to have an advantage crossing the blood brain barrier. The final forms of magnesium are topic, Magnesium sulfate and chloride. Magnesium sulfate is found in epsom salt and relaxes muscles. Magnesium chloride is often found in oils or lotions and can be used to target specific muscles.

The recommended daily intake of magnesium for a healthy adult male is 400mg/day and for a healthy adult female 310mg/day, however pregnancy can increase demands. 

Dr. Nelson

     Cardio, weight training, stretching, yoga, pilates, swimming, sprinting, interval training. There are so many types of exercise that are all basically a combination of strength, endurance and flexibility. Of course there are factors including body awareness, agility and balance among others that are improved with exercise. And there are a myriad of health benefits as well. With so many options, which is the best. Which is the most efficient and offers the most benefit. A recent long term study showed that of all the various types of exercise the absolute best form of exercise is the one you will actually do consistently. That's right, there was no statistical difference between types of exercise. The deciding factor was frequency.
     Another recent study showed heart health benefits of exercise increased with duration. 30 minutes a day of moderate exercise should be a minimum. In this study people exercising moderately 1 hr and 2 hrs per day showed 20% and 35% respectively fewer cardiac events. To understand this better you need to look at what moderate exercise is defined as: walking briskly, water aerobic, riding a bike on level ground or with few hill, pushing a lawn mower. Vigorous exercise can be thought of as worth double the amount of moderate exercise and includes: Jogging or running, swimming laps, riding a bike fast or on hills, playing basketball. When put this way it seems much more reasonable, 1 hr of vigorous exercise per day will reduce your chance of a heart issue by 35%. Heart disease accounts for 25% of deaths reducing your chance of that by 35% is significant.
     Go out and exercise the way you like the best and do it frequently!


Dr. Nelson

     There are different reasons for stretching: injury prevention, improved flexibility, and injury recovery. Each of these goals will have a different routine of timing, type and frequency. For all three, consistency is very important.
     Stretching to prevent injury works on two levels. The first is a warm type stretch which will increase circulation and bring blood to muscle you intend to use. The second is greater overall flexibility can reduce injury frequency. I will discuss this under the improved flexibility goal. A warm up stretch is of course best done before any vigorous exercise. The type of stretching is the key. Static stretching, eg the sit and hold a pose, is not the best choice before exercise. When your muscles are cold they have less flexibility and blood flow. You won't gain much in terms of flexibility stretching cold, and you won't get the blood flowing in a static posture. Dynamic stretching is best pre-exercise. Leg and arm swings anterior/posterior and lateral, shoulder shrugs, high knees and leg kicks are all good examples of dynamic stretches. Focus on the muscle groups you intend to use, start slow and build up intensity for 5 to 10 minutes. 

      Stretching to improve flexibility comes in different forms. Many people think of yoga or ballet and the extremes of flexibility. Increasing your flexibility can reduce injuries, up until a point. There is a trade off of strength for flexibility. Think of it as a bell curve, or inverted U curve. Inflexible people are prone to injury because their limit of flexibility is low and they push their boundaries easily. Extremely flexible people can give up strength for more range at their end limits which can lead to injury as the muscles become a larger portion of stability than the joint capsules and ligaments. More is not always better. That said, extreme flexibility is far less of an issue than limited flexibility. The best time to increase flexibility is when muscles and ligaments are already warm. Traditional static stretching will receive the most benefit following exercise. Balance is key, if you stretch your hamstrings, stretch your quads as well. Also, do not stretch into pain. Dynamic stretching such as during a yoga class is a great way to increase flexibility. If you have attended a class before you may have noticed that they generally start out light and build in intensity. The most vigorous stretching is near the end where you will get the most benefit. Yoga also incorporates balance work, which I personal feel is a great attribute to improve. Consistency is important which ever method you choose. If you stretch once a week then you may see benefits a year later. If you stretch 3 times a week or do a 40 day yoga challenge you may see benefits much more quickly. Everyone's body composition is unique and will progress and different speeds.

     Stretching is a vital component of recovering from injury. After an injury your body lays down scar tissue to hold together the damaged tissue. Initially scar tissue is disorganized and has a random arrangement. Movement breaks through that randomness and helps your body remodel the scar tissue to have a similar function to the tissue it is replacing. It is best to stretch without pain and at a mild or moderate level. The key for injury recovery is consistency. Stretching 3 or 4 times a day will help the tissues regain their former flexibility. It is an organic process that can take up to a year or more depending on the age and severity of the injury. Chiropractic care can facilitate this process by breaking scar tissue in difficult to stretch areas.

Dr. Nelson

     Maintaining a health weight is important for many aspects of health. There are main differing points of view on the definition of a healthy weight. One reason is that there are many ways to measure a healthy body weight. BMI is a simple measure of height vs. weight but isn't particularly valid for muscular people. Body composition is a better measure but skin fold testing is rarely done outside of personal training. Body composition can be measured by electrical current and is included in some scales, however hydration levels can create inconsistency. And some people just have a gut feeling that they are in at unhealthy weight. But that's all for another time, including the reasons for maintaining that healthy weight.

      This post is about losing weight. It doesn't matter if your goals are motivated by health or vanity. You have decided to lose some amount of weight. I have a bachelor degree in kinesiology and plenty of personal experience in many types of exercise so of course I get questions about exercise and weight loss. There are many great benefits of exercise and weight loss is one of them, but, and this is a big but, it doesn't guarantee success. Many people who exercise end up eating more. Depending on your cravings, will power and an underestimation of the actual calories burned during your workout, you may actually wipe out all of the weight loss benefits of exercise. Running 1 mile will, roughly speaking, burns between 100-150 calories depending on your speed, weight and efficiency. A little more for men, a little less for women. How many calories were in that can of coke or beer you had after your workout, or even with lunch or dinner? 150-200? In my opinion it is much easier to eliminate excess empty calories than to tack on an extra mile in a workout. 

     Alcohol is particularly troubling because of it's effect on metabolism. Your body can burn alcohol for 7 calories per gram. More than sugar and protein at 4 calories per gram and less than fat at 9 calories per gram. Alcohol is not useful for anything other than those calories and the byproducts of metabolism cause a hangover. Your liver has to process alcohol, but your liver also works on many other metabolic pathways. Your liver is critical in many forms of sugar metabolism: fructose processing (a form of sugar naturally in fruit among other things), storage of glucose as glycogen and maintenance of blood glucose levels. Nonessential amino acids are synthesized in the liver and ammonia, a toxic byproduct of protein metabolism, is converted to urea.  The liver is responsible for a large amount of fatty acid metabolism as well. Your liver has all the protein machinery present to convert alcohol into fatty acids, which then go into your blood stream and to surrounding muscle and fat cells. So not only are you taxing your liver with extra work, which may slow down the good metabolic processes, you are also giving it a lot of energy to create the fat you are trying so hard to lose.

     In the ideal world you can employ all 3 strategies: Exercise, eat well and save alcohol only for special occasions. But if you can't do all 3 at once start with nutrition and reducing alcohol consumption.

Dr. Nelson