Why Injuries Happen

How do injuries happen and what is the best way to avoid them? As Tim Gabbett, one of the leading sports coaching consultants of our time says, it’s not the load that injures us, it is the load that we are not prepared for. So whether you’re talking about a traumatic injury, or a repetitive stress injury (which account for the vast majority of injuries I see) the insult occurs because we performed an action we were unprepared for, that our body wasn’t physically able to do correctly.

So if you are a runner, and your glutes are under performing, your hamstrings or calves or something else is going to take up the slack. That is just an example of the endless amount of scenarios that can play out and result in injury. Rarely does somebody know how they tore their rotator cuff; even if they think they know the insult that caused their injury, such as a pitcher throwing too many curve balls. This begs the question of why some pitchers tear their rotator cuff and others don’t. It all comes down to being properly prepared for the load you are asking your body to bear.

Your body is a symphony of movement and your nervous system is the conductor. It is the proper interplay of all the muscles in our bodies that keep us upright against the force of gravity. It is the agonists and antagonists and synergists all working in unison. It’s the interchange between the glutes and hip flexors, or the abs and the diaphragm all working with the help of that motor program in your brain that keep us moving along without thinking of how to put one foot in front of the other. These motor programs begin to develop from birth as we develop strategies to reach, grab, crawl, stand upright and move.  If all goes well the primary movers learn their jobs and the helpers (or synergists) lend a hand. The first assault on these motor programs is if we don’t progress properly through stages of development. As they say, you have to crawl before you can walk, and walk before you run.

It is also in youth, once exploration begins, that injuries start to happen and we begin to compensate. A seemingly innocent fall on the playground might have set off a compensatory cascade. We get older and more injuries ensue and then more compensations. A big one is too much sitting, which sets up a scenario where the hip flexors get too tight and the glutes (from sitting on your butt) become weak. Combine the sitting with looking down at a phone or a computer and then you have tight traps and weak neck flexors. Then when you do get out and run or bike you are doing so with a bad motor program and injury happens.

A large percentage of injuries are repetitive stress from the poor movement patterns over a long period of time. Over-tight hamstrings through miles of running will result in a tear.  Other outcomes could be plantar fasciitis, or shin splints. There are endless scenarios that result from the breakdown of proper biomechanics.

Even injuries that are a “direct” result of trauma might have been set in motion because of poor form. The pitcher who tore his rotator cuff on a particular pitch might have set things in motion by using poor form over time. That one pitch where he felt something pop was actually just the straw that broke the camel’s back. Why do some athletes have long careers?  Are they just lucky, or is proper form and biomechanics involved? Could a running back have avoided an MCL injury if his body could move more efficiently to avoid a hit or to perhaps mitigate a collision? Is it just bad luck when a point guard makes a sharp cut and blows out her ACL?

Obviously, some injuries can’t be avoided, but through proper movement many could. As I said at the beginning, it is not the load that injures us but the load we are unprepared for. The bottom line is all of us need to be checked to see if we are moving efficiently and if the proper muscles are doing their job.

Heart disease and cholesterol

What is the cause of heart disease, or is cholesterol really the bad guy?

Cardiovascular disease is rampant in America today. Over 65 million people are affected.  One in three deaths in America is caused by cardiovascular disease, although Lipitor is the one of the most prescribed drugs in America. You have to ask why prescribing massive amounts of cholesterol lowering medications hasn’t put a dent in reducing cardiovascular disease.

Obviously we are doing something wrong. There are a couple of ways we can look at this.  First of all, maybe cholesterol isn’t the bad guy. Cholesterol is a sterol hormone which is essential for the operation of our body. It is a necessary precursor for all our sex hormones. It lines all of our cell walls. Moreover, there have been a number of studies that demonstrate a cholesterol level below a certain number can cause other conditions, including dementia and early death from other factors. Some studies have tied low cholesterol to an increased risk of cancer.

There are numerous new advanced lipid profile tests that are looking at cholesterol in a different way. First of all you have to understand that when you get a lipid profile the numbers you see are measurements of lipoproteins, which are the molecules that carry cholesterol through our blood stream. Low density lipoproteins (LDL) are the “bad cholesterol” and HDL is the “good cholesterol.” There is now evidence that the number of LDL particles (LDL-P) is a more accurate determinate of vascular disease than the amount of cholesterol inside the lipoprotein (LDL-C).  Another more accurate marker for cardiovascular disease is LDLa which is a lipoprotein that is not even affected by statins.

Perhaps, as I have stated before, INFLAMMATION is the bad guy. The new advanced heart studies are also looking at inflammatory markers in you blood. It is now widely accepted that arterial plaque is a result of the body reacting to damaged arterial walls. The most likely suspect in arterial wall damage is inflammation. The new profiles look at inflammatory markers, which are indications that some other pathology is happening in your body. Some of the important inflammatory markers are c reactive protein, fibrinogen, LpPLA2, and oxidized LDL.

Another way to look at high cholesterol is a symptom rather than a cause. There are other metabolic processes which might be the underlying cause of your higher than normal cholesterol. Your liver might be producing more cholesterol to protect you. There are a number of factors that can drive your liver to produce more cholesterol. And no, eating too much cholesterol is not one of them! Seventy five percent of the circulating cholesterol in your body is produced in your liver and not from your diet. So what are the metabolic factors that you need to address if you have high cholesterol?

  • Metabolic dysfunction such as high blood sugar or insulin
  • Chronic infections
  • Heavy metal toxicity
  • Hypothyroidism
  • Gut dysbiosis
  • Genetics – Familial hypercholesterolemia

There could be any number of these underlying factors that could be driving your numbers up. Rather than taking a statin, which inhibits your liver in making cholesterol, you might want to figure out first of all if the cholesterol you have is really putting you at risk for cardiovascular disease and if so, determine the underlying cause of why your liver is in crisis. Maybe if you fix these, your cholesterol numbers will drop back to the normal range without taking a drug that has some pretty serious side effects.

So the first test would be to have an advanced lipid profile. This is a more sophisticated look at your cardiovascular risk. After evaluating your history at your first functional medicine appointment, I will order an advanced lipid panel. I prefer Boston Heart because it includes all the markers I mentioned, including inflammatory markers. At your follow up appointment we can then address all metabolic factors.

For our health’s sake, we need to start taking a new approach, because what we are doing now as a society is not working!

Call today to schedule your functional medicine appointment and begin your journey to better health.

Patient Heal Thyself

When given the right fuel and the right stimulus your body has an amazing ability to heal itself. The right fuel does not come in a pill and the right stimulus is not a knife. Yes there are times for drugs and surgery, but that usually comes when you have ignored and neglected your problems for so long things have gotten out of hand. The right fuel is healthy food and the right stimulus is proper exercise. If you are consistent with that you won’t need the pills or the surgery.

The right food is different for everybody. We all have varied food intolerances. What might be a super food for most might be the worst thing you can eat. Everybody has a diet that they’re passionate about, but the truth is we are all individuals and while a low carb diet might work for me it won’t necessarily work for you. The best way to find out is food testing. The cheapest way to figure it out is through an elimination type diet. That being said there are some basic ideas that should guide us all in the “good fuel” department.

  1. Eat organic and non GMO whenever possible.
  2.  Eat lots of various colored vegetables. I had a patient this morning tell me, “I hate vegetables.” Learn to cook them right, and learn to love them!
  3. Lose grains, or at the very least drastically reduce them. We get all the fiber we need from fruits and vegetables.
  4. Drink plenty of filtered water.
  5. Get enough healthy fat in your diet. Salmon, avocados, olive oil, and some raw nuts are some of the healthy fats.

As for exercise, again this is very individualized. Just as we have food intolerances, we all tolerate exercises differently.  Here are some ideas to guide us in the exercise department.

  1. Do lots of core work on a daily basis. As I have said this does not include crunches. See my Facebook page for lots of posts on core exercises.
  2. As one of my favorite physical therapists, Gray Cook says, learn how to move well and then move often.

Learning how to move well is where a movement specialist like myself comes in. You might have a mobility or stability issue that keeps you from moving optimally and that is when you need to be guided in the right direction. My goal is to be your guide toward the right path, not to be a crutch. That is why I shy away from long treatment plans. There are people who do need a lot of work, but most people just need to be nudged in the right direction and then maybe tweaked from time to time. So get to a functional medicine and movement specialist and get nudged in the right direction.

Take Care of Your Gut

You are what you eat!

As modern science finds out more and more about what goes on in the ecosystem that is our gut, it has become clear that what we put in our mouth is crucial to our health. And our bodies are an ecosystem, a combination of our own cells and billions of outside microbes all living together in a symbiotic relationship. Scientists have discovered in the past several years that our bodies contain more foreign microbes than actual human cells.   And more importantly, the relationship we have with these guests can have a huge influence on our health.  If they are happy, they help us with our digestion, fight inflammation and promote antibodies which help fight foreign invaders.  If they are angry, they can produce a host of bad effects. The collective term that is used for the microbes in our body is called the microbiota.  These include bacteria, fungus, viruses and other microscopic critters, many of which can be unwanted.

Most of the microbes that inhabit our body reside in the large intestine, and like I said before, they can be our friends. As long as the good bacteria outnumber the bad bacteria we have a much better chance of being healthy. Obviously, there are a lot of other factors in our health, such as genetics, environmental toxins and emotional stress. A healthy gut will go a long way towards positively influencing these factors. For instance, we know that healthy microbes when fed the right foods produce short chain fatty acids that are anti-inflammatory.   If we starve these microbes by not giving them the right food, or kill them off by taking too many antibiotics, our body becomes inflamed.  It is becoming more apparent that most of the chronic diseases today can be tied to systemic inflammation. So a healthy gut is key in fighting chronic disease.

Depression in many cases is the lack of a neurotransmitter called serotonin which is produced in our gut. When we are depressed it may be due to a disrupted gut, and often we deal with depression by eating more bad food. This creates a vicious cycle.

So a healthy gut is your first line of defense and an imbalance in the gut, called dysbiosis, has now been tied in some way to just about every chronic disease out there. Because the gut is related to the development of immune cells, several autoimmune diseases have been tied to dysbiosis.  Cognitive disorders like Alzheimer’s, Parkinson’s and even autism, have shown vast improvements when the gut flora is improved and the diet is cleaned up. There is increasing evidence that inflammation can be tied to many of the chronic diseases out there and as stated before, imbalance in the gut sets up an inflammatory cascade.  And of course all the digestive disorders out there were some of the first conditions to be tied to dysbiosis.  If you are overweight and have dieted to no avail, more than likely your gut should be looked at closely. So what can we do?

Eat More Vegetables

What we put into our mouth greatly affects our microbiota.  They feed mainly on fiber that is indigestible by our stomach.  So if we don’t get enough fiber in our diet we starve these microbes and are deprived of the benefits they provide.  This also lets bad bacteria have free rein. So the first thing we can do is eat more vegetables. It is the fiber in vegetables that feed the helpful flora in our large intestine.

Avoid Antibiotics When Possible

Obviously, there is a time for antibiotics. They are of course necessary to fight bacterial infections. Unfortunately, lots of kids get them every time they get a cold or the flu.  Both of these are viral and antibiotics can’t help. What they do accomplish is to kill off the good bacteria as well as any bad ones. Any time you take a course of antibiotics you should counter the damage to your healthy flora by supplementing with probiotics, and not just any off the shelf probiotic. If you are going to take a probiotic make sure it is a high quality product or you’re doing yourself no good.  The more live cultures the better, and since an effective probiotic must have live cultures, make sure it is sold to you refrigerated.

Get Tested

So, in many cases getting your gut in order may be the first order of business in fighting just about every chronic disease out there.  Of course, there may be other factors. That is why it is good to be examined from a functional perspective. There are some great tests out there to determine whether you have an out-of-balance gut and great strategies on what to do about it. Come see us and get tested today!

Introducing Functional Medicine

Functional Medicine

In the New Year, Baer Chiropractic will be adding functional medicine to its list of services provided. As powerful as pain relief is, we are no longer satisfied with just getting people to feel better. Yes, it is the first step toward a healthy lifestyle. People have to move better before they can take control of their health. But that alone doesn’t address the epidemic of chronic diseases that we are experiencing in modern industrialized society today. Every one of my patients either has a chronic disease or is on the way to getting one. As Harry Truman said, “The buck stops here.”

All of the chronic diseases we are faced with today are lifestyle diseases that conventional medicine is approaching with pills and surgery.  Heart disease, diabetes, autoimmune diseases, Alzheimer’s, and yes, even cancer are a direct result of poor diet, lack of exercise, exposure to toxins and poor handling of stress. The medical community and drug companies have been working toward curing these diseases, and perhaps with the best intentions, but things are getting worse. More diseases are born each year. “Adult” onset diabetes is now a disease of young teenagers.

Medical doctors have become so specialized that some of my patients have as many as five different specialists for each of their chronic conditions. Oftentimes they have symptoms that no one has time to treat and they get shuttled from one specialist to the next. Their cardiologist says their chest pain is reflux, and their gastro doctor says it is a pulmonary problem. And your family doctor is now merely a traffic cop that hopefully directs you to the proper specialist. In the end the answer is pills and more pills. And yes, sometimes pills are the temporary answer, but they can never take the place of a healthy diet and exercise.

Functional Medicine is a whole systems approach of finding the root cause of disease, not dispensing pills to mask the symptoms. If you are depressed maybe your body isn’t producing enough serotonin, but why? Why is your liver producing too much cholesterol and why is it causing plaque formations on your arteries? Why are there amyloid formations sticking to the brain cells in your hippocampus? Why are there tumors forming in your body? The answer is that the environment in your body is favorable for these pathologies to happen.

In functional medicine we simply ask the why questions. To do this we have to take a detailed look at the environment of your whole body. This might require a lot of specialized tests, and maybe temporarily taking supplements that aren’t covered by your insurance. But in the end, the answer is almost always going to be proper diet, consistent exercise, and stress management. Of course, it might be harder than just taking pills for the rest of your life, but it works.

And it does work!  I recently went to my now former medical doctor with a list of the supplements I was taking. She took the list and without looking at it said, “There is no evidence that any of this works.” Well, the fact is, there is evidence.  For years I have been touting Omega 3s and probiotics, based on evidence in medical journals that they do work. And suddenly, because they do work, pharmaceutical companies are marketing prescription forms of these supplements. I recently lowered my own cholesterol from 270 to 155 with diet, exercise and supplementation alone.

The bottom line is functional medicine doctors are reversing chronic diseases such as diabetes, heart disease, autoimmune diseases and even Alzheimer’s. Call us today, we will happy to answer any questions and schedule an appointment for you. We look forward to helping you be the best that you can be.

Just Breathe

In my opening blog I encouraged you to just move.  Today I’m going to peel it back a bit and tell you that on the most basic level the most important thing you can do is breathe properly.  We breathe on the average around 20,000 times per day.  If we don’t do it right there are numerous consequences.

Your diaphragm is your major muscle of inhalation.  It serves another vital function as a stabilizer of the spine.  How does this work you might ask.  If you look at an anatomy chart there are lots of muscles posterior to the spine but none in front of the spine.  So how do you maintain stability in front of your spine?  This is done by intra-abdominal pressure, the dance between your muscles of inhalation, primarily your diaphragm and your muscles of exhalation, largely your abdominal wall muscles.

So poor breathing overuses our helper breathing muscles, such as our scalenes and upper traps, typically over-tight muscles in the neck.  Overusing these muscles several thousand times a day make them extremely tight.  You can see this in its extreme in those people who appear to have steel cables running down the front and back of their neck.  These in turn can cause neck pain and entrapped nerves and in extreme cases herniated discs can be the result.

Another consequence of dysfunctional diaphragmatic breathing is low back pain due to poor spinal stability.  As we lose our anterior stability, through the above mentioned mechanism, our back muscles have to work extra hard to stabilize our spine.  Any number of spinal stabilizing muscles can become overworked and over-tight, and back pain follows.

Other consequences of dysfunctional or paradoxical breathing are acid reflux and high blood pressure.  The diaphragm has canals through which the esophagus and inferior vena cava travel and in cases of long term dysfunction these vessels can become constricted.  Obviously, a constricted diaphragm is not the only thing that can cause reflux or high blood pressure, but it can be a major contributor.

Poor breathing habits can be the cause of your back and neck pain, or can be the precursor of problems to come.  Correcting your breathing can be a simple solution that puts you on the road to recovery.

Here is a video on the diaphragm function.  Notice how the ribs are supposed to move during functional breathing.

So get checked by a professional to make sure your diaphragm is working optimally.

Seek out a movement specialist

Stability or mobility? That is the question. For our bodies to move optimally we have to display the perfect combination of mobility and stability, having the ability to move fluidly from a stable platform. Every physical task we perform requires a delicate ballet between our ease of movement and our ability to stabilize ourselves in anticipation of that movement. Pain-free and injury-minimizing movement requires both. As a chiropractor and a movement specialist it is my job to help you strike that balance.

As far as the chicken and egg argument, mobility came first. When you were born your body was nothing but a floppy mass in search of ways to fulfill its needs. Lack of mobility was not an issue. You had to earn stability to develop purposeful movement. To look up and find your way you had to first stabilize your head on your neck. That is why to this day it is more important that your neck, especially the middle part, be stable. Then you learned to reach and roll and stand up and ambulate, all through trial and error until finally your brain and body worked as a team, and you learned how to stabilize enough to make the movements necessary to get what you wanted.

So through a maturation process, early on, we become a perfect union of stability and mobility. Then we go about mucking it up. We sit on our butts too much or we experience physical traumas or we do ill-advised exercises which either compromise our movement ability or sacrifice stability. There are hundreds of ways for us to screw up. Just eating a fast-food diet or not drinking enough water can compromise our body’s ability to move properly. Early on, as we lose this balance, we become, as one of my teachers puts it, dirty rotten compensators. Stabilizing becomes inhibited. Muscles which are designed as movers take on a roll of stabilizer helpers and become overworked. A good example is your spinal erector muscles, whose purpose is to help you stand up straight. Their primary job is NOT to stabilize the spine. Yet when the stabilizers of your spine are not doing their job, the erectors take over and back pain ensues.

So we need mobility to move and stability to have purposeful movement. Working out in a gym can do more harm than good. Most of us, because we do not have proper guidance, go too far in one direction or the other.   Maybe you can squat 400 pounds, but can’t touch your toes. This could mean you’re using your hamstrings more than your glutes. This is a body waiting for an injury. Why do some great athletes have their careers cut short because of non-contact injuries? Simply put, they have lost their balance between stability and mobility. They have poor form. They are dirty rotten compensators.

Can you have too much mobility? Absolutely! There are parts of your body which must be stable. As I said earlier, the middle part of your neck needs stability to support your head. So having your neck adjusted five times a week for six months is probably not a good idea. Of course, if you have had neck trauma you do need adjustments and soft tissue treatment to mitigate long term stiffness. But for the most part neck adjusting should focus on the upper and lower part of your neck where most of the movement is supposed to happen.

And yes, you can have too much stability. Our thoracic spine needs to be mobile for us to breathe fully and for all the adjacent appendages to move freely. If you have poor movement in your thoracic spine and have a job which requires a lot of reaching, or even mousing, you can eventually develop shoulder or elbow problems.

So our bodies are a succession of joints stacked on top of each other which are alternatively designed to be stable and then mobile. Our feet, which are the foundation of our locomotive system, need to be stable and our ankles should be mobile, our knees should be stable and our hips mobile, and so on up the body. And yes, a foot can be too stable and an ankle too mobile. To navigate this sea of confusion you need to see a trained movement specialist who looks at your body as a whole and addresses all of your faulty movement patterns.

Welcome to my blog

This is the opening entry of many blogs to come. My intention is to guide people to a healthier lifestyle, and to do so with a new paradigm. I consider myself part of a growing movement of chiropractors and other physical health specialists who are going old school and trying to encourage people to be healthy through diet and exercise, not to become dependent on drugs or long treatment plans to feel better. Being an active participant in your health is the only way to feel better and stay better. It’s like the old saying “give a man a fish, you feed him for a day. Teach him to fish and you feed him for a lifetime.”

There are a lot of people out there trying to sell you a bunch of junk. The infomercials and commercials abound:

“Take this pill and your life will turn around.” (Just don’t read the fine print!)

“This machine will cure your back pain.”

“Come see me 60 times and you will be pain free.”

The secret is, you and you alone hold the power to improve your life and yes, even rid yourself of pain. You don’t need a pill, or a lifetime of adjustments. You need to get back to basics like how to sit and stand, how to move and what to eat and drink. And yes, you may need some adjustments and soft tissue work to get your body moving in the right direction.

As world-renowned physical therapist Gray Cook says, “First learn how to move well, and then move often.”

We have just become lost in all the smoke and mirrors of advertising. Bottom line is you have to want to get better and you have to do it yourself with some proper guidance. That is what I provide to my patients and what I hope to provide in posts to come.

Yours in Movement!

Dr. Andrew Baer