Neck Pain with Breastfeeding

Do you struggle with neck pain when breastfeeding? Maybe you’ve tried heat and ice packs and ibuprofen and nothing seems to help? Eventually you start to dread sitting down for another nursing session because you know the pain will still be there. In this video I’m going to show you how you can fix your neck pain so you can get back to breastfeeding more comfortably.

I will show you three simple stretches and three self-care muscle therapies you can do to help reduce your neck pain with breastfeeding. And I’ll explain what the next steps are if the issue has become chronic and isn’t responding to at-home care.

If you’d like to book your free consultation, please fill out the form below and we will contact you within 24 hours.

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Diastasis Recti: What it is and how to treat it without surgery

Oakland chiropractor how to treat diastasis recti

 

Diastasis Recti is a condition in which your most superficial abdominal muscles (rectus abdominus) separate along the midline of the body. The left and right sides of the abs split apart and the connective tissue along the midline stretches and becomes weaker. It most commonly occurs during pregnancy or during childbirth, but many people, including some men, have a diastasis recti and just don’t know it! It has been said that even the founder of Pilates, Joseph Pilates, had a diastasis!

Other than the abdominal “pooch” appearance that can go along with a diastasis, there can also be functional deficits. These muscles are designed to help support your back and your organs, and if they are no longer in the proper location and holding the proper tension, they fail at these important jobs. Pelvic pain, incontinence, back pain, and poor joint mechanics can all occur when someone has a diastasis. The goal is to draw the muscles back towards the midline, so that they can start doing their job again, and that the connective tissue no longer has to work overtime to provide that support in their absence.

The main cause of a diastasis is continuous stretching or overuse of the rectus abdominus muscles.  Pregnancy or carrying a lot of excess weight in the abdomen is the primary cause of stretching of these muscles. Strangely enough, overtraining this set of muscles (overuse) in the quest for better looking abs, can actually cause a diastasis to occur, which allows for an abdominal protrusion, which causes the abs to look more “pooched-out”. So many fitness buffs create that vicious cycle because there is such a strong popular focus on crunches, bicycles, jackknives, and similar exercises that contract the rectus abdominus almost to the exclusion of the transverse abdominus (the deepest, most stabilizing layer of the core). If we can strike a balance between training the front of the abs, as well as the deepest layers of core support (deep low back muscles, transverse abs, diaphragm, and pelvic floor muscles), we can prevent a diastasis from occurring. And once a diastasis occurs, shifting the focus away from traditional abdominal exercises and towards more comprehensive core strengthening, can help decrease the severity of the condition and also increase the stability and function of the core.

Treatment of Diastasis Recti

***Exercises to do:

Transverse ab strengtheners (heel slides, modified dead bugs, core contractions/compressions)

Glut exercises (gluteal bridges, squats, single leg deadlift, squats)

Pelvic floor exercise (kegels with transverse ab contraction)

Diaphragm exercises (deep breathing relax on inhale, pull navel to spine on exhale)

***Exercises to avoid:

Forward flexion (Crunches, bicycles, rollups and rolldowns, jackknives, boat pose)

Forward loaded exercises (front plank, full pushup, bird-dog, burpees)

Extreme extension (ab exercises over exercise ball, full upward facing dog)

Auxiliary Care for Healing Diastasis Recti

It’s important for the pelvis to be well aligned and balance while you work to heal a diastasis. If the pelvic joints are restricted or out of alignment, it will be more difficult to maintain proper core stabilization during challenging exercises and everyday activities. Likewise if the any muscles that attach to the pelvis or core are overly tight, that can cause a pull on the bony structure of the pelvis and skeleton, resulting in pain, tightness, and lack of function. A major culprit that causes a whole cascade of dysfunction is the psoas muscle. Chiropractic adjustments and Active Release Techniques (ART) can help restore proper pelvic alignment and muscle balance.

If you think you may have a diastasis, or if you are suffering from any pain or tightness in your pelvis, hips, or glutes, please give us a call to see if and how we can help. 510-465-2342.

Image credit: wikipedia commons

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Does Your Belly Always Feel Protruded? Check Your Psoas.

anterior pelvic tilt protruding belly psoas

It’s often thought that a protruding belly posture is due to weak abdominals. In terms of fixing that faulty posture, it seems logical that if you were to “pull” the belly in by strengthening the abdominals, you would no longer have that protruding belly posture. That’s understandable, and may even be the case with a condition such as diastasis recti, but before we assume we’ve found the cause of the postural issue, let’s look at one alternative viewpoint.

250px-Psoas_major_muscle11

It is tight psoas muscles, which lie behind the contents of the abdomen, that pull the spine forward and pull the pelvis into an anterior tilt (top of the pelvis rotates forward). They will also push the abdominal contents forward, creating the appearance of a protruded belly.

Have you ever noticed that your belly looks flatter in the morning (after you’ve been lying flat for 8 hours, your psoas muscles are more relaxed and lengthened) and looks more rounded or protruded later the day (after you’ve been sitting, driving, running, etc, your psoas muscles are chronically shortened and contracted). Of course there are confounding factors to this, timing of meals and digestion, etc. that can make a belly appear more or less rounded, but psoas muscle tightness is an important factor that contributes to a protruded belly posture. This is important not only for looks (not all of us want to constantly look like we’ve just eaten a big meal), but for function and comfort. Tight psoas muscles are a big contributor to low back pain, not to mention chronically tight psoas muscles can reciprocally inhibit the gluteal muscles, leaving us with dead butt syndrome.

So what should you do about tight psoas muscles? You could stretch them. And that will work great if this is a new tightness. But if the tightness has been going on for awhile, the muscle will have entered the cumulative injury cycle.

First line of defense is to try stretching your psoas muscles. Here’s how:

Stretch your hamstrings too, since tightness in the psoas and the hamstrings often occur together.

Any time a muscle is overworked (repetitive motions, repeated contractions) or acutely injured (fall or collision causing a tear or crush), it receives a decreased amount of bloodflow (read: oxygen flow).  If this condition continues, the hypoxia (lack or oxygen flow) causes adhesions to form in the muscles.  These are sticky areas, almost as if someone poured glue into the muscle, which limit range of motion, alter your biomechanics, and cause pain.  Adhesions remain until they are treated.  Rest, ice, stretching, and ibuprofen will not make them go away!  It’s like trying to stretch a rope that has a knot in it. You might get a bit of stretch on either end, but the knot in the middle will just become tighter. You may get some temporary relief with rest, ice, or stretching, but once you resume your activities, the issue will make itself known once again.

So what will work to resolve the muscle tightness? Active Release Techniques (ART) is a great option. ART will increase circulation to the muscles, decrease inflammation, and restore functional motion to the hips.  What this means, is that it will clear out adhesions through an entire range of movement.  ART protocols will typically require the sports chiropractor to shorten the involved muscles (to shorten the psoas muscle you would bring the knee towards the chest), take a thumb or hand contact with a specific direction of tension, and then maintain that tension while the client lengthens out the muscle (bringing the leg behind you in hip extension).  This breaks up the adhesions and allows for the restoration of full functional movement.

If you are suffering from low back pain, hip pain, or feeling like your belly is constantly being pulled forward, call us today to schedule an appointment to find out whether a tight psoas muscle is to blame. 510-465-2342.

Image credits: wiki commons

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Treatment for Tendinitis and Tendinosis

oakland chiropractor tendinitis

 

A tendon is what connects a muscle to a bone, thus a lot of force gets transferred through a tendon during activity. There are two types of tendon pathologies aka tendinopathies:

Tendinitis: a symptomatic degeneration of a tendon with vascular disruption and inflammatory repair. There will often be a sharp and localized pain with activity, first thing in the morning, and after long periods of rest.

Tendinosis: a chronic tendon injury, having a focal area of noninflammatory degeneration that may be asymptomatic. A person will feel a fairly constant dull ache that is difficult to localize (it’s difficult to put your finger on exactly where the pain is).

The progression of a tendon injury is usually linear, and follows these states:

Nirschl’s stages of tendinopathy:

Stage 0 (Healthy): firm tendon with no pain or swelling, normal temperature of tissues.

Stage 1 (Acute tendinitis): acute swelling and pain, tenderness, warmth, dysfunction.

Stage 2 (Chronic tendinitis): ongoing pain with tenderness, more dysfunction, desire to take load off the area.

Stage 3 (Tendinosis): enlarged tendon, tissue swelling, increased dysfuntion with or without pain, tendon sheath may be swollen.

Stage 4 (Rupture): weak and painful when testing muscle against resistance, inability to move the affected joint.

Tendons get injured because of the “tendon paradox“.

paradox escher waterfallOxygen consumption is almost eight times lower in tendons and ligaments than skeletal muscle. In order to protect against situations involving serious decreases in blood supply, tendons have evolved to have a low metabolic rate and a low anaerobic generating capacity. This allows them to carry loads and maintain their tension over time.

The problem develops, however, once a tendon becomes injured. Due to it’s low metabolic rate, it is very slow to heal. This may explain why tendon injures take so long to treat, and why they often develop into chronic issues. If an athlete doesn’t allow their tendon a break from the aggravating activity, the tendon will be in a losing battle against it’s own poor blood supply.

What are the factors that can cause a tendon injury?  There are internal and external factors.

Internal factors
-Born with one longer leg
-“Knock knees”
-Q-angle
-Age
-Sex
-Flexibility
-Fatigue

External factors (overuse and training errors consisting of):
-Faulty equipment, uneven running/playing surfaces
-Shoe wear
-Too much/too soon
-Not enough recovery time
-Asymmetrical training

To rehabilitate a tendon injury, you can do either concentric exercises (loading the muscle and tendon while it is shortening eg. bicep curls) or eccentric exercises(loading the muscle and tendon while it is lengthening e.g. calf drops off a stair; using both legs to rise, and only the involved leg to lower).

You get more for your money doing eccentric exercises because:
-Less oxygen consumption
-More force production
-Less energy requirement

Our protocol is to start with eccentric exercises for tendon injuries. Once the athlete has no pain with walking and stair-climbing and other daily activities (not including running or playing sports), concentric exercises can be started. And once concentric exercises can be performed without pain, a gradual return to sport can happen.

Studies of Concentric vs. Eccentric Exercises:

Systematic literature reviews of tendon injuries in the lower body, found that eccentric exercises may reduce pain and improve strength, but it is not clear that this type of exercise is better than other types of rehabilitation. So exercise is just part of the picture in terms of rehabbing a tendon injury.

Other Treatments for Tendinitis and Tendinosis:

Manual therapy (ART for example, or Graston).
Adjust any fixations in involved joint and further out along the kinetic chain.

If you think you have a tendon issue, please call us at 510-465-2342 to get started on your path to healing.

 

Reference:
Eccentric Exercise Interventions for Tendinopathies
Daniel Lorenz, PT, DPT, ATC, CSCS, USAW
National Strength and Conditioning Association Vol 32 #2 April 2010.

Photo attributions:
Ankle: wiki commons.
“Escher Waterfall”. Licensed under Fair use via Wikipedia – https://en.wikipedia.org/wiki/File:Escher_Waterfall.jpg#/media/File:Escher_Waterfall.jpg

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FOOT PRONATION: The Shock Absorber of the Body

shock absorber of the foot

When you think of shock absorption in a car, the above picture might be what you imagine.  A series of springs and rods that can take force from one direction and transfer it into another structure.  But what if I asked you to describe the shock absorber of the foot? Some people think of the cushion in running shoes, others picture the heel bone transferring the shock, and yet others think about insoles. While all of these things can contribute some shock absorption to the big picture, the biggest shock absorber of the body is actually FOOT PRONATION!

But Dr. Sandy, no…that can’t be right!  All I hear about is being careful not to pronate when I run or that some people need special shoes so they don’t pronate too much. Why would I want to pronate on purpose?!

Well, the answer to that lies in drawing a distinction between normal pronation and over-pronation. If the foot didn’t pronate at all, we would never be able to land our foot on the ground in preparation for pushing-off. We would all walk around with rigid levers on our feet… CLUNK, CLUNK, CLUNKETY-CLUNK like robots. We won’t get into the issue of over-pronation in this article, but let’s dive a bit further into the normal, healthy pronation of the foot.

robot pic

Shock is absorbed when the rapid pronation of the foot is controlled by the posterior tibialis muscle. This muscle functions in an eccentric contraction (slowing down the elongation of the muscle).  This careful control by the posterior tibialis allows the medial longitudinal arch of the foot to be gently lowered to the ground as opposed to letting it slap the ground.

Four common problems affecting pronation:

1. Joint fixation in the lumbar spine (the nerve flow to posterior tibialis comes from the nerve exiting the spine at L4/L5 in the low back).

2. Disc herniation in the lumbar spine, for the same reason as in #1.

3. Joint fixation between any of the 26 bones in the foot.

4. Adhesion in the tibialis posterior muscle itself, as a result of overuse of poor biomechanics.

Once we find out the problem that is limiting pronation, we can get started treating it through chiropractic adjustments, Active Release Techniques, or rehabilitation exercises.

If you are on your feet a lot and would like to make sure you’re achieving healthy shock absorption, please call us at 510-465-2342 to setup an appointment.

Love your Food, Love your Body upcoming workshop

We have a special announcement to share!  A colleague of mine, a very thoughtful and skilled yoga therapist, is offering a new workshop this summer called Love your Food, Love your Body. It’s on 8/23/15 from 2-4pm at Leela Yoga in Alameda. Participants will learn techniques to re-establish a healthy relationship to food and body: manage stress, enhance body awareness, and practice joyful and intuitive eating. Jennifer has shared with us her story here, as well as one of the exercises that she will feature in her workshop.

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One day during savasana (the relaxation pose at the end of a yoga class) I basically ‘woke’ up. In that moment, I felt completely content, possibly for the first time in my life. I began to clearly see the suffering I was putting myself through in relationship to my body and eating.

It set me on a track towards wholeness…towards getting back in touch with my true self – that part deep within you that is always content, peaceful, unchanging and unaffected by societal pressures.

Once I learned how to extend my awareness and acceptance of myself off the mat and into my life, yoga helped me both become more aware of and heal my disordered eating habits and negative body image.

It essentially rewired my thoughts and, in turn, my habits. I had no idea this was even possible! I truly thought I was doomed to live in a body I disliked and feel like a failure for not being able to change it.

Yoga and mindfulness give us so many brilliant tools for improving our relationship to our bodies and the food we offer them. I’m thrilled to share with you some of the tools that have helped me learn to once again enjoy food and enjoy living in my body.

Here’s one you can try right now:

  1. Lie down in a comfortable position.

  2. Take 10 relaxing breaths focusing on releasing any tension in your body or mind.

  3. Pick two areas of your body that you appreciate and clearly state to yourself why…and really mean it! Stay with each thought and let it soak in for several moments.

For example:

1. I appreciate my feet because they carry me around all day without complaint.

2. I appreciate my arms because they allow me to embrace my loved ones.

“It is through your body that you realize you are a spark of divinity.”

— BKS Iyengar

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Jennifer Meek is a Certified Yoga Teacher (RYT 500) specializing in Yoga Therapy for common challenges such as diabetes, hypertension, back pain, stress, anxiety, body image and trauma.

Yoga transformed her relationship with food and body and she is passionate about sharing these tools with others. You can find her teaching private lessons, public group classes, as well as incarcerated youth in Alameda County. More info at www.jennifermeek.com.

Did You Know That a Chiropractor Can Adjust a Jaw?

jaw pain helped by oakland chiropractor

Of all the areas of the body that I regularly adjust in my office, the jaw is the one that draws the most surprise from my patients. Many people don’t know that the jaw can get fixated, and that a chiropractic adjustment can restore the mechanics of the jaw.

The jaw has two joints (temporal-mandibular joints) each cushioned by a disc, and one or both can become problematic under the influence of stress, trauma, teeth grinding, poor head posture, or prolonged dental work. The issue is that the disc material can get entrapped either in front of or behind the hinge-like ends of the jaw bone (the condyles of the mandible). The clicking or catching feeling you may hear or feel is the condyle slipping past the trapped disc.

Jaw pain treated by Oakland chiropractor

The rounded condyles of the jaw are shown on the far right of this picture.

On a side note, during an extremity adjusting seminar we had the opportunity to watch videos of surgical procedures showing several types of TMJ surgery. One surgery was to scrape out scar tissue that had built up around the disc that was preventing proper motion. Another surgery was to remove an entire damaged disc! It was amazing to see the texture of the disc material. It was not at all what I had imagined it would be. It stretched quite a lot and looked extremely sticky.

According to Dr. Hearon, an expert on extremity adjusting, you must have three of the following twelve symptoms to have a diagnosis of Temporal Mandibular Syndrome (TMS). If you have fewer than three of this list, you have Temporal Mandibular Dysfunction (TMD). So basically, your treatment will look similar, but you get a less-fancy diagnosis.

12 Major Signs/Symptoms of TMJ:

  1. Pain at the TMJ
  2. Crepitus (a grating sound) at the TMJ
  3. Bruxism (grinding the teeth, especially at night)
  4. Inability to open mouth more than 3 stacked fingers)
  5. Inablitiy to close teeth together
  6. Headaches
  7. Neck pain
  8. Tinnitis (ringing in the ears)
  9. Tracking deviation (jaw veers to one side upon open/close)
  10. Chronic recurring neck subluxations
  11. Muscle weakness in jaw movements
  12. Occular dysfunction (eye movement issues)

Depending on which direction the disc has slipped, there are two main jaw adjustments that a chiropractor can do that restore the function of the TMJ joints in order to decrease a patient’s jaw pain and other symptoms.

Do you experience three or more of the symptoms on this list? Schedule an appointment with your Oakland chiropractor to find out whether you have TMS, and to get started on treating it.

Photo credits: wiki commons

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Is Your Knee Pain Caused by a Mechanical Problem in Your Foot?

knee pain caused by foot pain

Your knee aches everytime you go down the stairs, it flares up after a long run, maybe you’ve even iced and foam rolled and gotten treatment of the knee itself, but the pain continues. What’s going on?

Many of my patients are surprised when they find out that a mechanical dysfunction in their foot was the cause of their knee or hip pain. Especially because they never had any foot pain!

When you push off the ground, your big toe (hallux) dorsiflexes, the rearfoot and midfoot supinate, the forefoot pronates on the midfoot, and the tibia externally rotates. This mechanism is called the Windlass effect.

If the Windlass effect is not working well or if the big toe is limited in its ability to dorsiflex, then we have a mechanical problem known as functional hallux limitus (FHL). When the foot is unable to move properly, something else will move more than it is supposed to in order for us to get from point A to point B. The forces get transferred abnormally into the soft tissues in the lower leg and around the knee, causing knee pain. If the issue continues upwards, hip or gluteal pain will often result as well.

 

There is a movement test that we do in the office to find out whether a patient has FHL. If the Windlass effect is not working correctly, we adjust the joints of the foot/ankle that are preventing this mechanism from occurring, and we strip the adhesions out of the overly tight muscles that go along with these joint fixations.

Book your appointment now to find out whether you have a mechanical problem in your foot. Call 510-465-2342.

Photo credit:wiki commons

Graston Technique Explained aka “How Do Those Metal Torture Bars Fix My Injury?”

oakland chiropractor graston tools

If you’ve ever seen the set of stainless steel Graston tools in our office, you may have wondered what those scary-looking devices are good for!  You may have even experienced a Graston treatment on your knee or shoulder, but not really understood what the tools do.  Today’s article will explain the theory behind Graston, aka “Why This Torture is Really Effective”

*Since this is the internet, it should be noted that we use the word “torture” in a tongue and cheek way.  Of course we’re always working within patient tolerance and encouraging our patients to use breathing techniques to keep the muscles relaxed and their mind distracted from the pain.  And some people report that it doesn’t feel like torture at all, and that they even prefer the Graston technique to manual therapy.  But for most people, it’s worth the temporary discomfort during treatment to arrive at a pain-free place after treatment.
Oakland sports chiropractor uses Graston Technique to treat shoulder pain

Graston falls under the umbrella of Instrument Assisted Soft Tissue Mobilization (IASTM).  This is a form of therapy that uses specialized stainless steel instruments to assist the clinician in the mobilization or poorly organized scar tissue in and around muscles, tendons, and fascia.  The instruments are solid and have angled edges, and are guided with the help of a lubricant such as coconut oil.  Longitudinal strokes are applied parallel to the fiber alignment in a stroking motion along the skin to mobilize the underlying soft tissues.

As the instruments move over an area with underlying fibrotic adhesion, a change in texture is palpable.  The initial strokes, which are used for screening purposes, are smooth and flowing, but become shorter and more concentrated to increase the pressure per unit area once the fibrosis is located.  The pressure needs to be firm enough to locate the fibrosis and cause microtrauma, but not so hard that macrotrauma occurs.  The microvascular trauma and capillary hemorrhage induces a localized inflammatory response and stimulates the body’s healing cascade and immune-reparative system.  (We need to stir up a little bit of inflammation to get rid of a larger inflammatory problem).

Usually upon completion of treatment, there is immediate erythema and the potential for some transient ecchymosis.  (This means there are some tiny red dots that show up as the tiny microcapillaries burst open, and there can be some possible short-term bruising.)

Treatments can be one-time only, or performed over a course of 6-8 sessions, depending on the severity and duration of the injury.

Have you experienced Graston treatments?  What do you like or dislike about it?  Let us know in the comments below.

Source: Orthopaedic Examination, Evaluation, and Intervention.  Dutton, Mark.

Photos: Wiki commons

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Sciatica – 5 Things You Didn’t Know

sciatica

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Riverstone Chiropractic is conveniently located on Grand Avenue in Oakland CA. We serve patients from Oakland, Berkeley, Albany, Richmond, Walnut Creek, El Cerrito, Emeryville, San Leandro, Alameda, and surrounding cities in the bay area. Riverstone sports chiropractor Dr. Sandy Baird uses their background in athletics and massage therapy to provide their patients with effective and personalized sports medicine treatments, which include Active Release Techniques, chiropractic treatment, deep tissue massage, and rehabilitation exercises. Riverstone Chiropractic - 3409 Grand Ave #5 Oakland California 94610 - (510) 465-2342