Doctorate of Chiropractic degree (D.C.) in 1977 from the Canadian Memorial Chiropractic College in Toronto.
Definition of chiropractic
Anatomy
First Visit
Chiropractic Treatment
Chiropractic Treatment & Management of Headaches
Conditions Treated At Dr. Fuller's Clinic
Motor Vehicle Accidents (MVAs)
Weight Training Injuries & Management
Nutrition Corner
Orthotics
Origins
Research & Other Updates
When To Consult A Chiropractor
Laser Therapy & Phototherapy
 
Recent research on use of ice as therapy
1.
Dykstra et al in Journal of Athletic Training 2009;44(2):136 compared use of a) 2000 ml of crushed ice, b)2000 ml cubed ice, c) 2000 ml crushed ice in 300 ml of room-temperature water and concluded that a “wetted ice pack is more effective at decreasing treatment area temperature and at maintaining it than cubed or crushed ice.” The greatest change in surface temperature was achieved at 18 minutes for all methods.
2.
Anaya-Terroba et al in Journal of Manipulative Physiological Therapeutics 2010;33:212 concluded that ice massage increases pressure pain thresholds following isokinetic exercise and increases EMG activity, indicating a possible activation of descending inhibitory spinal cord pathways.
3.
Herrera et al in Physical Therapy 2010;90(4):581 determined that ice therapy decreases nerve conduction velocity and increase the latency and duration of action potentials, thus nerve current is reduced and the refractory period is increased… translation, pain relief. However, while ice massage produces the greatest change in skin temperature, cold water immersion produces the greatest effect on nerve conduction velocity and most likely to reduce pain and inflammation.
4.
Bleakley et al in British Journal of Sports Medicine 2006:40:700 performed randomized clinical trials and concluded that short and intermittent applications of ice therapy may promote better pain relief than continuous application.
 
Long term benefits? Knowledge of long term outcome following cryotherapy for soft tissue injury is minimal and insufficient.
 
The main determinants of health are a) behaviour, b) physical and social development.
Leading causes of death in 1990-2000 were tobacco use (19%) and poor diet/physical inactivity (14% &17%) far ahead of next causes of death which were alcohol (5%) and microbial agents (infections) at 4%.
Leading cause of disability in the all developed countries at present is musculoskeletal conditions, accounting for over 50% of chronic conditions in those over age 50.
 
When to use HEAT or COLD as therapy?
According to Chad Starkey, PhD, ATC, in the book, Therapeutic Modalities, 2004, “CRYOTHERAPY” (the use of ice) at temperatures between 32-65 degrees F causes heat to be removed from the body and absorbed by the cold source until the temperatures are equal.
The body responds with local physiological effects such as vasoconstriction (decreased blood vessel diameter), decreased metabolic rate, decreased inflammation and decreased pain.
The less body tissue that has to be penetrated, the less time required. In any event, the depth of penetration for cold is 5 cm. Cold therapy penetrates deeper and effects last longer.

“THERMOTHERAPY” refers to applying heat. Hot packs or whirlpool must be capable of increasing skin temperature in the range of 104-113 degrees to produce therapeutic effects and is limited depth of 2cm.
The effects of heat on metabolic rate, blood/fluid dynamics and inflammation are generally opposite of cold, BUT both can reduce pain depending on the condition.
Superficial heat applications work best with sub-acute or chronic conditions.

QUICK REFERENCE CHART
Use ICE for acute (new) sprains, strains always, and many people find ice therapy useful for chronic (long-standing conditions also). Use ice for inflammation around joints or muscle tissue and to help reduced range of motion of joints due to pain.
Use HEAT for delayed-onset muscle soreness after exercising or for range of motion stiffness due to stiffness.
Dr. Fuller recommends using ice cubes from your freezer in a zip-lock plastic bag directly on the skin (unless contraindicated, such as impaired sensory skin perception) for 20-25 minutes. Other commercially-available ice packs are helpful but not as good.
Various topical (on-the-skin) ointments are available from health food stores which contain natural healing properties, and while not as penetrating as ice, do have practical advantages such as working to reduce pain while sleeping, working, driving, etc.

 

Does chiropractic treatment require medical referral?

No, Doctors of chiropractic are legislated as primary contact health practitioners, hence patients can call directly. However, many doctors of chiropractic do receive direct referrals from medical physicians and specialists. Chiropractors have the obligation and the legal right to arrive at and provide a working diagnosis and/or make appropriate referrals for further investigations.

 
Is chiropractic adjustment a safe procedure?

Yes, it is a drug-free, non-invasive approach to common musculoskeletal conditions such as neck and back pain, headaches, and pains in the arms and legs. The chiropractor has the responsibility to ascertain if there are indications or contraindications to such treatment.

 

Is chiropractic appropriate for children?

Yes, children may benefit. They are very active physically and experience falls and blows from sports and daily activities. In the case of children, chiropractic treatment is very gentle and comfortable, and indicated for many common mechanical, uncomplicated back and joint problems.

 

Does chiropractic care require X-rays?

Careful thought and discretion is exercised before X-rays are considered. In general X-rays are mainly indicated when trauma (injury) is involved, where there is suspicion of serious disease or arthritis, or where a condition is not responding as expected to conservative measures.

Dr. Fuller is licensed and experienced in taking X-rays BUT does not take his own X-rays, preferring to refer to the patient’s medical physician with a memo explaining rationale for such consideration. Similarly, if Dr. Fuller deems that other diagnostic testing such as CT scan, bone scan, MRI, MRI/arthrogram ,bone densitometry,  ultrasound testing are indicated, he will communicate this to your medical physician and/or specialist.

 

Can chiropractic care cure colds, earaches, and other ailments?

Chiropractic care cannot cure these conditions, but there is some evidence that adjustments may have a beneficial effect on a variety of conditions, regarding some of the secondary or referred symptoms arising from the response of the musculoskeletal system.

A study in the Archives of Pediatrics and Adolescent Medicine 2003, Vol.157 concluded that manipulative techniques in children with recurring infections can prevent or decrease surgical intervention or antibiotic use.

 

Are chiropractors licenced to take x-rays (radiographs)?

Yes, doctors of chiropractic undergo extensive training and examination in measuring and taking x-rays as well of course in interpreting and conveying to patients the findings on x-ray films. However, in Canada the majority of chiropractors do not have their own x-ray equipment anymore but do prefer to provide any perceived rationale to the patient’s medical physician for x-rays. In the interim, depending on practicality, the chiropractor may avail himself of the films to discuss with the patient, then will follow-up to confirm that the ensuing medical radiologist’s report correlate with the chiropractor’s impressions.
All other medical imaging (CT scan, MRI, MRA) and electrodiagnostic (eg. EMG, NCS) testing must be arranged by medical physicians.

X-rays seldom provide useful information about back problems, and one must be judicious when considering possible importance of anyabnormalities seen on xray films. Certainly x-rays are needed to uncover pathological processes (diseases), fractures, dislocations, but judgment must be exercised in ascertaining if there are sufficient suspicions to order x-rays.

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What about “disc” problems?

Discs are a type of cushioning cartilage between the spinal vertebrae.
Discs can undergo several types of problems:

 

a)Degeneration is part of normal aging process since they lose fluid as we age and sometimes is seen on x-rays as “thinning” or degeneration” or “deterioration” as doctors call it ‘degenerative disc disease.’ This may or may not cause back pain or other spinal-related symptoms.
b)Bulging, protrusion and herniation of disc material means that some of the inner liquid part of the disc (“nucleus pulposus’) pushes out through the outer wall of the disc (‘annulus fibrosis). Disc protrusions can become torn or fragmented (‘sequestered’). These also may or may not cause back or back-related symptoms, but are potentially more serious, especially if coupled with an injury. If part of a disc breaks off completely and causes serious signs and symptoms such as bowel or bladder irregularities, this may signal a surgical emergency

 

Fortunately, most cases of these kinds of disc problems do respond to conservative measures, including chiropractic care.
For example, Dullerud in ‘Acta Radiologica 1994;35:415’ demonstrated that the greater the disc protrusion, the greater the reduction in protrusion from chiropractic care. Also, Komorl in ‘Spine 1996;21:225’ and Ikeda in ‘J. Spinal Disorders 1996;9:136’ concluded that migrating fragments actually resolve faster than the contained protrusions due to greater amount of inflammation around large protrusions.
Maigne in ‘Spine 1994;19:189’ reported that once disc fragments have broken off, inflammation around the disc decreases allowing the body to reabsorb fragments more easily.
The Alberta Workplace & Safety Board reported in 2002 that MRI follow-ups are proving that over time herniated parts of discs often shrink and are reabsiorbed by the body without surgery.

 
Is chiropractic care covered by any insurance?

Yes. 1. 65% of people who have a drug/dental plan (Extended Health Care or “EHC”) also have chiropractic coverage.

As with plans for drugs and dental, each plan has different amounts of coverage and we suggest that patients review their plan if they plan on having chiropractic care. Many people also have coverage via their spouse.

2. Those patients who are involved in automobile accidents (including those hit as a pedestrian) can request that their chiropractor complete a Treatment Plan proposal for the insurance company to determine if it is reasonable and necessary.

 3. Since 1937 those people legitimately injured while working qualify for the full cost of chiropractic care to be covered by WSIB..

 4. Extended health care plans also frequently provide coverage for shoe orthotics. and TENS electrical muscle stimulation machines for home use if these are legitimately indicated for a given person.

 

What about posture?

Correct posture means that the body is in a balanced position. The head, chest and pelvic areas are centred over each other.
Good posture improves appearance and makes clothes fit and look better.
It helps personality confidence and better health since body organs have room to work properly.
Causes of poor posture…….foot problems or ill-fitting shoes, weak muscles, tired due to health problems, poor nutrition, poor bedding, negative attitudes, injuries, excessive weight, emotional stress.
Improving posture…… learning and practicing daily good posture habits as directed by a chiropractor, good bedding, good shoes, opinion on any indications for shoe orthotics, exercise, good nutrition, adequate rest, fresh air, music, positive attitudes, regular chiropractic spinal checkups.

 

Your chiropractor is trained to answer your questions about your posture. Ideally, the spine should be straight when viewed from behind and obviously no one can do that for themselves. Your chiropractor is trained also to look for various clues such as uneven pelvis (one hip appearing lower than the other), uneven shoulders, unevenly developed muscles and more. Some of these may well be established beyond returning them to normal by early adulthood although chiropractic management and advice can certainly add good quality to your spinal health.

 

When seen from the side view, one should see 3 gentle curves, one we recognize as the mild rounding of the upper back, while the neck and lower spine should have gentle curves like the letter ‘C.’ These too must be seen by another person such as a chiropractor who is trained to comment on these patterns. Spinal alignment is important just as we recognize the importance of wheel and tire alignment on a car. However, unlike a vehicle, restoring spinal alignment, if possible, is not usually so simple or quick as one visit to the car mechanic. In addition to alignment however, your chiropractor would comment on the vitally important issue of the flexibility of the spine (and possibly of the extremities).

 

Avoid cradling phones between your shoulder and ear, carrying heavy purses or bags, falling asleep on the sofa with head on the armrest.

 
What about helmets?

If a helmet is more than 5 years old or if the helmet has been in even one crash, it should be replaced. Look for certification by CSA, COSC, ASTM, or Snell.

A helmet should comfortably touch the head all around and ride as low as possible to protect the sides of your head.
Check websites:
www.safekidscanada.ca
www.bhsi.org
www.yourhealthmatters.ccachiro.org

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What about booster and other seats for youngsters?

Regular car seats are not designed to protect children. The most basic kind of booster seat has no back support and the lap belt can result during an accident in damage to abdominal organs.. The seat bottom/back support type of booster can reduce injuries in the event of collision by 70% while backless booster was no more effective than at reducing injuries than seta belts without a booster (according to Arbogast in ‘49th Conference of Assn for the Advancement of Automotive Medicine’ 2005;201)
 
Another recent study found that 335 of parents did not use booster seats at all while 33% of those who did use them, did  so incorrectly (O’Neill in 50th Annual Meeting of the Assn for Advancement of Automotive Medicine 2006).
 
Also the shoulder portion of the harness can damage the throat and neck structures.
 
Children should use a booster until they are at least 4’ 9” tall. Once they have reached this height, if the child cannot sit all the way back against the seat and bend the knees over the edge of the seta, he or she should remain in the booster. If the seatbelt rides up over the abdomen or if the shoulder portion rides over the neck, the child needs to remain in a booster seat.
 
Most parents now know that a newborn requires a different seat product than a 3 year old.
 
Those with infants should face the rear and all child carseats should be placed in the rearseat, especially in cars having airbags.
 
What about reliable sources for infant and child seat safety?
 
 

What about backpacks?

The top of the backpack should not extend higher than the top of the shoulder and the bottom should not fall below the top of the pelvic bone.
Light weight vinyl or canvas is ideal material. Shoulder straps should be at least 2” wide, adjustable, and padded, not cutting into the arms or armpits.

 

A hip strap or waist belt helps to redistribute weight by as much as 50-70% off the shoulders and spine and onto the pelvis. Backpacks should never exceed 15% of a child’s body weight (a 90 lb child should not carry more than 14lbs in a backpack). Items in a backpack should be evenly distributed and teach children how to do this upon their return home from school.

 

Pack heaviest items closest to the body, and carry only items that a really needed at school.
Pack irregular shaped items on the outside so these cannot dig into the body.
Preferably place the backpack on a tabletop for example before slipping it on, even asking others for help.

 

Avoid twisting when lifting, lift with the legs, check for comfort of straps.
Do not carry a backpack with one arm.
These tips are provided by the Ontario Chiropractic Association who reminds everyone to “Pack it light and wear it right.”

 
What about airplane travel?

Most people realize now that periodic moving about in a plane is important for overall blood circulation health. While sitting, tuck a small pillow or cushion in the small of your lower back and another one in the gap between your neck and the seatback. You might also want to consider a small blanket under your buttocks. One can also occasionally massage one’s own calves and thighs as well as propping the feet up part of the time with a cushion or other object. When placing items in the overhead compartment, stand in front of the compartment so as to avoid twisting the body.

Avoid completely any objects that are more than 5-10% of your body weight, instead checking these in with regular luggage storage.

If the airline permits, bring your own supply of water to drink. If they do not allow it, request bottled water while flying.

Do not sit directly under air controls or at least turn off since the draft can cause chilling and increase muscle tightness.

Dr. Fuller can provide additional exercises that are easy to perform while flying. Children under 40 lbs weight should be given a booster type seat when traveling in a plane.

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What about automobile travel?

Consider a back support, the widest part being between the bottom of your ribcage and waistline. The  seat should bring you as close to the steering wheel as comfortably possible, with knees slightly higher than the hips. Make an effort to do simple exercises that move the neck, trunk, arms, legs, toes. While driving, frequently change the position of the hands of the steering wheel. Many people use too tight a grip. Rest breaks should be taken on longer trips, both for the driver and for passengers.

 

Vehicle head restraints?

The U.S. Insurance Institute for Highway Safety (HIS) in April 2007 concluded that only 22 of 87 cars tested were rated “good” for head and seat restraints as protection in rear end collisions.
Those rated “good” were Volvo S40,S60,S80; Ford 500; Mercury Montego; Jaguar S-Type; Audi A4,A6.S4; Nissan Sentra & Versa; Subaru Impreza, Legacy & Outback; Chevy Cobalt; Saab 9-3; Honda Civic & Hybrid; Hyundai Sonata; Kia Magenstis; Mercedes E Class; VW New Beetle. The ratings of good, acceptable or marginal were based on geometric measurements of head restraints and simulated crashes. Overall, 66% of cars sold in the U.S. in 2007 were rated as poor or marginal. 

 
What about knee pains?

Always an accurate or at least a viable tentative working diagnosis must be determined.

One common diagnosis is “chondromalacia patellae” or patellar malalignment syndrome” or “jumper’s knee.”

As indicated earlier in this site, orthotics are frequently a useful part of establishing more balanced alignment and movement of the knee and the structures above and below the knee.

Research by Rowlands et al in the Journal of the Neuromusculoskeletal System 1999, Vol.7, No.4, 142 concluded that chiropractic joint mobilization of the patella (kneecap) had positive improvements compared with a placebo group, and it was noted that this would be useful in combination with exercise, orthotics, and activity modification.

 

What about carpal tunnel syndrome?

The “carpal tunnel” is comprised of the bones of the lower arm (ulna and radius) + the ‘carpal bones’ (hand bones) + the various soft tissues such as the radial, median and ulnar nerves + blood vessels + the enveloping tendons and ligaments eg. Transverse  carpal ligament or “retinaculum.”

A “tunnel” exists through which all of these nerves and blood pass en route to the hand and fingers.

This delicate space through which they pass can become too tight due to (i) certain metabolic conditions involving fluid or blood pressure, (ii) pregnancy (iii) overuse (iv) activities requiring backward pressure(dorsiflexion) or pounding of the wrist.

These latter mechanical activities are the most common causes and often respond to chiropractic methods :
Chiropractic management usually involves manual (hands-on) massaging and stretching of the muscles and tissues of the palmar (underside) of the wrist, joint mobilization of any joints found to be fixated (stiff), which could be any of the inferior radioulnar, radiocarpal, or ulno-mensicotriquetral joints, ultrasound therapy, and certainly appropriate exercises and advice; in many cases, vitamin B6 is also helpful for the nerves and for fluid control.

 

In Canada the Canadian Centre for Occupational Safety & Health 1998 reported that 614 of 982 supermarket cashiers reported symptoms of carpal tunnel syndrome.
Medical treatment of CTS traditionally relies on 1. night splints…. These serve to further reduce oxygen supply which accelerates formation of more scar. Splints also serve to create muscle imbalances leading to more friction and adhesions, 2. anti-inflammatory medications which can be useful in relieving symptoms in the early acute stage but which actually accelerate the degenerative processes in these tissues (Newman and Ling in Lancet 1985, p 11), not to mention the high incidence of gastrointestinal damages, 3. surgery (260,000 CTS surgeries in the U.S. annually)… unfortunately wrist surgery leaves more scarring, and we know that 36% of all such people continue to require unlimited medical treatment after surgery (Cambridge Scientific Abstracts 1998;Vol.43,No12).

 

Chiropractic treatment targets muscle treatments at not only the wrist, but frequently in the pronator teres muscle of the forearm, the radial or ulnar nerve at the wrist, the brachial plexus of nerves in the scalene group of neck muscles, and/or the axillary nerve at the quadrangular space of the lower neck.
You may have realized by now, that many cases of CTS are misdiagnosed and are actually similar symptoms with causes in other parts of the arm and neck.
Another less recognized “tunnel syndrome” is ulnar nerve tunnel or Canal of Guyon syndrome in which the ulnar nerve is compressed by any combination of bones (eg. ulnomeniscotriquetral joint), ligaments, muscles on outer aspect of the hand/wrist.

 

What about helping myself with a REPETITIVE OVERUSE SYNDROME or condition?

 
1)Take frequent rest breaks and it will actually INCREASE your productivity (Galinsky in Ergonomics 2000;43(5):622).
 

2)Once your condition has been effectively treated, you must increase your strength, endurance (and oxygen). Such treatment and rehabilitation can be discussed with a knowledgeable chiropractor.

Such specific exercises that facilitate recovery from repetitive overuse syndromes are termed “nerve flossing,” “scalene wall stretches,” “subscapular stretches,” “serratus anterior & lower trapezius stretches,” “lunging on labile surfaces,” “the cobra,” “side bridges,” “dead bug,” “bird dogs,” ”power webs.”

 
3)The “amplitude” of movements you make…this means the degree of movement that you make while performing tasks that require repetitive movements. An example would be spending long hours doing deskwork or computer work. One should position a computer monitor so that the centre of the screen is at eye level and directly ahead, not to one side, ideally 18-30” from the eyes. The keyboard should be placed so that the elbows are close to your body with arms hanging loosely. The constant contraction necessary to operate a “mouse” causes exactly the problem described earlier with repetitive movement. One mouse that does ot require any arm/wrist movement is called a “glide point” (one such company is called ‘Cirque’) which requires only movement of one finger (some laptops now have these built in, and another is a vertical mouse invented by a chiropractor in the U.S. (www.zerotensionmouse.com). One’s chair should allow you to sit back with the back resting fully against the seatback, feet resting on the floor (or on a some support), and preferably a chair with adjustments for low back support and tilting (one such excellent manufacturer is ‘Herman Miller whose office chairs allow rearranging height of the arms and have lots of ventilation to avoid build up of body heat). Some people do deskwork while sitting on inflatable exercise balls (sometimes called ‘Swiss balls’) available at most exercise stores. If that seems too difficult or is impractical, these balls are good as a separate form of exercise due to their instability features (one good book to learn more is ‘Stability Ball Exercises’). Another device is a cushion to sit on that is like a wobble board (eg.www.fitter1.com).

 

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What about “plantar fasciitis”?

This is inflammation (pain, heat, redness on internal tissues, and swelling which is not usually visible) of the “plantar fascia.” This is a tendon-like connective tissue linking the bottom of the heel with the toes in a fan-like manner. Such inflammation is caused usually by a long time of overuse and/or direct trauma (injury) such as falling down on the heel or sudden unaccustomed hard running.

Treatment and management may involve the following: - ice therapy at home as advised by your chiropractor; depending on the individual chiropractor, ultrasound therapy, electrical muscle relaxation, joint adjustments of the foot and ankle where joint fixations may be found, plus hands-on myofascial (massage-type treatment of the small deep muscles and fascia) on the underside of the foot. Additionally, specific exercises for stretching (stretch calf muscles by leaning against a wall, ball rolling, ankle flossing) and strengthening will be demonstrated and given for home use. These include toe tapping, towel curls, picking up marbles with toes, rolling the foot over a pop bottle, tennis ball or rolling pin. As stated earlier in the site, custom-made orthotics are often necessary for optimal support in shoes. Overweight people with this condition would be advised to reduce weight. Also to be avoided is walking/running on hard surfaces, wearing badly worn shoes. If your home has hard flooring such as ceramic, marble, granite, it is useful to wear padded slippers.

 

What about gardening tips?

For many people the opportunity to return to gardening each spring is faced with use of the body in ways in which they have not moved during winter months.
Gardeners are athletes too, so one must follow rules for safe enjoyment of gardening. Ideally, one should be exercising all year round, in which case gardening will pose little if any problem.

 

Tips

Light to moderate gardening can burn 300-400 calories per hour compared to 40 calories while sitting, so warm up such as short walk before starting to do strenuous gardening.

Changing hands frequently and put one leg in front of the other, then change these when raking and hoeing prevents muscle strain on one side on the body.
This will keep you from bending and twisting your back. Alternate heavier then lighter tasks. into soreness. Take periodic breaks and do not try to finish one project all in one day.

Long padded handled tools, some having springs aid in avoiding bending forward too much.
Face the object which you plan to lift, bend your knees, and draw the load in close to your body. Use the muscle strength of your legs to lift. This may seem difficult for some people who are accustomed to relying primarily on the back but it is a worthwhile habit to develop.

Purchase knee pads which can attach with Velcro straps and/or use kneeling pads as these techniques greatly reduce back bending during long periods of working in the garden.

Drink plenty of fluids while working outdoors (another way to take a break), cool down at the end of your project by doing stretches suggested by your chiropractor…. these can include standing thigh stretches while lifting one heel up to your buttock, or if you cannot manage that use an old tie or pant leg to aid in pulling the heel up.  Try to hold this for 15-20 seconds then do other leg.

Hamstrings stretches for the back of the thigh are safely done by either sitting on the floor and bending from the waist toward the toes or standing with one heel on a chair or bench and leaning the trunk forward toward that foot.
Back stretches can easily be while sitting and simply leaning forward down toward the ground, then standing and bending from side to side (this can also be done with arms reaching up overhead).

Shoulders can be warmed up and cooled down by shrugging shoulders upward and by rolling them around.
Wrist stretches can be done with one hand bending the opposite wrist fully downward and then fully backward.
Use a hose instead of a watering can where practical.
Use a wheelbarrow with two wheels and/or dolley for transporting items.
Before actually lifting a load, squat down to the level of the load and test the weight first.
When lifting, remember to use your arms and legs, and to move your feet instead of twisting the body while lifting.
Avoid heavy lifting immediately after prolonged bending or kneeling.
Wear gloves, wide brimmed hat, and comfortable supportive shoes.
Any pains lasting more than 48 hours suggest getting an opinion from a chiropractor.
When retrieving items from inside the trunk of your vehicle, rock the weight as close to the rear of the trunk as possible, then use this momentum to lift the object allowing it to rest on the lip of the trunk while your rearrange your posture and avoid fatigue.
When shoveling (in garden or snow) keep the shovel as close to the body as possible using your legs to do the lifting. Bend at the knees, not at the waist, And do NOT twist and throe, but rather step forward first with hips and shoulders pointed in the same direction  
The Ontario Chiropractic Association (OCA) has partnered in the past with the Ontario Horticultural Society, the Garden Clubs of Ontario, and Sheridan Nurseries to help communicate gardening safety. The OCA website (www.chiropractic.on.ca) has a section entitled ‘Plant and Rake Without the Ache.’

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Snow shovelling

Many of the same principles apply here as with gardening including warming up first. If you find it hard to make time for warming up, then at least shovel light loads several times first, even pushing rather than lifting.
Dr. Fuller recommends the peculiarly bent snow shovels found in most stores nowadays that reduces much of the forward bending for the areas where you feel the need to lift and throw, but also have a regular shovel with which you can comfortably just push snow.
A person who weighs over 200 pounds can burn over 400 calories when shoveling heavy snow for 30 minutes. However, shoveling snow is a very demanding activity of the heart and cardiovascular system, especially if you do not regularly exercise.
In 1995 the Journal of the American Medical Association reported that after10 minutes of snow shoveling, ten healthy men showed average heart rate to be 97% of their maximal capacity, and their blood pressure during snow shovelling was significantly higher than during maximal arm cycling and using a snow blower and slightly greater than maximal treadmill testing.
Chiropractors recommend lifting a greater number of lighter weight loads of snow rather tan a few very heavy loads. Try also to alternate the number of times that you lift and throw snow both from the right side as well as the left side. Try to make the effort to bend the knees, keeping the upper body as straight as possible. Avoid creating your own snow mountain since it takes much greater force to throw snow higher.

For many people it is simply more advisable to either buy a snowblower (preferably with electric start) or pay a neighbour. It is always wise to listen to your body, especially heeding chest pain as a sign to stop.
Wearing several layers of loose clothing that creates heat traps will keep you warmer than tight bulky garments. A hat prevents heat loss from the head and wearing a scarf helps protect the neck and throat.
A winter jacket should be long enough to cover the lower back and consider slip-proofing winter footwear.

 

Making the bed

While standing, work from both sides of the bed and lean over on one arm and kneel onto the bed while reaching. If your chiropractor does not recommend making beds, wait until he or she advises that you are recovered enough from treatment, and enlist others to do it in the meantime.

Getting in and out of bed
Instead of jumping straight like an athlete, it is recommended to lie down and get up sideways using the arms to push up and support body weight on lying down. If your back is very troublesome, you may even wish to start on your hands and knees, then gradually lie down and turn over.

In the bed
Never lie on your stomach as it causes too much arching of the low back and twists and arches the neck also. Lie on either side as well as on your back if tolerable.  While on your side, if may more comfortable to place a pillow of cushion between your knees. On your back, a similar support under the knees.

 

Laundry

Do several small loads. When using a top-loading machine, use the straight leg lift where one leg rises up behind you while leaning forward into the machine.
For front-loading machines, kneel on one knee and use the machine for support when getting up.

 

Kitchen work

Keep frequently-used items in a convenient place, between shoulder and waist height. Climb up on step stool to reach higher shelves. Kneel on one knee to access low shelves, pushing up on your thighs as you stand up. Avoid bending over countertops for prolonged periods. When loading and unloading a dishwasher, have the dishes piled on the countertop nearby to avoid repetitive bending.

 

Sitting

Always avoid prolonged sitting (no more than 15-20 minutes). If sitting causes back pain, change positions, lie down, do stretches as advised by your chiropractor, and pursue treatment if recommended.
Do not sit in sagging or low slung chairs or sofas.
Cushions or other back supports help many people while sitting.
When doing deskwork, ensure that reading and writing surfaces are as high as reasonably possible to minimize forward bending. Use small stands that hold books and paperwork at 45 degree angle. Your feet ideally should be flat on the floor or periodically even supported on a footrest.

 

What about vaccination and immunization?

These are well-established and widely mandated public health policy and the chiropractors of Canada support public health promotion and prevention strategies that encourage physical and mental health and well-being.
The Canadian Chiropractic Association accepts vaccination as a cost-effective and clinically efficient public health preventive procedure for certain viral and microbial diseases as demonstrated by the scientific community.
The public responsibility for vaccination and immunization is neither within the chiropractic scope of practice nor a chiropractic specific issue.
Public health programming and literature provide appropriate sources of information for public education on these issues.

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What is osteoarthritis?(“O.A.”)
 
Arthritis is a general term implying inflammation of joints. The most common form of arthritis is osteoarthritis, better known as wear & tear. It is characterized by gradual joint degeneration and loss of cartilage, which is the shock-absorbing gel between bones of joints. Some estimate that 80% of those over age 50 have it, mostly the hips, knees, and spine, although any other being overworked may have it.
 
Self-diagnosis? While your physician is best equipped to be more specific (such as detailed history & lab tests) , rheumatoid arthritis and gout arthritis joints are red, warm, and spongy. Osteoarthritis typically is worse after rest such as arising in the morning, then lessens as you move about. Note also that with or without arthritis, this picture may spell “joint dysfunction” for which chiropractic care may be well indicated.
 
Aging? Just because you are aging does not mean that you must get O.A. nor suffer from it.
Once serious medical conditions are ruled out, one should consult a knowledgeable health professional for a comprehensive analysis of nutritional supplementation, not just glucosamine.
 
Traditional medical treatment of O.A. This involves prescribing NSAIDs (“anti-inflammatory” drugs) for relief. Unfortunately this family of drugs have a high rate of serious adverse effects such as stomach ulcers and bleeding, headaches, dizziness to name a few. These drugs work by inhibiting enzymes involved in the production of inflammatory compounds BUT ALSO inhibit the body’s production of enzymes that manufacture cartilage compounds (Shield in European Journal of Rheumatol. Inflam.1993;13:7 and Newman in The Lancet 1985;11)
 
Tamblyn in Annals of Internal Medicine 1997;127;429 reported thtain the U.S. annually there are 7,800 people who die from side ffects of NSAIDs while another 76,000 attend emergency rooms in hospitals.
 
Gastrointestinal bleeding and perforation from NSAIDs causes death in one of every 9,210 NSAIDs prescriptions.
 
Page et al in Archives Internal Medicine 2000;100:777 reported that the use of NSDAIDs dramatically increased risk of congestive heart failure.
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