Visions For Health, Episode 6: Chiropractic Care

Visions For Health Talk Show – Host Dr. Wendie Trubow speaks with Chiropractic Physician, Eric Roseen, DC.

To inquire about an individual appointment with Eric Roseen please call (781)-431-1333.


Reaching your goals for 2014

My favorite part about this time of year is that I get to meet a lot of new patients who have made ambitious goals for the New Year; and I get to see them develop and accomplish these goals over the coming months.  I get to develop fantastic relationships and help partner with people who want to get out of pain, help their bodies move in a healthier way and get them back to movement through an individualized stretching/exercise plan.  At Visions, we call this a Return to Movement program and through the care that we can provide on sight and through partnering with fitness professionals in the community we see amazing results.   Patients get their lifestyles back.

It is a great feeling for both me and the patient when the patient gets past a pain or condition that has potentially been with them for many years.   Or when we can get them back on track after a holiday season full of stress, unhealthy eating and inactivity.   Some people get better in one visit and with some patients we need to work at it a bit longer but this approach can help people become pain-free and work towards the goals they have set for the new year.   If your goal is to run a 5k or a marathon, to bench press 200 pounds or begin your yoga practice the team at Visions can help.

Chiropractic care and advanced soft tissue therapies like Graston and Active Release Technique can provide relief on your first visit.    By loosening tight tissues and helping restricted joints improve their motion we can get the process started.  Individual stretches/exercises and other self-care strategies like foam rolling are essential daily practices that we will teach you to help reverse poor postures and stretch tight tissues that have been overworked by your work or sport.

Every visit you will receive advice for how you can help take care of your body in between visits.   We will review and refine your self-care techniques at each visit.  Ultimately, our goal is to get you to your goals, to listen to you, come up with a tailored treatment plan and provide care that is beneficial to your overall health.

Save your lifestyle.   Pain is rarely life threatening.  But many know that back pain, a strained shoulder or a chronically sprained ankle can threaten ones lifestyle.  People give up their favorite things all too often due to pain.   The collaborative care that the Return to Movement program at Visions provides can allow people to do the types of things they want to do whether it is running a marathon or playing with their children.   If you are no longer able to do something you love, this is the place to be to get your life back.

Set goals and thrive. Not everyone wants to squat 400lbs or run a marathon, but some do.  This is one of the first questions I’ll ask my patients.  Do you want to be active?  How active?   Is your main goal to be able to play with your kids and keep your body strong and healthy?   These goals make an enormous difference in the rehab process.

I emphasize maintaining a full range of motion in every exercise.   For example, if someone lacks ankle mobility, hip and core stability, thoracic extension, or scapular stability then they’re going to have trouble with some of exercises like snatch and clean and jerk or repetitive movements like throwing a football.  If that athlete has shoulder pain during a movement that uses the whole body it could be coming from an ankle restriction or limited movement in the mid-back.

Along with helping people return to exercise, here is a list of common conditions that I treat on a regular basis:

Back Pain

Neck Pain

Headaches

Shoulder pain

Tennis Elbow

Carpal Tunnel

Hip Pain

Muscle Strains/overuse injuries

Ankle Sprains

Plantar fascistic

 


Building New Environments for Healthier Routines

A trend towards technology driven, less active American lifestyles has resulted in a heavy and unhealthy nation. Busy families are surrounded by fast-food restaurants instead of farmers’ markets and grocery stores with fresh produce. Desk jobs keep Americans sedentary and, in neighborhoods deemed unsafe, residents are less likely to get regular exercise by walking after work or on the weekends. If it’s true that a person’s environment can shape their health as significantly as genetics, then these scenarios have got to change.

Recently, the concept of a “Built Environment” has arisen to remedy the problem. It involves the purposeful development of a city, community space or designated green space with the goal of increasing community health. Built environments encourage inhabitants to walk more, move more and, sometimes, to perform more laborious work. Adding art to a park or green space is one way to create a built environment, and the deCordova Sculpture Park in Lincoln, Massachusetts, is such a place. With a large selection of eye-catching outdoor sculptures, the park offers visitors an afternoon of exploration and enjoyable walking.

City planners and public health researchers around the United States have applied the built environment concept to public parks and walkways. By strategically placing artwork along a path, a relaxing day in the park turns into a pleasant walk. This slight but significant change in design may go unnoticed by visitors, but the positive health implications include more calories burned, more minutes of light-to-moderate exercise performed and a healthier community.

Building healthy environments includes making new decisions about our existing surroundings and routines. Parking further away from work or home and walking the difference is one example. In fact, people can often save money by walking to work or school, or parking in a separate garage or an offsite parking lot. Walking on a daily basis can significantly improve health, and making physical activity a natural part of one’s daily activities can result in weight loss, greater fitness and increased energy for the workday. Regular exercise also prevents heart disease, stroke, hypertension, diabetes, osteoporosis and even certain types of cancer.

By making exercise and healthy food choices easy, enjoyable and accessible, American families have a better chance at reversing the alarming rates of preventable diseases.

This article was originally published in Natural Awakenings Magazine, August Edition. http://www.naturalawakeningsboston.com/MIDS/August-2013/BUILDING-New-Environments-for-Healthier-Routines/

 


10 Ways to Protect Your Back While Shoveling

Winter storm Nemo will provide us with heaps of snow, which means hot cocoa, snow angels and of course – snow shoveling.

When done with proper technique, snow shoveling can be a fun way to get exercise and enjoy the outdoors.  When done improperly – snow shoveling can lead to stiffness, muscle strain or worse.  You are most likely to be injured when you bend forward (flexion) to lift heavy snow (compression or pressure on back) and pitching the snow twisting to the side (rotation).  This combination of spinal flexion, compression and rotation is very hard on the spine and surrounding soft tissues (muscles, tendons, ligaments, fascia, etc.) and should be avoided.

Here are some tips to avoid back pain when clearing your driveway and walkways:

1. Snow shoveling = working out.   Snow shoveling is an athletic endeavor and after a winter without much snow ‘Nemo’ is surely the main event.  Be sure to hydrate adequately and avoid shoveling after a large meal.   Once you’ve started remember to stay hydrated and take body breaks to make the shoveling experience a fun workout rather than a painful chore.

2. Warm up your muscles.   Shoveling is a dynamic and physical activity so be sure to stretch all of your major muscle groups, including your hamstrings, back and shoulders.   Using a ‘foam roller’ or ‘tiger tail’ to loosen tight areas is also a great way to prepare your body for cleaning up after Nemo.  In addition to stretching you should walk, do yoga or another form of light exercise for 5-10 minutes to warm up the body before shoveling.

3. Whenever possible, team up.  Get your friends/family involved and make shoveling a team sport.   As they say, The more (shovels) the merrier -  and teaming up to clear snow will allow more time for assembling snow men and building igloos.

4. Lift with your legs, not your back.  Bend at your hips and knees instead of your back.  As you scoop the snow you should lower into a squat position and as you toss snow your back should stay straight and your legs should provide you with strength.  This is a basic yet essential tip.  If you start to fatigue and notice you are losing your form it is time to take a break for a glass of water and a cup of hot soup.

5. Avoid twisting in the low back. - Keep your toes and nose aligned when pitching snow.  Allowing your feet to move with your body as it rotates while pitching snow will reduce potentially harmful rotation in the spine. Alternatively, you can pitch the snow forward as long as you don’t extend your arms too far away from your body – see tip 6.

6. Don’t reach.  keep your arms and shovel close to your body.   Fight the urge to extend the shovel away from your body to capture more snow in each scoop.  By extending your body you flex the spine and place it in a weak position.  Stay strong by keep your shovel  close your body.

7. Push like a plow.  When possible push snow rather than scooping and pitching it to the side.  Bracing the handle against your belly as you push the snow (like a plow) is a great alternative to scooping snow.  This takes away much of the torque placed on the spine when you lift snow and toss it to the side.

8. Take smaller scoops.   Especially when snow is wet and heavy, a full scoop with a large shovel may be too much.  Try ‘half-scoops’ and only take as much snow per scoop as you are comfortable with.

9. All snow shovels are not created equal.  Use a snow shovel with a curve to it (as pictured).  This enables you to not have to bend as far over to reach the snow.

10. Shovel as the snow comes. Try to shovel periodically throughout the day, as the snow is falling.  By doing this, you will avoid shoveling the whole storm at one time.  If you do wait to the end, shovel at a comfortable pace and allow yourself as many breaks as you need.

Be safe and enjoy the winter wonderland.  If you do have pain after shoveling chiropractic care and/or soft tissue therapies such as Graston® or Active Release Technique® can help you recover quickly.

Dr. Roseen is available at the Visions HealthCare Wellesley facility on Mondays, Wednesdays, and Thursdays and at the Dedham facility on Tuesdays and Fridays.


A Health Burden on the Rise

“Prevention and wellness across a lifespan” was the theme at this year’s 140th annual American Public Health Association (APHA) Conference held in San Francisco. I had the honor of attending this years gathering of public health minded people and Hurricane Sandy stranded me on the west coast with my thoughts and the beginnings of a new blog series, ‘preventing low back pain – across the lifespan.’

Like heart disease, hypertension, or diabetes — low back pain is often a chronic condition that is best addressed before it occurs. With the number of Americans over the age of 65 set to double by 2020 it is important to consider how we can age well and prevent disease and disaTable:  Causes of Disability - CDCbility across a lengthening lifespan. Primary prevention for low back pain includes efforts that move Americans to exercise regularly, stretch daily, effectively manage stress, maintain a healthy weight, etc.

Back and neck pain are major health burdens here in Massachusetts and around the world. Low back pain is the second most common complaint to primary care physicians (trailing just the common cold in prevalence) and is the second leading cause of disability in America. 20-30% of Americans are experiencing low back pain right now – this may include you and certainly includes members of your family as well as your friends and coworkers.

With low back pain affecting over 80% of Americans and costing America over 50 billion annually – is preventing low back pain possible? Yes.

America would have less back pain if – we stretched with the same regularity that we brush and floss our teeth. OR – if exercise was as standard as a daily shower or washing your hands after sneezing or going to the bathroom. As we all can clearly see, improved personal and dental hygiene (as primary prevention) has largely improved dental health and the health burden of many infectious diseases has plummeted. Similar strategies could be used to prevent low back pain.

This blog begins a series on low back pain – how it can be prevented and when it does happen how it can be treated conservatively. An important part of preventing disability (and optimizing health across your lifespan) is periodic care that addresses minor and major episodes of pain or discomfort. Most important for prevention are ongoing self-care strategies such as yoga, foam rolling, stretching, meditation and more.

I will also explore how back pain affects different individuals (young vs. old, athlete vs. couch potato) and how communities can use primary prevention to reduce the burden of low back pain.


Soft Tissue – the Hardest to Heal!

It is impossible to look at proper bodily function or performance without a close and careful eye on soft tissue – the muscles, tendons, ligaments, fascia and nerves, that collectively make up a major portion of our body mass.  Soft tissues are what propel us, they are what hold us upright; soft tissues allow us to run a foot race or to pick up a child.  Essentially, healthy soft tissues give us our ability to live life optimally.

Pain and soreness often reside in the soft tissues when the muscles and tendons are injured or overworked.  Despite being so common, the healthcare system has not made soft tissue injuries a priority, leaving many patients with chronic problems.  When poorly understood (or ignored) soft tissue injuries can develop into limitations or pain syndromes that may not be recognized by your primary care provider (there are no lab tests) resulting in a non-specific treatment (there are no wonder drugs) without success.

Soft tissue injuries may include:

  • Restricted range of motion
  • Back pain
  • Headaches
  • Postural tension at neck and shoulder
  • Hip, knee and ankle injuries
  • Shoulder, elbow and wrist injuries
  • Over-use injuries
  • Shoulder impingement
  • Golfer’s/tennis elbow
  • IT band syndrome
  • Achilles tendonitis
  • Plantar fasciitis

In response to the needs of my patients, I developed a deep interest in the diagnosis and treatment of soft tissues injuries.  Treatment involves a unique combination of techniques for which I have postdoctoral certifications including Graston Technique®, Active Release Technique® (ART) and FAKTR Technique.  I combine these therapies with traditional chiropractic care to reduce pain, restore range of motion and support optimal movement.  These treatments are active, involve patient participation and are combined with home-care (individualized stretching and at-home therapeutic exercises) to help support optimal function and a quick recovery.

At Visions, our goal is to get you past the pain and dysfunction that is impairing your daily activities, your athletic performance and your overall well-being.  An accurate diagnosis and a cutting edge treatment plan will help you get back on your feet and back in the game.

For more information:
Graston http://www.grastontechnique.com/
Active Release Technique (ART) http://www.activerelease.com/
Functional And Kinetic Treatment with Rehab (FAKTR) http://www.faktr.com/


Pains and Gains of Gardening (Part 3 of 3)

The demands of your growing garden may lead to injury, but a speedy recovery and prevention of future injury will help you keep up with your crop and still enjoy the fruits of your labor! Many of the initial steps of planting a garden need to happen within a short amount of time. Gardeners often put in long hours early in the season to get their crop started. Getting sore is almost expected when your body is not used to so much physical labor, especially if you have been sedentary over the winter months.

Should I push through the pain?

NO! Because gardening is a big project, among other seasonal activities, it is important you do not write-off the pain and discomfort as a small problem that will go away on its own. Pain is a signal that something is not right and you should get it checked out to ensure your body is able to heal properly.

Pain Relief – Custom to you

If you overdo it, you can find quick relief at Visions HealthCare. I see patients with sore muscles and painful joints on a daily basis and can provide effective relief with individualized treatment modalities. Soft tissue techniques, such as myofascial release and Graston, are great ways to provide relief from pain and help the muscle tissue heal after significant strain. If gardening for long hours results in joint injury or painful restriction, gentle chiropractic adjustments can help mobilize the joint allowing it to function properly. Kinesiology tape is also a great way to support an injured area yet maintain flexibility and function.  Just as your plants need attention to thrive, so does your body!  Together we can determine the best combination of treatment modalities to get you back to feeling your best.

Recovery & Prevention – Guided exercise

After diagnosing areas of deficiency and providing pain relief, I often teach individuals a few stretches and exercises that will enable the body to rapidly recuperate as well as prevent the same injuries and issues. To strengthen areas of weakness, I can also refer individuals to a personal trainer or physical therapist who can implement an individualized exercise regimen. Teaming up with wellness professionals provides you the expertise and accountability to get back to your best condition.

With proper preparation and precaution, the gardening season can be an excellent time of the year to enjoy outside activities and the fruits (and vegetables) of mother nature. Don’t be in pain; get in the game!


Neck Pain – what is the best treatment?

What causes neck pain? Very often, neck pain can develop slowly from spending long hours at a computer or because your neck is straining to hold up your head while maintaining poor posture. Some have neck pain due to trauma such as car accidents or sporting injuries.  Additionally, pain may result from sleeping in an awkward position or sleeping with an inadequate pillow. Whatever the cause, neck pain is very common, with 70% of our population suffering from neck pain at some point in their life. Even more concerning, the number of treatments for neck pain is almost as immense as the number of causes!

Many sufferers turn to medication first to try and fix their neck pain, yet if effective at all, it is only a temporary relief.  Recent research has caught the attention of the New York Times, The Wall Street Journal, and Men’s Health Magazine.   This media buzz is causing many to doubt medication as a therapy of choice for neck pain, suggesting that there are much safer and more effective alternatives.

Recently the “Annals of Internal Medicine” published a study comparing the effectiveness of chiropractic adjustments, medication, and exercise for subacute neck pain. In this study, 272 people were divided into three groups for a 12 week course of treatment. One group received chiropractic adjustments. The second group received medication as prescribed by a medical doctor. The third group was assigned a series of home exercises to complete. After 12 weeks the researchers measured pain levels and functional movement and follow up measurements were also recorded 6 months and 1 year following the end of the treatment.

The results of this study found that both chiropractic adjustments and the exercise groups did better than the medication group. However, the chiropractic adjustment group did the best overall and was significantly better than the medication group. Also, the most serious side effects were seen in the medication group, with 60% of patients reporting side effects of some kind – “this included gastrointestinal discomfort and fatigue most commonly.  Dry mouth, cognitive disturbances, rash, congestion, and disturbed sleep were also reported.”

Therefore the conclusions of this study suggest that chiropractic adjustments are the safest and most effective treatment for subacute neck pain, followed closely by exercise. If you are experiencing neck pain, chiropractic adjustments done by a board certified chiropractor can help you get to the root of the problem. In my own practice, treatment plans typically include adjustments as well as individual stretching and exercise instruction.

Here is a video overview of this research from ABC News:
http://abcnews.go.com/WNT/video/common-neck-pain-treatment-wrong-15292471

1. Bronfort G, Evans R,AndersonAV, Svendsen KH, Bracha Y, Grimm RH. Spinal Manipulation, medication, or home exercise, with advice for acute and subacute neck pain: a randomized trial. Ann Intern Med. 2012 Jan 3;156(1 Pt 1):1-10.


Champion level care – includes chiropractic

Champion level care – includes chiropractic.

First off, Go Patriots!!! Since moving to Boston I have thoroughly enjoyed living in the city of champions!  It was very exciting to see the Bruins raise the Stanley Cup in 2011 and I look forward to watching the Patriots compete in the ultimate grudge match at superbowl forty-six.

Here is a quote from this weekend’s game-manager, and long time advocate of chiropractic care, quarterback Tom Brady, “Chiropractic just makes you feel so much better. When I walk out of the clinic, I feel like I’m about three inches taller and everything’s in place.  And as long as I see the chiropractor, I feel like I’m one step ahead of the game.”

In the National Football League (NFL), health is paramount and thriving longevity is the ultimate focus of the professional athlete.  Why suffer through pain and risk a career-ending injury when you can properly heal, rehab, train, and come back stronger and faster!?   This paradigm is a significant shift from the “no pain, no gain” mentality of the past and professional athletes are now allowed to mature into their careers and develop their talents so that they may enjoy longer, more successful careers through maintaining their health.

What about you? Think about it, like the professional athlete you also get bumps and bruises, aches and pains, locked up joints and bouts of a stiff neck…  when you have an injury do you suffer through the pain, or do you take the appropriate steps and have a champion’s approach to health?  Most Americans ‘tough it out’ and allow their small aches and pains to develop into chronic problems that limit them from doing the things they love!  Does your headache or bad back prevent you from reaching your health goals (exercise, weight loss, etc.)?   Does stiffness and pain limit your performance at work or reduce the quality of the time you spend with your loved ones?  With the appropriate care applied, it doesn’t have to!

As of 2012, every NFL team has a chiropractic physician as part of their athletes care team – chiropractic care is now viewed as an essential puzzle piece of maintaining and improving each athlete’s health.   Chiropractors most commonly work on improving joint function and helping improve soft tissue (muscle and fascia) mobility so that players can recover quickly from injury, prevent injury by addressing imbalances and restrictions, and reach the professional bottom line – that is, enabling athletes to function at their highest level.

Although we are not all professional athletes, we all deserve the best possible health, as do those we love.   NFL hall of famer Joe Montana said this about chiropractic care while he was with the San Francisco 49ers, “I only wish I had tried chiropractic a few years ago when I first started having back pain and maybe surgery would have never happened – now we know that chiropractic is not just for bad backs or necks. It’s about prevention, so your body can function at optimum health.”   Joe continues to receive regular chiropractic care and views it as an essential part of maintaining his health and wellness.

Should chiropractic care be part of your healthcare? I encourage you to think about this question and to schedule an initial consultation to have your body checked for locked joints, limitations in range of motion and muscular imbalances that may have developed over time.   In addition to treating the skeletal structure by mobilizing joints with chiropractic adjustments, I also care for the muscles and tendons that surround and support the joints.  Through soft tissue work like myo-fascial release, ischemic compression and Graston Technique, stiffness and scar tissue are released for optimal mobilization and range of motion.  Therapeutic exercises and stretching programs are tailored to your specific needs allowing you to better care for yourself and enjoy the activities in life that you may be missing.

I would be honored to be a part of your healthcare team and I look forward to the opportunity to help you reduce your pain and stiffness and achieve your health and wellness goals!

-

Dr. Roseen is now seeing patients Monday, Tuesday, Thursday, Friday and Saturday.  Schedule today for your initial Chiropractic visit by calling 781.431.1333


Is Your Posture Causing You Pain?

Whether you are sitting, standing or lying down how you hold yourself for long periods of time – your posture – influences your health. Although you may notice poor posture when you see it in others, do you grasp the importance of it in your own life?

As a chiropractor, I always observe the posture of my patients and see a clear and consistent connection between poor posture, a postural demand (ex. desk job) and their back/neck pain, headaches, shoulder pain, etc.  The American Chiropractic Association has guidelines relating to proper posture and in the text below I have shared some of their tips as well as a specific exercise you can do to improve your posture and reduce the related aches and pains.

Before you read further, stop and reflect – How is your posture?

Normally, we do not consciously maintain normal posture. Our muscles and ligaments support our skeletal structure keeping us upright and we rarely think about posture unless, perhaps, our grandmother sternly reminds us to ‘sit up straight’!

When we slouch in our seat and project our head forward (usually towards a computer screen) we place a strain on shoulder/neck muscles that are already over worked (ex. upper trapezius) causing them to fatigue and become pain generators (neck pain and headaches). These larger muscles are intended for periodic heavy lifting and smaller muscles along the spine are better suited to stabilize the spine and maintain an upright posture. Being upright and using these key postural muscles balances the pressure equally on the many joints of the spine preventing irregular wear and early degeneration (arthritis).

A very simple way to improve posture is to (1) recognize the difference between ideal posture and your own, and (2) practice postural exercises that activate and strengthen postural muscles.

(1) Recognize areas of improvement in your posture. Any habit developed becomes difficult to change. With regards to posture, your mind and body movements adapt and actively work around poor posture and over problems develop. Problems like irregular tension on spinal ligaments, muscle fatigue, spinal joint wearing and pain. Below are recommendations by the American Chiropractic Association (www.acatoday.org) on how to best develop your sitting posture.

How do I sit properly?

  • Keep your feet on the floor or on a footrest, if they don’t reach the floor.
  • Don’t cross your legs. Your ankles should be in front of your knees.
  • Keep a small gap between the back of your knees and the front of your seat.
  • Your knees should be at or below the level of your hips.
  • Adjust the backrest of your chair to support your low- and mid-back or use a back support.
  • Relax your shoulders and keep your forearms parallel to the ground.
  • Avoid sitting in the same position for long periods of time.

(2) Practice postural exercises that activate postural muscles. Once you appreciate proper posture you have to ‘wake up’ muscles that are very important in proper posture and use them. This is very important because muscles that are most important are likely to be weak from disuse. Use the description and images below to practice this postural relief position.

Postural Relief position.

Sit at the edge of a chair. Put your knees apart slightly and your feet under the knees. Arch your back. Rotate your arms outward so your palms face forward. Tuck in your chin. Hold this position for 30 seconds while taking deep breaths in through your abdomen. Repeat 2-3 times per hour.

Poor Posture

Poor Posture

Postural Relief Pose

Postural Relief Pose

Let me leave you with one last tip – sit well, sit less. Sitting for long periods of time for work is directly correlated not only to back pain and headaches but also obesity, diabetes, hypertension and many other chronic diseases. Take time away from sitting at least once or twice per hour – to stretch, practice your postural relief position or take a brief walk around the office.


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