In The News

(As seen in the Lakeville Journal, Millerton News, and Winsted Journal) 

As the temperatures drop many people are heading to the local gyms to get their exercise.  Many people switch from running and swimming to weight lifting in the colder months.  Weight training is an extremely effective way to lose weight, increase bone density, improve balance and improve your quality of life.  Unfortunately, there is a lot of confusion when it comes to lifting weights and this confusion leads to people avoiding this type of exercise.  The following are some pointers that I used during my time as a personal trainer and continue using today in my chiropractic practice.

Ages 5-18:
I see many children in my practice who have pain because they’ve started lifting weights or because they are involved in far too many activities    Parents now allow children to exercise everyday in many different sports and some even allow their children to weight train.  These parents believe they are helping their children but what they don’t know is that they may be doing harm to the growing body of their youngster.
The problem with children lifting weights is that they have open growth plates.  These growth plates can remain open up until the early twenties for some children, and these plates are how we grow.  Children who lift heavy weights run the risk of damaging these growth plates and altering how they grow.  These problems are relatively rare but the incidence is increasing as parents have their children training as if they were adults.
 I always have children avoid heavy weight training until we know their growth plates are closed.   If teenagers begin to lift weights I usually have them use less weight and do more repetitions.  This decreases the stress placed on the growth plates and moves the stress onto the muscles, which makes children stronger and prevents injury.  If your do wish for your child to weight train I urge you to research the topic, find a professional to help, and take things slow.

Adulthood:
Most people can see great benefit from weight training in adulthood.  It’s a time when your muscles are in peak form and bone density is at its greatest.  Unfortunately, many women won’t go to the gym because they don’t want to get big muscles.  This is a belief that I must put an end to.  If anyone could walk into a gym and lift a few weights and have huge muscles then every guy out there would have huge muscles.  Believe me when I say that building muscles is a very difficult and time consuming thing to do.  Lifting weights a few times a week will by no means give you huge muscles, but it will give you more strength and muscle tone.
The majority of exercise-induced injuries seem to occur in this age group.  I see many people come into the office for back pain after extensive weight training.  The majority of the time it is because they have overdeveloped their chest or abdominal muscles and neglected training their backs.  This causes their posture to start to slump forward and put strain on the back.  The back, upper and lower, should be the focus of any weight training program to prevent injury.  I see people developing their chest and abs far too often because those are the muscles people can see, which brings me to my next point.
    Your abdominals muscles are not the only part of your core!  Most people have heard that training your core can prevent back pain.  This is true, as long as you train your entire core and not just your abdominal muscles.  Most people over-train their abs so they can have a nice looking stomach.  Unfortunately this is only part of your core, the most important and most neglected part of the core is the low back.  The low back is vastly stronger than the abdominal muscles and is used much more often.  I urge you to start performing back extension exercises.  Lay on the ground on your stomach, hands may be to your sides or behind your head.  Now using only your low back muscles lift your upper body off of the floor, and let it back down again.  Perform only a few repetitions in the first week and then add more repetitions until you can do three sets of 15 repetitions.  This one exercise may save you from having a bad back.

60’s and beyond:

The main problems this population experiences is lack of movement and falling down.  Many people of this age haven’t ever exercised or have limited experience with exercise.  Weight training for this group should focus on balance.  Movements should focus around being on your feet and moving around, not lying on a bench or sitting at a weight lifting machine.  Although, machines are easier for people to use, they don’t develop your stability muscles and will do nothing to prevent falls.  These movements can be staggering in the beginning, which is why it’s always a good idea to use the services of a trainer.

Heavy weights should not be the focus of your routine, the joints can’t handle that type of activity.  The focus should be on lighter weights and more functional activity.  I see people on a weekly basis who have used weights too heavy for them and torn rotator cuff muscles or threw their back out.  If you use higher repetitions and lower weights you can easily increase strength and stability, which will improve your quality of life. 

The easiest way to do weight bearing exercise is to walk.  Our area has numerous track facilities available for the public.  Start slow and build up to 30-60 minutes a day.  Then I would look in your cabinets for cans.  Almost everyone has soup cans in their homes that can be used as weights.  Bring them along for your daily walks to exercise your upper body.  Lift them in front and to the sides of the body a few times during each lap.  Other things such as carrying your own groceries and cleaning the yard are good ways to incorporate weight-bearing activities into your everyday life. 

The second exercise is more for balance and should always be performed with someone watching you to prevent falling. Balance decreases rapidly as we age and like anything else, if you don’t use it…you lose it, so we need to train our bodies to be stable.  This can be done by standing in front of a mirror, with both feet on the ground.  Now slowly lift one foot off the ground and see how long your can stand on one foot.  Repeat on the other side.  The goal is to work up to a few minutes on each leg.  Once you advance past a few minutes you can add other movements into the routine.  It’s helpful to have a trainer create a balance program for you if you are new to the gym.

The most important thing to remember about exercise is that movement keeps us young and healthy and we all can do it.  If we want to be vibrant and alert to see our children and grandchildren grow up then we have to keep moving throughout life.  In the beginning of any exercise program there will be some muscle soreness and achy joints as we get our bodies used to the new activity.  But after a few weeks you will notice increased energy and strength that will trickle into every aspect of your life.  Of course, before beginning any exercise program you should consult your physician so that any other health issues can be monitored. 

Backpack Safety

September 1, 2008                                      

 As fall approaches and kids head back to school the use of backpacks is in full swing.  For many children the aches and pains of carrying a heavy backpack have become common place.  Unfortunately, backpacks are usually carried in a manor that sets children up for neck, shoulder, and low back problems. Imagine your child limping back from school and needing to ice their back, sounds like an adult injury, but sadly it’s now also a child injury.  I have worked on children as young as four years old because their parents unknowingly packed their bags much too full.  As a chiropractor I follow the American Chiropractic Association guidelines for backpack safety.  Here are some tips that will help prevent the common injuries I see during this time of year while using backpacks during hiking or heading to school.

• Is the backpack the correct size for your child? The backpack should never be wider or longer than your child’s torso, and the bottom of the pack should not hang more than 4 inches below the waistline. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking.

 • Does the backpack have two wide, padded shoulder straps? Non-padded straps are not only uncomfortable, but they also can place unnecessary pressure on the neck and shoulder muscles.

• Does your child use only one of the straps? Many children will use only one strap because they think it’s “cool” to do.  Lugging a heavy backpack by one strap can cause a disproportionate shift of weight to one side, leading to neck and muscle spasms, low-back pain, and poor posture.

• Are the shoulder straps adjustable? The shoulder straps should be adjustable so the backpack can be fitted to your child’s body. The backpack should be evenly centered in the middle or upper, not lower, portion of your child's back.  The pack should be close to your child’s body, never allow the pack to hang off the body.

• Does the backpack have a padded back? A padded back not only provides increased comfort, but also protects your child from being poked by sharp edges on school supplies (pencils, rulers, and notebooks) inside the pack.

• Does the pack have several compartments? A backpack with individualized compartments helps position the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your child's back, and try to place the heaviest items closest to the body.

∑The pack should never weigh more than 10% of your child’s body weight.  For Example: a 100 pound child should not have a pack that weighs more than 10 pounds.

• Does your child need all the things inside the pack? Some children put every book they have into their backpacks, but of course they don’t use every book every day.  Check with their teacher as to what books they truly need to take home each day.  

Children can experience things such as headaches, neck, back, and shoulder aches due to improper backpack use.  If your child seems to be experiencing hurtful symptoms of backpack wear please don’t hesitate to get them some help.  I see, all too often, parents neglecting to bring their children to the office.  By the time the child does come into the office they aren’t children anymore, but they have been living with pain for quite some time.  Most of the time it’s a quick fix for youngsters but the longer the parents wait to seek care the longer it takes to get the children out of pain.  Remember, no one should live in pain, especially children.  Prevention is always the key to good health, no matter how old you may be.  

June 1, 2008        "Why do I always have Headaches?"

(As seen in the Lakeville Journal, Millerton News, and Winsted Journal)

At some time in each one of our lives we’ve all experienced a headache.  Whether it’s after something we ate, drank or for unknown causes, it’s something that stops us in our tracks.  The aching, pounding, vision problems, or nausea can be at times debilitating.  For many of us the solution is taking Advil throughout the day until the pain is gone.  Sometimes this strategy will be very effective, but haven’t you ever wondered why you are actually getting the headache?  Let me be the first to tell you, contrary to popular belief, headaches are not caused by an Advil deficiency.

There are numerous types of headaches, too many for this article, so we’ll take a look at the most common ones.  The most prevalent type is a tension headache.  This is the type that you feel perhaps in your shoulders and up your neck into you head.  They normally come on after long days at work or a stressful situation.  Tight muscles and joints in the neck or shoulder area cause these headaches.  You’ll probably notice, if you experience these headaches, that you’ve got some sore spots on your upper shoulders and up near the base of your skull.  When the muscles and joints get too tight they send pain signals up to the head as a signal that something is wrong and you get a headache.

Tension headaches are treated very successfully in our office with numerous techniques.  The goal is to decrease muscle spasm and joint tightness in the shoulders and the neck.  Many people have points on their neck or shoulders, which re-creates the headache.  When the muscles and joints of the neck and shoulders are moving correctly the headaches subside.

The second type of headache that we see frequently in this area is a sinus headache.  These can be caused by an allergy or sickness that makes the sinus cavities fill with fluid.  This fluid pushes on the sinus bones and eventually pushes hard enough to cause pain.  These types of headaches are usually cured by avoiding sickness or by having a trained professional perform a painless sinus release technique.  This technique is used in our office and helps release the sinus pressure causing the headache.

A migraine headache is characterized by an intense throbbing with nausea and sensitivity to light.  Many people experience an “aura” which is a visual symptom that is similar to seeing flashing lights or being in a dream-like state.  Migraines are usually caused by a constriction in the blood vessels of the brain, followed by an expansion of these vessels.  This expansion causes more blood to flow into the brain and pressure to increase.  This increased pressure can also push on surrounding nerves and after all this you experience a Migraine.

For all headaches, but migraines especially, the first step is to avoid things that trigger a headache. These are things like alcohol, caffeine, foods containing nitrates (sandwich meats), the chemical MSG, and cheese, just to name a few.  Another way of decreasing headaches is to try a Gluten-Free diet.  Some people are allergic to Gluten (a protein found in Wheat products) and don’t know it, but this is the cause of their headaches.  I have seen simple dietary changes make drastic effects on headaches.

The vast majority of people who suffer from constant headaches are able to obtain relief from avoiding triggers, having relaxed muscles and proper joint function in the neck and shoulders.  If you have frequent headaches you should start a daily diary and keep track of when you get your headaches.  Make sure to note time of day and food intake so that you can figure out what may be causing the headaches.  No one needs to live their life in a state of pain, there’s always something that can help. 

May 1, 2008                “My hands sometimes go Numb”

An extremely common problem, and one which many people feel they must live with for their entire lives, is numbness in the hands.  The symptoms range from one finger feeling tingly all the way up to both hands going completely numb.  Many people come to see me after being told that they have carpal tunnel syndrome.  Now some people may actually have Carpal Tunnel but in actuality the majority of people have something quite different.  Most of us notice that something is wrong in our hands and assume that the problem is in our hands; it’s a reasonable assumption.   However, to really understand where the problem is actually coming from we must take a look at the anatomy of the upper body. 

    All the nerves and blood supply that eventually make it out to our hands come from the center of our bodies.   The spinal cord is at the center of our bodies and is encased by our vertebrae so that it stays protected.  The nerves and blood vessels that come out of our spinal cord take this path: From our neck, through our shoulder, through our elbow, through our wrist and into our hand and fingers.   To be able to feel and move your little finger the nerves and blood vessels have to travel through all those joints uninhibited.  Problems can arise if there is any interference from your neck to your fingers.

    When there is interference we feel the effects in the place furthest away from the center first.  Think of it this way.  In a drought the water in the lake starts to dry up and the towns furthest down the river coming from that lake will notice the problem first because they are furthest away.  This is the same way our body works.  The symptoms most people feel are in their hands and fingers but most of the time this means there’s a problem up near the neck or shoulder.

    Now it’s important to note that Carpal Tunnel Syndrome is certainly something people do experience and I have many people come into the office with this problem who experience great relief after treatment.  The majority of the time these people have a very active job where their wrists and finger don’t get a break. However, Carpal Tunnel Syndrome has become somewhat of a catch all phrase for numbness in the fingers or hands and in many cases the problem stems from somewhere else.  Also, there are some causes of numbness in the fingers that are more serious and you should always have a thorough checkup to rule out more harmful causes.

For the majority of people the problems stem from the neck and shoulder area.  These two areas are the most common because most people sit for the majority of their day and most people are also very stressed.  Take a moment and relax you shoulders.  If you are like most people then you probably just allowed your shoulders to drop a few inches and didn’t even know you were holding them up close to your ears.  Our stress response causes our shoulders to go up and also to roll forward.  This causes stress on the neck and shoulder muscles, which can then alter the normal flow of nerves and blood to the limbs. 

    Prevention is the key when it comes to numbness or tingling in the hands and fingers.  The easiest first step is to get a lumbar support for your chair at work and while driving.  This support forces you to sit up straight and doesn’t allow you to roll your shoulders forward.  Stretching your chest muscles can also prevent you from rolling forward and slouching.  If you must sit at a desk throughout the day you should stand up, if only for a few seconds, every 30 minutes.  This can help you maintain your upright posture and prevent slouching.  For many people the preventative steps help but for more advanced cases please see your health care professional for a complete examination.

April 1st, 2008

In my chiropractic practice I hear patients use the term “slipped disc” used to describe a low back injury.  Well, discs do not actually “slip”.  Rather, they may herniate or bulge out from between the bones.  A herniation is a displaced fragment of the center of the disc that is pushed through a tear in the outer layer of the disc.  Think of it as if you squeezed one side of a jelly doughnut and the jelly came out the opposite side.  Pain results when irritating substances are released from this tear and also if the fragment touches or compresses a nearby nerve.  Herniated discs are common in the low back or lumbar spine.

What causes discs to herniate?

Many factors decrease the strength and resiliency of the disc and increase the risk of disc herniation.  Life style choices such as smoking, lack of regular exercise, and inadequate nutrition contribute to poor disc health.  Poor posture, daily wear and tear, injury or trauma, and incorrect lifting or twisting further stress the disc. If the disc is already weakened, it may herniate with a single movement or strain.  Patients often say that the pain occurred during activities such as coughing or bending to pick up a pencil.

How do I know if I have a disc herniation?

Herniated discs are most likely to affect people between the ages of 30 and 50, although they can occur at any age.  The most common symptom will be pain in the area of the herniation that may radiate across the hips or into the buttocks.  You may also experience numbness or pain radiating down your leg to the ankle or foot.  If the herniation is large enough, you may notice weakness with extension of your big toe and you may be unable to walk on your toes or heels.  If a herniation is suspected your health care professional may order an MRI to be positive. 

How is a disc herniation treated?

With any injury, back injuries included, you want to apply ice as soon as possible.  I hear many patients tell me they put a heating pack on an injury.  Unfortunately this is one of the worst things you can do.  When we have an injury we always have swelling, even if you can’t see the swelling on the surface, and heat will only increase the swelling and pain.  When we apply ice the swelling and pain have a chance to decrease.  The easiest way to ice your back is to place a thin towel over the injury and place an ice pack on top of the cloth.  Use the ice for 20 minutes every hour or two.

Mild to moderate disc herniations can usually be treated conservatively with stretching, exercise therapy and chiropractic care.  More advanced cases will often require some form of spinal decompression, such as traction or mechanical decompression, in conjunction with chiropractic care.

Occasionally, a herniation may be severe enough to warrant surgical intervention.  These cases are usually reserved as a last resort when other forms of therapy have failed to relieve pain, or if there is significant compression of the spinal cord or nerves.  If you can relate to any of these symptoms please meet with your health care professional for a proper diagnosis.

 March 1, 2008

February 15, 2008

"I stretch all the time"

Due to the fact that the majority of patients I see have some sort of pain, this is a statement I hear all the time.  Of course this is because I ask everyone I see..."do you stretch?"  When we look at injuries, no matter if they are sports injuries or a random event we have to understand why the body was in the position to become injured.  In the majority of cases we get ourselves into trouble way before we feel the pain.  Pain is the last step in a long process of dysfunction.

The main problem people face is that we all get tight muscles.  If we have tight muscles they pull on the bones and alter how we move.  When this tightness becomes severe enough we can feel pain.  So does this mean that tight muscles is the cause of all pain?  Well of course not, but many injuries would not happen, or would be much less severe, if the muscles were loose.

We'll take a look at low back injuries.  When I see low back injuries there's usually two other things I see...tight hamstrings and tight gluteal muscles.  So why does this happen?  When people sit our hamstrings and gluteal muscles shorten, and when we sit each and everyday of our lives our muscles stay in that shortened state.  The problem with having these short muscles is that they attach to our pelvis.  If the muscles are tight enough to pull on the pelvis they will rotate our pelvis.  This would be fine except for the fact that something very important sits on top of the pelvis...our low back.  When the pelvis is pulled out of line then our back is pulled out of line...and we feel pain.  Of course most of us feel the pain in our low back, but the low back isn't the problem. 

So we now see how tight muscles, caused by a sedentary lifestyle, can cause low back pain.  The question is...how do we prevent this if we have a job where we sit a lot?  Stretching is the answer.

"But Doc, I stretch all the time"  Well, what most people think of stretching all the time is far from my definition of stretching all the time.  Most people say that they stretch for 15-30 seconds; her in lies the problem.

Every muscle in our bodies has what is called a stretch reflex.  Take your hamstrings for example.  When you bend down to touch your toes you feel the burn in your hamstrings.  This is because your hamstrings contract so that they won't rip in half when you try to touch the toes.  This is a defense mechanism that all our muscles have.  If we didn't have this reflex everytime we stretched our muscles would tear...not the best thing.  This reflex can last for 45-60 seconds.  Let me say that again...45-60 seconds.  And how long do most people stretch?  15-30 seconds!  So what are these people accomplishing?  Absolutely nothing!  This is why people say they stretch all the time but still get injured.  Once the stretch reflex relaxes, after 60 seconds, our muscles begin to stretch and we can increase our flexibility.

 So how should you stretch?  Each stretch should be brought to a point where you feel the burn and then held at that point for 2-3 minutes.  Let me be the first to tell you that 2-3 minutes seems like an eternity.  But you'll get used to it and once you notice the benefits you'll stick with it.  Stretching should be done at least 3 times a day for 2-3 minutes.

 If you take the time to sit down and quiet yourself a few times each day you can drastically reduce your risk of injury.  Also, if you incorporate deep breathing into your stretches you have an easy way to decrease stress and relax. 

Yours In health,

Dr. Piretti

February 1, 2008

    I spoke with a man yesterday who regularly consumes coffee and he told me that it was good for his health. This belief, he said, comes from one of the recent studies claiming that coffee increases alertness, productivity, and weight loss. With such a studies claiming these benefits I thought we’d take a closer look at the coffee culture.

    The morning cup of coffee is the most accepted ritual in the entire world. Most people can remember waking up as children to their parents drinking the morning coffee and reading the daily paper. It seems sometimes as American as apple pie. But is this ritual harmful or helpful to our health?

    The active ingredient in coffee is of course caffeine. A drug. Caffeine is the most popular drug in the entire world. It exists in coffee, soda, energy drinks…the list goes on. But why does caffeine work? Caffeine begins its effects by causing our adrenal glands to release adrenalin. It also causes our blood sugar to spike. These two events cause the euphoric feelings that most people feel after their morning cup of coffee. The “high” people experience is what causes most people to become addicted in the first place. But after you’re hooked is when your health really starts to change.

    To understand how caffeine starts to harm our bodies it’s important to understand one of the bodies’ greatest feats…the feedback system. Every system in our body works on feedback loops. These are like a check and balances system. It causes us not to produce too much or too little of anything. So how does caffeine affect these systems?

    When caffeine goes to the adrenal glands it causes them to release adrenalin, which would normally be released by your adrenal glands to wake you up. The caffeine gives the adrenals the signal they need to release your adrenalin. So what’s wrong with this? Well, now that your body notices that something external is waking up your adrenal glands it decides not to do the same thing on it’s own. So now your adrenal glands don’t work on their own, they rely on the caffeine. This is why people who are getting off of coffee find it so hard to wake up in the morning. Their bodies have gotten so used to having something external wake them up that they don’t know how to work anymore. Now it will take months or perhaps years for the adrenals to learn to work properly again. This is usually why people don’t stay off coffee for too long…they truly are addicted.

    The second, and more important, feedback mechanism that caffeine and coffee affect is your digestive system. We all know people, or maybe ourselves, who need the morning coffee to “go the bathroom.” Of course going to the bathroom means to have a bowel movement for those of you who have never experienced this. Coffee is an irritant to the digestive tract. This is why there are things out there called coffee enemas…to clean out the digestive system. So every morning people are cleaning out there digestive systems. So why would this be harmful? I thought cleaning out the digestive system is good?

    When a person reaches the point where they need coffee to go the bathroom the feedback mechanism has already done it’s job. The digestive system begins to realize that something external is going to flush the system. So the intestines, in an attempt to us the least energy possible, decide to shut down and allow the daily coffee to do their job for them. This means that the food we eat basically just sits in our intestines until the next coffee break when the food will be flushed out. The problem with this is that the digestive process is extremely important in overall health. The digestive system absorbs all our vitamins and minerals from foods, which is how we survive and stay healthy. It also absorbs water, so we don’t become dehydrated. When these functions shut down we absorb less vitamins and minerals so we become malnourished. We also don’t get any water back into the system and we become chronically dehydrated.

    I challenge anyone out there who drinks coffee on a daily basis to give it up cold turkey and see how your body feels. I will be willing to bet that you go through many detox symptoms such as…headaches, shaking, extreme fatigue, and of course constipation. Most people will notice that they won’t go the bathroom for days once they stop coffee. This is because the internal functions of the body have stopped working, thus proving to people that coffee isn’t a great health food.

    So is coffee healthy for you? As much as I would love to believe coffee is healthy for people, the science behind it just doesn’t support the health claims. For people who are addicted to coffee the daily cup does make them more alert and productive but sadly, this effect is short lived and has health consequences for your liver, intestines, heart and adrenal glands. I’ve only gone over a few harmful affects of coffee in this weeks blog but I assure you there are many more. So the key is to not become a coffee drinker in the first place. But if you are one of the millions of people who are under the tight grip of the morning coffee don’t fret, there is hope. Start by making baby steps to get you off this powerful drug.

    It’s never a good idea to stop coffee cold turkey, your body will put up a real fight for that caffeine fix. So start by deceasing your consumption from a Large to a medium for a few weeks, then to a small for a few weeks. Allow your body to acclimate for at least two weeks with every step down in your caffeine consumption. When you get down to a small cup then switch to green tea (which does have caffeine) every other day and coffee on the opposite days. Eventually go to all green tea.

    This is a tough process, I’m not going to lie to about that. But if you stick with it your body will eventually thank you. A few months after getting off of coffee you won’t even remember why you wanted coffee to begin with. Because for most people, if you really think about it, when you took your first sip off coffee you probably wanted to throw up…People don’t truly enjoy coffee…Addiction, on the other hand, loves coffee.

Yours In Health,

Dr. Piretti

January 16, 2008