Wellness Festival Memories

Thanks to everyone who participated! You guys rock!

The Wellness Festival!

A Three-Step Process for Enhancing Golf Performance

This is a recent article published in Dynamic Chiropractic written by Dr. Mark N. Charrette. He discusses the importance of foot orthotics, back exercises and stretches in order to improve golf performance. So come on golfers, check this out!


A Three-Step Process for Enhancing Golf Performance

Research studies confirm the importance of postural balance on effective biomechanical results. In a study on the effects of orthotic intervention on balance and proprioception among experienced golfers, data suggested a relationship between exercise and changes in standing balance and proprioception. Custom-made flexible orthotics positively influenced balance and proprioceptive symmetry and likely reduced the relative effects of fatigue associated with playing nine holes of simulated golf.1

In a second study, this one on the effects of orthotic intervention on club-head velocity (CHV), results showed an approximate 3-5 mph increase in CHV, or a relative increase by up to 7 percent, after experienced golfers wore custom-made flexible orthotics daily for six weeks. The effects of fatigue associated with playing golf (relative to CHV) were eliminated, therefore improving the likelihood for more consistent golf performance.2

In addition to the research findings, the three steps discussed below will likely help most of your patients who use them. The key to the last sentence is "use them." Without application, the best idea will never come to fruition. If you're a golfer, I recommend that you try these techniques yourself. If you are not a golfer, try them out on one of your patients. If you do them exactly as I recommend, you'll generate some excitement and very likely some new patients.

Step #1: Stabilize the Foundation

Stabilize and balance the foundation with flexible, custom-made orthotics. This will not only help structurally, but functionally as well. If there is a structural imbalance, the pulley system of the muscles will be adversely affected. The muscles will not be able to work as efficiently.

There is a direct correlation between the medial arch and the iliopsoas muscle, the lateral arch and the hip abductor (gluteus medius/minimus) muscles, and the transverse arch with the quadriceps/hamstring balance. All of the muscles inserting into the pelvic bowl should be working to their optimal ability and be approximately equal in strength and function. You will find that when there is asymmetry in the pedal foundation, there is muscular imbalance as well. Custom-made flexible orthotics were created to not only stabilize the bones of the foot, but to also enhance muscle function throughout the lower legs and spine.

Step #2: Strengthen the Lumbar Extensor Muscles

The most important muscle group for low back stabilization is the extensor group. Studies today clearly demonstrate that if you only strengthened one muscle group in the low back region, it should be the extensors. Many golfers, like just about everyone else, have lumbar extensor muscles that are not as strong as they should be. Adding to this, the nature of their golf stance further stresses these muscles. The constant bent-over position creates a postural distortion, further weakening these muscles.

According to Weishaupt, et al., when golfers who did not experience back pain were examined relative to isometric strength of trunk muscles, they showed highly significant stronger lumbar extensors, but also "muscular dysbalance in lateral flexors and rotators of the spine." This finding supports the recommendation of specific physical training for well-balanced strengthening of muscle groups involved in the maintenance of spinal stability, including the lumbar extensor muscles and the muscles of the mid-back region.3

For development of the lumbar extensors, simple surgical-tubing exercises will definitely strengthen these muscles. The protocol to start off with is three sets of six reps performed slowly, to benefit both the concentric and eccentric muscle contractions. The number of reps can be increased as the golfer gets stronger. The number of sets remains the same and can be alternated with this next key exercise:

Step #3: Strengthen the Mid-Back Region

Just as in the case of the lumbar extensor muscles, the mid-back region, especially the mid-trapezius, rhomboids, teres minor and infraspinatus muscles, are notoriously weak. This is true for the general population and particularly for golfers, if you look at their stance posture.

Simple surgical-tubing stretching exercise works wonders for stabilizing the mid and upper torso. The protocol for this is slightly different: three sets to fatigue at a fast but controlled pace. Again, these can be alternated with the above extensor exercises.

These exercises can be performed daily and can be done in five minutes or less. The cardinal rule is "no pain for maximum gain." This is not an intense body-building program. Rather, it is designed to help the nervous system enhance muscular coordination to stabilize the golf swing.

As simple as this approach appears, it gets great results quickly. Most golfers will notice the difference immediately; all will notice it within two weeks. They will notice a smoother, more controlled swing that produces greater distance with each club they use.

Postural Alignment and Health Disorders

Deed Harrison, DC, President of Chiropractic BioPhysics recently published a short article in regards to posture and how it affects health:

Posture has probably been one of the longest studied aspects of Humans. The correlation of posture and health has driven us to study our posture since at least the time of Hippocrates.1 Since Hippocrates’ time, many have attempted to categorize man into constitutional posture types.1-3

Even in present times, the criteria for normal and abnormal posture continue to be ill defined without clearly defined and agreed upon categories and measures. Before any possible consequences of abnormal posture can be addressed, normal posture must be defined and precise measurement methods developed.

DISCUSSION

• Ideal Upright Postural Alignment:

Herein, we use the definition of ‘Ideal Posture Alignment’. Ideal Posture is really a matter of simple engineering. The human body is designed such that the centers of mass of the head, ribcage, and pelvis should be perfectly centered and balanced on each other. From the front, the spine is perfectly aligned with gravity. But the spine, when viewed from the side, contains three curves to properly balance the weight of the body and allow free movement. Figure 1 depicts the proposed Ideal Posture Alignment. Note that we will ignore the ideal spinal curvatures that give rise to optimal postural alignment for the purposes of this short presentation.

• Postural Deformity, Pain, Disability & Health:

The cause-effect relationship between postural deformity-abnormality and health disorders has been the subject of numerous investigations and review articles and it has advocates on both sides of the debate. A comprehensive review of this information is behind the scope of the current short presentation. However, recent high quality case control investigations have found interesting and significant differences between condition groups vs. control groups and significant correlations between abnormal posture alignment and a number of health disorders including:

• Abnormal thoraco-lumbar alignment and back and neck pain in children and adolescents;12,13
• Hyper-kyphosis-round back and health perceptions and function in adolescents;14,15
• Hyper-kyphosis and rigid anterior head translation and functional impairments in seniors;16
• Hyper-kyphosis and early mortality in seniors;17
• Abnormal cervical spine postures in women with chronic pelvic pain;18
• Abnormal forward head posture and neck pain, headaches, disability, range of motion, respiratory muscle function, and carpal tunnel syndrome.19-23

However, scientific studies aside, ask yourself or others this question: Which one of the four persons in Figure 4 visually appears to be in good health and which one of the four persons would you say has poor health?

Your eyes (and mind), may in fact be pointing you to answer for the questions regarding the scientific connection between good posture and good health and poor posture and poor health. In the end, how do you wish to age with respect to gravity may be the only question that need be answered.

References
See AJCC Online at www.idealspine.com for the detailed list of references accompanying this article.
• Goff CW. J Bone Jt Surg Am 1952;34:115.
• Beck A, Killus J. Aerospace Medicine 1973;44:1277-1281.
• During J, et al. Toward standards for posture. Spine 1985;10:83-87.
• Panjabi MM, White III AA, Brand RA. A note on defining body parts configurations. Journal of Biomechanics 1974;7:385-387.
• Harrison DD. CBPâ Technique: The Physics of Spinal Correction. National Library of Medicine #WE 725 4318C, 1982-97.
• Harrison DD. Spinal Biomechanics: A Chiropractic Perspective. National Library of Medicine #WE 725 4318C, 1982-97.
• Harrison DD, Janik TJ, Harrison GR, Troyanovich SJ, Harrison DE, Harrison SO. Chiropractic Biophysics Technique: A Linear Algebra Approach to Posture in Chiropractic. J Manipulative Physiol Ther 1996;19(8):525-535.
8. Harrison DE, Janik TJ, Cailliet R, Harrison DD, Normand MC, Perron DL, Ferrantelli JR. Validation of an algorithm to estimate 3-D rotations and translations of the rib cage in upright posture from three 2-D digital images. Eur Spine J 2007; 16(2):213-218.
9. Janik TJ, Harrison DE, Cailliet R, Harrison DD, Normand MC, Perron DL. Validation of an algorithm to estimate 3-D rotations and translations of the head in upright posture from three 2-D images. J Manipulative Physiol Ther 2007;30(2):124-129.
10. Harrison DE, Janik TJ, Cailliet R, Harrison DD, Normand MC, Perron DL, Oakley PA. Upright static pelvic posture as rotations and translations in 3-dimensional from three 2-dimensional digital images: validation of a computerized analysis. J Manipulative Physiol Ther 2008 Feb;31(2):137-45.
11. Normand MC, Descarreaux M, Harrison DD, Harrison DE, Perron DL, Ferrantelli JR, Janik TJ. Three dimensional evaluation of posture in standing with the PosturePrint: an intra- and inter-examiner reliability study. Chiropractic & Osteopathy 2007; Sept. 24th 15:15.
12. Murphy S, et al. Classroom posture and self-reported back and neck pain in schoolchildren. Appl Ergon 2004;35(2):113-120.
13. Smith A, et al. Classification of sagittal thoraco-lumbar pelvic alignment of the adolescent spine in standing and its relationship to low back pain. Spine 2008;33:2101-2107.
14. Korovessis P, et al. Comparative multifactorial analysis of the effects of idiopathic adolescent scoliosis and Scheuermann kyphosis on the self-perceived health status of adolescents treated with brace. Eur Spine J 2007;16:537-546.
15. Petcharaporn M, et al. The relationship between thoracic hyperkyphosis and the scoliosis research society outcomes instrument. Spine 2007;32:2226-2231.
16. Kado DM. Narrative Review: Hyperkyphosis in older persons. Ann of Intern Med 2007;147:330-338.
17. Kado DM, et al. Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women. Ann Intern Med 2009; 150:681-687.
18. Mary LLS MontenegroPostural changes in women with chronic pelvic pain: a case control Study. BMC Musculoskeletal Disorders 2009, 10:82.
19. Fernández C, et al. Forward head posture and neck mobility in chronic tension-type headache: a blinded, controlled study Cephalalgia 2006;26(3):314
20. Yip CH. The relationship between head posture and severity and disability of patients with neck pain. Man Ther 2008;13:148-154.
21. Kapreli E, et al. Respiratory dysfunction in chronic neck pain patients. Cephalgia 2009;29:701–710.
22. De-la-Llave-Rincón A, et al. Increased Forward Head Posture and Restricted Cervical Range of Motion in Patients With Carpal Tunnel Syndrome.J Orthop Sports Phys Ther 2009;39(9):658-664.Lau KT, et al. Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Man Ther 2010; April 28 (E-pub ahead of print).
23. Lau KT, et al. Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Man Ther 2010; April 28 (E-pub ahead of print).


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Premiums for Pre-Existing Conditions Could Be Costly

This article was published by Ricardo Alonso-Zaldivar AP News...I thought it was quite intriguing and informative! (What happened to the idea of affordable health care? Give me a break.)

WASHINGTON — President Barack Obama's new health coverage for uninsured Americans with health problems won't be cheap — premiums averaging $300 to $600 a month in the largest states, according to a government website that went live Thursday.

From cheaper to most expensive, premiums will range from a $140 a month to as much as $900, Richard Popper, deputy director of a new insurance office at the federal Health and Human Services department, said Wednesday.

New website

Consumers shopping for health insurance can compare costs on a new federal website, www.healthcare.gov. The range is so wide because premiums will be keyed to standard individual health insurance rates in each state, which can differ dramatically because of medical costs and the scope of coverage. Also, older people will pay more.

"There are going to be meaningful premiums that are going to be required to stay in this plan ... in the hundreds of dollars," said Popper, with the Office of Consumer Information and Insurance Oversight.

Estimates on HealthCare.gov show premiums for a 50-year-old in Florida will be $552 to $675 a month; in New York the cost will average from $400 to $600; in Texas it's $491 to $600, and in Pennsylvania $283 on average. In many states, consumers can start enrolling immediately.
Coverage for pre-existing conditions

Despite the cost, consumer advocates are urging uninsured people with health problems to sign up soon, because they cannot be turned away for medical reasons. Family members may be able to help with premiums, which are competitive with rates paid by people who buy their coverage directly from an insurance company.

The Pre-Existing Condition Insurance Plan will start taking applications in every state by the end of the month. Coverage will be available as early as August 1.

Consumers can go to the website to find out about the program, as well as other coverage options in their state, including government plans such as Medicaid, and private insurance. Starting this fall, the site will feature easy price and coverage comparisons among private plans. The new health care law called for the site, as a way to offer Americans one-stop shopping for coverage.

The coverage is a stopgap for vulnerable people locked out of the private insurance market because of medical problems. It's intended to remain available until 2014, when core health care overhaul provisions take effect. At that time, insurers will be barred from turning away people in poor health, low- and middle-income households will get subsidized coverage, and most Americans will for the first time be required to carry health insurance.

To qualify for the pre-existing condition plan, people must be uninsured for at least six months and have been turned down for coverage by a private insurer because of a medical problem. U.S. citizens and legal residents are eligible.

Could funds run out?

The biggest question hanging over the program is whether the $5 billion allocated will be enough.

Millions of people meet the basic qualifications for coverage, and technical experts who advise Congress and the administration have warned the funds could be exhausted as early as the end of 2011.

HHS officials sidestepped questions about what would happen if the money runs out. One option is for the government to limit enrollment.

Popper estimated about 200,000 people would be enrolled in the program at any one time, but other HHS experts estimated that 375,000 would sign up this year, and the Congressional Budget Office says the total could reach 700,000 in 2013.

Parents Oblivious to Overweight Kids

This is an article written by Claudia Kalb in July 1 Newsweek:

The obesity alarm bells are ringing again. A new report out this week finds that more than two thirds of states (38 total) have adult obesity rates above 25 percent—a striking increase since 1991, when no state had an obesity rate above 20 percent. Hardest hit: Mississippi, which weighed in at 33.8 percent, followed by Alabama and Tennessee (tied at 31.6 percent), West Virginia (31.3 percent), and Louisiana (31.2 percent).

The report, “F as in Fat: How Obesity Threatens America’s Future 2010”, released by the Trust for America’s Health and the Robert Wood Johnson Foundation (RWJF), documents disturbing racial, ethnic, and economic disparities, too. Obesity rates for blacks and Latinos were higher than whites in at least 40 states; and 35.3 percent of adults earning less than $15,000 a year ranked as obese, compared with 24.5 percent of Americans making $50,000 or more. A lot of statistics. A lot to worry about.

Why are Americans getting fatter? As we reported in our March cover story, there are a host of factors, from the ubiquity of high-fat, mega-calorie foods to lack of exercise and too much TV. But another, more complicated, trigger appears to be at work as well: grave misperceptions about weight.

This is especially true of parents who mistakenly believe their kids are leaner than they are. A new poll included in the report finds that the majority of Americans believe that childhood obesity is a “significant and growing challenge for the country,” and yet 84 percent say their children are at a healthy weight—despite national stats showing that nearly one third of children and teens are overweight (their body mass index, or BMI, falls between the 85th and 95th percentile for their age and sex) or obese (at or above the 95th percentile). Americans understand there’s a problem; they just don’t think their kids are a part of it. The consequences are dire. “We’re in danger of raising the first generation of children who could live sicker and die younger than the generation before them,” says Dr. James Marks, RWJF’s senior vice president.

Skewed weight perception is a well-known phenomenon in the research world. In one study, only one third of parents of overweight kids recognized their child’s weight status accurately and few were worried that it might be a problem. In another, 60 percent of parents of overweight children inaccurately identified their child as healthy weight or even underweight. African-American parents were more likely to underestimate than white parents. And in a study of a low-income Latino population, mothers preferred a plumper figure for their children than themselves. This is especially worrisome given the trends in black and Latino obesity rates and the health problems—diabetes, heart disease, cancer—that can ensue.

Parents may not recognize a weight problem in their child for any number of reasons, says Dr. Judith Palfrey, president of the American Academy of Pediatrics. Weight can increase subtly and parents may not notice a change. The global rise in obesity means kids are bigger, so overweight kids look more like the norm than they used to. Parents also take pride in feeding their children. “We are naturally nurturing and nourishing, and we want our kids to have everything they possibly need,” says Palfrey. And there is the plump baby factor as well. There has long been the perception, says Palfrey, that if your child looked like the pudgy happy Gerber baby, “you were doing great.”

You may be putting your children in danger, instead. Dr. Elsie Taveras, an assistant professor of population medicine and pediatrics at Harvard Medical School, found that babies who gain weight rapidly in the first six months of life are at a higher risk for obesity at age 3. “A lot of families think that weight gain early on is just baby fat and it’s going to go away,” says Taveras. Plump babies may well slim out, which is why pediatricians aren’t necessarily worried, either. But when a baby who gains excessively turns into an obese toddler, he may be on track to become an obese adult, too. Unfortunately, pediatricians often sidestep the issue in the very young, says Taveras. “We don’t want to label children too early or we don’t know what to do,” she says.

This could lead to a delay in pinpointing a problem early on and allow an ongoing perception among parents that everything is fine. Even when children become preschoolers, most parents are unable to identify their weight problems, according to a study published in early June in Clinical Pediatrics. Lead author Dr. Raquel Hernandez, an assistant professor of pediatrics at the University of South Florida, found that almost three quarters of parents thought their overweight or obese toddler (between the ages of 2 and 5) was a healthy weight. Most alarming: when asked to point to a sketch most resembling their child’s weight (seven body images were presented, ranging from very slim to obese), 20 percent of parents of overweight or obese kids pointed to a body image that was actually lighter than a healthy weight.
Measuring a child’s BMI routinely can help identify unhealthy weight gain early; the American Academy of Pediatrics recommends doctors start taking these measurements at age 2. But tracking numbers isn’t enough. Pediatricians must also be more forthright about discussing a child’s weight with her parents, says Hernandez. In her study, only 7 percent of parents recalled ever being told that their child was gaining weight too fast or was overweight. And yet, when a pediatrician did raise a concern, parents were much less likely to misperceive reality. Bottom line: doctors, your patients are listening. It’s never too soon to start educating them.