MBT Shoes - The New Best Running, Training and Recovery Shoes

INTRODUCTION

After a detailed bio-mechanical and practical evaluation of the MBT shoe for both training and recovery I’m really a fan of this so-called “anti-shoe”. It is the contention of this researcher that MBTs will be validated as the new best running shoe for those suffering or recovering from back pain, hip injuries, arthritis, knee problems and conditions of the foot and ankle.

However, unlike the info most prevalently available about MBT shoes creating instability, I believe MBT shoes actually enhance overall stability because of their unique self-righting sole and its ability to act in symphony with the postural muscles. This improves stability as the user's foot interfaces with hard surfaces. The only portion of the gait whereby there is instability in MBT footwear is at heel strike. This functions to absorb the shape of the terrain and lessen pressure on the heel.

MBT functionality could be likened to that of the old Joe Palooka Bob Bag of the 1950's. This was a self-righting punching toy with a counter-weighted bottom. No matter what one did to it, it righted itself in a perfectly vertical format.

WHAT ARE MBT SHOES?

Quite simply they are rocker-bottom soled footwear that enhance a user’s ability to maintain natural and proper postural balance. They are super comfortable and nature’s answer to many sports’ injuries and orthopedic complaints of the back and low

er extremity.

“MBT” is an acronym for Masai Barefoot Technology and the shoes were engineered as a result of studying the Masai Tribe in Kenya. These people have a significant lack of knee, foot and ankle problems.

Most running shoes are designed to lessen the n

eed for a good set of balanced muscles. However, MBT design facilitates muscle activity and the recruitment of muscles maintain the balance of the user. This is similar to the benefits to be gained by running barefoot in semi-soft sand.

Although orthotics can be worn inside MBT Shoes, we find they are often unnecessary. That’s right, MBT shoes are a better substitute for most foot orthotics that were prescribed to either relieve heel pain or improve the biomechanics of the foot.

DESIGN OF THE MBT SHOE

The above diagram showing how MBT design aids the walking/running gait.

The diagram above demonstrates lateral stability and balance fore and aft with MBT footwear.

The unique features of the MBT design are (1) the soft Masai Sensor Cushion and (2) the Self-righting Rocker Bottom Mid-sole.

The sensor cushion is located under the heel, but is longer, less dense and has a different shape than most cushions in the heel of a shoe. On one hand its properties simulate uneven ground, subconsciously soliciting a proprioceptive response from the stabilizing muscles. This compensatory response facilitates adaptation to the terrain.

The balancing action of the mid-sole, with its integrated self-righting/rocker bottom technology, actively exercises the muscles and precisely guides the mid-stance through toe-off motion in a very controlled manner.

All parts of the shoe, work in harmony with the wearer, exercising the entire lower torso and lower extremities while virtually eliminating the stress to joints and ligaments.

MY PERSONAL EXPERIENCE

This researcher is now an avid MBT wearer. After a stay in the hospital as a result of cardiopathy, I noted that my right knee and right heel were in peril giving me trouble walking. Apparently, the lack of oxygen and immobility resulting from a hospital stay had caused a previously minor condition to rapidly deteriorate. Upon examination by a competent physiatrist (doctor of physical medicine), MRI showed a ruptured Baker’s Cyst combined with severe degeneration of my medial cartilage. I was also suffering from a heel spur and plantar fasciitis. I was determined to walk to rehabilitate my heart condition, so I went shoe shopping and purchased a $120 pair of Salomon XT Wings GTX Trail Runners. These shoes are really top of the line and I rather enjoyed them. My condition was slightly alleviated by them, but not to my satisfaction. After 2 months I purchased a pair of ASCIS Gel Kayanos which although nice and light and comfy, made absolutely no improvement. I’ve always been a fan of New Balance, so I looked for their best trail running shoes and purchased those; again to no avail. I then tried Pearl Izumi’s SynchroSync III, which is a wonderful shoe and the best running shoe I have ever tested by far. This made it possible for me to walk with less pain and even run a little bit. However, after 2 months of wearing those, I was still in pain and not complacent with the results. Only out of curiosity and with lots of skepticism did I try MBTs. I had already decided that Pearl Izumi made the best shoe on the market and since MBT is the “anti-shoe” I suppose that is still true. I was accompanying my sister on a quest for a good walking shoe and this led to my first MBT experience. Wow, I was sold the first time I put them on. The pain in my knee and heel were present, but tolerable. I bought a pair and within 3 day of wearing them I was able to run with minimal heel or knee pain. I’ve saw continual improvement over the next 3 months and today, I’m virtually free of the pain.

Sleeping with Hip Pain and Bursitis

Do you suffer with lots of pain in the hip after prolonged sleeping in a side posture? You’re certainly not alone. The cause may be bursitis and this can occur either with the hip/leg on top, or the one that is pressured against the mattress. Hip bursitis can either be acute or chronic hip bursitis.

WHAT IS BURSITIS?
Bursitis is dysfunction in the fluid-filled sac (bursa) that normally provides buffering and lubrication for tendons gliding over a joint. It is often caused by new or old injuries or can be a result of lack of important nutrients to the joint. Acute Bursitis is inflammation of the sac and perhaps over-production of fluid (swelling). Chronic bursitis actually presents with dryness, lack of fluid and poor lubrication for movement of tendons.

HIP PAIN ON THE DOWNSIDE
Although there are many facets of treatment and self-care for bursitis of the hip joint, a pressure point relieving, supportive foam mattress is one very important aspect of treating it. REASONING: (1) It is important to not have pressure on the inflammed bursa while lying on that side. (2) Additional to excessive pressure, poor mattresses lack support and often sag or hammock. That places an undesirable stretch on the muscles associated with the hip on the downside, thus irritating the bursa and impeding healing. One might wake up with pain, clicking, stiffness and limited mobility which may lessen after being up and about for awhile.

HIP PAIN ON THE UPSIDE
Alternatively, your pain may occur in the hip that faces upward. I know this seems sort of odd, but it is actually quite common. REASONING: (1) In most people, their hips are wider apart than their knees. This is especially true in women. This anatomical truth can create tension on hip muscles as the knees come together and stretch such muscles. (2) Or perhaps, one stretches their leg out in front of them twisting the spine and pulling on hip muscles. In those with bursitis, this can wreck havoc with the sensitive bursa. (3) Of course, a supportive, pressure relieving mattress is advisable to prevent excessive hip rotation.(4) However, in this case it is often advisable to also utilize a nice space occupying pillow between the knees. The pillow should be soft enough to not impede circulation but substantial enough to maintain a distance between the knees perhaps equal to the width of the hips. Please note that hip bursitis often is complicated by a component of hip tendonitis which may also be alleviated with the advice of this article. Please also note that this is not the panacea of care for hip bursitis. Functional care involving nutrition, stretching, strengthening and physical medicine are advisable but beyond the scope of this article.

HELPFUL SLEEP SOLUTIONS FOR HIP BURSITIS

Mattresses to consider:

• Nimblepedic Memory Foam Mattress
• Pincore Latex Foam Mattress
• Or, if your mattress is extremely firm, it likely causes pressure points and will actually bend the spine. In such cases, instead of a new mattress, one may consider a memory foam mattress overlay for firm mattresses.

Pillows to consider:

• Between the knees/legs pillow

Adjustable Beds: Enhancing the Sleep Experience

The current evolution of sleep technology suggests considering an adjustable bed for improving sleep quality at any age. Although hospital beds are a form of adjustable bed and have been around for years, the thought of placing one in the home was previously only considered for the elderly and debilitated. Why has the adjustable bed captured almost 40 per cent of premium beds sales in the 21^st Century? First let us understand the importance of a sound sleep.

UNDERSTANDING WHAT SLEEP REALLY IS

Sleep has all of the following characteristics:

• a lack of or decrease in awareness of environmental stimuli
• the maintenance of core body temperature (in homeotherms or mammals like us)
• is easily reversible (to wakefulness)
• has distinct EEG patterns in mammals (different from a state of wakefulness)
• has spontaneous occurrences with inherent repetition (independent of other bodily needs and environmental cues)
• sleep offers the benefit of conserving energy while focusing on repair of the body

WHY DOES ONE NEED A SOUND SLEEP?

Humans spend one third of their lives in a somnolent state. This is one reason your bed is so important. Here are some others:

Sleep deprivation impairs thinking and suppresses the immune system.

Neural activity inducing sleep is synonymous with such that regulates temperature. Much evidence exists that indicates the origin of the sleep process was simply a method of body and mind maintenance. This included both temperature control and the enhancement of memory recorded by neural activity during REM sleep. More specifically, sleep is a period of time whereby the brain and body can learn and mend without the interference of outside sensory stimuli or sleep-disruptive motor activity. In simple terms, we recuperate, learn and commit new information to memory when we sleep. How important might this be for a student?

Thus, sound sleep is a state required for learning new neural patterns. In other words, in order for the nervous system to grow and change, there must be down time from active behavior. Creatures as primitive as worms require adequate sleep. Don’t you think humans deserve at least as much?

EVOLUTIONAL HISTORY OF BEDS AND MATTRESSES

• First Beds - The first beds of ancient man likely consisted of soft grasses and leaves on rock palettes or open ground.
  
• Fancy Ancient Beds - Thousands of years before Christ, in ancient Egypt, royalty slept on the first feather bed mattresses supported by bed frames made of gold, bronze and ebony. Sometimes hay, wool or grasses were substituted for the feathers. Wool and feathers were great for maintaining body temperature and we’ve just touched upon the importance of such.
• Renaissance Materials - The Renaissance Era brought great improvement in mattress plushness. Feathers, straw and/or the shucks of legumes were covered with fine silky or velvety fabrics.
• 16^th Century - In the sixteenth century, foundations created by a web of ropes were developed to create flexible support for mattresses. This is thought to be the origin of the phrase: “sleep tight” because by tightening the network of ropes, more support was provided.
• 18^th Century - During the 18^th century, cotton was utilized for mattress stuffing which was a deterrent for bed bugs that had become accepted as commonplace.
• Early 20^th Century - In the 1930’s America introduced the innerspring mattress.
• 1950’s - Latex foam rubber mattresses were introduced by Goodyear in the 1950’s and marketed by Sears and Roebuck.
• 1980’s - Airbeds hit the market in the 80’s.
• 1990’s – Memory foam mattresses by Tempurpedic® ^® hit the USA.

ADJUSTABLE BEDS IMPROVE THE SLEEP EXPERIENCE

The advent of high quality foam mattresses in the 1990’s brought about innovation. In 1994, it is this author’s belief that, Back Be Nimble was the first company to expound on this by partnering a memory foam mattresses with an adjustable bed from Electropedic. BackBeNimble.com started a nationwide marketing campaign offering a combination of the now famous Tempurpedic® memory foam mattress with this high quality adjustable bed and groomed it for residential environs.

Labeled the European Adjustable Sleep System by Back Be Nimble in 1995 and offering a Tempurpedic® Mattress / Electropedic Adjustable Bed combination, it was brought to the attention of Dave Fogg, the then current CEO of Tempurpedic®, Inc. Mr. Fogg did not feel that the adjustable bed market could be expanded beyond the geriatric market and that Tempurpedic®’s target customers would not likely have interest in such. Additionally, he expressed that beds in this price range would also not sell through online catalogs.

Following this conversation, BackBeNimble.com proceeded to market the European Adjustable Sleep System via both brick and mortar and online media. After three years, almost 50 per cent of Back Be Nimble bed sales were adjustable beds vs. the conventional flat bed.

Needless to say, the bed and mattress industry took notice, nonetheless Tempurpedic®, Inc. It is this author’s contention that 50% of Tempurpedic®’s sales from 2004-2005 combined their Tempurpedic® mattress with one of their Leggett and Platt adjustable bed frames. The rest is history.

IS AN ADJUSTABLE BED RIGHT FOR YOU? Let’s investigate!

• Restful & rejuvenating
• Reduces tossing and turning
• Increases the period of REM sleep
• Comfortable & adjustable
• Pain free & relaxing
• No heartburn, no snoring
• Zero pressure-point adjustable bed mattresses
• 1000 positions for you and your partner with independent controls for each (with dual-adjustable beds)
• Wake up rested and refreshed
• Hmm… Maybe this is “Zzzz” sleep you’ve imagined

Gravity and Zero-gravity Effects of Adjustable Beds

While the beneficial floating or weightless effects of zero-gravity on the spine are experienced on an adjustable bed, these beds also use gravity to benefit your health.

Indigestion: By elevating the torso, normal digestion is enhanced. The stomach acids actually flow down hill, helping to alleviate the discomfort of reflux, GERD and acid indigestion. Breathing is enhanced for more complete oxygenation of the tissues.

Low Back Pain & Sciatica: By elevating the legs while bending the knees, your adjustable bed uses gravity to aid circulation while relieving lower back pain and tension on the sciatic nerve.

FINAL THOUGHTS

Still think adjustable beds are only for the elderly? We don’t either. Sleep was meant to be good at all ages and people of all ages have insomnia or less than adequate sleep. A pressure-reducing mattress on an adjustable bed platform is the current best practice for achieving a restful, rejuvenating sleep.

TEMPURPEDIC^® is a registered trademark of TempurPedic^®, Inc. and use of such does not imply endorsement of this blog by Tempurpedic^®,Inc.

Sciatica: A Real Pain in the Butt

THE MANY FACES AND CAUSES OF SCIATICA
Sciatica merely describes a path of pain and is not a specific diagnosis. The use of the term "sciatica" does not specify a cause.

Defined, "sciatica" is a description of a particular path of pain following the sciatic nerve as it traverses the buttock (hip) and/or continues down the back of the thigh, outside of the leg and perhaps the foot. As our article title denotes, sciatica can be a real pain in the buttocks.

Generally, the worse the condition, the further down the leg the pain travels and may even affect the foot. However, there are certain cases that although severe, only affect the hip area or buttock. It suffices to say that the symptom picture can be quite varied from one individual to another. Although most commonly associated with nerve compression from a low back disc condition, there are many causes of sciatica, some of which are not back related. Interestingly enough even those cases originating from a low back condition may not exhibit any back pain.

Some authorities would argue that if the origin of pain is not compression of a nerve root in the lower back, the result is not a "true sciatica", but a pseudo-sciatica. Synonyms for sciatica would be sciatic neuralgia or sciatic neuritis.

ANATOMY OF THE SCIATIC NERVE

The sciatic nerve is about 1/2 inch in diameter and is known to be the longest and largest nerve in the human body. The nerve originates in the lower spine as nerve roots exit the spinal cord (between the vertebrae in the spine), and combine to extend all the way down the back of the leg to the toes.

It is thus composed from a combination of 5 nerve roots exiting holes known as foraminal openings between vertebrae in the lower lumbar and sacral region. These include the following nerve roots: L4, L5, S1, S2, and S3. Nerve roots in the lumbo-sacral area of the spine are named by the vertebrae above. Thus if the nerve root exits between L5 and S1 it would be considered the L5 nerve root. By understanding this one can correlate the area of symptoms with a specific spinal level.

The five nerves combine anterior to (in front of) the piriformis muscle to become the sciatic nerve. This nerve then travels down the back of each leg, branching out to innervate specific regions of the leg and foot. It should be mentioned here that a spasm of this piriformis muscle where the nerve crosses the sciatic notch can cause sciatic neuralgia and often mimic symptoms of a herniated lumbar disc.
Just above the back of the knee, the sciatic nerve divides into two nerves, known as the peroneal and tibial nerves, going to various parts of the lower leg:

• The peroneal nerve innervates the shin and outer aspect of the leg down to the upper foot.
  
• The tibial nerves innervates the posterior portion of the leg and traverses all the way to the feet to innervate both the heel and sole of the foot.
  

The sciatic nerve supplies both motor input (eliciting muscle movement and reflexes) as well as sensory innervation.

SYMPTOM PICTURE OF SCIATICA

Pain: searing , stabbing, usually intermittent pain is generally the overwhelming symptom. The pain can be felt in the low back, buttock, posterior and outer side of the thigh or leg and possibly all the way to the toes. The pain is most often felt in certain positions, while walking or while straightening the leg. It may occur on both sides (bilaterally), but it is more often one-sided (unilateral). Pain is sometimes exacerbated by sneezing, coughing, laughing or pushing during a bowel movement (Valsalva's Maneuver).

Numbness/tingling: sometimes the pain is either accompanied by or replaced by numbness and tingling known as paresthesia or radiculopathy.

Weakness: in the most severe cases of sciatica there is actually impairment of the motor nerve functions causing weakness in the leg and/or foot. The most common sign of such would be foot drop or the inability to pull the big toe up toward your knee (aka: lack of dorsiflexion).


CATEGORIES OF CAUSES

Mechanical Spinal Nerve Compression: most often from a herniated, ruptured or extruded disc but can be from severe misalignment or vertebral subluxation.
Compression by Muscle Spasm: most commonly known as a "Piriformis Syndrome" whereby the muscle underlying the gluteus maximus (buttock) is spasmed applying pressure to the sciatic nerve underneath. This is known to clued physicians as an "entrapment neuropathy" and is often misdiagnosed as a low back disk herniation because it mimics many of the symptoms of such. This can prudently be differentially diagnosed from a disc herniation by either MRI studies, CT scan or just a good old fashion history and exam including questions regarding pain during coughing, sneezing and bowel movements.
Trauma to the Sciatic Nerve: bruising, puncture wounds, or over-stretching injuries to the nerve itself can produce the symptoms of sciatica.
Spondylolisthesis: this is a slippage of one vertebral body on top of another and may be a result of fracture or a genetic defect in the pars interarticularis. If in the L4 to S1 region, sciatic neuritis symptoms can occur. Although many authors seem to describe a compression of nerve roots resulting from a spondylo-listhesis, it has been my experience both clinically and in my review of the literature that the most accepted authorities believe the nerve root irritation to be a result of traction or stretch of the nerves vs. an actual compression.
Spinal Tumors: space occupying lesions, of the spinal vertebrae, spinal cord, cauda equina, or surrounding muscles or sciatic nerve itself can cause sciatic symptoms.
Sacro-iliac Joint Sprain or Subluxation: this is actually one of the least understood or recognized conditions causing sciatica, but in this clinician's experience is one of the most common causes of sciatica not resulting in pain extending below the knee. Coughing and sneezing does not increase the symptoms in this case and often Kemp's sign will NOT be positive. Subluxation or sprain of the sacro-iliac joint leads to a referred sciatica in this case. This is generally best treated by a chiropractic physician.
Chemical Irritation: although not even known or considered by most practicing physicians, chemical radiculalgia is one of the physical results of back dysfunction and can be the primary cause of sciatica. This is an actual irritation to nerve roots caused by the swelling pressure of inflammation against the nerve. It is a major factor in what is called the "cycle of pain". It may be interesting to note that it has been this practitioner's experience that this is often the factor that is most concerning when dealing with the sequela of a disc herniation or injury. It is the overwhelming reason that Lumbar Epidural Steroid Injections have been so effective in relieving the symptoms of herniated or ruptured disc conditions. It leads some researchers to believe that inflammation may play an even greater roll in symptomatology than the mechanical pressure of displaced disc material.
Viscerally Referred Pain: although not as common as some of the other causes of sciatic symptoms, paresthesias, pain and odd sensations may be felt along the sciatic nerve distribution as a result of problems with internal organs. For example, problems with the prostate gland or female organs can refer sensations along the sciatic nerve. This can easily be ruled out by a thorough examination.

TREATMENT OF SCIATICA

Certainly the best treatment practices for sciatica would include addressing the cause in addition to alleviating the symptoms. Thus the approach may be different dependent on the cause. Sitting, driving and arising from the sitting position is usually a problem for all sciatica sufferers and thus one of the most recommended items would be a pressure relieving seat cushion. One type is known as a memory foam seat wedge. The 2nd type is a gel seat cushion that is wedged for ultra comfort.  Make sure that the cushion you select has a cut-out for the coccyx or tailbone and that it is solid, fairly dense memory foam or a solid type of gel. Ice is nice in the case of sciatica and heat should generally be avoided in acute cases.

Other treatment protocol is more causal specific and usually requires a battery of prescribed and self-care. Some of these are listed below:

DON'TS
Avoid irritation and stretching of the nerve during the healing process. This would eliminate toe touching with the leg straight.

Avoid running, fast walking or other physical activities that increase pain.

Avoid heavy lifting, stooping, squats or prolonged bending.

Avoid sitting on soft overstuffed chairs or couches or desk chairs that fall away when leaned against.

Avoid fast movements.

Avoid arising out of bed w/o first turning on your side

Avoid stomach sleeping or sleeping on your back with both legs straight out.

Avoid straightening the involved leg when sitting.

DO'SDo see a physician or chiropractor for a proper diagnosis and treatment. Depending on findings your doctor of choice may suggest: spinal adjustments or manipulation, deep tissue massage of the buttocks, core muscle strengthening and stretching, repair of a disc herniation, oral anti-inflammatories, lumbar corset or lumbar epidural cortisone injections. Lumbar traction and/or gravity inversion may be advisable in some cases. For less common causes like tumors or referred pain from internal organs, your doctor will likely refer you to a specialist for further investigation.
When sleeping on your back, keep at least the involved leg slightly bent with an orthopedic bed wedge or soft fluffy pillow.

When side sleeping, place a soft pillow between your legs starting at the knee and positioned downward from there.

Do utilize a memory foam seat wedge to keep good posture and remove pressure from the sciatic nerve when seated or driving. For chronic sciatica seated workers should consider the purchase of a nimble ergonomic chair like the Bodybilt task chair.

Heart Healthy Living and Yet My Heart Was Broken

One expects that if they live a healthy lifestyle there should be an absence of heart disease and a portrait of a healthy heart. However, this does not always ring true and my self-portrait is testimony to such. Actually, as friends and family might attest to, I have always been a little different. Some of my friends think I eat cardboard and birdseed, but this is far from the truth. Organic foods and healthy eating can often be very tasty and highly misunderstood. I probably exemplify the phrase “healthy lifestyle”. I do eat what some might call health food, organic when I can and almost always low fat/low sugar. For much of my life I suffered an addiction to sugar, so today I exercise great discipline in this regard. When I do eat sweets (generally only on the weekends), they are made from whole grain flours, utilize either palm oil or coconut oil and are generally sweetened with agave nectar, fruit juices or real maple syrup. I eat many meals out, but I’m selective in my choice of both the restaurant, menu items and cooking technique. Did you know that you can maintain a healthy eating style while traveling or eating out, even at fast food restaurants? I’ll get more into this later or perhaps in another post.

I’m also a fitness fanatic, self-proclaimed at 14 years of age after my heart was broken from rejection by the first girl I asked out on a date. She was a cheerleader and I was NOT a jock. I was not terribly overweight, but I was a sugarholic and had what one might call a pudgy, non-athletic appearance. So, I began running and working out at a time when the only runners were those on a track team and when working out with weights was for jocks or bodybuilders. Gyms were not air-conditioned and so-called “health clubs” were exclusively for the wealthy country club goers. Inspired by the likes of Jack Lalane, Steve Reeves (Hercules) and Paul Bragg I was determined to be fit, ripped and most importantly to have a date with the girl who turned me down.

This became a lifestyle for me, continued throughout college and carried over into my education and professional career. I had originally intended to be what is now called an exercise physiologist, yet that field of education did not exist at the time. I started with physical ed and pre-med in college with the intention of being the world’s guru to fitness. Wow, isn’t it amazing how being rejected by a pretty girl so greatly influenced my life?

Well, unexpectedly, I hurt my back in an accident and my treatment and recovery for such sparked my interest for becoming a chiropractic physician. So, that is exactly what I did. As I always say: “life is what happens while you’re making other plans.” Actually, it was a way I could live and preach all the healthy living techniques I was incorporating into my own life.

I LIVED A HEALTHY LIFESTYLE, SO WHY WAS MY HEART SICK?

To summarize and make a long story short, I’m a health and fitness nut; lived and breathed it. Ironically, but true, I recently almost died of a heart problem. How can that even be? I never smoked, rarely drank alcohol, lived a healthy lifestyle and yet in March 2008 I was suffering grade IV congestive heart failure. This was quite an eye-opener for me. I realized that there are circumstances beyond our control and no matter how “good” we are, we can still get sick. I had no heart disease, no coronary disease, no atherosclerosis and nonetheless, my heart just short-circuited. I developed a severe arrhythmia whereby my heart was beating out of control and not pumping blood. Fluid was building up in my stomach, liver, lungs and I was literally drowning in my own secretions. Thanks be to God and the expert medical care of Dr. John Seger (electro-physiologist), my heart has a normal sinus rhythm again. Dr. Seger performed ablation, a surgery whereby the short circuit pathways of my heart’s rhythm were blocked by overheating the cells in specific areas of my heart muscle. He also prescribed a small amount of a beta blocker called Bystolic to calm my heart and lessen the fight/flight response to stress. In addition and on my own accord, I take health supplements and continue my healthy lifestyle.

WHAT’S TO BE GAINED FROM THIS EXPERIENCE?

Some might say that all my health efforts were wasted because I got very sick in spite of my healthy lifestyle and ode to clean living. To accept such would be a tragedy because I believe in my heart of hearts that I would not have survived the incident nor returned to my current state of health if I had lived a less than healthy lifestyle. In addition, my fairly quick return from the "jaws of death" and return to fitness would have been hendered if I had not followed up my surgery with a good supplement program, healthy eating, stress reduction and an awareness of my body’s feedback.

I live, I breathe, I feel very lucky, and I’m here to tell you about it. I’ve learned that the integration of western conventional medicine with traditional alternative methods is often imperative. I’ve realized that a broken heart is not always a bad thing and that when one door slams shut, another pops open. I did find the love of my life and I’m still here to share life’s challenges and rewards with her.

SO WHAT’S NEXT?

I’m concepting what might be the neatest, life-changing wellness, health-spa-retreat ever conceived. We've selected a choice spot in the mountains, to be revealed later. The concept will integrate western and eastern philosophies of health care under the cloak of both conventional medicine and alternative medicine. Here, guests will learn how to live well and be well while working toward current health and fitness goals and overcoming their obstacles to such.

Be Well !

What's All the Buzz About Wellness, Really?

How should one define the term "wellness" and why is the concept all the rage these days?

A search query of Google for a definition of wellness ("define: wellness") elicits 15 different results, some sensible and similar and others as simple as a brand name for pet food.

The first search result on Google for the query define: wellness was as follows: "a healthy state of wellbeing free from disease; physicians should be held responsible for the health of their patients." Since Google's search algorithm often presents the most popular definition first, this is apparently one of the most read and perhaps more accepted definitions.

Wow, that's a real debacle for me because it puts the responsibility of a patient's health in the hands of their physician. Is personal accountability for one's health not a priority?

Ironically, the recent focus on wellness involves a desire for awareness and self involvement in the quest to get well. In my opinion this desire was brought about by the fact that many physicians are focused on treating disease symptoms rather than zooming in on the holistic or overall portrait of their patients' health. Patients are no longer viewing physicians as God-like authoritarians for health, but are asking questions and seeking alternative methods or advice for self help, nutrition and exercise. New terms are cropping up like "well care", anti-oxidants, polyphenols, PPO and HMO.

This brings up the question of whether HMO really means Health Maintenance Organization? Maybe HMO should have the acronym of PPO or as I liken it: "Pissed-off Patient Organization". In any event, in the minds of insurance executives, HMOs are economical in spite of the fact the costs of health care keep rising. Hopefully they will someday figure out that prevention and maintenance is more cost effective than conventional symptomatic medical care. Chiropractors have preached this for years, but insurance carriers are clearly blinded to recognizing chiropractors as candidates for primary care physicians.

Thomas Edison once said: "the doctor of the future will not dose us with drugs, but will interest his patients in the care of human frame, in diet and in the cause and prevention of disease. The simple truth is you cannot improve on nature." Now that sounds like a mantra of wellness to me.

The quest for wellness is a journey and begins with personal accountability; supported by a symphony of factors like committment. Key components are highlighted below:

• Personal commitment (1) self-reliance and determination to be healthy and well.
  
• Awareness (2) listening to the sometimes subtle signals of your own body.
• Homeostasis (3) achieving balance of your own physiological state.
• Harmony (4) a harmonious, peaceful balance in your relationships with nature, the earth and others.

So now we have the foundational pieces for concocting a good definition of WELLNESS. I believe wellness is always in a state of flux or change and thus the best we can do is view wellness as a journey.

My father instilled the most basic concept of wellness in me when I was a small child by repeatedly saying: "Son, everything in life is balance".

Wellness; defined:
"Wellness is a personal commitment to seek harmonious balance of body and mind with that of nature and others. It is the process of monitoring and fine tuning the underlying mental and physiological processes that are often in a state of flux and when out of balance result in disease".

Chiropractors or Orthopedists?

I pose the question: “If one has back pain should they seek a consult with a chiropractic doctor or an orthopedic surgeon?” In other words, which doctor should be the initial primary care physician?

80 % of adults suffer from back pain, so I must assume that this is a concern pondered by many. As a chiropractic physician, my thoughts maybe somewhat biased, however my intention with this article is to present helpful insight for those who wish to make smart decisions about their back care.

I am not anti-medical and have often referred patients to medical doctors or orthopedists (aka: orthopods) when I deemed it in the patient’s best interest. As a matter of fact, I was one of a handful of chiropractors that pioneered hospital privileges for the purpose of chiropractic spinal manipulation under anesthesia. Thus, I worked successfully with and helped educate members of the medical profession on the benefits of chiropractic.

Quality, Competency and Humility of Physicians

To answer the question regarding chiropractor vs. orthopedist, I will begin my answer by saying it really depends on the doctor and his or her willingness to be open-minded about what is in the best interest of the patient(s). I believe either type of doctor could be an excellent primary care physician for the diagnosis of back pain. Doctors in general need to be aware of their limitations and realize they are not the end-all panacea for all types of conditions. As long as they have humility, and they are known to be competent diagnosticians, their patient(s) should be in good hands. One tenant of the health care profession is to “do no harm” and there is much value in this simple phrase.

Practitioners of either profession are trained to utilize a familiar treatment protocol. In other words, orthopedic surgeons often do surgery and chiropractors like to physically manipulate the spine. There is however no guarantee that a patient’s condition warrants either one of those treatments. Sometimes, the necessary treatment is as simple as applying ice and electrical muscle stimulation to a mild strain of the back. The prudent physician offers both a kind listening ear and competency as a diagnostician. Only with a complete history and thorough examination will a physician be in a position to make an accurate assessment, thus suggesting the next step in the doctor’s decision process -- “Do I treat, or do I refer?”

The Doctor Making a Diagnosis is NOT Always the Best Treating Physician

I’ve heard it said: “What’s you’re not up on, you’re down on.”

I believe it is important for a physician of any type to have knowledge of alternative treatments that are beyond the scope of their own practice. Given this knowledge and an open-mind, prudent recommendations are likely to be forthcoming.

Matching Your Back Condition with the Appropriate Doctor

The majority of back pain cases do not require surgical intervention and they are often best handled by a chiropractor. However, it is good for back pain sufferers to know what cases are predominantly amenable to chiropractic care, as well as those that often require the care of an orthopedic surgeon or perhaps a neurosurgeon. The following chart should be helpful.

Condition/Symptoms	Chiropractor	Orthopedist	Neurosurgeon
back strain/spasm	X
back sprain (1 or 2 grade)	X
back sprain (grade 3)		X
pinched nerve (with foot drop or drag)		X	X
pinched nerve (with just numbness or pain)	X
herniated disk (with pain or numbness as low as knee)	X	X
ruptured disk (pain extends below the knee; weakness)		X	X
fracture of vertebrae		X
bony tumor		X
neurological or soft tissue tumor			X
pulled muscles	X
scoliosis	X	X
auto injury	X	X
arthritis or degenerative disk	X	X
sacro-iliac	X
lumbar facet syndrome	X
infection or hot puffy swelling with or w/o fever		X
spinal cord injuries			X
back pain with loss of bowel or bladder function			X

Dynamics and Treatment of Back Strain

DEFINITION

Back Strain is defined as an injury to the muscles and tendonous tissues of the back. By definition, it excludes injury to ligaments and joints that is more correctly denoted as a “sprain”.

The term Back Strain is the most common diagnosis utilized for back pain of acute origin when a more finely tuned diagnosis can not be derived from the presenting history, symptoms and clinical signs. Physicians are quick to lump the majority of patients into this category of diagnosis. Ironically, they won’t really be wrong because almost all back injuries will have “back strain” as at least one component of the injuries. However, a prudent examination should be utilized to rule out more severe and complicated injuries like Sacro-iliac Sprain, Facet Syndrome or Lumbar Disc Herniation. With inadequate care or repetitive use, even a very mild acute back strain can turn chronic.

ACUTE BACK STRAIN CAN LEAD TO CHRONIC BACK STRAIN

• An acute back strain is one that is of recent origin and often has never occurred before. It is most often brought on by an incident. Pain is often sharp, burning, stabbing, pulling and/or intense. It has a probable prognosis of being finite or coming to an end. Application of an ice pack or cryotherapy is one of the treatments of choice.
• A chronic back strain is one that persists with some level of discomfort over a long period of time. A chronic strain can at times become an acute episode, sometimes for no apparent reason. Pain level is usually, but not necessarily less intense than an acute episode and is often described as stiffness, limited mobility, arthritis or fatigue. Application of moist heat packs is one of the treatments of choice.

PULLED MUSCLE OR MUSCLE SPASM?

The term Back Strain is often associated and used interchangeably with the term pulled muscles. It may be interesting to know that a pulled muscle rarely occurs with the onset of back pain. The Erector Spinae and Quadratus Lumborum muscles of the low back are so strong, that it takes incredible forces to actually pull, strain or tear the muscle fibers. On the other hand, muscles spasm in response to the shock of injury. This occurs because an unexpected or jerky shock to the body may either elicit inflammation or irritate sensitive nerves adjacent to the joint capsule. This often causes the body to respond with a muscle spasm as a result of an overload of stimulating nerve impulses. Consistent spasm leads to a vicious cycle of pain, persistent inflammation, vertebral subluxation (misalignment) and a repeating barrage of nerve impulses offering feedback to the brain and spinal cord that something is wrong. Spasm is the body’s protective mechanism, acting to splint the area to prevent movement, not unlike putting a brace or back support on.

GOALS AND PROTOCOL OF TREATMENT

Unfortunately, a rather minor back strain can become chronic and produce a battery of systematic sequelae that lead to future generative changes. Such changes in adjacent joints manifest in the form of arthritis of the posterior facet joints or degenerative changes in the spinal disks. Salter’s work on joint degeneration with immobility proved this point. Dr. Salter provided extreme examples by reporting what happened when he restricted the movement of a joint in dogs to virtually zero. These immobile joints would completely degenerate and become fused within a relatively short period of time. As a more minor example, this is why old sports injuries come back later to haunt us or the reason an old injury becomes a good weather forecaster someday.

Two factors responsible for converting an acute strain to a chronic strain with degeneration:

• Lack of movement and inflexibility of the spinal joints. Movement is restricted by muscle spasms and later the infiltration of scar tissue and/or joint capsule adhesions. Inflammation and low oxygen concentration are impetuses for scar tissue formation.
• Lack of oxygen (O2), water (H20) and nutrients for healing. With lack of movement comes lack of all 3 of these. Beyond the age of 25 years, our spines are very dependent on individual joint flexibility for the flow of nutrients, O2 and H20 into our joint cartilage and surrounding structures.

The two ultimate goals of treatment for back strain are (1) to increase (maintain) flexibility and (2) to reduce inflammation.

Treatment Protocol

• ICE IS NICE - 15-20 minutes of ice packs or ice massage twice per day to control inflammation is always a good initial therapy because it helps break the cycle of pain and lessens scar formation by reducing swelling and inflammation.

• REST – Initial rest for the back is necessary to give the body a chance to begin healing. However, it is important to begin a program of movement exercises beginning no more than 4-7 days after the initial injury.

• SPINAL MOBILITY THERAPY – should be specific hands on mobilization by a trained physical therapist, chiropractor or medical professional. This is often referred to as spinal manipulation or an “adjustment”.

• EXERCISE ROUTINE - These may begin with simple isometric contraction and relaxation of core muscle groups, depending on the severity of injury. The important thing is that this routine be progressive whereby the number of reps, intensity and complexity of exercise increases with the tolerance of the patient. The overall program should strengthen and stretch all core muscles of abdomen, lower back, gluteal, hip and even thigh muscles. Regimen should at least begin under the guidance of a trained rehabilitative exercise specialist to guarantee proper form in the performance of such.

• NUTRIENT CONSIDERATIONS – To properly heal and maintain the integrity of the spinal joints and soft tissues, we need an abundant supply of oxygen, clean water, amino acid proteins and other micro-nutrients necessary for building strong joints and producing copious amounts of joint lubricants. If you learn nothing else from this article, start drinking at least ½ once of water per pound of body weight per day. This should be either purified, distilled or a spring water, preferably with a PH of 6 or greater (more alkaline is better). Your joints will degenerate without it, not to mention the rest of your body. Other nutrient considerations are numerous and probably beyond the scope of this initial article. Let it suffice to say, that you eat a well balanced diet with lots of good protein, omega 3 fatty acids, olive oil and take a good natural multi-vitamin-mineral supplement. Additional supplements of Glucosamine and MSM have proven benefits for joint healing and maintenance.

• LIFESTYLE CONSIDERATIONS – let’s just put this in very simple terms and say: “what you walk in, what you sit in, what you sleep on and what you think about are all extremely important.” So, consider things like having an orthopedic foam mattress and an ergonomic chair if you spend lots of time sitting. These are simply necessary tools for healthy living.

• HEAT PACK THERAPY – note that I put this last. I did this on purpose because it is the first thing most people think of (including physicians) when someone strains their back and really a bad idea in initial or acute stages. It is however great for chronic strains or to alternate with ice treatments once the pain has become dull and the condition is healing.

Treat Your Own Plantar Fasciitis

Understanding the Cause Suggests the Cure for Plantar Fasciitis
Plantar Fasciitis defined is simply an inflammatory condition caused by strain and over stretching of the ligament that spans the bottom of the foot. This plantar ligament functions to provide spring in your step as well as support the longitudinal arch. Inflammation of such can cause severe pain, particularly when barefoot, when first standing, upon awakening, or standing after prolonged sitting. Plantar fasciitis often precedes and plays a major factor in heel spur formation. As a side note, Plantar Fasciitis has a funny sort of spelling and is often mis-spelled as plantar facitis or plantar fascitis.
The use of gel or cushion under your foot can temporarily relieve or soothe plantar fasciitis. However, this offers temporary relief at best and should not be considered a long term solution. It is a common misconception by both sufferers and physicians alike that a soft cushion under the foot resolves a bevy of foot problems. In reality this measure compromises foot support in the long run, similar to the lack of support for the spine when sleeping on a soft mattress. I prefer to recommend proper support of the arch of the foot, thus relieving strain on the plantar fascia. This functions to actually reduce pressure on the attachment point where the plantar ligament (fascia) attaches to the heel. Excessive tensile forces at this point of insertion over time are the etiological factors that form heel spurs. In essence, a heel spur is your body's response to the ligament pulling on the bone, forming what doctors call a traction spur.
STEP BY STEP SOLUTIONS TO PLANTAR FASCIITIS

1. The first step is to break the cycle of inflammation (swelling) and pain with ice and cold therapy.
2. You must wear an orthotic that both supports the arches of the foot and offers a heel cup. The heel cup serves to elicit side pressure, thus squeezing and fluffing up your own natural fat pad. Your fat pad is nature's way of providing good shock absorption and comfort under the heel. It is not uncommon for those presenting with plantar fasciitis to have signs of a compressed, flattened out fat pad, subjecting the heel to undue stress and increased inflammation. Custom orthotics are great, but there are some over the counter orthotics like Superfeet Orthotic Comfort Insoles that do a great job as well.
3. Wear only rubber soled shoes with good heel counters, good pronation control and good lateral stability.
4. Other important factors to consider:

• Going barefoot is a no no, even in the shower. It is important to wear massage or acu-pressure sandals with arch support. Make sure they are rubber so you can wear in the shower. Keep them by your bed and slip your feet in to them first thing, so your heels never have to touch the floor.
• Never allow swelling to build up in the plantar fascia. Pain is a good indicator of swelling. Thus, if your arches and/or heels get sore during the day, make sure to soak your feet in ice water at night for 10-15 minutes. This is every bit as effective as shots of cortisone.
• Maintain flexibility in your achilles tendon and calves. Tension in these soft tissues is transmitted to the plantar fascia as you walk or run. The best method is to first warm-up your calves somehow as they will stretch more easily without straining them. It is best to stretch them while wearing shoes that includes the orthotics we have already discussed (never barefoot and never with cold muscles).
• It will also greatly benefit you to utilize deep tissue massage manipulate and to loosen the plantar fascia and muscles of the calf. There is a specific muscle called the "posterior tibialis" which almost always involved in the formation of plantar fasciitis. You can use your own home massage devices or try something like a Footsie Massage Roller. If you cannot implement your own massage at home a competent deep tissue massage therapist would be advisable.

Body Torso Elevation for GERD and Acid Reflux

DEFINITION OF GERD: (Gastro-esophageal Reflux Disease) is best defined as the symptoms and/or esophageal mucosal damage produced by the abnormal reflux of stomach contents into the esophagus, causing heartburn or acid regurgitation.

BACKGROUND AND SYMPTOMS:
Although this often produces discomfort, like burning in the upper chest, indigestion, choking at night and a possible sore throat, there is sometimes no discomfort whatsoever. This prospect is a little disheartening because the stomach acid can be damaging the esophagus without the patient being aware of such until it is too late. In late stages, this disorder can lead to erosion or even cancer of the esophagus. Thus, it is quite important to consult a physician if you suspect you might have such. Approximately 7% of the population suffer from acid reflux.

SIGNS:

• snoring, choking or breathing problems often noticed by a spouse or partner
• sore throat upon awakening
• often preceded by recent weight gain around the abdomen

MEDICATIONS:

• H2 Blockers - most commonly Tagament, Pepcid or Zantac and function to reduce stomach acid in mild cases.
• Proton Pump Inhibitors - most commonly Nexium and Prilosec, function to decrease stomach acid production and thereby provide the chance for the esophagus lining to heal. Usually used in the more severe cases or if H2 Blockers should fail.
• Antacids - most commonly Mylanta, Tums or Rolaids, function to buffer an acid stomach and are used more symtomatically in intermittent cases of heartburn.

One common problem with all the above medications that is not often considered by physicians and/or patients is the fact that decreasing or buffering stomach acid, stifles proper protein digestion leading to decreased absorption of nutrients and improper elimination via bowel movements. Thus, sensible natural alternatives should be considered. One proven such alternative frequently recommended by gastroenterologists is upper body or torso elevation while sleeping.

ELEVATING YOUR UPPER BODY WHILE SLEEPING
There are 2 viable methods of elevating the body to relieve the symptoms of reflux or GERD.

1. Use an electric adjustable bed. The head and leg portion are both adjustable and can offer great comfort if combined with the right foam mattress. NOTE: a RX from your physician can often substantiate insurance re-imbursement as a necessary medical device.
2. Use a torso elevating foam or inflatable bed wedge. This is an economical method and also the inflatable type facilitates the ability to travel without discomfort from your acid reflux condition. Most patients find the inflatable type more comfortable than foam even for use at home. Either wedge may be placed at the head of the bed, either on top of the mattress or underneath the mattress. If used on top, we recommend that you use your head/neck pillow on top of the wedge. A soft pillow should be utilized to keep the knees slightly bent to prevent causing low back discomfort when sleeping face up. A wedge may be utilized in both face up and side postures.
   
3. DO NOT use regular pillows to elevate the body, they allow slumping and bending of the esophagus and thus allow acid accumulation in the bend.

ALTERNATIVE NUTRITIONAL COMPONENTS
It's sufficient to say at this time that there are some very good alternatives for the medications that are conventionally prescribed for GERD and acid reflux. However, we'll save that for a future post.

Osteoporosis - Natural, Alternative Treatments

Dear Anonymous "Fragile" person,
Osteoporosis can be a very uncomfortable, scary and debilitating condition. Hopefully, you have a good physician that is working to differentially diagnosis the reason for the early and rapid decline of your bony matrix. Fosamax does have it's drawbacks, although it often is helpful for osteoporosis involving the neck of the femur in the hip. Some of the latest research shows value in natural and alternative supplementation with Calcium Collagen Chelate under the trade name of "Koact". When utilized in conjunction with a good Vitamin K2 supplement and 10 minutes of sun exposure per day the prognosis shows much promise. Research on such is published here: "Increase in bone mineral density through oral administration of shark gelatin to ovariectomized rats"
Nutrition, Volume 21, Issues 11-12, November-December 2005, Pages 1120-1126. In addition, according to Wolff's Law of Bone Adaptation, bones remodel according to stress applied. Thus, weight bearing exercise and iso-tonic exercises like leg press machines can help increase bone mass.

Let's Talk Back Pain

Hi all,
This is our new journal for blogging about your back pain, condition or product experience. I am the "backdoc" at Back Be Nimble and would love to here from you about your back pain, neck pain or other painful conditions. If you purchased a product from the Back Be Nimble Back Store please let us and others know how you feel about it. Would you recommend it as a valuable product for your particular condition? If you have a question about self care products that might be beneficial for your needs, just fire away.