It is no secret that at the Canadian Chiropractic Association (CCA) we often promote the benefits of regular physical activity as a way to stay healthy and happy. In fact, the CCA thinks it’s so important that we’ve created a free app: Straighten Up Canada! The app is currently available for download via Apple Store, Google Play and Blackberry World. Featuring easy-to-follow exercises, it helps to improve your posture and allows you to stay active during your day!
Investing time to do activities or sports that you enjoy is key to healthy aging and an active lifestyle. Being physically active is often a good way to prevent and manage musculoskeletal (MSK) injuries as well as helping maintain strength and mobility. Varying your routine between high- and low-impact activities is a great way to modify your workouts and challenge the body. We’ve outlined some great suggestions for both so you can get up and get moving!
High-impact exercise is typically described as an (often aerobic) activity where both feet leave the ground at the same time1. Often, high-impact activities may include exercise classes which involve jumping, leaping, or jogging in place. Doing high-impact exercise can put you at greater risk of injury if your body is not prepared, especially if you’re just starting out. Be cautious and adapt to a lower impact version of the activity if in doubt. Otherwise, before starting high-impact exercises make sure you have warmed-up.
Good examples of high-impact exercises are:
- Jumping jacks
- Jumping rope
- Running or jogging on a treadmill (or outdoors)
- Performing plyometric exercises
High-impact exercises tend to be more intense and expend more energy, so it’s important that if you’re doing high-impact exercises that you’re well-prepared. For some, high-impact exercises are not appropriate: they may increase the risk of injury, commonly to the ankles, knees, hips, and even the back. That being said, high-impact exercises can have a lot of great benefits too2:
- Improves bone density
- Increases an individual’s heart rate more quickly, thereby burning more calories
- Improves a person’s stability, balance, and coordination
- Strengthens the heart and lungs
Low-impact exercise tends to be less jarring on the body and joints, and less intense overall. According to the American Council on Exercise, keeping at least one foot on the ground at all times also reduces your risk of musculoskeletal injury. Some examples include4:
- Working out on an elliptical machine
- Low-impact aerobics
- Using a rowing machine
- Home exercise
- Nordic walking
It’s important to realize that low impact doesn’t mean low intensity (unless purposely designed to be so) because you can still get an intense workout keeping both feet on the ground. Low-impact exercises are great for beginners, people with arthritis or osteoporosis, older adults, individuals who are obese, pregnant women, and people with bone, joint, or connective tissue injuries.
Whichever form of physical activity you choose, make sure you do it safely.
Provided by the Canadian Chiropractic Association
1Amy Gonsalves, “High Impact versus low impact.” Diabetes Outside blog. April 19, 2011. https://blog.diabetesoutside.com/?p=1060
2Paige Waehner, “High Impact Exercise—Is High Impact Exercise Right for You?” VeryWell.com. May 2, 2016. https://www.verywell.com/is-high-impact-exercise-right-for-you-1230821
3Nicole Nichols, “low impact vs. high impact exercise: Which is right for you?” SparkPeople.com. April 14, 2010. https://www.sparkpeople.com/blog/blog.asp?post=fitness_defined_lowimpact_and_highimpact_exercises
4NHS, “Easy exercises.” NHS Choices. Page last reviewed: 01/03/2016. https://www.nhs.uk/Livewell/fitness/Pages/Lowimpact.aspx
You’ve made the decision to take your cardio routine from the treadmill to the sidewalk – congratulations! You’re on your way to reaping some amazing benefits. If you’re feeling wary about transitioning your routine to a new location, we’ve got you covered. With a good pair of running shoes and some healthy preparation, you can get the most out of your running session outdoors.
Note: Running is a high-impact activity. If you’ve never run before, please consult a chiropractor/medical practitioner to ensure you won’t worsen any pre-existing conditions or cause injury to your joints.
Here are some tips to help get you started:
Warm up and cool down: Make sure you stretch before and after your run. Stretches are an essential part of your running routine to avoid injuries. Some important points to keep in mind:
- Never stretch a cold muscle
- Hold each stretch for a slow count of 30
- Repeat twice on each side
- Don’t overstretch—be comfortable
- Don’t bounce when stretching
Pick a road or trail you are familiar with: When starting out, the last thing you want to worry about is getting lost. Before you lace up your sneakers, do some research: ask friends where they like to run, use online running forums to find popular routes, and check to see if your park has designated trails. The more popular and visible the trail, the better.
Wear the appropriate footwear: Adapt your shoes to your environment. A regular running sneaker works for the flat, predictable surface of a treadmill. But once you are outdoors, make sure the sneaker’s tread can handle the gravel, dirt roads, and slick trails. Runners should get a sneaker that supports the feet while having the appropriate sole to help maneuver and provide support over uneven surfaces.
Start slow: Running outside is more taxing on your muscles, joints and bones, making you more prone to injuries like shin splints. Start off with shorter distances on flat roads or trails. As your endurance improves, gradually increase your mileage and hill work.
Maintain a constant pace: Don’t feel compelled to push yourself to run at the same pace that you would on a treadmill. Start with moderate and comfortable pace that allows you to run safely, and gradually increase your speed over several weeks as your body allows.
If you’ve been running on a treadmill for a while, transitioning to the outdoors may take time. The mechanics of running on a stationary treadmill are different than running outside on an uneven surface.
Originally published June 2016 by the Canadian Chiropractic Association
1Shape Magazine, “Don’t make these mistakes when running. https://www.shape.com/fitness/cardio/dont-make-these-mistakes-when-running-outdoors
2Popsugar, 4 things you need to know before running outside. https://www.popsugar.com/fitness/Tips-Running-Outside-28328027
Many Canadians continue to have questions about the role that chiropractors play in the healthcare team, and what benefit chiropractic care may have to their health.
1. Once you see a chiropractor you have to keep going back
This is false. When seeking care from a chiropractor, we will perform an assessment including a history and physical examination to determine the cause of the pain or dysfunction. From these observations, a diagnosis will be made and the treatment plan developed in collaboration with the patient – according to their needs and goals. The treatment plan will recommend a number of initial visits to see if the patient responds to care and scheduled re-evaluations. Depending on the patient and the condition, the recommended course of care may vary. Ultimately, the decision to continue care is yours. As a patient, if you have questions or concerns about care, you should feel comfortable to ask the chiropractor for more information on the recommendations made and address any concerns. The care plan should be part of a shared decision-making between the patient and practitioner.
2. Chiropractors are not ‘real’ doctors
Chiropractors are regulated in all 10 Canadian provinces, and are designated to use the title “doctor” similar to physicians, optometrists and dentists after completing the extensive Doctor of Chiropractic degree program. Those professions who are recognized to use the “doctor” title have extensive training in their area of expertise that allows them to be diagnosticians – to provide a diagnosis.
Chiropractic care in Canada
3. A medical doctor must refer you to a chiropractor
In all provinces in Canada, chiropractors are primary contact providers, which means you can access them directly. Due to the extensive training of chiropractors as diagnosticians, chiropractors will perform a comprehensive assessment to help determine a diagnosis or clinical impressions. Depending on the outcome, the chiropractor can discuss a course of care or refer to another healthcare professional, as needed. However, in some cases, you may need a referral to access coverage depending on your benefits provider.
4. There is no evidence to support the effectiveness of chiropractic care
Chiropractic treatment is at times questioned on its effectiveness. Yet, the chiropractic profession and others have invested significant resources to build a robust body of evidence studying the impact of manual therapies on MSK conditions. For example, spinal and joint manipulation has been shown to be effective treatment for acute and chronic MSK conditions, like back pain. In fact, spinal manipulative therapy (SMT) is recommended as first line intervention for back pain in numerous clinical practice guidelines including the Bone and Joint Decade Task Force1, the American College of Physicians and American Pain Society2 as well as Britain’s National Institute of Health and Care Excellence3.
5. Chiropractors can only treat back pain
Chiropractors are musculoskeletal (MSK) experts and are trained in assessing, diagnosing, treating and preventing biomechanical disorders that originate from the muscular, skeletal and nervous system. In addition to the evidence that supports chiropractic care in managing musculoskeletal complaints of the spine, there is also evidence that it supports chiropractic management of the extremities, headaches and even TMJ pain,5,6. Chiropractors are also able to provide lifestyle counselling about nutrition, fitness and ergonomics among others that may be useful in managing or preventing a variety of health conditions. The health of your MSK system doesn’t just start with a healthy spine, you need to be fully aware of your health to maintain a well-rounded healthy lifestyle!
6. Adjustments are painful
In general, adjustments or joint manipulations do not hurt. In fact, many patients report immediate pain relief. Patients may be nervous about the ‘cracking’ or popping sound that may occur during an adjustment. The sound is believed to result from the release of gas bubbles from the joint – similar to cracking your knuckles!
Asking questions about your health and treatment options are very important. You are a partner in your care and your participation is critical to helping us provide the best care to meet your goal. To do so, as a profession, we strive to better understand what information you need to make those important decisions. We want to hear from you! If you have any questions beyond this blog about chiropractic treatment, visit a chiropractor in your area. To learn more about what to expect at your first chiropractic treatment, you can take a look at our online videos.
1Haldeman, S., Carroll, L., Cassidy, J., Schubert, J., & Nygren, A. (2008). The bone and joint decade 2000–2010 task force on neck pain and its associated disorders: Executive summary. Spine, 33(4S), S5-S7.
2Chou, E., Qaseem, A., Snow, V., Casey, D., Cross, T., Shekelle, P., & Owens, D. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478-491.
3National Institute for Health and Clinical Excellence. (2009). Low back pain early management of persistent non-specific low back pain. Londres, Angleterre.
4Hoskins, W., McHardy, A., Pollard, H., Windsham, R., & Onley, R. (2006). Chiropractic treatment of lower extremity conditions: a literature review. Journal of manipulative and physiological therapeutics, 29(8), 658-671.
5McHardy, A., Hoskins, W., Pollard, H., Onley, R., & Windsham, R. (2008). Chiropractic treatment of upper extremity conditions: a systematic review. Journal of manipulative and physiological therapeutics, 31(2), 146-159.
6Bryans, R., Descarreaux, M., Duranleau, M., Marcoux, H., Potter, B., Reugg, R., White, E., & , (2011). Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of Manipulative and Physiological Therapeutics, 34(5), 274-289.
When it gets cold outside, we tend to spend more time indoors doing sedentary activities and it can be difficult to stay active. It’s helpful to plan ahead and set some time aside in your schedule a few days a week to make sure you’re getting the activity you need.
To have health benefits from exercise, adults need a total of 2.5 hours of activity spread across the week, in bouts of ten minutes or more. These activities need to be moderate-to-vigorous intensity aerobic activities. Moderate-intensity physical activities include brisk walking or bike riding. Generally, you know your activity is moderate-intensity if you sweat a little and breathe harder than when you’re moving about day-to-day. Vigorous-intensity activities include jogging or cross-country skiing, and you’re likely to find yourself sweating and feeling out of breath.1
Here are a few tips to help keep you motivated to stay active during the winter months2:
- Plan activities ahead. When activities are in your calendar, you’re less likely to forget them. Preparedness also helps set good habits.
- Find a fun local activity, like snow shoeing, skiing, skating, or cross-country skiing.
- Dress in layers. Insulate your body. When you can keep your body warm, it’s easier to continue being active outside.
- Use your daylight hours. It’s easier to stay outside while it’s still light out. It’s easy to miss out on activities when you start them too late in the day.
- Find indoor activities at your local community centre. This could be aerobics classes, badminton, basketball, or yoga classes.
- Climb stairs. Deliberately add more steps to your day. Consider going up and down a flight in your home, the mall, or an office building more than once over the course of your regular daily activities. As little as five minutes can make a huge difference for your health.
- Visit a library to find more motivation. There are plenty of free exercise DVDs you can borrow, including dance, step, aerobics, or Pilates. You can use the return date as a deadline to pick up another one!
- Sign up for a fun run. You can often find non-competitive “fun runs” in your community that are usually between 5 and 10 kilometers. You can invite friends and family to join in!
- Find an activity buddy. Find someone willing to commit to being active as often as you are, and set a plan. That could be planning to meet for morning walks or afternoon workouts. Having a friend keeps you accountable.
Whatever your activity level is, remember to stay hydrated. It is easy to forget to drink water when it’s cold out, but your body needs just as much hydration in a snowstorm as it does in a heatwave.2
Most importantly, stay motivated. Revisit your goals (or look for tips to set new ones) to make sure you’re still on track. Plan ahead and make sure you can envision your goal as you look ahead towards the finish line.
Here’s to staying active in the new year!
- Canadian Physical Activity Guidelines. 1st ed. CSEP; 2016. Available at: http://www.csep.ca/CMFIles/Guidelines/CSEP_PAGuidelines_adults_en.pdf. Accessed November 7, 2016.
- Heart and Stroke Foundation of Canada. 11 ways to stay active in winter. 2009. Heartandstroke.ca. Available at: http://www.heartandstroke.com/site/apps/nlnet/content2.aspx?c=ikIQLcMWJtE&b=4832209&ct=7596299. Accessed November 7, 2016.
Your core muscles are essential for supporting your back, stabilizing nearby joints, and reducing the risk of injury.1 A stable core helps to maintain the integrity of the spinal column and if it isn’t stable, you may experience low back pain.2 The good news is that there are a few exercises you can do to help reduce or even prevent low back pain.3,4
Below are three core exercises developed by Dr. Stuart McGill designed to increase your endurance, support your core, and, ultimately, protect your back5:
- Modified Curl-up: Lie on your back with one knee bent and the other straight. Place your hands under the arch of the low back and maintain the arch during the modified curl-up. Start by bracing your abdomen by bearing down through your belly and focus your gaze at one point in the ceiling. Lift your shoulder blades off the ground about 30° while keeping your neck and spine in line. Make sure your chin remains tucked, rather than pointing at the ceiling during the movement. Complete 3 sets of 10 to 12 curl-ups.5
- Side Bridge: Lie on your side and prop yourself up on your elbow, which should be placed directly under your shoulder. Keep your legs straight, and put your top foot on the ground in front of your bottom foot. Place your top hand on your bottom shoulder. Maintain the natural curve of your spine, brace your abdomen, squeeze your gluteal muscles, and lift your hips off the ground. Hold for 8 to 10 seconds and repeat 3 times on each side. If that’s too easy, increase the number of repetitions rather than the length of time.5
- Bird Dog: Begin on your hands and knees with your hands directly under your shoulders and your knees directly under your hips. Brace your abdomen and squeeze your gluteal muscles. Lift your right arm straight in front of you until it is level with your shoulder and squeeze your muscles between your shoulder blades. At the same time, straighten your left leg straight back until it is level with your hips, keeping your hips square to the floor. Return to the starting position in a slow and controlled manner and switch sides. That is one repetition. Do 3 sets of 8 to 10 repetitions.5
Core exercises are just one of many ways to support your back and to help with back pain. Dr. Luciano Di Loreto & Associates at Fit for Life Wellness & Rehabilitation Centre are is trained to offer a range of treatments which includes guidance on strengthening exercises.
- Abdelraouf OR, Abdel-aziem AA. The relationship between core endurance and back dysfunction in collegiate male athletes with and without nonspecific low back pain. Int J Sports Phys Ther. 2016; 11(3): 337-44.
- Gordon R, Bloxham S. A systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Healthcare. 2016; 4(2): 22.
- Willson JD, Dougherty CP, Ireland ML, Davis IM. Core stability and its relationship to lower extremity function and injury. J Am Acad Orthop Surg. 2005; 13(5): 316-25.
- Chang WD, Lin HY, Lai PT. Core strength training for patients with chronic low back pain. J Phys Ther Sci. 2015; 27(3): 619-22. doi: 10.1589/jpts.27.619.
- Callaghan J. ‘THE BIG 3’ EXERCISES FOR YOUR CORE – RunWaterloo [Internet]. RunWaterloo. 2014 [cited 8 September 2016]. Available from: http://runwaterloo.com/the-big-3-exercises-for-your-core/. Accessed November 18, 2016.
Sourced from the CCA Blog
Osteoarthritis is the most common form of arthritis. In fact, it is a growing epidemic in Canada which is only expected to rise as the population ages. Osteoarthritis is described as the “degeneration of joint cartilage and underlying bone” often resulting in pain and stiffness. Even though osteoarthritis can affect any joint in the body, the most commonly affected joints are in the hands, knees, hips and spine. It is often considered as “wear and tear”; however, it is believed instead that it may be due to abnormal stress or injury to the joint(s).
What we know is that osteoarthritis affects one in ten Canadians. By 2040, it is estimated that approximately 470,000 Canadians will suffer from osteoarthritis1. Unfortunately, for many, osteoarthritis is a painful condition that can make daily activities very difficult.
To best manage the symptoms and prevent the progression of the condition, it is important to pay attention to early signs. Although there is no cure for osteoarthritis, there are options that can reduce the risk and relieve pain, stiffness and improve function.
Here are some early signs to take note of2:
- Joint stiffness: Aching, pain and/or stiffness usually occur in the morning or after a period of inactivity and once movement resumes. Typically, stiffness may decrease after about 30 minutes.
- Joint swelling: A person may notice some swelling in the joints and a reduction in range of motion.
- Joint crepitus: The joint may grind, grate or experience a crackling sensation, commonly accompanied by a cracking sound.
- Pain: Pain is usually worse after activity and improves with rest. Early on, the pain may only be triggered by high-impact activities but as it progresses, there may be more frequent episodes of pain. The joint pain or discomfort may affect the person throughout day.
Here are some tips to help manage the condition and prevent progression:
Exercise: Exercise can help manage symptoms while increasing your endurance and strengthening the muscles that help support the joints. Good options for activity include walking, biking and swimming. Download the Straighten Up Canada app for easy to follow exercise videos. Get moving!
Weight management: Excess weight can be an important risk factor due to the additional stress put on your weight-bearing joints. Even a small amount of weight-loss can help reduce pain and limit further joint damage.
Mobility: Gentle stretching may help improve flexibility and mobility, while decreasing stiffness and pain. Exercises like yoga and tai chi can help manage stiffness.
Heat and cold: Applying heat and cold can help relieve pain when aggravated. Heat can relieve stiffness, while ice may help with pain.
Manual therapy: Manual therapy can help provide treatment not only for pain management, but help improve function and prevent progression. Addressing biomechanical dysfunctions can help relieve pressure on joints.
Positive attitude: Studies have demonstrated that a positive attitude can help increase a person’s ability to manage pain.
Like all medical conditions, it’s important to ask questions and get the appropriate information to best manage the symptoms and slow down progression. Osteoarthritis can alter the way you live your life, speak to chiropractor Dr. Luciano Di Loreto & Associates today.
Sourced from Canadian Chiropractic Association
1 Claire Bombardier, The Impact of Arthritis in Canada: Today and over the Next 30 Years, https://www.ergoresearch.com/wp-content/uploads/2012/04/Impact%20on%20arthrisis%20in%20Canada_Today%20and%20over%20the%20next%2030%20years.pdf
2Arthritis Society of Canada, Osteoarthritis, https://arthritis.ca/understand-arthritis/types-of-arthritis/osteoarthritis