Author Archives: scottdunham

Death of the sit-up

By scottdunham on November 3, 2009

Sit-ups used to be the go to exercise for getting that tight, toned midsection and rock hard 6-pack abs.  Athletes did them, fitness buffs advocated them, even doctors prescribed them to their couch-potato patients who wanted to lose inches and get that David Hasselhoff-like body.

 

And somewhere between the Hoff prancing down the beach on the set of Baywatch and the infomercial-driven world of closet-clogging exercise equipment, the sit-up developed a bad reputation.  Exercise science started to come out with studies indicating that the stress and strain put on the body while doing a sit-up could actually be harming the individual and leading to further injury in the future.  Statistics also started to arise that injury was not necessarily prevented with a six-pack type physique, but rather was dependent upon the balanced strength of an individual’s core.

 

The anatomical “core” is a complex of muscles which encircles the abdomen.  They are composed of your low back muscles, your abdominal muscles (six-pack abs) as well as muscles which encircle your entire mid-section called the transverse abdominis (TA).  It turns out that those who suffer back injuries have poor recruitment of both the small muscles in their lower back as well as the transverse abdominis. 

 

Core-training has also been well publicized and has lead to another wave of inventions and training systems flooding the Infomercial market on late-night TV.  The most common reserach-supported exercises to help strengthen the core include the plank, side bridge and the “bird-dog”.  Pictures of these exercises can be seen here.

 

If you have any questions regarding proper core training or beginning an exercise program, please contact the health professionals at Kew Gardens Health Group.

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Paddling Injury Treatment

By scottdunham on October 30, 2009

Traditional methods of treatment, such as rest, ice, ultrasound, anti-inflammatory medications, muscle stimulation, steroid injections, and surgery, are generally ineffective. While these methods may address the symptoms of the injury, they do not fix its cause.  Consequently, they will often only provide temporary relief. Because these methods take a  long time to begin providing the patient with relief, they are not ideal for paddlers who would like to or have obligations to begin training again.

 

 A combination of ART (Active Release Technique) and stretching and ice is the best remedy for paddling injuries. The Active Release Technique addresses and corrects problems in the soft tissues of the body – such as muscles, fascia, and nerves- and associated problems in the kinetic chain. This hands-on treatment is very effective for paddling injuries, as it can locate and treat scar tissue adhesions.  This allows adhesions to be broken up, tissue flexibility and movement to be regained, and flexibility and balance to be restored.

 

 ART is essentially an intensive massage.  The injured muscle, ligament, or tendon is tightened, and the patient will then actively stretch the tissue. As the tissue is stretched, the practitioner will apply a certain amount of pressure to the area. The muscle’s tension and texture can be assessed, to identify scar tissue. The amount and direction of applied pressure will depend on the injury, and can be modified to treat the specific problem. ART is a fast and effective method of treatment, and this is why it is recommended for paddling injuries.

 

For a full comprehensive assessment and treatment of any of your repetitive type injuries, contact Kew Gardens Health Group at 416 907-0103.

 

Written by Megan Meisner

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Paddling Injuries – Intro

By scottdunham on October 22, 2009

Paddling involves the repetition of certain movements and strokes. Although acute injury- the injury that results from sudden trauma – is uncommon among paddling athletes, repetitive injury is very common. This is because of the repetitive motions the athlete must perform when training or racing.  At the end of a training season, paddlers may have taken several hundred stokes.

 Not only can the repetitive motion of paddling be damaging, but the motions themselves may cause injury. The force exerted by the athlete onto the water causes a reaction force from the water to be transferred back through the athlete’s body, to ultimately shoot the boat forward. It is this reactant force, affecting numerous muscles and joints throughout the body, that is the cause of many injuries. Common sites of injury in paddling athletes are the hip, back, shoulder, and forearm. The integrated manner, in which the muscles and joints of the athlete must work while paddling, is known as the “kinetic chain”.

 Sometimes, the underlying cause of injury lies not in the actions of paddling, but in the athletes themselves.  In response to problems with strength, flexibility or balance in muscles or joints, the body will try to compensate. These “movement compensations” are generally inefficient and can be damaging. Although these “movement compensations” do not usually cause problems in the demands of everyday activities, they cause the athlete great problems while paddling. The forces associated with each stroke can not properly be controlled by an athlete with “movement compensations”, and consequently, the athlete moves inefficiently. Additionally, the force of each stroke is not evenly received throughout the body, as it is usually concentrated on the area of the “movement compensation”.

 It is possible that by attempting to repair itself, the body can in fact worsen an injury. Over time, strains that result from paddling can develop into what is called micro-trauma. The body will build up scar tissue as it attempts to heal what may initially be painless strains. However, as time goes on, the body develops new strains, which in turn cause the body to build up more scar tissue. When enough scar tissue is accumulated, it negatively impacts the health and function of the muscles. Built up scar tissue at this stage is referred to as an “adhesion”. Muscles must work against the adhesions, which consequently causes additional strain.  Adhesions may also reduce blood flow, restrict joint motion, or cause pain, tightness, and stiffness. This repetitive cycle of micro-trauma and adhesions, may over time turn into an acute injury, as stain builds.

It is therefore critical that the human kinetic chain be in good condition. If an athlete has sufficient flexibility, strength, and muscle balance, they will be much less susceptible to injury.  It is wise to address these issues before they start negatively impacting your performance and lead to injury which keeps you out of action.

written by:  Megan Meisner

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Osteoporosis common questions

By scottdunham on October 15, 2009

What is osteoporosis?

Osteoporosis is a decrease in bone mass and density and an increased risk of fracture.

 What causes osteoporosis?

 There is no single cause of osteoporosis.

 Our bodies constantly build new bone and remove older bone. In childhood, more bone is built than removed, and so the bones grow in size. After age 30 or 40, the cells that build new bone do not keep up with those that remove bone. The total amount of bone then decreases, and osteoporosis may develop as a result.

 Are women more affected than men?

The average rate of bone loss in men and in women who have not yet reached menopause is small.  But after menopause, bone loss in women accelerates to an average of one to two percent a year.

 This is because after menopause the level of the female hormone estrogen sharply decreases.  Estrogen protects the skeleton by helping the body’s bone-forming cells to keep working.  After menopause, when the level decreases, some of this protection is lost.

 How can I prevent Osteoporosis?

A combined approach of nutrition and exercise can help prevent the onset of osteoporosis.  Adequate Calcium and Vitamin D helps keep the bones strong to withstand everyday forces.  1000 mg of Calcium and 400 IU of Vitamin D are recommended daily for women, through both food and supplement sources.

Exercise is also extremely important in preventing the onset of osteoporosis.  Regular weight-bearing activity puts stress through the bones, and they react much like muscles do by becoming stronger through use.

 

It is important to consult with a health professional before beginning any new exercise program or adding supplementation to your diet.  Contact the professionals at Kew Gardens Health Group for more information.

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Congratulations Norma Wilkie!

By scottdunham on October 5, 2009

Congratulations to Kew Gardens Health Group Osteopath Norma Wilkie who competed in the “Head of the Trent” regatta this past weekend.  Her boat placed first in the Women’s 8s division!  A youtube video of the race can be seen at:  http://www.youtube.com/watch?v=XobzM1WYO4g

Congratulations Norma on your achievement, and good luck in future races!

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Back-Pack Safety

By scottdunham on September 29, 2009

With September rolling around and the kids going back to school, now is a good time to review some simple tips for Back-Pack Safety

 

1)  Encourage children to utilize both straps when carrying a backpack

2)  Make sure to adjust the straps properly to ensure proper distribution of weight

3)  Pack the heavier items at the bottom of the bag for better distribution

4)  Maximum load should be less than 10% of the child’s weight

 

If you follow these guidelines, you can ensure that your child is safe when returning to school!

For more details on the Ontario Chiropractic Association’s “Pack it Light, Wear it Right” campaign, visit them at:  www.chiropractic.on.ca

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Congratulations!!!

By scottdunham on September 22, 2009

A big heart-felt congratulations goes out to Kew Gardens Health Group patients Andrea Mierzynski, Jane Weninger and Daria Nardone.  On September 12th and 13th they participated in the 60km walk to end breast Cancer.  As part of their team “Breast ov Beach” they raised over $20,000 for the Princess Margaret Hospital to support Breast Cancer Research.

Kew Gardens Health Group would like to congratulate them on their achievement and for raising funds for this very worthy cause.

 You can check out their website at:  

http://www.endcancer.ca/site/TR/Events/Toronto2009?px=2862588&pg=personal&fr_id=1323

 

Breast ov Beach

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Stretching – Does it increase performance?

By scottdunham on September 3, 2009

Our second BLOG about stretching looks at the assertion that stretching before competition will increase performance.

A common claim was that stretching immediately before competition would increase your performance.  A 2004 literature review found 21 studies which looked at performance and stretching prior to competition.  20 of the 21 studies actually found a DECREASE in performance if stretching is done prior to the activity with 1 study finding mixed results.  These studies involved jumping, lifting or throwing types of activities.  The reason for these findings is that stretching puts your muscles into a temporarily lengthened state that is not well equipped for maximum contraction.

So if stretching before activity does not prevent injuries and can actually decrease performance – What is a better alternative?  A study conducted in 2004 involving rugby players demonstrated that dynamic stretching (quick stretching through a range of motion) produced significantly faster 20 meter sprint times than static stretching or no stretching at all.    A follow-up study looked at combining dynamic and static stretching (slow, methodical stretch and hold) and revealed that static stretching could actually undo the effects of dynamic stretching, making the athletes slower, and less powerful.

The success of dynamic stretching is due to preparing the athlete for competition by mimicking the movements they will have to perform on the field of play.  Especially at the higher levels, the emphasis now is on general body warm-up and dynamic stretching to prepare the athletes for competition.  Warm-ups which mimic game-like situations will help prepare the athletes mentally for competition, and dynamic stretching will best prepare the body for the situations one will encounter during the course of play. 

The take home message is that statically stretching immediately before competition may actually hinder performance.  Getting away from slow stretching and towards quicker stretching techniques will help your athletes to avoid injury and perform at their very best. 

In good health,

Dr. Scott Dunham

References

  1. Does Stretching Increase Performance? Clinical Journal of Sports Medicine, Sept 2004, Shrier, Ian
  2. The effect of different warm-up stretch protocols on 20 meter sprint performance in trained rugby union players. Journal Of Strength And Conditioning Research / National Strength & Conditioning Association 2004 Nov; Vol. 18 (4), pp. 885-8.
  3. The acute effects of combined static and dynamic stretch protocols on fifty-meter sprint performance in track-and-field athletes. Journal Of Strength And Conditioning Research / National Strength & Conditioning Association 2007 Aug; Vol. 21 (3), pp. 784-7.

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Stretching – will it prevent injuries?

By scottdunham on August 12, 2009

For years people have stretched before activity under the premise that it will prevent injuries.  But is there research to substantiate this claim?

Flexibility is defined as “the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain-free range of motion”.1  A literature review by Thacker et Al. in 2004 looked at various studies on flexibility and injury rates.  They found conclusively that stretching was NOT significantly associated with a reduction of total injuries.2  Those most prone to injury were found to be either really inflexible or really over-flexible.2  So if you are in the mid-range of flexibility then you are less likely to have an injury compared to your over-flexible or inflexible peers!  If you find yourself excessively inflexible, a selective stretching program may prove beneficial when performed regularly at non-competition times (not right before exercise).

So if stretching before activity does not prevent injuries  – What is a better alternative to prepare properly?  Recently there has been a shift away from “static stretching” which is the typical slow, holding type of stretch which we are so accustomed to.  The newest type of stretching that is increasing in popularity is “dynamic stretching” which involves stretching the muscle in a relatively fast-moving manner.  Examples of this would be leg swings, butt-kicks, lunges, arm circles etc.  The research is still accumulating, but the general consensus to date is that this is a much better way to prepare athletes for competition, and thus prevent injuries from occuring.

The take-home message would be to participate in activities that will get your body warm and mimic the motions and actions that will occur during the game, practice or exercise you are about to perform.  Getting away from slow stretching and towards quicker stretching techniques will only help your athletes to avoid injury and perform at their very best. 

In good health,

Dr. Scott Dunham

References

  1. Therapeutic Exercise: Foundations and Techniques.  Carolyn Kisner, Lynn Allen Colby, F.A. Davis Company (April 2002), ISBN 080360968X
  2. The impact of Stretching on Sports Injury Risk: A Systematic Review of the Literature. Medicine & Science in Sports & Exercise 2004 Thacker et al.

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Ice versus Heat

By scottdunham on July 21, 2009

A common question I get with regards to injuries is when to apply ice and when to apply heat.  There is no simple answer to this question, but rather some general guidelines and strategies which should be followed.

When an injury takes place there is a natural inflammatory process which begins to help repair the tissues involved.  Blood is redirected to the area, (swelling) and the body attempts to repair the tissue in a fast and effective manner.  The body also attempts to prevent further injury to that area by limiting movement through swelling and tightening of muscles.

Initially following any injury ICE is the preferred treatment choice.  The acronym “PRICE” is often used for advice IMMEDIATELY after the injury and for at least 24-48 hours following.  It stands for Protect, Rest, Ice, Compress and Elevate.  The goal of “PRICE” is to speed up the healing process by shortening the amount of time the athlete spends in this initial inflamed state.  Ice application combined with a compression bandage and rest is an excellent way to recover from injury.

Proper ice application is extremely important.  Frostbite can result from keeping ice on for too long or applying it directly to the skin.  Believe me I have seen this in my practice!  Safe ice application would be to apply for 10 minutes, take 10 minutes off and then reapply for 10 minutes on again.  This has been proven to keep the area good and cold, while minimizing the risk of frostbite.  Gel ice packs or bags of frozen peas are effective, and placing a wet t-shirt or thin cloth between the ice pack and the skin can protect it from sticking.

Once the injury has been iced for an initial 48 hours, heat application MAY be warranted.  Because heat brings more blood-flow to the area, if it is applied too early inflammation and swelling may persist thus delaying recovery.  Heat should only be applied once the initial swelling and bruising has disappeared.  Heat is excellent for preparing the body for movement (as mentioned in our article on proper warm-up) and should be applied prior to exercise, whereas Ice is more effective after activity.  Heat is also much better for muscular injuries, with ice being better suited for joints. 

After an injury there is always a risk for re-injury.  Taking care to properly warm-up the area before exercise and icing using the 10-10-10 protocol following activity can help prevent future injury and assist the continued healing process.  Injuries are a part of sport, but with proper addressing of these injuries you can get back to activity quickly and avoid recurrence of injury.

In good health,

Dr. Scott Dunham

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