Did you know that getting a Massage has many benefits that can enhance your day from a good to a great one? Yes, its true massage therapy not only feels nice but it can also reduce your stress and anxiety by releasing feel good endorphins such as dopamine which enhance your mood and happiness! A relaxation massage will increase your circulation and provide an energy boost to combat fatigue. On bad days when you have a headache or back aches, massage therapy has been shown to relieve these symptoms so before you resort to your pain meds, contact your Registered Massage Therapist to heal the body naturally!

Keep Calm and get your Massage on!

If you suffer from lower back, hip, knee or shoulder injuries, you could have Gluteal Amnesia.
With the advent of technology, computers, smart phones, smart homes, cars and pretty much wireless everything, physical movement has taken the back seat to convenience. This is great for making life simpler and easier in many ways, but definitely has contributed to an an epidemic of inactivity. Like everything in life, there is a cost and the cost we often pay for convenience is a toll on our physical health. Ever heard that saying “if you don’t use it you lose it?” Well, this holds true for many things including your butt, aka glutes.

So other than something that makes you want LMAO what the heck is Sleepy Butt syndrome/ Gluteal Amnesia?  Basically, it is when the gluteal muscles forget what they need to do!  The glutes (maximus, medius, and the minimus) are one of the largest prime movers of the human body, when working at full potential can pack quite the punch. In addition to filling out a nice pair of skinny jeans they help control the muscles of the hip and are excellent at force production. One of the main reasons they can begin to shut off is we spend so much time sitting and not nearly enough time utilizing them for what they were made for, such as running/ sprinting, thrusting, jumping etc so much so that they forget to stay turned on. They can also become inhibited when you have chronic low back pain which can lead to continuation of pain.

Ever heard of muscle memory? Well your muscles have memory and through repetition it gets stronger. If you have consistent exercise program your muscles can quickly adapt and know how to react, but it you have a sedentary lifestyle they completely forget what to do!  When you sit for long periods of time you are not using your glutes and this leads to the amnesia.  This inactivity often causes muscle imbalances and tightness in the hip flexors which further cause an inhibition (turning off) of your glutes.

This sedentary lifestyle leads to weakness and increased muscle tightness in your hips which will limit the range of motion of your hips, leading to misalignment and stress to your knees, low back, and even shoulder.  Some of the common injuries resulting from gluteal amnesia are patellofemoral syndrome (PFS), iliotibial band syndrome (ITB), lumbar disc herniation, and even rotator cuff strains.

How do you know if you may have Gluteal Amnesia?
Some movement compensations that can indicate Gluteal Amnesia include:

• Feet turn out
• Knee’s cave in
• Low back arches
• Leaning forward excessively
• Low back rounding
• Asymmetrical weight shift

How can you change this situation? Following these simple steps can return your gluteal memory and reduce pain and immobility.  

• Prevent yourself from being sedentary during the day - take breaks from sitting every 30-60 minutes by setting a timer. Something as small as a 30 second change in body position can pay off big over time
• Core strength/stability and pelvic mobility are essential to maintain healthy gluteals.  Ensure core strengthening is part of your everyday work out program as well as focusing on hip mobility.
• A basic stretching program to lengthen the hip flexors and hamstrings can prevent inhibition of the gluteal muscles. Follow this with glute activation drills to help keep the flexibility.
• Once the glutes can learn to ‘turn on’ more optimally and stay on focusing on exercises such as loaded hip bridges as part of your regular exercise program can go a long way.

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Your chiropractor is an expert in human movement and function; if you are unsure of whether or not you may suffer from gluteal amnesia and what to do about it, come in for an assessment - we can help!


References:
Hughes, L. (2017, May 25). WTF Is 'Dead Butt Syndrome' and How to Know If You Have It, from https://www.self.com/story/what-is-gluteal-amnesia
McGill, S. M. "The painful lumbar spine." IDEA Fitness J 7.1 (2010).

With the much anticipated spring weather finally settling in, it’s time to shake off the winter blues and welcome the sunshine and warm temperatures. Here are 5 benefits of Chiropractic care that will help you feel rejuvenated for spring.  
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1. Improved posture
During treatments, your chiropractor will correct the alignment of your spine. Over time, and with regular treatments, this can help improve your posture - allowing you to stand straighter and taller. Check out our other article, “7 ways to Improve Your Posture - The Proactive Approach”, for further tips and tricks!

2. It can brighten your mood
For some of us, a long and dreary winter can really take a toll on our mood. Adjustments don’t just align your spine, they also help balance out the rest of your body as well. With regular chiropractic adjustments, certain chemical imbalances in the body can be corrected and your mood can be improved. You’ll feel better physically and emotionally!

3. It can help relieve stress
The nervous system is made up of the brain, spinal cord, sensory organs and nerves, and is in charge of sending and receiving information throughout the body. When it is not functioning to its fullest capacity and is out of alignment, the rest of your body will feel off too. In addition to causing physical discomfort, this may also result in the manifestation of mental stress. Realignment of your nervous system, and having your body balanced will relieve tension and stress, and promote relaxation in the body and mind.  

4. You’ll sleep better
Many sleep related issues are connected to body pain, aches and stress. As regular chiropractic treatments help relieve those issues, your sleep quality will also improve. You’ll feel better during the day, and rest better at night!

5. Your immune system will get a much needed boost
Does your immune system need a bit of a kick-start? Chiropractic can alleviate issues that may be preventing your nervous system from working properly. As previously stated, the nervous system is in charge of sending and receiving information throughout the body - this includes to and from the immune system. If your nervous system is working properly, your immune system will be too, and if your immune system is working properly you will be able to prevent and recover from illnesses faster.

For more information on the benefits of visiting a Chiropractor, check out our blog post, “7 Health Benefits with Chiropractic Care”, to discover a few more ways chiropractic care can improve your health and wellness this spring!
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Our very own, Dr. Albert Huang was recently nominated as a top chiropractic practitioner in Toronto by threebestrated.ca. Check out the article here!

Albert is humbled and honoured to be  recognized as a leading chiropractor in the city. "When you love what you do, great things happen!" 

Albert has always been fasinated with health, fitness, and the human body and to be able to be working on it day in day out is a blessing! Big thanks goes out to all the people and patients who have been a part of this success and healing!

With warmer weather (hopefully) soon approaching, we can spend more time outdoors enjoying the sunshine and fresh air after a long winter season. For a lot of people, the warmer weather also means that outdoor sports and activities will be starting up again. If you are thinking of taking up a new sport or activity, or returning to a spring or summer league, here are my top 5 tips to help prevent injuries so you can enjoy your activity all season long:

1. PRE-SEASON TRAINING. To help get your body in peak shape for your upcoming activity, it is important to train the muscle and energy systems used during your activity. This involves gradually increasing your strength, balance, and endurance. For example, if your activity involves short bursts of running, try interval training to improve your anaerobic capacity; on the other hand, if the activity or sport lasts for a long period of time, improving your aerobic endurance is more suitable.

If you are unsure of which strengthening exercises and/or training programs are right for you, a physiotherapist or other qualified health care professional can help you determine what areas you should focus on.

2. WARM-UP & COOL DOWN. An adequate warm-up should last between 10-15 minutes. Keep the exercises dynamic (stretching through movement) as much as possible to help warm-up the muscles and increase circulation. Some warm-up ideas include karaokes, knee-high running, butt kicks, and arm circles. After exercise, 5-10 minutes of light jogging clears lactic acid from the muscles, helping to prevent muscle soreness and stiffness the next day.

3. STAY HYDRATED. The average person loses between 1-1.5 litres of water for every one hour of exercise, so be sure to drink enough water before, during, and after you exercise to help prevent dehydration and muscle cramping. During those hot, humid summer days, this point is even more important to reduce the risk of heat stroke. If you sweat profusely or are exercising for over an hour, you will also need to replenish your electrolytes.

4. ALLOW FOR REST & RECOVERY. The general rule of thumb is to give at least 24 hours of rest between bouts of vigorous physical activity (e.g. a long run or bike ride, a game of soccer, or a tournament). However, light exercise, such as cycling with light resistance or lifting light weights, can be done on rest days.

One of the most common times we injure ourselves is when we are tired. If your muscles and body aren’t given enough time to recover from the previous activity, your form and performance may pay the price, and the risk of injury increases as a result.

5. EQUIPMENT. Having the proper footwear and protective equipment will help to protect against any head and/or body injuries. While having the proper equipment for your activity is important, it is also necessary to make sure everything fits you properly.

Safety and Contraindications

In the study by Stuber, Wynd et Weis, 2012, they concluded from their systematic review that “there are only a few reported cases of adverse events following spinal manipulation during pregnancy and the postpartum period identified in the literature. While improved reporting of such events is required in the future, it may be that such injuries are relatively rare.”8

There are still modifications in chiropractic treatments that should occur when treating this group of patients, some of which include:
1. Low force adjustments, as relaxin plays a factor throughout pregnancy and during postpartum.9
2. Avoiding pressure on the abdomen.9
3.  Provision of uterine support when recumbent, along with decreased hip flexion during manual therapy.9
However, this is by no means an exhaustive list.

Some contraindications to exercise during pregnancy, found in the article by Davies et al., 20037 are listed below. 

“…Contraindications to Exercise in Pregnancy
Absolute Contraindications
Ruptured membranes
Preterm labour
Hypertensive disorders of pregnancy
Incompetent cervix
Growth restricted fetus
High order multiple gestation (≥ triplets)
Placenta previa after 28th week
Persistent 2nd or 3rd trimester bleeding
Uncontrolled Type I diabetes, thyroid disease, or other serious cardiovascular, respiratory, or systemic disorder

Relative Contraindications
Previous spontaneous abortion
Previous preterm birth
Mild/moderate cardiovascular disorder
Mild/moderate respiratory disorder
Anemia (Hb <100g/L)
Malnutrition or eating disorder
Twin pregnancy after 28th week
Other significant medical conditions
Note: Reprinted and modified with permission from the Canadian Society for Exercise Physiology…”

More in Depth Information on Pregnancy Related Benefits of Chiropractic Care

Pregnancy causes a drastic change in body biomechanics, as the stomach is increasingly protruding in an anterior direction, causing an increased tendency for hyperlordosis of the lumbar spine.5 It has been reported that “…approximately 20% of pregnant women experienc[e] pelvic girdle pain, and 50% to 85% experienc[e] low back pain[,]”5 and “…up to 40% of patients report musculoskeletal pain during the 18 months after delivery…”6 The increased lordosis can have undesirable effects on the pregnant woman including lumbar and pelvic pain.5 It is increasingly important to manage the rapidly changing biomechanics of a pregnant mother as she gets further along in her pregnancy.

Chiropractic can be a conservative means of healthcare by which a woman can be followed from prior to her pregnancy, throughout the pregnancy, and postpartum. Musculoskeletal issues are effectively looked after through the use of chiropractic, without the use of medications, some of which are potentially contraindicated or risky for pregnant women. Since “[p]regnancy-related LBP contributes substantially to health care costs[,]”6 chiropractic should be an initial source of referral once more ominous conditions have been ruled out.

“A 2012 study compared standard obstetric care alone to standard obstetric care combined with chiropractic care including spinal manipulation, education, and exercise”5 based on the biopsychosocial model of care.6 “The authors found that a multimodal approach resulted in greater decreases in pain and dysfunction both subjectively and objectively in pregnant patients with low back or pelvic pain.6 Patients in the multimodal care group also reported greater improvement in their quality of life, with the greatest improvements seen in their sleep patterns.”5 The authors “…conclude[d] that a multimodal approach to musculoskeletal LBP/PP that is instituted in the late second and early third trimesters of pregnancy benefits patients above and beyond standard obstetrics provider care.”6

Chiropractic can be a useful tool in creating an inviting environment for health education. As chiropractors commonly see their patients more frequently than medical doctors or other health providers, we are an excellent source of reassurance to the mother-to-be as she experiences her ever-changing body. For example, a mother may be having sacroiliac related pain, but mistakenly think and worry that it is in relation to her uterus, placenta, or an issue with the baby.5 Being primary health practitioners, chiropractors are trained to assess for potential red flags or conditions that need referral to another health care provider, while providing their expertise in the musculoskeletal system.5

We know the body does not heal overnight, and that is why chiropractic care is so important even before a woman enters into pregnancy. Not only is a mother going to have a plethora of changes to her body in a short amount of time, once post-partum rolls around, she has to shift her body mechanics as her body changes back to its original size. Through early assessment, treatment, and education, chiropractors can understand a woman’s musculoskeletal-based deficiencies before she gets pregnant, regardless of symptoms. Both active and passive care, with proper education, can empower these patients to make necessary changes to multiple areas of their health, including but not limited to posture, exercise, nutrition, sleep, and stress. I place great focus on these types of education and active care when treating my patients. If a patient can understand what is causing dysfunction, and understand the tools required to fix it, not only do they feel empowered in their healthcare, but they are able to take that education with them throughout their lives, understanding how to make better choices in their daily living that they may not otherwise have known.

Keeping the mother involved in an active exercise plan similar to the frequency and duration of exercise she implemented before becoming pregnant is another focus of mine when treating pregnant mothers. Often these patients are nervous that exercise will hurt the baby, when in fact, if the pregnancy is not one of complicated origin, it is recommended.7 Both sedentary and non-sedentary pregnant patients alike, are encouraged to become involved in programs aimed to improve strength and aerobic capacity.7 Postpartum is also an important time to focus on pelvic floor exercises, as these have potential to “…reduce the risk of future urinary incontinence.”7

Focus on education and reassurance to the “mother-to-be” about the benefits of exercise and movement, and the power their body holds to adapt to their ever-changing environment (in this case a pregnancy) is crucial. Patient education is vital to improving outcomes and coping strategies.6 A happy healthy mom is the first step to a happy and healthy baby.

References

2. Weis CA, Stuber K, Barrett J, Greco A, Kipershlak A, Glenn T, Desjardins R, Nash J, Busse J. Attitudes toward chiropractic: a survey of Canadian obstetricians. J Evid Based Complementary Altern Med. 2015 Sep 8.

3. International Chiropractic Pediatric Association: Establishing and advancing the chiropractic family wellness lifestyle. [Internet]. ICPA 2015 [cited 2015]. Available from: http://icpa4kids.com

4. Ohm J. Great Expectations with Jeanne Ohm, D.C., F.I.C.P.A., [unpublished lecture notes]. 2015. Lecture given 2015 October 10-11.
5. Oswald C, Higgins CC, Assimakopoulos D. Optimizing pain relief during pregnancy using manual therapy. Canadian Family Physician. 2013, Aug. 59: 841-2.

6. George JW, Skaggs CD, Thompson PA, Nelson DM, Gavard JA, Gross GA. A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy. American Journal of Obstetrics & Gynecology. 2013, Apr. 295.e1-7.

7. Davies GAL, Wolfe LA, Mottola MF, MacKinnon C.  Joint SOG/CSEP clinical practice guideline: exercise in pregnancy and the postpartum period. 2003. Can. J. Appl. Physiol. 28(3): 329-41.

8. Stuber KJ, Wynd S, Weis CA. Adverse events from spinal manipulation in the pregnant and postpartum periods: a critical review of the literature. Chiropractic & Manual Therapies. 2012. 20:8 doi:10.1186/2045-709X-20-8


9. Browning MC. Low back and pelvic girld pain of pregnancy: recommendations for diagnosis and clinical management. Journal of Clinical Chiropractic Pediatrics. 2010, Dec. 11(2): 775-9

Adults spend approximately 9.5 hours (or 69% of all waking hours) sitting each day according to Statistics Canada. Partly to blame is the fact that most job positions involve a lot of sitting – whether you are sitting in a meeting, sitting at your desk, or sitting during your commute to work.

While leading a sedentary lifestyle can increase the risk of disease and health complications, too much sitting can also lead to musculoskeletal injuries. There are 3 factors that can increase the risk of injury; a combination of these factors increases injury risk even more:

1. Force
2. Repetition
3. Awkward Posture

Considering the fact that a lot of office workers sit hunched forward in their office chair (an awkward posture) while working on the computer (a repetitive task), it is no wonder many people develop low back pain, neck and shoulder injuries, carpal tunnel syndrome, etc.

However, there are several quick, simple, and easy changes that can be made to your desk set-up and sitting habits that will help to prevent the above mentioned injuries:

1. Adjusting the Chair. The image below outlines a better sitting alternative to sitting hunched forward. Here are some general guidelines:
a. Sit right back in the chair and avoid leaning forward
b. Tilt the seat pan forward so that the thighs are parallel to the floor or angled slightly downward
c. Rest your feet fully on the floor, or use a foot rest if unable to reach the floor
d. Recline the back rest to tilt back 100-110°
e. Adjust the arm rest height so that elbows have a bit more than a 90° bend and shoulders are relaxed

2. Posture. When sitting, try to keep your ears, shoulders, and hips in line while gently squeezing the shoulder blades together and down. This will help keep the natural curves in your spine, reducing stress on the spine and surrounding muscles.

3. Monitor Placement. Keep the monitor an arm’s length away with the top of the screen no higher than eye level

4. Use a Document Holder. Keep any papers being used beside the monitor or between the keyboard and monitor. If possible, tilt the papers up towards you to allow you to glance at documents, rather than having to repeatedly bend or turn your head

5. Use a Headset. If your job requires a lot of time spent on the phone, consider using a headset instead of cradling the phone between your ear and shoulder or holding the phone for prolonged periods of time

6. Desk Layout. Keep frequently used objects and equipment within forearm’s reach and occasionally used items within arm’s reach

7. Take Breaks. Stand up and stretch for a couple of minutes every 30 minutes to 1 hour. Even if there is only time to stand up and take a few steps, it will give your body and your mind a short break

8. Set a Timer. To help implement these changes, set a timer to go off on a regular basis. For example, set a timer every 20 minutes to remind about posture, or every hour to get up and stretch
If you are already starting to feel the effects of too much sitting, a physiotherapist can help in a couple of different ways:

* A physiotherapist can treat any injury or pain you may develop as a result of too much sitting, helping to rehabilitate your injury and manage your pain through hands-on techniques, education, home exercises, etc.

* Physical Therapists can make recommendations, above and beyond the tips outlined above, to help optimize your office and desk set-up based on your needs

The physio’s role can be endless, but the over-arching goal is to help rehabilitate the current injury and prevent injuries from recurring in the future.

References
1. Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay MS. Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. (Catalogue 82-003-XPE) Statistics Canada, Health Reports. 2011 Mar;22(1).
2. University of Toronto Department of Physical Therapy. Office Ergonomics. 2015 June.