Travelling

Sleep Tips

mvcchiro.com

Sleeping while travelling can cause significant problems for some. There are a number of factors that can affect your sleep including light, noise, and changes to your routine to name a few. Here are a few tips to help you get a better night’s sleep.

1. Try to block out as much light as possible when sleeping. Even small amounts of light can affect your sleep cycle.
2. Bring something familiar from home. Your pillow might be the best thing you can bring but if that’s not possible even bringing music or photos can help.
3. Try to stick to your usual bedtime routine and avoid things like caffeine, alcohol and heavy meals right before bed.
4. Take naps during the day to make up for any lost sleep. You might not want to lose time napping but the quality of your awake time will benefit greatly.
5. Studies done at the Sense of Smell Institute showed that the scent of lavender increased the amount of time spent in deep restorative sleep.

Luggage:

wyliemac.com

Carrying luggage can cause back, shoulder and neck pain. There are some things you can do to decrease the risk of injury.

First, choose lightweight, sturdy luggage that has wheels and extending handles.

Try to pack as light as possible to reduce the load you have to carry around with you and check your luggage as soon as possible. Finally, always lift with the weight of the luggage close to your body and USE YOUR LEGS WHEN LIFTING.

HAPPY TRAVELS

Before going on a long drive or flight be sure to remove bulky items from your back pockets! Sitting on objects like wallets can cause misalignment of the body resulting in muscle fatigue and strain as well as spinal subluxations.

The Ergonomics of Driving

jacksdrivingschool.com

Low back pain is a common complaint when driving long distances but it’s not the only complaint. Neck, leg and arm discomfort can also happen if you’re not positioned properly and taking regular breaks. Here are some positioning tips that should help prevent the discomfort of a long drive.

Make sure the seat you’re sitting in is supportive. The seat back should be wide and high enough to support your shoulders and your headrest should be positioned behind your head.

Your seat should be positioned so that your legs are supported as well. If your seat is too far forward your thighs will be up off the seat and if you’re too far forward you’ll have to stretch to reach the pedals.

Lumbar support is also important on a long drive. The low back muscles can become fatigued if the lumbar region is unsupported causing low back pain. If the car you’re driving doesn’t have good lumbar support you can get a back rest with lumbar support.

The seat belt should be adjusted so that it is going over your shoulder. It should not rub on your neck and you should never tuck it under your arm.

Distance from the steering wheel is another important positioning consideration.

You should be close enough that your arms are slightly bent at the elbow.

Many things in a car are adjustable such as the seat, steering wheel positioning and seatbelt height. Take the time to make the adjustments before you leave and remember to take breaks about every two hours to have a good stretch and reduce fatigue.

Vaccinations

andesproperty.com

If you’re travelling outside Canada it might be necessary to get vaccinations to protect you from diseases such as Hepatitis, Typhoid Fever or Yellow Fever to name a few. The vaccinations you require depend on where you’re traveling to.

Some immunizations can take several weeks before they are effective protection so it’s a good idea to talk to your doctor about what vaccinations you need around 6 to 8 weeks before you actually go on your trip.

For more information on necessary vaccinations when traveling check with the Public Health Agency of Canada, a travel health clinic or your physician.

The Foot

The foot and it’s parts

The feet are flexible structures of bones, joints, muscles, and soft tissues that let us stand upright and perform activities like walking, running, and jumping. The feet are divided into three sections:  
The fore-foot contains the five toes (phalanges) and the five longer bones (metatarsals). The mid-foot is a pyramid-like collection of bones that form the arches of the feet. These include the three cuneiform bones, the cuboid bone, and the navicular bone. The hind-foot forms the heel and ankle. The talus bone supports the leg bones (tibia and fibula), forming the ankle. The calcaneus (heel bone) is the largest bone in the foot.

Muscles, tendons, and ligaments run along the surfaces of the feet, allowing the complex movements needed for motion and balance. The Achilles tendon connects the heel to the calf muscle and is essential for running, jumping, and standing on the toes. 

The foot contains 26 bones, 33 joints, 107 ligaments and 19 muscles.   All of these are used during walking and running – known as the gait phase.  When we put out foot down on the ground the hind-foot bones (joints) need to bend and rotate.  We make use of the tendons and muscles to help.  Then when we move forward on foot to the mid-foot all the bones in that area need to roll, tip and glide in different motions.  Then finally when we come off the front of the foot the fore-foot bones in the toes need to perform specific motions.  

If one of the 26 bones in the foot is out of alignment this will affect a person’s walking/running. Then add in muscle issues and there is a major problem!  

Any type of problems above the foot in the knee, hip, pelvis, tailbone or lower back will affect this motion chain as well.  We also have to think of the transfer of weight to the opposite side – which will affect the other side too!  COMPLEX!

Of Special Interest

The foot contains: 26 bones, 33 joints, 107 ligaments and 19 muscles. 

1/4 of all the bones in the human body are down in your feet. When these bones are out of alignment, so is the rest of the body. 

The average person takes 8,000 to 10,000 steps a day, which adds up to about 115,000 miles over a lifetime. That's enough to go around the circumference of the earth four times.

During an average day of walking, the total forces on your feet can total hundreds of tons, equivalent to an average of a fully loaded cement truck.

Foot and Shin Issues

Flatfeet and rotation of the leg
The feet are the foundation of the lower limb. Poor biomechanics often start with the foot.  If a foot is flat or has high arches there are abnormal changes that can occur to all of the postural joints of the body.

Our feet are highly adaptable.  As they hit the ground and begin to absorb load, the motion they undergo is called pronation.  The flexibility of our joints determines how much energy the lower extremity chain (foot-ankle-knee-hip-pelvis-low back) can absorb. 

For different reasons, both flat and high-arched feet channel a large amount of energy to skeletal structures high in this chain — especially the knee, hip and lower back—making those structures more susceptible to injury.

For example, it is common for the kneecap (patella) to develop pain because a flat foot forces the patello-femoral joint to absorb more energy. The patella can become poorly aligned because of rotation of the foot as shown in the picture to the right. 

Running sports add ‘impact loading’ to the equation. Running and jumping amplify the effects of failed biomechanics. 

Sprains and strains are likely to occur when joints are poorly aligned or when they absorb forces that should be directed to another part of the body.  Make sure your footwear is supportive and appropriate for the activity you’re doing.

Did you know that we have metatarsal pads for sandals and dress shoes?

Heel lifts are used when there are leg length discrepancies – one leg can be shorter due to lower back, hip, knee, leg and/or foot issues.

Lower back pain due to the legs

Figure 2:  When the feet flatten out, this causes shifting of the legs and a change to the lower back curve.

There are a number of causes for low back pain. In many patients excessive foot pronation may contribute to lower back problems. Bilateral excess pronation causes internal rotation of the tibia which in turn leads to anterior tilt of the pelvis and a forward shift of the body's center of gravity.

The result is increased lordotic curvature. Increased lordosis at L1-L5 and compensatory muscular tightness of the lumbo-sacral region causes pain and discomfort especially when standing upright for longer periods of time. The thoracic region commonly develops a secondary kyphotic curvature. 

Unilateral pronation lowers the vertical distance of the foot to the ground, creating a functional short leg and causes a hip mis-alignment. Structural leg length discrepancy means that one leg is actually shorter than the other. In this case the patient will often present with unilateral pronation (i.e. worse on one foot) as a natural compensation for the structural imbalance.

Both functional and structural leg length discrepancy can cause back pain. Patients presenting with a leg length discrepancy often also exhibit Scoliosis. 

Back pain can be treated with stretching and strengthening exercises, chiropractic spinal adjustments, soft tissue massage therapy, and active release. Adding orthotic therapy to your treatment regime can be beneficial. Correcting excessive pronation with FootMaxx orthotics will assist by posteriorly rotating the pelvis, thus reducing pressure on the sacro-iliac and lower back area. 

A heel lift should be added to the orthotic on the shorter leg. By doing so the shorter leg will be raised which aids in rebalancing the lower limb and removing compensatory mechanisms that contributes to lower back pain. 

If you have lower back pain, have your leg lengths checked. Also, check the alignment of your feet, femur, tibia, fibula, and patella bones checked for rotational problems. Also, have a foot scan/gait analysis. 

Please book an exam with Dr. Barbara Rodwin and Keri-Lyn Dudgeon to have these checked. 

Shin splints and Achilles tendonitis

Figure 3: Shin Splints

Shin splints are caused by overusing the lower leg or by using it incorrectly. Improper stretching, warm-up or exercise technique will increase the chances of shin splints. They can also be caused by improper footwear and flatter feet (pronation) which causes rotation of the shin. The soft tissue becomes inflamed due to the stress that has been put onto the shin. This area is enclosed in a compartment and if the tissue swells, there is no place for it to go so the pressure increases. The increased pressure makes it hard for the blood to flow freely and the net result is pain and sometimes tingling, numbness or weakness.

Figure 4: Both the Achilles tendon and the plantar fascia

Achilles tendonitis is a common injury in the running community. It is an inflammatory process that leads to swelling, pain and tissue damage. It results from repetitive strain, which in turn makes it more susceptible to tearing or even rupturing.  

The Achilles tendon attaches onto the heel of the foot as do the posterior muscles of the leg, which help to plantar flex the foot (point the toes down). It is responsible for providing the push that drives the foot down and forward when walking, running, and jumping. All in all, it generates a lot of tension and absorbs a lot of force. It‘s involved in most actions of the lower extremity and becomes more susceptible to tendonitis when engaging in sports where it is under a constant, repetitive load.

Chiropractic treatment of shin splints involves addressing any joint restrictions in the foot, ankle, and knee, muscle tightness and imbalances as well as assessing any biomechanical deficiencies in the feet that may be causing the shin splints. If deemed appropriate orthotics are prescribed to remedy the condition. Also stretching and strengthening exercises will be given.

The goals of massage are to reduce any inflammation, pain, and swelling, muscle spasm, and trigger points. Massage will also maintain range of motion as well as eliminate any scarring or adhesions. Muscular imbalances that may be causing the problem would be addressed during the treatment.  

The Active release technique is very effective in treating these problems!

Plantar Fascia

The plantar fascia (fash-ah) of the foot is a thick band of tissue that connects your heel to the base of your toes. When it is torn, inflamed or over-stretched, this is called plantar fasciitis (fash-e-it-is). This condition can be a result of:  an acute injury (strain) that places an excessive load on the foot, prolonged or excessive pronation (flat foot) of the foot, a high-arch or a change in footwear. You will often feel the pain at the base of your heel when you step out of bed in the morning or through the arch of your foot. This injury can be very pesky and quite painful limiting your daily activities significantly

Self Care Tips:  Before you get out of bed, wrap a towel around your toes and gently pull them towards you. Do this with your knees straight as well as bent.  Massage your arch often by sitting on a chair and rolling a marble, golf ball or another massage device under your foot.  Stretch your calf and Achilles tendon - we have specific stretches that we can suggest for you to take home….Just ask us!! Keep your shoes by your bed and wear around them house.  Rolling a frozen water bottle under the foot helps too!

Chiropractic adjustments, active release, and massage are effective treatments for plantar fasciitis. Custom orthotics are also very effective because they can correct the excessive pronation of the foot causing the problem.