Preparing for Winter Sports

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It’s that time of year to begin thinking about and preparing for winter sports. Skiing, snowboarding, ice skating, ice hockey, and snow shoeing are some of the most popular activities that tend to start as we head into winter.  If you don’t take the time to properly prepare the body for the stress placed on it during these activities (some more than others), then you are setting yourself up for muscle aches and soreness and also pre-disposing the body to injuries.

Your preparation should include the following:

1.   Stretching and strengthening

2.   Preparing yourself and winter gear

Strengthening and Stretching 

Many winter activities use the strength and power of the lower body. The lower body holds the largest and strongest muscles, which many of us neglect all summer. Come first snowfall, we are out there on the mountain unable to participate to our full capacity because our legs become tired after two runs.

Strengthening your muscles before the season starts will also help prevent injury. Our joints endure a tremendous amount of pressure and instability in many winter activities. If we have strong muscles, ligaments and tendons surrounding the joints, there is less of a risk of injuring the joint. For example, many of us know of someone who has torn the ACL or meniscus in the knee while downhill skiing. This injury can be prevented if you have a strong quadriceps and hamstring muscles surrounding the knee joint because these muscles do not allow the knee to torque in a way that will tear those ligaments. Being strong going into your winter season of fun will also help with your recovery process. Many of us have woken up after a day of fun unable to hop out of bed. Muscles have memory and must practice to remember. They get used to the movement and the way they are required to fire to move properly. The more you do it, the easier it is and the less sore you are!

Strengthening: Snow Sport Circuit

• 10 min warm-up (running, cycling, cross trainer)
• 10 calf raises
• 10 push-ups
• 10 lunges on each leg
• 30 bicycle crunches
• 10 box jumps (or tuck jumps)
• 10 triceps dips
• 10 single leg squats on each leg
• 10 bridges
• Repeat 3 times
• 5 min cool-down

Stretching

Think of a top down approach:

• Neck and Shoulders
• Back and Sides
• Thigh and Extensors
• Gluteals and Hamstrings
• Lower Legs and Feet

Preparing Yourself and Winter Gear

1.  Be sure your diet is adapted to the physical activity.

2.  Drink lots of water and drink it often to avoid becoming dehydrated, which can be caused by physical exertion and the cold.

3.  Protect your’s and your children’s faces with sun block (adapted to your skin type) and renew its application throughout the day, even when it’s cloudy or overcast.

4.  Never leave without your sunglasses.

5.  Check weather, snow and ice conditions beforehand and dress, wax and sharpen accordingly.

6.  Wear a helmet!

7.  Maintain your chiropractic and other treatments!

Ribs and Healing

Rib issues—often overlooked!
The human rib cage, also known as the thoracic cage, is a bony and cartilaginous structure which surrounds the thoracic chest and supports the pectoral (shoulder) girdle, forming a core portion of the human skeleton. A typical human rib cage consists of 24 ribs, the sternum, costal cartilages, and the 12 thoracic vertebrae. It, along with the skin and associated fascia and muscles, makes up the thoracic wall, and provides attachments for the muscles of the neck, thorax (mid back), upper abdomen, and back.

The human rib cage is a component of the human respiratory system. It encloses the thoracic cavity, which contains the lungs. An inhalation is accomplished when the muscular diaphragm, at the floor of the thoracic cavity, contracts and flattens, while contraction of inter-costal muscles lift the rib cage up and out. The ribs must move outwards and upwards with the inhalation. With the exhalation the rib move in the opposite direction.

Many people have rib misalignments and they occur as a result of coughing, sneezing, faulty postural mechanics, abnormal spinal curves, asthma, allergies and childhood diseases such as: Scheuermann's disease, pneumonia, bronchitis, scoliosis.

You will often feel pressure on the chest, in the middle back, lower neck. Sometimes you can experience a sharp pain when breathing in or out.

This can be treated with a combination of: chiropractic adjustments, Active Release, working on the postural faults, and stretching.

Adhesions—what are they?
An adhesion is a band of scar tissue that binds 2 parts of your muscle, tendon, ligament or nerve together. Theses 2 parts should remain separate. Adhesion may appear as thin sheets of tissue similar to plastic wrap or as thick fibrous bands. Adhesions develop as the bodies attempt to try to repair itself. This normal response can occur after surgery, falls, repetitive strain on a body part, faulty body mechanics, incorrect posture while sitting, other traumas, and radiation. Repair cells in the body cannot tell the difference between normal tissue and themselves. They then connect the 2 surfaces. Visualize a spider web and the adhesions look somewhat like this. The normal tissue is supposed to appear linear in nature.

Are you not flexible?
Here's the clincher: Reduction of supraspinatus function results in compensation from the remaining muscles of the rotator cuff. The subscapularis muscle works hard to prevent the humerus from riding upward towards the acromial roof, while the remaining rotator cuff muscles expend greater energy to stabilize the joint. Overuse of the muscles lead to an excess build-up of metabolites, which the circulatory system cannot transport effectively. The accumulated metabolic waste products soon gel together forming adhesions, the scar tissue that entraps the muscles, ligaments and nerves between fibres. The cascade doesn't stop here. In fact, with repeated exposure to micro-trauma, the network of soft tissues of the shoulder complex and spine become affected. Joint capsule inflammation, nerve, vascular and lymphatic supply, are swiftly altered to accommodate for the changes. Ultimately, something has to give pain and dysfunction prevent the athlete from performing with maximum efficiency.

Supraspinatus tendonitis is only one example of this mechanical imbalance. In fact, dysfunction of any muscle or complex attaching to the shoulder joint may stimulate a similar cascade of events.

One of the most effective forms of treatment for repetitive strain injuries is a soft tissue therapy called the Active Release Technique (ART). ART in conjunction with neuromuscular re-education is one of the most effective combinations of treatment available. Chiropractic and massage are beneficial to ensure the functional  integrity of the surrounding elements work properly as well!

What’s up with my shoulder?
Why shoulder injuries are so common among triathletes.

Shoulder injuries are common with triathletes, either as a result of direct contact from a collision or fall, or from repetitive overhead motion. By far, the majority of cases stem from repeated stresses that, due to the accumulative effects, lead to mechanical impingement and micro-trauma.

Improper stroke technique is the culprit for most overuse injuries of the shoulder joint in freestyle swimming. 
Supraspinatus tendonitis, with or without subacromial bursitis, is renowned in swimmers, hence the name swimmer's shoulder. The reason why? It's as simple as looking at the anatomy of the shoulder joint. As a group, four muscles attach to the scapula and stabilize the shoulder by compressing the humerus into the glenoid fossa. All four muscles join the scapula to the head of the humerus, with each muscle running a slightly different course to get there.

Supraspinatus makes up one of the four rotator cuff muscles. The supraspinatus muscle is unique in that its tendon must pass under the roof of the acromium, sandwiched between the subacromial bursa and the tendon of the long head of biceps brachii to attach to the humerus. 

Repeated overhead motions render the supraspinatus tendon susceptible to impingement between neighboring structures. Before you know it, the supraspinatus tendon is irritated and inflamed becoming a nagging source of pain and discomfort.

FEATURE STRETCH: Low Back Twist

Lie on your back with your arms out from your sides and bend one knee. Move your bent knee across your body to the opposite side, trying to touch the floor on that side while keeping your shoulders flat on the floor. Look to the opposite side, away from your bent knee. Hold the stretch for 30 seconds and repeat 3 times. Repeat on the other side.

The Shoulder

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Clicking, crunchy noises?
Often patients complain of a clicking shoulder. The age at which the clicking began, whether they eventually became aware of it after an injury, and whether it's a painful click are all factors we consider when evaluating a clicking shoulder.

Under 25, clicking is probably more related to an instability problem than in later years in which loose bodies and a thickened bursa are frequent causes. A painful click represents some type of pathology. A painless click indicates internal imbalances in the shoulder with the joint, muscles, tendons and ligaments.

The clicking can also be caused by a loose body (some type of extra material in the shoulder) and these are usually visualized by radiography. 

The above causes of a click may also cause a palpable and audible crepitus (crunchy noise) at the same time.

A tear in the glenoid labrum can also cause a clicking shoulder. The labrum is a fibrous structure joined to the glenoid fossa (the socket of the shoulder blade which faces the ball of the shoulder bone). Its function is to deepen the concavity of the glenoid fossa (see picture to left), act as the origin for the some shoulder ligaments, and has a role in resisting forward movement of the ball of the shoulder (humeral head).

Often we are asked, Is it normal for my shoulder(s) to click? I have no pain associated with it.

The answer is: No, it is not normal, there is some type of underlying issue and with continued use can lead to future problems.

A complex structure: 
3 Bones, 3 Joints which attach it to the neck, mid back, elbow, arm and hand, 5 Ligaments, over 30 Muscles,
4 Bursa, 3 capsules.

75% of North Americans will experience shoulder problems requiring care at some point. In 2003, approximately 15.7 million people in North America sought care for shoulder problems.

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Forward Shoulders/Forward Neck

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Probably one of the most common postural distortions we see is the forward head, forward shoulders posture. This distortion often appears in teenagers and progresses to old age. This forward head/forward shoulders places stress on the neck joints—leading to early arthritis, shoulders, causes nerves to be pinched, the jaw muscles can be tight and can lead to tension headaches/ migraines.

This causes the chest to descend with the shoulder blade (scapula) shifting forward around the rib cage. In this position, the humerus rotates inward and the head and neck are brought forward.

This can be examined and worked on!

Scapulo-thoracic motion—often overlooked!

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The muscles and joints of the shoulder allow it to move through a remarkable range of motion, making it the most mobile joint in the body!

The six motions in performs are: flexion (bringing forward), extension (to go backwards), adduction (to bring together), abduction (to bring apart), medial rotation (inward), lateral rotation (outward).

One most often over looked movements of the shoulder, which is key to resolving shoulder problems is known as: Scapulo-thoracic motion. The Scapulo-thoracic motion is between the shoulder blade (scapula) and the thorax wall). The Scapulo-thoracic motion is a critical element for normal shoulder motion. During normal Scapulo-thoracic motion the shoulder moves 2/3 and the scapula 1/3 of the motion. When someone has a shoulder problem the mechanics are normally changed. 

This change is that the shoulder starts to move only 1/3 and the scapula 1/3. This places pressure/force on the scapula, thoracic shoulder problems spine, muscles in these areas and the tops of the shoulder. There would be tension in the tops of the shoulders due to over-use of other muscle groups.

A Shoulder Aggravating a Neck that Aggravates a Shoulder
The title of this article looks odd, usually when we attempt to find the source of pain in a shoulder; we also evaluate the cervical spine.

If motion testing of the cervical spine does not refer pain to the shoulder, and motion testing of the shoulder reduplicates the patient's shoulder pain, we would probably as- pain is localized in the shoulder.

It is very important to evaluate the neck as well, because muscles from the neck insert into the shoulder blade.

These muscles can shorten, causing rotation of the neck vertebrae and restrictions in the neck vertebrae can result.

Also the nerves from the neck supply the sensory sensation to the shoulder. So shoulder dis-comfort can often be referred from the neck due to nerve related issues. Many people who have their shoulder treated do not have full resolution of the shoulder because the neck and upper back are not evaluated and treated with their shoulder condition. It will often get better, but not be quite 100%.

Posture

Good Posture...just how important is it?

Posture ranks right up at the top of the list when you are talking about good health. It is as important as eating right, exercising, getting a good night's sleep and avoiding potentially harmful substances like alcohol, drugs and tobacco. Good posture is a way of doing things with more energy, less stress and fatigue. Without good posture, you can't really be physically fit.

Surprised? Well, you're not alone. The importance of good posture in an overall fitness program is often overlooked by fitness advisers and fitness seekers alike. In fact, the benefits of good posture may be among the best kept secrets of the current fitness movement. The good news is that most everyone can avoid the problems caused by bad posture...and you can make improvements at any age.

Good Posture is Good Health
We're a health conscious society today and good posture is a part of it. Because good posture means your bones are properly aligned and your muscles, joints and ligaments can work as nature intended. It means your vital organs are in the right position and can function at peak efficiency. Good posture helps contribute to the normal functioning of the nervous system.

Without good posture, your overall health and total efficiency may be compromised. Because the long-term effects of poor posture can affect bodily systems (such as digestion, elimination, breathing, muscles, joints and ligaments), a person who has poor posture may often be tired or unable to work efficiently or move properly.

Even for younger people, how you carry yourself when working, relaxing or playing can have big effects. Did you know that just fifteen minutes reading or typing when using the wrong positions exhausts the muscles of your neck, shoulders and upper back?

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Poor Posture? How does it happen?

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Often, poor posture develops because of accidents or falls. But bad posture can also develop from environmental factors or bad habits. This means that you have control.

Today, posture-related problems are increasing:
• As we become a society that watches more television than any previous generation;
• As we become a more electronic society, with more and more people working at sedentary desk jobs or sitting in front of computer terminals;
• As more and more cars are crowding our roads, resulting in accidents and injuries; And as we drive in cars with poorly designed seats.

In most cases, poor posture results from a combination of several factors, which can include: 
• Accidents, injuries and falls
• Poor sleep support (mattress)
• Excessive weight
• Visual or emotional difficulties
• Foot problems or improper shoes
• Weak muscles, muscle imbalance
• Careless sitting, standing, sleeping habits
• Negative self-image
• Occupational stress
• Poorly designed work space

Poor Posture and pain
A lifetime of poor posture can start a progression of symptoms in the average adult. It can start with...
Fatigue - your muscles have to work hard just to hold you up if you have poor posture. You waste energy just moving, leaving you without the extra energy you need to feel good.

Tight, achy muscles in the neck, back, arms and legs - by this stage, there may be a change in your muscles and ligaments and you may have a stiff, tight painful feeling. More than 80% of the neck and back problems are the result of tight, achy muscles brought on by years of bad posture.

Posture is important to aid in decreasing force on all tendons, muscles, ligaments and joints of the body!

Joint stiffness and pain - at risk for "wear and tear" arthritis, or what is termed degenerative osteoarthritis. Poor posture and limited mobility increase the likelihood of this condition in later years.

Self-Test for Posture problems
The Wall Test 
1. Stand with the back of your head touching the wall and your heels six inches from the baseboard.
2. With your buttocks touching the wall, check the distance with your hand between your lower back and the wall, and your neck and the wall. If you can get within an inch or two at the low back and two inches at the neck, you are close to having excellent posture. If not, your posture may need professional attention to restore the normal curves of your spine.

The Mirror Test 
(Front view) Stand facing a full length mirror and check to see if:
1. Your shoulders are level
2. Your head is straight
3. The spaces between your arms and sides seem equal
4. Your hips are level, your knee-caps face straight ahead
5. Your ankles are straight

(Side View) This is much easier to do with the help of another, or by taking a photo.
Check for the following:
1. Head is erect, not slumping forward or backwards
2. Chin is parallel to the floor, not tilting up or down
3. Shoulders are in line with ears, not drooping forward or pulled back 
4. Stomach is flat
5. Knees are straight
6. Lower back has a slightly for-ward curve (not too flat or not curved too much forward, creating a hollow back).

The 'Jump' Test 
Feel the muscles of your neck and shoulders. Do you find areas that are tender and sensitive? Are the buttock muscles sore when you apply pressure? What about the chest muscles?

Your posture is important when you do everything in daily life.

It can be worked on via specific stretches for your imbalances, strengthening for the specific areas, treatments can help you work towards proper alignment of your body.

We can help!
Treatments such as: orthotic therapy, chiropractic adjustments for the different joints of the body that are affected—from the jaw, neck, mid back, lower back, shoulders, elbows, wrists, hips, knees, and feet. As well the Active Release technique is very effective in decreasing adhesions due to imbalances and so is massage therapy.