Tag Archive for 'headaches'

Cincinnati Cycling Injury Prevention

Published
by
Dr. Edward Gould
on February 26, 2010
in Cincinnati Chiropractors, Cycling Injuries and Wellness 101
. 0 Comments

LAThe beauty of cycling, is that it is a very low impact form of exercise that results in fewer injuries than higher impact activities such as running. However, the number of repetitions that cyclists perform (roughly 6000 revolutions per hour) is much greater than any other sport. Chronic injuries can occur from riding too long, too fast or too often. I always advise my patients to have a professional evaluate how their bike fits their body. An improper fit of the handlebars, saddle, frame or pedals can cause a predisposition to musculoskeletal problems aka pain and injuries.

Common Injuries Encountered By Cyclists

Neck & Mid Back Injuries

  • Causes – This problem is typically due to over exertion of the muscles that extend the neck and raise the shoulders. The cause of this is usually the rams-horn style of handlebars that cause the rider to hold the head and neck in a hyperextended position for prolonged periods of time. Some individuals have problems with this due to the loss of the normal forward curve (lordosis) in their neck.  This type of structural problem is best addressed with chiropractic care.
  • Symptoms – Spasm, tenderness and soreness of the muscles of the neck and upper back. Pain is usually felt with extension and rotation of the neck.
  • Treatment – Initially stretching and strengthening the muscles of the neck and upper back is advisable. If the problem persists, it maybe due to structural problems in your neck.  If the neck and upper back pain persists for more than a week you need to be evaluated.

Lower Back  & Injuries

  • Causes – Lower back strain and pain can occur when an unconditioned rider rides too long with the back flexed forward.  Other causes are obesity, weak trunk muscles or biomechanical dysfunction in the form of lumbar and sacroiliac subluxations .
  • Symptoms – Decreased mobility of the trunk and spasms of the lower back. Pain is usually felt with flexion and rotation of the trunk muscles.  In many instances, lower back pain will be felt more on one side due to asymmetrical loading of the sacroiliac joints. If not corrected the individual may begin experiencing Sciatica.
  • Treatment – Strengthening and stretching of the torso, lower back and hip musculature will help remedy many of the lower back symptoms many riders experience due to muscular weakness. If the injury has caused pain due to misalignments in the lower back or sacroiliac area strength training will only irritate the condition. If this is the case, chiropractic evaluation is indicated.

Trochanteric Bursitis

  • Causes – Trochanteric bursitis is an inflammation of the bursa on the side of the hip, typically caused by the gluteus medius or iliotibial band rubbing over the bursa and causing irritation.  The injury is most common in cyclists with a saddle adjusted too high, unequal leg lengths (possible sacroiliac subluxation) or weak hip muscles.
  • Symtoms – There is a gradual onset of pain. Typically, the pain is on the side of the hip and will gradually migrate down the side of the leg.  If not properly treated, sleeping on the affected side and climbing stairs will begin to cause pain.
  • Treatment – Resting and icing the area is always beneficial.  Trochanteric busitis is usuallly a symptom of riding with a saddle that is too high.  Consider lowering the saddle to limit hip extension with each stroke.  Once the pain begins to subside begin stretching the gluteus medius and the IT band.

As I mentioned in the beginning of this post it is very important to have a professional help you to set up your bike.  Ergonomics are not just for the office.  A properly set up bike will not only increase your bike riding enjoyment but it will also minimize your chances of overuse injuries. Below is a video of a professional setting up a riders bicycle.

I hope this post has been helpful.  If you live in the Cincinnati area and are still experiencing pain while riding, even though your bike has been professionally fitted to your body give me a call and schedule an exam.

Happy Riding,

Dr. Gould

Postpartum Headaches

Published
by
Dr. Edward Gould
on January 5, 2010
in Conditions & Treatments and Headaches
. 0 Comments

migraine0.bmpOn a daily basis, I see and treat a variety of health problems. One of my more interesting cases began with a phone call from an Internist, located in the Kenwood area of Cincinnati.

The conversation went something like this, Doc, I have a 43 year old female that just gave birth several days ago. She was in labor for almost 3 days. While in labor, she developed a severe migraine headache, which she has had ever since. Here is my dilemma, she is determined to breast feed and because of that fact, I cannot give her any narcotics for her pain.

An MRI study of her head was completed, a vasculature study of her head was completed and x-rays of her neck. It’s a mystery, we cannot figure out what is causing the headaches. Would you take a look at her for me? I agreed and told him to send her immediately to my office.

When she arrived at my office, she was crying due to the unrelenting pain. She looked absolutely exhausted. I had her sit down on my examination table, then I asked her several questions. She described her headache and said that it was so painful she could hardly sleep, think or function.

I examined her paying particular attention to her upper neck area. I had suspected that her top vertebrae in her neck (C1 or Atlas) had gotten displaced while she was in labor. I was correct it had. After explaining what I had found and pointing it out to her, she was eager for me to try to help her.

After carefully positioning her on my adjusting table, I adjusted her atlas or the top vertebra in her neck. I then told her to go home and try to sleep and to return to my office the next morning.

I was working on another patient the next morning when she walked in. She walked past the room I was in and smiled at me. No tears just a smile. I knew she was better! I finished up with the patient that I was with and then went in the other room to see how she was doing. She was amazed that she was 95% better. I rechecked her Atlas it was barely out, I re-adjusted it and told her to call me in two days to let me know how she was doing. She did, her headache was completely gone.

Do you suffer with headaches?

If you do and you have never had your spine, specifically your upper spine, chiropractically evaluated you should. You may find that it’s the solution. Strong medications and narcotics never get at the true cause. They only treat the symptom and leave you dealing with side-effects. If you live in the Greater Cincinnati area and you are suffering with headaches call me.

Yours in Health,

Dr. Gould

Pain at Work

Published
by
Dr. Edward Gould
on March 30, 2008
in Carpal Tunnel Syndrome, Headaches and Repetitive Stress Injuries
. 0 Comments

ergo2.bmp

Since opening my practice in 1988, I have had the privilege of teaching many local companies both big and small, the importance of Work-Station-Fit. What do I mean by Work-Station-Fit? I teach people how to make adjustments to their work environment so that the work environment fits their body, instead of their body trying to fit their work environment. By making a few simple changes comfort and fatigue are greatly reduced. This is what Ergonomics is all about.

Regardless of what you do for a living, having a simple understanding of Ergonomics can prevent a lot of pain syndromes and health problems. Improper ergonomics can lead to a variety of problems. Here are the most common problems: headaches, neck pain, shoulder and arm pain, carpal tunnel syndrome, upper back and lower back pain, varicose veins in the lower legs.

I’d like to give you a brief simple lesson in body mechanics.

First of all, our body is very efficient when it comes to energy consumption when we maintain an ideal posture. This ideal posture has a name, it is called the Neutral Position. Our body is said to be in a neutral position when all the weight of our body is balanced on the boney structures of our body, allowing it to be transferred into the seat pan of a chair (if we are sitting) or into the floor (if we are standing).

However, when we deviate from this neutral position our energy consumption goes up due to our weight being transferred away from our bone to the muscle. Going from the sitting position to the standing position requires us to get out of the neutral position. Imagine trying to stand in a position that is halfway between sitting and standing. I can tell you you would not last long. Why? Your muscles are now primarially responsible for holding all of your body weight up, not your bones. The load gets transferred from the boney structures of your body to the muscles.

So now you understand why you should try to obtain this neutral postition. So what does the neutral position look like? Here are a few guidelines:

If you are standing…

Stand straight up. Legs and feet symmetrical. Your head is looking straight ahead. Your arms are at your sides or if you are working at a table your elbows can be bent at a 70 to 90 degree angle. If you are working with your hands and eyes the table top should be elevated.

If you are sitting…

As you sit down push your bottom all the way back into the back of the chair, that way when you straighten up a natural curve will form in your lower back. Your head should be looking straight ahead. Not looking up or looking down. Now position your monitor, so that if you brought it to your face the center of the screen would touch your chin. Remember the 90 degree rule, elbows and knees should be at 90 degrees. Your feet should be flat on the floor. The edge of the seat pan (the part directly underneath your knees) should not be putting pressure on the back of your legs. Pressure on this area prevents the blood from returning from the lower leg, this can cause varicose veins. If your chair allows you to make and adjustment, make the adjustment. If not, put something under your feet to eliminate the pressure on the back side of the knee. If you use a keyboard keep your hands and wrists straight. Any deviation from this can lead to carpal tunnel issues.

Below is a humorous example of both good and bad ergonomics. Pay attention and learn.

I hope this has been helpful.

Yours in Health!

Dr. Gould

Neck Pain & Stiffness

Published
by
Dr. Edward Gould
on February 8, 2008
in Cincinnati Chiropractors and Neck Pain & Stiffness
. 0 Comments

neck-pain.bmpOur neck or cervical spine has quite a job to do. It holds our head up and gives us incredible mobility allowing us to look all around. However, with all this mobility comes vulnerability. There are a variety of reasons that the neck becomes painful and stiff. Below are just a few.

Torticollis (Wry Neck) – A person with torticolles typically enters my office with his head tilted to one side and is able to turn his head in one direction but not the other. The pain initially is mild but becomes intense as time passes. This can actually happen at any age. Some people are born with it. Torticollis usually has an insidious onset. Sleeping funny or having your head turned to one side for a prolonged period of time. In fact, initially most people think they just have a crick in their neck.

The problem in the majority of cases begins at the spinal joints or facets. When the spine is put into rotation for a prolonged period of time, this causes the affected spinal joints to separate. This separation causes the capsule to stretch. As the spinal joint surfaces get pulled apart, the surrounding capsule can be pulled into the joint due to a negative pressure. Once this occurs, the joints are now able to “pinch” the capsule. This pinching in turn causes the muscled that cross that joint to go into spasm which causes more pinching. This in turn causes more spasm. This is why the pain tends to spread over time and is always on one side. Warning: Get this treated ASAP.

Whiplash Injuries – It’s surreal… One moment you are stopped at a red light. The next moment you hear screeching tires, you look up into your rearview mirror and immediately feel the impact. You have just been involved in an accident. Within moments a policeman taps on your window to ask if you are okay… You move around a bit and much to your surprise, you feel fine, other than feeling a bit anxious. Two days later however, you cannot lift your head off your pillow and your body feels like it has been beat up. How can this be? You feel okay immediately after the accident but with 48 to 72 hours you feel miserable. I’m always asked this question… Doc, I felt fine right after the accident, why do I hurt so badly now? A quick anatomy lesson will help here. It is all about blood supply. Tissues that have a good blood supply swell quickly after an injury. Tissues that have a poor blood supply swell slowly after an injury. There are several things that are significant about this. Not only does a poor blood supple delay the onset of pain, it also significantly increases healing time and in some cases healing outcomes. Properly treating this type of injury is critical. Left alone, improper healing can occur leaving the individual with chronic pain for the rest of their life. We all know people like this. I have been treating whiplash injuries since 1988. If you live in the greater Cincinnati area and have been in an auto accident, call me and set up an appointment to be examined. The sooner treatment begins the better the outcome.

Poor Workstation Ergonomics – For years I would do Ergonomic walk through and lectures at companies throughout the greater Cincinnati area. I was amazed that companies would spend thousands of dollars on adjustable furniture, yet 99% of the people had the furniture adjusted improperly. A thousand dollar chair is useless unless you know how to properly set it up. So what exactly is the point of ergonomics in the work place? Simply put… a properly set up workstation fits the individual’s body allowing it to stay in a relaxed, low energy consuming neutral position. Unfortunately, what I found was the opposite at most companies I visited. If you feel like your workstation is not set up correctly have it checked or give me a call.

Sleeping Posture – Any posture that is held for a prolonged period of time can cause the spinal segments to misalign or become subluxated… sleeping 4 to 6 hours definitely falls into this category. If you wake up with a stiff painful neck on a regular basis you need to evaluate your sleeping posture(s) and you should also have your spine checked for subluxations.

Slips & Falls – Cause a rapid motion in the neck. This can cause muscular, ligamentous and disc injuries. Just like a whiplash. If you have recently slipped or fallen you should have your spine checked immediately.

Loss of Spinal Curve – All of the above can cause a loss of the curve in your neck or cervical spine. Below are some of the consequences of a loss of curve in your neck:

• Spinal Cord Tension – As the neck straightens out the spinal cord gets pulled taunt. This cord tension can cause symptoms throughout the body.

• Headaches
o Migraine Headaches – Vascular in nature.
o Tension Headaches – Muscular in nature.

• Cervical Brachial Syndrome – Neck pain that refers into the shoulder and arm.

• Degenerative Disc Disease – Also known as Osteoarthritis.

Headaches

Published
by
Dr. Edward Gould
on February 6, 2008
in Conditions & Treatments and Headaches
. 0 Comments

headache.bmpAlthough the International Headache Society lists 129 different types of headaches, the general categories are Tension, Cluster and Migraine with associate pain being described as sharp, stabbing, dull, throbbing and vice-like. Migraine with or without aura is the most common form of acute recurrent headache in children.

Different types of physical, chemical and emotional stress— including fatigue, worry, noise, fluorescent lights, travel, improper sleep, smoke and food additives such as MSG and nitrates, often trigger headaches.

Although these things may trigger a headache, the actual cause of the headache is often a series of traumatic or repetitive micro-traumatic events—including motor vehicle accidents, contact sports, postural habits, whiplash and occupational tasks. Headaches and other symptoms may take weeks, months and even years to manifest.

It’s estimated that 25% of the population has a headache right at this moment. Headaches have many causes. Some of which are benign others not so benign. Because of this, it is crucial to get a thorough workup. Once all the examination and diagnostic findings are correlated the appropriate treatment can begin or a referral is made.

A frequently overlooked cause of many types of headaches is structural. Structural problems are due to misaligned spinal bones (subluxations) in the neck and upper back. When the vertebrae in the spine, lose their normal position (become subluxated) this sets in motion a variety of events that ultimately leads nerve irritation, changes in blood flow, muscle spasm and PAIN! If you live in the greater Cincinnati area and are suffering with headaches and are tired of the pain, call me.