Balanced Chiropractic and Physical Therapy

From Pain to Progress: What Real Patients Say About the Balanced Chiropractic & Physical Therapy Experience

Thu, 18 Sep 2025 14:26:24 GMT

When you're in pain — whether from a nagging injury, post-surgical recovery, or chronic discomfort — finding the right care can feel like a maze. At Balanced Chiropractic & Physical Therapy, many patients walk in skeptical but leave with something they hadn’t experienced in other clinics: real relief and a clear plan forward.

What sets this clinic apart? It's not just the treatment. It’s the total experience — one where skilled practitioners combine chiropractic care, physical therapy, and patient education to help individuals regain mobility, confidence, and quality of life.

A Different Kind of Care Experience

From the moment individuals arrive, they notice a different tone. The team at Balanced doesn’t just treat the symptoms — they take time to understand the full picture. Many patients describe the approach as comprehensive, personal, and results-focused .

Whether recovering from orthopedic surgery or managing long-standing joint pain, patients often comment on how the care they received here was more effective than what they experienced elsewhere. The key difference? Integration.

At Balanced, chiropractic and physical therapy are used in combination — not in silos. This means spinal adjustments might be paired with strengthening exercises, or dry needling might be used to reduce tension while also building joint stability. It’s a multi-modal approach designed to accelerate healing while helping prevent future injury.

Common Conditions Addressed

Patients come in with a wide range of challenges:

Shoulder pain and limited mobility
Back and neck discomfort, including sciatica
Hip pain and post-surgical recovery
Sports-related injuries
Plantar fasciitis and foot issues
Nerve-related symptoms, including numbness or tingling
Knee pain and age-related joint stiffness
Repetitive strain injuries from work or athletics
Postpartum musculoskeletal challenges

In each case, treatment plans are tailored — not only to the condition but to each patient’s lifestyle, goals, and progress.

What Patients Consistently Say

Here are some recurring themes reported by patients in public reviews:

“I finally found relief after years of trying other providers.”
“The care team really listens and adjusts based on how I feel week to week.”
“The home exercise programs helped me stay consistent and feel in control of my progress.”
“They went above and beyond — even following up after care to check on how I was doing.”
“I was able to return to normal activities that I hadn’t done in years.”

It’s not just about symptom relief. It’s about restoring function and confidence — whether that means returning to work, walking without pain, playing sports again, or simply sitting comfortably during long drives.

Results That Speak for Themselves

Across the board, patients report:

Reduction in pain (often from high pain levels to minimal or none)
Improved mobility and flexibility
Faster recovery timelines post-surgery
Better outcomes compared to previous care elsewhere
Knowledge to self-manage and prevent recurrence

One of the most notable differences? Patients feel like they are part of the process , not just receiving care but actively participating in their own recovery with a supportive team behind them.

A Team That Prioritizes People, Not Just Protocols

Balanced Chiropractic & Physical Therapy isn't just known for clinical skill — the people are a major part of the equation. Chiropractors, physical therapists, massage therapists, and administrative staff are frequently described as:

Attentive
Encouraging
Thorough
Responsive
Easy to communicate with

This atmosphere of support and collaboration often leads to stronger patient engagement and better long-term results.

Why It Matters

Musculoskeletal pain doesn’t just affect the body — it affects work, sleep, relationships, and mental focus . The goal at Balanced isn’t just pain reduction; it’s full-body function and restored confidence in movement.

Whether you’re facing a complex injury or a nagging issue you’ve ignored for too long, Balanced Chiropractic & Physical Therapy offers something that’s hard to find in today’s healthcare landscape: individualized, integrated care that actually works.

If you're exploring options for recovery, rehabilitation, or chronic pain management, Balanced may be worth your time — and could be the turning point your body’s been waiting for.

Contact us today

Yes, We’re Chiropractors that Accept Blue Cross Blue Shield

Thu, 20 Jan 2022 21:40:00 GMT

At Balanced Chiropractic, our goal is to help you become a stronger version of yourself to enable you to overcome pain and injury through comprehensive care. Whether struggling with a sports injury or chronic pain, you can meet and exceed your goals by focusing on long-term solutions to your condition.

We provide same or next-day Chiropractic services. Call us to schedule your free consultation.

RESET. REHAB. PERFORM.

When searching “Chiropractor near me” you can depend on Balanced Chiropractic and Physical Therapy. We are proud to offer the best in research-based Chiropractic and Physical Therapy services. We accept insurance, including these providers:

Aetna – Cigna – Blue Cross Blue Shield

5 Signs You May Need Chiropractic Care Consultation

Thu, 15 Jul 2021 17:27:00 GMT

A lot of the aches and pains that we experience in daily life can be solved with Chiropractic care. If you haven’t visited a Chiropractor yet, here are some signals that it may be time to pay a visit.

1. Daily Troubles

You are having trouble with your daily activities: getting dressed, preparing meals, taking care of children, shopping, getting through your workday without pain, exercise and sports are limited.

2. Medication Avoidance

You want to avoid opioid medication. Patients who see a chiropractor are 50% less likely to fill an opioid prescription than patients who don’t .

3. Prolonged Pain

You might need to visit a chiropractic professional if you’ve had pain for longer than 3 weeks without seeing improvement in symptoms.

4. Usual Remedies No Longer Work

Your pain is not responding to more conservative treatments like over-the-counter medications, hot packs, or topical pain relievers.

5. Unusual Bodily Changes

You have increased pain at night, unexplained weight loss, changes in bowel/bladder function related to your back pain, visual disturbances, trouble speaking/swallowing, neck stiffness with a fever, progressive weakness, saddle paresthesias. If you have any of the above symptoms you should see your healthcare provider immediately. These are red flags and suggest a serious condition.

Looking for a Chiropractor in Charlottesville, VA? Contact us to book an appointment .

4 Myths About Chiropractic Care Debunked

Mon, 31 May 2021 16:38:00 GMT

You may have some preconceived ideas about Chiropractic Care that have been built up over the years. We’re here to bring you 4 truths that can help to separate facts from fiction.

1.Chiropractic adjustments or spinal/joint manipulations align the spine.

It’s just not true. This is a very old explanation used by chiropractors, physical therapists, and osteopaths because it is simple to explain to the patient. But spines and joints are not so fragile and manipulation doesn’t put you back into alignment. And I’ve got good news — you’re not out of alignment. So what does joint manipulation do? Joint manipulation provides short-term improvements in pain, range of motion, and proprioception. A course of manipulation can be an effective tool as part of a care plan for musculoskeletal conditions.

2.You have to go forever.

This is not true. While healing is a process and seeing a chiropractor or a physical therapist often involves several visits over several weeks (more or less depending upon your condition/injury) it should not be forever. Now, some patients like manipulation because it feels good and like to go on a regular basis, in much the same way that some people like to get regular massages. And that’s totally fine. But it isn’t a requirement and it isn’t medically necessary. It is fine to go regularly if you enjoy it. But it is also fine to see your clinician until your injury is resolved and then not see them again.

3.Chiropractic care is dangerous.

While no treatment is without risk, chiropractic care is very safe. The most common adverse side effects are soreness. There is no evidence that chiropractic manipulation is correlated with strokes (this has been looked at repeatedly) and no evidence that chiropractic manipulation is correlated with a vertebral disc injury.

4.X-rays are necessary to diagnose and treat your condition.

This is also not true and we believe this may be more harmful than helpful due to the effects of radiation on the body. Most people hurt when they move, not when they are sitting still. That being said, how much can a static picture tell us about your condition? Not much. There is also a very poor correlation between imaging and the amount of pain a patient experiences, further debunking the need for imaging. Of course imaging is required when red flags are present: when fracture or serious illness is suspected but in absence of that, we don’t recommend it.

Improving Ergonomics While Working from Home

Thu, 15 Apr 2021 14:14:00 GMT

Are you working from home lately? You are not alone. Workstation ergonomics has become a hot topic over the past 2 years due to many people shifting from working at the office to working from home . This shift has lead to a lot of people seeking care due to a new ache or pain in the neck or lower back. Most of these people know that it may be due to the new work environment, but there are a lot of people who continue to wonder what might be the cause of this new symptom. If this scenario sounds like you, read on!

What are workstation ergonomics?

Workstation ergonomics is the set-up of your work environment and how you interact with this setup. At the bare minimum things involved in the workstation include a desk, chair, computer monitors, a keyboard, and a phone. The more often forgotten things that are included in this setup are a water bottle or coffee, notebooks, pens and pencils, a cell phone, etc. All of these things can be set up in a specific way to ensure the best possible work environment for the worker.

How does an improper setup lead to pain?

When proper ergonomics are accounted for, natural curves throughout the spine and musculature in the area are able to sustain these positions for longer without fatigue. This leads to less pain and discomfort and a better workday.

Exercise Series: Deadlifts

Tue, 02 Mar 2021 18:02:00 GMT

Deadlifts

Deadlifts have long been a staple in strength training. It is a very complex movement that requires movement throughout multiple joints and using multiple muscles. If you’re looking for an exercise that gives you the most bang for your buck to shorten your leg days, look no further.

Deadlifts can simulate multiple movements and everyday activities like lifting a heavy box from the ground, picking up your kids or grandkids, or even leaning over the sink to do the dishes to a lesser extent. You can see how training with this movement can help to give you functional strength for many things you do in a day. Because the movement is so complex and involves multiple joints, it can help to improve movement control throughout the entire body. Improved motor control will help muscles to turn on and off appropriately during motion or in anticipation for motion.

We use deadlifts in the clinic for many of our patients due to the high value if the movement. We often use this with our patients who have lower back, hip or knee issues. The muscles that this movement works span across these joints, so strengthening often helps to reduce overloading of painful structures and adds active stability back to the system. Below is an overview of some of the muscles this movements trains, benefits, as well as cues for proper form.

Targeted Muscles

Benefits of the Deadlift

Variations and Form for Deadlifting

Standard deadlift

Romanian Deadlift

Single leg RDL

You see this less often with a barbell and much more commonly performed with a kettle bell or a dumbbell. This can be performed conventional style, stiff legged, or Romanian. We will review the conventional style and Romanian style. This can be performed with a kettle bell in one hand, or in each hand. If you perform this with a single kettlebell or dumbbell, then the leg that moves backward should be the SAME side holding the weight.

Sumo deadlift

Exercise Series: Squats

Fri, 01 Jan 2021 13:00:00 GMT

The first in our exercise series covers one of the most fundamental lifts: The squat. This is an exercise that simulates and helps to build strength for multiple functional movements like running, jumping, walking, stairs, picking up your children, and even getting on and off the toilet. Staying strong with a squatting movement helps you keep up with life while you’re young and helps you stay independent as you age.

The squat is a great multi-joint exercise that you can use to increase range of motion and build full body strength. This is why it is a mainstay of almost any strength program. There is a lot of misinformation around the squat and we are here to talk about squatting safely and get more people interested in this exercise.

Form

We’ve got great news! There is no need to pay super close attention to squat form for most of us. There is no one perfect squat. Form becomes important when we are getting near our max lift as proper form will give you a mechanical advantage and reduce your risk for injury, but outside of that it isn’t very important.

Everyone has variations in the anatomy of their hips as well as knee and ankle flexibility. These variations can affect form when completing a complex lift like the squat: So how can we say there is only one way to properly perform a squat?

There is little evidence to support that idea that improper form can directly lead to an injury.

Tips and tricks

Common form issues

Benefits

Squat Variations

There are as many variations of squats as your imagination can come up with. Front squats, back squats, box squats, sumo squats, belt squats, goblet squats, split squats, starter squats… Below are some common variations that we use with our patients and athletes.

Back Squat

Benefits and Uses

Box Squat

Benefits and Uses

Sumo Squat

Benefits and Uses

Split Squat

Benefits and Uses

The Balanced Difference

Thu, 31 Dec 2020 06:00:00 GMT

The Balanced Patient Difference

We often ask ourselves what makes us different from the other clinics in the area and what we can do to help our patients get the most out of their time with our practice. These are the questions that have continued to help us grow both as individuals as well as a clinic. Below are a few of the things that set us apart from some of the other clinics in town.

We are always working to improve as a clinic and individuals and we never stray away from these 7 points. We also keep our mission close to heart to serve the greater Charlottesville community by delivering the best in evidence-based care with integrated chiropractic, physical therapy and massage therapy to help each patient reach optimal health and well-being.

Early Intervention is Key to Quick Recovery

Tue, 01 Dec 2020 08:00:00 GMT

When asked WHERE to begin in the healthcare spectrum following an injury, the answer should be up to you and where you feel comfortable starting. All healthcare professionals have been through extensive schooling to help patients and clients. Obviously, we’re a little biased towards chiropractic and physical therapy for all musculoskeletal issues. Here are a few of the reasons why:

In general, you do not need a prescription from your doctor to see a chiropractor or physical therapist in Virginia. This can help to save you time and money, as well as help you get to the route cause of your symptoms without having to cut through all of the red tape.

Now that you have a general understanding about where to start following an injury, now we’ll address WHEN to start. The sooner you seek care, the better for almost every single condition out there. Although money can always be an issue, I can almost guarantee you you will save money if you come in sooner in the injury process. Coming in early allows us to:

Top 10 Tips for Migraines

Fri, 31 Jul 2020 13:44:00 GMT

Top 10 Tips for Migraines!

Spinal manipulation is a useful tool in migraine prophylaxis. One study demonstrated a “significant reduction” of migraine intensity in almost half of those patients receiving spinal manipulation. Nearly ¼ of migraine patients reported greater than 90% fewer attacks. (11) Spinal manipulation has demonstrated similar effectiveness but longer-lasting benefit with fewer side effects when compared to a well-known and efficacious medical treatment (amitriptyline). (11,12,13,14)

A Harvard study found that SMT significantly reduced migraine days as well as pain intensity. (52) And SMT is safe; a study to define adverse events following chiropractic spinal manipulation for migraines found that “adverse events were mild and transient, and severe or serious adverse events were not observed.” (53)

Several recent studies have shown that acupuncture is another viable tool for managing migraines. (49-51,59,60)

Dietary fats trigger the synthesis of prostaglandins which are known migraine triggers (19). Low-fat diets have been shown to play a role in migraine prophylaxis. (20,21) Weight loss may decrease the frequency of migraine and other primary headaches (tension, cluster). (16-18) Patients on a low sodium (DASH) diet report a decrease in headache frequency vs those on a high sodium diet. (23) One new study showed that “adherence to the Harvard Healthy Eating Plate advice, particularly the reduction in carb, red and processed meat consumption, is useful in migraine management, reducing migraine frequency and disability.” (47)

Increased hydration may produce subjective improvement in headache disability and intensity. (22) A study published earlier this month, showed “The results showed that the severity of migraine disability pain severity headaches frequency and duration of headaches were significantly lower in those who consumed more total water.” (48)

Vitamin D deficiency is associated with migraine attacks. (54,55) Vitamin D supplementation in a dose of 1000-4000 IU/d has been shown to reduce the frequency of migraine attacks. (55-57)

Riboflavin (Vit B2) may help prevent migraines. (26, 29-38) Dosage recommendations vary, however, the average dose used in the studies was 400mg/day. Vitamin B6 supplementation (with or without concurrent B9 and B12) has also demonstrated prophylactic benefit. (58)

Feverfew may be a useful tool for preventing migraines. (24,25,26) Dosage recommendations vary, however, the average dose used in the studies was 125mg/day.

Magnesium may provide migraine prophylaxis. (26, 39-42) An umbrella review found strong evidence that “Magnesium supplementation can reduce the intensity/frequency of migraine.” (61) Dosage recommendations vary, however, the average dose used in the studies is 400-600mg/ day for the prevention of migraine in non-pregnant patients.

Coenzyme Q10 may be effective in migraine prophylaxis. (26, 43-46) Dosage recommendations vary, however, the average dose used in the studies was 100mg TID.

One systematic review and meta-analysis concluded: “Melatonin may be of potential benefit in the treatment ‐ prevention of migraine in adults.” (62) Study doses varied widely (0.05-50mg), however, the typical dose used in the studies was 2-3mg, taken before bedtime.

Tim Bertelsman, DC

Do you struggle with migraines? Give us a call to see how we can help! 434-293-3800

References

How To Start Running

Tue, 26 May 2020 15:16:00 GMT

How to Safely Build your Running Volume and Intensity

While things are slowly opening back up around here after a two-month quarantine, it looks as though gyms and fitness centers will be among the last things to return. And for many of us, it will take a long time before we’re comfortable exercising in an enclosed space with a bunch of heavy-breathing strangers. With that in mind, many of us have taken up running – one of the best full body and cardiovascular workouts out there, and one that can be done literally anywhere and requires nothing but a solid pair of shoes.

Running is incredible. I am of the opinion that human beings WERE indeed “born to run” – we are built for it. It strengthens almost every muscle in the body, it contributes to a robust and durable skeleton, it will quickly develop your cardiovascular fitness; and it’s fun. Joyful. Freeing.

However, it is also a lot of impact. With each step, running imparts forces up your foot and leg that are FIVE TIMES YOUR BODYWEIGHT. That’s a LOT of force. And for this reason, most individuals need to progress into running slowly in order to avoid injury. All you need is a plan (and some self-honesty), and it IS possible to build your running volume over time without sustaining an injury.

Step 1: Get Assessed.

For those of you without pain and without a history of lower-body injury, you can *probably* skip this step, and add some jogging into your routine in a systematic fashion (more on that in a bit). But, if you are coming off an injury and/or having some pain, it’s best to get checked out by a professional. Whether you decide to see a physical therapist, a chiropractor, a PA or a physician is up to you – but make sure they have experience in working with runners. Please note that having some pain doesn’t mean that you can’t start running (especially if your pain is unrelated to, or even relieved by, physical activity) – but it’s safest for you to get a professional opinion first.

A sports physical therapist will be able to perform a running readiness screen, which includes testing your range of motion, strength, stability, and power output to make sure your muscles, tendons, and bones are up for the task. Additionally, if you’re having pain, we can help determine which tissues might be contributing, and determine whether it’s safe for you to begin running. If it’s not – no worries! We can work with you to get you to the point where it is.

Step 2: Walk

You have to crawl before you can walk…and you have to walk before you can run. If you already walk regularly, great; it’s likely you can skip this step. If not, I’d recommend starting by walking 30 minutes, 4 days per week. Gradually add time and days until you can walk 60 minutes without pain and without stopping, on at least two days per week. When you’ve reached this milestone, you can be certain that your body is ready to up the ante a bit

Step 3: Start with intervals

Where you start when you start running all depends on your fitness level and your experience in the sport. If this is your first time committing to a fitness routine (which, by the way – major props and congratulations!), then running a 5k per day is not a smart way for you to begin (it will likely lead to an overuse injury). If you’re a division I soccer player who’s just graduated and looking for a new way to stay fit, however – you can probably tolerate a three-mile run.

For those who are new to running, or if you’re coming off an injury, I suggest starting with intervals. These can be as short as 30 seconds of running, or as long as one minute to start with – depending on your fitness and the severity of your injury (for example, if a stress fracture has kept you out of running for 4+ months – start small. If you pulled a muscle and were out for 4 weeks, you can start with a little more). Give yourself a minute to rest in between sets, and repeat 8-10 times. That’s your run for the day.

I recommend repeating each “level” of progression three times before increasing the time spent running and decreasing your rest intervals. Almost every major sports medicine center has a “return to running” progression; Feel free to search the googles, but i feel strongly that progressions should be highly individualized based on the nature and severity of the injury and the athlete’s fitness levels.

Follow the 10% rule. When increasing your mileage, don’t add more than 10% of your total volume from week to week. For example, if you ran a total of 10 miles this week, then next week, you can add one mile to your weekly total.

Step 4: Add Volume before you add Speed. Never add both at the same time

Speaks for itself. Build yourself a comfortable base – I’d say of at least 15-20 miles per week – before you start increasing the intensity of your runs. This allows both your cardiovascular and your musculoskeletal system to adapt to running. Both volume and intensity contribute to the overall load of running; so adding both at once will likely just overload your system and create injury. CONSISTENCY is key; don’t be afraid to build slowly, because that is your ticket to a lifelong relationship with running.

Step 5: Don’t Ignore Pain

If you should feel pain while progressing your running, a good first step is to simply take 1-2 days of complete rest, and then resume your running intervals at the level below where you were when you felt the pain. This is going to look different on every program, but for example: if you were running for two minutes, walking one minute and felt pain, then you would, after rest, initiate running at run 1: walk 1, a level below. If you’re still having pain after a few days of rest and dropping it down a level, now’s the time to call your PT or physician.

Remember that any time you push your body’s limits, it’s going to respond by pushing back a little. Some aches and pains here and there are a normal part of life for a runner. I don’t want you to think that every little niggle requires medical attention. However, pain that is persistent and prevents you from finishing your runs or forces you to change your gait, definitely warrants a workup.

If you have questions, or want a personalized plan for building your running volume after an injury or time off (or for the first time!), don’t hesitate to reach out to sam@bcptva.com

Training, Fueling, Fitness, and Body Image During COVID19

Mon, 11 May 2020 15:07:00 GMT

This started as a blog on “how to keep training during quarantine”. Which is an important topic, especially because it seems as though this is how life is going to be for the time being. But as I was writing, this is what came out instead. There are questions I need to answer, thought patterns I need to shed light on, and reassurance that needs to be given….so here it is.

“Training looks different for me now and I’m scared I’m going to gain the “COVID-19 Pounds that everyone keeps joking about”

I have several responses to that. For one, it goes without saying that if the worst thing that happens to you during this pandemic is that you pack on a few extra pounds, consider yourself very lucky. I would much rather gain weight than get sick and die, or see my loved ones get sick and die. I don’t think there’s anyone who doesn’t truly feel that way deep down. In the grand scheme of things, this is an incredibly scary and unprecedented time, and if you need an extra snack or two to cope with it? There’s nothing wrong with that. No one is judging.

That being said, being worried about your weight and fitness when your entire routine has been upended by the universe does not make you a bad person. If you are a female of any age, any background, any shape, size, activity level – you’ve had diet culture forced down your throat since the day you were born. You’ve most likely been made to feel, your whole life, that your body is inadequate and that it must be small to be “worthy”. We all have. I don’t know a single woman who’s somehow escaped that message. Men too, for that matter. If you find yourself freaking out a little extra about your weight, it doesn’t make you selfish and uncaring about the rest of the world – you literally can’t help it because this is what you’ve been taught by society to value. Regardless of whether you got that message from a magazine, a movie, your mom, or your coach – it’s ingrained.

For individuals with eating disorder history, this is also an especially difficult time because many eating disorders are a form of control. There’s a LOT of things we don’t have control over right now, and it is terrifying. When the rest of your life is scary, uncomfortable, and inconsistent, focusing in on your body and food intake is a way to cope and feel like you have control over SOMETHING. Is it a healthy coping mechanism? NO, of course not – but it is effective. If you’ve fallen into this kind of pattern when stressed over midterms, deciding on a university to attend, going through a divorce or a death or a marriage…then a global pandemic is most certainly going to trigger you too, and that’s not your fault.

If this is you, I suggest forgiving yourself, showing yourself some extra love, and meeting virtually with a therapist who can help you get through this time.

On the opposite side of the coin:

It is also totally okay to continue caring about your health and fitness during this pandemic! And in that regard, I am pleased to report that the laws of physics remain the same regardless of whether you are still at work or you’re on house arrest. Physics doesn’t care about Corona. The calories in/calories out rule still applies for weight loss or weight maintenance! So, all the “covid-19 pounds” memes are truly kinda dumb. Staying at home doesn’t cause weight gain – eating more calories than you burn does (regardless of your location).

If your activity level has changed drastically and you don’t want to gain weight, eat less calories. If your activity level has increased, then rest assured that extra coronasnack isn’t doing you any harm.

Some general rules of thumb that still very much apply in this pandemic:

-Eat only when you are hungry, most of the time. Stop when you are satisfied, not stuffed

-Choose mostly whole, unprocessed foods (bonus: they’re better for your immune system than pop tarts!)

And it’s highly unlikely that your weight or fitness will be impacted by staying at home. If you are still concerned and want something more specific, I highly recommend connecting with a sports dietician – most of them do remote consults and they can put you on a plan that will take a lot of the stress out of eating. Who needs one more thing to stress about right now anyway?

As for your activity level? Keep in mind that we are all, collectively, under a great deal of psychological stress right now. Your body does not know the difference between physical stress and psychological stress so…it all adds up in the same way. Think of your stress capacity like a bucket. Both physical and psychological stress fill up the bucket, so the more emotional stress you have – like living through a global pandemic– the less room in the bucket there is for adding physical stress (workouts) – before the bucket spills over (aka you get injured or get sick).

That being said, most of us actually need to slow down with our training, rather than ramping it up. Have you noticed your legs feel heavy? Or that you wake up stiff as a board? Or that you’re sleeping way more than usual, or having more trouble sleeping than usual? That’s the stress – and those are the same symptoms as overtraining syndrome. Slow down, and your body will thank you.

If you are struggling with this quarantine in any way – with body image, with food intake, with exercise, with training for a sport, with an injury – please reach out to me: kate@bcpt.com Let’s talk, I’m happy to help you with all of the above.

COVID-19

Sun, 26 Apr 2020 14:17:00 GMT

COVID-19 Update:
WE ARE NOW OFFERING TELEHEALTH VISITS TO IMPROVE SAFETY AND ENSURE CONTINUITY OF CARE

In order to keep our patients safe who still wish to be seen in the clinic, we have established new guidelines and requests for patient care. :
1. If you have traveled outside of the country, please do not request or attend an appointment until you have surpassed the minimum 14 days of quarantine. The same applies if you have traveled to a domestic ‘hot zone’ NY, CA, LA, etc.

2. If you are feeling unwell (whether you think its allergies or not), please reschedule your appointment. No cancellation fees will apply during this precautionary timeframe.

3. If you are over 60 years of age or have any underlying health conditions, please reconsider attending your appointments at this time. You have an increased health risk associated with this virus and we would like to minimize that risk, if at all possible.

4. Upon entry and exiting our clinic, please sanitize your hands with the sanitizer located near the check-in kiosk.

5. Please be cognizant of our social distancing measures. Our waiting room allows 6ft of distancing as does our treatment area. Our providers will adhere to maintaining 6ft of distance whenever possible during your treatment.

6. We will be keeping windows and doors propped open as weather permits to allow constant air flow and to prevent our patients from repetitively touching door handles etc. Please dress appropriately as the clinic may be cooler than usual.

7. Our providers may wear masks and will be wearing gloves when performing any manual therapy on our patients.

As we remain open, the safety of our patients and staff is our number one priority. We have made changes to cleaning of the clinic space and equipment as well as to our scheduling policies during this time. Thank you for your patience and understanding during this trying time.

Sport Specialization: How Soon is Too Soon?

Thu, 02 Apr 2020 14:54:00 GMT

Abby Wambach. Golden Tate. Morgan Brian. Colin Kaepernick. Sue Bird. RGIII. Mia Hamm. Allen Iverson. Tom Brady .

What do these individuals have in common, aside from being highly accomplished professional athletes?

They were multi sport athletes all the way through high school. That means they played one sport in the fall; another one in the spring; some of them a third, still different, in the winter; and likely took summer as an off-season where they remained physically active – playing kickball with friends, jumping in the lake, riding bikes around the neighborhood – but weren’t formally training for a sport.

As a sports specialist physical therapist, parents are constantly asking me when, and whether, their child should specialize in a certain sport. I understand -when you notice that your child is good – even exceptional! – at something, you want to help them develop that as best you can, as soon as you can. You also generally have the ability to do so, with school teams, travel teams, and local leagues in abundance.

So when SHOULD a young athlete specialize in one sport? As late as possible. Here’s why.

Risk: Overuse Injury

Repetitive stress is one of the primary causes of sports-related injury. Despite how we usually consider children to be “spry” and “resilient”, they are actually much more susceptible to certain kinds of overuse injury than adults because 1) their skeletons are not fully developed and 2) they are not able to build muscle strength and hypertrophy the way adults are. When a young athlete participates in the same sport year-round, they are only developing one set of skills, one set of movement patterns; this can lead to increased risk of injury outside their sport too. Additionally, repetitive movements like pitching a baseball, bringing the shoulder through a swim stroke, or striking a soccer ball actually involve higher forces going through the body than you might think. This puts extra stress on the athlete’s still-developing muscles, tendons, bones, and especially growth plates.

It needs to be said too that the number one risk factor for sustaining a sports injury is….having had a previous sports injury! Overuse injuries, while they’re rarely a career-ender (but can be!), are in many ways setting the young athlete up for a tough ride in their sport.

Risk: Burnout

The developing brain of a young athlete is not meant to focus on a singular task day after day, year after year. Quite the opposite – children and adolescents need variety in order to thrive and grow, both mentally and physically. The more specialized a young athlete becomes, the more likely they are to become frustrated and, well….burned out. Did you think burnout was just for medical students or adults working desk jobs they hate? Think again. When kids do too much of one thing, and experience too much pressure from coaches and parents, they will fold, and it is harder for them to recover than it is for adults with fully developed brains.

Burnout is a huge problem that has dire health consequences for young athletes. Involvement in sport has endless benefits, from learning how to work as part of a team to keeping a person’s heart and lungs healthy to controlling their weight. If an athlete becomes burned out by their sport at a young age, they are much less likely to ever participate in sport; and are even less likely to continue with physical activity. This puts them at risk down the road for obesity and cardiovascular health issues. You can see how this is not just a problem at the individual level, but at the societal level as well. The key to keeping young people involved in sport all through life is VARIETY.

Reward of Waiting: Athletic Prowess

You read the names I listed above. There are countless more. The more variety a child has in their athletic activity, the more comprehensive their athletic development. Athleticism is not the same thing as having skill at a particular sport. Athleticism refers to strength, power output, speed, agility, reaction time, and endurance. Sport-specific skill refers to things like refining your pitching biomechanics, honing the accuracy of your shot on goal, working on your running form, gaining confidence with tackles. Sport-specific skill, of course, is important for performing well and reaching the highest levels of a particular sport BUT, this should be built on a foundation of athleticism. Skill work is the steering wheel, athleticism is the engine. Build the engine first; and the best way to do that is variety. Running cross-country in the fall is a great way to build endurance so that you can play the full 60 minutes of your lacrosse game in the spring without needing a sub. Playing soccer in the fall helps build that sprint-endurance capacity you need for your finishing kick in the 800m spring outdoor track season. Riding bikes through the neighborhood with your buddies all summer allows you to rest and recover from a tough spring season while still keeping you active. Sport variety, with natural periods of exertion and rest, help your athlete grow from a curious child into a strong, athletic adult.

Reward of Waiting: Growing a high-functioning, well-adjusted adult.

Above EVERYTHING else, sports should be fun. This obviously goes for adults as well as kids, but it needs to be said that your child is not a small adult – they do not have the mental capacity to go to work at the same job day in and day out the way we do as adults. Think of their sport like a job; it is not hard to see how playing soccer 365 days a year can eventually come to feel like a job. Kids are meant to spend most of their time playing, exploring and having fun, and movement is one of the best ways to do that. There is no reason for any child under the age of 18 to be experiencing burnout or injury; let’s not take their childhood from them too early. I promise, it will have no detrimental effects on their ability to be a high-performing adult. Quite the opposite in fact.

If you are curious about how to optimize your child’s athletic development, reach out to our sports specialist Dr. Wason. She can answer any questions you may have, provide athletic development training sessions for healthy athletes ages 10-18, and physical therapy services for young athletes with overuse injuries. kate@bcptva.com

Patellar Tendinopathy: Not All Tendons are Created Equal

Mon, 23 Mar 2020 16:56:00 GMT

Have you ever experienced anterior knee pain? The likely answer is yes, and it can be quite debilitating! There are a variety of causes for anterior knee pain including patellar tendinopathy (tendonitis), chondromalacia patella, patellar tracking issues , and more serious injuries like ACL tears. This blog with focus on patellar tendinopathy .

What is Patellar Tendinopathy

So, you may be wondering how this condition starts in the first place. It is usually the result of overloading the tendon before it has time to adapt. By not allowing for a gradual increase in training load, the tendon faces more stress than it is capable of tolerating. G enerally it affects the adult population ranging from 16-40 year olds, but can affect anyone if a training schedule is not properly developed. Once the condition has developed, it can take anywhere from 2 weeks to 2 months to fully resolve.

Biological signs of the injury include up regulation of cells that create the tendon, ground substance, nerves, and blood vessels. One hypothesis for why the tendon becomes painful is the in-growth of nerves and blood vessels; picture packing all of these substances into a compact area. T he brain and central nervous system may also play a big role in sensitization of the tissue. Pain with this condition like serves more as a “danger signal” to allow the human to know something is happening in that area of the body, and is likely not a signal of tissue damage. Think of this as a warning sign to slow down and let the tendon adapt.

Diagnosis of Patellar Tendinopathy

Functional movements that usually become painful with patellar tendinopathy:

Other hallmark signs of the condition:

Real Life How it Happens

Now that we’ve gone through all the logistics of this condition, lets look at a real life example of how this can happen with running. Picture this: It’s winter, the weather isn’t great for running so you’ve been inside running on a treadmill. You have been consistently running 5 miles with no pain throughout 4x’s a week.

Then BOOM. March hits and its 60 degrees out with the sun shining. New shoes are unboxed and you can’t wait to get outside and hit the pavement. You start running outside with the same mileage, but now you’re running 5-6x’s for 6-7 miles a week because you can’t resist how nice its been outside. One morning you wake up to walk to work or class and you notice that as you’re walking down hill your knee is bothering you a little (nothing serious 1/10 pain). Over the next few days you notice the pain is getting a little worse (2-3/10 pain with stairs, hills, and now its even bothering you a little with running). Now you’re concerned because its starting to affect running.

So let’s break that story down and see how training may have overloaded the tendon before it was able to adapt:

Wrap-Up

As you can see, outside of the obvious, there are a lot of other variables that need to be accounted for to allow the tendon to adapt properly. No matter the activity, it is important to allow adaptation to training volume, load, surface, or equipment. The importance of ramping-up training or allowing appropriate time for tissue adaptation can not be overstated. This is why this injury is usually more prevalent at the beginning of a sporting season or training regimen.

Treatment

As always, better outcomes are seen with more timely interventions versus the wait and see method. Treatment is generally aimed at reducing pain, promoting tissue adaptation and healing, and improving proprioception in the joint and surrounding tissues. Eccentric and heavy slow resistance exercises have been shown to be the most beneficial in treating this condition and some protocols have been established. Since everyone’s tendon quality and pain levels may be different, it’s essential to ensure you are starting at the right level for your level of tissue irritability. If the tendon is stressed too much during recovery, the tendinopathy cycle may repeat itself and may become worse.

Remember, there is no established time frame for recovery, so being patient with recovery is important. The good news is that you can usually continue training during rehab, but it is best to consult your physical therapist about adjusting impact training, training load, or training volume.

Bryan Esherick PT, DPT

So you tore your ACL…now what?

Fri, 06 Mar 2020 12:58:00 GMT

Anterior Cruciate Ligament (ACL) ruptures are one of the most common injuries in sport. Most occur without contact, and occur far more often in female athletes than in males. There are many ways to injure the ACL; maybe you’re a soccer midfielder who got into a 3-way tackle at practice. Maybe you’re a goalie who went to clear the ball and felt your plant leg crumble underneath you. Or maybe, if you’re really unlucky, you stepped in a pothole walking home from a game. Regardless of the scenario, when an ACL ruptures you will feel a pop, likely feel your knee “go inward”, and experience immediate swelling.

While there are several clinical tests that a physical therapist can use to determine the status of your ACL, the gold standard for diagnosis is MRI. Once an ACL tear is confirmed on imaging, the gold standard of treatment is still surgical reconstruction. Research is coming out now suggesting that some individuals can “cope” with intensive rehab, but what we see in the literature is that this only occurs for about 25% of patients who sustain an ACL rupture. If you are going to return to a high-level contact sport – and especially if you’re female and under 30 – your best bet for returning to optimal performance is a reconstructive surgery.

While it’s a common injury in sport, it’s also an emotionally difficult one; it’s likely your season will be over. Athletes will usually feel grief grief over suddenly not being able to do the thing you love, anger at watching your teammates continue to thrive and perform in your sport, and fear that you’ll never be the same again.

These are all normal feelings to have, but in excess, they’re actually going to prevent you from making a solid comeback. So, here are some steps to take to get your head back in the game, and some information for you so that you know exactly what to expect after you’re wheeled out of the operating room.

First: Know that it’s going to be okay.

While an ACL rupture is likely a season-ender, it doesn’t have to be a career-ender if you find the right orthopedic surgeon and a physical therapist who specializes in sports. How many of you watched Megan Rapinoe this year in the world cup? Did you know she tore her ACL – for the THIRD time – in 2015, and was back on the field for the Rio Olympics? . Yes it takes a long time and a lot of hard work, but know this: you WILL play again.

Second: Learn about what’s going to happen in the Operating Room.

Surgeries are scary, but the good news is that sports medicine surgeons perform this operation all the time. Choosing your surgeon is important – you want someone who is board-certified in sports medicine and who does this operation regularly. It is more than okay to ask your surgeon how many ACLs they have reconstructed! Choose your surgeon well – make sure they have LOTS of experience with this operation and make sure that they share your goal of getting back with your team – and you will be just fine. In the operating room, the surgeon will make a small incision and will first debride, or clean up, the inside of your knee. She will likely remove the torn portions of your old ACL. Then, she will take a portion of one of your tendons – either your patellar tendon (front of your knee), hamstring tendon (back of your knee) or quad tendon (just above your kneecap) and creates a “graft” by re-inserting the tendon into the joint, such that it will act like a new ACL.

Third: Get your dang knee straight!

After you wake up from surgery and make it home from the hospital, you’ll likely be sore, but it’s important to get that knee moving. Check with your surgeon about specific precautions and limitations, but in most cases physical therapy should begin 1-5 days after your surgery. The most important thing in the early phases of rehab is to regain full range of motion, especially extension. Without full range of motion, strength gains will be hard to come by. The earlier you start working on this, the less painful and difficult it will be over time!

Fourth: Train Hard.

Find yourself a physical therapist who specializes in sports rehabilitation. Your physical therapy sessions should feel progressively harder and harder, and your PT should be stressing your cardiovascular systems in addition to getting you strong. If you’re not sweating during your sessions and have mild DOMS afterward – and if you’re not eventually doing things that look and feel like your sport – find a new PT.

Lastly: Be Patient. Play the Long Game.

You’re six months out from surgery, running intervals, doing box jumps, and feeling GOOD. So…why can’t you play? The sports medicine and rehab research overwhelmingly and unequivocally shows that for every month you wait to return to play after that 6 month mark, you decrease your risk of reinjury by 50% . That’s huge. Even if your ligament has healed and you’re passing your return to sport tests, the extra three months to get fitter and stronger matter so much to keeping you in the game. You can reduce your risk of re-injury by waiting until you are stronger and fitter than you were even before your injury. Your physical therapist should be guiding you there and encouraging you every step of the way.

If you have questions about how to prevent ACL ruptures, or whether we’d be a good fit for your pre- and post-operative rehab following this injury, reach out to our sports specialist Dr. Wason: kate@balancechiropracticva.com.

What You Need to Know about Stress Fractures

Fri, 21 Feb 2020 13:29:00 GMT

A more accurate term for a stress fracture is “bone stress injury” (BSI). This is because bony stress injuries occur along a continuum based on how much loading the bone is being asked to sustain. When caught early, that dull ache at the front of your shin, for example, might just be what we call a stress reaction: there is edema (fluid) in the bone marrow, but no visible fracture line. If a stress reaction isn’t caught in time and/or the athlete continues to run through the pain, the bone can be stressed to the point of a partial fracture, what we call a “stress fracture”. Usually, pain with a stress fracture is significant enough that the athlete cannot continue to run through it. However, in cases where the bone continues to be loaded beyond what it is capable of tolerating, a stress fracture can widen and deepen and eventually progress to a complete break in the bone. Again, this is rare because most athletes will voluntarily stop their training due to intolerable pain with a stress fracture.

Who gets stress fractures? Bones respond to impact. Moderate amounts of impact activity, such as walking, running, and jumping – when progressed appropriately – are actually GOOD for your bones. Bones actually cannot get strong and dense (aka, strong enough to resist fractures and stress fractures and reducing the likelihood of osteoporosis in your later years) without some impact loading. The best way to go about this – if you’re not already a runner or involved in a running/jumping based sport like basketball or soccer – is to schedule a visit with a sports physical therapist who can help create a program for you to safely and effectively load your bones.

However, when it comes to loading your bones, it’s very easy to have too much of a good thing. HIgh volumes of load, or increasing your load very suddenly, will “stress” the bone and eventually cause it to crack. Generally, stress fractures occur in athletes who run – cross country, track, marathoners, as well as running-based sports like soccer and lacrosse – and in athletes who jump. They also occur commonly when an athlete is transitioning from a nonweightbearing sport like cycling or swimming into more running. A stress fracture is typically preceeded by a significant increase in impact activity beyond what the athlete is used to.

Stress fractures can also occur in the absence of an increase in training load. However, the reason is always due to an increase in stress on the body. This can be physical stress in the form of training load, but can also be emotional/psychological stress (for example, making the transition from high school to college), or metabolic stress from not eating enough. Bones, just like muscles, need fuel to build themselves up and keep from breaking down. For more information on the relationship between energy balance and bone health, see our last post on relative energy deficiency in sport!

A clinician will usually be able to determine whether or not they suspect a stress fracture based on the patient’s history and on several clinical tests. However, imaging is necessary to rule these in or out. Despite being a bony injury, most stress fractures will NOT show up on X-Ray; MRI is the gold standard for diagnosis.

Following diagnosis, a stress fracture will usually require a period of unloading depending on severity. Stress fractures in the foot and ankle will usually require a walking boot; stress fractures higher in the leg will require crutches. THe length of time on crutches is entirely dependent on the severity of the fracture. During this time, most athletes will be allowed to cross-train in the pool (swimming or deep-water running) or on a stationary bike – again, depending on the severity of the injury.

Most stress fractures take 6-8 weeks to heal. A common misconception, however, is that once the bone is healed the athlete is clear to resume running. While it’s true that after the bone has healed, the athlete can resume LOADING the bone, this does not mean they are ready to run. With every step you run, your leg has to absorb forces that are FIVE TIMES GREATER THAN YOUR BODY WEIGHT. Starting at this amount of load will likely just lead to a second fracture.

This is where physical therapy comes in! A sports specialist will be able to design a gradual loading program for you, involving progressing walking speed and distance, improving global lower body and core strength, and eventually, progressing plyometric activity in order to guide you safely back into running. This way, you can return to your sport stronger than you left it, and with full confidence that you will not experience an injury like this again anytime soon. Additionally, a female athlete specialist (like Dr. Wason!) can help coordinate the resolution of any risk factors you may have, such as your training volume, your fuel intake,body image issues, and your menstrual cycle status (for more on how your menstrual cycle affects your bone health, see our previous post on RED-S).

If you are a runner or running athlete and you:

-have been diagnosed by a physician with a stress fracture

-have had a bone stress injury in the past and are struggling to return to training

-are having pain with training and suspect you might have a stress fracture

-just want to avoid a bone stress injury

Send an email to Dr. Kate with any questions or concerns or to set up an appointment!

kate@balancechiropracticva.com

Relative Energy Deficiency in Sport

Thu, 06 Feb 2020 19:04:00 GMT

Most everyone reading this has heard of eating disorders. Somewhat less of you, but still a lot, will also have heard of the Female Athlete Triad. But likely few will know what RED-S is. RED-S, or Relative Energy Deficiency in Sport, actually encompasses and expands on the female athlete triad and is essential for you to know about if you are an athlete, a parent of an athlete, or work with athletes in a coaching or healthcare capacity.

The Female Athlete Triad describes three inter-related health issues that occur specifically for female athletes when their food intake is not enough to support their activity levels. Oftentimes, this imbalance occurs due to disordered eating; intentionally restricting food intake in order to achieve leanness or small-ness which, for better or worse, can be advantageous in sports like distance running, triathlon, gymnastics. Over time, this lack of fuel triggers the body to essentially curl up in a ball and protect itself via shutting down the reproductive system. Your body will always prioritize survival over reproduction; this is why most women with eating disorders will lose their period due to low energy availability. The way this occurs is through alteration of hormone production and circulation in the body. In women, bone health is directly tied to reproductive hormone levels. Estrogen and progesterone levels are altered, which then has a cascade effect on your bone health. In sum: disordered eating leads to menstrual cycle disruption/hormone dysregulation and sad bones.

It seems fairly comprehensive, right? But it actually leaves a lot out, and that’s where RED-S comes in. This is the new term that we’re using instead of the “female athlete triad” for the following reasons:

Relative Energy Deficiency in Sport affects men too.

Men certainly don’t menstruate and don’t have the same link between bone health and sex hormone profile that women do, but they do still suffer the consequences of not eating enough. As we’ll talk about later, not eating enough can affect ALL your body systems, not just bones and reproduction. This is one of the main reasons for the change in terminology!

The “ED” in RED-S stands for “Energy Deficiency” and not necessarily “Eating Disorder”

It’s true that eating disorders are a massive problem in sport. The vast majority of women and girls will at some point and in some way, struggle with their body image and their relationship with food. However, it is also common for athletes to under-eat simply because they don’t know any better. Young women and girls are especially unaware of how many calories they actually need. I blame diet culture for this – many of us are lead to believe through the media that 1500 calories a day are sufficient. In reality if you’re active and/or still developing, it most definitely is NOT appropriate. Most female athletes need between 2,000-3,000 calories per day. (If you are curious about your own personal needs, I encourage you to get in touch with a Registered Dietician). As an example, consider the following scenario:

You’re a college freshman and you’re trying to balance 1) being a member of a sports team 2) classes and homework 3) finding your way around campus 4) making friends 5) being homesick 6) oh and the dining hall doesn’t have anything you like, ugh.

It isn’t hard to see how this young woman – and thousands just like her – are not getting enough calories. And it doesn’t mean she has an eating disorder. So that’s another reason for the change in terminology – being energy-deficient isn’t always due to restriction. This is where healthcare providers and coaches can play a huge role in educating girls and young women about what they actually need to consume and how to do so conveniently!

RED-S affects MUCH MUCH MORE than bones and sex hormones

Low energy availability affects every system of the body. It absolutely can lead to low bone density which increases an athlete’s risk of stress fractures. It will also shut down a woman’s menstrual cycle because with limited resources the body needs to choose between reproduction and survival. However, it also has effects on:

Mental health : poor regulation of serotonin/dopamine = bad moods, irritability, lashing out, and increased feelings of depression and anxiety. Your body needs fuel to appropriately store and release hormones too!

Energy levels : The term “energy deficiency” says it all. Feeling sluggish, foggy, sleeping excessively or having difficulty with sleep are all potential symptoms of RED-S. Additionally, athletes will often struggle to complete workouts or will feel that a volume/intensity of work that has been typical for them has suddenly become challenging

C ardiovascular health : Your heart is a muscle, and it uses carbohydrates and fats for fuel just like all the other muscles of your body. Without enough fuel, your heart muscle will not be able to work as efficiently. This can change the electrical conductivity of the heart leading to things like arrhythmias – which will disqualify an athlete from participating in sport. It also leads to feelings of fatigue – workouts suddenly feel hard because the heart is having to work with less fuel!

Your musculoskeletal system: If you’re not putting in enough fuel to allow your body to recover, it breaks down more easily. This is true

In summary, Relative Energy Deficiency in Sport is the new term we’re using to describe when athletes of all genders don’t eat enough to support their activity.

Motor Control, Part 2

Fri, 24 Jan 2020 14:40:00 GMT

Our bodies are built to do what our brains ask it to do. If you ask it to move in a particular way, it will do it, but it may not always be exactly how we imagined it. Think about watching people pick up an object from the ground: There are many different ways to do this, and your body will choose the best one suited for you. If you read part one of this series, you should now have a better understanding about what motor control is. Here in part 2, we’ll discuss how motor control may cause and be affected by pain.

Issues in motor control may be a likely culprit if part of a certain motion is pain free but other parts painful. From an observational standpoint, issues are usually evidenced by “jerky” or “ratchety” motion: Compensation patterns are also usually noted like moving from the hips when asked to flex in the lower back. Not everyone with these issues present with all of these characteristics, but it is likely to see at least one if this is contributing to the painful experience.

Now that you know a little more about what motor control is and how to spot it, you may be wondering how it can lead to pain and dysfunction. Depending on who you ask, you may get a different explanation! In my opinion, there are two different schools of thought on the subject: Pain causing motor control issues, or motor control issues causing pain. I’m personally a believer that motor control issues are caused by pain via a complex interplay of different systems.

We know that pain can affect a lot of things including activity level, social interactions, movement, mood, etc. When pain is present in an area it begins to affect proprioception and muscle activation, both of which are required for pain free control of movement. When the muscles and nervous system aren’t communicating optimally, pain and movement difficulties begin to occur. This leads to a cyclic pattern between pain and movement. Rather than put it in words, there is a graphic below that describes this cycle. Keep in mind, the arrows can go in both directions on the graphic, and one does not necessarily cause the other. So although it may be a case of which came first, the pain or the motor control issue, either pathway leads to a continuous cycle of pain and discomfort and needs to be disrupted with intervention.

So although motor control exercises should be a component of treatment in some conditions, it is not the magical cure to any musculoskeletal issue. It should be combined with other treatments including active therapeutic exercises and manual therapy. When we work with clients that we believe have issues with motor control, we focus on performing slow purposeful movements. It’s like taking baby steps and learning how to walk, or move your shoulder, properly again. Purposeful thoughtful movement allows the nervous system to begin communicating with the muscles more efficiently. Overtime, this will begin to improve motor control and break the pain cycle above.

Unfortunately, without a specific injury or examination, we cannot go into much more detail than that in terms of treatment. Please reach out if you have any questions on this topic and check out our instagram and facebook for some motor control exercises you may be able to do if you are experiencing pain.

Bryan Esherick PT, DPT

bryan@balancechiropracticva.com

Motor Control

Fri, 10 Jan 2020 13:24:00 GMT

Motor control: What is it and how does it affect you?

Aching shoulder or neck? Feeling a catch when you move that causes pain? Motor control issues may be affecting how you are moving without you even knowing it. It can affect people of all ages and can affect many different parts of the body from head to toes.

I want to preface this blog with the comment that there is no one right or wrong way to move! Generally, movement variability is necessary to maintain a healthy movement system. Motor control is a buzzword that gets thrown around a lot by movement professionals today. It describes how the body, through a complex link between the nervous system and muscles, is able to control movement through a range. Motor control is not how accurately a movement, like a squat, deadlift, or lifting a box is performed.

All the movements that we perform throughout the day require fine tuning by the nervous system. For example, as you raise your arm, for every 1 degree of arm movement your shoulder blade needs to rotate 2 degrees as well as tilt forward and move away from your rib cage. In addition to this your rotator cuff needs to contract just enough to keep your shoulder in its socket. You can imagine that to control this small amount of movement, there needs to be a constant feedback loop supplying the brain with a barrage of information.This is just one example of how amazing and precise our movement has to be to create movement.

So how does this feedback loop work? Your brain gets information via nerves carrying signals from proprioceptors and other specialized sensors hidden throughout different tissues. These cells are specialized receptors found in muscles, tendons, ligaments, and even the joint capsule. They generate and relay information about stretch, tension, muscle activation, joint angle and positions to give your brain a representation of what the body looks like in space. The brain then uses this information to finetune and adjust movements as needed.

Now that you know a little more about what motor control is and how it may be affecting you, you may be wondering how to spot it and what you can do to fix it. Stay tuned for the second part of the blog which will be posted in mid-January 2020.

Bryan Esherick PT, DPT

Hip Pain – Part 2

Fri, 13 Dec 2019 04:19:00 GMT

Did you catch our last blog? If so, you’ve probably got a pretty good idea about what FAI and labral tears are. Hopefully this will make it easier for you to talk to your physician and physical therapist about your healthcare. There’s a lot of options out there, but everyone involved – patients, surgeons, and rehab professionals alike – agrees that targeted sport-specific physical therapy is essential to a full recovery, with or without medical intervention.

“Calm stuff down, then build stuff back up”. This quote from Greg Lehman , a dual-doctorate physical therapist and chiropractor, basically sums up how a physical therapist works to help you get past your hip pain and back to your sport. First – and we know athletes in particular need to hear this – the rehab process generally needs to start with a de-load. Taking time away from the activities that aggravate your hip is necessary to allow the joint to calm down and get out of an inflammatory state. However, it’s important that you stay active in ways that don’t aggravate your hip to avoid weakness and deconditioning (and to keep you sane, of course). If you have pain with running, for instance, try swimming or cycling; If you’re struggling to play a full 90 minutes of soccer, try decreasing your time on the field or avoiding drills that you know will flare things up. The decrease in load through the joint will help it calm down. If your physical therapist is familiar with your sport, they can take a look at your training plan and/or talk with your coach to determine what might look like for you, and for how long.

A physical therapist can also help decrease joint irritation with manual therapy. Especially when FAI is at play and stiffness is present, a PT can use their hands to move the head of the femur away from the acetabulum, creating space within the joint. This allows fluid to pass through the joint more easily – carrying in nutrients and carrying out waste and inflammatory cells (movement does this too, hence staying active!). Painful joints can also cause muscles to tense up, so a physical therapist can help release and relax those muscles. On the other end of the spectrum, some labral tears occur due to too much motion of the joint versus an impingement. In these cases, joint mobilization is not a good idea, but soft tissue work can be great as the muscles around the joint tense up to protect it.

Manual therapy (and similar adjuncts like dry needling and cupping) feels good, but the secret sauce of physical therapy is targeted strength training. This is how we “build stuff up”. Pain tends to shut down muscle function around the joint. This is your body’s way of protecting yourself (“it hurts, so don’t move!”). Strength training can get those muscles activated again, and research shows that strength training can actually help control pain. Your PT should be working one-on-one with you to find exercises that feel good, and don’t aggravate your symptoms.

If you are struggling with hip pain that’s significantly impacting your ability to train and compete, contact our sports specialist, Dr. Kate. She’s been through this too, and is here to help!

You can email Kate with any questions or comments: kate@balancechiropracticva.com

Hip Pain

Wed, 04 Dec 2019 18:21:00 GMT

Like other parts of the body, pain at the front of your hip can mean a lot of different things. For runners and soccer players especially, repetitive impact activity can lead to a stress fracture of the femoral neck or shaft – which presents as pain at the anterior hip with running, walking, and jumping. Soccer and hockey players are also susceptible to groin strains, or pubic bone pathology due to the strain on the inner thigh during that sport. A diagnosis that’s common among all of these sports, and many more, is femoroacetabular impingement (FAI) and labral pathology.

The hip is a ball and socket joint, formed by the acetabulum – the “socket” – on the pelvis -and the head of the femur, on your thigh bone. The joint is surrounded by a rim of cartilage called the labrum (heard this term before? There’s one on your shoulder joint too!), which helps the joint absorb shock and also deepens the socket, creating more stability through the joint.

FAI can occur without labral pathology, and labral pathology can also occur without FAI; but, frequently, they do occur together. Labral tears can cause a significant amount of pain, however it must be said that just because a tear is seen on imaging does NOT mean this is the source of pain. There have been several studies showing that when imaging the hips of young, active individuals who don’t have hip pain, up to 70% of them have labral tears.

SO…you’ve been diagnosed with FAI and/or a labral tear. Now what?

Luckily, there has been an explosion of medical interventions for hip pain, as well as significant improvement in the way rehab professionals treat.

Injection Therapies: An orthopedic surgeon may choose to inject the joint with a corticosteroid to decrease any inflammation in the joint. Alternatively, some surgeons can do “regenerative injections” – either Platelet-Rich Plasma (PRP) or bone marrow aspirate concentration (BMAC), both of which serve to stimulate healing of the labrum and cartilage.

Surgical Interventions: There are several arthroscopic surgical techniques that can be used to correct FAI and repair labral tears. For FAI, the surgeon may perform an osteoplasty – essentially shaving down the bony outgrowths so that the joint surfaces can roll and glide on each other smoothly. Surgeons can also use sutures or anchors to secure torn portions of the labrum back to the acetabulum; this can significantly decrease painful clicking and catching. In more involved cases, the surgeon can also take cadaver tissue and create a brand new labrum for the patient.

It is important to note that these medical interventions, advanced as they are, do not guarantee pain relief. Surgery in particular CAN be extremely helpful, and as such it is still considered the gold standard treatment – but like we talked about earlier – pathology does not always equal pain. Therefore “fixing” or eliminating the pathology does not guarantee elimination of pain. Surgery should be considered a last result option, if injection therapy and high-quality sports rehab do not help.

Arthritis: Take back your life

Sun, 03 Nov 2019 20:57:00 GMT

What is it exactly, and how can you get back to the things you love? Unfortunately, we hear the phrases above far too often. If you have arthritis and have had an x-ray to confirm your diagnosis, you’ve likely heard one or two of these troubling phrases. The truth is, sometimes these are a poor choice of words. I hope aim to provide you with some peace of mind, by explaining what arthritis is, the reasons why it develops, and what you can do about it.

What is Osteoarthritis?

Osteoarthritis (OA) is a condition that has been affecting an increasing amount of the aging population. It typically affects the larger, weight bearing joints in the body, but can also be found within the smaller joints of the hands, feet, wrists, etc. Development occurs when the cartilage begins to wear down over time. This can lead to increased loading of bony tissue, poor movement mechanics, or even the growth of new bony tissue usually called bone spurs.

Since arthritis usually becomes painful, it is typically associated with a decrease in activity level. This decrease, which I’m sure most of you can attest to, is out of fear of making things worse due to something a doctor or friend has told you. Interestingly enough, reductions in activity can actually increase symptoms, pain, and progression of the disease. Although it is counter-intuitive, it’s true!

Whats the deal with my cartilage?

Cartilage helps our joints absorb forces and move smoothly. Did you know that the cartilage in your joints is actually 10x’s more slippery than ice?! This is what allows our joints to flex and extend without much effort. So, whats the number one thing you can do to keep your cartilage healthy? Move! Every tissue in our body is highly specialized and needs certain stimuli to thrive and survive, and cartilage is no exception.

Lets think about the knee for example: Compression and sliding of the joint surfaces create a sponge-like mechanism for the cartilage. When compressed, metabolites are squeezed out and when relaxed the cartilage expands again taking in nutrients. It’s just like a living breathing tissue! When activity is stopped or avoided, this process no longer occurs which can exacerbate the degenerative process leading to worsening arthritis. So what can movement do for your cartilage?

Why else should you exercise for arthritis?

Just like cartilage, muscles are important for protecting joints as well. They function to not only help us move and stabilize our joints, but also to help dissipate forces going to the joints. Without adequate strength, these forces need to be absorbed by other structures (think cartilage in our joints). This is another reason why avoiding activity with arthritis can actually make the pathology worse.

That said, there are some ways to begin activity to help set you up for success:

You should always discuss your options and activities with your healthcare provider before starting any new regimen or treatment. If your skeptical, we challenge you to try increasing your activity slowly, stick with it for one month, and see how you feel. I’m willing to bet you may find you have less pain.

If your not sure where to start, feel free to call to book and appointment or reach out to me at Bryan@balancechiropracticva.com to get started!

Here’s a great article that discusses the benefits of exercise for OA and may be a good reference for where to start. I promise it is an easy read!

Chronic Back Pain

Sun, 06 Oct 2019 21:47:00 GMT

Chronic back pain is caused by a number of different contributors, and is defined as back pain that lasts longer than three months or that occurs episodically. It can affect people of all walks of life, regardless of age or physical condition.

The good news is that backs are just like any other body part, and the will heal.

We do have a good understanding of some common causes of chronic back pain as well as an understanding of how pain can manifest itself. Many people experience going to bed feeling fine and waking up with significant back pain. This can be caused by swelling of a disc as it re-hydrates during the night. Another common trigger is doing something simple like reaching for the milk carton and the back suddenly spasms. This is the result of poor motor control and the spasm is a protective mechanism. Sometimes it is more obvious and we experience pain during an effort of some kind like sneezing or lifting something heavy. However focusing only on the possibility of what has been “damaged” can lead us into unnecessary imaging, inappropriate treatments and much higher healthcare costs while still not solving the underlying problem.

Pain is defined as an unpleasant physical and emotional sensation that we experience when injured OR when there is a threat of injury and no actual tissue damage present.

It is a protective mechanism our brain uses to keep us from getting hurt. It has biological components, psychological components and sociological components. Unfortunately, we can get stuck in a loop where we get very good at experiencing pain and our brain tells us our back is hurting even when nothing has been done to injure it. This short video does an excellent job of explaining further.

If you experience this, here are some things to consider.

If your chronic back pain is constant and not episodic, then a multi-modal approach is best, especially if it hasn’t responded well to individual treatments. There is excellent evidence for a multidisciplinary approach as well as solid evidence for exercise therapy and spinal manipulation. You can read the full guidelines from the American Academy of Family Physicians here .

You should have a team that includes a pain management physician, a chiropractor or physical therapist and a mental health therapist that work with you to help with your symptoms. A psychologist trained in Cognitive Behavioral Therapy can be very helpful in these situations. If you’re having chronic back pain and have questions, please feel free to email me at sam@balancechiropracticva.com

Samuel S. Spillman, DC

Sleep: It Does a Body Good

Mon, 08 Jul 2019 04:15:00 GMT

If you have trouble sleeping here are some tips to help you get those all important ZZZZZsss. Improving your sleep hygiene will improve your life!

Try these tips and see if your sleep doesn’t improve over the next week or two. Let us know your results!

Exercise Is For Everyone

Mon, 17 Jun 2019 03:37:00 GMT

Exercise. Some of us love it, some of us don’t. But we all need it. Truth. It was part of daily life for previous generations before technology stepped up and made simple functions far easier. So, now we need to be more intentional about getting our bodies movie for good mental and physical health.

We believe movement is medicine. That’s why we focus on it with our patients. Research tells us it’s good for your heart, brain, and body . It can boost your immune system, balance your emotions, increase your productivity, and helps you maintain a healthy sleep schedule. Exercise brings all of this good for you, but also takes time and many of us find precious time in short supply these days.

So, here are a few of my top tips to help you get your exercise on!

Walk – Take the stairs and park at farthest from entrances. Those extra few minutes of walking will really add up by the end of the week. This is a kind of exercise snacking (see below).

Have a “snack” – R esearch suggests that even very brief bouts of activity can accumulate to meaningful benefits. The New York Times shares ways you can fit these “snacks” into your daily routine.

Chores – Doing chores like vacuuming and scrubbing the bathtub is great exercise. You can add mowing the lawn to that list as well. So combine those chores with exercise needs and burn 165-200 calories/hour – and you can swap out that yoga class.

Micro workouts – We’re huge fans of the NYT 7-Minute Workout . T his high intensity workout takes only a few minutes a day, and can be modified if the intensity is too challenging for your fitness level. We even gave it a try right here in our clinic !

Do something you like or find something new – I love jiujitsu and my love for it motivates me to exercise to keep up with my training partners. There are so many activities that speak to a number of different personalities and interest – martial arts, tennis, basketball, salsa, rollerblading, yoga, hiking, climbing, you name it. If you enjoy doing it, you’re more likely to make time doing. We’ve pulled some local resources together to help you find your groove.

Workout with a friend – It’s a great way to catch up on the latest, and get some good emotional well-being at the same time. Exercise partners help keep us honest with our commitment, and can make that accountability a little more fun at the same time.

Staying in good health is important for physical and mental. So make exercise a priority, because there is no better medicine for life!

Sam Spillman, DC

Frozen Shoulder: The Culprit Causing Your Shoulder Pain

Sat, 08 Jun 2019 15:56:00 GMT

Frozen Shoulder is real, and doesn’t only occur in the winter! Generally the condition doesn’t have a definite start point, ie. patients often can’t think of an injury that started the pain. Some warning signs to look for include pain and a loss of motion in multiple directions.

Medically termed adhesive capsulitis, frozen shoulder is a condition that affects the capsule surrounding the shoulder joint. The capsule is a sheath of tissue that maintains fluid within the joint and maintains pressure, ensuring relative stability. Inflammation causes the capsule to become more fibrous and thicken. This causes limitations in range of motion and pain. If your shoulder is feeling stiff and painful, with loss of motion in multiple directions, you may be facing frozen shoulder. Identifying it early is the best

way to help effective progress.

Who gets it?

Although anyone can get this condition for a variety of different reasons, there are a few predisposing factors:

There are 3 overlapping stages of the condition called the freezing; frozen; and thawing phases. Each stage has certain treatments that may be beneficial to help speed recovery, which will be discussed below.

Recovery from the condition generally takes anywhere from 6 months to 2 years, and has the following stages and interventions that can help at each stage:

The Start (months 0-3)

What to expect:

In this stage, you should see a physical therapist for a few visits to learn exercises to maintain range and slow the loss of motion. You will also be educated on the condition and general progression through the stages.

A few tips:

Freezing (months 3-9)

What to expect:

Physical therapy continues to be beneficial in this stage to maintain ROM and function. PT interventions will be tuned to the amount of ti ssue irritability the patient is experiencing.

A few tips:

Frozen (months 9-15)

What to expect:

You will likely be working with a home program for care at this point. Let your PT know if you have any changes that you have questions during this stage.

A few tips:

Thawing (months 15-24)

What to expect:

The shoulder will begin During this stage you should begin appointments with your PT for more intensive stretching and manual therapy. Functional strengthening exercises will be used to begin returning the shoulder to normal.

A few tips:

Treatment of frozen shoulder can be long and arduous, but arming yourself with information can be one of the most effective tools. Make an appointment with your physical therapist or chiropractor to learn more about the condition and how you can manage it effectively. Remember, early intervention and education is essential for recovery.

Bryan Esherick PT, DPT Have questions? Email me at bryan@balancechiropracticva.com

Information adapted from the clinical practice guidelines Shoulder Pain and Mobility Deficits: Adhesive Capsulitis from the JOSPT.

Headaches: Cause and Relief

Wed, 08 May 2019 18:17:00 GMT

The majority of primary headaches are associated with muscle tension in the neck. Today, Americans engage in more sedentary activities than in the past, and more hours are spent in one fixed position or posture (such as sitting in front of a computer). This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.

What Can You Do to Prevent?

The American Chiropractic Association (ACA) offers the following suggestions to prevent headaches:

(1) Bryans R, Descarreaux M, Duranleau M, et al. Evidence based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34: 274-89.

CBD Oil: Newest Tool for Chronic Pain

Sun, 07 Apr 2019 19:07:00 GMT

CBD oil is gaining in popularity and is showing up everywhere – across the web and on store shelves everywhere. But, many of us are just hearing about it and have some questions – so let’s take a closer look.

CBD stands for cannabidiol – and it is a compound found in both cannabis and cannabis sativa (better known as hemp).

While both plants have hundreds of compounds that may be pharmacologically active, the best known is THC, which has a psychoactive component. However, both plants also contain CBD which also has pharmacological effects but NO psychoactive component. The CBD products at health food stores, grocery stores, and doctor’s offices are sourced from hemp and have no psychoactive properties.

OK, but why is it suddenly all over the place?

There are a number of reasons. It has been found to help with certain seizure disorders and recently the Virginia board of medicine has added it to the legal formula and it can now be prescribed for this purpose. But it is also available over the counter. The recent Farm Bill in 2018 among other things, designated CBD products to be “generally recognized as safe” or GRAS, which means it can be added to food stuffs and sold. For the time being the FDA and DEA have not taken any steps to change that, although they could at any time. Common side effects may include tiredness, diarrhea and changes of appetite/weight.

What can CBD oil do and why would anyone take it? Well in addition to the above mentioned anti seizure properties, there is some limited research that suggests that CBD oil can help people with chronic pain, as well as with sleep, and anxiety. Now the research is far from conclusive and there are many more double blind random control trials that need to be performed before the science and medical communities are going to get behind this being a new cure-all. However, as it has been generally recognized as safe and there are anecdotal reports popping up everywhere with people touting its benefits, people are flocking in droves to try it. We began carrying these products after a few patients requested them and they’ve proven to be very popular with patients for pain relief.

Samuel S. Spillman, DC

Ankle Sprain: Is Status Quo Enough?

Thu, 04 Apr 2019 02:46:00 GMT

Ankle sprains affect people young and old, in any population, and whether athletic or not. It may happen while playing – or cutting – during a sporting event; when walking on uneven ground or into a small hole in the yard; or you might miss-step off of a sidewalk. Sprains generally affect the outside of the ankle when the ankle rolls, making the anterior talofibular ligament (ATFL) the most commonly injured tendon – which attaches from your outside ankle bone to a bone in your foot.

Once an ankle sprain occurs, there is tissue damage. This can range from a few fibers tearing – causing minor discomfort for a day or two – to a full-blown tear. Unfortunately, with status quo treatments re-sprains are far too common.

We have sensors in all of the muscles, tendons, ligaments – and even in the joint capsules surrounding the joints. Sensors provide our brain with important information about stretch, muscle activation, and joint position. This information allows the brain to form an internal picture of how the joint is doing at that moment. When the initial injury occurs, these sensors get disrupted and stop working properly. When this happens, the brain is unable to create an accurate picture of how the joint is functioning. This altered picture causes the ankle to be less responsive to demands put onto it, preventing your brain to effectively stabilize the ankle. As a result, something simple you may have done thousands of times – like jumping and landing on a volleyball court – may be the cause re-injury. Minor re-sprains can also happen without you knowing. These small injuries usually occur with simple activities like walking in grass. Unfortunately, these minor injuries will continue the cycle of chronic ankle sprains and may delay healing.

So, bracing and rest may not always be the best treatment for ankle sprains.

Of course they have their place with more severe sprains. However, in the case of minor to moderate sprains, braces can actually decrease proprioception and strength, making the ankle more prone to even more sprains! Physical therapy – to build up strength – is often the best treatment for a patient with this condition.

Physical therapy in ankle sprains will help guide you through progressive exercises that will improve ankle muscle strength as well as retrain the joint sensors to perform their job properly. Treatments generally consist of balance and proprioceptive drills on a variety of surfaces and with targeted strengthening exercises. Treatments should be tuned to specific tasks that will be encountered often whether in sports (cutting) or in daily life (walking on uneven surfaces). This is the best route to train the ankle to react to different challenges and prevent chronic sprains.

Bryan Esherick PT, DPT

Spring Training and Reducing Risk of Injury

Sat, 16 Mar 2019 15:29:00 GMT

Increased activity can bring injury – and while there is no such thing as injury “prevention”, there are measures you can take to reduce your risk of injury. Reducing risk is mostly about planning and timing. You want to give your body ample time to adapt. Your risk of injury goes up when you make sudden large changes in activity or load over a short period of time.

C heck out these tips to help you enjoy and injury-free season:

If you liked this, please feel free to share it. If you’ve got any questions about your spring training plan, feel free to ask questions: sam@balancechiropracticva.com

Samuel S. Spillman, DC

Age is just a Number

Tue, 12 Mar 2019 22:58:39 GMT

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Just because you are 60+, it doesn’t mean you should be suffering from chronic pain. Targeted exercises can relieve you of pain and enable to lead an active life. This can slow the aging process and help relieve other signs of aging.

Treating Injuries with Tape

Tue, 12 Mar 2019 22:56:39 GMT

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Kinesiology tape, also known as kinesio tape, is a stretchy, elastic tape that is almost identical to human skin. It can help you treat a wide range of sports injuries and control inflammatory conditions.

Physio during Pregnancy

Tue, 12 Mar 2019 22:53:36 GMT

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Your pregnant body goes through a lot of changes in a short period of time. Physiotherapy can help you with a thorough assessment of your posture, pelvis, pelvic floor and abdominals, and give you pointers on how to get feel like yourself again.

Treating Swimmers

Tue, 12 Mar 2019 22:51:54 GMT

Blog posts are a great way to get recognized within your community and share your voice. Here are the top 10 reasons you should love writing blog posts.

While swimming remains one of the most injury-free sports around, swimming injuries do happen, due to repetition and other factors. Treating injuries early, before they become serious, is critical for ensuring that you can continue doing the sport you love.

Patellar Tendinopathy: Not All Tendons are Created Equal

Mon, 04 Mar 2019 01:30:00 GMT

What is Patellar Tendinopathy

Diagnosis of Patellar Tendinopathy

Functional movements that usually become painful with patellar tendinopathy:

Other hallmark signs of the condition:

Real Life How it Happens

So let’s break that story down and see how training may have overloaded the tendon before it was able to adapt:

Wrap-Up

Treatment

Bryan Esherick PT, DPT

Cardio Health for a Longer Life

Sun, 24 Feb 2019 15:01:00 GMT

As heart health awareness month comes to an end, we want to highlight the wonders of cardiovascular exercise – help clarify exactly what it is – and remind you to keep your heart healthy all year long.

Cardiovascular exercise – or cardio – is defined as any activity that gets your heart rate up. Now, that’s a pretty wide definition which is great because that means you can choose from a ton of different activities – some that you might enjoy more than others, and that means you’ll be more apt to get your body moving more. You could choose anything from: running; dancing; using the elliptical; rock climbing; swinging a kettlebell; playing tennis, basketball, soccer, football; practicing martial arts; taking classes like zumba, kickboxing, or jazzercise… and the list goes on and on – even sex can count! The idea is to choose activities you enjoy, and shift your mind from thinking it needs to be something you don’t like doing.

The benefits are cardio are huge. Most people immediately associate cardio as a weight loss tool, and it’s true that it is a big benefit. But there are so many other wonderful benefits to highlight as well.

Here is a list of health benefits you may have not have associated with cardio:

There is also some evidence to suggest that regular exercise effectively slows how quickly our bodies age by helping to repair the little proteins at the end of our DNA strands – called telomeres – which can help to keep us younger and fitter longer. Perhaps we have found the Fountain of Youth after-all!

–Sam Spillman, DC

Tennis Elbow: What You Need to Know

Sat, 16 Feb 2019 22:00:00 GMT

If you’ve ever noticed an ache around the outside of your elbow that just doesn’t seem to go away, you might be experiencing a condition commonly known as tennis elbow. Once it starts, this type of injury can affect your strength and function in your arm. So, if you’re feeling that ache and haven’t done anything about it, now might be the time.

It’s most common in sports and occupations that require repetitive movements – think computer work, climbing, heavy labor jobs, etc. Tennis elbow is a form of a tendinopathy – affecting the tendons of the forearm muscles – classically called tendonitis. The tendons undergo a degenerative process as a result of highly repetitive stresses. This process causes: increased blood to flow to the area; collagen creating cells; and ground substance. This cascade of changes can lead to pain and discomfort in the area – as well as poorly formed tendon structure which is then vulnerable to further injury.

Due to the nature of the injury, and the general inability to stop activities that aggravate the condition, it can take from a few months to up to two years for the tendon to fully recover and for pain to subside. It is possible for the condition to subside on its own, but there are steps you can take to decrease the duration of the symptoms.

Treatments for this condition vary greatly from surgery at the most extreme end, and to wait-and-see on the other, with everything in between. At Balanced we focus on rehabilitating the tendon through gradual loading of the tissue to reorganize collagen; and soft tissue work to relax overactive muscles; and education to empower our patients to heal quicker. We generally recommend avoiding bracing, cortisone shots, and surgery. By optimizing the environment for the tissue to heal, our patients often obtain quicker results and are able to return to normal activity and reach their goals within a more predictable time frame.

Bryan Esherick PT,DPT

Recipe for Love

Mon, 11 Feb 2019 01:12:00 GMT

A good recipe can help you cook your way to one’s heart. Someone also once told me that the key to a happy life, is a happy wife. So, for this Valentine’s Day, I decided to put the two together and share this idea for your special holiday planning this week. h/t to Mark Bittman of the NYT for this inspired meal.

This is a great recipe for someone who is not an experienced hand in the kitchen. It’s amazing, and tastes like the most complicated and delicate dish ever prepared. But, as it turns out, is really easy!

Miso Cod

Pair it with some miso soup (also easy to make):

I’d consider a simple tossed salad with Japanese style ginger dressing.

Lastly no Japanese meal is complete without a bowl of steamed rice! Any Japanese short grain will do, I usually choose Calrose.

Finish it off with chocolate covered strawberries, with fresh ganache:

*If you don’t mind a little corn syrup you could add a splash to the chocolate mixture (just a splash) and it will give the ganache a nice shine. But this is optional. Make as many as you’ll think you’ll eat.

Voila – simple to make, decadent and romantic Valentine’s dinner!

– Sam Spillman, DC

Skiing: How to Prepare and Avoid Injury

Sat, 19 Jan 2019 17:13:00 GMT

The knee joint is the most vulnerable and most common snow sport related injury. The good news is there are steps you can take to condition and prepare your body for winter sports such as skiing.

Things to do in preparation for your ski trip:

Preventing Injury on the slopes:

The following are exercises should be preformed several weeks before you plan to ski. All of the exercises should be attempted for 1 minute and increase the time as you improve.

Balance

Standing on one leg reach the other leg toward an imaginary clock face. Repeat on other side.

Lateral Jumps

With both feet close together bend your knees and jump side to side while maintaining a straight spine and a flat back as well as even weight in both feet.

Rotational Jumps

Start from a squat position with feet close together jump from diagonal to diagonal landing on the balls of the feet.

Side to side skaters

Stand on one leg and take a large step to the with the other leg and then take another large step back to where you were. Make sure your pelvis stays level and your knee does not buckle inward.

Check out the full video for these fun and helpful exercises!

Rotator Cuff: Repairs and Road to Recovery

Tue, 15 Jan 2019 03:41:00 GMT

The cuff’s main purpose is to improve shoulder stability by actively pulling the arm bone into the shoulder socket with arm motion. It does this through a concert of contractions of the 4 muscles that make up the structure. Each muscle works intricately with the other to provide the most stability possible: Even when one muscle is not working properly, it can lead to issues. Without the rotator cuff, the shoulder generally becomes unstable which can lead to further tearing or other injuries affecting the shoulder joint.

Tears are fairly common and can affect people of all ages. They occur most commonly in patients in their 50’s and above, likely due to tissue deconditioning and other age related changes. Tears also occur frequently in overhead throwing athletes. Cuff injuries generally occur gradually over a period of time where symptoms begin to evolve and worsen. Warning signs of tears include deep, dull shoulder pain, trouble sleeping, and an inability to move the shoulder through its full range of motion. Labral tears and biceps tendinopathy are common concurrent injuries that may also be addressed.

Surgery vs. conservative management will generally be decided on a case by case basis and based on failure to conservative treatment, imaging results, signs and symptoms, and quality of life reported by the patient.

Here is what to expect when surgical repair is indicated.

Day 1- week 2: Surgery is generally performed at an outpatient surgical center. Most repairs are done arthroscopically meaning a small camera will be inserted with tools on the end to complete the repair. A local nerve block as well as general anesthesia is used during the procedure so you will be asleep the entire time. The nerve block will also help to ease pain for the hours following surgery and likely into the next day. This usually only requires 2-3 small incisions in your skin. You will return home the same day following the surgery. Pain killers are generally prescribed to help ease pain, and they should be taken to make you more comfortable.

The next 2 weeks are used to allow the repair to heal properly and is the maximal protection phase. During this time your arm will be in a sling and you will likely sleep in a recliner to protect the repair. Moderate pain is a normal experience during this time so be sure to ice and take any medication as prescribed.

Week 2-4 Post-op: This is generally when physical therapy is initiated, but some surgeons will wait for 6 weeks before therapy is initiated. During this period in therapy, the therapist will move your arm for you to begin regaining normal motion. You will also begin working on activating the muscles around your shoulder blades. Gentle activation of your shoulder muscles will also start.

Weeks 5-10 Post-op: The goal of this phase is to obtain good range of motion and to be able to stabilize your shoulder throughout the range with your muscles. Range motion will continue to be progressed and active motion will be progressed gradually within relatively pain-free ranges to hopefully reach full range by week 7-8. Range of motion progresses differently in different patients so don’t be discouraged if it takes longer than normal. Strengthening exercises will also progress gradually to gain strength for normal activities.

Weeks 10-20 Post-op: The goal of this phase is to continue progressing strength and stability to prepare your shoulder for return to all prior activities. You will also be expected to become more independent with exercises. Challenging functional movements will be performed later in this stage. Complex movements like throwing will be broken down into parts to practice before performing the actual movement to ensure proper shoulder function. You will likely be weaned from PT and may be discharged to continue with comprehensive home program to continue toward the end of this period. Athletes that need more intense treatment will continue with therapy into the return to sport phase.

Be sure not to perform activities that are too taxing for your shoulder at this point. Your shoulder will be feeling much better, which makes this a common time for re-injury to occur. Although your shoulder is feeling better, that does not mean it is fully healed and ready for full return to all of your normal activities.

Weeks 20+: Typically the safe return to sport phase. You will progress back into your sport or other activities. Continue with your home exercises to continue building strength and stability throughout your shoulder complex.

You can expect to be checking in with your surgeon throughout this process to insure that everything is going as planned. Your therapist should be in contact with the surgeon throughout the process to ensure you are progressing as expected as well.

I hope this blog can ease any anxiety about your upcoming procedure and give you a brief guide for what to expect following a RTC repair. Surgery can be intimidating, but the more you know going into it, the better the outcomes!

We will be following one of our patients through rehab and will post exercise videos and updates throughout his recovery. Be sure to check them out!

Bryan Esherick, DPT

New Year, New Resolution

Sat, 29 Dec 2018 16:30:00 GMT

It is that time of year again, the birth of a new year and maybe a new you. Are you making any New Year’s Resolutions? In the fitness and health care communities we tend to focus a lot on losing weight, diet, starting an exercise program. And all those are wonderful things. But I think it is important to focus on what will make your life better. What kind of resolutions will improve YOUR life. Not necessarily what your healthcare provider would choose for you, or your spouse, or your parents. We might want to swear less, or improve a relationship with a loved one, visit family more, get a promotion at work, get more involved with charity, and so on.

Whether you are trying to resist something that is bad for you or start a new thing that is good for you, making a change can be difficult.

I like to start with the end result and work my way backward. For each goal, I like to make it SMART: Specific, Measurable, Attainable, Realistic and Timely. This is a commonly used business idea, but it can be applied to personal goals too. To me, using this method can help really set ourselves up for success.

For me, less screen time in the year ahead is a big goal. You may have noticed that it is more difficult to NOT do something than it is to add a new activity. So instead of setting a screen time limit for myself, I’m endeavoring to fill up my time with other things, so that screen time is less of an option outside of work. I’m making a list of books I’d like to read, and a commitment to do more activities after work. I’ve joined a committee of a local charity and I’m going to attend one evening jujitsu class a week.

So as you make your New Year’s Resolutions, try to spend time planning out how you might achieve your goals, as well as determining what goals to set.

You’ve got this. Happy New Year!

—
Sam Spillman, DC

Health Insurance Coverage Explained

Tue, 04 Dec 2018 03:07:00 GMT

Co-insurance

A coinsurance occurs when there is cost-sharing between the insurance company and the covered member/family. The insurance company may tell you that your responsibility is a 20% co-insurance and that they will cover the rest of the charges (remaining 80%). Quite often a coinsurance comes in to play after an individual or family deductible has been reached.

Example: Your opthamologist visit is $400 and Optima informs you that you have a 20% coinsurance after meeting your $200 deductible. Currently, you have met $0 of your deductible. Your responsibility would be: $200 of the deductible and then 20% of the remaining $200 specialist visit charge = $40.00. The total you can expect to pay for the visit is around $240.

This can vary visit to visit depending on the types of services and procedures your healthcare provider performs (even when it may seem routine to you).

Co-pay

A copay is a set fee that you are responsible for each time you visit a doctor. There are usually tiers or copays where a primary care doctor is typically less than the copay you may have for a specialist. Some plans have a copay due in addition to a co-insurance.

Deductible

The set amount an individual or family must reach before transferring over to coinsurance coverage for medical services. Some plans have relatively low individual and family deductibles of $200 – $500 while other plans have larger $5000 – $9500 deductibles. Once you have met your deductible you may only be responsible for a fraction of the percentage of your medical care, referred to as a co-insurance. However, even if you have a deductible, your insurance company has likely provided you with a negotiated discount on services. In-network providers have agreed to discounted rates (although these are different for every insurance company).

Out of pocket maximum or stop loss

This is the absolute maximum a covered member or family will pay out of pocket for medical care including copays, deductibles, and co-insurance for a defined period of coverage (usually a calendar or a contract year)

Giving Thanks for Balance

Wed, 21 Nov 2018 19:10:00 GMT

Schedules

For me, as an introvert, I’ve learned it is really important not to over schedule myself. If I do, it can really wear me out. So I keep track of my schedule in a calendar, and when I consider any invitation I look at the time slot and see what’s around it. If attending the event doesn’t leave me any recharge time, or there’s too much travel time, or if it means I’ll miss too much of my exercise plans, it’s likely a pass for me. Of course for those with children, schedules can be more complicated. You just have to keep your mind on the balance.

Food

Another consideration around the holidays is food. I love food. You can often hear me talking about cooking, restaurants, and value-driven ingredients. To balance food around this time of year, I try to keep lunch light and very healthy – especially if I have plans for dinner or a party later. Then there are the oh-so-tempting sweets that pop up everywhere during the season. So, I eat a healthy snack before I head out since counting calories doesn’t work for me. When I am trying to relax and enjoy a party the last thing I want to think about is how healthy the food is I am eating. Filling up a little on healthier foods before I go can also help ease the guilt along with the managing how much I eat. I gain weight easily if I’m not careful, so I tend to stick with my plans.

Exercise

I’m a big proponent of exercise, as many of my colleagues in the healthcare field are. If you’re trying to keep from gaining weight, or if you’re trying to lose weight during the holiday season, you’ve got to pay attention to your diet the most. However, exercising during the holidays will also help keep your weight in check as well as help to alleviate stress and keep you in a better mood overall. Of course, if you’re on a set plan for a competition, stick with your plan. If you’re like most people, you exercise more because you should and less because you love it – or perhaps you don’t exercise at all. Time is a big factor for those who don’t, but it doesn’t need to be all or nothing. The key thing is to keep your body moving. If during the holidays, you drop from four days a week to three, that’s a good trade-off. Another way to make the most of your time is to consider high-intensity interval training to make your exercise shorter but more intense. You’ll still build muscle, improve your cardiovascular function, and get all those wonderful stress relieving chemicals – going hard for 10-15 minutes can be as useful as an hour of moderate exercise on the bike or a long walk.

So, take these tips and find your balance this holiday season:

Sam Spillman, DC

A Balancing Act: How Does Balance Work?

Sun, 11 Nov 2018 01:57:00 GMT

Somatosensation

This is the feeling that we have in our feet, and is sometimes intertwined with proprioception. Somatosensation and proprioception are defined as how the sensors within the skin on our feet, joints, muscles and tendons sense where we are in space. These sensors constantly give feedback to different parts of the brain and brain-stem to correct movement, and ensure that the proper muscles are contracting to stabilize and move our body. This system can be disrupted by nerve damage (often called peripheral neuropathy), which often occurs with diabetes and some artery diseases. It can also be disrupted by pain, which is why anyone who has had an ankle sprain will tell you that they sprain the ankle over and over after the first injury. This is because the system is disrupted in the presence of pain so the ability of the ankle muscles to contract and prevent further sprains is impaired. When this system is disrupted due to lack of sensation or pain, the body relies on the other two systems below.

Vision

Simply put, vision gives us our picture of the world and integrates with the other systems to adjust muscle activity and movement to match what we see. We rely most of our vision during balance.

Vestibular function

The vestibular system is an integral part to the balance system. It activates postural muscles throughout the day and also helps us move our eyes independent of head movement. This allows us to focus on one thing while there may be a lot of other things going on around us – think about reading a street sign while driving on the highway, for example. If both of your vestibular systems were non-functioning (you have two, one in each ear), the horizon would bounce up and down instead of being still when walking. Mismatches in information within this system is usually what causes motion sickness. The reason people get nauseous with motion sickness is that the brain has trouble with deciding which input to use – vestibular, somatosensory, or vision. Nausea is your brain’s way of saying: we need to sit down and take a break so I can figure this out . When this system is not functioning correctly, patients generally experience dizziness – defined as feeling off, light-headed, or spacey – and vertigo, which gives the sensation that the world is spinning around you. This system is most important for balance at night when vision can be eliminated.

Balance may not be as straightforward as it seems. It requires a lot of input and processing within our nervous system to work well. The good news is that our balance system can adapt to use one part of the system more than the other through training and practice. The bad news is that as we age, we generally lose sensation in our feet and vision leading to increased risks for falls.

We can help you find your balance before issues develop. Give us a call for your balance screening today!

Bryan Esherick, DPT

Preventing Inflammation Naturally

Thu, 20 Sep 2018 02:20:00 GMT

Inflammation can strike at any time. Anti-inflammatory drugs can be helpful, especially for new injuries and certain inflammatory-based pathologies. However, our bodies experience new episodes of inflammation (both beneficial and detrimental) all the time. So, using natural remedies is a safer way to decrease those frequent bouts of non-beneficial inflammation.

Remember, your body is your greatest asset. Take good care of it, and it will take care of you for years to come!

Bryan Esherick PT, DPT

Treating Pain without a Pill

Sat, 08 Sep 2018 18:19:00 GMT

As physical therapists , chiropractors , and massage therapists , we look to provide that first-line treatment for acute and chronic injuries alike – including: manual therapy; joint mobilizations; massage and soft tissue release; targeted therapeutic exercise; and health education. Let’s take a closer look at these distinct areas.

Joint Manipulation and Mobilization

Manipulation and mobilization are used throughout musculoskeletal health by chiropractors, physical therapists, and some osteopathic doctors. Despite popular belief, the aim of these treatments is not to put a bone back in place. Treatments like this work with the nervous system to affect pain (through release of endorphins), muscle tension (through reduction in pain and thus reduction in spasm), and proprioception (your brain’s sense of your joint position). In my opinion, 95% of cases require exercise to reinforce the effects of the manipulation. In other words, mobilization and manipulation gives your body a window to exercise with less pain so that you can correct the issue at fault and increase muscle tone. However, it does not correct the underlying cause of the pain independently. These are powerful pain relieving tools that can be employed to aid in your recovery from pain, especially in the spine.

Massage

Generally massage is thought of as a relaxation and stress reducing technique, but it can also be used as a powerful pain relieving and recovery tool. Therapeutic and sports massage are given in order to improve recovery through reduction in muscle tone and improvement in blood flow . Relaxation in muscle tone allows the muscle to receive the adequate nutrition is desperately needs to heal. Think of a muscle as a sponge; when it is squeezed out (overactive) it is not able to receive the water (blood) it needs to function. We see this happen often in cases of back pain associated with sustained postures, and receiving occasional massages would help alleviate this chronic paid in a more effective and cost-effective treatment. Massage also releases endorphins through a healing touch and targeted techniques, which helps to ease pain and creates a relaxing therapeutic environment for the body to heal. Your chiropractor or physical therapist may also use targeted soft tissue techniques to promote healing and pain reduction.

Therapeutic Exercise

Therapeutic exercise is used widely by physical therapists and chiropractors as well. Movement encourages the body to release endorphins, reduce tissue tension through increased blood flow, promote healing through cellular processes, and prevent chronic pain from fear of movement. Exercise can be used as a means for tissue to adapt and heal to specific stresses it will encounter through daily activities. We use therapeutic exercise not only as a pain relieving mechanism, but also as a way to introduce stress to healing tissues in a controlled manner . If the tissue is not properly loaded over time, it can be substantially weaker than it was prior to the injury causing recurrent injuries. The best example of this phenomenon is chronic ankle sprains. Without proper rehabilitation, ankle sprains are likely to keep occurring as the body is unable to fully heal the tissue prior to sustaining a second, third, or fourth injury. Another common misconception is with arthritis. Many people stop moving because the arthritis is causing too much pain. On the contrary, our joints need to be loaded in order to provide nourishment to the joint surfaces. Without movement, joints can continue to degrade and become more painful. Remember, movement is your friend and is ultimately what will keep you feeling happy and healthy for years to come.

Education

Education about a particular condition should not be taken for granted. It is the responsibility of your healthcare provider to educate you on your conditions, the treatment options, and expected recovery prognosis. Please don’t hesitate to ask your provider questions – fully understanding your condition is a key element to complete recovery. Education about pain can also be invaluable for the patient, which is why our office strives to provide pain education to help contextualize thoughts and beliefs about pain. Sometimes education is the stepping stone to preventing a patient from progressing to a chronic state of pain. For this reason, our office doesn’t just treat your condition, we help you understand it.

As you can see, there are many alternative treatment options for pain relief – and with far fewer side effects – than prescription drugs. It is important when seeking care for pain, that you explore all options landing on an course of treatment. Second opinions can often be helpful when you are unsure if a certain treatment is right for you. Trying a more conservative option first may save you time and dangerous side-effects from other riskier alternatives.

Our office uses all of the above techniques , and when necessary, uses other techniques including modalities and dry needling. Our goal is to provide our patients with the most comprehensive, evidence-based treatments to ensure the fastest and most complete recovery path from injury. We ensure that each patient is treated individually, as every patient has different needs from the healthcare system. Still have questions? Give us a call to learn more. We’d love to help you become the strongest version of your best self!

Bryan Esherick PT, DPT

Five Tips for Easy and Healthy School Lunch

Sat, 25 Aug 2018 15:29:00 GMT

Healthy School Lunch

Don’t sacrifice healthy for easy. Try these quick lunch tips to help you save time during hectic schedules while packing all the nutrition your kids need. Good nutrition is important for growing minds and growing bodies. A good lunch can be a part of better athletic AND academic performance for your children. Cafeteria school lunches tend to be focused around limiting costs for the school and not necessarily the healthiest options for kids. But making lunch can be a time consuming part of the day, on top of being just one. more. thing.

Enjoy healthy and happy lunching!
~ Angie

If you have more questions about a healthy diet, please don’t hesitate to email me at sam@balancechiropracticva.com.

Concussions and a Safe Return to Sport

Thu, 16 Aug 2018 03:49:00 GMT

Concussions. They can have lasting effects later in adulthood, so prompt treatment is essential to mitigate long-term effects. While the end of summer draws near, and fall sports get underway at the start of a new school year, it’s important for parents, trainers, and coaches to remain vigilant in watching for signs and symptoms of concussion in young athletes.

One of the best things that you can do for your athlete as a parent or coach is to be sure that they have baseline testing consisting of physical, cognitive, and equilibrium tests prior to participation in practice and games. Should an injury occur, baseline testing allows the coach and trainer to know when it is safe to allow the athlete to return to sport after an injury has occurred. Also be sure that the testing for your athlete is comprehensive, and not performed only using the IMPACT computer-based test that doesn’t take into account the other functions of the body that may be impacted through concussion.

When seeking medical advice, remember that advice can come from a variety of medical practitioners including medical doctors, physical therapists, athletic trainers, etc. Medical examination usually consists of some tests and measures to determine the severity of the injury. Examination is necessary to rule out other serious pathologies, including a brain hemorrhage. Usual care for a concussion is a brief period of rest (1-3 days), followed by a graded return to sport and school, and then rest. Rest is essential for the brain to heal itself in the early stages, although activity should be resumed as quickly as possible while maintaining little to no symptoms. Physical therapists can help by determining a safe level of activity for the athlete and developing a sport specific training plan. Before your child returns to sport, ensure all testing compares to baseline, that physical activity has been progressed, and that your child is symptom-free with sport specific training.

By following these key steps after sustaining a concussion, your athlete can return to sport as quickly and safely as possible.

Note: This blog is not considered medical advice that should be used if you suspect a concussion in your child. If you believe your child may have suffered a concussion or would like to receive baseline testing, contact our clinic at 434-293-3800.

Sleep and School Performance Go Hand-in-Hand

Mon, 06 Aug 2018 02:21:00 GMT

Sleep is vital for so many functions and processes in the body: memory, cognitive function, blood pressure, hormone regulation (cortisol, insulin, leptin, grehlin, testosterone), healing, muscle recovery, immune system, etc., etc.,. And, it is especially important for children. Sleep deprivation can significantly impact a child’s performance in school.

So, how do you know if your child is getting enough rest? Here’s a good rule of thumb:

While these are good gauges to check patters in your household, that’s just a starting place. Behavior can be a great clue.

Signs of sleep deprivation are similar to symptoms of ADHD. They include:

Most likely, we could all make a few adjustments to get a better night’s sleep.

The best rules work for both children and adults:

With these simple tips, you and your little ones will be sleeping sounding and reaping the benefits in no time!

Sam Spillman, DC

Backpack Safety Tips

Mon, 06 Aug 2018 00:31:00 GMT

Backpack Safety

Here are some backpack tips to lighten the load:

Happy backpacking!

If you have any questions on backpack safety or back pain please email me at sam@balancechiropracticva.com You can learn more about us here .

Cornell Chicken from the Heart

Wed, 27 Jun 2018 03:51:00 GMT

My grandfather was a farmer in the heart of Cornell chicken country. He raised dairy cows, chickens, and corn in upstate New York and when he retired, he continued farming the most delicious corn – and even became adept at growing brussels sprouts – on the few acres behind his house.

Back in the day, Cornell chicken was widely popularized by Cornell University’s poultry science and agricultural program as an inexpensive protein alternative to beef. And Cornell’s very own Robert C. Baker actually invented the barbecue recipe now famous in Cornell chicken recipes – like the one my grandfather perfected. However, Baker’s real claim to fame was his invention of the chicken nugget, which he actually invented while at Penn State but only gained appreciation after he joined the faculty at Cornell. He would travel all over the country sharing his love of poultry and demonstrations of his recipes.

At one point, Cornell had approached my grandfather inviting him to be one of their instructors at the agricultural school but his love of farming kept his focus. I must say I’m glad it did because my grandfather’s Cornell chicken recipe is a summer classic, and brings back some of my fondest childhood memories.

This Fourth of July I’ll be grilling up a batch of my grandfather’s signature summer fare, complete with corn-on-the-cob for the side – though I’ll be getting my corn from the local farmer’s market. Give it try!

What to do:

Enjoy!

Research Leads to a Better Practice

Fri, 01 Jun 2018 02:36:00 GMT

Research. It’s the core of success. In our clinic, we pride ourselves on evidence based practice. But what does that really mean to the patient? Evidence based practice combines three things: clinical experience; research; and patient preference or values. So how do the articles we read from the research that’s done in universities filter down to affect our actual patient care?

For an example, the Journal of Orthopaedic and Sports Therapy published this article that looks at using the drop vertical jump task as a way to predict an ACL injury. What we learn is that this task isn’t a good indicator of predicting a possible injury. So many variables are involved in athletic injuries that it is very difficult to predict an injury from just one factor.

However, we also learn that increasing the cognitive demand on an athlete when performing the vertical drop jump task, makes the activity more difficult – and therefore, likely increases an athlete’s risk of injury. While this isn’t a perfect simulation of what might be happening on a soccer field or basketball court, it can help guide our rehabilitation of patients.

The result? We’re adding increased cognitive demands in the rehab process for our athlete patients before returning to sport.

Just another example of how research informs on how we care for our patients, through evidence based practice, in the “real world.”

Spring Vegetable Challenge: What’s New to You?

Sun, 08 Apr 2018 17:51:00 GMT

Below I have highlighted some of my favorite spring vegetables.

Amanda Terillo, MS, RD

Home is Where Charlottesville Is

Wed, 04 Apr 2018 01:54:00 GMT

Lynchburg boasted far greater weather than Indiana, PA, and I found myself taking up more outdoor activities – hiking, biking, exploring Virginia and all that it has to offer. I knew then, Virginia was for me. As I wrapped up my time in Lynchburg, I took an internship at UVA’s hospital for the summer. My fiance, then girlfriend, was living in Charlottesville at the time and as we took in the sights of Charlottesville – hitting up the shops, restaurants, and events around town – I quickly realized this was where I wanted to make my home.

A few years later, and we find ourselves residents of one of the most charming towns I’ve ever been in.

From the events constantly going on; the character of the people around us; the nature trails; outdoor sports; wineries; and breweries – I couldn’t imagine living anywhere else.

– Bryan Esherick PT, DPT

Benefits of Strength Training for Runners

Mon, 12 Mar 2018 18:59:00 GMT

Benefit #1: It Makes You Faster

Proper strength training has been shown to improve running economy , or the ability to run faster while using less energy. Let me put it this way, if you could run a 7-minute mile with the same amount of effort it takes you to run an 8-minute mile right now, you would take that deal right? Of course you would. Faster runners spend less time on the ground and produce more force when they strike the ground. You can improve your force production and ground contact time through various exercises, drills, speedwork and plyometrics that can actually train the neuromuscular system to fire faster. Make sure you are complementing your runs with all of this ancillary work. Take that deal!

Benefit #2: It Reduces Injury Risk

A strong body is crucial to tolerate the repetitive load of running. Many overuse injuries can be avoided with the addition of strength training and a variety of functional, rotational, and multi-directional movements to your regimen. I like to explain it this way: if you have an overuse injury like plantar fasciitis, you know the plantar is working too hard. Rest is an answer, sure. But come on, you and I both know you aren’t taking more than a day off without losing sanity! If you are able to strengthen the posterior chain (glutes, hamstrings, calves) to carry more of the load that your plantar is currently taking, you will reduce the use of your plantar and improve its function.

Benefit #3: It Enhances Recovery

This is probably my favorite fun fact that many runners don’t realize. When done correctly, lifting heavier loads produces a positive hormonal response that can rev-up the recovery process AND significantly reduce the risk of over-training. Lifting heavy will improve your overall strength, and metabolism; but what’s more I guarantee you will sleep really, really well at night.

All In All…

When done correctly and consistently, strength training and other ancillary work like drills and faster running can make you more efficient, reduce risk of injury, and enhance recovery. You will feel stronger on your runs and in races, and you will be able to tolerate higher training loads and have more energy.

Make strength training a priority and your body and mind will thank you!

Ann Dunn, M.S., CPT
BCPT Guest Blogger

Cardio: 30 Minutes A Day for a Healthy Life

Tue, 20 Feb 2018 04:26:00 GMT

Cardio. Personally, I am not the biggest fan of cardio workouts. The equipment at the gym is typically crowded, running isn’t comfortable to me, and it’s hard to find the time that fits into my schedule. But, I know it’s important for my health, so I’ve found ways to incorporate it. Enjoying your cardio workouts is half the battle in making the time to stay fit and healthy.

Cardio gets a bad rap for being repetitive, boring, and time consuming. But, cardio doesn’t only have to be a run on the treadmill, or spin on the bike, or an hour on the elliptical.

Find a physical activity you enjoy doing, and turn it into a hobby – outdoor activities are excellent for your lungs and your heart. Here are a few ideas for activities convenient for us here in the Central VA area:

The possibilities for a good cardio workout are endless.

All it takes is 30-minutes a day of moderate (50-60% of your max heart rate) activity to reap the benefits (improved immunity, healthier heart, healthier blood vessels, healthier lungs). So, find something you love and make the change to promote a longer, healthier life!

Bryan Esherick PT, DPT

Four Ways to a Healthier Heart

Sun, 11 Feb 2018 02:31:00 GMT

February is heart health month, and we’re celebrating by sharing tips to help you keep your ticker ticking!

Some of the best indicators of a healthy cardiovascular system include a normal heart rate, low blood pressure, low cholesterol and A1c levels.

So, remember to take care of yourself, and keep your heart in check!

Bryan Esherick PT, DPT

Resolutions Checklist for Health in 2018

Wed, 17 Jan 2018 03:47:00 GMT

We’ve rounded up a checklist to help create realistic, actionable, and attainable goals for a healthier lifestyle in 2018.

Remember that you should not try to achieve every one of these goals all at once. Living a healthy lifestyle begins with one simple choice after another. Even choosing just a few of these to help you create better habits for yourself will put you on the right path.

4 Tips for Sticking to Your Resolutions

Tue, 02 Jan 2018 19:48:00 GMT

New year. New resolutions. But will we stick to them this year?

Here are four tips for helping you stay true to you.

Set specific achievements. Sometimes we make resolutions that follow the trends in society – to be healthier; to exercise more; to join a gym. But, it will be far easier to stick to your goals if they are personal, and specific, to you. To set a specific goal, try thinking of those things that cause you to feel anxious when the do or don’t happen as planned. If falling behind on your work causes stress, resolve to set a goal of creating a daily time keeper tracker to help you more proactively manage your projects. This makes the goal specific to you and directly helps to address a negative feeling you have. This correction will make you feel better, and you will be more likely to stick to it as a result.

Create SMART goals. SMART is an acronym that can help us manage our personalized goals:

Finally, don’t fret if you stray from your goal occasionally.

It’s part of human nature and the society we live in. We all get busy. Life has a way of interjecting its own plans, and some days that might mean not finding the time to go to the gym or prepare that healthy meal you were planning. It’s OK to slip on your resolutions occasionally… just don’t make it a habit!

Tips for a Stress-less Holiday

Sat, 09 Dec 2017 01:35:00 GMT

The holidays. Some would say it is the most wonderful time of the year. Others might argue it’s actually the most stressful time of the year. To stress, or not to stress – that is the question.

Whatever you stance, here are my 6 tips to a stress-less holiday season:

6. Think of others in this season of giving – from your community, place of worship, family, friends, neighbors, and even those you’ve never met – give of yourself, give what you can. What you get in return will be a comfort of knowing you made a difference.

5. Plan for holiday of tradition that fits your family – introduce activities and traditions that mean the most. Remember you can’t make everyone happy all of the time, so be sure to find happiness for you as you plan your festivities.

4. Just say no. There may be some holiday events you simply cannot make. It’s OK. After all, you’re only human!

3. Prioritize your parties. As you look at the calendar of events, try organizing against opportunities to see all of your friends and family at least once. Aunt Sally’s brunch? Yes. Visit to your great-grandmother? Absolutely. Champagne with your best friend? Yes. That co-worker who invited the whole office to her holiday gathering? Maybe not.

2. Set aside time for your immediate family – your partner, your kids. Create special memories from those unforgettable moments with those closest to you.

1. Make time for yourself. To be your best self during the fun and festivities, be sure to maintain healthy sleep and exercise schedules. Take a break from the chores – maybe schedule a healing massage – and seize opportunity to steal away enjoy a little ‘me-time’.

If you stay true to yourself and manage your stress, you’ll enjoy this time of year much more and limit your personal health risks.

Parkinson’s Disease: Who, What, Why

Fri, 03 Nov 2017 16:10:00 GMT

What is Parkinson’s Disease?

What is a Basal Ganglia and a Dopamine?

The basal ganglia are a collection of clustered cell nuclei that control movement. They are divided into two different pathways, each with different functions. The one pathway receives input from the muscles of the body about how a movement is being performed. This information is then interpreted to determine if the movement that is being performed matches what was intended by the brain. In other words, this pathway determines if the movement is of the right amplitude (big enough or small enough) for the intended task. If the movement does not match the picture the brain wanted, the first pathway sends this information to the second pathway. In the second pathway, the nuclei interpret the information received, and send signals to the brain to adjust the movement. Areas that can be adjusted from this information include consciousness, muscle tone, and appropriate “gain” of movement (bigger or smaller movements). To make it simple this corrective information can either ramp up (increase) the intended movements or it can ramp down (decrease) unintended movements.

The two systems use a complex loop to provide a system of checks and balances. The messenger that relays information between the two systems is called dopamine. This substance is classified as a neurotransmitter and provides a way for cells to communicate. Since Parkinson’s is characterized by a loss of dopamine in the two pathways, they essentially lose their messenger and are unable to communicate properly with each other. This can lead to faulty movement patterns or small movements and quiet speech, which are often a characteristic of Parkinson’s.

Current treatments for Parkinson’s vary from pharmacological treatments to increase the amount of dopamine in the brain to exercise therapy. Stay tuned later this month for a blog post about the LSVT BIG program and how it can help decrease the rate of progression of the disease and improve overall function in the population affected by Parkinson’s.

Bryan Esherick PT, DPT

Why Chiropractic or Physical Therapy before Opioids?

Sun, 08 Oct 2017 23:39:00 GMT

Opioid prescriptions have skyrocketed over the last 25 years. Originally they were intended for post surgical patients and those in the end stages of cancer. In 1991 there were around 76 million prescriptions but by 2013 that number had risen to almost 207 million prescriptions.

As prescriptions have risen, so have abuses. According to the CDC more than 1000 people a day are treated in emergency rooms for inappropriate opioid use. As many as 1 in 4 people using opioids long term struggle with addiction. In 2015 there were nearly 60,000 drug overdose deaths, nearly half of those were from opioid drugs and opioid prescriptions frequently lead to other narcotic abuse. The economic costs of opioid abuse is estimated to be$75 billion a year. On top of all of that, there is no research to suggest that the amount of opioids has had any impact on people suffering from chronic pain. Patients who take opioids for even 1 day have a 6% chance of using them a year later, a 13% chance if they are used more than 8 days and a 30% chance if they are used for a month.

This year the American College of Physicians updated its guidelines for the treatment of acute and chronic back pain to recommend first using non-invasive, non-drug treatments before resorting to drug therapies.

The Joint Commission (the organization that accredits hospitals) has also added chiropractic treatment to its pain management recommendations. The guidelines were published in the Annals of Internal Medicine and based on reviews of randomized controlled trials and observational studies, and recommend spinal manipulation, massage and therapeutic exercise as first treatments for low back pain. Multiple studies support manual therapies and exercise to both resolve acute and chronic pain, but also for conditions you might not expect to see a chiropractor or physical therapist for: Parkinson’s, balance disorders, arthritis, and many others.

Chiropractors and physical therapists have excellent patient satisfaction scores.

A typical treatment plan for a chiropractor or a physical therapist costs less than an MRI. Chiropractors and physical therapists are neuromusculoskeletal experts, and do far more than just pain relief, they create treatment plans that correct problems. You’ll be stronger, have better range of motion, and in general be more functional and be better able to do the things you love and your chance of recurrence will be lower. Do you have pain? Give us a call and see how we can help!

More Than Just a Bump on the Head

Thu, 14 Sep 2017 21:21:00 GMT

Concussions have become more and more “hot topic” in sports in the United States over the last decade. They have been put in the spotlight by the media and even become the subject of major Hollywood films. According to the International Symposia of Concussion in sport, a concussion is defined traumatic brain injury induced by biomechanical forces. That’s right, a concussion is now considered a traumatic brain injury which represents the seriousness of the condition.

Concussions occur in many different ways ranging from sports related impact to car accidents. Many people do not understand that a concussion can occur by either contact with the head or contact with the body causing head movement (whiplash from a car accident). Sports concussions will be expanded on in the rest of this blog post, but remember they can occur in a variety of ways.

Although helmets are designed to aid in the risk reduction for concussion, their main function is to prevent skull fractures not concussions. Even with improvement in helmet padding through innovation, concussion rates continue to increase. This increase in occurrence is partially related to both the increase in athletic ability and an improvement of sideline diagnosis of the condition. Football continues to be the sport that puts athletes at the highest risk for concussion. To the right is a graph representing concussions by sport in both high school and collegiate players.

What to Watch For

What to do If you think you or someone else has experienced a concussion?

Get that person to a medical professional ASAP! Getting an examination by a medical professional allows for early diagnosis and treatment. Early treatment generally consists of mental rest. This means time away from the TV, computer, cell phones, work, and school. This usually lasts for 1-3 days until symptoms resolve and then these activities can be reintroduced gradually as symptoms allow. Most concussions resolve within 10 days for the majority of people.

Sometimes symptoms may last past the first 1-2 weeks following the injury. When symptoms present past a week or two, the person should seek out additional support to treat possible symptoms stemming from the cervical spine or vestibular system. With treatment of these areas, symptoms generally resolve within the first month of treatment.

In summary, concussions are a serious condition and are now classified as a mild traumatic brain injury. When someone is suspected of having a concussion, medical assistance should be sought out immediately for prompt diagnosis and counseling on appropriate rest procedures. Do not hesitate to reach out for help if a concussion is suspected. It is more important to protect the brain for the future than to stay in the game and risk further damage!

Healthy Snacking

Sat, 12 Aug 2017 15:57:00 GMT

It is back to school time! That means busy schedules, last minute plan changes and sleeping in to the last possible minute. Nutrition and healthy meals can easily slip through the cracks. Having healthy meals and snacks planned can greatly help you and your family work through this busy and transitional time. Having a nutritious snack in between meals is a great way to incorporate nutrient dense foods into your day. Often we are so busy during the day and either we ignore our hunger cues and inhale our lunch or dinner or we go visit our receptionist friend and get some candy from their basket. There is nothing wrong with the occasional candy, it is just that candy is not going to give you the nutrition you need to stay focused, have energy or be satisfied. Snacks are just as important for our kiddos. Let’s be real, kids are not worried about their nutrition or what type of snack they are eating. Their priority is not being late for their next class, their pop quiz that they are totally unprepared for, or the game they are playing at recess.

Below is a list of some great snacks that you can easily bring with you to work or pack in your kiddos bag.

Happy snacking!

Guest Blogger , Amanda Terillo , is a Registered Dietitian Nutritionist (RDN) who specializes in integrative practices .

How To Fit a Backpack

Wed, 02 Aug 2017 02:48:00 GMT

The first consideration for a good fit will be the the torso sizing. To measure the torso, start from the base of their neck and bring the tape to their hip bones:

The second consideration will be the multitude of features. You’ll want to be sure whichever backpack you choose has the following elements:

Once you’ve identified the appropriate features, and measured your child’s torso, you’re ready for the fitting to make your final selection. Have your child put on the back pack, and follow these steps:

Be sure to steer clear of these ‘don’ts’:

So, if you’ve selected a backpack that fits the torso, has all of the right features, and has been adjusted to a good, comfortable fit, you’re ready to go. DO have a fun and safe return to school!

Summer Fitness: 4 Injury Warning Signs

Wed, 28 Jun 2017 00:52:00 GMT

Summer is here again, and with it comes the feeling of needing to get into shape. We want to look our best, so naturally our activity levels increase drastically. This isn’t necessarily a bad thing – as exercise is one way to ensure a long and healthy life. Unfortunately, for a lot of us, a large increase in activity level without a sufficient ramp-up period can spell injury trouble . The good news is there are warning signs your body sends prior to actually sustaining an injury.

Our body does a great job of helping us know whether something is harming us. There are many checks and balances within the body that allow this to happen. For one, the level of pain does not necessarily equal the level of tissue damage. A little ache in the knees could be osteoarthritis or a torn meniscus. Sharp pain may represent only a minor ligament sprain or inflammation. So, how do you know if you’re over-doing it?

Here are the warning signs to watch out for:

Getting back into shape for the summer can be extremely rewarding to just about everyone. But, a phase-in period to safely ease into your programs will help to ensure your body has enough time to adapt. Remember – listen to your body, learn from your mistakes, and build on the progress that you have already made. Stay healthy my friends!

Bryan Esherick PT, DPT

Posture Perfect

Tue, 11 Apr 2017 20:20:00 GMT

With the increase in technological devices of late, posture has been a recurring theme in physical health news more and more. You may have even heard the term “text neck”. If you’ve ever been to a physical therapist or a chiropractor you may have even heard more sophisticated terms like “Upper Cross Syndrome” and “Lower Cross Syndrome.” If you’ve been to Pilates, yoga or barre classes you’ve also probably heard about pelvic tilts and “tucking.”

We know that a good posture is healthy for us. But, you may be asking yourself – what exactly is good posture, and how can I maintain it?

Your ears should be in the middle of your shoulders – and your shoulders directly over your hips – and all of that in-line directly over your ankles. Be sure and keep your shoulders down and back, too – not rounded forward. When you’re in a good posture position, you should notice:

The affects of not maintaining correct posture can be significant. Bad posture can lead to pain, injury and even degeneration of the spine. So, take heed and be mindful of your posture in during everyday activities – including how you are holding your head and neck while texting.

Stay tuned for more in our series on posture – the positive, and negative, affects it can have on your health.

Break the Injury Cycle

Tue, 28 Mar 2017 19:02:00 GMT

You’ve recently recovered from an injury, so you started a new workout program, and now you’ve just suffered another injury. Sound familiar? You’re not alone. It’s a common problem that lots of people face. The trick to breaking the cycle is in understanding the cause.

Exercise and rehabilitation is predicated on the SAID principle. This refers to the S pecific A daptation to I mposed D emand. Let’s break it down. We all have our own unique stress line – that limit within each of us that, if breached, will result in injury. This holds true for each system in our body – cardiovascular (heart, blood vessels, lungs) and musculoskeletal (bones, joints, muscles, ligaments, tendons). When we start a new exercise program, we start stressing these two systems. We push too hard and we suffer injury, don’t push hard enough and we don’t gain any results. So how do you overcome this conundrum? Strike a balance on exertion load over time.

Here are a few injury risk signs that indicate need for increased recovery time:

It’s important to listen to your body and not overdo it. The concept of “no pain, no gain” is a fallacy. When starting a new program, it’s a good idea to meet with your chiropractor or physical therapist . They should evaluate your fitness, sleep patterns, and diet – and can help you learn the best movements for your fitness level to avoid risk and injury.

Food Can Make Us Strong

Thu, 23 Mar 2017 18:31:00 GMT

In honor of National Nutrition Month, I’d like to share a few thoughts on one of trickier health subjects – food.

With so many different types of dietary models: Paleo, Atkins, Vegan, etc., it can be hard to figure out what’s right for you. There are merits behind so many of them, but the way we think about what we eat is what’s most critical.

Too often we think of food in black and white – as bad for you (but delicious and wonderful) and good for you (but so unappetizing). A few weeks ago, I enjoyed opportunity to discuss nutrition with a patient in the office. Her name is Christa Bennett , and something she said really struck a chord with me. She was telling me that she doesn’t talk about food with her children in terms of good or bad. Instead she frames it like this: “is it strong food or weak food?” It made me think – will this food make me strong or make me weak. I really liked it.

When we think of food in terms of good or bad, we are placing an emotional value on it. This isn’t always a healthy thing for our bodies, our minds, or our hearts. Let’s take a note from Christa. As we sit down to our next meal, consider what’s on the plate. “Will this make me strong? Will it make me weak?”

We want to eat better so we can feel better, and we want to eat food that tastes good. But we can do without the calorie counting, countless hours preparing in the kitchen, and ultimately feeling deprived and hungry. With a little bit of will power and some slight adjustments to how we think about food, we can feel strong and fuel our bodies right. I have been getting ready for a new jiu-jitsu belt test lately and eating a lot of strong foods because I want to feel strong. And thanks to Christa, I do. I hope you do too! Have questions about a healthier diet? Email me at sam@balancechiropractiva.com

Healthy Sleep Habits, Happy Back

Tue, 21 Mar 2017 17:54:00 GMT

Sleep is important. Yet, despite our awareness of sleep benefits, we often don’t make getting enough of it a priority. Sleep loss costs the U.S. $4.2 billion dollars a year – an equivalent of 1.2 million work days a year. But there is more to sleep than getting enough. How you sleep can be just as important to your health.

Stomach sleeping.

Many people sleep on their stomachs. And while stomach sleeping can help with snoring, it can also exacerbate and prolong neck and shoulder pain from a recent or recurring injury.

Side sleeping.

Side sleeping – with your arms below chest level – is better. But, also brings risk of waking with numbness and tingling in your arms from having them in the wrong spot. I recommend sleeping on your side with your arms down, and your legs almost straight, with a pillow between your knees. Many people have a tendency to bring their chin toward their chest in this position. Try to keep your neck straight, and be sure your pillow is thick enough to keep your spine straight. Side sleeping requires a thicker pillow than sleeping on your back.

So, what’s the best sleep position to cover by best?

Back sleeping.

As a chiropractor , I like back sleeping with your arms down best. It keeps your spine straight and level. This is the ideal position for back health and injury recovery. Tucking a pillow below underneath your knees can be a good extra measure as well. However, if you snore or have sleep apnea, this may not be the best position for you.

So, be sure to get your sleep – and be mindful about how your body is feeling when you wake up – you might need to make some adjustments. If you have pain or stiffness when you wake that’s a good sign that you’ve some adjusting to do. When we wake we should feel our best.

Healthy Life, Healthy Back

Wed, 15 Mar 2017 14:20:00 GMT

When life’s physical demands exceed your body’s tolerance for those challenges, muscle, bone, joint and nerve problems begin. So, how do you prevent recurring injury?

Here are five tips to help keep the back strain away.

Of course, prevention is always the best measure to keep your body pain-free. But, if you do encounter a mishap, partnering with your physical therapist and employing these measures to help increase strength and flexibility can also help increase your threshold for future injury.

Fitness Apps and Trackers: Is Technology Right For You?

Fri, 17 Feb 2017 14:38:00 GMT

Technology is everywhere. We consume tons of media on our phones. We adorn wearable tech that improves our posture. Sleep apps (Rested, Sleep++, Sleepbot) that use motion sensing, sound, and a smart alarm help us measure our sleep quality. All are agreed – there are some great innovations that have entered the marketplace in recent years. But there’s so much to choose from. How can we determine which technology is best to support our health and fitness goals. The trick is in finding what’s right for you.

If you find that using an app is causing you stress and anxiety, or affecting your self-esteem, it’s a warning strategy is not good for you.

Fitness trackers are another tool for supporting your fitness goals. The philosophical idea behind them is “that which is measured, improves.” However, a new study revealed that people who used fitness trackers actually lost less weight than a control group that didn’t. The trackers and apps rely on an algorithm to determine your ideal caloric intake – but, in many cases, this one-size-fits-all approach doesn’t get it right. So, while you may be moving more, you also may be eating more.

It takes years of research and dozens, if not hundreds, of research papers before the scientific community is able to achieve consensus on what truly works and what doesn’t. These devices are only a few years old, so those studies are far from over – until then, research should be used merely as a guide to help shape personal opinions. If you want to try a fitness tracker, go for it. If it helps you, that’s great. But, if you find yourself using an app or following a tracker without the results you wanted, try making modifications. These tools should help to take the guess work out.

This technology is new and all devices currently on the market have quite a way to go before they will fulfill their promises.

While the technology gets a little better each year, it will likely still be a while before we can rely on them completely. They are a good starting point. But, if you think fitness technology might work for you, be sure to read reviews first – the good, the bad, and the ugly. If you are using one but not getting the results you want, talk to your healthcare provider about help in finding a support solution that’s right for you.

Patient Centered Care: Putting the Patient First

Thu, 09 Feb 2017 05:24:00 GMT

Patient-centered care is a custom-tailored approach. It takes the individual patient into account when making care recommendations. While the practice of medicine uses a great deal of science, not all approaches will work well for every patient. That’s where this approach comes into play. It’s more than just following intuition and the available science. It takes unique patient preferences into account – from individual challenges to lifestyle factors. As care providers, we need to listen to our patients and prescribe programs that adapt to their needs and align with what is realistic for them. A doctor driven approach is different- the doctor is the authority and dictates the nature of care and can leave the patient feeling unheard and uncared for.

So, how do you know if your healthcare provider is truly taking a patient-centered approach? Check these three cues:

Your health and well-being require action on both your part and that of your healthcare provider. You and your doctor should achieve a therapeutic alliance- to be working together toward the same goal. It should feel like your doctor is treating you and not your illness/injury/body part. You will achieve better results when you follow the requirements within a customized recovery and wellness plan. So, look for a partner when seeking medical assistance – and, remember, when choosing a healthcare provider or a hospital, look for a patient-first approach.

10 Tips to Keep Your New Year’s Resolutions

Mon, 02 Jan 2017 20:56:00 GMT

Keeping your New Year’s resolutions. It’s tough – we’ve all been there. You gain so much clarity at the end of another year and you find your focus – determined to (finally) achieve those targeted goals. January is welcomed in with a surge of excited anticipation at how amazing everything will be once you hit those goals. Then, February comes. Sticking to those resolutions may be tough but, with a little help, we can do it.

With these tips, we hope you keep all of those resolutions – and wish you all the best for a happy, healthy and fit 2017.

Five Chiropractic Myths Busted

Sun, 04 Dec 2016 01:35:00 GMT

We’re not your average chiropractic clinic – with an integrated health and wellness approach , physical therapy, and lifestyle counseling offered as well – yet some popular misconceptions about chiropractic still rise to the surface. So, we thought it might be helpful to bust a few popular myths on the topic.

Chiropractic Myths Busted:

At the end of the day, if you’re suffering from pain, a visit to a chiropractor may be just what the doctor ordered.

Learn and Win

Mon, 17 Oct 2016 02:13:00 GMT

“I never lose. I either win or I learn.” I was struck by this quote from Spartan (an obstacle race course and fitness group) the moment I read it. It’s probably the closest thing I’ve seen to a real credo to live by: embrace setbacks as an opportunity to learn, instead of rejecting them as a personal failure.

When we accept that we will make mistakes, we learn that we will fail before we can succeed.

“I either win or I learn” takes that important acceptance one step further: you can turn that fall, or that fail, into something valuable if you are open to learning from it. I’ve since adopted this credo and apply it to my every day life – helping me to overcome the challenges we all face. Like mom always used to say: if at first you don’t succeed, try and try again.

Learning from our past is an important lesson. I know it’s been true for me in a number of different ways. It was true when I was trying to lose weight; when I was training for my black belt; training for a Spartan race; it was true in graduate school; and it has been true in my professional life as well.

While my list of Do’s is long, my list of Don’ts is short:

Most of all, don’t give up because you’ve tried and failed. Try it again, but try it differently. Fail differently.

Win or Learn…words to live by.

Five Chiropractic Myths Busted

Mon, 10 Oct 2016 00:47:00 GMT

Doctors of Chiropractic (DCs) sometimes get a bad rap when it comes to perceptions on the efficacy of the practice, with common myths playing culprit. Although, a 2015 study by the NCBI (National Center for Biotechnology Information at the National Institutes of Health), found that generally DCs are regarded favorably and largely believe chiropractic to be safe. As the study respondents’’ likelihood to use a DC increased, the perceptions of effectiveness and trustworthiness also increased. Good news for our industry. However, there are still a few popular misconceptions about the profession.

1. All they do is “crack” backs.

While it is true that spinal manipulation is a frequent part of chiropractic care, it is not the only thing. DCs are spinal and musculoskeletal specialists. In fact, our foremost provided care is diagnosis. Identifying your injury, and its underlying causes – while providing a clear path for how to overcome it – is paramount to the success of any recovery plan. In addition to manipulation, chiropractors provide soft tissue treatments; physical therapy modalities; therapeutic exercises; nutrition counseling; and lifestyle advice .

2. Chiropractic manipulation is dangerous.

No treatment or intervention comes completely without risk. However, chiropractic manipulation is safe with the most common side effect being soreness. Additionally, specially trained osteopaths and physical therapists also perform spinal manipulation as part of their healthcare delivery. One common misconception on the dangers is that manipulation of the cervical region can cause a stroke. However, no scientific evidence demonstrating causation has ever been put forward. In fact, far more dangerous and common complications stem from the use of prescription drugs and over the counter medications to treat chronic pain – resulting in DCs and PTs paying far less in malpractice premiums than their medical colleagues.

3. I will have to go forever.

Not true. Most acute injuries will respond to a focused course of care. There is some evidence to demonstrate that regular spinal manipulation decreases the risk, and incidence, of low back pain. Many patients choose to get regular adjustments in much the same way that many people get regular massages. Just as dentists recommend two visits a year, and PTs recommend monthly therapy, patients may elect to get regular adjustments.

4. Chiropractic care is expensive.

Today, patients are responsible for more and more out-of-pocket expenses with higher deductibles and copays than ever before. However, most insurance plans cover chiropractic care and even Medicare covers in-part. Overall, chiropractic and physical therapy treatment plans are often far less expensive than beginning your treatment with a medical physician – whether with a family doctor or a specialist. Most chiropractors and physical therapists can accurately diagnose and treat your injury for less than the cost of a single MRI. Additionally, pain medication only masks symptoms while chiropractic care and physical therapy can fix the source of the underlying problem.

5. Chiropractors only treat back pain.

While chiropractors frequently specialize in low back pain, DCs treat most musculoskeletal injuries from work injuries, whiplash, and headaches, to hip and knee pain. Some chiropractors even specialize in sports injuries – as we do in this clinic – others in vestibular and balance dysfunction; chronic pain; peripheral neuropathies and so on.

Myths will persist.

But, if you are suffering from chronic pain and haven’t thought about chiropractic with physical therapy as a solution, give it a try. You may just find that that the myths aren’t all they are cracked up to be. In our clinic we provide integration with chiropractic and physical therapy helping our patients with lasting solutions. We focus on treating the patient and not the diagnosis.

The Power of Courage

Wed, 28 Sep 2016 12:00:00 GMT

In honor of National Women’s Health and Fitness Day, I am inspired to share a personal story of courage and choice.

How many times in our lives are we faced with discouragement? I am faced with discouragement regularly. Whether it’s with work goals, relationships with other people, parenting challenges, problems with our health, fitness goals, important life changing decisions and the mundane struggles of life, it can be easy to give in to discouragement.

As a chiropractor, I see many people who had at one time, lived with pain on a daily basis. For many of these people chiropractic care was that first courageous step of taking control of their health.

Disappointments are inevitable, but discouragement is a choice. Let’s choose courage.

Step by step and day by day our little courageous choices will bring about big results. So get your feet wet – or in my case, immerse yourself in that frigid Canadian water – and see yourself soar.

— Dr. Sarah-Ann Eng

Obesity: A Struggle for 1 in 5 Children

Fri, 09 Sep 2016 12:03:00 GMT

Today I’m going to get a bit personal. September is Childhood Obesity Awareness Month ( learn more at CDC ), and this is a topic I’m very passionate about.

By the end of high school, and early into college, I’d lost most of the weight and was in good shape. But it was hard. Really hard – and took four years. My doctor put me on a high-carbohydrate, low fat diet. (We didn’t know this wasn’t the best advice back then.) I worked out 1-3 hours a day, every day – and kept myself to a strict 1200-1500 calorie-a-day diet.

As I moved on to grad school, I started to struggle with my weight again – and found myself back up to 205 pounds. This time, my doctor told me I was pre-diabetic. That was the tipping point for me. I got intense about exercise again, and learned a lot about nutrition. With my new found discipline and diligence, I lost 60 pounds and was back in shape.

This journey has been a life-long discovery, and I’ve learned a lot about myself along the way. When I help make recommendations for patients dealing with obesity, I understand their struggles. I understand the challenges with self-confidence, embarrassment and guilt. I understand feeling tired and struggling through exercise when it seems so easy for those around you. I understand how easily those pounds can slip back on when you’re not paying attention. At the same time, I appreciate my journey because I learned that I can accomplish anything I want to. I learned that I was a good athlete. I learned to make a plan; to stick with it; to push myself and succeed. I’ve taken these lessons and applied them to other areas of my life, and have found my happiness – comfortable in my own skin.

If you struggle with obesity, your weight in general, or see your children struggling, reach out for help.

As healthcare providers, we understand so much more than we did when I was a kid. Of course, there’s no magic bullet (not yet) – but there is help, and there are lots of things you can do. Just ask. Ask your doctor, ask your pediatrician, ask me. We’re here to help.

Rest and Recovery

Mon, 05 Sep 2016 14:29:00 GMT

The word is pretty much out on the benefits of working hard – at work to earn more money; at eating right and exercising to stay healthy; studying to get top grades. You get the picture. We live in the land of opportunity, and have always heard that you need to work hard to get ahead and achieve your goals. While that’s true, sometimes less is more – especially when it comes to impact on our bodies. The value of rest and recovery is severely underrated, and the health benefits are a lesser known cousin of the ‘work harder’ family.

Sleep is like a magic elixir. If you’re not getting a full eight hours every night, you might be struggling with increased levels of fatigue; memory challenges; poor moods; weight gain; strains and stress fractures. Sleep gives your mind, body and soul the fuel needed for a happier and healthier life.

So take time to rest and let yourself recover from strenuous work and exercise.

Rest. Sleep. Recover. Take a break from the screens and spend time with those who matter most to you. Skip a workout and sleep-in when you need to. Listen to your body. If you feel stressed out, your body probably feels it too – and that little voice that says: “just one more…” could be what sets you back.

3 Tips To Help Your Lumbar Disc Problem

Mon, 08 Aug 2016 16:27:00 GMT

3 Tips to Help Your Lumbar Disc Problem

1. Home Ice – Application of ice will help reduce inflammation by constricting swollen blood vessels. Ice may also help reduce muscle spasm and numb irritated nerves.

• Apply for 10-15 minutes. Break for 30 minutes. Reapply. (Alternatives to the ice pack include Ziploc bags filled with ice, or a bag of frozen vegetables.) Repeat several times a day as needed. • Place a thin towel between your skin and the ice pack for comfort and safety. • Use ice-massage for smaller areas. Begin by freezing a small paper cup of water. When frozen, tear off the bottom inch of the cup to expose the ice. Massage the indicated area for 5-10 minutes in a slow figure-eight pattern. Do not hold the ice in one position.

2. Perform the Abdominal Brace Exercise – The basic goal of “abdominal bracing” is to tighten your abdominal wall in order to protect your spine. To help you perform this exercise, imagine that someone is about to punch you in your stomach. Your stomach muscles should contract to brace for the punch. Your abdominal wall should not be “sucked in” nor “pushed out”. Do not move your spine or pelvis. This contraction should be performed during all movements throughout the day to assist in spine stability. Watch a video of this exercise here .

3. Be Cautious Entering & Exiting a Vehicle – Entering and exiting your vehicle is a potential risky activity for low back pain sufferers. Follow these tips to limit problems: • To enter the vehicle, open the door and stand with your back to the seat, legs close to the side of the vehicle. For larger vehicles, you may wish to begin by standing on the running board. Place your hands on the door and doorframe to keep your movements slow and controlled then slowly lower your body into the vehicle. • Tuck your head into the vehicle. Keep your knees close to each other, as though they have been taped together, brace your abdomen as though you’re about to be punched in the stomach and pivot your body as a whole without twisting or bending at the waist. You may grasp the steering wheel with your right hand to help you pivot. • Use a lumbar roll or other support to help maintain good posture. Position the roll slightly above your belt to support the “small of your back”. Adjust your seat so that your knees are slightly lower than your hips. Try to avoid prolonged car rides- take frequent breaks. • Before exiting, create adequate space by pushing your vehicle seat back as far as possible and move the steering wheel up and out of the way. To exit, first scoot slightly to the door side edge of your seat, then keep your knees together and pivot with the same cautions that you used to enter the vehicle. When your feet are shoulder width apart and firmly on the ground or running board, grasp the door and doorframe, lean forward, but be sure not to bend your back as you tighten your abdominal muscles. Slowly thrust your hips forward to stand up.

Healthy Lifestyles- Weight Loss

Mon, 08 Aug 2016 16:07:00 GMT

Exercise! This is another key component of a weight loss program. Where to begin? It depends on your physical fitness level. You want to stress your system, but that may mean different things to different bodies. As you begin to add or increase exercise it is easy to over do it. This can lead to frequent or recurrent injuries which can be very frustrating and unfortunately it is all too common. Consulting a chiropractor or physical therapist before starting an exercise regimen can be a way to limit risk with a new workout routine. In general, you’ll need to have both a strength or weight training component along with a cardiovascular component to maximize results. Charlottesville has many wonderful exercise options .

Sleep ! This is a major factor. You should be getting 8 hours of sleep. Sleep is vital for good health and aids in muscle and tissue repair, memory, and cognitive function. If you’ve been struggling with performance or weight loss, sleep can be one of the best ways to break through a plateau.

Advice for Migraines in Charlottesville

Fri, 01 Jul 2016 17:28:00 GMT

Migraine Triggers

There are many types of headaches and not all severe headaches are migraines. The Mayo Clinic defines a migraine as ” severe throbbing pain or a pulsing sensation, usually on just one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.”
The best way to identify foods that may be triggering your migraine is to keep a daily
food journal. A journal allows you to look back and identify specific foods that may be
contributing. If you can identify food triggers, then you’ll be able to avoid them and reduce how often you get migraines.

Not all triggers affect everybody, but here’s a list of commonly reported
triggers:
• Chocolate and cocoa (Chocolate: milk, ice cream, pudding, cookies, cake, or
pie).
• Alcoholic beverages (especially red wine, beer, and sherry)
• Caffeine
• Nuts & nut butters
• Pumpkin, sesame and sunflower seeds.
• Fruits such as: Figs, raisins, papayas, avocados (especially if overripe), red
plums, overripe bananas
• Beans such as: broad, fava, garbanzo, Italian, lima, navy, pinto, pole & string
beans.
• Other vegetables such as: snow peas and onions (except for flavoring).
• Raw garlic
• Anything fermented, pickled or marinated (sauerkraut, olives, pickles).
• Freshly baked yeast bread or coffee cake, doughnuts, sourdough bread.
• Cultured dairy products (buttermilk, sour cream).
• Cheese: blue, brick (natural), Gouda, Gruyere, mozzarella, Parmesan, provolone,
romano, Roquefort, cheddar, Swiss (emmentaler), Stilton, Brie types and
Camembert types.
• Aged, canned, cured or processed meat, including ham or game, pickled herring,
salted dried fish, sardines, anchovies, chicken livers, sausage, bologna,
pepperoni, salami, summer sausage, hot dogs, pâté, caviar, mincemeat pie.
• Other high sodium products: Meat tenderizer, soy sauce, monosodium glutamate
(MSG), seasoned salt, (Accent), canned soup, soup or bouillon cubes,
• Nutrasweet
• Excessive Vitamin A (over 25,000 I.U. daily)

Mattresses!

Fri, 03 Jun 2016 20:53:00 GMT

Mattress Replacement

The age and quality of your mattress have a major impact on how you feel. A worn-out mattress can certainly contribute to back and neck problems. Most experts agree that traditional mattresses should be replaced every 5-8 years. A traditional mattress is one with springs inside, as opposed to a mattress made from memory foam or rubber. Since you spend about one-third of your life in bed, choosing the right mattress is critical. Unfortunately, mattress selection is a highly individual process as there is no single “best” mattress. It is also to remember that like with running shoes, spending more won’t necessarily guarantee you a better night. The following tips will help you make an informed decision:

• Choose a medium-firm model . Mattresses that are either too soft or excessively firm can aggravate back pain.

• Keep the pillow-top relatively thin. An excessively plush topper is the equivalent of placing a cheap mattress on top of a good one.

• Always replace the box spring foundation when you replace the mattress.

• Don’t choose the most expensive mattress in the store- but don’t set your budget unreasonably low. Bargain mattresses are not a good option. Your savings should be focused on avoiding unnecessary add-ons (mattress covers, custom sheets, pillows, etc).

• Look for vendors that provide an in-home warranty that allows you to exchange the mattress if it does not meet your expectations. I think this is very important, a good company will stand by their product.

• Your chiropractor may be able to provide additional suggestions to help you choose between coil spring, memory foam, water and air beds.

Foam Rolling

Fri, 03 Jun 2016 20:45:00 GMT

Foam Rolling

You may have heard of foam rolling. It can help relieve back pain and also be performed as a relaxation exercise. If you have a foam roller at home, give this back exercise a try. While seated on the floor with a foam roller positioned directly behind you, lie back onto the foam roller. Elevate your pelvis and begin gently rolling back and forth over the roller. If less pressure is desired, this exercise may be performed upright, against a wall. Perform for one minute, twice per day or as otherwise directed. Additionally, laying on the foam roller with your tailbone, spine, and head resting on the roller is a great relaxation exercise. Allow your arms fall to the side with elbows touching the ground as you relax on the roller for a minute or so.

Foam rolling doesn’t need to be an all-day activity. A few minutes here and there can be a helpful self-care tool but spending too long on it can be counterproductive. This can be a wonderful exercise to do when you get home from work and have finished with work for the day. If you have any questions, please feel free to email me at sam@balancechiropracticva.com. Or check out our home page for more information.

Fun ways to Exercise in Charlottesville

Fri, 03 Jun 2016 20:21:00 GMT

I know, not everyone thinks exercise is fun, and then others love it! I decided to compile a list of some of my favorite places to work out in Charlottesville. Now, we all know everyone should exercise. But just because you should do something doesn’t mean it actually happens. And continues to happen. I think that the most important thing with exercise is finding something that you actually enjoy doing. There is a reason the exercise guidelines are vague- it doesn’t matter so long as you do something and do it regularly. So you look forward to it, like it, and make it a priority. So take a look at the list below and see if it gives you some ideas. #cvillesweats

If you love being outside:

Hiking

Running

Seal Team Training

If you think Dance might be more your thing:

Salsa Nights

Contra Dancing

Hip Hop

If you’d like to release your inner ninja:

JiuJitsu

Kung Fu

If you want a rock solid core:

Pilates

If you want to get bendy and you like the hot

Hot Yoga Cville
Fly Dog

If you want to try something adventurous:

Climbing

Outdoor Adventures

Social Kickball

You want an all round full body workout:

MADabolic

You’ve always wanted to be the Incredible Hulk:

The Gym

You aren’t sure and want to try somethings:

ACAC

There are countless other ways to get out and be active. Charlottesville is a wonderful area with loads of resources. This list is just the tip of the iceberg. A little googling and you are sure to find what you’re looking for. But exercise can be much more fun than staring at the treadmill in your basement with your sweatshirt hanging on it to dry… If you feel like you need help getting started, email sam@bcptva.com and I’ll help you.

4 Ways to Alleviate Back Pain While Driving

Mon, 25 Apr 2016 17:48:00 GMT

Entering and exiting your vehicle is a potentially risky activity for back pain sufferers.

I hear from patients all the time about difficulties getting in and out of cars while they are suffering from back pain so I came up with 4 tips on ways to alleviate the pain while riding in the car.

1. Entering the car

Open the door and stand with your back to the seat, legs close to the side of the vehicle. For larger vehicles, you may wish to begin by standing on the running board. Place your hands on the door and doorframe to keep your movements slow and controlled, then slowly lower your body into the vehicle. As you sit down, tuck your head to avoid hitting the roof.

2. Getting in the driving position

Keep your knees close to each other, as though they have been taped together, brace your abdomen as though you are about to be punched in the stomach and pivot your body as a whole without twisting or bending at the waist. You may grasp the steering wheel with your right hand to help you pivot.

3. Use a lumbar roll to ease pain

Or another support to help maintain good posture. Position the roll slightly above your belt to support the small of your back. Adjust your seat so that your knees are slightly lower than your hips. Car seats are typically soft and so you may need a little more lumbar support than you think. Also a lot of cars now have built in adjustable lumbar support, but even with that you may still need a support. A little trial and error will do wonders. I recommend everyone do this BEFORE their back starts to hurt because it will be no fun figuring it out while you are in pain.

4. Getting out

Before exiting, create adequate space by pushing your vehicle seat back as far as possible and move the steering wheel up and out of the way. To exit, first scoot slightly to the edge of your seat closest to the door, then keep your knees together and pivot with the same cautions that you used to enter the vehicle. When your feet are shoulder-width apart and firmly on the ground or running board, grasp the door and doorframe, lean forward but be sure not to bend your back, as you tighten your abdominal muscles. Tighten, but don’t suck in or push out with your belly. Slowly thrust your hips forward to stand up. As you stand, one your head has cleared the roof, look up as you stand, this often helps reduce back pain when moving from the sitting to standing position.

If back pain is affecting your day to day, book an appointment or contact us today.

About the Author

Dr. Samuel Spillman attained his chiropractic degree in 2008 from Western States Chiropractic College in Portland, Oregon. His undergraduate study was spent at Miami University of Ohio where he earned dual bachelor’s degrees in Interdisciplinary Philosophy and International Studies in 2001.

Feel free to email me with questions!

How To Make An Exercise Plan In Charlottesville

Sat, 23 Apr 2016 15:21:00 GMT

A Healthier You in 2016 –Safe and Effective Exercise in Charlottesville

An ideal exercise program includes both resistance exercise for your muscles and aerobic exercise for your heart and lungs. Aerobic exercise is brisk physical activity that requires the heart and lungs to work harder to meet the body’s increased oxygen demand. Aerobic exercise promotes circulation of oxygen through the blood. The American College of Sports Medicine (ACSM) defines aerobic exercise as “any activity that uses large muscle groups, can be maintained continuously, and is rhythmic in nature.” It is a type of exercise that challenges the heart and lungs- causing them to work harder than at rest. The most important idea behind aerobic exercise is to get up and get moving today!!

Aerobic Exercise Recommendations in Charlottesville

• Exercises : Activity selection depends on several factors: Your current level of fitness, joint health, resources and interests. You should use a variety of exercise options to prevent overuse injuries and to maintain interest. Examples of aerobic exercise are bicycling, swimming, treadmills, eliptical exercisers, rowing machines and low-impact aerobics (i.e., walking, dance, or Tai Chi). Other options include basic activities such as walking the dog, mowing the lawn, and raking leaves. We recommend aquatic exercise as a good alternative for patients who cannot tolerate weightbearing exercises. This is an excellent option for patients with osteoarthritis and other degenerative conditions. Charlottesville has many wonderful exercise options. ACAC offers a wide variety of choices from classes, to open cardio and weight areas to pool based exercise and swimming programs. The area has many yoga and pilates studios. I’m personally a fan of Hot Yoga Cville and FlyDog for yoga and Tru Pilates for pilates classes. Madabolic offers an all inclusive workout program combining cardio, functional movement and strength training. The Gym offers great strength training programs. The area also has two crossfit boxes and a wide variety of hiking and running clubs, dance and martial arts studios , fencing, climbing gyms and more. I’m composing a more complete list of resources and will post it soon.

• Intensity : This is very subjective and is usually better addressed on an individual basis depending upon your health status. An easy starting tool is what is referred to as the “talk test” (whether an exerciser can converse comfortably during the activity without getting short of breath). If you are able to carry on a conversation, your exercise is light to moderate. If you are unable to carry a conversation, your exercise is considered vigorous. A more involved measurement is to workout at your target heart rate. This is calculated by maintaining between 50-75% of your maximuum heart rate. Your maximum heart rate is 220 minus your age in years. The table below will help, but remember this is only a guideline. If you have heart disease or are on medication it may alter your heart rate and you should consult with your primary physician before beginning any exercise program.

Target Heart Rates

Age Target Heart Rate Zone 50-75% Average Maximum Heart Rate 100%

20 years 100-150 beats per minute 200

25 years 98-146 beats per minute 195

30 years 95-142 beats per minute 190

35 years 93-138 beats per minute 185

40 years 90-135 beats per minute 180

45 years 88-131 beats per minute 175

50 years 85-127 beats per minute 170

55 years 83-123 beats per minute 165

60 years 80-120 beats per minute 160

65 years 78-116 beats per minute 155

70 years 75-113 beats per minute 150

• Volume : The recommended amount is generally 20-30 continous minutes per day. For those of you who think this is not feasible, you can start with shorter sessions spread out through the day and slowly increase up to the 20-30 minutes. Specific suggestions include such easy changes as taking a walk during lunch breaks and climbing the stairs instead of using the elevator. • Frequency: You should perform aerobic exercise around 4-6 days per week.

• Progression : The progression of aerobic training intensity and volume should be gradual in nature- as with any exercise.

• Precautions : More often than not, injuries can be avoided if you gradually work up to the desired activity level and avoid excessive increases. Other precautions relate to your specific health risks and we would be glad to discuss this individually. However, remember there is always something each one of us can do to increase our aerobic activity without aggravating other conditions.

Resistance exercise should be performed 3-4 times per week. Beginners can start with elastic tubing and progress to machines or free weights. Tubing or free weights may be a better option for long-term programs as they may pose less of a chance for overuse injury compared with “one motion fits all” machines. Begin with light weights and progress slowly. A lifting program is not beneficial if you injure yourself by lifting heavy weights too soon. Lifting lighter weights for higher repetitions (12-20) will build strength and endurance. Lifting heavier weights for fewer repetitions (6-10) builds strength and bulk but also poses a greater chance for injury.

Make sure that your lifting program balances muscle groups. Lifters often focus on the large muscles that are more noticeable (i.e. chest and shoulders) and forget about the reciprocal muscle groups (i.e. scapular stabilizers). This leads to postural imbalance and an increased chance of injury. Many rotator cuff injuries result from this seemingly harmless imbalance. A good rule of thumb is to balance “pushers” with “pullers”. Pushers include; shoulders, chest, triceps, abs, quadriceps, and calves. Pullers include; biceps, back and posterior shoulder muscles and hamstrings. Pushers and pullers do not need to be worked during the same session; in fact they should probably be worked on different days.

While all this may all seem like a lot of work, the benefits of exercise will actually make your life a lot easier. Participating in physical fitness can help you more easily perform many of your day-to-day tasks. For example, being more flexible will help you do things like reaching into your cupboard and tying your shoes. Being stronger and having more balance will help you lift and carry items like groceries and will make it easier to get in and out of chairs and the bathtub. Improving your cardiorespiratory endurance will allow you to do things like climbing stairs, dancing, or playing with grandchildren without getting out of breath.

All are very good reasons to start exercising today! Just remember to make gradual changes to avoid injury and experiment with different activities until you find something that works for you.

Healthy Cycling in Charlottesville

Mon, 04 Apr 2016 17:09:00 GMT

Proper adjustment of your bicycle helps to minimize fatigue, discomfort, and overuse injury. The following guidelines should help fit your bike to your body:

• Choose the right size bike – a rough estimate for choosing the proper frame size is to subtract 10.5 inches from your inseam. Straddling a proper-sized bike will leave approximately 1” clearance between your groin and the top of the frame. • Adjust the saddle so that when the ball of your foot is on the pedal (with your leg fully extended in the six o’clock position) there is approximately a 10-degree bend in your knee. The saddle surface should be horizontal or tilted slightly up at the neck. Off-road riders may benefit by using a stem that contains a spring for additional shock absorption.

• Your stem height should be somewhere between parallel and 1” lower than the top of your saddle. A gentle rule of thumb for selecting the proper stem offset is to place your elbow on the nose of your seat and stretch your arm forward over the stem. The tips of your fingers should touch your handlebars. • Cycling accessories can dramatically affect your comfort level. Padded bicycle shorts are the single most important piece of clothing for long rides. Wearing cycling gloves

Hamstring Stretching

Mon, 07 Mar 2016 14:42:00 GMT

It is getting to be running season again…and that is as good a time as any to get some hamstring stretching in. Your hamstring is the group of muscles in the back of your thigh that flex your knee, i.e., moving your heel toward your buttock. Tightness in this muscle is a common contributor to low back pain, especially in those who sit all day. This can be for a variety of reasons: quadricep dominance, weakness in the hamstring, weakness or inactivity in the glutes or many other issues.

Here’s an exercise to help stretch your tight hamstrings. Remember that static stretching should NOT be performed within 2 hours of a run. Stretch after your workout but not before. Static stretching beforehand leads to weaker muscle contraction, poorer performance and increased risk of injury.

<iframe width=”560″ height=”315″ src=”https://www.youtube.com/embed/JiReHZmOcVg” frameborder=”0″ allowfullscreen></iframe>

A clinical tip: if your hamstring is persistently tight and stretching on your own hasn’t helped, it may only feel tight. But it could be neural tension or limited mobility in a joint elsewhere in the body. You can also see this video here on youtube.

Chiropractic As A Component Of Medical Management

Thu, 07 Jan 2016 22:52:00 GMT

Chiropractic As A Component of Medical Management

The Ontario Ministry of Health has funded a study to determine the value of MD/DC collaboration in the management of lower back pain. Study participants were evaluated by their primary care physician and also by a chiropractor, in the same office. Physicians and chiropractors partnered to discuss decision-making for; appropriateness of advanced imaging, specialist referral, patient education/ self-management and care plans.

The study’s outcomes are as followed: • High patient satisfaction (94% of patients said they were “very satisfied” or “satisfied”) with care. • High provider satisfaction. All physicians made reference to the value in referring Low Back Pain patients to the consulting chiropractor assessment. • The majority of physicians perceived the consulting chiropractor’s assessment and management of Low Back Pain as being of higher quality than physicians. • Increased patient confidence in diagnosis and treatment options. • Decrease in referrals for imaging and specialists (71% of physicians reporting).

Endicott, A. Working with MD’s to Treat Back Pain, Dynamic Chiropractic, Vol. 30:20, September 2012

Living Our Best Lives in the New Year

Tue, 05 Jan 2016 21:00:00 GMT

While I can’t give you a step-by-step guide to achieving all of these things, I have learned tools for creating your own map and sticking with the journey.

In martial arts, we study balance. An important principle of balance is that where the head goes, the body follows. You must keep your head pointing in the direction you want to move.

The same is true for life. Our actions go where our vision goes. If we’re focused on not eating a brownie, soon all we can think about is brownies, and we are more likely to end up eating the whole pan. A more effective approach to living well is focusing on what we want: to go for a walk, to read books with our children, to cook dinner with our partner, or to pick up the phone and call or text a friend.

A Native American proverb states that there are two wolves that live inside us. One is evil, full of anger, worry, and greed. The other is good, full of love, compassion, and peace. The two wolves are in a battle. The one we feed the most is the one that wins.

Precommitment means planning what you will do to avoid obstacles that would derail you from meeting your goals. This could mean setting your alarm for ten minutes earlier in the morning so you can finish your physical therapy exercises before your day gets busy, or doing dinner prep on the weekends, so you have more time to help your kids with their homework on week nights.

As you practice precommitment, reach out to people who can help you come up with ideas for tackling those obstacles. If you want to grow in your job, ask someone you respect in your field if they could serve as a professional mentor, or if you could take them to lunch and ask them questions.

Of course, for increasing fitness, a healthcare provider is a great resource. Creating health plans with clients is one of my favorite parts of my job. Read my blog about precommitment for more practical ideas and schedule an appointment if you would like assistance in coming up with a plan to help you move more and feel better.

Your resolutions should be doable. We don’t start with 50-pound weights; we start with 5 pounds. If it’s the end of January and you still haven’t enacted your plan, your plan is too hard. Set your sight on an action that is easier for you to take right now, as you are. Haven’t run a mile yet? Try walking to the mailbox. Take the stairs instead of the elevator at work. Park at the end of the parking lot so you walk farther to get to the store. Believe it or not, the great Bruce Lee employed those exact strategies, and couldn’t we all be a little more like Bruce? The sense of accomplishment you feel when you achieve a smaller goal will give you the energy you need to do something harder.

If I had to summarize my advice for a healthy life into one sentence, it would be a short one: eat well, sleep enough, and move around (which happens to be the secret to avoiding the doctor entirely).

Planning ahead is good – I’ve already suggested you do it! – but a healthy life is one in which planning is balanced with being present in the moment.

In a research study aided by an app called Track Your Happiness , it was found that, “[P]eople are substantially less happy when their minds are wandering than when they’re not.” The researchers probed a little deeper to try to determine whether our minds wander because we are unhappy, or if we tend to be unhappy because our minds wander. The evidence seems to be shaping up that it’s the latter: a wandering mind makes us less happy.

Being mindful of the present is a habit, just like exercising. Some people start with small steps, like asking themselves a series of short questions throughout the day, such as, What does the room I am in feel like? Is it hot or cold? Can I feel my feet on the ground? What is my breathing like? Can I slow my breath down? What does it feel like to take a deep breath?

Any small question that draws your attention to the physical sensations you are experiencing can help you begin to notice your present.

While you’re in the moment, find something to be thankful for. Again, it can be something small. You can be grateful for how good your morning coffee tastes. Thankful for the hug your child just gave you. Thankful to be wearing your favorite pair of shoes.

Studies have shown that gratitude has many benefits for our health, including improving our sense of wellbeing. Gratitude can help us keep our balance, standing in the present while looking up and ahead at the life we are creating.

Balance Chiropractic in Charlottesville: Past & Present

Tue, 22 Dec 2015 17:48:00 GMT

Balance Chiropractic in the Charlottesville Community

Seven years ago, Dr. Sam Spillman moved to Virginia to work with Dr. David Brown , a fellow chiropractor and businessman who was also serving as the mayor of Charlottesville. Dr. Spillman was from upstate New York and had lived in Japan, but it didn’t take long for Charlottesville, with its friendly people and focus on healthy living, to begin to feel like home.

In 2008, Dr. Spillman became the primary chiropractor of Balance Chiropractic and Physical Therapy, the practice Dr. Brown had created in 1982. Dr. Spillman says of taking on the practice from Dr. Brown – who in 2014 was appointed by Virginia Governor Terry McAuliffe as eighth Director of the Virginia Department of Health Professions – “I had big shoes to fill. It was an honor and a challenge to take on the practice David had started.”

Since then, Dr. Spillman and his colleagues have worked hard to make sure Balance continues as a vital part of the community where it began and contributes to Charlottesville’s growth.

Through Balance, Dr. Spillman donates to local nonprofits that focus on empowering women who have experienced violence or are survivors of human trafficking. (For more information about the nonprofits and how you can help, please see the links at the bottom of this page.) Dr. Sarah-Ann Eng, a chiropractor Dr. Spillman brought on board at Balance, volunteers time with Habitat for Humanity.

Balance is also part of the revitalization of a historic Charlottesville area on Preston Avenue. In February, the practice is moving to the restored King Lumber warehouse. King Lumber was once the largest employer in Charlottesville, and at one time over 300 people were working in the warehouse. Its restoration is part of a larger plan to bring more employment opportunities to the Preston Avenue corridor.

The move will give Balance more space for performance enhancement services for Charlottesville’s running and sports enthusiasts, including Titleist Performance Institute golf analysis and corrections to help golfers improve their game.

Dr. Spillman gains a lot from Charlottesville, as well. An avid runner, he has participated in the Martha Jefferson Hospital Foundation 8 K, Cville 10 Miler, Run for Autism 5k, and the Pepsi 10k. He practices at Charlottesville Brazilian Jiu-Jitsu (he decided to become a chiropractor after chiropractic care helped him recover from a martial arts injury), attends classes at tru PILATES and Hot Yoga Charlottesville, and works out at acac .

When asked what his favorite part of Charlottesville is, Dr. Spillman replies, “My patients. They are always telling me about new things to try, from restaurants to the best running trails. I also like that everything is close. I have easy access to great food, fun, my work and my friends all within a few minutes. I’d much rather spend my time with people that are important to me than in the car!”

He follows up, “I look forward to being part of Charlottesville for many years to come.”

*****

Balance Chiropractic supports the Sexual Assault Resource Agency and the Arbor . Please click on their names to follow the links to their websites, where you can learn more about these important Charlottesville community services.

Holiday Stress Management

Sun, 06 Dec 2015 20:23:00 GMT

Holiday Stress Management

The end-of-the-year holiday season may be the best time of the year, but it can also be one of the most stressful. Decorating the house and hosting parties and attending your children’s holiday pageants is a lot to keep up with. Learning about holiday stress management to take care of ourselves during stressful times is a tool that will serve as well throughout our lives and its seasons.

Here are six stress relief techniques that I’ve found helpful.

1.Be Positive.

In my Thanksgiving blog , I mentioned the power of gratitude in keeping us healthy. Turning our attention to the good things in our lives and even in our day-to-day interactions promotes a sense of overall well-being.

Think of it as gratitude meditation. People who meditate often talk about the “monkey mind.” This is when our minds, like hyperactive monkeys, begin swinging between thoughts about the past and future instead of being in the present moment. Similarly, during stressful times we might be even more inclined than usual to focus on what is causing us anxiety. We have the ability, though, to recognize that we are doing this and remind ourselves of what is good in our lives.

What will help you bring your monkey mind back to gratitude? Some people find keeping a journal helpful. There are also several apps that can help you focus on positivity. Happier.com is a great website and app for cultivating positivity.

2. Organize and prioritize.

If your brain feels full trying to remember all the things you have to do and it is weighing you down (all that information gets heavy after awhile), get your to-do list down on paper (or the Notes function on your phone).

Does that idea sound overwhelming? Perhaps you need to say no to some activities this holiday season. Sometimes we remain disorganized to protect us from facing the reality: we’re simply trying to do too much.

Organize your to do list, then prioritize what is most important. Let go of the rest. You’ll be better able to enjoy what matters most this holiday.

In an article on stress management , the Mayo Clinic gives this good advice on how to say no: “If you have a hard time turning down requests, try saying, ‘No, I can’t do that now.’ Don’t hesitate — be direct. If an explanation is appropriate, keep it brief.”

3. Communicate with people who care about you.

A recent study found that having a best friend present during a stressful situation prevented a spike in cortisol , the hormone that is released when we are stressed.

The Mental Health Center at the University of Texas points out, “Talking with someone else can help clear your mind of confusion so that you can focus on problem-solving.”

Hanging out and talking with supportive friends and family make us better able to deal with stress.

4.Relax.

But it’s also important to take time to allow your body and brain to rest. Take a bath, listen to music, dance, or take a walk just for fun. A recent study found that practicing yoga and meditation is particularly helpful in helping us relax and relieving stress and anxiety.

Find what relaxes you and enjoy it.

5.Exercise .

The positive connection between exercise and less stress has been proven by study after study. Just type “effect of exercise on stress” into Google, and you’ll see what I mean. Articles by the American Psychological Association and Anxiety and Depression Association, emphasizing the power of exercise to relieve and prevent stress , will be a couple of the first results to pop up. A Harvard Health Publication even advises, “ Exercising to relax ”!

If you are already active, keep it up – and remember that high intensity exercise helps you more effectively process cortisol out of your body! (Read more about high intensity interval training in my blog 8 Tips to a Healthy Weight and Active Life. The article includes links to HIIT routines.)

6.Address the physical symptoms of stress .

Stress shows up in our bodies. Headaches, jaw pain, neck and upper back and shoulder pain are common physical manifestations of stress. This discomfort can itself raise cortisol levels, throwing us into a stress-pain-stress cycle. Practicing these holiday stress management techniques can really help with this.

Chiropractic care, such as spinal manipulation, can relieve many of these painful issues, as can therapeutic and relaxation massage. Along with exercise, chiropractic and massage will help our bodies be pain-free and stress resilient, so that we can enjoy the holidays and every day. Other practices like yoga, pilates and meditation can also be very helpful.

Book a chiropractic adjustment and a massage today with Balance Chiropractic and Physical Therapy by calling (434) 293-3800 or emailing info@balancechiropracticva.com.

Thanksgiving: What I’m Thankful for in 2015

Fri, 20 Nov 2015 20:26:00 GMT

WIN A $25 GIFT CARD TO MARIE BETTE!

With numerous studies showing that gratitude promotes health , maybe I should consider handing out prescriptions for thankfulness. Or even better, give you a chance to win a gift card to Marie Bette for telling Balance what you’re thankful for – just like this post and leave a comment with at least one thing you’re grateful for this year. Winners announced this Friday, November 27!

I’ll go first. I have a lot to be thankful for in 2015!

Zoe made me an uncle. I was able to visit her and my sister and brother-in-law shortly after her birth, and we FaceTime every week. I have been most surprised by how quickly Zoe changes as she grows. Half the memory on my phone is now taken up with pictures of the best baby I’ve ever met, and I’m reminded to take care of myself so I can be an uncle who is around for a long time to come.

I’ve also celebrated the birth of Dr. Eng’s daughter, who arrived last month. Everyone at Balance is happy that Hannah and Dr. Eng are doing well.

As I wrote in a blog about my first yoga experience , it’s good to try new things. Getting in a rut of doing the same exercises over and over doesn’t give your body a chance to fulfill its greatest health potential and can even result in a repetitive strain injury. Realizing I needed more flexibility training, I took a hot yoga class earlier this year – and I liked it! I’ve attended several classes since and am making it a regular practice.

I’m constantly thinking about how Balance can offer the best services to our patients and recently hired Dong Ha to offer therapeutic massage. Dong brings to Balance over twenty years of experience as a physical therapist and great massage skills. I am delighted that Balance patients are now able to receive massage as part of their treatment plan.

In early 2016, Balance will be moving into renovated space in the historic King Lumber Company Warehouse on Preston Avenue. Just a quarter mile away from our current office, the new location will be larger, allowing us more room for physical therapy and for performance enhancement services. The new office will also have more parking. Stay tuned to our blog and Facebook for updates on this exciting move!

Gray Cook is the founder of Functional Movement and a professional hero of mine. Gray’s work has significantly influenced my professional development and my patient care. It was an honor to introduce him when he spoke to Virginia chiropractors at our fall convention.

And last but certainly not least…

I hope to be learning as long as I’m living, and I learn a lot from you, my patients! You are a wonderful source of new information. You’ve told me about therapies that you have had success with at other places. You’ve given me suggestions for good places to eat in Charlottesville and when traveling, hotels to stay in while visiting Costa Rica, places to visit in Paris, the best place to try hot yoga in Charlottesville… Each of you makes it really fun to come to work.

Thank YOU for choosing Balance Chiropractic as your partner in health in 2015. I look forward to helping you stay strong and healthy in 2016.

6 Ways to Be Safe & Healthy and Have Fun on Halloween

Fri, 30 Oct 2015 18:07:00 GMT

Cinderella’s gown might not have included a reflective light band, but your princess’s costume should. Reflective bands – the kind worn by cyclists around their legs or arms – are cheap and easily available at local bike shops, Target, Wal-Mart, and online at Amazon. Wrap one around your child’s arm so they can be easily seen even as the sun goes down.

And slow down when you’re driving through neighborhoods on Halloween! Remember that children aren’t always aware of their surroundings or potential danger – so we need to be aware of them.

Encourage your children to choose a costume without a face mask, which has a risk of suffocation. A full mask may also make it harder for a child to see, causing lesser injuries like bumps and bruises from tripping and falling.

Opt for a hat, crown, or face paint instead. Easy to use face paint can be found on the costume aisle or at a craft store.

Throwing an old-fashioned block party lets your kids – and you! – have fun while finding safety in numbers. Invite neighbors to bring treats for all to share and throw some apples for bobbing in a large basin of water, and you have a party. Don’t forget to set out safety cones or “watch for children” signs to remind passing drivers to be extra careful in your neighborhood.

If your neighbors aren’t up for a party, find one at a local community center or church. In Charlottesville, you can join the popular Trick or Treating on the UVA Lawn , where UVA undergraduates living on the Lawn pass out candy. Several University groups also set up games and prizes at the end of the Lawn. If you’re worried about all the candy piling up in your child’s bucket, stop by the Department of Family Medicine’s booth, where they pass out books.

Dressing up for Halloween gives children of all ages an opportunity to use our imaginations to be creative and have fun. For children in particular, the scary elements of Halloween can help them face fear in a controlled way, giving them a sense of power over it. For younger or very sensitive children, however, the scariness can become overwhelming. If your child seems anxious about all skeletons, scary masks, and faux headstones popping up in October, read her or him books about Halloween or being scared that have positive messages, such as The I’m Not Scared Book . You may also explain the how behind scary things: How does that skeleton move? Is it alive? No, it’s blowing in the wind!

Most importantly, just listen to your children and let them know that however they feel is ok, and you are there to protect them – and help them choose a non-scary costume!

Many dental offices have begun collecting excess Halloween candy, which they then send to military personnel serving abroad. Some dentists offer incentives in return. The Halloween Candy Buyback website allows you to input your zip code and find a dentist near you who is participating. Platinum dental participants are offering xylitol-based sweets in return. The Halloween Candy Buyback is also donating toothbrushes to overseas military.

All parents know that by the third or fourth block of trick or treating, there’s a decent chance you’ll be carrying a Minion or a Tinkerbell who is too tired to walk back home. Between that and staying up late the night before to make enough monster cupcakes for your kid’s class, you may be feeling drained come November 1.

Regain your wellbeing with a massage by Dong Ha at Balance Chiropractic & Physical Therapy . Dong is trained in both massage and physical therapy and has twenty years of experience, ranging from working with national-level athletes to post-orthopedic surgery rehabilitation. Book your appointment by calling (434) 293-3800 or emailing info@balancechiropracticva.com.

Prevent Running Injuries This Fall in Charlottesville

Thu, 29 Oct 2015 15:42:00 GMT

Prevent Running Injuries This Fall

With cooler temperatures and less humidity in the air, you may be inspired to lace up your running shoes and hit the road. There are always lots of races in and around Charlottesville this time of year. Whether you’re a seasoned runner or a beginner, it’s wise to take precautions to avoid injury, especially if you’ve been less active in the preceding months. Here are a few of the most common running injuries and helpful tips to prevent them. In general it is a good idea to spend several weeks and month building up mileage. It is also important to have great footwear. You can head out to Ragged Mountain Running Shop or Crozet Running to get the right footwear. Both stores do running and gait analysis and will take plenty of time to help you find the right shoe.

Plantar Fasciitis

Plantar fasciitis is a painful irritation of the fibrous band running from your heel to the ball of your foot. It’s caused by chronic overstretching and is more common in women, overweight people, or those who participate in endurance sports, such as running. Hill running (especially down hill) can accentuate this problem and as we all know it is hard to find a flat place to run in Charlottesville.

Tip : To prevent this condition, avoid wearing shoes that lack proper arch support. Also try to run on soft surfaces and do not increase your mileage by more than 10% each week.

Runner’s Knee

(Patellofemoral pain syndrome) This most common cause of knee pain results from an imbalance between the muscles that help to guide your kneecap in its V-shaped groove at the end of your thigh bone. Repeatedly flexing and extending a misaligned kneecap leads to pain, swelling, and eventually arthritis.

Tip : There are several things that you can do to help prevent this problem. Runners knee often arises secondary to weakness in the muscles that control your hip, so strengthening your glutes and hamstrings is critical- as is stretching after a workout. Wear shoes with good arch supports and avoid running with an excessively narrow or “crossover” stride.

Shin Splints

Shin splints are caused by repetitive overuse stress- especially running or jumping on firm surfaces. Symptoms can arise from tears in the anterior tibialis muscle or even micro-fractures of the tibia (shinbone). The pain can range from mild to severe and can last for months.

Tip : You can help prevent shin splints by avoiding overtraining and limiting running on hard or uneven surfaces. Always perform a proper warm-up before running, especially when sprinting. Your training plan must be taken into consideration, as doing “too much”, “too soon” or “too fast” can contribute to any overuse injury. Help for your pain! If you notice symptoms related to any of these conditions, it’s best to avoid running, or at least decrease frequency and speed to prevent further damage. Cross training activities, such as cycling or swimming, can be good alternatives while you heal. Fortunately, each of these conditions can be treated conservatively. Our providers are highly trained to help you feel better, so you can get back on the road quickly. If you or someone you know is struggling with pain, call our office to schedule an appointment today.

The Functional Movement Screen (FMS)™

Tue, 13 Oct 2015 20:39:00 GMT

“No pain, no gain” – that’s the mantra of many people dedicated to fitness. However, exercising through pain may mean that you are ignoring an underlying issue, a risk that can make the problem worse and result in having to take more time off later on while you heal from an exacerbated injury.

While some discomfort during activity – for example, when you would rather be sitting on the couch watching TV instead of lifting weights – is normal and necessary for growth, pain is an indication that something is wrong and needs to be corrected. You may simply have incorrect form or technique, or you may have an injury.

A score below a 14 represents an elevated risk of injury. If you score in the mid-range, you could also benefit from developing a plan with a chiropractor or physical therapist to improve your mobility and stability. In the meantime, you would want to avoid situations that could aggravate an existing issue, such as large group classes at the gym, where you receive little personal attention and correction for improper form. At 14 and above you are likely to be able to perform any exercise without elevated risk of injury, but this is where the performance enhancing comes in. Increasing your score will likely result in improved performance in your sport, in and above any necessary skill training.

A good score means that you can feel free to engage in any activity, knowing you are at low risk for injury.

In addition to appointments at his clinic, Dr. Spillman is available to provide on-location screenings at offices and other facilities, including gyms, martial arts schools, sports teams, running clubs, or other fitness studios. Call Dr. Spillman at Balance Chiropractic and Physical Therapy at (434) 293-3800 or email info@balancechiropracticva.com.

The Last Diet You’ll Ever Go On

Sat, 15 Aug 2015 10:58:00 GMT

Scientific research confirms what many of us already know, that our impulse control, or lack thereof, affects our ability to lose weight and keep it off. How we set ourselves up for failure is to respond, “So all I have to do is control my impulses to overeat.” Not so fast. When that oversimplified approach fails, we beat ourselves up, resulting in even less energy to make good choices next time.

Instead, we need to understand that the degree to which we can exert effort to change behaviors (say, to eat sensible portions instead of overfilling our plates) is governed by the current state of our brains – which is a result of both genetics and the social environments we have lived in. It is also the result of the immediate situations we face. We know that stress seems to lower our self control, but numerous studies have also shown that making decisions – even decisions as seemingly innocuous as completing your wedding registry or ordering a new computer! – lowers one’s impulse control (a.k.a. “willpower,” “self control,” and “the way you stop after one doughnut”). Pretty much anything that requires mental energy is tapping into the same reserves that willpower needs.

In a cruel twist for anyone trying to lose weight, glucose will restore willpower in the moment. When you reach for the brownies after a hard day of work, with a long To Do list still waiting for you at home, you’re not a failure. Your body is doing what it knows to do to make sure you have mental energy.

The good news is that our brains also have an amazing feature called plasticity . Scientists used to think that the brains we were born with were the ones that we had for life. In recent years, however, we’ve learned that’s not true – our brains can grow new neurons! We have the ability to begin to think differently.

The question, then, is how to cultivate higher behavioral impulse control, and the answer is to practice precommitment .

Precommitment is defined by researchers as “the voluntary restriction of access to temptations.” Precommitment means taking steps before an event occurs to ensure that you will stay on track to meet your goals. Images of the brain have shown that precommitment changes the way the brain responds to the need for willpower, increasing its ability to delay gratification, especially in individuals who tend to be more impulsive.

In addition to limiting factors that might derail your weight loss goals, another key component of precommitment is self-care – knowing what you need to feel well and actively incorporating it in your life. This will help keep your emotional and mental bank account full, allowing you to make withdrawals later when you need strength for impulse control.

There are numerous ways to incorporate precommitment.

If you’re like many of us, at least one of the above tips feels like an indictment.
“I could never convince my kids to help with kitchen chores!”
“How am I supposed to find time to meet up with friends? I brush my teeth in the shower and eat standing up!”

Fortunately, making changes isn’t a one-chance deal. Plasticity is achieved over time. If you didn’t reach your goals this week, you have another opportunity to practice pre-commitment by figuring out why it didn’t work and how to make it work next week. You can also change your goals if you continue to miss them, which can be a sign that they aren’t realistic, or at least not realistic for now. Your goal is to cultivate habits you can enjoy over a lifetime.

What many weight loss plans are missing – and what keeps us hopping from one fad diet to another – is that we are not machines, where you plug in a specific formula and an ideal weight pops out. We are humans, with rich lives and living brains, which respond to the choices we make over time.

That’s the secret. That’s the last diet you will ever go on.

8 Tips for a Healthy Weight and Active Life

Sat, 15 Aug 2015 10:56:00 GMT

Need inspiration for how to achieve a healthy weight and improve your fitness? We’ve put together top tips, based on the latest research.

The effectiveness of HIIT has been confirmed in numerous studies over the past few years, with Science Daily summarizing the results of a 2013 clinical study of HIIT: “Inactive people can achieve major health and fitness gains in a fraction of the time.”

One of the ways HIIT increases fitness levels is by promoting post-exercise oxygen consumption , which means you burn more calories, even after your workout is over.

There are numerous interval workouts online to try out.

2. Don’t forget to strength train.
Too often, we focus on aerobic exercise – think jogging, cycling, and using the elliptical machine at the gym – and neglect strength training (also called resistance training). This is a huge mistake, as strength training has been shown to control belly fat ; ease lower back pain ; improve glucose control ; improve cognitive function , including memory ; and decrease the risk of osteoporosis . Scientists have yet to determine whether it will make your mother-in-law like you, but it probably won’t hurt.

Lifting weights is a method of strength training, as is using the resistance of your own body, such as when you do certain yoga poses .

3. Eat the rainbow.
Include lots of colorful vegetables and fruit in your meals and snacks. Michael Pollan encapsulates this idea in one of the shortest diet plans ever: “ Eat food. Not too much. Mostly plants.”

The “eat food” part means eating real food, not the stuff we’ve created in the last century (ahem, Twinkies). Highly processed food should be avoided – the longer the list of ingredients, the more processed the food is.

Fill out your diet with lean protein and going easy on the carbohydrates, especially simple (and often highly processed) ones like bread.

4. Go to bed.

In research studies, people who had not had enough sleep ate 260 – 550 extra calories a day! Sleep deprivation may increase your risk for obesity and diabetes. Adults should sleep for 7-8 hours every night.

5. Practice a technique known as precommitment to avoid overtaxing your ability to make good choices.
Impulse control, the skill that keeps you from eating an entire box of Girl Scout cookies in one sitting, requires mental energy. You know what else requires mental energy? Pretty much any decision, from picking out what shoes to wear to whether to ask for a raise at work. (Many highly successful people are noted for wearing similar clothes every day – Steve Jobs’ iconic black mock turtleneck shirt is one example – so they can focus on decisions that are more important.)

Precommitment is planning beforehand (like Steve Jobs) how to minimize energy-tapping decisions and preserve impulse control. Make it easier for yourself to make good choices by practicing precommitment, especially during times like the evening when you are fatigued from a long day. On the weekend, cut up veggies to have on hand for dinners. Tell the waiter not to bring out the bread basket when you go to a restaurant after work.

And a tip you can really enjoy: eat your Girl Scout cookies with breakfast. Seriously. In one study , participants who ate dessert with their high carbohydrate, high protein breakfast lost more weight than those who ate smaller breakfasts and larger dinners. Having a slice of cake in the morning may take away the temptation to eat half a cake at night after a day of eating yogurt and fruit.

Rest! Recover!

Tue, 14 Jul 2015 12:28:00 GMT

So it should be no big surprise to you to learn that my back has gradually gotten worse. That’s what happens when my patients don’t follow my advice, and that’s what happens when I don’t follow my own advice. I finally made an appointment to get it looked at, and the prescription is REST. And finally the gears turned and clicked and I understood: I should have taken some time off when my back first began to hurt. I should have stopped that cycle of chronic inflammation before it started. I’ve often warned, “if you don’t slow down when you need to, your body has a way of slowing you down.” True story. I could have been pain free this year if I’d listened to my own advice.

Reach Your Goals!

Thu, 14 May 2015 19:52:00 GMT

I admit that lately, I don’t always have the energy to do an intense workout. But I like to set goals and try my best to achieve those goals! If you’re not used to doing this in your exercises routine, start with something easily attainable then work your way up to some more challenging goals. You may be surprised at what you can achieve! Hope you’re having a wonderful week!
~Dr. Eng

We like to use SMART goals in our office. This is a common practice in the business environment but I think it works very well for health goals as well.

S-specific. Say you want to run faster. That’s a great goal but it is very open ended. How would you know you’ve achieved it. Instead you might say I want to improve my mile time from 8:30 to 8:15.

M-measurable. You have to be able to measure your goal, otherwise you won’t know when you’ve achieved it.

A-Attainable. The goal should be realistic. If you want to run faster and achieve that 8:15 mile time that’s great. But if you want to do it by tomorrow, that’s a touch unrealistic.

T-timely. You should have a time frame for your goal. While tomorrow might be a little too soon, a year might be too long. Creating a training program to achieve your running goal should match your lifestyle.

Trying New Things

Thu, 19 Mar 2015 01:03:00 GMT

Trying new things…

Most of us don’t like change. Oh, sure, we want to improve, to do it better, faster, and have more fun doing it. Tomorrow. Today, we creatures of habit are most likely going to do what we did yesterday. We liked it then and we’ll like it tomorrow, and it’s easy to keep doing it. It’s pretty easy, too, to limit our ideas about self-improvement to the things we already enjoy doing. Maybe I’m a runner, and I want to run farther or faster. Maybe I like getting stronger, and in pursuit of that improvement I’ll do more reps, more of the same thing. You get the idea.

Last night I tried something I’ve never done before: Hot Yoga. I’ve always been a fan of balance, in theory. Strength should be balanced by flexibility, and flexibility should be tempered with strength.

Hot Yoga

In theory. But I hadn’t done much about flexibility in my own training. I didn’t know what yoga would be like. I didn’t know if I’d like it. But I spent an hour putting myself in new positions, and breathing, and paying attention to exactly how my body felt… and I liked it.

So let me encourage you to move in a new direction by trying something new. If you’re like me and you’ve focused on strength or speed, try a yoga or stretch class. If you do yoga, some strength training will help you hold your poses longer. If you play a sport focused on a skill, like golf, try exercising a different skill set. And if you are an all-round athlete, try sitting still and meditating. Get out of your comfort zone. Stretch yourself. Grow.

I Never Lose

Sun, 22 Feb 2015 11:49:00 GMT

SNOW Safety!

Mon, 16 Feb 2015 16:18:00 GMT

Shoveling snow can really do a number on your back!

Here are some things to keep in mind when shoveling.
Pick the Right Snow Shovel
Pick a light shovel so it doesn’t add to the weight of the snow. Make sure the handle is adjustable or long enough so you don’t have to bend over more than absolutely necessary.

Warm Up!
Shoveling snow is strenuous exercise. You should warm up beforehand just like you would before working out in the gym or playing basketball. Do some light calisthenics (arm circles and raises, spinal twists, body weight squats) to warm up your muscles. You’ll know you are warmed up when you feel warm, start to sweat and are a little out of breath. Avoid stretching before you exercise…stretch after.
Use Good Form
Whenever possible, push the snow to one side rather than lifting it. Many shovels are designed to let you push snow. When lifting the snow shovel is necessary, make sure to use ergonomic lifting techniques:
Always face towards the object you intend to lift – have your shoulders and hips both squarely facing it.
Bend or HINGE at the hips, not the low back, and push the chest out, pointing forward. Tighten or flex your abs (think bracing) and your buttocks. Then, bend your knees and lift with your leg muscles, keeping your back straight and keep your face looking straight ahead or up. Just like you would doing an exercise in the gym.
Keep your loads light… work smarter, not harder .
If you must lift a full shovel, grip the shovel with one hand as close to the blade as comfortably possible and the other hand on the handle (handle and arm length will vary the technique). Keep your body as close to the blade as possible… the longer the lever arm, the more pressure on your back.
Turn to the side to dump your snow, avoid twisting your back (I know, it seems easier but it is much riskier for your back). Resist the urge to throw the snow.
Wear proper footwear to avoid slipping and falling.
Pace Yourself
It is easier to remove small amounts of snow than large amounts. Consider breaking the chore up into several sessions. Also, if possible, it is easier to shovel as the snow falls, rather than waiting for it to accumulate. Usually, you can push a few inches around.

This is also important for your heart. Snow shoveling is strenuous work and as you are bending and lifting, your muscles tighten around your organs, this internal pressure will raise your blood pressure. So it can be an intense workout for your body and your heart. If you start feeling dizzy or light headed, take a break. Heart attacks are common during snowfalls for this very reason. If you have high blood pressure or a heart condition, you’ll want to be extra careful when going out to shovel snow. If you have any questions, be sure to consult with your doctor or cardiologist before shoveling snow.
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If possible, use a snow blower or borrow one from a friend or neighbor. If you already have back trouble, consider using a service for snow removal. If you have elderly or infirm neighbors, please help them!

Yoga

Wed, 11 Feb 2015 23:02:00 GMT

Yoga is the poetry of movement. It helps you to push yourself, to slow down and be in the present. I really just do it so that I can polish my toenails. ~ Dr. Eng

Dr. Eng does yoga

Aside from polishing your toenails, what are the benefits? Yoga is a slow form of exercise done in silence. You’ll spend 60-90 minutes breathing, stretching and posing. You’ll have nothing to think about but how you are balancing and how your body feels. No cell phone, no laptop, no screens. This mindfulness has been shown to relieve stress, improve the mood, and lead to a happier life. While yoga isn’t the only mindfulness practice out there, it is one of the most common. Hot yoga adds to this by providing a very warm room to enhance sweating and blood flow.

Strength

It is also a form of light strength training and stretching. People who practice often go at least once a week and often more than that. This kind of focused stretching can be great for building sturdy yet flexible joints. Many yogis realize after a year or two of practice that they can move better than they could before they started. Improvements in balance, strength, and range of motion are all part of the benefits.

Lastly, a big part of yoga is a sense of community. Yoga is usually performed in a group. If you attend regularly you will make friends with a group in your class. This sense of fellowship is another reason yoga has caught on and continues to grow. Being part of a group with a shared purpose can bring unexpected joy to your life. That’s why you see all those pictures of sweaty yogis group together after a class on social media. Charlottesville has many wonderful yoga studies. If you’re wondering where or how to get started, email me at sam@balancechiropracticva.com and I’ll be happy to connect you with a studio.

Exercise Can Be Fun

Mon, 02 Feb 2015 13:43:00 GMT

Everyone knows we should exercise, and reminders are everywhere.

Another note about exercise, is that it can feed the soul as well as the body. I reconnected with cousins I hadn’t seen in the last year and I got out of the house; out into nature. What could be better than reconnecting with friends and family and getting some exercise while you’re at it?

Foam Rolling!

Fri, 30 Jan 2015 14:24:00 GMT

If you’ve never tried it, I recommend doing so immediately! Check out our how to post here ! ~Dr. Eng

Foam rolling can be used all over the body from the back to the legs and hips and beyond. You can also substitute a lacrosse or tennis ball if you wanted to feel deeper pressure. Foam rolling is typically done on the floor but it also can be done standing against the wall. Many athletes use foam rolling as a self-care technique to manage the minor aches and pains that come with sports. While foam rolling is very beneficial in the short term, it should replace other parts of your fitness routine. It is no substitute for stretching or strength training. Foam rolling, in essence, is a supplementary activity.

One of the things I like best about foam rolling is that it is a relatively simple activity that our patients can do on their own at home to manage symptoms. We focus on giving our patients agency and being as independent as possible. If you have any questions about foam rolling, feel free to email me at sam@balancechiropracticva.com. Happy rolling!

The Secret To Staying Active

Thu, 15 Jan 2015 00:44:00 GMT

Variety. Why is variety important to fitness routines? I believe that it is important to do a variety of activities for physiological and mental reasons.

I have had many patients who are a superstar at one par ticular activity but they are getting injured too easily. In physiology, there is a term called the SAID principle. This stands for Specific Adaptations to Imposed Demands. This means that the body will adapt to the specific demands that are placed on it. If you train to run long distances at a slow pace, your body will adapt to that. If you train to lift heavy weights at the gym, your body will adapt to that training. I believe that your body needs different exercises so that it doesn’t adapt to the same stresses placed on your body all the time. Multiplanar movements will stimulate all muscles evenly and will reduce risk of injury.

Variety is important for mental reasons. I can’t stand doing the same thing every day or even every week! I get too BORED!!! Running outside, exercises DVDs at home, running on the treadmill, lifting at the gym, walking with my dogs, all kinds of sports, dancing, Pilates, yoga, Kettlebell workouts – you name it!!! (except for baseball- I can’t stand baseball. Sorry baseball lovers) All these different activities keeps me excited and challenged!

So, variety. That’s my secret! ~Dr. Eng

How to Choose a Mattress

Tue, 18 Nov 2014 02:49:00 GMT

So you need a new mattress — but what should you get?

That’s a great question! I just found myself in the same position. A few years ago I bought an expensive name-brand mattress that felt great in the store… and slowly started to kill me. When I reinjured my back this past summer and it just wouldn’t heal, I began to suspect my mattress. A few weeks ago my suspicions were confirmed when I stayed in a hotel for a few nights, and my back pain got a lot better… until I got home. So it was time for a new mattress!

So many mattress options confront us that it’s no wonder my patients ask me which mattress they should buy. Soft, firm or something in between? Innerspring, memory foam, latex, air or some combination? Pillowtop or customer topper or feather bed? And just how much does a good mattress cost? Just like televisions (or wedding dresses), mattress models start around $500 but the scale goes up to premium models costing more than $5,000! And no one mattress works for everybody: it’s a very personal choice.

Consider Your Sleeping Position

So here’s the skinny: the first and best way to narrow down your options is to consider your sleeping position. There are basically three sleeping positions to help determine what level of mattress firmness you should aim for: the stomach , the side , and the back . Everything else is down to budget and preference.

Stomach sleeping: just stop

Stop it right now! Sleeping on your stomach puts additional strain on your spine, especially at the lower back and neck. But, if you insist on sleeping on your stomach, choose a soft pillow but a firm mattress to support your body.

Back sleeping: fine for most of us

If you have low back problems it may be helpful to elevate your legs from time to time by placing a pillow or a folded towel beneath your knees, but check with your healthcare provider. If you snore or have a cold it may be helpful to elevate your head and shoulders with firmer or additional pillows. Habitual back sleepers are likely going to be better off with a mattress in the range of medium to firm – again, to relieve strain on the spine. If you have respiratory or cardiac issues that require other sleeping positions, consult your medical specialist.

For exercises to help enhance the musculoskeletal system’s mobility and strength, read our post on Active Release Techniques (ART) .

Side sleeping: the most optimal for spinal health

Also the most popular sleeping position. I sleep on my side for that matter. People with low back or hip pain may find it comfortable to sleep with a pillow between the knees. People with shoulder pain who like this position will prefer a softer mattress. I’d recommend a firm pillow but a soft to medium mattress for these sleepers, one that will conform to the body’s natural curves and pressure points. A firm mattress will press into the hips and shoulders to create pressure.

The Many Types of Mattresses

After you’ve thought about your sleeping position and desired firmness, another element to consider is the type of mattress and the material it’s made from.

Innerspring Mattresses

The plain old-fashioned mattress. These can range from soft to firm . Most innerspring mattresses these days are pillowtop mattresses, probably so you won’t be able to flip it when it starts to sag forcing you to buy a new one. The classic innerspring is perennially popular, but you can also find hybrids with memory foam or gels.

Memory Foam

A polyurethane foam made from oil . Polyurethane foams have been around for a while, but memory foam was developed by NASA in 1966, eventually released to the public domain, and popularized for mattresses by Tempur-Pedic. Memory foam is exceptionally comfortable because it molds to the body in response to both heat and pressure. Of course, it also traps heat, which some people find uncomfortable, although newer mattresses include gels to dissipate that heat. Memory foams also come in different levels of density, viscosity, and resilience, which can be combined for different effects, so there are a lot of options available — some Tempur-Pedic mattresses have 9 different types of layered memory foam!

Other issues to be aware of before purchasing a memory foam include off-gassing (when unwrapped they release chemicals for a few weeks), and their energy absorbency, which means they absorb motion which can make it difficult for infants and small children to adjust position if sleeping on them. For this reason, it is not recommended that you put infants down to sleep on memory foam mattresses.

Companies like Tempur-Pedic and Serta are known for their memory foam mattresses, but smaller companies you’ve never heard of make them too. These mattresses can also vary quite a bit in price. A name brand will cost you quite a bit, while a less well-known brand might cost you less than $1,000.

Latex Mattresses

The bounciest mattress around! Latex is made from rubber trees, a sustainable natural material. They have a really bouncy feel, but they don’t trap heat or smell . They can be layered or blended with other materials like memory foam or gels. All of those factors help make latex mattresses very popular, and it’s nice to know that, according to Sleep Like the Dead , latex mattresses mostly have higher-than-average customer satisfaction ratings. However, these mattresses can be pretty expensive, and because the price point keeps some consumers away, they can be hard to find in showrooms for testing.

Air Mattresses

Adjustable air chambers surrounded by padding. The famous Sleep Number Bed is the most well known of these. The mattress can be inflated to your “perfect “ level of comfort. These mattresses can be good for couples who have different preferences in firmness.

Waterbeds

Water chambers on top of a platform base, without additional padding. Water displaces at the heaviest pressure points of your body, relieving pressure but causing you to sag into the mattress. While some people find waterbeds comfortable, I do not recommend them.

Eco-friendly Mattresses

Many people would prefer to find an environmentally friendly mattress. There are many options available, from latex to wool blends , and they can vary quite a bit. Most green options will be found at local vendors, so if that interests you make sure you do a local web search to find vendors in your area.

Mattress Warranties

Many mattresses come with confusing warranties: 7 years, 10 years, 20 years, 10 years with 10 years prorated. Most warranties will list at what point they will consider a mattress “failed.” The standard for this is 1.5 inches of sag. However, many people start to experience aches and pains with as little as .75 inches of sag…so read this information carefully. While many companies claim that their mattresses will last 10 years or more, online reviews often suggest less. And it can be hard to claim on a warranty: you will probably need your purchase paperwork and a measurement of the sag.

Research

When choosing a mattress, start by doing some research on your own like you would for any other major purchase. You can easily begin online. I think you’ll find what I did: a ton of information, some of it confusing, some of it contradictory. I found two articles on how to choose a mattress with completely opposite advice on sleeping positions — both written in an authoritative style (but not with actual professional expertise!). So be aware of the need to evaluate what you read and hear about mattresses.

Consumer Reports provides mattress ratings that may help guide your choice, but always test the mattress before you buy. Many new mattress companies sell directly to the customer online and they have robust money-back guarantees. These newer companies provide great mattresses at a fraction of the cost of more expensive brands.

Buying a mattress

When you’re ready to look in person, take the time to test mattresses. Lie on a mattress in your favorite sleeping position for several minutes. Think about how it feels. Do you feel pressure anywhere? How would lying on it for an hour feel? Think about your neck, shoulder, back, and hips. Think about any injuries you currently have and how it makes you feel. Do you have any chronic issues? Test several mattresses before you choose one. And before buying, check on the return policy. Many companies offer upwards of 120 days to try it out, although beware return shipping and restocking fees.

Also, consider a less well-known brand. While brands like Tempur-Pedic, Serta and Simmons are familiar and reliable, they have also been marked up many times over by the time they reach the showroom where you are seeing them. There are several companies that will sell great mattresses to you directly at a fraction of the cost of a name brand mattress from a furniture or mattress store: Casper , Purple , Nolah , Level Sleep to name a few. However, you might be then taking a risk on a mattress without laying on it first.

Local Charlottesville stores that I’ve had good experiences in:

Essentials by Classic Furniture : Ask for Zeke, and he’ll take good care of you.

Mattress Firm : I worked with the manager. They have a wide array of Tempur-Pedic mattresses. The manager was very kind and very helpful in urging me to pay attention to how a mattress felt.

Well-reviewed online mattress companies:

I have an update on these online mattresses. I’ve now slept on both a Casper and a Tuft and Needle. I have to say I was really impressed. I thought they were a great “Goldilocks” mattress. Not too firm, and not too soft. To be honest, I wish I had tried one. The last mattress that I got to help with my back cost 3x more than a Casper and I prefer the Casper! I now encourage all my patients to consider one of these online companies because of my own experience, the cost, the excellent online reviews, and the return policy. After a lot of my own research, I wound up purchasing a Nolah which (as a side sleeper) I’ve been very happy with.

Comfort Is Key

Most importantly, think about what is comfortable for your body and for your budget. Bear in mind that you’ll be spending a third of your life on this mattress and it’s probably worth a level of serious consideration and financial commitment. If you aren’t spending that much of your life on the mattress… you don’t sleep enough. Start!

Questions about choosing a mattress? Shoot me an email . If you are having pain and aren’t sure what is causing it, contact us !

About the Author

New to Blogging

Mon, 30 Jun 2014 12:49:00 GMT

I’m no blogger. At least that’s how I’ve thought of myself. But it is 2014, and we live in a world that is immersed in web browsing and blogging. These web logs have morphed into an enormously powerful form of com munication and source of information, so I have decided to get with the times. As I’ve gotten older and a little bit wiser (hopefully), I have learnt that I have this new-found passion and desire to share with people the things that encourage me, things that motivate me, and in some cases things that truly move me, to a bigger audience. This is why I have decided to blog.

My name is Sarah-Ann Eng and I am a chiropractor who is new to Charlottesville. Now if you know me well, you will know that I’m a woman of few words. I’ve always been more of a listener. This is why you will notice that I love to take pictures of practically everything, so you will see a lot of the sights that I see. You will also notice that I love food. And I mean LOVE food. Being outdoors with my dogs, getting fit at the gym, travelling, fashion, chiropractic; these are some of the many topics in which I will write and post pictures about. I hope to inspire and motivate

Follow me on Instagram: chirolady901 (name:Sarah-Ann, D.C)

Balanced Chiropractic and Physical Therapy

From Pain to Progress: What Real Patients Say About the Balanced Chiropractic & Physical Therapy Experience

A Different Kind of Care Experience ﻿

Common Conditions Addressed

What Patients Consistently Say

Results That Speak for Themselves

A Team That Prioritizes People, Not Just Protocols

Why It Matters

Yes, We’re Chiropractors that Accept Blue Cross Blue Shield

RESET. REHAB. PERFORM.

5 Signs You May Need Chiropractic Care Consultation

1. Daily Troubles

2. Medication Avoidance

3. Prolonged Pain

4. Usual Remedies No Longer Work

Your pain is not responding to more conservative treatments like over-the-counter medications, hot packs, or topical pain relievers.

5. Unusual Bodily Changes

4 Myths About Chiropractic Care Debunked

1.Chiropractic adjustments or spinal/joint manipulations align the spine.

2.You have to go forever.

3.Chiropractic care is dangerous.

4.X-rays are necessary to diagnose and treat your condition.

Improving Ergonomics While Working from Home

What are workstation ergonomics?

How does an improper setup lead to pain?

Exercise Series: Deadlifts

Deadlifts

Targeted Muscles

Benefits of the Deadlift

Variations and Form for Deadlifting

Exercise Series: Squats

Form

Tips and tricks

Common form issues

Benefits

Squat Variations

Back Squat

Box Squat

Sumo Squat

Split Squat

The Balanced Difference

The Balanced Patient Difference

Early Intervention is Key to Quick Recovery

Top 10 Tips for Migraines

Top 10 Tips for Migraines!

Tim Bertelsman, DC

References

How To Start Running

Training, Fueling, Fitness, and Body Image During COVID19

COVID-19

Sport Specialization: How Soon is Too Soon?

Patellar Tendinopathy: Not All Tendons are Created Equal

What is Patellar Tendinopathy

Diagnosis of Patellar Tendinopathy

Real Life How it Happens

Wrap-Up

Treatment

So you tore your ACL…now what?

What You Need to Know about Stress Fractures

Relative Energy Deficiency in Sport

Motor Control, Part 2

Motor Control

Hip Pain – Part 2

Hip Pain

Arthritis: Take back your life

What is Osteoarthritis?

Whats the deal with my cartilage?

Why else should you exercise for arthritis?

That said, there are some ways to begin activity to help set you up for success:

Chronic Back Pain

The good news is that backs are just like any other body part, and the will heal.

Pain is defined as an unpleasant physical and emotional sensation that we experience when injured OR when there is a threat of injury and no actual tissue damage present.

Sleep: It Does a Body Good

If you have trouble sleeping here are some tips to help you get those all important ZZZZZsss. Improving your sleep hygiene will improve your life!

Exercise Is For Everyone

So, here are a few of my top tips to help you get your exercise on!

Frozen Shoulder: The Culprit Causing Your Shoulder Pain

Who gets it?

There are 3 overlapping stages of the condition called the freezing; frozen; and thawing phases. Each stage has certain treatments that may be beneficial to help speed recovery, which will be discussed below.

The Start (months 0-3)

A Different Kind of Care Experience