Winter is Here!

With the winter season in full effect and our first major snowstorm out of the way, it is time to get out your winter sports gear and prepare for the slopes.

Although winter sports are a great way to keep fit during the winter it is important to remember that they can be hard on your back especially if you have not exercised as regularly over the last few months, which can be a challenge with the dropping temperatures and shorter days. That is why it is really important to take care of your body and especially your back before starting any new winter sport or heading out for the first time.

Whether you are a snowboarder, skier, cross-country skier, snow-shoer, snowmobiler or skater, you need to prepare your body for all the sudden bumps, twists, turns and possible wipe-outs that can lead to painful muscle strains and tears.

Visit your neighbourhood Chiropractor to have your back assessed and analyzed for its stability, endurance, and strength.


Here are a few simple recommendations to help keep your back safe and injury-free this winter:

Warm-up – It is essential to warm up your body before jumping into anything. Try doing a few squats, jumping jacks, or lunges to activate your muscles.

Stretching – After a few simple warm-up exercises, stretch for 10-15 minutes. Stretch your quads, hamstrings, and calves.

Always end your work-out with some good stretches as well!



Simple Low Back Core Stability Exercises
* Bracing – Start by teaching the muscles around your core to activate. Think about tightening up your abdominal muscles, while still breathing freely.
* Curl-up – Lying on your back with one knee bent. Maintain the slight curve in your low back and then lift your shoulders and head up a few inches from the floor. Hold for 5 seconds and repeat 10 times. (3-5x/week)
* Bird-dog – On your hands and knees, brace your abdominal area and then lift one leg back with the opposite arm out in front without twisting your low back. Imagine you have a glass of water on your back that you don’t want to spill. Hold for 7-8 seconds, repeat 10 times. (3-5x/week)
* Side-bridge – Lie on your side and lift your body up with your hand. Imagine your body is straight and stiff as a board. Hold 5 seconds and repeat 10 times per side (3-5x/week)

Don’t forget to rest if you feel tired and stay hydrated!

So get out there and have fun this winter while playing safe and don’t forget to wear your helmets and other safety gear!



References:
1. Ontario Chiropractic – www.chiropractic.on.ca
2. McGill, Stuart. Ultimate Back Fitness and Performance 4th Ed. 2009.

Be Healthy.

Dr. Romana
Visit my online schedule here for both Chiropractic and Acupuncture services!

Must-reads for the new mom

There are a few books I recommend over and over to new mom's.  When you become a mom for the first time, the information overload from friends, family, and the internet can be overwhelming, and quite frankly panic - inducing.  Here are a few of my favorite, well-balanced books that hopefully will calm the madness that is the reality for the new mom.

1.  From The Hips : A Comprehensive, Open-Minded, Uncensored, Totally Honest Guide to Pregnancy, Birth, and becoming a Parent

This was such a find for me when I first pregnant.

Not only does it not go through the what-you-must-do-when-your-expecting-or-else-you-fail-as-a-mom mantra of other books, it is totally honest, and gives you a full picture of what labour, parenting, and recovery will be like.

I found it much more comprehensive that other pregnancy books, and especially loved the comment bubbles and very candid experiences from new parents, both the good, bad, and the ugly.

Just an absolute must have for the new mom.

2. The Baby Book: Everything You Need To Know About Your Baby From Birth to Age Two

Considered by many the mother (pun intended) of all parenting books, Dr. Bill's massive book stresses the importance of learning to listen to your baby's cues, and responding appropriately to them.  

While there are some who have taken this attachment parenting to the extreme, this book is full of common sense and incredibly useful information for new parents.  No, you are not raising a criminal if you feed your baby formula or let them sleep in a crib.  But yes, your baby will cry less if you wear them, or spend time interacting with them with developmentally appropriate games.  

The book covers everything and is a great resource to have on the shelf in any nursery.

Dr. Bill also has a pretty good website that covers many topics he covers in the book, but (bonus!) they are searchable by topic with lots of updated information.

3. Gentle Birth Method

The author, Dr. Gowri Motha, is a Obgyn turned Doula from the UK who noticed a trend of unhealthy practices during pregnancy which lead to multiple undesired interventions during labour.  She developed a comprehensive protocol for pregnancy that she felt would rebalance the body and prepare the mom for a natural births, with less intervention.  Everything from diet, acupuncture, Reiki, and exercise is covered in this book.

Lots of women love this approach to pregnancy, because it not only stresses the importance of the baby, but focuses on the mother's well-being.  While it is not for everyone, I do love the emphasis on women taking control of their health, and being a part of the pregnancy and labour experience.  It takes a lot of the fear-mongering out of the equation, and emphasizes lots of relaxation and pampering for the mom (what's not to love there!)  Kate Moss, Elle MacPherson, along with many of the London elite have followed her method.

It does have a lot of "rules" to follow and are specific to each trimester, so I recommend reading this early on in pregnancy, or even before conception.

4. KellyMom.com

So not a book, but an incredibly comprehensive website on breast feeding.  Baby won't nurse? Can you breastfeed if your sick and on antibiotics? Cracked nipples? What is a let-down reflex? Basically any question in the world about breast feeding and this website has evidence-based, logical information on it and solutions for it.

5. Vaccinations: A Thoughtful Parent's Guide.  How to Make Safe, Sensible Decisions about the Risks, Benefits, and Alternatives.

The only (and I mean only) book I have come across that comprehensively covers both sides of the vaccination debate.  It is a non-hysterical, pragmatic approach to decision making.  It covers all the basics of vaccines - and what is relevant to you, as the parent.

The book does not take a side either way, but rather presents information in a systematic way that allows the reader to draw their own conclusions about whether or not vaccination will be right for their families.  The author is both a medical doctor and a midwife.

It can be a medically heavy read at times, but all the facts are there for the parent to come to their own conclusions.  What I like most about this book, aside from the way the information is presented, is that it allows parents to have finally have a handle on the vaccine information that is often not readily available.  This allows parents to be an active participant in the decision of their children's health - rather than just blindly delegating the responsibility to a pediatrician.

Babywearing and Your Baby's Spine

Baby wearing is one of the easiest ways to get around when you are a new mom, or if you have other children running around that you need to attend to.

It uses less of your energy, and frees your arms to other things.  It is also extremely comforting for your baby who can hear your heartbeat, and, when they are snuggled up properly, it can mimic their conditions in the womb as they are gently rocked around while you are walking.  It has been documented that infants who are carried for 3+ hours per day in the first 3 months of life cry 43% less than those who are carried less frequently.  It helps with digestion, and, of course, helps with bonding.  Pretty amazing for you and for baby, huh.

There does seem to be some concern, however that baby wearing is somehow bad for baby's spine, specifically in the upright position as baby's cannot hold up their heads,  and can cause developmental problems in the hips, pelvis, and spine such as spondylolisthesis (or when a vertebrae, usually in the lumbar spine, slips forward and causes instability).  I am not sure where this concern originated, but there is almost no evidence that supports this, when the positioning of the baby is correct.




When you are wearing your newborn, it is important that the baby's legs are brought up more than 90 degrees and spread out about 90 degrees.  It kind of resembles a frog leg. This supports the thigh bone in the hip socket and helps promote a healthy maturation of the hip joint, and prevents hip dysplasia.

The hip joint is basically a ball and socket joint.  Infant hips are so soft and malleable in the first months of life, it is important they are supported properly so that they can take the right shape.  If they are constantly placed in the wrong position (ie allowing the legs to dangle) this can cause permanent deformation of the ball part of the joint, and can cause over stretching in the hip capsule.

It is also important to note that with babies under 5 months of age, they should be facing towards the mother, and not facing outward.  This can cause strain on the infant's upper spine and shoulders as the carrier will likely be pressing the shoulders backward, causing the mid-back and lower neck to flatten out.  Babies have yet to develop the main curves in their spines the way adults have, and forcing an infant's spine flat will affect the development of these primary curves.

To summarize, the top 3 take home tips for baby wearing are:
1. "Frog leg" position for legs (brought up and out 90 degrees)
2.  Face the baby inwards, towards you
3.  Keep the neck in a neutral spine, and remember to alternate which side the baby's head faces regularly

So, go ahead and enjoy bonding and baby wearing with your new little baby! When I had my first born in a sling in those few early months, it was all I could do to just watch him, smell him, and kiss him over and over and over again.  In the right position, it is hugely beneficial for you and your little love bear.

Happy baby wearing.

Dr. Stephanie

The dreaded W sitting

I had a patient recently ask me if it ok for her 13-month old daughter to be W sitting during playtime.  The short answer is absolutely NOT!

It is never ok to be sitting like this for a prolonged period of time, and should be stopped immediately whenever you see it.  There are a few reasons for this, and I'll go into some detail on all of them:

1. Hip Distortion
2. Knee and Foot Distortion
3. Poor development of Core Muscles
4. Lack of Cross-body co-ordination

1. Hip Distortion

With the legs externally rotated, this puts an enormous amount of pressure on the internal aspect of the hip joint.  Muscles that stabilize the hip joint become short and contracted in this position which restricts future mobility of the joint.  This can and will impact the development walking, and how the hip and pelvis move later in life.  The joint itself, which is made up of the femur bone and the acetabulum of the hip, has a greater chance of dislocating when placed in this extreme rotation.

2. Knee and Foot Distortion

So with the hips at the extremes of internal rotation, in the W sitting position the knees are are also placed in extremes of internal rotation, and the ankles are places in extreme external rotation.  The shearing forces over the knee, coupled with the shearing forces in the hip will inevitably cause spasm and contracture through the hamstrings and the adductor muscles (inner thigh muscles), as well as the Achilles tendon.

If we extrapolate this a little further, as a chiropractor who has been in practice for 9 years, I can easily say that a most of patients who come into my office with low back pain almost always have something going on in the hips, and almost 100% of them have tight and short hamstrings.  This is not the precident we want to start forming with our little kidlets!

3. Poor Development of Core Muscles

A secondary, but important, side-effect of W sitting is poor use and development of core muscles (another common problem I see in practice - lots of weak core muscles coupled with low back pain).  Because the toddler is stabilized by the extreme rotation of the legs, they do not need to use the muscles in their core to stay upright or to give feedback about balance and spatial awareness.  The hips and pelvis are sort of "locked" into place and the abs and pelvic muscles can just relax as they do no need to work.

4. Lack of Cross-body Co-ordination



This is related to the poor development of core muscles.  With a lack of muscle stability and tone in the abdomen, there is also lack of cross body movement, or as chiropractors refer to it, neurosensory integration.

As most moms already know, cross-body movements are the essential key in crawling, and later walking (try walking without swinging your arms to see how awkward that is!).  When in the W position, you will notice that the right arm of the child will stay on the right side of the body and will not reach across to the left, and vice versa.  Bilateral movements are critical for brain development, and are needed for reaching more advanced developmental milestones later on (such as reading and writing). Interestingly, lack of cross-body movements have been noted in children who show signs along the Autism spectrum.  Now, to be clear, W sitting does not cause Autism, but is commonly noted in this group of patients, and is considered in part with abnormal development.

So there you have my long and short answers on W sitting.  Whenever you see it, correct it. Prevention is absolutely the key here!  If your child has developed a W pattern of sitting, bring them into see a Pediatric Chiropractor for a check-up and specific suggestions on what your child needs to correct.  You can search for chiropractors with this specific training here.

Be Healthy.

Dr. Stephanie

We all love us a little Gwyneth

Especially when she uses and recommends some of the products we have here at the clinic!

Last week in her newsletter, goop, Gwyneth reviewed products found at English pharmacies.  Of these products, This Works was one of them.  I can't tell you how thrilled I was to read this!   First, because the things Gwyneth recommends are always top notch, and it reinforced for me how great I think the product line is.

I was first introduced to the line during my first pregnancy. A girlfriend of mine in London recommended the This Works: Stretch Mark Oil, and it didn't take long before I was hooked.

The 100% natural blend of pure and essential oils that absorb quickly into the skin was a dream (in comparison to the often tacky residue of other brands), and true to its name, it really did work.

I loved it so much that I decided to bring it to our clinic here in Toronto for my pregnant patients to use. Great for during and after pregnancy, and it is also great for those who are in the process of or have just lost weight as it helps tighten up the skin by replacing its elasticity.

Thanks, Gwyneth!

--

Dr. Stephanie

The Webster Technique and Pregnancy

Pregnancy is such an exciting time.  Oh the dreams you will dream about this tiny little person!

Chiropractic during pregnancy is usually not at the top of everyones list, what, after the nursery shopping, the rocking chair, and the bajillion strollers to choose from!  However, when we are talking about the health of you and your baby, chiropractic care should be right up there with finding the right OB or midwife, and your prenatal nutrition.

There are a couple of reasons for this.  First, any aches and pains you had before conceiving your baby will likely be amplified when you are pregnant.  If you had a history of a bad back before getting pregnant, it is highly likely (and by highly likely I mean almost definitely) the pregnancy will aggravate your back.  Second and third time pregnancies will also tend to see these aches and pains show up even sooner than during their first pregnancy.  Chiropractic care can get to the source of the aches and pain and correct it.

Secondly, and the main reason for this post, is chiropractic care can ensure that your spine and pelvis remain in as optimal a shape as possible while your baby grows (and kicks and flips, and plays) inside your uterus.

This is incredibly important, and I'll tell you why:

When the spine or pelvis is out of balance, the diameter of a woman's pelvis is decreased. Chiropractors usually refer to this as a "subluxation". This subluxation in turn causes an imbalance to her pelvic muscles and ligaments.  When the pelvic and ligaments are balanced, the uterus enlarges symmetrically.  When the pelvis is subluxated, the uterus can torque and reduce the maximum amount of space for the developing baby!

In some cases, this restricts the baby's movement during pregnancy, and can prevent baby from getting into the best possible position for birth.

So, this is where the Webster technique comes in.  This is a specific chiropractic analysis and technique that reduces the restriction and subluxation in the spine and pelvis and balances out the maternal pelvic muscles and ligaments.  What this does is reduces any torque that ay have developed in the uterus and allows for optimal positioning of the baby in preparation for birth.

Pretty powerful stuff, huh.  The best part is, it is super gentle, safe, and can be done right up until your due date.  Chiropractors report over 85% success rate with this technique's ability to balance pelvic structures and remove constraint to the uterus, which can allow the baby to turn into the vertex position for birth.

To find a chiropractor in your area who is Webster Technique certified, follow this link.



Be Healthy.

Dr. Stephanie

The Naturopathic Approach to Constipation

Constipation is an extremely common problem in naturopathic medicine, and it is experienced by approximately 63 million people in North America. This condition is so common that people often do not acknowledge it as an abnormality!

Constipation means that a person is having fewer than 3 bowel movements in a week, those of which can be hard, dry, and/or painful to pass.  

Conventional medicine and naturopathic medicine view constipation very differently. Conventionally, constipation is not usually viewed as a serious concern until complications occur (such as hemorrhoids or fissures that result in discomfort, rectal prolapse, and fecal impaction).

Naturopathic medicine views digestive and bowel function as one of the most important factors that contributes to optimal wellness. It is more often than not, one of the first conditions addressed when visiting a Naturopathic Doctor. Why? The digestive tract is responsible for not only breaking down the foods that you ingest, but also for the absorption of nutrients and the elimination of waste and toxins. Therefore, constipation can lead to nutritional deficiencies and toxin accumulation. 

In fact, the digestive tract is one of the most important means of detoxification. Without healthy bowel movements, toxins accumulate and can spread throughout the body. This can impact a wide range of other bodily functions. Everything from cramps to acne an be a result of constipation. 

Understanding the cause of constipation is important as it makes the treatment for constipation clear.  For example, if there is not enough fluid or fibre-rich food in the diet, it becomes difficult for the intestines to move food through the digestive tract. This results in waste moving too slowly through the digestive tract, causing it to become hard and dry, and therefore even more difficult for the muscles of the intestines to contract. 

Other factors that may play a role include:

• Ignoring the urge to have a bowel movement
• Delaying bowel movements
• A change in routine or lifestyle
• Lack of physical activity
• A diet too high in protein
• Illness
• Frequent use or misuse of laxatives
• Certain medications (such as pain, high blood pressure, and depression medications, diuretics, Parkinson's disease treatments) and chemotherapy
• Hormonal imbalance
• Pregnancy
• Digestive tract conditions such as irritable bowel syndrome, intestinal obstruction, diverticulousis, anal fissures, hemorrhoids, pelvic floor dysfunction (anismus), colon cancer, and in children, Hirschsprung's disease
• Loss of body salts through vomiting or diarrhea 

The conventional medical approach to constipation is by the use of laxatives; which works by artificially increasing the movement of fecal matter along the colon. There are problems associated with the use of laxatives that should be noted. Laxative abuse and chronic use of laxatives is potentially dangerous, as it can lead to the loss of ability for the intestines to contract on their own, irritable bowel syndrome, and renal failure.  

Naturopathic treatment approaches overlap with conventional approaches in the initial stage of treatment (stimulating bowel movements). However, it also places emphasis on long-term treatment, as it focuses on the root cause of constipation that is specific to the individual patient.

Once serious causes are ruled out, constipation is addressed initially by stimulating bowel movements using gentle and safe natural fiber and nutraceutical supplementation. It is then followed by improving regularity, using diet and lifestyle modification that are tailored to the individual. This takes away from the need for external stimulation of the intestines, therefore reducing the risks associated with treatments with laxatives and provides a more effective and sustainable treatment protocol. 

Diet is the main focus, such as increasing fruit and vegetables, fiber, and water intake, avoiding foods with saturated fats, foods that are high in cholesterol, sugars, and animal protein. Lifestyle modifications include appropriate stress management, increasing exercise, and establishing routine. 

Other modalities may also be used alongside diet and lifestyle modifications, including supplementation, herbal medicines, massage therapy, acupuncture, cleansing protocols, and Traditional Chinese Medicine depending on the needs of the patient. 

Dr. Cristina