The lettuce sea slug, otherwise known as Elysia crispata is a neat creature often encountered by slow-moving scuba divers (or those looking for them any way).  They camouflage themselves very well in the wild, hiding next to moss-like growths on coral rock formations.

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These pictures were all taken in the southern most region of the Caribbean Ocean.  The island is called Bonaire and offers a wide variety of marine aquatic life.   The sea slugs pictured range in size but are approximately an inch to about four inches.  They move slowly and methodically trying not to attract attention and foraging on small plants and algae.  Like many other bivalves and slower moving marine slugs, they push themselves with a singular foot for their motility.

One other very neat thing about these creatures is that some of them are solar-powered!  That is, they use the chloroplasts in their body to synthesize sugar they will use for energy.  They get these chloroplasts from the algae they eat, a process called kleptoplasty.

Stay tuned for more pictures to come from my last scuba diving adventure.

Charles Hecht, DC, CCSP is a chiropractor in Chapel Hill, NC who enjoys spending time with his wife and dog.  He also enjoys working out, playing tennis, and scuba diving (of course!)  You may contact him at http://www.drcharleshecht.com/contact-us/

The National Institute of Dental and Craniofacial Research estimates that there are approximately 10 million people who suffer from some sort of TMJ dysfunction in this country.  With the difficulty in diagnosis and treatment, many people will just live and suffer with this condition.  The NIDCR indicates that the two most widely accepted triggers for TMJD is direct trauma to the jaw and stress.  There are also debates (and strong doubt) on whether braces or clicking of the jaw can lead to TMJD, however research is not available. (1)

So what is a person supposed to do who is suffering with TMJD?  Good question.  The common answer seems to be less is more.  The NIDCR indicates in another article that the best things you can try at home are:

• Try simple self-care practices such as eating soft foods, using ice packs and avoiding extreme jaw movements, like wide yawning and gum chewing. Short-term use of over-the-counter or prescription pain medicines may also provide relief.
• Avoid treatments that cause permanent changes in the bite or jaw. Such treatments include crown and bridge work to balance the bite, orthodontics to change the bite, grinding down teeth to bring the bite into balance (occlusal adjustment), and repositioning splints, which permanently change the bite.
• Avoid, where possible, surgical treatment for TMJ. There have been no long-term studies to test the safety and effectiveness of these procedures. Before considering any surgery on the jaw joint, it’s important to get opinions from other doctors and to fully understand the risks. (2)

An Alternative Treatment:

Like any other articular bone in the body, the first thing that I test for is biomechanical integrity.  If a joint is not moving properly, it may be from an actual joint issue, a muscle imbalance, a compensatory pattern that was never properly treated or corrected, or a combination of all three.

The most important part of the treatment in my opinion is the observation and diagnosis aspect.  I have seen dozens of cases of TMJD, and although they are similar, no two cases are exactly the same.  More often than not, the history and initial assessment will give 80% or more of the diagnosis.  From this, a treatment plan can be formulated but will often have to be revised once rehabilitation is started because of the many changing clinical factors.

So What Exactly is the Treatment?

Manipulation:  Treatment for TMJ usually starts out with a light manipulation.  I do not use the internal method that many have tried.  The method used is a light skin contact on the angle of the jaw.  Most patients say that they have very little to no discomfort.  With soft manipulation, it is possible to allow the disc to reposition itself properly without a lot of firm pressure.

Myofascial release:  One of the staples of treatment involves myofascial work on the muscles of the jaw.  This is the most difficult part of the process as many chronic TMJ pain patients will have a lot of scar tissue and inflammation surrounding these small muscles.  With gentle soft tissue mobilization, patients will experience more movement with less compensatory motion (Z-pattern).  This is ultimately the first part of the rehabilitation.

Rehabilitation:  This is the most important part of care once the patient’s jaw starts moving again without catching or locking.  The exercises start light and very easy.  They progressively get more challenging but require no special equipment or braces.  Ultimately, it is every patient’s responsibility to make sure that they continue their home care.  The patterns or habits that  one has ultimately affects their ability to recover.

Referrals:  I work with several dentists in my area.  I feel that it is a very important part of my patient’s care that we work with their dentist.  We utilize the dentist’s professional skill and advice on items like braces or mouth guards, bruxism, and of course injury/risk to the teeth.

Like any other joint in the body, the TMJ is a joint that requires care and rehabilitation if there is an injury.  Improper care or ignoring the problem can lead to more serious issues and can effect every aspect of your life if it becomes chronic.  In a future blog, I will discussing three cases that all had successful outcomes, but also a few unexpected twists.

Dr. Charles Hecht is a chiropractor serving Orange County, Chapel Hill, Carrboro, and the surrounding areas.  If you have more specific questions about your TMJ problem or another musculoskeletal problem, please contact Dr. Hecht at http://www.drcharleshecht.com/contact-us/.

References:

1.  (http://www.nidcr.nih.gov/nidcr2.nih.gov/Templates/CommonPage.aspx?NRMODE=Published&NRNODEGUID=%7b53FD7A9D-B819-4CE4-8AFB-65BBD352BD26%7d&NRORIGINALURL=%2fOralHealth%2fTopics%2fTMJ%2fTMJDisorders%2ehtm&NRCACHEHINT=Guest#pageContent.

2.  http://www.nidcr.nih.gov/oralhealth/topics/tmj/lessisbest.htm

TMJ stands for temporomandibular joint.  Many people who have jaw pain exclaim that they have TMJ, which is of course a misnomer because everyone has TMJ, more specifically two of them  However, TMJ disorder can cause severe jaw, face, ear, and mouth pain.  It is also often related to certain types of headaches as well.

The Basic Anatomy

The TMJ is a highly unusual joint in that it has two actions.  It both opens like a simple hinge as well as glides backwards to forwards.  As you can see from the pictures below, there is a disc and cartilage that pads the jaw joint from the skull.  This disc will rotate as the jaw slides to protect it throughout the motion.  There are also several muscles that play a major role.  The pterygoids, masseter, and temporalis.

Problems of the TMJ

The normal structures when working properly allow us to sing, laugh, eat, chew, and converse without any problems.  However, the disc, muscles, and joint itself can all cause issues.  For example, the disc can cause problems if it slides too far forward or too far backwards.  If it slides too far forwards, it is difficult to open your mouth and often results in a Z-pattern and an audible pop or click.

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The muscles of chewing can also cause issues.  For example, if the pterygoid muscles are tight, you may have clicking or popping in the jaw.  They are also a possible culprit for the source of deep jaw pain, as well as the reason your mouth shifts to the left or right when you open and/or close it.  The masseter and temporalis, if in spasm, can cause headaches, bruxism, and tooth damage.

Symptoms of TMJ Dysfunction

• Jaw pain and soreness
• Jaw locking
• Jaw crepitus or popping
• Abnormal bite/painful chewing
• Pain referring into the base of the neck, ear, and back of the eye
• Inability to open your mouth fully

In our next post, we will discuss various alternative forms of treatment for TMJD.

Dr. Charles Hecht is a chiropractor in Chapel Hill, NC.  He is a Certified Chiropractic Sports Physician and has completed post-graduate work in treatment of TMJ.  You may contact him via his website at: http://www.drcharleshecht.com/contact-us/.

*Reference: http://www.google.com/imgres?imgurl=http://www.destinchiropractor.com/wp-content/uploads/2009/07/tmj-chart.jpg&imgrefurl=http://www.destinchiropractor.com/destin-chiropractor-conditions/tmj/&h=390&w=415&sz=62&tbnid=8OYNUQo2iWh_6M:&tbnh=91&tbnw=97&prev=/search%3Fq%3Dtmj%2Bpics%26tbm%3Disch%26tbo%3Du&zoom=1&q=tmj+pics&docid=GU9JJS8O6p-U-M&sa=X&ei=a5eYT7e-Bo2k8QSp6p2NBg&ved=0CEUQ9QEwBA

I got to enjoy a quiet Sunday morning with some coffee, my dog, and the most recent version of the Strength and Conditioning Journal (April 2012).  I was intrigued to find another article regarding minimalist running.  This article, written by Carey Rothschild*, revisited whether or not there was real evidence supporting the notion of barefoot running.

Her conclusion was that several studies supported barefoot running because of the increased proprioceptive feedback to the foot and the reduced impact to the foot, however, there was no evidence showing that it actually reduced injuries or improved overall performance.  However, she admittedly calls for more research and the difficulty of establishing parameters that can test reduction of injuries.

Some interesting points to take away from her paper include the following:

• Barefoot activities have been demonstrated to spare the plantar fascia from impact forces because the foot is required to activate its intrinsic muscles.  The reason this is significant is because it also indicates that the muscles of the foot can be strengthened which can help support the arches.
• Injury rate is higher in the shoe wearing populations
• Minimalist runner lifestyles have a lower frequency of lower extremity pathologies such as bone spurs or fractures.  Again, this reiterates the importance of both proprioception (where the foot is in space) and the activation of the muscles of the foot.

The review of Carey Rothschild’s article reaffirmed my beliefs after reading it.  Further, she reiterates the importance of prehab training before barefoot running.  She includes a lengthy section similar to the one I have in my earlier blog (http://wp.me/p1Si61-3h) about how to properly train before barefoot or minimalist running.  Regardless of how long the fashion fad stays in vogue, I think it is important for each individual to examine whether barefoot running is a possibility for him/her.

Dr. Charles Hecht is a chiropractor from Chapel Hill, NC.  He enjoys working out, playing tennis, and spending time with his wife and dog.  You may contact him at http://www.drcharleshecht.com/contact-us/.

*Source for today’s article by Carey Rothschild

Running Barefoot or in Minimalist Shoes: Evidence or Conjecture?

Rothschild, Carey

Strength & Conditioning Journal. 34(2):8-17, April 2012.

doi: 10.1519/SSC.0b013e318241b15e

In my last post, we discussed tennis elbow or lateral epicondylitis.  This condition is quite common and is often not caused by tennis.  Repetitive injuries requiring finger dexterity, lifting, or excessive wrist motion can often lead to (non-tennis) lateral epicondylitis.  When the injury is caused by tennis, it is usually from one or more factors that when corrected will often alleviate the condition.

So What Do I Do If I Have Tennis Elbow?

Treatment for lateral epicondylitis is usually pretty simple if you catch it early enough.

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If the injury is new or acute, I suggest the following things:

1. Stop the insulting activity.  Many people will try using braces or medications in order to continue their activities.  Unfortunately, until the tendon is allowed to heal, every new insult prolongs your recovery time.
2. Rest.  If you are having tendonitis, don’t carry or lift things with the arm.  Avoid gripping or gripping and twisting motions.
3. Use ice.  Remember that the skin and tissue around the elbow is usually thin, so make sure you use protective layers between you and the ice.  Also, make sure you do not use it too long (in general 5-10 minutes per 30-60 minutes).
4. Consult a physician.  If you have had an acute trauma (car accident, sports fall, or other direct blow to the elbow) consult a medical professional immediately!  Also, if the problem lingers past 4 days or gets worse, don’t wait, get a medical exam to rule out other threatening and more serious problems.
5. If it is a minor injury and you have less pain with conservative care, start making changes to your activities or equipment.  If you are suffering with a tennis injury, check in with your tennis professional.  They can examine your grip, string type and tension, as well as your stroke.  One or all of these may be contributing to your problem.

Elbow pain can definitely slow you down.  So if you are experiencing pain or have experienced it in the past, I suggest that you rehab your arm after treating the acute symptoms.  Rehabilitation can be done with daily stretching and easy strengthening exercises.  I will include three video links from my website for samples of stretches and strengthening exercises.

Forearm stretches: http://www.youtube.com/watch?v=ZplAWn3wCrc&feature=player_embedded

Forearm strengthening:

• http://www.youtube.com/watch?v=Nf27x6uYD7A&feature=relmfu
• http://www.youtube.com/watch?v=u44SdIGzEuY&feature=player_embedded

Final Notes:  Hoping something will go away is not an effective strategy.  Injuries like tennis elbow, if left untreated can cause longer term muscle and joint issues, as well as nerve damage.  I highly recommend that you seek professional medical care if you have been suffering for more than four days.  Also, if the problem continues to return, that is a good indication that either it was never healed properly or you have not finished your rehabilitation.

Dr. Charles Hecht is a sports chiropractor practicing in Chapel Hill, NC.  He enjoys tennis, weight lifting, and scuba diving.  If you have questions or would like to reach him, try us on our contact page at http://www.drcharleshecht.com/contact-us/.

*Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00068

Tennis is a fantastic sport.  It requires coordination, agility, and endurance.  It also allows you to get exercise in an individual or team environment.  It is appropriate for people of all ages.  However, there are a few pitfalls to the sport.  One such injury is what we will be discussing today and that is tennis elbow or otherwise called lateral epicondylitis.  Our discussion will be divided into two major topics, background information of the injury in this post and the treatment of the disorder in a future post.

So What is Tennis Elbow?  Lateral epicondylitis is the inflammation (-itis) of the outside (lateral aspect) of the elbow.  Symptoms usually occur on or close to the elbow, but may radiate as far down as the wrist.

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*(source at end of post)

Starting with the basic anatomy around the elbow, we will discuss the bony landmarks first.  The lateral epicondyle (of the humerus) is located on the outside of the arm.  The two bones of the forearm are the radius and ulna, with the ulna on the outside of the forearm (pinky finger side) and radius inside (on the thumb side).  If you look at your own arm now, first move your fingers and watch the muscles move in your forearm.  These are the muscles we will be addressing.

The muscles of our discussion will be generalized into the affected muscles, the extensors of the forearm and the compensatory muscles of lateral epicondylitis including the pronator teres and brachioradialis.  The reason for discussing both is simple as most people are prone to ignore pain or worse yet mask pain with an assortment of braces or medications.  When that happens, other muscles will be called upon by the body and thus become part of the injury cycle.

So What Causes Lateral Epicondylitis?

Lateral epicondylitis has many causes, one of which is tennis!  Tennis can cause elbow problems in so many ways, most of which are not traumatic like in contact sports.  However, many of them are caused by isometric (muscle does not change length while under tension) or eccentric (muscles lengthens while under tension) forces.  The top five sources of elbow pain from tennis are:

1. Poor backhand technique
2. Your racquet grip is too small
3. Your strings are too tight
4. Your racquet is too stiff  (stiffness rating 65 or higher)
5. Playing with wet or heavy tennis balls

Further, repetitive activities can also increase your risk and clinically are more common.  Daily activities such as typing on a keyboard, using a screwdriver, or opening a jar can all trigger an attack of tennis elbow.  Other activities like using a pickaxe or shovel, carrying luggage into and out of cars and airplanes, as well as so many more.  Once the extensor muscles of the forearm have been compromised for an extended period of time, the condition moves to more of an arthrosis (long-term degenerative) cycle.  This means, that the overall integrity of the muscles are compromised being interlaced with poor healing and less tensile scar tissue that will keep tearing when pressure is applied.  Further, it will cause your body to start using accessory muscles like the brachioradialis and pronator teres to assist with daily functions.  Eventually these muscles will become compromised and enter into the injury cycle as well.  The brachioradialis is located in the crease of the arm and runs down the forearm.

Once compromised, most people will complain of pain when lifting objects using a hammer grip such as lifting milk out of the refrigerator or while doing a pull up with wrists perpendicular to the bar.  The pronator teres can be more complicated and cause symptoms of carpal tunnel.  Often times patients will be mis-diagnosed with carpal tunnel complaining of a numb hand.  Unfortunately, cutting the flexor retinaculum will not help and myofascial work is needed further down into the wrist flexor bellies and the pronator teres.

If you suffer from tennis elbow, make three lists to analyze the possible origins of the problem.

1. What do you do on a daily basis that is repetitive and done for more than three hours?
2. Have you started any new activities that may require more use of your wrist or hands?
3. Have you noticed that you perform activities that only require you turning your wrist the same way, or maybe lifting your arm in a locked position?

Once you have found a few possible sources, start eliminating them one by one to see if your pain changes.  If not, consult a doctor or chiropractor trained in extremity work or that does myofascial release.  On our next blog, we will be discussing some home remedies that may help minimize or alleviate your problem.

Dr. Charles Hecht is a chiropractor in Chapel Hill, NC.  He enjoys working with athletes of all ages.  He is the only certified chiropractic sports physician in Chapel Hill.  If you have any questions, feel free to contact him at: http://www.drcharleshecht.com/contact-us/.

Source of picture 1: http://www.google.com/imgres?imgurl=http://www.home-remedies-for-you.com/health-images/tennis-elbow-picture.jpg&imgrefurl=http://www.home-remedies-for-you.com/remedy/Tennis-Elbow.html&h=235&w=458&sz=19&tbnid=vY_xpsUxnDMUKM:&tbnh=68&tbnw=132&prev=/search%3Fq%3Dpicture%2Bof%2Btennis%2Belbow%26tbm%3Disch%26tbo%3Du&zoom=1&q=picture+of+tennis+elbow&docid=SC1WiIwZUufBWM&sa=X&ei=4gWCT_idDo2O8wTAsLDZBw&ved=0CH0Q9QEwEA&dur=2074

Source of picture 2: http://frontalcortex.com/?page=oll&topic=1495&qid=1569

Many people have already started gardening with the warm winter that we experienced.  However, even more folks will start with the onset of Spring.  Things like planting vegetables, pruning flowers, mulching the yard, and of course cutting the grass.  Before you get started into your routine, I would like to offer you five tips that will help to reduce your risk of injury this year.

Try These Five Quick Gardening Tips!

1.  Make a plan of what you want to do.

I always advise patients to make a written plan or drawing of what you are planning.  Now, if you are just planning on maintenance work like trimming flowers and pulling weeds, a simple list will do.  The reason is that you will have a clear vision of what you want to get accomplished without feeling pulled in several directions once you get started.

2.  Inspect your tools and equipment.

This is usually neglected as most people don’t keep track of sharpening blades or replacing damaged equipment.  Damaged equipment will compromise your normal body mechanics and can lead to back, neck, or shoulder pain.

3.  Make sure you rotate your activities.

The example I give most of my patients is you should think of your yard work like you would a work out.  No one would give a second thought of why you should not do the same bench press activity for 45 minutes.  However, most of us won’t even think twice about raking leaves or digging in the yard for the same amount of time.  Again, refer back to your plan that you created and start two or three small projects and rotate between them.  For example, if you are weeding a bed, putting in plants, and mulching/watering, start with a small area and kneel while you weed, dig for 10 minutes or less (with proper equipment), and then stand upright as you finish (watering or mulching)  the area.

4.  Make sure you take regular breaks.

The most common mistake for non-professional yard workers is that they do not take regular breaks.  I advise you to break for at least five minutes for water and stretching every hour.  If you are doing intense yard work such as building a retaining wall or mowing acres of grass, the breaks should be for longer or more often.  Grave consequences can occur from overheating the body such as muscle strains and disc injuries, but even more serious accidents like fainting spells or heart attacks.  It is not advisable to push your body to the max in conditions that you do not regularly perform.

5.  Do not improvise or make changes after starting.

Many times I will hear patients talk about how they started a project, then got distracted by three or four other things that “threw them off course.”  It also usually causes back pain or discomfort.  A well planned day in the yard can provide you with the sense of accomplishment you are looking for while reducing your risk of injury.  Enjoy your gardening season!

For more information, feel free to contact Dr. Hecht at http://www.drcharleshecht.com/contact-us/

So earlier this week we discussed the what and the why of plantar fascitis so now we need to discuss its treatment.  Lucky for us, the treatment is essentially stretching the foot and possibly doing some myofascial work if necessary.  I must warn you, if you are not medically trained this may be very difficult to understand . . . NOT!

One of the reasons I like home/self-treatment for plantar fascitis is because it is so easy.  Referring to the picture below, you can see the “hot spot” that is plantar fascitis.  The middle diagram provides the best view because you are able to see the five distal (toe) attachments with the one anchor (heel).  The reason this is significant is because the five toe attachments can distribute the pressure from the body’s weight equally on them whereas all five points pull on the one heel attachment site.

*Picture provided by: http://www.plantar-fasciitis.org/images/plantar_fasciitis.jpg&imgrefurl=http://www.plantar-fasciitis.org/&h=240&w=626&sz=32&tbnid=zCARnmoBOfuPRM:&tbnh=43&tbnw=111&prev=/search%3Fq%3Dpictures%2Bplantar%2Bfascia%26tbm%3Disch%26tbo%3Du&zoom=1&q=pictures+plantar+fascia&docid=MZUrpOOWZHuc3M&sa=X&ei=tvp0T9enBoms8QSl0LWbDQ&ved=0CE8Q9QEwAg&dur=691

Treatment of the Plantar Fascia

1.  Stretching the plantar fascia.  I recommend that before you get up, you should slide yourself to the foot of the bed and allow the covers to gently pull your toes to your nose.  Hold this position for 10-20 seconds.  If you foot begins to cramp or hurt, stop immediately.  Stretching can also be accomplished with a band or towel with which you wrap the toes and pull back towards your body.

2.  Home massage is an easy and gentle way to help the plantar fascia.  Warning:  aggressive massage may cause severe pain and difficulty with walking.  Massage can be done with your hands or a soft tennis ball.  I recommend that if you use a tennis ball, do so in a non-weightbearing position (seated) first.  Standing on a tennis ball initially will be quite painful and you risk causing spasm and severe pain.  Work the non-weightbearing massage for two to three weeks before trying to do the massage in a standing position.  If you have tried it in a standing position, I would recommend consulting a physician or a massage therapist experienced in plantar fascia treatment.

3.  Strengthening the plantar fascia is also important.  This will be the last phase and may take weeks to months to work up to in order to be successful.  (Your plantar fascia-heel should not be hurting at this point.)  I recommend sitting on a chair in a room with tile or hardwood floors.  Start with a thin wash cloth and try to scrunch it up with your toes about five times.  As you become stronger, you can use a thicker/heavier cloth or towel and increase your repetitions and sets.

4.  Other notes:  Rolling on a foam roller for your calf muscles and hamstrings will also help loosen the lower extremity.  Also, if you do have an acute flare up, try using an ice bucket/bath for it.  Your foot will be placed in the ice water for 10-15 seconds, then removed for at least 2 minutes.  Warning: if you leave it in the ice bath too long, cramping and pain can result!  Then, make sure your foot has warmed up and even try putting a little pressure on your foot before walking.

I hope you have enjoyed this post.  I would recommend that if you have had previous foot surgery or may have an unusual condition to consult with a physician.  The dangers of home treatment is that you may harm yourself.  If you have tried the above measures and are still having trouble or are doing worse, contact your doctor immediately.

Dr. Charles Hecht is a sports chiropractor practicing in Chapel Hill, NC.  He enjoys spending time with his wife and dog, as well as scuba diving and gardening.  You may contact him at http://www.drcharleshecht.com/contact-us/.

Plantar Fascitis

So what exactly is plantar fascitis?  If you look at the diagram below, notice the white material stretched between the heel (calcaneus) and the toes (just past the metatarsals).  This white material, also known as fascia is the connective tissue within the foot.  Incidentally, you also have this material in your hand.  So, to put it all together, the “plantar” refers to the foot, the “fascia” is the connective tissue between the bones, and the “-itis” is the inflammation of it.  Easy enough, right?

Source: http://www.google.com/imgres?imgurl=http://chicagodancesupply.com/wp-content/uploads/2011/08/PlantarFasciitis2.jpg&imgrefurl=http://chicagodancesupply.com/2011/08/dancer-dilemma-i-have-plantar-fasciitis/&h=290&w=300&sz=13&tbnid=2CdbKTTbr-sZPM:&tbnh=81&tbnw=84&prev=/search%3Fq%3Dpic%2Bof%2Bplantar%2Bfascia%26tbm%3Disch%26tbo%3Du&zoom=1&q=pic+of+plantar+fascia&docid=y8nNjpgbl2sINM&sa=X&ei=VxFvT7zuOMPMtgen-cWlBg&ved=0CHQQ9QEwEA&dur=4713

So why do we get plantar fascitis?

Plantar fascitis is the result of any irritation to the plantar fascia.  This may be from a genetic disorder like flat feet or it may be from walking in shoes that are old and worn out.  Your weight can also negatively affect the plantar fascia.  Many will find that by dropping a few extra pounds, they will also feel improvement in their feet.

So how do I get rid of plantar fascitis?

There are so many options on the market today.  There are many different brands of shoes, inserts, orthotics, and customizations to your shoes that are available, most people are paralyzed with their choices.  Today, I will focus on the healing aspect of the condition, rather than the consumer product support (i.e. I’m not going to tell you a certain brand of shoe or insert to buy )

New research is emerging daily suggesting that if a person will strengthen their feet, it is possible to improve a flat-footed condition.  I have done some personal case studies in my office that are shocking.  In one study, I found a patient who had been prescribed orthotics (customized) 11 years ago.  My findings were that his foot got flatter!  We have started working with him by doing myofascial release and adjusting the foot, as well as doing some physical strengthening and proprioception exercises with him.  He has also taken his orthotic out and is using a shoe that has less arch support.  He was very sore for the first two weeks, but over the course of the last month, he has not only had less pain, but his foot is less flat when scanned using our custom orthotic device!  (and no, I didn’t make him new orthotics)

In my practice, I am trying to improve people’s feet with gate analysis and exercises, as well as strengthening protocols.  Please understand, I do not recommend anyone just trying to go to a less supportive shoe unless you have consulted with a professional.  Why?  You could experience increased plantar fascia pain, the inability to walk without severe pain, Achilles’ tendonitis, shin splints, knee pain, and hip pain just to name a few.

If you have tried everything else, I invite you to consider doing a foot strengthening protocol.  Our bodies were not designed to run with two inches of padding on the sole of our foot.  If you have a large barrier, your muscles will weaken and the chance at atrophy is much higher than if you exercise your muscles fully.  However, please be smart and do it in a controlled manner and under the care of a professional.

Dr. Charles Hecht is a chiropractor in Chapel Hill, NC.  He treats runners of all ages and skill sets.  If you have any direct questions, please feel free to contact him through his website at http://www.drcharleshecht.com/contact-us/.

Good question!  In the present day, many people use medication on a regular basis.  As a matter of fact, there were approximately 131 million prescriptions written last year for just pain medicine!  According to the CDC, nearly half of all Americans have taken at least one prescription in the past month; nearly one-third use two or more, with women more likely than men to take them.  However, at least one medical doctor says that may not be the safest and best alternative for us.  Jacob Teitelbaum, MD has written a book called Real Cause, Real Cure; in it he discusses the United States pill popping habits.  He states, “There are natural therapies available that are much safer, often more effective, and cost much less,”  Of course, he follows this statement that all people should FIRST consult their doctor before experimenting with natural source supplements (and I strongly agree with him!)

So if Americans are using so much medication, why are we as a nation not healthier?  The cliche is, “We are treating the symptoms, not the problem.”  Sometimes this may be true, especially in the case of the number one most prescribed drug hydrocodone/acetaminophen such as Vicodin. (http://health.yahoo.net/articles/healthcare/photos/natural-alternatives-top-5-most-prescribed-drugs#1)  However, the alternative of suffering with severe mouth pain after a root canal (sorry dentists ) or falling down the stairs and fracturing an ankle without pain medicine doesn’t sound very nice either!  Should we be allowed to take medicine for surgical pain but not “inconvenient” pain?  Where do we draw the line?

It all comes down to a matter of opinion, right?  If you ask Sungwon D. Yoo, D.C., M.S.A.O.M., L.Ac, he feels that pain is a response alerting us to symptoms of a deeper problem, not the problem itself.  He says, “Pain can be caused by an interference in our body’s nervous system, so manipulating the body’s main nervous system channel to the brain—the spine—can help remedy aches.”  Further, science supports the fact that people with lower back pain who received just four chiropractic treatment sessions in two weeks showed greater improvement in disability and pain compared to those receiving usual care, according to the Archives of Physical Medicine and Rehabilitation.  However, what if I don’t want to have an adjustment?  What if I prefer an easier way even if it doesn’t fix the underlying problem?  So again, we come back to the question, where do we draw the line?

The answer is clearly not getting rid of medication as it is a great source of improving one’s health in a crisis or short-term pain alleviation.  For example, diabetes, not able to be controlled with diet and exercise requires insulin.  Without it, dire consequences will certainly happen.  However, what about high blood pressure medication like Lisinopril?  It is true that we don’t want 144 million people walking around like ticking time bombs (or at least I hope it’s true; 144 million prescriptions were filled last year for blood pressure medications).  What if all people on high blood pressure medications were required to do four to five hours of exercise per week, would it reduce that 144 million number?  What if that same 144 million people were put on a more restrictive diet?  What if they were not allowed to eat at fast food restaurants?  Wow!  I know what you’re thinking, health nut trying to control the world!  Actually, I believe in freedom of choice.  However, I feel that if America was forced to limit portions at dinner, control their diets better, and exercise regularly, the overall health of this nation would increase dramatically.  The push is there and is gaining strength; ergo McDonald’s now offering healthier options than ever before with apples rather than deep-fried apple pie.  However, there has not been an overall trickle-down effect to the populus as a whole.

So, instead of closing with a question, let’s try a suggestion.  Contact your doctor for a full physical today.  Have them run a blood screen, have them calculate your BMI, and then ask them Is there anything else that I can be doing to make me a healthier person?  I admit, you may not like the answer they give you, but it will probably make you a healthier person in the long run.  As always, the decision is yours!

Sources from: http://health.yahoo.net/articles/healthcare/photos/natural-alternatives-top-5-most-prescribed-drugs#0

Dr. Charles Hecht is a sports chiropractor serving the Chapel Hill, Carrboro, and Orange County area.  He enjoys working out, photography, and spending time with his wife and dog.