The Integrative Wisdom Project

The Integrative Wisdom Project

I strenuously applaud the naturopathic profession’s masterminds behind this movement to expose elements of collaborative natural health care.  It’s an extremely forward-thinking and inclusive group of minds putting social media to use in the name of holistic health for all and by all.  I wish for my own profession to get on this bandwagon.  Just today I had an exchange about recent shifts happening in one of the chiropractic associations as they scramble to keep step with the times and join these progressive voices.

I am very grateful for the opportunity to speak with this movement.

“Persistent limited beliefs along with complacency are part of the biggest barriers to making integrative medicine standard in healthcare. Every discipline of provider in health care, both conventional and alternative medicine practitioners, are guilty of this.”

integrativewisdom_blog_header_yalingliou

For more voices on this progressive movement follow the source of the original post here: The limited beliefs of integrative medicine limit progress | Integrative Wisdom

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What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

Is this you when your back feels stiff?  Looking for relief from stiffness or pain by twisting it out?  Hoping for that crack that feels like what you get from your chiropractor?  It’s not the same.  It’s more dangerous to do this yourself and you should learn about why this is.

 

Read more from the original post and early book excerpt by following the link below: “When the jammed-up joints are properly released, then the hyper-mobile joints – the ones that are cracking all the time – should not feel the need to do so much of the work anymore”

It might be that you’re noticing cracks and pops with regular daily movement or you are making your joints do this repeatedly throughout the day in the hopes for relief from pressure.  In both cases you should learn more about what’s really going on, so you make informed choices…

Source: What’s the Big Deal if I Crack My Own Spine? – Stop Everyday Pain

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Pain Research – Someone’s Got To Do It.

Pain Research – Someone’s Got To Do It.

It’s abundantly clear to me after this weekend, that the folks at the Neuro Orthopoedic Institute (NOI) group in Australia have been busy doing exactly that.

img_6417My writing relies heavily on the hard research work of people like these and I am so happy not to have to be the one to produce it.  I have the utmost regard for the kind of mind it takes to do that sort of work.  I, on the other hand, much prefer bringing the information to real people for whom it has practical application in a way that makes sense to them individually.

This past weekend, I was able to attend part of the NOI group‘s EP3 West Coast version of the US edition on Friday at the Washington State Convention Center. Those in attendance were primarily physical therapists, some with doctoral PT training, a few medical doctors, a few adjunct providers – one other chiropractor, a couple of osteopaths, nurses and a some psychologists.

Axons and Dendrites and TLR-4 Cells Oh My!

tlr4What I love about this particular body of pain research presented by the NOI group, is the neuro-biology of it. While sitting in the conference and happily soaking up the neurological terminology familiar to me, I wondered how well the basic physical therapy education covers neurology in the US.  Chiropractors get extensive exposure to neurology with increasing detail through the progression of the 5000+ hours of doctoral level curriculum.  It appears that Australian physiotherapy schooling also includes a fair amount of neuro-physiology training.  As I looked about the room at the blank stares, I wondered if perhaps the American PT curriculum isn’t quite as rigorous in this area until perhaps the elective doctoral level? Something for the NOI instructors to perhaps become aware of.

The minds behind this approach to understanding pain via this group out of Australia, is headed up by the two Australian educators who created the book behind the tour. One is a clinical and research physiotherapist and professor of clinical neurosciences at the University of South Australia . The other calls himself a “freelance educator” and sports the suffix EdD, also a physiotherapist who holds a graduate degree in “advanced manipulative therapy” which I believe is the Australian preference over chiropractic although it seems there is significant overlap. As with many different regions in the world there are political reasons that one profession is regarded more highly or accepted more widely.

This weekend they were joined by a local talent, editor-in-chief of the Journal of Pain and University of Washington professor in the Department of Rehabilitation Medicine.

Guess What? “Sh*t” Happens and That Same “Sh*t” Matters When it Comes to Pain.

statue_trippingWhat tickles me about the NOI group research – at least as presented by the neuro-literate educator of the group – is that it is finally providing scientific evidence of things that we all as humans at some level already know.  Life experiences affect our relationships with pain.

Happy or sad, the things that happen to us as we navigate life, impact us in ways that can cement in time, our cellular reality. Our neuro-physiological responses to pain are significantly dependent upon the molecular patterns set up by a wide array of events and can set us up to experience recurrences of pain more easily or keep us from being able to find our way out of pain.

I was pleased to see that the substance of their work corroborates what many of us who work extensively with patients in pain have always known, and that is the practical reality that pain is often independent of tissue damage. Long after a legitimate tissue disrupting trigger has passed, pain can linger. Pain can also return in the absence of proportional local tissue damage and this is where things get quite fascinating.

The entire premise of my book series about everyday pain is that helping patients grasp the reasons behind their pain and helping them see that they are not irreparably damaged, massively speeds recovery from pain and keeps relapses to a minimum.

Teaching the Teachers

landaff_1940sThe most lovely thing about these three clinical research masterminds is that they have uncovered and provided the science and research behind the validation needed to implement this pain education. The NOI group seems to be working to educate more clinical educators which is truly going to the source to effect change and I applaud that.

It’s extremely important to refine the professional messaging behind how we greet pain in the practice setting and it will go a long way to changing our pain culture. But what I want to do and am focusing on with my publishing project  these next few years but also farther into the future, is to bring much more of this directly to the patients – the everyday person.

Pay to Play – Healthcare as Usual?

dandy_pickpockets_divingI learned that it was primarily a few local larger medical institutions that brought this conference to their employees by virtue of allotted benefit dollars that provide them with reimbursement for continuing education. The cost of the conference was unfortunately prohibitive to anyone not affiliated with an organization with deep pockets.

The financially prohibitive nature of these conferences (geared specifically to the mainstream medical institutions) presents a discriminatory challenge to equally qualified and information-hungry solo (or small practice) practitioners from a wide variety of relevant specialties. Nevertheless I must applaud the forward-thinking by these health care organizations and hospital groups for embracing the reality and changing attitudes towards the psycho-biology of pain.

It is a changing world and there is hope.
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What IS “Integrative” Healthcare?

What IS “Integrative” Healthcare?

By The U.S. Army (2012 Warrior Games) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

“Integrative medicine” is a term that has become very trendy in the health and wellness industry.  It’s an approach inspired by some of the leaders in the Functional Medicine movement.  As soon as it became evident that patients demand it which means there are big dollars at stake, even mainstream medicine is coming on board.  Cleveland Clinic has opened a dedicated wing for Integrative and Lifestyle Medicine  as has Johns Hopkins with their Integrative Medicine and Digestive Center.

So, what is it exactly?

It’s healthcare designed to treat the whole person (shocker). Many of us in the natural healthcare industry who have been practicing with this mindset for decades can’t help but roll our eyes a little bit at this “new” movement, but it is one to celebrate.

It feels to me like the general public is just catching up with how I’ve been living for most of my life personally, and now professionally for close to 25 years.  What we see in the integrative circles of healthcare is a coming-together of East and West, an acceptance of the interdependence of both sides.

“Integration” refers to the coordination of care between mainstream Western medicine and traditional or “alternative” methods including but not limited to acupuncture, chiropractic, massage therapy, yoga, meditation and other lifestyle modifications. You can find “Functional Medicine” on Wikipedia defined as: medical practice or treatments that focus on optimal functioning of the body and its organs, usually involving systems of holistic or alternative medicine.  

The functional medicine movement was started by a chiropractor with a PhD in biochemistry – Jeffrey Bland.  He bravely championed the long held old-world wisdom of viewing health and disease not as a linear process between one cause and one effect, but rather a complex symphony with multiple orchestral sections that all depend on each other for harmony.   Now people like Mark Hyman MD and a slew of others, straddling mainstream and traditional methods, have embraced this much needed common-sense approach.

Integration? Or Collaboration?

What we are seeing and hearing increasingly from numerous medical centers and hospitals, as many of them move to offer these kinds of approaches under one roof, is validation of this kind of wisdom-medicine for use in the Western model.

This week’s national news headlines on ABC’s GMA morning programming included a story highlighting the benefits of integrative medicine for cancer patients at all stages of care.  The use of acupuncture, movement therapy like yoga, massage and meditation were given as examples of treatment methods used to address the emotional, spiritual and physical needs together.

Some of you who follow this blog know that, just a few weeks ago, I attended a conference held by the Academy of Integrative Health and Medicine (AIHM) where I met medical doctors, physician assistants, nurses, naturopaths, acupuncturists and other chiropractors.  All of us together acknowledging the role of each other’s specialties in the full care of a patient while remembering to also live the path that we advocate for by indulging in some reflective self care.

In conversation with someone over breakfast at this AIHM conference I shared that I am a chiropractor in solo practice. I was met with “So you don’t actually practice integrative medicine…”

This took me aback a bit because I believe I actually do the ultimate integrative practice.   This exchange made me consider that perhaps the confusion is with the concept of “collaborative” vs. “integrative”.  Solo practice means I run a one-woman-show but does not preclude my patients from receiving collaborative (or “integrative”) care.  In my opinion collaboration is essential to integrative approaches.

This meeting of two worlds, in my opinion, can happen just as effectively in a more expansive community setting and not just under one roof. Successful collaborative care for the whole person is much more about the attitudes of providers than a physical facility with a name. I see my job as more of a healthcare traffic cop of sorts.

With the training that every chiropractor receives – to serve as a primary / portal of entry provider  – we are charged with the responsibility of knowing when chiropractic will serve our patients and when other modalities are more appropriate or needed in conjunction with our work.  Who better then, to assess and help patients prioritize treatment methods and direct them to the right practitioners?

I am extremely comfortable with my limitations as a practitioner and for true whole-person healthcare I think it’s essential to beware the delusion that any one of us can be everything to everyone.

For patients who don’t yet have a healthcare team, I regularly bring their attention to physiatry, physical therapy, massage, acupuncture, psychotherapy, and whenever needed, direct them back to their mainstream medical provider or any  number of medical specialists.

Do you have a healthcare team of alternative and mainstream providers?  Are you enjoying the integrative medicine movement?  You deserve to.  Status quo is changing.  Expect more.

 

 

 

Stretching Out the Pain: Feels Good But is it Good FOR You? – Stop Everyday Pain

yoga-dancer-1024x855Recently I’ve had a few questions from patients who are reading the book.  One that keeps coming up is about whether or not stretching is good or bad for us.  Stretching is a very confusing topic and has been one of scientific controversy for years which makes the answer not so straightforward.

In this first volume of my book series Every Body’s Guide to Everyday Pain™, Put Out the Fire I spend some time explaining that stretching is actually a mechanical stressor and therefore risky for people dealing with everyday pain.  This means that the elongation we cause by stretching can result in stress to the underlying structure.  Usually  when all things – mechanical, biochemical and emotional – are in balance, a reasonable stretch doesn’t cause any trouble.  However, when we are out of balance in any one of these areas and if we are already in pain, then stretching the compromised area is a terrible idea.

We often get away with stretching without consequences during times when we are not in crisis. Unfortunately with this sort of benign experience in mind and due to the fact that stretch-sensation neurologically eclipses the pain of inflammation, the concept that stretching is not good for your pain, is a very puzzling one to accept.

If you stretch a muscle in distress, you are basically signalling to your body that the tightening over-reaction – the one you are trying to find relief from – is indeed justified.  In this case, your stretch will perpetuate the underlying reason for muscle pain and tightness instead of resolving the problem.

The reason muscles grab and get tight is 100% protective in nature.  It is always the most reasonable response to unreasonable conditions.  You may not agree that the conditions are “unreasonable” but your brain and body’s assessment is all that matters during times like this.  If you don’t stop and find out what they’re protecting you from, there may be much worse discomfort lurking around the next corner.

Another interesting point is that the elongation stress associated with stretching can happen without, what looks to us like, a traditional intentional stretch.  Lengthening stress to muscle fibers is something that can be produced with sustained pressure on a muscle or a tendon.  When a muscle bundle is made to deform in this way it’s perceived by the brain as elongation. If that area is already inflamed, it will be a problem.  So, all of you foam rolling or ball rolling advocates beware!

A large part of my mission in educating patients is to highlight the subtleties in movement and posture that matter when we are in pain, but which often don’t seem very obvious to us.  By learning about these not so obvious contributions to pain, we can stop berating ourselves for “falling apart” and acknowledge the way forward. Recognizing the validity in our pain is a vital step towards feeling better and staying out of pain in the future.

An important part of Volume Two – Fix the Fire Damage will include information about exactly how and when to stretch safely and how to solve the problem of muscle tightness for the long term.

Click on this link for more at the original article Source: Stretching Out the Pain: Feels Good But is it Good FOR You? – Stop Everyday Pain

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Taking My Own “Medicine”

Taking My Own “Medicine”

Dobbins'_medicated_toilet_soap,_advertising,_1869When you’re a chiropractor, what does it mean to “take your own medicine” ?

“Walking my own talk” consists of more than just making sure I receive chiropractic care myself.  It’s about seeking balance in all areas of health.  With balance in sight, the need for professional treatment decreases.

My motivation is maybe a bit more intensely fueled than for most people because my body is my essential work tool.  If mechanical, biochemical or emotional balance is off, it directly affects the ability to fulfill my commitment to patients which in turn could potentially risk my livelihood.  This is an intense interdependence that I would never trade for anything but it can be more than stressful to be even just a little bit laid-up.

In last week’s post I alluded to a recently renewed return to health by restoring balance to my own life, after a year of pushing to get my book out, followed by the release and adventures in promotion.

Block Quote 4I cannot emphasize enough how much this pursuit of balance can differ from person to person.  I am taking a moment to briefly outline what this looked like for me at this particular juncture, to give you a very general idea of the factors to consider when thinking about your own balance in wellness.  In particular I want to illustrate some of the principles outlined in my book (Every Body’s Guide to Everyday Pain, Volume One – Put Out the Fire). Don’t wait until you’re in pain to find your true healthy balance. The everyday variety of pain is always a sign that something has fallen by the wayside in one of the three main categories (mechanical, biochemical or emotional) but things can be “off” long before pain strikes.

In my case, this time I needed first to focus on returning to a more regimented sleep/wake schedule.  I’ve learned that my body and mind operate optimally with 6,1/2 – 7 hours of sleep per night and this means I need to exercise a little discipline about getting to bed on time because I am not willing to get up late.  The morning hours are treasured time and important to my emotional well-being.  I’m very lucky to have good sleep hygiene and my body cooperates well when put to bed.  For times when that’s not the case (as everything ebbs and flows), I reach for homeopathic remedies, herbal teas or magnesium to calm the nervous system before bed.  A controversial trick that isn’t advisable for everyone but that works well for me, is to have a small bite to eat before bedtime as well.

Test tubes science backgroundRe-balancing my biochemistry is something that I dedicated the better part of two consecutive months to. Resetting my organ systems and aiding the natural detoxification, involved some herbal and food therapy.  I returned to eating simply by avoiding my known sensitivities: dairy, all animal protein, simple starches (sugar), nightshades and a few other specifics that I’ve come to recognize over the years as taxing to my system.  I’ve since then slowly returned to more variety based on what my appetite dictates.

Block Quote 2Some signs that will tell you about your sensitivities can be as subtle as an increase in heart rate within 1/2 hour of eating. Sometimes it’s just a little tickle in the back of the throat that passes quickly but is still a significant sign of intolerance.  Other times it can be a generalized increase in mucous production and that might be harder to spot.  The need to clear your throat or blow your nose in the morning might be signs of excess mucous production in response to a food trigger from the day before.  The point is that foods (sometimes very delicious food), not overtly considered as “allergenic” like peanuts, can still be considered by your body as a burden for your biochemistry.  So, it’s always important to pay attention to subtle reactions.

When I commit to helping my body unload excess waste, I also utilize dry sauna sweats, infrared if possible and pay extra attention to optimizing kidney and bowel function.  This makes a big difference in the associated discomfort of “detox”-related headaches and body aches that can happen when large amounts of waste are mobilized throughout the body for elimination.

My herbal and nutrient based regimen was also targeted, in part to facilitate elimination via the kidneys, liver and colon.  There are many different philosophies on which herbs are most appropriate and this is something that is best done with the advice of a natural health care doctor.  Focusing on aiding natural elimination is the best way to help decrease your body’s chemical burden from exposure to complex molecules in our air, food and water.

Balancing RocksFor me, restoring mechanical balance can’t happen without first adequate rest and attention to nutrition.  After re-setting sleep and nutrition I found my energy returning and started to increase activity based on that, but not until then.  If fuel or rest and recovery are lacking, then the exercise output ends up adding stress to the system instead of strengthening it.  This is why sleep and nutrient intake is first priority. It sets the stage for successful return to exercise.  Without this in place, workouts are pointless and counterproductive, potentially resulting in inflammation-causing stress.

Block Quote 3What my body and mind are willing and able to do changes with the seasons, years and stages in life.  This Spring, yoga was the doorway back to physical empowerment.  It helped me begin to feel able to return to swimming and weightlifting.  Now, my routine includes one yoga class per week and two other days of gym workouts which consist of a warm-up swim followed by an upper body or lower body weight resistance workout.  That’s three days a week of 1-2 hours of exercise. They are strategically spaced from my days with patients so that I am not too sore to be effective in the office, but also to avoid muscle fatigue related injuries.

There’s nothing rigorous about this current exercise schedule which is what makes it completely sustainable.  When starting a new routine, being consistent is more important than making a huge impact.  Come wintertime, it’s possible that my needs will change and I will change my exercise accordingly.  Perhaps in a future post I will take some time to address the how of tuning in to your own changing needs from season to season or depending on life and work situations.  It’s mostly a lifelong process of trial and error.

It can be tricky to walk the fine line between the intended exertion of exercise and inescapable demands of work life. But as you slowly increase physical activity, what always holds true is that you increase your body’s capacity for emotional, chemical and physical stress to keep from rebounding into exhausted inactivity.  It must be done in a loving way. Self-care routines are best implemented with gentle caring instead of harsh reprimands.  If you’re someone who thrives on hard line tactics for motivation – find a trainer or someone outside of yourself to play that role.

Even though it’s not an easy daily practice for many, being loving and yes even permissive with yourself makes room for healthy choices.  Remember real health can and does exist in imperfect bodies everywhere.  It’s about balance, not perfection.

Block Quote 1Lastly, you should know that it takes at least two full months – often three months – of consistent activity in order to surpass the “transition reaction” of new exercise.  When introducing a change in routine or physical demands, the brain and body will express themselves by exhibiting physical sensations that aren’t always 100% comfortable.

Sometimes the transition to a better balance in life includes re-visiting old pain that might feel like re-injury as we work to strengthen around these old vulnerabilities.  This is why it’s important to line up some outside help during these transitions either via massage, acupuncture, or chiropractic.  It’s the time when I see the greatest need for support in my patients.

Food for thought while you consider your own healthy balancing act: When we act in reaction or opposition to an idea or a feeling, we set the stage for inevitable failure. When we act out of caring and acceptance for the imperfection that is, we make good and sustainable choices.


Image Credits: Wikimedia Commons, Fotolia

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Do You Have a “Flexion Intolerant” Back?

GEDSC DIGITAL CAMERAYou may or may not have heard this new buzz term in the world of physical medicine and rehabilitation.  It is certainly gaining traction in my industry thanks to a couple of brilliant minds in the world of functional movement and kinesiology: Stuart McGill Ph.D.,and  Craig Liebenson D.C. for starters.

I see how  very helpful it can be, to the average person in pain, to be able to identify and label their condition.  The term “Flexion Intolerance” has come to serve that very purpose in my own practice.  In particular I’ve found it very helpful to point people to this internet resource developed by a fellow chiropractor: Fix Your Own Back dot com.  Dr. Snell provides an easy to use guide to help people in pain figure out if their back pain situation might be one that can respond very well to some basic changes to just a few everyday things.  We often take for granted these everyday activities until we’re in pain.

Pain is the primary and most effective motivation for most of us to want to investigate and learn more about our bodies. I believe it’s important that everyone realize before they are in pain, that “flexion” is not something our lower backs are very well designed to put up with in the first place, but especially not in the way that our modern lives demand.  We are all actually, by design, flexion-intolerant.  In particular, we are intolerant of the kind of flexion and the amount of flexion our modern day backs are exposed to.

What is Flexion?

It’s the technical term used to describe a forward bending motion (in the spine) which in the extreme looks like rounding.  Imagine the fetal position  – the ultimate example – full body flexion.  It’s no secret that bending to pick up something heavy can be “dicey” for the back and most of us know that this could result in pain if we’re not careful.

The unfortunate thing  is that flexion in the lumbar spine / lower back can be happening without the outward appearance of rounding – for example while sitting many of us are actually putting the lower back into flexion without meaning to – even if we’re not necessarily slouching.  The brain is pre-programmed with what can be considered our “safe” amount of flexion both in degree and frequency.  This pre-programmed set point is different for every single body, but it’s what determines when and under which conditions we suddenly experience our flexion intolerance as full blown pain.

You’ll find much more about this idea of our individual mechanical set point or blueprint for safe movement at Stop Everyday Pain dot com.  This is where my blog to book project is taking shape.  Check it out, become part of the process or just follow along to find out why things hurt that didn’t used to hurt and figure out what you can do about it.


 

[photo credit: wikimedia commons]