Health and Well Being

17
Aug

Inspired By Our Excelling Olympians?

Then Join In On The Fun The Next Time You Watch Sport.

 

In August our amazing Olympic team brought home life time best performances and medals galore. The joy and delight on their faces was moving and something you can share to an extent by joining the para-olympic athletes as they inspire even more through their heroism in the face of adversity.

The common theme from the Rio games is one of inspiring the next generation to compete, but what about the current and former generation? Yes that’s us lot, who have probably been mainly sat on the sofa while watching, possibly with a glass of wine and a few crisps and nibbles. Well, we all need a break from the usual bad news don’t we?

But why not participate yourself next time you settle down to watch some sport. You could do a stretching routine or even some floor exercises and feel the burn with those on the screen. I’ve been doing it for F1 for years as it stops me falling asleep, even on the highlights program!

If that seems a little too much there are exercises you could do while barely leaving the sofa. Here are a few to help you.

Hip Hinge, Hip Hinge 2, hip-mobilityhip-mobility2, Cat-stretches-and-bridges

 

6
Jan

How to avoid injury when you restart exercise.

2016 new years resolution is to exercise!

How to avoid injury when you restart exercise.

 

After a break from exercise it is easy to get carried away and bite off more than you can chew. If you don’t take a sensible controlled view you will be more likely to get injured. So here are a few steps to consider when you restart……

 

 

 

 

  1. Firstly if you have any niggles or have had achey joints and muscles recently then have a check up before you start training again. Stiff joints and tight muscles will hamper and alter how your body functions. They can also inhibit key stabilising muscles. The result is lack of bounce at the very least but possible serious injuries such as ligament tears if you overload a poorly stabilised joint. A quick check up can restore function and a follow up can iron out any niggles that have occurred in the early stages of exercise.
  2. Make sure you warm up using active stretches. Theses are when you swing the limb through movements like a pendulum so the limb is always moving. Stretches done like this activate muscle sensors and improve tone. They also keep the tendons short and so help to preserve elastic recoil, an essential element of energy transfer for joint movements.
  3. Concentrate on form. We can all exercise to fatigue but what we need to do is maintain good form when we are getting fatigued. This takes concentration and effort. You will probably need to stop your routine earlier but it’s better to be a flowing runner than a bag of jelly. That way you will build strength faster and maintain efficient form. If you are in doubt about how to do your particular exercise with good form then seek help from an experience athlete or your personal trainers who are there to guide you.
  4. Do your conditioning. Yes it’s boring and you are unlikely to develop too much of a sweat but it is essential to enable you to maintain that form we just touched on. So what do we mean by conditioning? It’s the good old planks, glut lifts, foam roller etc. Painful but worth it.
  5. Warm down from intensive exercise. This allows lactic acid to leave muscles and be metabolised. You’ll be less stiff next time round.

 

9
Dec

Are your anti-cholesterol drugs compromising your energy levels?

The Technical Bit:

Anti-Cholesterol drugs such as statins reduce your cholesterol by slowing down the production of cholesterol by the liver.  They do this by interfering with the action of a key enzyme, HMG-CoA-Reductase.  Cholesterol production is not fully blocked nor is the production of other substances that are derived from the same pathway, such as steroid hormones and vitamin D.

Close up of a Statin tablet - the controversial cholesterol lowering drug. Shallow d o f

Close up of a Statin tablet – the controversial cholesterol lowering drug.

Because cholesterol synthesis is reduced, the liver takes up more cholesterol carrying LDL particles from the blood. The net result is a reduction in circulating LDL-cholesterol (bad cholesterol).

Statins also help to stabilise the fatty plaques (fatty deposits or atheroma) within the lining of the arteries. This is why people who are at high risk of heart disease or stroke or who have diabetes, may be prescribed a statin even if they have a normal cholesterol level.

There’s no doubt that a healthy lifestyle helps lower cholesterol. The question is whether it can lower your levels enough – and that depends on how high your levels are and what your doctor has set as your goal.
Eating a heart-healthy diet can lower LDL cholesterol at least 10%. If you lose 5% to 10% of your body weight, you can cut LDL cholesterol 15%, and reduce triglycerides 20%. If you exercise at a moderate intensity — meaning you have enough breath to talk but not sing — for at least 2 ½ hours a week, you can further cut triglycerides 20% to 30%. (Exercise can also increase your HDL, the “good” cholesterol.)

That’s a great start, says Michael Miller, MD, director of the Centre for Preventive Cardiology at the University of Maryland Medical Centre. “Lifestyle changes certainly are the cornerstone of cholesterol reduction.”

So does taking a statin mean you can sit on the couch and eat bacon all day?

Of course not. Doctors say the best way to protect your heart is to make healthy lifestyle changes while taking a statin. I say the best way is to make healthy lifestyle changes and avoid the statin unless you are diabetic or have recently had an acute cardiac event.

Potential Side Effects

If you look at the medicine supported websites you’ll see the following:

Like many pharmaceutical drugs, statins can have body wide side effects and may also interact with other medicines you take.  potential side effects can include:

  • More common: Headache, GI problems, muscle and joint aches, or rash
  • Less common: Memory loss, mental confusion, high blood sugar, and type 2 diabetes
  • Very rarely: Muscle or liver damage
  • Nevertheless, much is left to be understood and accomplished because approximately 60% of patients treated with statins did not have a beneficial reduction in CV events. 

MY VIEW:

Did I just hear that right? 60% of people on statins get no benefit from reduction in heart attacks! I wonder what the figures are for reduction in heart attacks by adopting a healthier lifestyle. When you consider that 9% of people on statins will get adverse effects on every cell in their bodies. This is due to a reduced ability to release energy from the mitochondria (the powerhouses of the cell) due to the reduction of Co-Enzyme Q10. This is well documented to adversely affect muscle, but it can also lead to fatigue of nerves too. However some studies have found that Statins may help improve dementia. These studies however are not high quality and further research is needed. (3)

When I see data like that and patients who are stiff and ache all over I begin to question if this reliance on statins is worth the loss of quality of life for at best a 40% reduction in CV events. I also wonder why time and time again patients who are on statins don’t get advised to take Co-enzyme Q10 when statins adversely affect your ability to produce energy through the inhibition of Co Q10.

Here’s another little known fact. After a year of taking Atorvastatin any increase in HDL (the good fat) is gone and in fact a reduction in the good fat from the starting baseline is often found. It is also noted that the first dose is the most effective, subsequent increases in dose have a much reduced benefit at 6% reduction in LDL as opposed to around 50% for first intial dose.

If your GP recommends that you go on a statin and you have struggled with commonly associated significant stiffness aches and pains; there are alternatives available. Colesevalam is a statin that works more specifically at a “gut level”, so does not produce side affects of  muscle and joint pain and stiffness. It can for some however cause constipation and flatulence. So neither is perfect but may be a more favourable solution. It is however much more expensive that a generic statin.

Here’s a viewpoint from a GP;

http://www.theguardian.com/commentisfree/2014/jul/18/statins-gp-vested-interests-nice-drug-company-heart-attacks

The important bits: Nice (the National Institute for Health and Care Excellence) has issued guidance that proposes reducing the cardiovascular primary prevention risk threshold – the level of risk at which statins can be prescribed – from 20% to 10%. In other words an increase in prescribing of statins.

In May 2014 a national conference of general practitioners passed a unanimous motion calling for Nice to recommend such changes only on the basis of a full disclosure of trial data. This was followed in June by an unprecedented open letter to Nice (click link to read) from a number of senior doctors and academics expressing four main areas of concern: medicating healthy people; non-disclosed side-effect data; relying on industry-funded statins trials; and conflicts of interest within Nice.

My View;

There needs to be more transparency with respect to statins. Eat a diet high in good fats and lower in bad fats. There is plenty of info out there and we will add some suggestions in the near future.

  1. A viewpoint on statin effects – benefits and problems Thomas F Whayne, Jr, MD PhD FICA Int J Angiol. 2008 Winter; 17(4): 178–180.

  2. Coenzyme Q10 and statin-related myopathy. Drug Ther Bull. 2015 May;53(5):54-6. doi: 10.1136/dtb.2015.5.0325.

  3. Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects.Swiger KJ1, Manalac RJ, Blumenthal RS, Blaha MJ, Martin SS. Mayo Clin Proc. 2013 Nov;88(11):1213-21. doi: 10.1016/j.mayocp.2013.07.013. Epub 2013 Oct 1.

     

 

21
Apr

Is Your Posture Saying Something About Your Brain?

Poor posture can be a sign that there is a weakness in your brain function.

Take a look in a full length mirror at yourself and see if the following applies to you.

A commonly seen aberrant posture in clinic is one where your foot is turned out, the arm on the same side is held slightly flexed at the elbow and is rotated inwards so that you can see more of the back of the hand than the other side when looking face on. The same shoulder will also be held forwards. Typically this is due to weakness of the anti-gravity muscles down one side of the body and is a milder presentation than Pyramidal Weakness found in some typical stroke patients.

The anti-gravity postural muscles hold the shoulder back and rotate the arm outwards. They also lift the leg and foot from the floor. Commonly this pattern of weakness leads to rotator cuff problems, tennis elbow, hip pain, shin splints etc. If you have had any of these problems or get them repeatedly despite having had treatment then you possibly have a functional weakness of a relay area in the brain called the Ponto-Medullary-Reticular-Formation or PMRF for short.

You can have as much Physiotherapy, Chiropractic, Osteopathy or whatever other therapy you like, but if the weakness is established the problem will keep recurring. Why? Because the brain will keep pulling you into the poor posture. If you are exercising and getting stronger you will have less symptoms, but push it hard and you’ll be likely to get your injury again. This is because the area in the brain will fatigue one side faster than the other and your control will diminish. The result, yet another injury. Just think how many sports people have struggled through their careers with hard to treat injuries. The list is endless.

By specifically treating to enhance function in this area we can help to restore normal function. If we combine this with visual exercises we can help to hard wire the pathways to strengthen them. This requires repeated stimulation over a short period to get the nerves to express genes that lead to growth of new connections. It won’t happen without repetition.

So if you’ve ever had a car accident or a whiplash type injury from sports such as horse riding, skiing, boarding and obviously boxing then you may be prone to these problems. If you’ve ever had a concussion or been knocked out the chances of this are significantly increased.

Make sure you find someone who can look at these patterns to help you for the longer term and not just a quick fix.

10
Apr

Paracetomol and Back pain

Paracetomol ineffective as treatment for back and joint pain.

 

Last week (April 2015) a study was published in the British Medical Journal that got a lot of headlines. An analysis of 13 quality trials showed that Paracetomol is no better than a placebo for treating back pain, arthritic pain and disability. What’s more, those patients regularly taking Paracetomol for back pain or arthritis were 4 times as likely to have abnormal results on liver function tests. So taking this medication for your pain will make you less healthy.

Similarly taking Non Steroidal Anti-inflammatories (NSAIDs) such as Ibuprofen and Naproxen can lead to health problems related to gastro-intestinal inflammation. Interestingly Aspirin did not cause inflammation of the small intestine (2). This inflammation leads to increased permeability of the intestine. If you consider that the intestine is the barrier between you and your food, bacteria and powerful enzymes it’s good to keep it healthy.

Do You Have A Leaky Gut?

If larger molecules cross the gut wall they can stimulate your immune system to attack them. Unfortunately, this reaction can then continue on similar molecules within you. Therefore increased gut permeability (caused by expression of a protein called Zonulin) contributes to the development of  auto-immune diseases such as coeliac disease and diabetes type 1. (3) It has also been recently hypothesised that joint inflammation in relatively benign osteo-arthritis is also a product of this process. If that is the case then taking Nsaids could actually contribute to the cause  of the problem you are taking it for.

How do you keep pain free then?

The research paper from the BMJ recommended exercise and manipulation to help stay pain free. Manipulation stimulates the nerves that regulate muscle tone and also inhibits pain. Most people will have pain from either over doing things or not doing enough. So if you are not active start by taking walks and then think about swimming, cycling and general workouts. Build up slowly over time and you will soon start feeling better. If you are a weekend warrior make sure you do regular consistent exercise to build up your conditioning or you will get injured. If you do have pain don’t take painkillers and NSAIDS. Use Ice, get help from an expert who understands biomechanics, athletic training, neurology, anatomy, diagnosis in other words us!! Don’t pop a pill, it will make you less healthy in the long run. If something’s wrong find out what and why and do something constructive about it. Your liver, kidneys and gut will thank you for it.

Taking Nsaids and exercising.

So, when you consider all of the above it is crazy to take paracetomol and anti-inflammatories as part of your training. Pain is there to warn you. If you listen to it properly it can be your best friend as it will keep you healthy and aware of issues before they become established. If you ignore your warning systems you are heading for trouble.

Is there an alternative to Nsaids?

Yes!! Studies have shown the efficacy of taking a concentrated turmeric formulation (4). Turmeric contains Curcumins which have been shown to reduce inflammatory cascades in the early phases of inflammation. It is not heat stable so cooking will nullify it’s effects. So a curry on the way home  is not good practice. It won’t act instantly like a drug but is a useful supplement to help with a number of problems caused by inflammation if taken daily. We stock it as part of our holistic approach to improving musculo-skeletal health.

For more information on any of the above topics contact us on 01202 733355 or email us.

 

 

REFS:

(1) Machado GC, Maher CG, Ferreira PH et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials.The BMJ 2015;350:h1225. doi:10.1136/bmj.h1225.

(2) G Sigthorsson et al. Intestinal permeability and inflammation in patients on NSAIDs. Gut. 1998 Oct; 43(4): 506–511.

(3) Leaky gut and autoimmune diseases. A Fasano. Clin Rev Allergy Immunol. 2012 Feb;42(1):71-8.

(4) Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: a component of tumeric (Curcuma longa). J Altern Complement Med. 2003 Feb;9(1):161-8.

 

22
May

Vitamin D3

I asked you what was the most important vitamin for fighting colds what would your answer be? Many people think it’s Vitamin C. It is certainly important in helping to mop up free radicals which cause damage through a process known as oxidative stress, but it’s not the most important. Vitamin D3 has been shown to boost immune function thereby helping you fight the invaders before they get a foot hold. To put it another way, Vitamin C helps you fight the effects of the chemicals released by inflammation, vitamin D3 helps to stop it in  the first place.

What is Vitamin D3?

Vitamin D3 is synthesized in the skin when exposed to sunlight. Vitamin D2 is found in plants. Vitamin D has long been known to support the absorption of calcium and formation of bone. A deficiency leads to softening of the bones and Ricketts (bandy legs). This disease is on the increase again, due to people covering up for cultural reasons and lack of sunlight in higher latitudes, especially for those of darker skin.

 What is it’s role?

More recently Vitamin D3′s role in immune function regulation has been studied extensively and new research is confirming it’s importance as a vital supplement. Poor immune function obviously can leave you more susceptible to infections such as the common cold and flu. It can also reduce your ability to recognise and destroy cancerous cells, and can lead to the development of auto-immune disorders where your immune system actually attacks your own body. This process has been implicated in some inflammatory arthritis, multiple scerosis, systemic lupus. A correlation has been found between low levels of Vitamin D3 and all of these disease processes. In addition macular degeneration (blindness), hayfever, chronic rhinitis have all shown signs of being affected by low vitamin D3 levels.

Are you getting enough?

This depends on your location, skin colour, diet and sun exposure. In the UK 90% of the population are below recommended levels. 75% of young adults are deemed deficient. 20-40% of young adults 19-24 years old, care home residents and children of British Asians have been found to have only a third of recommended levels. The amount needed varies according to who you read, the Endocrine Societies Clinical Practice Guidelines state from 400 iu to 800 iu as a daily requirement. With an optimum of 1000 iu to 1500 iu. In cases of deficiency 2000iu to 10000iu. You can read the guideline here. One thing is clear, if you are wrapped up for several months of the year in low sunlight you won’t be getting as much as in the summer. Is this why you are more likely to have “bugs” in the winter? Is it also why cancers such as colo-rectal cancer are more common at higher lattitudes? There is also a possible link between latitude and multiple sclerosis and diabetes. Also have a look at this site which has a good deal more on the topic.

How do you top up?

Natural food sources are oily fish, such as salmon and sardines and eggs. It is also in fortified cereals, spreads and powdered milk. The NHS sitestates that most people should have enough, but latest clinical guidelines dispute this. Supplementation should be 1000iu for babies and children (be aware that baby formula milk commonly contains vitamin D, so adjust accordingly). 1500-2000iu for adults 18+ years of age.

Can You Test For It?

Generally because vitamin D deficiency is so widespread in the UK routine measurement is deemed unnecessary. A more cost-effective approach is routine supplementation with sensible sun exposure in the spring summer and autumn. High risk groups should be screened, these include people at high risk of inflammatory bowel disease, cystic fibrosis, gastric bypass patients and patients taking medication that effects vitamin D metabolism (anti-seizure meds, glucocorticoids, AIDS meds).

Can You Overdose?

Historically there have been concerns as very high levels can be toxic and cause too high a level of calcium and phosphate in the blood leading to bone conditions. However it is now well established that toxicity is extremely rare. Doses of up to 10,000iu a day have been used for up to 5 months with no adverse effects, suggesting that only long-term over supplementation is an issue. However it is important to stick to the guidelines.

Can’t I just get it from the sun?

If you live in northern latitudes, are inside alot and use sunscreen extensively you won’t get enough from the sun. Especially with our weather!

How can I take it?

There are many products on the market, I would recommend a natural food source variety and not a synthetic one. A quick search online should provide a wealth of information to help you choose.

14
Jul

What is Health?

This is a fundamentally important question when considering a “healthy” spine or body.

In the Western World health care is concerned mainly with getting you painfree, and unfortunately in general only lip service is paid to the preventative side of therapy. The commonest way of doing this is with medication until the pain goes, then you are healthy! This is fundamentally wrong and short-sighted.

Health is NOT an absence of symptoms, health is good function, everything working correctly, in a good environment, efficiently. Just focusing on being painfree will not result in good health.

In modern times we are all (well most of us) leading very busy lives, we are having to work harder, for longer, many of us travel ever increasing distances to work. We are under more pressure due to the cost of living, we have less time for ….

 

family and friends. There is an increase in the number of people being labeled as having behavioural disorders, ADHD, ADD etc and this is just a symptom of the environment that children are now being exposed to as a result of social changes that have taken place over the last 20 years.

All around the western world increasingly  children are babysat with computer games or television, many complain of being bored in the holidays as many have reduced ability to partake in imaginative play.

There is a reason for this neurologically that relates to musculo-skeletal health, more on that in the next issue.

So what does western culture do about this growing epidemic? It gives it a name and medicalises what is essentially behavioural problems due to poor central nervous system stimulation. It prescribes drugs such as Prozac to make you “feel” better, but these drugs don’t make you better. Do you know that in the USA there is now a disease called shyness!! The cure? Prozac, but under a different name, how crazy is that?

Many of the serial killing gun sprees in America have been perpetrated by children who have been prescribed Serotonin re-uptake inhibitors SSRI’s. These affect the way the brain processes information and enhance the formation of repetitive patterns of activity, hence the multiple events. Consider also the relatively recent phenomenon of Fibromyalgia, how many people have you heard of that have been diagnosed with this condition. In my opinion this diagnosis should not be made as it labels individuals with a negative outlook that has detrimental effects on that persons prognosis, I’ll explain more on this subject in the next few entries.

I’m sorry if this is getting too morbid, but we really do have a health crisis on our hands if we don’t take steps to encourage children to explore imaginative play, exercise, challenging balance, eating well, communicating with friends and family, the same goes for adults too, although I’m not expecting you to get out the figurines from the attic if they are still there!

These are all positive feedback tasks that enhance and stimulate the central nervous system and lead to a sense of well-being.

Before I finish for now, ask yourself how you can make gentle, progressive and positive changes to your lifestyle that can help you feel better in general and also help you stay free of pain, both physical and emotional.

I’ll be covering the research on these subjects in the next few updates so do have a look soon. If you have children or are thinking of having them, this is information that you really should look at as a matter of utmost concern.

Until the next time.

22
Sep

Wall Angel Part 2

Building Resistance

You’ve Should Have The Flexibility Now It’s Time To Go For Strength And Stamina. Only complete this part if you can comfortably get your arms flat to the wall and keep them there as you lower them on the Wall Angel. Make sure you read this first if this is the first you’ve heard of Wall Angel.

You Need Equipment For This!!

What? Equipment? I hear you say. Never fear this is where the wonderful world of exercise bands come in to play. These are relatively inexpensive but highly versatile rubber bands, the beauty of these is that they improve your control of joint movement while under resistance. As the rubber is constantly working against you you have to work harder to control the bounce back so to speak. They come in a variety of resistances that are colour coded.

The other great thing about them is that they fold away and you won’t stubb your toes on them like a set of dumbells just hidden out of sight beneath the bed!

How To Add Stamina And Strength.

Take a two metre length of band and fold it over, start with a resistance that is comfortable. Remember no pain no gain is frankly a stupid way to train, so if you are struggling after just a few reps, get an easier band.

  • THIS IS ABOUT STAMINA PRIMARILY NOT POWER.

It’s great to be able to do a huge lift, but after one go you’re bust, what practical use is that in every day life?

Take the band as shown below between the hands and make sure you have some tension, then lower the arms and the band will stretch. Hold for a few secs, SLOWLY raise the arms back up, pause for a few seconds and repeat until you feel that you are starting to lose good form or begining to tire between the shoulders. Remember if you are getting pain, reduce the resistance, if it continues to give pain STOP, go back to unloaded exercise, i.e. no band.

Start position (arms are actually not bent enough!)

Start position (arms are actually not bent enough!)

Ladies, a little advice…don’t do this before going out, it can do strange things to the hair on the back of your head and you may end up looking like this.

Aim to do the exercise once or twice a day with a rest break of 2 days in the week. If you require more assistance you can contact me through the clinic website.

Have Fun

Steve Oldale BSc, DC

www.backinform.co.uk