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The Webster Technique: Chiropractic Care for Pregnant Mothers

The Webster Technique may be familiar to you, especially if you’ve been under Chiropractic Care during a previous pregnancy.    It is a Chiropractic Technique used primarily during pregnancy to optimize normal functioning of the pelvis and sacrum (tailbone).  

The actual technique is quite different from traditional Chiropractic care but the underlying principle remains unchanged.   Chiropractic has always been to correct and optimize function of the spine and nervous system.  Chiropractic adjustments are intended to restore normal function allowing  your body’s inherent ability to heal itself to do so without inhibition.   When we apply this principle to the Webster Technique, it simply works to aid a pregnant mother’s own body to function optimally as she adapts to her body’s natural changes through her pregnancy.

FREQUENTLY ASKED QUESTIONS

How does it work?

To describe how it works, I think Dr. Jeanne Ohm, long time instructor of the Webster Technique with International Chiropractic Pediatric Association (ICPA) provides a clear and concise description:

“Performance of the Webster Technique involves analysis of the relationship of the bones of the pelvis, and correction of aberrant neuro-biomechanics through the use of a light force chiropractic adjustment of the sacrum (Step 1). It also involves analysis and light contact to a supporting pelvic ligament. (Step 2). Both steps are intended to restore neuro-biomechanical function in the pelvis. “

 

 Is it safe to receive Chiropractic Care during pregnancy?

The Webster Technique has been safely used in pregnant mothers since 1978.  There have been no reported injuries associated with the use of the Webster Technique.  With any Chiropractic Treatments, minor discomfort may be experienced for 24 hours after treatment and typically resolves on its own.    Many midwives and doulas recommend pregnant mothers to receive care from Chiropractors certified in the Webster Technique.

 

Does it really ‘turn babies’ from Breech Position?

Dr. Larry Webster, the founder of the Webster Technique, described that the Technique is intended to improve nerve and structural function in the pelvis.  Along the way, Dr. Webster found that pregnant mothers under his care with breech presentation turned head down in majority (95%) of cases.  A recent study in the Journal of Manipulative and Physiological Therapeutics reported that the Webster Technique had a success rate of 82% in promoting natural turning of breeched babies.

While I must emphasize Chiropractors DO NOT turn babies, even while applying the Webster Technique.  Chiropractors only apply treatment to the mother’s pelvis  and tailbone to normalize their function.  By optimizing the structural health of the mother, the Webster Technique allows the natural process of pregnancy and birth to occur.  In cases of breeched babies, often the fetus turns naturally in preparation for birth because that’s what nature intended.

 

Does the Webster Technique relieve Back Pain?

While the Webster Technique has received the most attention in pregnant mothers who are carrying breeched babies, this form of treatment is just as successful in relieving back or pelvic pain common in  pregnancy.   Simple daily stresses for a pregnant mother can be triggers causing shifting of the pelvic structures.  The hormone Relaxin, relaxes the ligament structures around the pelvis to allow for growth of the fetus but it also makes the pelvis vulnerable to malpositions causing pain.

 

Dr. Kevin Ho is certified in the Webster Technique and has successfully treated numerous pregnant patients assisting them through a full and healthy pregnancy.  Should you have any questions about the Webster Technique, please contact Dr. Kevin Ho through email at kevin@drkevinho.com or by phone at 647-931-8108.

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Glucosamine: Not All Created Equal

In the medical community, there has been much debate over the effectiveness of glucosamine and chondritin for relief of arthritis pain.  According to the Arthritis Foundation website, they state that ‘Glucosamine and Chondritin maybe not effective for Arthritis’ and that ‘Major study suggests that placebo works just as well.’  However, segments of patients continue to experience reduced arthritis pain after taking Glucosamine / Chondritin.  Why is there such a discrepancy between the results of research studies and actual results?  Is there any difference between what kind of glucosamine you buy?  We will attempt to discuss some of these questions.

First, let us briefly review arthritis, specifically osteoarthritis and how glucosamine factors into this condition.  Osteoarthritis pain, not rheumatoid arthritis, has been attributed to the loss of the smooth cartilage that covers the surface of bones.  The function of this smooth (articular) cartilage is to provide a cushion effect between bones.  Glucosamine supplements are intended to give the body a key ingredient for reproducing lost smooth cartilage associated with arthritis.

Why does glucosamine work for some but not others?

 a. Severity of Arthritis:  Glucosamine is not as effective in severe arthritis

In a study published by the Osteoarthritis Research Society International, it was reported that glucosamine supplementation was beneficial in reducing the progression of mild or moderate knee arthritis over a 3 year period.   However, no notable difference was noted in subjects with severe arthritis.  As a result, if you want to try glucosamine & chondritin, start using it early.

 b.  Pre-existing conditions

Do you have type 2 diabetes or elevated cholesterol as well as arthritis?  Recent studies have now shown that some types of glucosamine supplements can actually increase cholesterol and further increase insulin resistance.  In theory, this could contribute to weight gain, adding additional strain on arthritic joints and possibly reducing the effects of the glucosamine.

 Are some glucosamine better than others?

In 2011, a study was released in the Journal of Pharmacy & Pharmaceutical Sciences and it tested 14 different glucosamine products in the Canadian market.  It showed that the bio-availability of glucosamine was <80% of the dosage shown on the label in 12 out of 14 products.  Specifically, they ranged from only 41-66%.  A generous estimate says you’re probably getting at most 2/3 of the glucosamine the labels says.

The new Challenger: N-Acetyl Glucosamine

Some data is now showing that N-Acetyl Glucosamine may actually deliver the intended dosage.  Some manufacturers of N-acetyl Glucosamine say that it is a more stable form because it doesn’t require salts in its formulation.  They also claim that it does not interfere with insulin resistance.  This product is still very new on the market and very little research has been done to compare it against traditional glucosamine products.  It remains to be seen whether it can support its claims down the road.  However, it may be safer to try N-Acetyl Glucosamine especially if you also have diabetes or have borderline diabetes.

If you have any questions regarding glucosamine supplements, please do not hesitate to contact Dr. Kevin Ho.

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Stop bunions before Summer Arrives

If you’ve been following some of my recent posts on Facebook, you may have noticed that our theme has been feet to get you ready for spring!    Foot & ankle problems are fairly common at my practice and often I get asked questions about bunions.  This problem is of special concern for ladies in preparation for sandals and open toe shoes.

Bunions, in case you didn’t know, is medically known as Hallux Valgus and affects the joint at the base of the first toe.  Bunions typically cause a deformity in the first toe, sometimes an enlargement of the joint or a bony bump can be seen.  As Bunions progress, the first toe starts to angle towards the 2nd toe, often pressing up against the 2nd toe.  Common symptoms include pain and swelling over the joint.  In some cases, osteoarthritis can develop in the joint, resulting in loss of range of motion.  This can cause increased pain during walking especially during the ‘toe off’ phase.  The toe off phase is when you push your back foot forward in preparation to take the next step.

Fact:  You can blame your family for your Bunions

Yes you can, you can tell them I told you so!  Bunions have a strong familial tendency.  Up to 68% of  bunions are hereditary.

Besides genetics, bunions have been linked to frequent use of tight fitting shoes and high heels.   Some medical literature also indicate that having flat feet (pes planus) leads to faster progression of bunions.

 

What can be done before it’s too late?

Custom Orthotics

Should you suspect that you have flat feet or excessively high arches, having an assessment of your foot structures would be quite valuable.  Adding custom orthotics BEFORE you develop bunions is much more effective in preventing bunions.  Once the bunion has formed, it is much harder to reverse the process.

 Acupuncture & Chiropractic

If you notice a bump forming over your big toe then you may want to consider acupuncture to some of the key muscles affecting the big toe.  There is an imbalance of the muscles controlling the big toe and acupuncture works to release a key taut muscle known as Adductor Hallucis.  Chiropractic adjustments also help to restore normal motion in the numerous small joints in your foot.  YES, your foot has bones can be adjusted.

Omega 3 Fish Oil

This product has tremendous evidence in reducing pain and inflammation related to any type of joint pain.  Contact me by e-mail if you’re not sure how much Omega 3 fish oil is necessary for relieving joint pain.  Check out this link on how to select a good fish oil that previously posted on my Facebook timeline.

Last resort:  Invasive Treatments

When the pain is unbearable, a cortisone injection into the joint can relieve the inflammation.  However, short-term and long-term side effects should be considered before you receive cortisone.  There are surgical procedures to address pain and immobility caused by bunions.  Personally, I would trial all other options before undergoing surgery.

Make sure you don’t have Gout

Sometimes people mistake a bunion for what really is gout.  Gout is an inflammatory type of arthritis that commonly affects the big toe also.  When Gout attacks, the big toe joint is red, hot and swollen.  Sometimes wearing socks or having blankets covering your feet can be enough to cause pain.  Gout can be managed with prescription medication from your family doctor.  Gout is also a something that occurs intermittently and can be limited with diet modification.  Bunions itself is not arthritis but it can lead to a osteoarthritis.  If you’re not sure which one you have, come in to see me for an evaluation.

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Why a Firm Mattress is not for Everyone

At my office, I often get asked various questions on how to keep  one’s back healthy.  A very popular question is what kind of mattress should I sleep on?  So here’s a short and sweet discussion on what kind of mattress is best.

Myth:  A firm mattress is better for my back.

I hear this one a lot.  Many people believe that if they’re having back pain, they should sleep on the floor or on a board.   However, this strategy doesn’t work for everyone.  The reason is the spine has natural curves known as kyphosis and lordosis but people with deep ‘curves’ in their spine cannot tolerate a firm surface like the floor.   You can check the curve of your spine by looking in the mirror from the side.  If you have a notable hunch in your upper back or a deep indentation in your lower back, sleeping  a very firm surface is not recommended.

Fact:  A medium-firm mattress is ideal

For most body types, studies out of Europe have suggested that a medium-firm mattress is the most equipped to support the natural curvatures of the spine.  On a scale of 1-10, 1 = soft and 10 = firm, a number between 6-8 should be your target.  Unfortunately, no such consistent rating scale exists across all the major brands but different manufacturers have tried to provide a rating of firmness on their products.

A quick firmness reference guide when you’re at the mattress store.  This is a general guide and may vary subjectively as you test different mattresses.

Firm = 7.5-8

Cushion Firm = 7

Plush = 6

Pillow Top = 6

Ultra Plush = 4

Tip:  Ask about a trial period

Many mattress stores now offer a limited trial period when you purchase a new mattress.  Depending on the store, these can be 30-60 days.  It does take 2-4 weeks for your spine to adjust to a new mattress so don’t judge your new bed after a couple of nights.

What about Memory Foam?

There is very limited research information available on memory foam mattresses and whether it actually prevents back pain.  However, there was a small study in Europe that found medical residents that slept on foam mattresses reported of more low back aches than compared to when they slept on cotton mattresses at home.  The study did not indicate if they were Memory Foam mattresses.   I’ve personally tried Memory Foam mattresses at the store but have never owned one.  But if you really think a Memory Foam mattress would give you a better sleep, there is no harm in trying it for a month.    Have your spouse or friend take a picture of your back while you lie on your side.  An ideal position is that your spine is straight and horizontal.

If you have any questions about mattresses or sleeping habits, please feel free to make a comment below or contact me at Kevin@drkevinho.com.

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Is Yoga Safe for you?

With 2014 only 4 weeks old, I hope some of your new year’s resolutions are still being kept!  Perhaps you were one of those that said, I will do more exercise this year and thought about trying yoga.  Over the last decade Yoga has gained tremendous popularity, from fitness guru’s to regular office workers.   Yoga is also full of endorsements from celebrities including Lady Gaga, Jennifer Aniston, Jon Bon Jovi and Adam Levine.  In fact, I have recommended Yoga many times to clients looking for ways to maintain good posture and improve flexibility.

 

However, if you are new to yoga or have had previous injuries to the neck or head, some yoga poses may not be safe for you.  Recently, several previously healthy clients have suffered neck injuries after performing what is known as the Sarvangasana (Shoulder stand) and/or the Sirshasana (Head stand).

 

The International Journal of Yoga Therapy surveyed 1336 yoga teachers from 34 different countries in 2007 and found that neck injuries were specifically linked with these 2 poses.  The yoga teachers attributed several factors to such injuries including poor technique or alignment, previous injury, excess effort, and improper or inadequate instruction. In the medical literature, muscle strains, ligament injuries and cervical disc injuries have been reported.

 

If you have suffered previous neck and/or head injuries, you should be cautious before performing these 2 specific yoga poses.  Prior injuries such as whiplash, concussion, pinched nerves and herniated discs just to name a few.  Also, you should avoid these poses If you have any conditions that gives you loose ligaments or you believe you are very flexible.  If you are unsure if these yoga poses are safe for you, be sure to consult with me or your trusted health practitioner.

 

If you did suffer an injury after these yoga poses, you should pursue treatment immediately especially if your symptoms last beyond your typical after workout ‘soreness’.  Signs of neck injuries can include but not limited to neck pain, shoulder pain, arm pain, numbness/tingling, headaches, dizziness, nausea and arm/hand weakness.  Depending on your diagnosis, Chiropractic therapy and/or Acupuncture treatments are very effective in treating yoga related injuries.  For more information on this, please feel free to contact me by e-mail at Kevin@drkevinho.com.

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4 Reasons for Low Back Pain Before & After Pregnancy

There are four reasons why you may experience low back pain before and after pregnancy.

1. Hormonal Effects of Relaxin

It is well known that a mother-to-be will ride the roller coaster known as hormones through the journey known as pregnancy.   The ups and downs of hormones contributes to feelings of food cravings, morning sickness and swollen breasts.   One of the lesser known hormones during pregnancy is relaxin, it quite simply relaxes ligaments and fibers around a mother’s pelvis, making extra room for the growing fetus.   However, one downside to Relaxin is that it can soften pelvic ligaments too much and result in some pelvic instability and triggering back pain or muscle spasms.   I have worked with new mothers who were surprised that they were still having low back pain months after delivery.  Medical literature suggests that the effects of Relaxin can linger for up to 6 months, well after the baby has been born.  This can create pregnancy-like low back pain and even sciatica.   The good news is that 90% of mothers with post-pregnancy low back pain make a full recovery!

2. Complicated & Prolonged Deliveries

Having one toddler at home, new parents-to-be often ask my wife how long her labor and delivery was.   Many pregnant moms fear that her labor will be long but in predicting post-pregnancy back pain, a prolonged delivery process is much more of concern.  If a delivery (when the ‘pushing’ starts)  is complicated by a lack of progress, prolonged periods of excessive stretching of the pelvic ligaments can cause subsequent ligament injury.   The use of medical instruments like forceps or suction could also indicate a difficult or narrow path leading to further ligamentous stretching.  These conditions create instability of the pelvis leading to ongoing low back, buttock or tailbone pain well after delivery.

3. Old Back Injuries

Have you had a previous back injury?  There are 2 kinds of back injuries that might increase your chances of pregnancy and post-pregnancy low back pain.

A. Major trauma – an injury to the lower back, buttock or tailbone area after a memorable incident like a car accident or a significant sports injury.  These types of injuries typically had a long recovery time (> 3 months)

B. Micro trauma’s – these injuries occurred over time and may have been ignored as chronic aches or dull pain.  Typically seen in women who played sports competitively or regularly (> 3 times / week) like running.

4. Too Flexible

Have you been told you were ‘double jointed’ or more flexible than your peers?  Can you do the splits or contort your body in ways your friends cannot?  The technical term for being excessively flexible is hypermobility and according to the Hypermobility Syndrome Association, a high Brighton Score is what defines someone to be ‘too flexible’.    Click on the link above to see what your Brighton Score is.   Individuals with high Brighton scores experience even further softening of their pelvic ligaments resulting from Relaxin as noted above.   If I am working with an individual with a high Brighton Score, I typically caution her on a higher possibility of low back pain during pregnancy and she should be monitored closely throughout her pregnancy.   However, being too flexible should not make getting pregnant a danger to the baby or the mother.

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Top 5 Chiropractic Myths Busted!!

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Knee Pain: Is it Arthritis?

 

Ms. H. whom I will refer to as Nancy, is a 65-year-old retiree who has experienced knee pain for years.  She complained her knee pain made it difficult to bend or squat  when she cleans her home.

She began treatment with me after reading a brochure in our waiting room about the Activator® Method.  At her age, she didn’t realize that Chiropractic offered gentle treatments suitable for seniors but her persistent knee pain motivated her to seek out other forms of treatment.  She had been using glucosamine chondritin without much success.   She had also seen her family doctor who recommended the use of anti-inflammatory medication to be used when pain intensity increased.    However, like most seniors, she didn’t welcome the idea of becoming dependent on prescription medication to relieve pain.    She was previously diagnosed with mild knee arthritis but after taking x-rays, no signs of arthritis was found!  An ultrasound was also done to check for ligament or tendon injuries but it was also normal.   Using the Activator® Method, her entire skeletal structure was assessed which revealed flat feet, producing domino effects that altered the alignment of her knee, hip and pelvis.   These findings had likely been there in the background for many years, leading to her knee pain.  The gentle nature of the Activator Method® is ideal for seniors who may have other health conditions like osteoporosis.   Similar to traditional chiropractic treatments, the Activator® Method works to return the body to optimal alignment allowing the skeletal and nervous system to function without interference.  Yet the Activator Method is not forceful and tolerated well by patients of all ages, including seniors.

After her first treatment, she immediately began to experience some relief.  She received weekly treatments for 4 weeks, started using Omega 3 Fish Oil daily and was prescribed custom orthotics to her footwear.  She has been reporting that her knee pain became much less intense and found that squatting or bending was much easier.  She was able to travel over the Christmas holidays with very little discomfort.  Nancy was so pleased with the results that she referred a friend, also a senior citizen, for treatment on her low back pain.   If you have nagging knee pain or think you have knee arthritis, speak with Dr. Ho by email or call 647-931-8108.

 

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Acupuncture Relieves Foot Pain: Case #1 – Bunions

Bunions

A 64-year-old retired golf enthusiast was complaining of pain over his ‘big toe’.  After examining him, it appeared that the source of his pain was a bunion.  He had hoped that treatment could help him avoid surgery.

A bunion is also known as ‘Hallus Valgus’ which means an inward angling of the first toe.   It is the most common foot complaint in the population.  The most common cause of a bunion is actually flat feet or overpronation.  It is believed that tight fitting shoes or ‘pointed-toe’ shoes is NOT the direct cause of bunions but do contribute to the progression of a bunion’s severity.

Most common symptoms include deep dull ‘in the joint’ pain, difficulty with prolonged standing / walking and pain noted when wearing shoes.  As this condition progresses, there is more stiffness in the joint and loss of movement in the big toe.

Changes in the alignment of the big toe alter the balance of muscles controlling the movement of the first toe.  Treatment for this gentleman focused on releasing the tight muscle(s) that pull the big toe inwardly.  In his case, we focused on the extensor hallucis longus by applying acupuncture as well as a form of friction massage over the muscle.  He also began supplementing with Omega 3 Fish Oil  by Metagenics, intaking at least 2700mg daily.  After 2 weeks of treatment, his pain severity reduced by 50% and could play golf at full capacity.

Bunions with greater than 50 degrees of inward misalignment typically require surgical interventions, so early treatment is critical. Bunions with less than 30 degrees of inward angling are considered to have the best chance of success with non-surgical strategies.  Besides acupuncture and omega 3 fish oil, assistive devices (custom orthotics  and straps) can be helpful.   If you have a bunion, connect with Dr. Ho and see if he can offer you pain relief soon.

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Orthotics can be… uh, sexy!

It’s a well known fact of the world that women (and some men) have an incredible fascination with shoes. Not just do women like to look at and wear shoes but they also seem to like buying them just for the sake of it. Be it a part of your perfect outfit or it’s just what you wear to get to work, it is a reflection of your style and personality. But sometimes style and maintaining healthy feet forces one to give up one for the other.

Have you been recommended for custom orthotics? Are you unwilling to give up your favourite pair of shoes for orthotics? Put your worries aside because custom orthotics can now be altered to fit into most shoes, even high heels, flats and boots! In fact any shoe with minimal heel support can be fitted with custom orthotics.

Did you know that numerous styles and minor modifications are available when making a pair of custom orthotics. Here are some examples just to name a few:

– Low heel cushioning to accommodate flats and dress shoes
– Shortened orthotics to accommodate ‘pointy-toe’ shoes
– Narrowing of the midfoot area to fit into high heels

What’s all the fuss with feet?

According to the National Foot Health Assessment from 2012 and reported on CNN.com , 78% of adults over the age of 21 have experienced foot problems during their life.

CNN goes on to report that:
“Although feet were designed to walk barefoot on Earth’s natural surfaces (grass, sand or gravel), they were not prepared to endure the concrete, asphalt and steel that covers so many landscapes today… These unmovable surfaces are harsh on bare feet.”

Shoes such as flip flops, lace up wedges or many elegant dress shoes lack the proper heel and structural support to absorb the daily shock your feet are subjected to. Alignment of your feet sets the foundation for the rest of your body. Even if you avoid or minimize the use of ‘low support’ shoes, underlying faulty foot structure may appear as knee, hip or back pain.

Custom orthotics added to a well constructed pair of shoes is a great combination to ensure your feet are protected and doing what they were made to do.

Most employee insurance plans include coverage for custom orthotics and as the calendar year draws to an end, November and December is your last chance to take advantage of your benefits plan before 2013 arrives. If you have any questions about custom orthotics, please do not hesitate to contact Dr. Ho at Kevin@drkevinho.com.

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