Learn how to prevent ankle sprains

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Learn how to prevent ankle sprains!

An athlete is at a much greater risk of another ankle sprain for 2 years after an initial ankle sprain.  Rehabilitation exercises focusing on balance and proprioception results in a 2-3 fold decrease in risk after 8 weeks of exercises; also, ankle braces can decrease your risk by 3-4 fold.  Check out Dave, from Valley Active demonstrating some rehab exercises that can help!

 

To learn more, check out our Facebook page at Valley Sports & Spine Clinic, or at Valley Active.  Come visit us at our Blacksburg office, right next to Christiansburg, in front of Lewis-Gale Montgomery Hospital.

 

Good Luck!

 

Sitting is Bad for Your Health

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A new meta-analysis shows that sitting too much increases your risk of early death from any cause.  The other important finding is that this increases your risk even if you exercise.  Further, the study showed that the less active you were, the more likely you were to die prematurely.

Previous studies have also showed that you should get get up 35 times a day or get up about every 15 minutes throughout the day.

For many of our patients in the Christiansburg, Radford, and Blacksburg area, the struggle after successfully completing physical therapy has been finding a way to continue to exercise and keep moving afterwards.  Valley Sports & Spine Clinic and Valley Active are committed to finding a personal exercise plan to keep you regularly moving for a healthy lifestyle.

 

Good Luck!

 

Dr Ethan Colliver

What do I do next?

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Rehabilitation is a continuum of care.  As someone goes through the three phases (pre-rehab, rehab, and post-rehab) of recovery from an injury, the goals change and so should the rehabilitation provided.

Pre-habilitation is the exercise, conditioning, and education someone may go through prior to undergoing a hip replacement or other major surgery.  For example, patients who are stronger and more functional before they have a hip replacement will recover quicker and be more active after a their surgery.

Rehabilitation is the phase of training, education, and recovery from an injury or surgery which often occurs with a physical therapist and may last for several months.  This is a very critical time for many patients as it may be the first time they have had a major injury or have participated in a formal exercise program.  The physical therapist and physician work closely to help the patient establish goals, create a home exercise program, and help the patient envision how they will return to their normal everyday activities.

Unfortunately, 75% of patients stop doing their home exercise program within 6 months of stopping physical therapy.

rehabInsurance companies usually only cover physical therapy until a patient can carry out normal activities in the home; however, insurance will not cover rehabilitation aimed at the goals of returning to a sport or to a demanding work environment.

Post-rehabilitation is the phase afterwards, focusing on helping you maintain a home exercise program and establish new goals.  This is important for an athlete who needs to continue getting stronger and faster to meet the demands of his/her sport.  But it is also important for an industrial worker who has a demanding job or for a 65 year old grandmother who needs to pick up her grandchildren.

Having the patient create a personal exercise routine, under the supervision of a therapist helps you successfully stick to a healthy lifestyle and decreases your chance for recurrence of many painful conditions, and improves overall health.

Valley Sports & Spine Clinic and Valley Active help people through all phases of rehabilitation.  We are committed to helping people improve their function and return to their life.

Introducing our newest team member, Shannon

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IMG_4074I love my staff. We have had many of the same faces at Valley Sports & Spine since the beginning. Their dedication and knowledge are an integral function of the clinic and I am finally getting around to writing about them on the blog.

A recent addition to our Medical Assistant position is Shannon. Shannon recently graduated from VT and is now in a Masters Program with an ultimate goal of Public Health work. She has a passion for Africa and desires to work in West Africa where the Ebola outbreak is exploding.

She recently completed the Eagle Man triatholon with three generations of her family, her mother and grandmother in a team named TriGenerational.  Their team placed 2nd in the relay division.  Her mother swam for 1.2 miles, her grandmother biked for 56 miles, and Shannon finished with a 13.1 mile run.  Shannon called the experience “Awesome!” and looks forward to more races with her family.

Her family has always been into competing and exercise.  Shannon’s grandmother, who was born in 1939, has competed in the Iron Man triathlon at least 5 times and stars in her own Spinning training videos.  Shannon has been a competitive swimmer since 5 years of age and participated in District and Regional swimming competitions in high school.  She admits she likes the competition more than the practice, and always try to beat her best time in any given sport.

Shannon has an upcoming 1/2 marathon and continues to swim and run regularly. She wants to master bicycling next so she can compete in triathlons, like her grandmother.

Good Luck, Shannon!

Muscle & Bone Health in Aging

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The muscle and bone systems are constantly changing and reacting throughout our lives; and the effects are different for men and women, but remarkably similar. Both muscle and bone will undergo a normal decline as we age; somewhere around the age of 25 in men.  Muscles lose strength and power for various reasons:

1. muscles lose mass: there is a decrease in muscle fiber size and a decrease in muscle fiber quantity, starting at the age of 25, due to decreases in estrogen, testosterone, and Insulin-like Growth Factor-1 (IGF-1).
2. loss of motor units: the number of motor nerves that innervate muscle cells decreases
3. less muscle protein synthesis
4. loss of aerobic capacity: this is multifactorial in itself
5. loss of synchronization of the firing of motor units: also, multifactorial, such as with prior sciataca or disc herniation

Bones lose mass as we age because of several reasons:
1. loss of sensitivity of bones to muscle: loss of testosterone, IGF-1, and estrogen decreases bone response to mechanical stimulation by muscles and result in loss of muscle mass.
2. loss of muscle mass, area, and strength: due to loss of IGF-1, estrogen, and testosterone and this loss of muscle can also decrease the stimulation on bones.
3. increased bone resorption: due to loss of estrogen and testosterone

You can counteract this decline in bone and muscle health with strength and endurance training. Regular strenuous exercise (20-60min, 3-5 days/week)increases muscle strength and power, aerobic capacity, and bone density. Currently, no medications are approved for the treatment of muscle loss that occurs with aging and some treatments, including testosterone, can have dangerous side effects. For bone loss, exercise can increase the stimulation on bones by muscles and improve power and balance to decrease your risk of falls. Many medications exist for treating thin bones, including testosterone in men, but it appears that exercise can be as effective and both treatments should be implemented.

If you are concerned about your bone and muscle health, you should check with your doctor to see if an underlying medical condition is present, or if this a natural process with aging. Your doctor may prescribe medications and exercise to treat your issues.

Good Luck!

Valley Sports & Spine Clinic
Giving you Back your Life

Dr Ethan Colliver

 

Owww…. My disc hurts!

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One of the most common causes of low back pain is lumbar disc pain.  The disc has an outer layer made up of cartilaginous (annulus fibrosus) layers surrounding a gel-like center (nucleus pulposus). There is one disc between each bony vertebral level in our low back.  According to Stuart McGill, PhD, it behaves more as a ball-bearing joint than a “shock absorber” (that is for a later topic).  The anatomy allows us to bend our low backs with great flexibility in all directions. The outer third of the disc is innervated by sinu vertebral nerves, meaning that it can transmit pain signals coming from the low back.  The annulus fibrosus is thinnest near to where the nerves to our legs are traveling in our spinal canal.

A disc injury is a tearing of the outer layer allowing the inner gel to work its way to the outside of the disc. The tearing and subsequent leakage of disc material causes a lot of inflammation in the spinal canal. This inflammation can cause back pain, muscle spasms and irritate the nerves to the leg, causing leg pain. If the disc material causes pressure and compression of the nerves of the legs, this can lead to weakness.

Stuart McGill PhD showed that the lumbar disc material can herniate through the outer layer (annulus fibrosus) in as little as 20,000 repetitions of forward flexion or twisting through the lumbar spine. It is unlikely to cause a disc herniation if you bend backwards or sideways. Stooping, sitting, and bending at the waist are causes of disc herniation and subsequently back or leg pain.

His research also has shown that humans will bend forward over 1,000 times a day and backwards only 150 times a day. With this in mind, it is easy to see how we can cause a disc herniation just by doing our day-to-day routines. However, we move in ways that are safe for our discs, such as backwards, very rarely. Therefore, WE CAUSE LOW BACK PAIN BY THE WAY WE MOVE!

There is good news. Proper lifting mechanics can decrease your risk of lumbar disc herniations and back pain. For example, professional weightlifters lift extreme amounts of weight in a squatting position and you find that they do not get disc herniations more frequently than the general population. Why is this? They have proper strength and flexibility within their core, pelvis, and in their hips.

 

Most treatments for low back pain are reactive, meaning that treatment is started after someone is already experiencing back pain.  Most treatments do not decrease your risk of future back pain. Research shows that the only thing to decrease your risk of future low back pain is exercise. So again I encourage you to get into that exercise program and if you have pain with exercise, ask for help from a physical therapist and physician.

Good luck!

Valley Sports & Spine Clinic
Giving you Back your Life
Dr. Ethan Colliver

 

Your back hurts because you’re pooping wrong!

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Low back pain in Western society is very common.  Studies suggest up to 90% of Americans will have an attack of back pain and 26.4% have had back pain in the past 3 months.  Koreans have a lifetime chance of around 60% and 15% chance of having back pain in the past year.  Why the difference?  Squatting may be one of the most important things for your back pain and your health, and American toilets don’t let us do it.

 

Western toilets became common the late 19th century.  Prior to that, most people would squat to eliminate, over time sitting became a sign of being “civilized”.  With that change came a decrease in communicable disease like cholera but also brought new diseases like appendicitis, hemorrhoids, and back pain.

One of the best treatments for preventing back pain is proper exercise.  Exercise should focus on flexibility and strength training.  A full squat requires full hip flexibility and great hip, pelvic, and core strength to perform properly.  Asian or squat toilets require the user to perform a full squat to eliminate.  Now, if the average person uses the bathroom 4-7 times a day, that is an opportunity to do a great exercise for your back and health 4-7 times a day.  Further benefits may include decreased constipation, hemorrhoids, diverticulitis, appendicitis, and possibly colon cancer.

asian squat

You can take advantage of a squatting toilet without spending $1000 to install one in your house.  I recommend two products: Squatty Potty for a beginner and a Squat Platform for an advanced full squatter.

Valley Sports & Spine Clinic
Giving you Back your Life
Dr. Ethan Colliver

 

 

Stick with that new exercise program!

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With New Years Resolultions abounding, lets discuss how to stick to a resolution to start exercising!  Naomi Beinart, BSc Psych, presented a recent review in The Spine Journal (December 2013, Volume 13, Number 12) of all the current research looking at this question.  According to Beinart, between 50-70% of patients with chronic low back pain stop their home exercise program, despite knowing that exercise is a major way to treat low back pain.

Here are some positive factors in predicting the continuation of an exercise program:

1. If you believe you have control over your health, and your back pain, you are more likely to keep exercising.

2.  Actively develop your own exercise program.  If you work with a personal trainer, or Physical Therapist to design a program specific to you and your needs, you are more likely to succeed.

3. Working with a health care provider or therapist while exercising  increases your success rate!

4. Psychological counseling to work on self-motivation will help you succeed.

In summary, the more you believe that you control your health, help develop your own exercise routine, and have supervision while exercising, the more likely you are to keep your exercise program and your New Years Resolution.  Some people may benefit from counseling to help motivate themselves.

For supervision, you can try working out with a friend who has lots of experience, or perhaps sign up for weekly sessions with a personal trainer.  Another option may be to enroll in an exercise class at a local community rec center.  If you have persistent significant pain with exercise, seek medical help.

Good Luck!

Valley Sports & Spine Clinic
Giving you Back your Life
Dr. Ethan Colliver

Sitting is Bad for Your Health | Valley Sports & Spine Clinic

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Having a regular exercise routine is important; but, how much time you spend sitting throughout the day may be just as important.  A British Journal of Sports Medicine article in 2009 correlates total sitting time in a day to “an increase risk of type 2 diabetes, heart disease, and other prevalent chronic health problems- even if you exercise regularly.”  Research now suggests being active throughout the day, whether you like lawn care, gardening, hunting or fishing, for example, reduces your risk for cardiovascular disease and other chronic health conditions.

Long periods of sitting leads to a lack of muscle contractions and decreased blood flow.  Dr Vernikos, former NASA specialist, conducted research that supports getting up from sitting around 35 times a day to reduce your risk of cardiovascular disease.  The author of the cited article suggests setting a timer to remind you to stand up and move every 15 minutes.

Sitting with poor posture increases stress on your discs in your low back.  This is a common cause of back pain.  If you have a herniated disc, you may find sitting to be intolerable.  Avoid sitting for more than 15 minutes and avoid long car rides, as both will aggravate a disc injury.

To read more about prolonged sitting and your health, check out:
The Importance of Intermittent Movement For Longevity, by Dr. Mercola

Valley Sports & Spine Clinic
Giving you Back your Life
Dr. Ethan Colliver