"...chiropractic has been demonstrated to be more effective for the management of lower back pain than conventional hospital outpatient care"

British Medical Journal, 2004.

"...spinal manipulation is a cost effective addition to "best care" for back pain"

British Medical Journal, 2004.

"...patients receiving chiropractic care for lower back pain were more satisfied with their care than patients receiving hospital outpatient care"

British Medical Journal, 1995

Take Flexibility Training Seriously

IF you have ever seen me as a patient, you have heard me ask this question....on EVERY visit! When it comes to the Big Three of exercise - cardiovascular, strength training and flexibility - it's pretty clear which one can get overlooked. After all, while we prize cardiovascular and strength training for their role in helping us lose weight, build muscle and get fit, the benefits of flexibility training are less immediately alluring. Or to put it another way, just not as sexy!

However, as the population ages, more of us (including myself) are learning to appreciate the rewards of stretching. Staying limber can offset age-related stiffness, improve athletic performance, and optimize functional movement in daily life. Research shows that flexibility training can develop and maintain range of motion and may help prevent and treat injury. In fact, the American College of Sports Medicine has added flexibility training to its general exercise recommendations, advising that stretching exercises for the major muscle groups be performed two to three days per week.

How can you include an effective flexibility workout in your fitness program? Here are some guidelines:

Think in Terms of Serious Flexibility Training, Not Just Brief Stretching.

Squeezing in one or two quick stretches before or after a workout is better that nothing, but this approach will yield limited results. What's more, generic stretches may not be effective for your particular body. The more time and attention you give to your flexibility training, the more benefits you'll experience. A qualified chiropractor, personal trainer, physical therapist or health professional can design a functional flexibility program specifically for you.

Consider Your Activities.

Are you a golfer? Do you run or play tennis? Do your daily home or work routines include bending, lifting or sitting for long periods? Functional flexibility improves the stability and mobility of the whole person in his or her specific environment. An individualized stretching program is best to improve both stability (the ability to maintain ideal body alignment during all activities) and mobility (the ability to use full, normal range of motion).

Pay Special Attention to Tight Areas.

Often the shoulder, chest, hamstrings and hips are particularly tight, but you may hold tension in other areas, depending on your history of injuries and the existing imbalances in your muscle groups. Unless you tailor your flexibility training to your strengths and weaknesses, you may stretch already overstretched muscles and miss areas that need training.

Listen to Your Body.

Stretching is an individual thing. Pay attention to your body's signals and don't push too far. Avoid bouncing or jerking movements to gain momentum; this approach can be dangerous.

Instead, slowly stretch your muscles to the end point of movement and hold the stretch for about 10 to 30 seconds. Older adults, pregnant women and people with injuries will need to take special precautions.

Get Creative.

Varying your flexibility training can help you stick with it. You can use towels, resistance balls and other accessories to add diversity and effectiveness to your stretching.

Warm Up First.

Don't forget to warm up your muscles before you begin. Walking briskly for 10 to15 minutes is a simple way to do this.

Find a Flexibility Class That Works for You.

Classes that include stretching are becoming more popular and more diverse. Some combine cardiovascular and strength components with the flexibility training; others focus exclusively on stretching.

Stretch Your Mind and Body.

Did you know that your emotional state may affect your flexibility? If your body is relaxed, it will be more responsive to flexibility training. Listening to music and focusing on your breath can help you relax as you stretch. You may also want to explore yoga or Pilates. In addition to stretching, classes in these disciplines may include relaxation, visualization and other mind-body techniques designed to reduce stress and increase mindfulness.

It's Not Just for Wimps.

Forget the idea that stretching is just for elderly, injured or unconditioned people. Many Olympic and professional athletes rely on flexibility training for peak performance.

Do It Consistently.

It doesn't help to stretch for a few weeks and then forget about it. Integrate regular stretching into your permanent fitness program. For inspiration, look to cats and dogs - they're dedicated practitioners of regular stretching and you rarely see them getting the kind of joint or muscular injuries that humans get!

Getting Started

I want to be a resource and coach for functional stretches specific to your needs. Be sure to ask about a customized flexibility program at your next visit. You can also visit our video exercise page here.

Back pain relief is just one component of chiropractic care, but it is often a patient’s first introduction. Back pain is horribly debilitating affecting all aspects of work and personal life. If you are suffering from back pain, you are not alone. Here are a few facts about back pain that may (or may not) surprise you.

• Back pain is the number one disability for those under age 45.
• In the United States of America alone, there is an expected 31 million people with lower back pain at any given time.
• Back pain runs second, after only the common cold, as the top reason for visiting a healthcare provider in the United States.
• Experts place the likelihood of any person to experience some type of back problem in their lifetime at about 80%. That’s four out of every five people!
• Over 50 billion dollars are spent per year in the pursuit of clearing up cases of back pain.
• Around 30 to 40 percent of all workplace absences are due to back pain.
• Approximately one quarter of U.S. adults reported having low back pain lasting at least one whole day in the past three months, and 7.6 percent reported at least one episode of severe acute low back pain within a one-year period.
• One-half of all working Americans admit to having back pain symptoms each year.
• Approximately 2 percent of the U.S. work force is compensated for back injuries each year
• Lower back pain accounts for two thirds of all back pain-related cases.
• More than two-thirds of back strains are caused by lifting and other exertions like pulling and pushing.
• Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

The key to proper treatment of back pain is to understand the cause. Remember, pain is always a sign that something else is wrong and if continually ignored may lead to more serious harm. The providers at Koenig Wellness are experts in assessing the root cause of your back pain and putting you on the right course to recovery!

I have found that many people use the term sciatica incorrectly. Sciatica is pain along the path of the sciatic nerve which extends from the lower back down each leg. Sciatica is a symptom (like itching), it is not a diagnosis (like Parkinson’s disease). Sciatica can range from an occasional nuisance to excruciating pain that makes walking near impossible. There can be multiple underlying reasons for your sciatic nerve pain. It is my job to help find the root cause of the problem with an exam and I may also order some diagnostic imaging such as an x-ray, MRI or CT scan to examine the underlying structures.

To answer the question, ‘what is sciatica’ it is helpful to explain some of the relevant anatomical structures. The sciatic nerve is both the longest and the widest nerve in your body. It begins in the lower back as five separate nerves that extend from five different vertebrae – L4, L5, S1, S2, and S3. These nerves meet up to form one large bundle which runs through the buttocks and down the entire length of the leg. The sciatica nerve is responsible (directly or indirectly) for nearly all the sensation in your leg including the skin of the thigh and gluts.

Sciatica occurs when there is compression or irritation of the sciatic nerve. The pain is felt in the low back and leg, but the site of the pain isn’t always the site of the underlying issue. Since the sciatica nerve is so long and travels around or through the large muscles of the buttocks, it takes an expert to determine if the pain is coming from disc compression, from muscle spasms or from something else. Again, sciatica is a symptom, not a diagnosis.

While sciatica is most often associated with pain, other symptoms may be present such as tingling, numbness, or muscle weakness. The pain can be nearly constant or intermittent. If you think you are experiencing sciatic nerve pain, keep a record of the location, duration and intensity of the pain. Your specific history plays an important role in determining the cause of the pain.

Treatment for sciatica depend on the underlying cause, so there is no one recommended course of treatment for all sciatic pain sufferers. I use use a variety of non-invasive approaches that include spinal and joint manipulation, physiotherapy, acupuncture, cold laser, targeted stretching and active muscle release. I will also discuss the role that nutrition and hydration play in reducing tissue inflammation and keeping discs healthy. The spine, discs, muscles and soft tissue all have a role to play in sciatica and should be evaluated and treated as a connected system.

The most important thing to take away from this article is that sciatica (sciatic nerve pain) is a symptom of an underlying condition. You’ll only start to get better once the underlying condition is identified and this is done through a combination of an exam, history and recommended diagnostic imaging. I hope this helps answer your question!

-DR K