Why Flexiblity is Important

The ability to move in a full range of motion is important because we use our bodies the way we were meant to move. We use ALL of a muscle instead of only a part. We use ALL of our muscles instead of a specific few. This is healthy, balanced movement.

Once we start losing flexibility, our tightness snowballs. My grandmother would ask me at least once a day to get something out of the cabinet for her that was right above her head. My grandfather didn’t have the flexibility or strength to perform a squat; he died as he fell going to the bathroom, hitting his head on the sink on the way down.

Flexibility allows movement. Movement allows the body to function. You (and your grand-kids) can be happy because you are able to do everything you want and need to do in life.

How to Make a Human Cell Out of an Apple

Flexible people made themselves flexible. Inflexible people made themselves inflexible. Everything we do has a cause and an effect.

It is easy for us to forget sometimes just how amazing the human body is. We start life as a single cell. We can put all of the most brilliant minds with all of the money and technology in the world and they still wouldn’t be able to turn an apple into a human cell like the human body can. We can observe the world, and adapt to it. We can treat our bodies like garbage, disrespecting it with poison in the form of processed foods, alcohol, and chronic sitting, and still live a mid-range life into our 60’s.

Being as amazing as it is, everything that our body does is an adaptation to the environment we put it in. Every disease or condition is a SMART response from our body.

Arterial plaquing is a condition characterized by the accumulation of fatty plaques and inflammation in our blood vessels. Too much sugar damages our whole body, including the blood vessels. Plaquing is the body’s attempt to patch the holes caused by the presence of too much sugar. Everything has a cause!

Conventional Wisdom – To Stretch or Not to Stretch?

Fitness enthusiasts and healthcare practitioners alike say “if a muscle is tight, stretch it.” This is a very general level of detail. In order to get to the bottom of “tightness,” we need to delve a bit deeper into specificity.

If everything our body does is smart, why is your hamstring “tight?” A muscle can be “tight” for 3 reasons:

1. Actual mechanical stiffness

According to the “use it or lose it principle,” our body will use energy for necessary body processes because we evolved with a limited food supply (unlike American culture today). Using our muscles in large ranges requires energy. Being efficient, if we don’t use our muscles, our body makes our active muscles passive so that they don’t require energy, thus conserving it for other processes. This is the stiffness that occurs.

This mechanical stiffness is the only reason you would want to stretch a “tight” muscle. A “normal” stretch should be experienced in the whole muscle, not a small part of it. So if you are stretching your hamstrings, you should feel the same intensity stretch from your butt to your knee.

2. Adhesion

Muscles, ligaments, tendons, and nerves develop adhesion (a form of scar tissue, that by definition, formed without trauma). Adhesion is like taking a piece of gum and putting it between muscles, ligaments, tendons, or nerves so that it becomes difficult for them to slide past one another when moving. It is another way to make muscles stiffer as to conserve energy. But it also is a result of tissue overload and injury.

Overloaded muscles without the proper healing environment will heal with adhesion because the damage done cannot be optimally repaired. Overload can occur from:

• doing the same exercises day after day (too much bench press)
• holding the same postures such as sitting or typing or playing an instrument
• stretching or shortening a tissue for too long

3. It’s protecting something.

Yes, your hamstring contracts to protect you. Certain tissues of the body are more sensitive than others, especially when already irritated or overloaded. Nerves are particularly sensitive because once damaged, they have limited healing ability.

The sciatic nerve is a nerve the size of your index finger running down from your butt to behind your knee where it splits. Because of our sedentary lifestyle, this nerve is apt to developing adhesion between it and the muscles it runs near due to the pressure (sitting on our butt) and stretch (sitting puts tension on the sciatic nerve). Again, imagine multiple wads of gum stuck between this nerve and the muscles. As you bend forward at the back and hips, you put tension on the sciatic nerve (will often be felt in the calf!). If it is adhered and stuck, it won’t like being pulled. Hence, your body contracts your hamstring so that you don’t put any more tension on the nerve.

The 2nd and 3rd conditions are more common than the 1st. This is evidenced by the number of people who stretch without effect, not becoming any more flexible and staying in pain.

What To Do

1. Prevention is the first step: Move often. Don’t do any activity (ie. sitting) for longer than 30 minutes without stretching and moving that muscle in its full range of motion for a couple of minutes. So do a 2 minute lap to get a drink of water every 30 minutes at your desk job. Move your wrist as far as it will go back and forth for 10 repetitions when taking a break from playing an instrument or typing.

2. Perform exercises in a full range of motion with good form. This tells our body that we need to use the full range of our muscles and maintains our flexibility.

3. If tight, perform dynamic stretching. This is stretching into a lengthened position, holding for 2 seconds, then coming out of the stretch. Perform repetitions of 10 before and after workouts. Also, doing this throughout the day is not a bad idea.

If daily stretching does not get you increased flexibility after a couple of weeks, chances are that you have significant adhesion in that area of your body. Continued stretching of adhered muscles or “protective contractions” may make it feel better temporarily. But stretching nerves for long periods of time is not healthy and can contribute towards significant damage. If chronic pain goes along with that inflexibility, an Active Release Technique (ART) provider can help you with this specific problem.  Active Release Technique is quickly becoming the gold standard in soft tissue treatment.

Stretching and flexibility is an area of fitness and health that is overlooked. While stretching does have a place, it is not the be all-end all to the “tightness” you experience. If it doesn’t help, you weren’t born tight.  Just don’t let your inflexibility progress until you can no longer do the things you love in your life.

Proper Lifting Techniques

You have heard it before. “Bend your knees when you pick that up or you’ll hurt your back.” Well, that’s true, to a degree. The fact is though, simply bending your knees is not enough to prevent low back injury.

The reason chiropractors, physical therapists, and personal trainers alike advise bending your knees is because they do not want you to put stress on your low back. The thought is that bending your knees will shift the stress from the back to the knee, but this is not always true. Don’t get me wrong, you should always bend your knees when lifting, but there are other things that must be done as well.

To understand what you need to do to protect your back, you will first need to understand some basic bio mechanics. I promise to keep it very simple. You have 24 vertebrae sitting directly on top of one another that make up your spine. Your spine rests on top of a bone called the sacrum. The sacrum is positioned directly in between two bones called the pelvic bones. In between each of the 24 vertebrae and where the spine meets the sacrum is a disc which you have probably heard of before. While the vertebrae and the sacrum are bones, the discs are made of cartilage and fluid that is structurally not much different than a jelly doughnut; they are hard on the outside and soft in the middle.

Simply put, those vertebrae work together like a spring when you bend over. Imagine bending a spring back and forth over and over again. While that spring might be very strong at first, over time, it would weaken and eventually break. Most commonly with bending, the injury is to your disc. Imagine squeezing a jelly doughnut on one side, all the jelly would squirt out the other direction. This is a simplified example of a bulging or herniated disc. So how do we prevent this from happening?

The answer is very simple. Your back shouldn’t move. Your vertebrae shouldn’t be asked to bend on one another. Discs should not be squeezed on either side. The best way to prevent this is by bending from the hips and the knees at the same time. In case if you weren’t clear on where your hips are, they are the place where your legs attach to your pelvis. Run your hands down your sides, the first bone they come in contact with is the pelvis, as you continue to move your hands down towards your feet you will feel two large round bones, those are your hips. When lifting large, awkward objects from the floor, it is often advisable to drop to one knee in order to get the object off of the floor. For smaller objects or for objects that are located in an elevated position, bending at the hips and knees is advisable.

The first important point when lifting objects from below your hip height is the most simple. Stand close! I mean really close. You want the object that you are about to lift to be located as close to your legs as is possible. The closer the object is to your legs, the less it stresses your spine. Also, to avoid twisting, make sure whatever you are about to lift is directly in line with your belly button at all times.

Avoiding twisting when you lift...

Next comes the pelvic tilt. I give my patients a visual aide for this movement. You want to visualize yourself breaking a sheet of glass with your butt. Imagine that you are standing directly in front of a glass window, and you want to break it without bending your knees. You will have to thrust your butt backwards which will create a very stable arch in your low back. Once you have shifted your pelvis in this manner, your focus should be to continue to squat while reaching backwards with your butt as if you were hovering over a public toilet. Pairing the pelvic tilt with the squat will enable you to lock your lower back from any movement and thereby protect it from any injury! This will take practice to perfect, which is why I recommend to my patients that they practice the squat without weight daily.

So let’s recap. The first step in lifting an object is to stand close to it and make sure it is right in line with your belly button. The second step is tilt the pelvis forward to lock the low back. The third step is to squat while reaching your butt backwards the whole time as if hovering over a public toilet. If the object is too large or too low to squat down to, drop to a knee before lifting. My last piece of advice in regards to lifting is very easy to remember. If it’s too heavy, get help with it!

Every day people hurt themselves performing activities that should not cause them any pain or discomfort. If your form while performing these activities is perfect, you significantly reduce your likelihood of becoming one of these people. I recommend that you practice this technique a few times without any weight before you attempt to lift any objects in this manner. At first it will feel strange and unnatural. Give it time. You will quickly begin to take notice of how much better your low back is feeling, and you will be able to attribute that improvement directly to your new lifting technique. I wish you the best of success with this lifestyle change on your way to better health.

Forward any questions regarding this article to drsean@islandchiropractic.net

Dr. Sean Pastuch, D.C.

Think beyond the weight...

Well it’s that time of the year again. Time to take a look back at 2009 and review your successes and failures. What goals did you set out to achieve? How long did it take for those goals to be forgotten? What new year’s resolutions are you going to set out to achieve in 2010?

The holidays are a fantastic time of the year to review your successes and failures because it’s a time when we are reminded of the important things in life. Perhaps now is the best time to outline what goals are important to you and begin establishing a detailed plan to attain them.

I don’t like “New Year’s Resolutions”. Even the wording rubs me the wrong way. Why not call them “New Year’s Commitments”? Better yet, last year Chris Guillebeau from “The Art of Noncomformity” talked about the process of conducting your own annual review. According to Chris “The idea is to create a road map for the year ahead – not a rigid daily schedule, but an overall outline of what matters to me and what I hope to achieve in the next year.”

Unique to Chris’s annual review is the concept of having a yearly theme. You see when we choose goals like “Weight Loss” and “Get Rid of Debt” it limits us to only achieving weight loss and becoming debt-free. There are 3 things to consider when making your 2010 New Year’s Commitments.

1. Ensure a deeper meaning is attached:

What are you looking to achieve by losing weight and exercising more? What plan of action have you developed that systematically keeps you accountable, but also works in the context of your busy life? Having an annual theme gives a deeper context to your individual goals. If you fail to lose weight despite exercising more and eating better, perhaps now you recognize that you’re thinking more clearly and that you have more energy throughout the day. You still may be hobbled by consumer debt, but you’ve gained a greater consciousness of your monthly cashflow and perhaps you started a retirement account and put money there instead.

At the Wellness Solution Centers in Newtown, PA, chiropractors routinely provide a comprehensive physical examination that includes bloodwork, body fat analysis among numerous other measures. Initial examination takes 1 hour. Patients enter the office with the traditional goals of losing weight, but often find after an 8 week intensive program, their weight has not changed, and in some cases they have even gained weight. Now that the program has been up and running for a few years, patients now come in with goals to lower their blood pressure and improve their cholesterol and triglycerides. When they look at the full measure of their health through bloodwork and body fat analysis, they then realize that they have much more leaner tissue, less inflammation and are in fact much healthier than what they were when they arrived. Limiting your New Year’s Commitment to just one outcome measure causes one to monitor their status too frequently. Having a deeper theme to your goals will allow the completion of larger goals and keep your attention away from the small failures.

2. Individual goals may require completion of seemingly unrelated goals:

What’s been limiting you from taking action on your goals? Perhaps it’s a non-supportive relationship in your life. Perhaps its the stress of your job. Maybe it’s a lack of planning meals, or finding a time that allows you to go to the gym consistently. When it comes to health goals, many people take action in every way imaginable EXCEPT for the one actionable step they really need to take. Often times people will be chronically sick and spend every other week at their doctor’s office. Their goal may be to improve health, and they could exercise, follow-up appropriately with their doctor, but still eat McDonald’s once a day. It’s difficult to eat healthier at work, when you don’t prepare a meal ahead at home.

Our goals can very well be to lose weight, so as to improve deeper goals of self-image and confidence, but what if accomplishing that goal meant you needed to reevaluate how supportive your family and friends were? It’s difficult to take care of your debt when you hang out with high-spending friends with their parents’ credit card. It’s difficult to lose weight when those close to you are continually offering you sugary treats.

When you truly examine your goals appropriately, you have to dig deep to find the patterns behind those goals. You have to identify the root cause of the problem.

3. Inappropriate timeframe for completion of the goal:

I had a close family member approach me about a goal for weight loss. She exclaimed that she did not know what else she could do, she had been working out and eating better and had not seen any results. To figure out her problem, I had to only ask one question. “Well how long ago did you start?”. She responded “Two weeks ago”.

We live in an information age full of short soundbytes and bulleted lists. To lose weight healthily, you should look to only a few pounds a month of weight loss. When you focus on short-term gains and losses, your consistency becomes short-term.

My theme for 2009 was gratitude. It brought me a beautiful girlfriend, less stress at school and closer and more authentic relationships with family and friends. My theme for 2010 is “following through”. I’ve found that I start projects but leave them half-finished. So many great projects are left unfinished just when they approach the brink of greatness. I assure you 2010 will be different.

So now that you’ve had some time to think about it…what’s your annual theme for 2010?

Is the risk real?

Chiropractic is the largest alternative medicine profession in the United States, and probably the most debated. Undeniably, the hottest debated topic concerning chiropractic is stroke risk. But are you really flirting with death when you visit a Chiropractor? This article, written with common argument headers, attempts to discern if cervical manipulation is a risky treatment, especially when compared with other popular treatment options.

Neck manipulation dissects the vertebral basilar artery leading to stroke…

The most basic argument that needs to be proven for anti-manipulation activists to have a ground to stand on is whether a neck manipulation has the physical means to cause a stroke. Detractors claim that forceful manipulation of the neck dissects the vertebral basilar artery, which passes through the atlas (top neck bone/vertebrae) before it enters the skull. This dissection is caused by either the physical stretching of the artery or by its contact with the bone. This very idea is actually what many chiropractic colleges teach, but its reality becomes doubtful when viewing the research.

A series of studies were conducted to determine how much force and stretch the vertebral artery can sustain before it fails. Symons study, using cadavers, applied multi-directional forces to the the neck while measuring its effects on the vertebral artery. It was determined that the arteries could withstand stretching between 132% and 160% their normal length before failing. The study was repeated utilizing cervical manipulation techniques, and it was found that the vertebral arteries were maximally stretched by 6.2% their resting length (Symons 2002). Even more interesting was although cervical manipulation is often perceived as inducing large amounts of neck rotation, due to its controlled nature the vertebral arteries are actually stretched less than in normal neck range of motion (12.5% max).

The idea that the problem is a disruption of blood flow is also not supported by the literature. Licht et al performed a study in which vascular flow was monitored pre and post adjustment. There was no difference between either groups.

Further proof that cervical manipulation is unlikely to cause vertebral artery dissection can be seen when you compare it to motor vehicle accidents. Although MVAs are a traumatic event linked to many health complications, stroke is not one of the commonly associated events. Studies measuring the force of an MVA on the neck demonstrated peak forces of about 241 Newtons, while studies focusing on forces of neck manipulation show a maximal force of 93 newtons. On top of that, rotatory forces maxed out at only 50 newtons (Haneline 2005) If the greater force seen in an MVA fails to cause strokes, why would a lower force adjustment cause it?

The number one cause of cervical arterial dissections are idiopathic. In other words, doctors have no idea what has caused it and thus it is considered spontaneous and unpredictable. Spontaneous Vertebral artery dissections occur at a frequency of about 1 per 100,000 people in the general public (Haneline 2007). Which is an eye opening statistic when the chiropractic population experiencing a CAD is believed to be about 1 per 100,000 patient, which would mean chiropractic patients are at no greater risk for stroke than the general population.

This neurology study showed that stroke occurred after adjustments…

Probably the most cited research article by neck manipulation detractors is a Canadian population based case-study by Rothwell (2001). The study demonstrated that patients who had a stroke were 5 times more likely to have seen a chiropractor within the previous week, and is a perfect example of correlation, but not causation. One key variable that the study had failed to address was why the stroke patients had visited a chiropractor in the first place. Unfortunately, many of the symptoms of a stroke are the same as the reasons people see Chiropractors: neck pain, headaches, tingling or numbness in the extremities, and occasionally mild dizziness. Strokes also present with more pathognomonic warning signs, but these signs tend to be rare, such as severe dizziness, nausea, vomiting, abnormal gait, trouble speaking, and loss of vision in one of the eyes (AHA 2009). Also, the demographic group most prone to idiopathic strokes are also the Chiropractors biggest patient base, young to middle aged women with no major health concerns.

Anti-Chiropractic bias also appears to taint many cervical adjustment articles. One key example is an article in the Journal of Neurology entitled “Vertebral Artery Dissections after chiropractic neck manipulation in Germany over three years.” Not only was this study, like Rothwell’s, a purely correlative study with no modification for external variables such as presentation, but the study’s title unfairly targets Chiropractors. Analysis of the data shows that 11% of all strokes recorded were performed by chiropractors, while 50% were performed by orthopedic surgeons and 14% by physical therapists (Rueter 2006). Even though the manipulations by MD’s and PT’s had a higher rate of associated stroke, it is the Chiropractic Adjustment that is dangerous.

Finally, recent reports have shown that an elevated incidence of stroke is seen equally in Chiropractic and medical physician offices (Cassidy 2008); once again supporting the theory that patients are presenting with a stroke, and not that DC’s, or MD’s for that matter are causing a stroke.

A signature isn't enough.

Chiropractors don’t inform patients of the risk…

A rare valid argument. Some chiropractors do not inform patients that there is a risk for stroke, others do have it written in their informed consents but fail to verbally state it (who reads those things anyway?) Legally, Chiropractors are not required to inform patients of the risk for stroke because the odds of one are so low. However, informed consent should not merely be a Risk Ratio, but also a Perceived Risk-Ratio (Ziker 2003). Since the risk of stroke is perceived in chiropractic, the doctors should address it, regardless if the risk is real or not.

I read a case study in which the person had a stroke…

We’ve all seen the case reports or the news stories where someone immediately suffered a stroke right after receiving an adjustment. However why the stroke happens presents us with three options.

1. The doctor’s impulse caused a stroke in an otherwise healthy patient. Not possible, as the prior argument has already established.
2. The patient was a stroke waiting to happen. The adjustment was the final straw. This is the most likely situation. As noted prior many patients who are currently in a stroke status may visit a chiropractor for their symptoms. In this case, any minute trauma may either mobilize a clot or cause the artery to dissect. Whether or not the doctor should be held responsible in this situation really depends on the circumstances. An unfortunate reality is that there are currently no known reliable orthopedic or neurological tests for stroke (although the Newton Neurological Battery looks promising). The best tool a doctor has is a thorough complaint history and the presentation of the pathognomonic signs. When a patient presents with the hallmark red flags, the doctor should send the patient to the hospital immediately.
3. The patient suffers an idiopathic stroke unrelated to the adjustment. Pure dumb luck.

The risk outweighs the benefits…

The rate of stroke associated with cervical manipulation varies widely among the literature. Figures place the occurrence at as often as 1 in 400,000 cervical adjustments (Dvorak, 1985) and up to 1 in 5,850,000 cervical adjustments (Hosek, 1981). Currently the generally accepted odds are about 1 in 1,000,000 to 3,000,000 cervical adjustments (Lauretti 1997); the RAND report, which is the document most federal mandates concerning chiropractic effectiveness is based upon, also puts the risk at about 1 in a million. However, there is an inherent problem within all manipulation risk studies, in that they are based on correlations, and none are experimental or direct causation models. One of the oldest tenets of research is that correlation does not equal causation. For example, there are an increase in armed robberies when ice cream sales increase. Of course its ludicrous to say that ice cream cause robberies, and instead there must be other variables in play. In this case, robberies increase during the summer, which is the same time ice cream sales increase.

For the sake of our argument, we will be using the 1 in 1,000,000 estimate, and I will compare it to the serious risks associated with other common treatments for neck pain and neck related conditions, all of which are considered safe alternatives. Serious risks are defined as those requiring medical attention.

No treatment is without its risk.

NSAIDS (Aspirin, Aleve, Ibuprofen, etc…) One key meta-analysis using 18 studies published between 1990 and 1999 assessed the risk of life threating upper gastric complications (bleeding, perforation, and hospitalization) when confounding variables such as age, previous complaints, and other medications were removed. It was found that individuals taking NSAIDs (ibuprofen, naproxen “Aleve”, etc…) were at a 380% increased risk of a serious upper GI complication (Hernandez 2000). Mathematically, if you take NSAIDs that equates to the odds of 3500 per million of having a serious upper gastrointestinal condition.

Another study focused on the risk of selective inhibitor anti-inflammatory drugs, such as COX-2 which is designed to prevent GI complications, was analyzed for myocardial infarctions (heart attacks). It was found the relative risk for these drugs are 24% higher than the standard population (Levesque 2005). Adding fuel to the fire, and resulting in the lost license of two major NSAID medications, a Medicare database study after removing most confounding variables, determined that serious cardiovascular complications resulted about 4.1% of the time when taking NSAIDS, including Aspirin (Solomon 2008). What are serious cardiovascular complications? Heart attack, stroke, congestive heart failure, and death. Other studies take these findings ever further claiming drugs such as aspirin, may actually increase the risk of heart attack up to 71%, with an average risk of about 12% (EULAR 2005). Taking the average, this could mean that an additional 570 people suffer NSAID induced heart attacks a year.

Acetaminophen (Tylenol, Excedrin, etc…) The good news with Tylenol is that it is not associated with cardiovascular or gastrointestinal disorders. However, that doesn’t mean its off the hook. Acetaminophen is associated with liver damage, and according to the FDA it is the number 1 cause of acute liver failure in the United States. Usually this is associated with over-dosage, but even minimal usage over the recommend dose is associated with death. This is especially a concern because many people will double or triple their dosages when they are in a lot of pain. Acetaminophen is the cause of 56,000 emergency room visits and 458 deaths a year (FDA 2009). The drug has also been indicated in kidney failure, as an article published in the New England Journal of Medicine determined that regular acetaminophen or aspirin usage put users at 2.5 times the risk for kidney failure, or 250% (Fored 2001). The general public sees about 1550 per million in end stage kidney failure, so if you overuse Tylenol, your odds become 3875 per million. In all fairness, this was a correlative study, not causative. (Coresh 2007)

Neck Surgery Neck and arm pain, tingling, and numbness are often the result of cervical disk herniations, stenosis, and spondylosis; all conditions that are treated with chiropractic. However, if diagnosed in an allopathic office, patients are often recommended for surgery. Although frequently uneventful, surgery obviously has its own risks. One study assessed the complication rate of cervical spine fusion for primarily the noted above conditions (Wang 2007). It was found that 0.83% of all surgeries are associated with a serious complication: Cord injury, artery dissection, infection, cardiovascular comprise, respiratory distress, nerve damage, and death. Therefore, for every 1 million cervical fusion surgeries, 8300 result in serious complications . Once again in all fairness, surgery will often involve the most serious cases and therefore their odds for complication should be elevated.

Physical Therapy & Exercise Serious complications associated with physical therapy are almost as difficult to determine as they are in chiropractic care. Most likely stroke risk matches that of the general population and initial cardiovascular risk may be somewhat increased due to increased physical load, but should decrease over extended treatments due to improving physical health.

Table 1

Conclusions

Compared to the risks associated with the most commonly used treatments for neck pain, it becomes clear that chiropractic neck adjustments are at the very least, comparatively safe. In fact, you are more likely  to die while driving to the doctor’s office in an auto accident than at the hands of the doctor. Furthermore, current research fails to even demonstrate a physiological or anatomical means for a chiropractic adjustment to induce a stroke in healthy patients. Therefore research and debate should begin to move away from attempting to determine if adjustments are safe, and move towards ways to increase the effectiveness of adjustments and improved methods of detecting the small at risk populations.

In closing, a little perspective…

By Kristopher Robert Schuster, D.C., B.S.

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References

1.AmericanHeart Association. Stroke warning signs. Retrieved from http://www.americanheart.org/presenter.jhtml?identifier=4742 on November 20, 2009.
2.American Heart Association. Heart attack and angina statistics. Retrieved from http://www.americanheart.org/presenter.jhtml?identifier=4591 on November 20, 2009. 3.Cassidy JD, Boyle E, Cote P, He Y, Hogg-Johnson S, Silver F, Bondy SJ. Risk of vertebrobasilar stroke and chiropractic care: Results of a population-based case-control and case-crossover study. Spine 2008; 33 (4S):S176-S183.
4.Coresh, J, Selvin, E., Stevens, L.A., et. al. (2007). Prevalence of Chronic Kidney Disease in the United States. J American Medical Association, 298(17), 2038-47.
5.Dvorak J., Orelli F.V. (1985) How dangerous is manipulation to the cervical spine? Manual Med. 2(1), 1–4.
6.European League Against Rheumatism (2005). Retrieved from http://www.theheart.org/article/502645.do on Nov19, 2009.
7.FDA Eyes Acetaminophen Liver Risks (2009). Retrieved from http://www.webmd.com/news/20090528/fda-eyes-acetaminophen-liver-risk on Nov19, 09.
8.Fored, C.M., Ejerblad, E. Lindblad, P., et. al. (2001). Acetaminophen, Asprin, and Chronic Renal Failure. New England Journal of Medicine, 345(25), 1801-1802.
9.Haneline M, Triano J. (2005). Cervical artery dissection. A comparison of highly dynamic mechanisms: manipulation versus motor vehicle collision. J Manipulative Physiol Therapy, 28(1), 57-63.
10.Haneline, M.T., Rosner, A.L. (2007). The etiology of cervical artery dissection. J Chiropractic Medicine, 6(3), 110–20.
11.Hernandez-Diaz, S., Rodriguez, L.A., (2000). Association between nonsterodial anti-inflammatory drugs and upper gastrointestinal bleeding/perforation. An overview of epidemiological studies published in the 1990s. Archives of Internal Medicine, 160, 2093-99.
12.Hernandez-Diaz, S., Rodriguez, L.A., (2002). Incident of serious upper gastrointestinal bleeding/perforation in the general population: review of epidemiologic studies. Journal of Clinical Epidemiology, 55, 157-63.
13.Hosek, R.S., Schram, S.B., Silverman, H., Myers, J.B., Williams, S.E. (1981). Cervical manipulation. J American Medical Association. 245(9), 922.
14.Lauretti, W.J. (1997). Retrieved from http://www.chiro.org/chimages/chiropage/cva-1.html on November 20, 2009.
15.Levesque, L.E., Brophy, J.M., Zhang, B. (2005). The Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors: A Population Study of Elderly Adults. Annals of Internal Medicine, 142(7), 481-89.
16.National Safety Council (2004). Odds of dying. http://www.nsc.org/lrs/statinfo/odds.htm
17.Rothwell D.M., Bondy S.J., Williams J.I. (2001). Chiropractic manipulation and stroke: a population-based case-control study. Stroke, 32,1054-60.
18.Rueter U., Hamling M., Kavuk, I. et. al., (2006). Vertebral Artery Dissections after chiropractic neck manipulation in Germany over three years. Retrieved on-line from the J Neurology. 19.Solomon DH, Glynn RJ, Rothman KJ, et al. Subgroup analyses to determine cardiovascular risk associated with nonsteroidal antiinflammatory drugs and coxibs in specific patient groups. Arthritis Rheum (Arthritis Care Res), 59, 1097-104.
20.Symons B.P., Leonard T., Herzog W. (2002). Internal forces sustained by the vertebral artery during spinal manipulative therapy. J Manipulative Physiology and Therapy, 25, 504-10. 21.Wang, M.C., Chan, L., Maiman, D.J. (2007). Complications and mortality associated with cervical spine surgery for degenerative disease in the United States. Spine, 32(3), 342-47.
22.Ziker, D. (2003) Reviving Informed Consent: Using Risk Perception in Clinical Trials. Retrieved from http://www.law.duke.edu/journals/dltr/articles/2003dltr0015.html on November 20, 2009.

Is the Mercury in Thiomersal Dangerous?

Thiomersal is a preservative that is added to  vaccines to prevent contamination. It contains roughly 49% mercury; therefore a vaccine containing the standard Thiomersal dosage of 50mcg contains 25mcg of mercury. For adults, there are thiomersal free and preservative free vaccines. Thiomersal-free has no thiomersal, while preservative free contains trace amounts, or about .3mcg per dose. Although childhood vaccines can no longer contain thiomersal (as of 1999), the government considers the trace amounts in preservative free versions acceptable, plus, any vaccine that was produced prior may be still be used (assuming its shelf date has not expired).

The FDA set the daily safe limit of mercury at 1.0mcg per kg of bodyweight per day to avoid neurological damage. However, paying attention to the weekly average tends to be a more accurate indicator.

The ultimate question of course is,  “Is it Safe”?

How much mercury can I have “safely”…

• Average American Male, 86.5kg (190lbs) * 0.1 = 8.65 mcg per day= 60.55 mcg a week = 242.2 mcg a month
• Average American Female, 74.5kg (165lbs) * 0.1 = 7.45 mcg per day= 52.15 mcg a week = 208.6 mcg a month
• A Schoolchild, 22.7kg (50lbs) * 0.1 = 2.27 mcg per day =  15.9 mcg a week = 63.6 mcg a month
• 2 Month Old baby 4.54 kg (10lbs) * 0.1 = 0.454 mcg per day =  3.18 mcg a week = 12.72 mcg a month
• Calculate your own mercury risk from the seafood you eat. http://www.gotmercury.org/article.php?list=type&type=75

How much mercury is in Tuna…

• Tuna is considered a safe fish, at least compared to Swordfish or other fatty fish, but it still contains mercury. Chuck light has 0.112ppm of mercury, and white albacore has 0.357ppm
• So if you eat a can of the popular Solid White Albacore Tuna you are consuming… 170.1grams (6 ounces) * 0.357 = 60.726mcg of mercury. That’s the monthly allowance of mercury for children!
• The cheaper chuck light… 170.1grams (6 ounces) * 0.112 = 19.05mcg of mercury.

Regardless of my own opinion on vaccination, this is the take home message.

One can of tuna contains 175x more mercury than a vaccine does, plus tuna contains methylmercury, which of the two forms of mercury is more difficult and takes longer for the body to eliminate. BUT, the body only absorbs between 2 and 38% of mercury in the GI tract, that means at max a can of albacore delivers 20mcg of mercury, or as little as  1.0 mcg of mercury, mattering on a slew of variables (hydration, pH, mineral interaction, etc…).

If you are an adult, avoiding a vaccine only because of the trace amounts of mercury seems unwarranted… your food has more of it (which is a problem in itself… another time…). If you decide thats too risky, then quit eating fish too.

If you are concerned about vaccinating your infant, your fears may be warranted. If the mother has mercury in her system it will be transferred into the breast milk, add that to the 0.3mcg in the vaccine, possible multiple vaccines, and you’re likely well over the limit for an infant. Plus, during this critical stage of neurological development a little extra mercury could have a big effect.

In an attempt to bar my personal bias, this article contains no reference to PRO or AGAINST literature on Thiomersal, only numerical facts on mercury contents in the above mentioned foods & preservatives. This is NOT an article on the safety of vaccines in general, or of other non-mercury related concerns of vaccination.

Author: Kristopher Schuster

References

Clarkson TW, Magos L (2006). “The toxicology of mercury and its chemical compounds”. Crit Rev Toxicol 36 (8): 609–62.

http://www.clu-in.org/contaminantfocus/default.focus/sec/Mercury/cat/Toxicology/

http://www.fda.gov/Food/FoodSafety/Product-SpecificInformation/Seafood/FoodbornePathogensContaminants/Methylmercury/ucm115644.htm

http://www.cdc.gov/FLU/ABOUT/QA/thimerosal.htm

Yess, Norma J. “US Food and Drug Administration Survey of Methyl Mercury in Canned Tuna,” Journal of AOAC International, Vol. 76, No. 1, 1993, pp. 36-38.

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Now let’s be a little more physical….

When an adjustment or an impulse is put through a joint what happens and what is the large noise that people are afraid of? First the noise; the noise is the       escaping of gas through the joint, it is also known as a cavitation. It is a release of pressure from the the synovial joints, it can occur in any area where there are synovial joints in the body, it is like when someone cracks their knuckles.

*Here is a video of the same concept.

At a mechanical level you are putting a joint through its full range of motion that will allow for full range of motion through that specific joint complex. This will allow proper movement of the spine. This will directly effect degenerative joint disease, disc herniations, facet imbrication, canal stenosis, cervicogenic headaches, hypomobility, and sciatica.

This will also alter your mechanics though out your body, it will allow muscles that have been inappropriately shortened through lack of movement to lengthen and stretch. This will also allow for the joints to begin to move properly as well.

If the mechanics of one part of the body are altered in any way shape or form it will alter the mechanics through the body in many different ways and will bring up many pain patterns that many people will not recognize as originating from another part of the body. As an example; a person has low back pain and finds that leaning forward relieves their back pain. By leaning forward in the low back this causes a hunching forward at the shoulders and the head. This will further a forward head carriage (imagine someone sticking their neck out). This posture will in turn cause shortening of the suboccipital muscles that are found at the base of the skull as well as the scalenes which are found on the front of the neck above the collarbone. This increase in tension will lead to tension headaches and then they will come in saying that they have headaches and never bring up the low back pain because they do not see a relation between the two problems when there is a direct correlation between the two problems.

The adjustment will allow for proper range of motion of the joints, this will also require the need to reeducate the muscles through exercise that will activate muscles that have not been functioning properly to ensure that this increase in motion will be sustained over a long period enhancing overall function.

Author: Dennis Lesniak