You Can Be Fit Newsletter
Our Fate on Your Plate program gives you the all the tools necessary to design your own weekly meal plans that meet YOUR bodys nutritional needs by creating a customized report card that tells you the best foods to eat based on YOUR nutrient needs and the calories you need to eat to reach your goals for your lifestyle!
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View Our Past Editions!
January 15, 2012:
1. Field Hockey Injuries, Bethesda Office, Anti-Aging from the Outside and Inside
2. Teens need exercise too
3. Your new year
4. AgeLoc Vitality
5. Recipe: Chocolate Protein Pudding
January 1, 2012:
1. Field Hockey Injuries, Bethesda Office, Biophotonic Scanner, AgeLoc Galvanic Spa
2. How To Get Everything You Want in 2012
3. Listen and Learn
4. AgeLoc Vitality
5. Recipe: Sesame Chopped Salad
November 1, 2011:
1. Bethesda Office, Biophotonic Scanner, AgeLoc Galvanic Spa
2. Weight Gain Season Begins
3. Burn the Most
4. AgeLoc Vitality
5. Recipe: Low Carb Pumpkin Muffins
October 15, 2011:
1. Bethesda Office, Biophotonic Scanner, AgeLoc Galvanic Spa
2. 5 Easy Ways to Drop 5 Pounds
3. The Halloween Excuse
4. AgeLoc Vitality
5. Recipe: Tasty Tuna Lettuce Wraps
October 1, 2011:
1. Bethesda Office, Biophotonic Scanner, AgeLoc Galvanic Spa
2. What You Can Learn From Cavemen
3. The Whole Grain Debate
4. AgeLoc Vitality
5. Recipe: Wild Blackened Catfish
September 15, 2011:
1. Bethesda Office, Sports Nutrition at Richard Montgomery High School, Rocktape at the Run in the Parks Marathon
2. 4 Ways To Burn More Fat
3. Find your motivation
4. AgeLoc Vitality
5. Recipe: Guilt-Free Cobbler
September 1, 2011:
1. Bethesda Office, Fate On Your Plate
2. Transform From "Before" to "After"
3. Get Disturbed
4. AgeLoc Vitality
5. Recipe: Spinach, Mango, and Red Quinoa Salad (with Chicken)
August 15, 2011:
1. Bethesda Office, Fate On Your Plate
2. 5 Diet Tweaks for Flat Abs
3. Say Yes to Good Fat
4. AgeLoc Vitality
5. Recipe: Salmon and Broccoli Scramble
August 1, 2011:
1. Bethesda Office
2. Get to the Bottom of Your Weight Gain
3. Say Yes to Good Fat
4. AgeLoc Vitality
5. Recipe: Spinach, Mango, and Red Quinoa Salad (with Chicken)
July 1, 2011:
1. NFL Player Injury Rehab, Training
2. Grill Your Way Lean
3. Magic Pills
4. AgeLoc Vitality
5. Recipe: Grilled Bok Choy
June 15, 2011:
1. 3 WOOTTON HIGH SCHOOL STUDENTS HOSPITALIZED, RHABDOMYOLYSIS
2. 5 rewards of a 5K
3. 5K
4. AgeLoc Vitality
5. Recipe: Smoked Salmon Wrap
May 15, 2011:
1. 3 WOOTTON HIGH SCHOOL STUDENTS HOSPITALIZED, RHABDOMYOLYSIS
2. 5 rewards of a 5K
3. 5K
4. AgeLoc Vitality
5. Recipe: Smoked Salmon Wrap
April 15, 2011:
1. Montgomery County's Injury Prevention Guru
2. 13 Reasons To Exercise
3.An attitude with gratitude
4. Del-Immune
5. Recipe: Cranberry Quinoa Mini Muffins
April 1, 2011:
1. Grassroots Youth Football League, Run with Dr. Julie, Kettlebells with Jason
2. 13 Reasons To Exercise
3.An attitude with gratitude
4. Del-Immune
5. Recipe: Cranberry Quinoa Mini Muffins
March 15, 2011:
1. Erectile Dysfunction and Anti-inflammatory drugs, Yoga Class, Kettlebell Classes, Iron Deficiency Anemia
2. 7 Secrets to Maintain Weight Loss
3. Reinvent Yourself
4. Del-Immune
5. Recipe: Garlic Asparagus
March 1, 2011:
1. Hypermobility in the Female Athlete, Neck Strengthening, Yoga
2. How to Achieve Any Goal
3. Just a few minutes
4. Del-Immune
5. Recipe: Seasoned Ahi Steak
February 15, 2011:
1. Functional Movement Screen (FMS), Antibiotic Warning for Athletes
2. 5 Obstacles to Fitness Success
3. Your friend, Regret
4. Del-Immune
5. Recipe: Healthy Chocolate Shake
January 15, 2011:
1. Del-Immune and Olbas Oil
2. Complex is Best
3. You're in Charge
4. Del-Immune
5. Recipe: Quinoa and Winter Squash Salad
January 1, 2011:
1. 100 Percent Club
2. 2011 Fitness Predictions
3. Home Cooking
4. Vitamin D
5. Recipe: Easy Turkey Wrap
December 15, 2010:
1. Functional Movement Screen
2. Simple 50 Pound Slim Down
3. Eat it Early
4. Vitamin D
5. Recipe: Broiled White Fish with Brown Rice & Veggies
December 1, 2010:
1. Steroid Shots for Tennis Elbow, Cervical Traction: Cervico-2000
2. Are You Powerless to Holiday Pounds?
3. Don't Stress
4. Vitamin D
5. Recipe: Spinach & Egg White Wrap
November 15, 2010
1. Still Drinking Soda?, Vitamin D and the Flu, Seated Band Abductions
2. Don't Complicate Things
3. Not another diet
4. Vitamin D
5. Recipe: Chicken Quinoa Stir Fry
November 1, 2010
1. Still Drinking Soda?, Vitamin D and Asthma, 141 lb. Pistol
2. The Exercise Prescription
3. The Healthy Food Trap
4. Vitamin D
5. Recipe: Creamy Carrot Soup
October 15, 2010
1. Vitamin D, Concussions, Renegade Rows
2. The Power of Change
3. Smartsize Your Weight Loss
4. Vitamin D
5. Recipe: Herb-Coated Halibut with Zucchini and Whole Wheat Couscous
October 1, 2010
1. Vitamin D
2. 7 Habits of Highly Fit People
3. 3 Anti-Fitness Habits
4. Vitamin D
5. Recipe: Delicious Kale and Pinto Bean Soup
September 15, 2010
1. AC Milan - Milan Lab, Plank Press, 100 Percent Club
2. Chronic Pain and Your Diet
3. The Better Booty Diet
4. Vitamin D
5. Recipe: White Bean Hummus
September 1, 2010
1. USATF Level One Coach Certification, It's all in the Hips- Part 3
2. 7 Steps to a Perfect Packed Lunch
3. Push Yourself
4. Vitamin D
5. Recipe: Perfect Packed Lunch
August 15, 2010
1. USATF Level One Coach Certification, It's all in the Hips- Part 2
2. Your Self-Guided Kitchen Raid
3. Shop Your Way Thin
4. Vitamin D
5. Recipe: Best Spinach Salad Ever
August 1, 2010
1. How Important is Sports Nutrition?, It's All in the Hips
2. 2010 NATA Convention
3. Easy Slim Down Tip
4. Vitamin D
5. Recipe: Sweet & Tangy Salmon
July 1, 2010
1. Stroke Recognition
June 15, 2010
1. Kettlebell videos
2. Mountain or Molehill?
3. Picture This
4. Vitamin D
5. Recipe: Sweet & Tangy Salmon
June 1, 2010
1. Kinesio Tape Makes Wall Street Journal
2. The Top 7 Reasons to Exercise
3. Your Reason
4. Vitamin D
5. Recipe: Fresh Mango Pie
May 15, 2010
1. Soccer/ACL Conditioning, Get Strong
2. The End of Food Temptation
3. The Domino Effect
4. Vitamin D
5. Recipe: Quinoa Breakfast Bowl
May 1, 2010
1. Soccer/ACL Conditioning, Get Strong
2. 6 Vacation Tips to Keep You Fit
3. Snack Healthy
4. Vitamin D
5. Recipe: Tender Homemade Baked Beans
April 15, 2010
1. Soccer/ACL Conditioning, Get Strong
2. Are you lazy?
3. Your Ideal You
4. Vitamin D
5. Recipe: White Bean Ratatouille
April 1, 2010
1. Lunchtime office hours, Get Strong, Soccer/ACL Conditioning
2. The Missing Link to Optimal Health
3. Green Weight Loss
4. Vitamin D
5. Recipe: Guiltless Zucchini Pasta with Turkey
March 15, 2010
1. Dizzy Dean, The Doaker's Story
2. 7 Reasons Why You Can't Lose Weight
3. Creature of Habit
4. Vitamin D
5. Recipe: Green Smoothie
March 1, 2010
1. HKC CERTIFICATION
2. Getting Past Mental Roadblocks
3. Creature of Habit
4. Golf Fitness Made Easy!
5. Recipe: Quick Chicken and Veggie Bowl
February 15, 2010
1. Prevent Sports Injuries!
2. 5 Stupid Things Healthy People Do
3. Instant Accountability
4. Golf Fitness Made Easy!
5. Recipe: Gourmet Open-Faced Salmon Sandwich
February 1, 2010:
1. Prevent Sports Injuries!
2. What you don't know could hurt you
3. Naturally Sweet Valentine
4. Golf Fitness Made Easy!
5. Recipe: Lime-Spiked Asparagus
January 15, 2010:
1. Montgomery County PTA Special Presentation - Sports Injury Prevention
2. Your Fast-Track to a Flat Tummy & Tight Abs
3. Instant Ab Flattener
4. Golf Fitness Made Easy!
5. Recipe: Moroccan Stew
January 1, 2010:
1. Dr. Horwitz on News Channel 8's Sports Talk with Glenn Harris
2. 27 Fitness and Fat Loss Tips
3. The New Year's Resolution Trap
4. Golf Fitness Made Easy!
5. Recipe: Healthy Winter Hash
December 15, 2009:
1. Disc Herniations, Cold Laser
2. Your Holiday Party Cheat-Sheet
3. Your Focus this Season
4. Golf Fitness Made Easy!
5. Recipe: Festive Hummus (Sun-Dried Tomato and Basil)
December 1, 2009:
1. CycleLife Endurance Athlete Clinic, Montgomery County Recreation Department Kettlebell Class, 8 Steps to a Pain Free Back
2. The 5 Biggest Fitness Mistakes
4. Del-Immune Immune System Booster!
5. Recipe: Tuna & Salad Pocket
November 15, 2009:
1. CycleLife Endurance Athlete Clinic, Montgomery County Recreation Department Kettlebell Class, 8 Steps to a Pain Free Back, Protein Powder
2. Where Did the Time Go?
3. Give Thanks, Get Fit
4. Del-Immune Immune System Booster!
5. Recipe: Grilled Fruit
November 1, 2009:
1. 8 Steps to a Pain Free Back, Kettlebell Class
2. The Culture of Overeating: A Survival Guide
3. Starting Out Right
4. Del-Immune Immune System Booster!
5. Recipe: Veggie Power Juice
October 15, 2009:
1. Salute Military Golf Association, Nation's Triathlon, Walk Away From Cancer, AIDS Run/Walk 5K, ACL Injury Prevention
2. Flipping the Switch: Turn Your Motivation On
3. Plan Ahead
4. Del-Immune Immune System Booster!
5. Recipe: Easy Homemade Lentil Soup
October 1, 2009:
1. Cleveland Park Hours
2. Unleash the Power of Fiber
3. Check Your Fiber Score
4. Del-Immune Immune System Booster!
5. Recipe: Sweet Braised Figs
September 15, 2009:
1. Do You Take Anti-inflammatory medications before your workouts? STOP IMMEDIATELY!
2. 21 Universal Rewards of Exercise
3. Guarantee Your Success
4. Del-Immune Immune System Booster!
5. Recipe: Fastest Chicken Stir Fry
September 1, 2009:
1. Time Off for Athletes!
3. The Freedom of (Self-Imposed) Chains
4. Confidence Booster
5. Recipe: Fresh Vegetable Tacos
August 15, 2009:
1. BACK PACKS
3. The Trans-Fat-Free Decoy
4. Vitamin D
5. Recipe: Summer Time Gazpacho
August 1, 2009:
1. MAINTENANCE CARE WORKS
2. The Missing Link for Motivation
3. The Rocking Chair Test
4. Vitamin D
5. Recipe: Roasted Brussels Sprouts
July 15, 2009:
1.NEW CPR GUIDELINES, HEAT AND DEHYDRATION INJURY PREVENTION
2. 3 Steps to Overcome Overeating
3. No More Clean Plates
4. Vitamin D
5. Recipe: Rainbow Kebabs
July 1, 2009:
1.FREE ENTRY FOR CRYSTAL RUN TWILIGHTER 5K July 25, 2009 and Two D.C. Locations - City Fitness Gym and Cyclelife USA
2. 5 Beach Body Myths (and 3 Steps to Look Amazing)
3. It's Grill Time
4. Vitamin D
5. Recipe: Mediterranean Lettuce Wrap
June 15, 2009:
1.Two D.C. Locations - City Fitness Gym and Cyclelife USA
2. It's Anyone's Game
3. Who Knew?
4. Vitamin D
5. Recipe: Mango Marinated Tofu
June 1, 2009:
1. Kinesio Taping, Two D.C. Locations - City Fitness Gym and Cyclelife USA
2. Your New Favorite Thing
3. Small is Better
4. Vitamin D
5. Recipe: Energy Muffins
May 15, 2009:
1. GET STRONG!, Hydroxycut Recall
2. The Sweetest Scam of All Time
3. The Many Names of Sugar
4. Vitamin D
5. Recipe: Lentil Fruit Salad
May 1, 2009:
1. Wellness Care Continued
2. What's Lifestyle Got To Do With It?
3. The Liquid Calorie Ban
4. Liquid Multi Vitamin
5. Recipe: Sauteed Soybeans
April 15, 2009:
1. Wellness Care
2. The Top 5 Side Effects of Exercise
3. Know Your Number
4. Liquid Multi Vitamin
5. Recipe: Smoked Salmon Salad
April 1, 2009:
1. Our New You Tube Channel!
2. Your Most Neglected Body Part
3. Want Antioxidants? Go Blue
4. Liquid Multi Vitamin
5. Recipe: Easy Lentil Soup
March 15, 2009:
1. Our New You Tube Channel!
2. Go FITNESS Shopping
3. Upgraded FITNESS Shopping
4. Liquid Multi Vitamin
5. Recipe: Albacore Lettuce Wraps
March 1, 2009:
1. Rich Eisen of the NFL Network Runs the 40 Yard Dash at the NFL Combines!
2. The Blame Game
3. Got Stress?
4. Liquid Glucosamine
5. Recipe: Healthy Man's Steak
February 15, 2009:
1. Attention Patients with Arthritis!
2. Can You Game Yourself Thin?
3. Veggie Power
4. Liquid Glucosamine
5. Recipe: Potato & Carrot Casserole
February 1, 2009:
1. ACL Injury Prevention
2. Are You Wired to Relapse?
3. Think Small
4. Vitamin D
5. Recipe: Healthy Chicken Fajitas
January 15, 2009:
1. Kettlebells and Lance Armstrong
2. Dont Believe the Lies
3. Don't Try!
4. Vitamin D
5. Recipe: Roasted Citrus Cod
January 1, 2009:
1. The New Years Resolution Trap
2. So-Called Health Food
3. Vitamin D
4. Recipe: Eat-Your-Spinach Frittata
December 15, 2008:
1. SPEED, AGILITY, AND INJURY PREVENTION DAY at Champions Field House!
2. 5 Signs That You're Doing it Right
3. That's Nutty
4. Golf Fitness Made Easy!
5. Recipe: Pear Power Snack
December 1, 2008:
1. Champions Field House is Now Open!
2. Active Release Techniques and USA Weightlifting's Sports Performance Coach Course
3. Comfort Food...Your Two-Sided Friend
4. Perfectly You
5. Recipe: Pumpkin Zucchini Muffins
November 15, 2008:
1. Champions Field House is Now Open!
2. A Bucket of Crabs
3. Are you Vitamin D deficient?
4. Super Flour
5. Recipe: Whole Grain Pretzels
November 1, 2008:
1. More On ACL Injuries and CPR for Coaches
2. A Bucket of Crabs
3. Why is it ESSENTIAL that you start a training program??
4. Super Flour
5. Recipe: Whole Grain Pretzels
1. Flex Spending and Exercise
2. Sports Injury Handbook!
3. Weight-Loss Pills: Do they work?
4. Trick or (Healthy) Treat?
5. Recipe: Healthy Tuna Melts
1. Sports Injury Handbook!
2. Small Changes Make a Big Difference
3. Emotion Creates Motion
4. 7 dirty words about heart disease
5. Recipe: Curried Chicken and Veggies
1. The Lance Armstrong Laser!
2. Got Muscle Confusion?
3. Plan Ahead
4. Recipe: Veggie Protein Rice
1. Laser Therapy ...Our Results So Far
2. The 5 Most Outrageous Weight Loss Myths
3. Too Little of a Good Thing
4. Recipe: Rosemary Lamb Chops
1. Laser Therapy
2. Is your goal SMART?
3. To Snack or Not To Snack
4. Simple: A Daily 45 Minute Walk Limits the Impact of Diabetes
5. Recipe: Glazed Chicken & Couscous
1. Kettlebell Classes
2. You Are What You Eat!
3. Study confirms the Fountain of Youth
4. Want a Smaller Stomach?
5. Recipe: Perfect Honey-Glazed Salmon
1. Kettlebell Classes, T-Bolts Baseball
2. Don't Let Weight Gain Ruin Your Vacation
3. Lifestyle Interventions - The Only Answer
4. Recipe: Fruit Medley
1. Make It A Habit
2. Do You Have A Child Who Plays Sports?
3. Kettlebell Testimonial
4. Summer time means one thing it's barbecue time!
5. The Magic Fat Burning Pill...
6. Recipe: Sunny Day Grilled Chicken
1. Dr. Paul Glodzik, Yoga Classes, Kettlebell Classes, T-Bolts Baseball
2. If I Only Had the Time?
3. Get Out the Camera
4. Recipe: Spicy Veggie Stir Fry
1. Join Yoga & Kettlebell Classes
2. Do You Need This Surgery?
3. Can You Change in a Single Moment?
4. Smart Shopping
5. Recipe: Springtime Shrimp Salad
1. It's Not To Late To Join Yoga & Kettlebell Classes!
2. Thunderbolts Summer Baseball Camp
3. Great Grains! What's a whole grain?
4. Taking Your Fitness To A Whole New Level
5. Recipe: Rosemary Dijon Chicken
1. Congratulations To Dr. Paul Glodzik!
2. Yoga Classes To Begin May 8th
3. Free Video Analysis For Female Athletes
4. Dr. Horwitz Teams Up With Thunderbolts Baseball
5. Recipe: Simple Spaghetti Squash
1. Kettlebells in Full Swing for Spring!
2. Thunderbolts Baseball
3. Why Aren't You Motivated?
4. The Art of Eating Mindfully
5. Recipe: Spring Salad
1. Thunderbolts Baseball
2. Congratulations to Mi Seitelmans Personal Training Clients
3. The Action Taker in You
4. It's Just a Number
5. Recipe: Flax Meal Protein Cakes
1. Yoga Classes
2. Kettlebell Classes
3. Who Else Wants the Secret to Great Abs?
4. Back to Basics
5. Recipe: Fiesta Breakfast Taco
1. Yoga Classes
2. Kettlebell Classes
3. Do Your Kids Exercise?
4. All In Good Time
5. Recipe: Turkey Spaghetti Sauce
1. Yoga Classes
2. Kettlebell Classes
3. Are These 3 Foods Making You Fat?
4. Lighten Up
5. Recipe: Fitness Casserole
1. Yoga Classes
2. Kettlebell Classes
3. Do You Have the Stubborn Fat Blues?
4. Sneaky Calorie Burning
5. Recipe: Fast & Healthy Fish Tacos
1. The Ultimate Prescription - Exercise lowers blood pressure and improves cholesterol levels
2. Guilt Free Flavor!
3. Recipe: Chocolate-Berry Parfaits
1. Why Are You Eating That?
2. It's Time to Relax!
3. Recipe: Light 'n Tasty Egg Salad
1. When Holiday Tips Fall Short
2. Watch Your Mouth
3. Recipe: Celery Sticks with Roasted-Garlic Hummus
1. Hold the Salt
2. Excuses, Not Reasons
3. Undercover Calories
4. Recipe: Smoked Salmon Mousse with Crackers
1. Thanksgiving on the lighter side
2. Tricky Sticky
3. Recipe: Low Fat Thanksgiving Green Bean Casserole
1. How Good Is Your Balance
2. Walking for Fitness
3. Love Yourself
4. Recipe: Chicken Breast and Black Bean Quesadilla
1. Nutrition Tips for Vegetarian Athletes
2. Why all the Diet Talk?
3. Trim the Fat
4. Recipe: Garden Lasagne
1. The Magic Ingredient for Body Transformation
2. Eat to your Heart's Content
3. Recipe: Stuffed Egg Salad
1. Backpacks for Students
2. Kids and Computers - A Pain in the Neck
3. File of Life and Emergency Alert
4. Fitness Corner: Golf - How to Make Swing Changes Stick
5. Nutrition Corner: Celiac Disease - Get Rid of Gluten
6. Golf Fitness Made Easy!
7. Rotator Cuff Relief - the DVD is Here!
1. Read What Our Patients Say About Our Training...
2. Strength and Conditioning for Volleyball
3. Fitness and Nutrition Corner: Obesity is Bad for the Bones!
4. Golf Fitness Made Easy!
5. Rotator Cuff Relief
1. Adverse Reactions to Cough and Cold Medicines Sent 1500 Babies to the Emergency Room in 2004, 2005
2. 2007 Maryland Strength and Conditioning Clinic
3. Fitness and Nutrition Corner: Heat Illness and Hydration
4. Golf Fitness Made Easy!
5. Rotator Cuff Relief
1. Your Car + Your Commute = A Visit to Your Doctor
2. Nerve Damage from Bike Riding
3. 2007 Maryland Strength and Conditioning Clinic
4. Fitness Corner: Weight Training Helps Phelps Break Records
5. Nutrition Corner: Protective Effect Of Fruits, Vegetables On Asthma And Allergies Among Children
6. Golf Fitness Made Easy!
7. Rotator Cuff Relief
1. Have You Looked Under Your Hood Lately? Men's Health
2. Deep Vein Thrombosis
3. Fitness Corner: 2007 Maryland Strength and Conditioning Clinic
4. Nutrition Corner: Kids Nutrition - The Incredible Importance of Snacking
1. Introducting Mi Seitelman: Director of Functional Training
2. Fitness Corner: Exercise Won't Make It Worse
3. Nutrition Corner: A Poor Diet Can Lead To Bigger Problems
1. Headed for the Hospital?
2. Snow Removal
3. Mid Atlantic Strength Symposium
4. Fitness Corner: Stay Trim for Baby
5. Nutrition Corner: Avoid Cola Drinks to Keep Bones Strong
1. Rotator Cuff Relief
2. Golf Fitness Made Easy
3. Fitness and Nutrition Corner: A Reality Check During the Holidays
1. When to Use Ice and When to use Heat
2. Overweight Youth Face More Joint Pain
3. Fitness Corner: Warm-Up Before You Play
4. Nutrition Corner: Superfoods
1. Heat Illness and Hydration Requirements
2. Atlantis MediSpa
3. Fitness Corner: Building Bones
1. Disc Herniations
2. Get It Checked!
3. Fitness Ball: How to Select the Proper Size
4. CPR Guidelines
5. Free Exercise Guide for Seniors
1. Stroke Recognition
2. Preventing Youth Baseball Injuries
3. FITNESS CORNER - Abdominal Bracing
4. The STICK
1. Fish Oil Supplements
2. To Stretch or not to Stretch
3. They're Sly: The Dirty Little Secret About Office Germs
4. Product of the Month: Shower Head Chlorine Filter
1. Golf Fitness Made Easy
2. Strength Training and Stretching for Runners
3. Osteoarthritis: Is it really caused by wear and tear?
4. Laura's Corner
5. Health, Fitness, and Nutrition Briefs
1. Dr. Horwitz Featured in Washington Post
2. Laura's Corner
3."Hipper than BMI"
1. Golf Fitness Made Easy
2. ACL Injury Prevention Program
3. Product Sale
4. Laura's Corner
1. Golf Fitness Made Easy
2. ACL Injury Prevention Program
3. Back to Back Pain For Students?
4. Laura's Corner
5. New Product: Body Rite Posture Pleaser
1. ACL Prevention Program
2. Golf Fitness and Injury Prevention Program
3. Laura's Corner
4. Medication Cards
5. New Product: Sole Custom Inserts
1. Dr. Horwitz on WUSA TV to discuss Heat and Hydration
2. DINO restaurant opens in DC
3. Squats are for everybody!
4. New Massage Chair
1. 17th Maccabiah Games
2. Care and Prevention of Athletic Injuries
3. So How Old is Old?
4. Another Success Story
1. Glucosamine, Multi-Vitamin, Calcium
2. My Pyramid
1. Youth Sports Radio
2. Running Shoe Selection
3. Air Travel Thrombosis
1. Read the article "Doctor's See a Big Rise in Injuries to Young Athletes"
2. Oils- Which are best?
3. Glucosamine Update
4. Blood Sugar, Cholesterol, Triglycerides - New Numbers
1. Laura Bradford
2. Ankle Sprains
3. Aneurysm Screen Urged
4. Anyone Can Make You Tired!
1. Introducing LAURA BRADFORD
2. Does Weather Really Affect Joint Pain?
3. SeniorCarePharmacist.com
1. Golfer's - Get Fit During the Winter
2. Vitamin E - Yes or No?
3. The Fact Burning Zone
1. Total Disc Replacement- Charite Artificial Disc
2. Lumbar Disc Herniations
1. Vioxx Recall
1. Stroke Prevention
2. "Overfed, Undernourished"
3. ClinicalTrials.gov
1. "Accept No Substitutes"
2. Exercise to Reduce Injury Risks
1. Sports Performance Training
1. Research Affirms the Foundations of Chiropractic
2. Aspirin and Heart Attacks
3. More on the Risks of NSAIDs
4. Running and Joint Pain
5. Fat Intake Limits
1. MomsTeam.com
2. Maryland Council on Physical Fitness
3. Safe Use of Over the Counter Pain Products
4. Ergonomist's Desk Set-up
5. Knowing Your Supplements
1. MomsTeam.com
2. Bowflex Recall
3. How Sweet It Isn't
4. Vitamin D Deficiency
5. Heat Illness and Hydration Guidelines
1. "Do Net Carbs Add Up?"
2. Kids and Restaurants: What are your children eating?
3. Why We Eat More Than We Think
1. Special Fitness Training
2. Low Carb Crazed
3. How To Give Your Child A Longer Life
4. Shovel Snow Correctly
5. New American Heart Association Guidelines for Women and Heart Disease
1. Special Fitness Training
2. Exercise as a Teenager Can Protect Against Cancer in Later Life
3. How to Pick a Treadmill
4. Shovel Snow Correctly
5. Mad Cow Disease - How Safe is Our Meat?
6. Ephedra Banned by FDA
1. Ten Most Common Health Complaints
2. Special Offer on a Very Special Computer Mouse
3. Strength Training and Low Back Pain
4. Food Labels and Sugar: Don't Be Fooled
5. Shovel Snow Correctly
6. Mercury Levels in Fish: New Recommendations
7. Special Products We Offer
1. Extra Pounds Can Increase Your Cancer Risk
2. Special Offer: Interactive Health Massage Chair
3. Tempur-pedic Products
4. ACL Injuries in Female Athletes
1. Custom Orthotics
2. Weight gain and inactivity - Increased Diabetes Risk
3. Fitness Classes
4. Unique Products We Offer
1. You Can Be Fit Personal Training Services
2. X-rays, CAT Scans and MRIs
November, 2002: Family Medical History, Does Dr. Horwitz Treat Muscles?,
July, 2002: Benefits of Broccoli, Celebrex Warnings, Organic Fruits and Vegetables, Graston Technique, Diet and Weight Loss Management
April, 2002: High-Risk Inactivity
January, 2002: Whiplash Facts, Shoulder Pain,
September, 2001: Use Ice, Magnets and Healing, Attention Parents of Athletes, Pregnancy and Your Health
July, 2001: Vitamin B2 for Headaches, Carpel Tunnel Syndrome
May, 2001: Whiplash Facts, Scoliosis
March, 2001: Osteoporosis, Glucosamine Sulfate Study, Neck Pain
January, 2001: Fibromyalgia, Snow Removal Safety Tips, Burn Off Those Holiday Calories
November, 2000: Backpacks - Are Your Children At Risk For Injury, Low Back Pain - Can You Prevent It?
September, 2000: Chiropractic and Kids, Whiplash
July, 2000: Headache
May, 2000: Strength Training, Active Release Techniques®
March, 2000: Maintenance Care Works, Osteoporosis
January, 2000: Chiropractic and Colic, What is F.A.T.?
November, 1999: Message for a New Millennium
September, 1999: Golf's X-Factor, Antibiotics=Childhood Asthma?, Cervical Adjustments
July, 1999: Active Release Techniques®, Weightlifting Injuries
May, 1999: Springtime Allergies, Cycling Injuries
November, 2002
Many patients have discussed the health status of parents, spouses and children with me. I appreciate this confidence. What I have discovered is that many of you do not have a brief health history including medications, especially for elderly parents and/or siblings. I suggest you have a business card sized health history for each parent, sibling and child (if necessary). Keep it in your wallet or purse. Here is an example:
| SIDE ONE | SIDE TWO |
| Bill Smith | 3/15/25 |
| PACEMAKER:Medtronic | Angioplasty 6/21/99 |
| Model 8530 800-551-5544 | Bypass 7/14//00 |
| Implant date: 5/26/95 Pacing Leads 5024 M58 |
Doctors: |
| LAT012436V | Heart: Dr. Jones |
| Medication Allergies: | 301-555-5555 |
| Sulpha drugs | Urologist: Dr. Hill |
| Medications: | 301-555-5555 |
| Coumadin 7.5 mg/day | Internist: Dr. Smith |
| Lanoxin 0.25mg/day | 301-555-5555 |
| Glucophage 500mg b.i.d | Diabetes: Dr. Taylor |
| Mevacor 20mg/day | 301-555-5555 |
| Flomax 0.4mg/day |
This history can be minimized to a font size of 10-11 and printed to fit on a business card sized piece of paper. If you need both sides, just print two of the same sized pieces. They can be laminated (it takes less than 60 seconds) at Kinko's for $2.50. When a loved one is sick emotions are high and it is very important to have this accurate information immediately accessible.
DOES DR. HORWITZ TREAT MUSCLES?
YES! Active Release Techniques® (ART) and Graston Technique (GT) are treatments specifically designed to treat muscles. Most of the time when muscles (tendons and ligaments also) are injured they actually tear. Pulls, strains (sprains are ligament tears), and ruptures are really tears of the muscle. Think of each muscle fiber as a single hair on your head. Did you cut (tear) one hair, all the hairs, or some portion of the hairs? What most people call a pull or strain is a tear of some of the muscle fibers, but not all, that make up the muscle. When a muscle tears, the first response in the body is an inflammation that may or may not cause significant swelling. The texture of the muscle changes and after the initial inflammation the muscle tissue feels taut like a guitar string and bumpy like gravel. Have you ever kneaded bread dough or pottery clay and tried to get the lumps out to make it smooth? This is like what treating an injured muscle feels like. This "adhesion" or scar tissue must be broken up or kneaded away. This can be accomplished with both ART and GT. This cannot be accomplished with anti-inflammatory medicines like ibuprofen (Advil, Motrin, Nuprin), naproxen (Aleve), Celebrex or Vioxx. These medications can help with the initial inflammation and pain, but they can disrupt and prevent proper healing of the muscle tissue. Also significant are the side effects, especially gastro-intestinal bleeding which kills thousands of people each year.
Most problems that present to my office are a combination of muscle injury, joint dysfunction and nerve irritation. That is why it is important to address all the components of the injury during treatment. Loosening up the muscle and removing the adhesions before making the adjustment to restore proper function to the joint is critical to proper and speedy healing. Many nerve injuries can be the result of torn muscles, tendons and ligaments adhering to nerve fibers and causing nerve irritation, e.g. carpal tunnel syndrome. If this is the case the nerve irritation can be removed by removing the adhesion of the muscle to the nerve. Proper stretching and strengthening are then added to the treatment program. ART and GT may allow the injured area to become pain free during regular daily activities, but only proper rehabilitative strengthening and stretching will allow the area to sustain the added forces of sports or rigorous training.
Common "muscular" injuries treatable by ART and GT include rotator cuff tears, frozen shoulder, tennis/golfer's elbow, carpal tunnel syndrome, ilio-tibial band syndrome, patellar tendonitis, shin splints, sprained ankles, Achilles tendonitis or rupture, plantar fasciitis, arthritic joints and common "pulls" like in the hamstrings. ART and GT work very well when combined with chiropractic adjustments for spinal problems as well.
July, 2002
Benefits of Broccoli
"A compound found in broccoli and broccoli sprouts appears to be more effective than modern antibiotics against the bacteria that cause peptic ulcers. Moreover, tests in mice suggest the compound offers formidable protection against stomach cancer- the second most common form of cancer worldwide."
Washington Post 5/28/02, A4
Celebrex Warnings
The FDA concluded that the drug labeling for Celebrex should continue to include the standard warning for doctors and their patients about risks associated with all NSAIDS [non-steroidal anti-inflammatory drugs], including risks of GI ulceration, bleeding and perforation. The labeling adivises physicians prescribing and patients taking these drugs to be alert for ulceration and bleeding that can occur with or without warning. "'After studies with 16,000 patients; there was no sign that Cox-2 agents [the class of drugs that includes Celebrex and Vioxx] are overall safer
"
Washington Post 6/8/02, A2
Organic Fruits and Vegetables
Conventionally grown fruits and vegetables in the supermarket are three times as likely to have pesticide residues on them as organically grown produce, according to a study in the May 2002 Food Additives and Contaminants Journal. Unfortunately, even organically grown produce had residues of DDT and dieldrin, which were banned in the 1970s but persist in the soil for many years. They were concentrated in fast-growing vegetables like zucchini, yellow squash and carrots.
GRASTON TECHNIQUE
I have recently completed Module 1 of Graston Technique, a new examination and treatment procedure for the management of musculoskeletal complaints. Graston technique was developed to aid in the treatment of patients who are experiencing pain and loss of function as a result of injury, cumulative stress disorders (e.g. carpal tunnel syndrome) and following some surgical procedures (e.g. ACL repair/replacement).
The technique is currently being used by many university athletic and professional sports teams in the treatment and prevention of athletic injuries and is also used in the management of work-related injuries. Graston Technique enables me to effectively break down adhesions and scar tissue that forms between muscle fibers. The technique makes use of scientifically designed stainless steel instruments that detect and treat tissue restrictions that result in pain and dysfunction.
Graston Technique combined with Active Release Techniques® will make adhesion removal that much more effective. Please see www.grastontechnique.com for more information.
DIET AND WEIGHT LOSS MANAGEMENT
"THERE IS NO DIET NOW, AND THERE NEVER WILL BE A DIET, THAT CURES A WEIGHT PROBLEM..."(Covert Baily)
Americans are fatter than ever before! The proportion of fat in Americans diets has decreased since the 1950s but obesity is at an all time high some 26% of Americans are obese! How can this be with all the different diet programs, weight loss nutritional supplements and appetite suppression medications available? None of the aforementioned solutions are really a solution at all. Heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes - all linked with obesity - hinder daily living for more than 10% of Americans. You must understand what you are eating to be successful at losing weight and learning to eat healthfully for the rest of your life.
I can now schedule the time in my new office to provide you with proper weight loss consultation. I have done this for many patients over the years with tremendous results. One patient was a 78 year old woman with left and right hip replacements, one of which was loose. She was unable to exercise due to this improperly functioning hip joint replacement. I performed a seven day dietary analysis and found she was eating too few calories, especially protein. I changed her diet and she lost 8 pounds in one month!
My favorite story is about a former Olympic athlete who had many injuries which were not healing. The first thing I did when he became a patient was to review his diet. He was consuming more than 50% of his total calories per day from fat! I changed his diet and his injuries began to heal. He then made the 1992 U.S. Olympic team and finished in 5th place in his event.
I will not promise to make you an Olympian, but I will promise you will be healthier if you learn to eat properly. Schedule an appointment and learn how to lose weight safely and effectively!
April, 2002
Newsletter by Email
If you would like to receive the newsletter by email, please email me at drsteve@youcanbefit.com and put your name and the word newsletter in the subject box. Your email address will remain confidential and you will receive no more than one email per month.
High-Risk Inactivity
This title was used in the Washington Post Health Section (3/26/02) to discuss an important study (3/14/02 New England Journal of Medicine) on the consequences of an inactive lifestyle to your overall health.
The study found the risk of death in the fittest patients was about half that of the least fit. The Washington Post article summarizes while the fittest patients had the lowest risk of death regardless of underlying condition, the biggest gain in the protective benefit of exercise occurred at the other end of the spectrum. When the least fit subjects stepped up their physical activity, their relative risk of death dropped by a higher proportion than any other groups. Yet, physicians rarely seriously recommend exercise as a therapy for patients with elevated health risks.
Sedentary Death Syndrome
The Presidents Council on Physical Fitness and Sports has coined the phrase Sedentary Death Syndrome to categorize the emerging entity of sedentary lifestyle-mediated disorders that ultimately result in increased mortality. Weak skeletal muscles, low bone density, hyperglycemia, glucosuria [sugar in the urine], low serum HDL [low good cholesterol], obesity, low physical endurance, and resting tachycardia [high resting heart rate] are a set or group of symptoms that together characterize Sedentary Death Syndrome.
The council goes on to say that 30% of the deaths for coronary heart disease, type 2 diabetes, and colon cancer would be prevented by moderate-intensity physical activity that expended 1000kcal/wk [1000 calories per week]. The number of deaths from sedentary living is two times greater that that from microbial agents and also exceed all deaths from firearms, illicit usage of drugs, sexually transmitted diseases, and motor vehicle accidents. Thus, a major cause of death in the US is sedentary living [highlights added]. In other words, the sedentary death syndrome comprises one of the top three causes of all-cause mortality in the US today . Therefore, in the last 100 years, the leading causes of death have dramatically shifted from the scourges of infectious disease (in 1900), to tobacco, obesity, and Sedentary Death Syndrome (in 2000), which in essence constitute the new scourge for humanity.
Studies published in 2000 and 2001 respectively show that 82 % of coronary heart disease and 91% of type 2 diabetes is caused by high-risk lifestyles. Thus, the corollary by logical inference is that a large majority of such disease are preventable by engaging in low-risk lifestyles. Low risk behavior was defined as a combination of five variables: BMI of less than 25 [to calculate your Body Mass Index see my website homepage and click on announcement #7]; a diet high in cereal fiber and polyunsaturated fat and low in trans fat [partially hydrogenated oil] and glycemic load (which reflects the effect of diet on the blood glucose level); engagement in moderate-to-vigorous physical activity for at least half an hour per day; no current smoking; and the consumption of an average of at least half a drink of an alcoholic beverage per day.
Of all the councils statements, the one I find most significant is preventing a chronic health condition in the first place is more humane and produces less suffering than secondary or tertiary treatment of full-blown over disease. In other words, the practice of primary prevention is a fundamental demonstration of the very essence of the Hippocratic oath . It is indeed ironic that practicing primary prevention is considered basic common sense in other inanimate aspects of our daily life, when we neglect to do the same when it comes to our own personal health, a most fragile entity. For example, is it not less damaging and expensive for an automobile to undergo routine maintenance such as oil changes rather than to undergo a complete engine replacement after several years of neglect? WOW! This is the Presidents Council talking, not me! PREVENTION WHAT A CONCEPT! To schedule an exercise/weight loss appointment please call the office!
January, 2002
WHIPLASH FACTS
Chiropractic is the most effective treatment for whiplash and other soft tissue injuries sustained in automobile collision. The faster a patient seeks help and is treated after one of these injuries, the better chances that patient has of healing optimally.
There are three stages of healing that occur with whiplash injuries. The inflammatory stage is the first stage, and lasts from 24 to 72 hours after the injury occurs. Healing occurs here through fiber repair of the muscles and soft tissue. Interference with this fiber repair can include anti-inflammatory steroids and aspirin. The repair stage is the second stage and lasts from 48 hours to six months. The body is constantly remodeling during this stage. If proper treatment is not incorporated during this stage, unwanted scar tissue will result. This contributes greatly to decreased strength and overall function of the musculature involved. The repair stage is the final stage and lasts from 3 weeks to 12 months or more. During this process, scar tissue that has developed in the repair stage goes through a reorganization, which can lead to deformation of spinal ligaments. This deformation eventually leads to degeneration and osteoarthritic changes in the spine.
To avoid these problems, make sure you seek proper treatment immediately if you are involved in a motor vehicle collision. It can save you years of suffering!
ROTATOR CUFF INJURIES
The rotator cuff is comprised of four muscles that aid in lifting your shoulder over your head, as well as in rotating it towards and away from your body. These muscles also contribute in stabilization of the shoulder joint. In synergy, they allow everyday repetitive motions like scratching behind your head and back, painting, waxing, using hand tools, reaching, and lifting overhead. They are used extensively in athletic activities like throwing a ball, serving a tennis ball and driving a golf ball.
The shoulder joint itself is a ball and socket joint in which the arm bone (humerus) ends and fits into a very shallow socket (glenoid) which is part of the shoulder blade (scapula). This shallow socket gives the shoulder tremendous range of motion. The musculature of the rotator cuff includes the subscapularis, supraspinatus, infraspinatus, and teres minor muscles. Together with the deltoid, they are responsible for placing the arm in overhead positions which is essential for many sports.
Rotator cuff injuries are most commonly a result of microtrauma occurring in repetitive movement. Chronic wear and tear or a fall or auto collision can cause injury to the rotator cuff. It is common for a patient to have intermittent shoulder pain for several years, which is not completely relieved by rest and anti-inflammatory medication. Symptoms may include pain in the front, side, back or deep inside the shoulder especially with overhead movements. Eventually, these problems can lead to pain in such activities as putting on a bra, shirt, or coat, as well as in even shaking hands or reaching for a door. These injuries need to be properly diagnosed through a complete consultation and examination of the region.
Pain symptoms are usually caused by a muscle strain or tendonitis, which can lead to further problems as well. An excellent treatment of rotator cuff injuries is Active Release Techniques® (A.R.T.), which is a muscular and soft tissue technique that is applied with the doctor's hands by using a specific pressure and tension on the muscle or tissue involved while the muscle is moved beneath the hand contact. This method optimizes healing through softening and stretching scar tissue, thus increasing range of motion, increasing strength, and improving circulation.
Along with A.R.T., chiropractic adjustments to the involved shoulder joint will aid in healing, as proper function of the joint is essential to its health. Different types of physical therapy including electric stimulation and ultrasound can also be applied to break up scar tissue and adhesions in the involved musculature.
Finally, proper exercises to strengthen and gently stretch the muscles are essential in the healing process. Rehabilitative exercises should not cause pain while being performed, and little to no pain should be experienced after the exercises. We can tailor an exercise regime to fit your specific needs, thus restoring proper function and health to the joint involved. If you or someone you care about is experiencing shoulder problems, don't wait - make your appointment TODAY!!
September, 2001
USE ICE
How many times have you come to the office only to hear me ask, "Did you ice the area?" Please remember, if you have injured yourself or you have worked particularly hard (gardening, painting, driving, housecleaning, golf, etc.), ice the area as soon as possible for 15 minutes. Even if you do not have ice available at the time, still ice the area before you go to sleep that night. Ice is the best anti-inflammatory and analgesic (pain-relieving) substance - use it!
MAGNETS AND HEALING
Many patients have asked about the use of magnets for healing. Magnets are often put in braces for different areas like the back, wrist, elbow or knee as well as in mattresses on which to sleep. Many wild claims about their effectiveness have been made. The bottom line is there is not enough research to give a complete answer. We have had patients who have been helped dramatically by magnets and others for whom they have not helped at all. Fortunately magnets are safe and can be used for almost anything that ails you. For more information, I suggest Gary Null's book Healing with Magnets and an article on his website entitled Biomagnetic Healing.
ATTENTION PARENTS OF ATHLETES
With Fall sports beginning, I want to bring to your attention several articles on our website:
Concussion Guidelines- 20% of brain injuries that occur in the U.S. can be attributed to athletics (300,000 per year!). The potential damage that can be caused by concussion is devastating. This article explains what a concussion is, how to recognize it and how to properly manage it.
Heat and Hydration- With the death of Vikings player Cory Stringer the topic of heat injuries has gotten a lot of attention. This article goes into detail about the signs and symptoms of the different types of heat injuries, current NCAA guidelines on how to manage and prevent these injuries and general hydration guidelines.
Pre-participation Physical Examination- This article explains what should be done during a pre-participation sports examination. This is a very important examination and it should be taken seriously.
Sports Nutrition- This article is important for all patients, athletic or not. Proper nutrition is essential for performance.
Anabolic Steriods- DON'T USE THEM! Read why not!
PREGNANCY AND YOUR HEALTH
Pregnancy is a time of many changes in your body, many of which can be quite challenging physically. As you gain weight and increase the load you are carrying in front of you, more and more impact is made on the spine, especially the lower lumbar region. This is because the center of gravity radically alters your posture and the inherent biomechanics of your spine.
Throughout pregnancy, the body secretes increasing amounts of the hormone relaxin, which causes the ligaments and tendons of the body to relax, soften and stretch - a very important part of the birthing process. However, this gives your spine less ability to resist the increased stresses of weight. The spine is very dependent on ligaments to maintain its structural integrity as they control both proper alignment and movement patterns. In back of each vertebra, on either side, are two "facet joints" which guide and control the interaction of the vertebra with the vertebra above and below it. When the spine is moving improperly these joints can cause considerable pain, something Chiropractic is very helpful in treating. It is important to understand these potential problems to try and minimize and even prevent them from occurring at all.
Here are some suggestions that will help you to achieve this goal:
1. Use Good Body Mechanics. (Lift with your legs, avoid lifting objects over your head or out in front of you, maintain good posture and use good "body sense" in everything you do.)
2. Stay In Tune With Your Back. (Back & neck pain is not "normal" during pregnancy. It is a signal that something is not right and should be evaluated by your chiropractor. Recent research has shown that women who received chiropractic care throughout their pregnancies demonstrated greater than 50% reduction in back pain, as well as a 24% reduction in mean labor time for those women who have given birth before.)
Planning Ahead for a Healthy Baby
In planning ahead early in pregnancy, future problems can be prevented. By following the list below, you can make a healthy start in your baby's life:
- Visit your health care provider early.
- Learn about your family history.
- Stop smoking, drinking alcohol and taking drugs.
- Avoid exposure to toxic substances and chemicals.
- Reduce stress.
- Consume at least 0.4 milligrams (400 mcg) of folic acid every day (found in vegetables, whole grain foods, and citrus fruits, this will help prevent birth defects of the spine and brain of the fetus).
- Achieve your ideal weight before you become pregnant. (The more in shape you are before pregnancy, the easier it will be to maintain exercise during pregnancy, as well as getting back into shape after the birthing process. Exercise enhances strength, stamina and flexibility, and reduces stress).
- Eat a balanced diet. (Healthy eating habits provide nutrients needed by you and the fetus. Avoid caffeine.)
- Manage existing medical conditions.
- Avoid eating undercooked meat or handling cat litter. (These are known forms of toxoplasmosis, an infection that can seriously harm your fetus).
July, 2001
VITAMIN B2 FOR HEADACHES
An estimated 26 million Americans suffer from migraines - Results of a study published in the scientific journal of the American Academy of Neurology reported that "after three months, patients taking vitamin B2 reported 37 percent fewer migraines than other comparable patients not taking the vitamin. That reduction in the frequency of migraine attacks is comparable to the effect of other drugs used to prevent migraines."
The dosage used was 400mg of vitamin B2, or riboflavin. "The effect on migraine frequency showed up after a month of daily doses and increased over the next two months. The vitamin also appeared to lessen the duration of migraines that did occur." "Patients in the study had experienced from two to eight migraine attacks per month for at least a year."
(Washington Post 2/24/97)
Other helpful supplements for migraine include magnesium (250mg-400mg three times daily), vitamin B6 (25mg three times daily), 5-HTP (5-hydroxytryptophan 100-200mg three times daily), feverfew and ginger (1/4" fresh slice).
Finally, in a six-month trial in Australia, chiropractic patients reported greater reduction in the pain associated with the attacks.
(Natural Medicine Journal, March, 1998).
CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome (CTS) is a very common ailment and is caused by occupational activities involving repetitive flexing of the wrist, which leads to irritation and compression of the median nerve inside the wrist.
Classified under the group "repetitive-motion injuries", it is the most prevalent nerve disorder in this category, and is linked to tasks involving overuse or improper use of both the hand and the wrist. This usually effects people with occupations that involve typing (computer or typewriter), grasping (store checkout clerks, painters, plumbers, electricians, carpenters), lifting (movers, construction workers), or any other type of repetitive flexion of the hand and wrist.
The anatomy of the carpal tunnel includes 8 bones called carpal bones, which make up the wrist (two rows of four across). The top of the "tunnel" is formed by a ligament, which runs across the carpal bones. The carpal bones make up the bottom of the tunnel. A nerve called the median nerve travels from the spinal cord in the neck down the arm, and through this tunnel to the tips of the first three fingers. This nerve controls the muscle strength and feeling of these fingers. The local entrapment of this nerve is the cause of CTS.
Symptoms of CTS
Depending on the individual, there can be many different signs and symptoms of carpal tunnel syndrome. CTS is a chronic and disabling condition which is typically characterized by nocturnal hand discomfort and finger paresthesias, as well as thenar muscle atrophy (loss in the bulk of the muscles in the thumb region). It may begin as a slight tingling in the fingers, which then may progress to numbness and pain in the wrist and hand. Elbow and shoulder pain also can be linked to CTS, as well as loss of grip strength and pain radiating into the cervical spine (neck) region.
Treatment of CTS
In approaching treatment of CTS, it is important to not only address the wrist involved, but also the elbow, shoulder and neck regions, as they may be contributors to the problem. By properly aligning and restoring the function of the joints of the wrist, elbow, shoulder and neck, chiropractic treatment will get to the nerve irritation, which is the cause of the problem. Many times in CTS the neck, shoulder and elbow are neglected, while treatment of these regions are critical to proper care. All of the nerves that innervate the shoulder, elbow and wrist come from the neck, and improper function of these joints will cause irritation, which can lead to further irritation of the median nerve.
Aside from Chiropractic adjustments, Active Release Techniques (A.R.T.) works amazingly well in treatment of CTS. In approaching the muscles surrounding the length of the median nerve in the arm, forearm and wrist, adhesions, scar tissue, and trigger points can be eliminated through this hands-on muscle technique. In A.R.T., patient puts the effected body part into active range of motion while the Doctor contacts the muscles involved. The action of the muscle pushes the doctors contact along the length of the muscle, releasing any adhesions, trigger points and scar tissue in the area. This has been found to be very effective in the treatment of carpal tunnel syndrome, and if used with chiropractic adjustments, results are excellent.
If you are experiencing numbness, tingling or pain in your wrists and/or hands, don't wait - CTS will get progressively worse if not treated effectively. The earlier you approach the problem, the faster you will get better. Call to make your appointment today!
May, 2001
FREE SCOLIOSIS SCREENING IN MAY
May is correct posture month, and during the month of May only, we are offering FREE postural and scoliosis screenings at the office to all children and family members of current patients. Not only will this benefit those who are currently having spinal pain and discomfort, but it also will help to diagnose ailments and postural issues before they become painful problems. Show a loved one that you care - call to make an appointment today!
WHIPLASH FACTS
- There are approximately 3 million Cervical Acceleration/Deceleration (whiplash) injuries in the U.S. every year.
- More than 10.5 million persons are subjected to crashes every year.
- Males are 1.5 to 1.7 times more likely to be involved in motor vehicle crashes than females.
- Rear impact collisions comprise 25.3% of all collisions
- 45% of the American population with chronic neck pain attribute it to a Motor Vehicle Collision.
- Crash speeds can go up to 10mph without sustaining visible damage to the car, while the reported threshold for soft tissue injury of the neck in healthy adult males is only 2mph.
SCOLIOSIS AND CHIROPRACTIC CARE
Scoliosis is defined as a lateral (sideways) curvature of the spine. Every person's spine has a front-to-back curve, which gives us the rounding of our shoulders and the sway in our lower back. The lateral curvature displayed in scoliosis is an abnormal curvature of the spine where the spine is twisted from side to side, making either a "C" shaped curve (with one major curve) or an "S" shaped curve (involving two curves - one major curve and one compensatory curve).
Approximately 30% of the population has some degree of abnormal (lateral) spinal curvature, and for some, it never becomes a problem. However, for others these curves can progressively get worse over time, causing frustration, pain, and limitations during even the simplest activities of daily living. For the most severe cases, restricted breathing and complications with circulation can be a serious result.
Unfortunately, most cases of scoliosis are known as "idiopathic" scoliosis, which means that the cause is unknown. It is the "most deforming orthopedic problem confronting children. It is a potentially progressive condition that affects children during their active growth phase and essentially subsides upon completion of spinal growth, leaving the child with a permanent deformity. Early recognition and early treatment can be effective in halting its progress and in many cases result in improvement Early diagnosis depends on an awareness of its possibility with the hope that early diagnosis will ultimately reveal early minimal scoliosis and result in early referral for treatment."(1)
Scoliosis affects girls more than boys, and it tends to run in families. Recent research indicates that girls are approximately 8 times more likely to have scoliosis than boys, and are 5 times more likely to require treatment for this condition (the curvature tends to worsen over time, especially if it is not diagnosed and treated at a young age).
How Can Chiropractic Care Help?
During an initial chiropractic evaluation, a thorough physical and diagnostic examination including range-of-motion testing and spinal x-rays (if indicated) will be performed to identify problems for both children and adults. If scoliosis is diagnosed during the initial evaluation, early treatment is usually highly recommended in order to prevent the problem from progressing further. If the patient is a child or adolescent, treatment can reduce and even reverse the lateral curvature of the spine. If the patient is an adult, the curve cannot be reversed, but it can be halted with chiropractic treatment, which will keep it from getting worse.
Chiropractic treatment of scoliosis includes physical therapy to effected joints and musculature, chiropractic adjustments to the involved areas of the spine, myofascial release (muscle work) to the involved surrounding spinal musculature, as well as stretching and strengthening exercises for the patient to do on their own.
If caught at an early age and treated with these methods, a scoliotic curve can be reversed and corrected, leaving the patient with best chances of optimal health, and decreased chances of back problems later in life.
March, 2001
PAINT BRANCH 5K RUN
Paint Branch High School in Burtonsville will be having their 5K run/walk on Sunday May 20, 2001 starting at 8:30 a.m. For more information call Margaret Mangum at 301-348-2168. Proceeds will benefit Paint Branch's PTSA.
FIGHT OSTEOPOROSIS - LIFT WEIGHTS!
"In a recent study 29 pre-menopausal women ages 30 to 45 who increased their bone mineral density after 12 months of impact and resistance training found those benefits reversed after six months of 'detraining'" (stopping exercise). "The 12 months of hard work were of little benefit if regular participation didn't continue," said Kerri Winters, assistant professor of exercise science at Northern Arizona University, who conducted the study.
The results of this study emphasize the importance of a consistent weight-training program. Walking and running do not build bone density to any significant degree. Only weight lifting, preferably free weights, stimulate the bone to increase the mineral (calcium mainly) content. Machines are fine to start, but free weights require coordination and stabilization by many muscle groups and therefore increase bone density more effectively.
One final point- Osteoporosis is really a disease of young women, not older women. Young women may never even attain complete bone density because of poor nutrition habits. Moreover, woman can begin to lose bone density as early as their thirties. LIFT WEIGHTS!
GLUCOSAMINE SULFATE STUDY
Researchers in the U.S. and Europe conducted a recent study testing the effects of supplementation of glucosamine sulfate on arthritis progression. 212 patients with arthritis were randomly divided into 2 groups that received either 1500 milligrams of glucosamine sulfate or a sham treatment daily for three years.
At the end of the 3-year study, x-rays of participating patients revealed that the sham group had a loss of 0.31 mm. in their knee joints, opposed to the 0.06mm loss in the subjects taking the glucosamine. It was also found that while the sham group had a worsening of their initial symptoms, the group taking the supplements experienced a 20 to 25 % improvement.
Degenerative Joint Disease (DJD) is the most common form of arthritis, and is caused by breakdown of cartilage in joints. Nonsteroidal anti-inflammatory drugs are commonly prescribed to relieve symptoms, but are the cause of digestive problems and worsening the disease. Glucosamine is safer - and it works!!!
CHIROPRACTIC CARE AND NECK PAIN
It has been estimated that approximately two out of every three people will experience neck pain at some point in their lives. Although many times a patient can pinpoint what brought on the pain, there are also many people who face the frustration of not knowing the initial cause.
There are three stages of neck pain - acute, sub-acute and chronic. The major causes of neck pain are trauma, usually the cause of acute and sub-acute stages, and postural imbalances, which is responsible for most of the chronic cases and can result from untreated acute and sub-acute stages.
It is important to understand some basic anatomy of the cervical spine (neck) before going into diagnosis and treatment options. The cervical spine is composed of seven bones called vertebrae. Between each two vertebrae (starting with the second and going through the seventh) are discs, which help to absorb shock. These discs also function to create joints with the vertebrae surrounding them. Multiple muscles, ligaments and tendons also surround these joints giving them both flexibility and stability. Any and all of these anatomical structures can be injured and contribute neck pain and problems.
WHAT CAUSES NECK PAIN?
As stated above, the two major causes of neck pain are trauma and postural imbalances. Trauma is usually an acute injury, and can be caused by a car accident (ie: whiplash), a work injury, by a fall or other injury at home. In most acute traumatic injuries, the patient has a combination of muscle stiffness, ligament instability, and joint misalignment. There is always a chance of disc bulge and fracture, as well, making it imperative for the patient to seek medical attention immediately and rule these diagnoses out.
Postural Imbalances usually occur after an acute or sub-acute injury has been left untreated. The patient compensates for this type of pain posturally. This eventually leads to other problems, and becomes a chronic injury, which can be a real "pain in the neck!" Patients also have postural imbalances due to improper sleep habits, improper work habits (both due to poor ergonomics), and incorrect posture when driving and sitting for long periods of time.
TREATMENT OF NECK PAIN
If you have an acute injury, the best thing you can do is seek professional help within the first 24 to 48 hours of the accident/trauma. If you wait for a week or two, the injury will then be considered sub-acute. For either case, as chiropractors, we will give you a thorough examination and x-rays (if needed) to rule out any serious injury. Treatments for both acute and sub-acute would consist of muscle and ligament work, as well as adjustments to get the joints moving properly again. The early treatment will get the area functioning normally again, and will prevent scar tissue from building in the surrounding tissues. The treatment of chronic injuries includes one or any combination of the following: chiropractic adjustments to the misaligned joints, muscle and ligament work to surrounding areas, exercise rehabilitation and nutritional supplements.
This will restore the function of the joints, as well as to the muscles and surrounding ligaments to decrease swelling and scarring, as well as increase the strength of the entire region. If proper care is not sought out within a week, the acute injuries then become sub-acute, which take more time to treat. The acute stages are always the best time to seek medical care also to prevent problems from getting worse.
The longer a patient waits to get treated for an injury, the longer it takes for the patient to get well after treatment begins. Whether you are in an automobile collision, a work accident, or have a chronic injury that just won't go away, make sure you seek our care immediately for the best treatment and fastest results.
January, 2001
SNOW REMOVAL SAFETY TIPS
The forecast for this winter is for a lot of snow. Please follow our safety tips to avoid injuries while shoveling snow:
- Don't shovel if you have had serious spinal, lung, or cardiovascular problems, or are out of shape.
- Warm up with some simple exercises (walk in place) and stretch your arms, legs and spine to limber up before shoveling.
- Dress warmly in layers, and wear an extra-long sweater to protect your lower back.
- Always stand erect and bend from the knees, not from the waist. Handle small to moderate loads of snow.
- Whenever possible, push the snow instead of lifting it. Deposit it nearby rather than trying to throw it over a wide area.
- Use the arms, legs, feet, and thighs in a coordinated effort.
- Try to find a friend or family member to help you out - just one additional person will cut the work in half.
- Stop if you feel pain, dizziness or shortness of breath.
BURN OFF THOSE HOLIDAY CALORIES!
Although we hate to admit it, all of the turkey, pumpkin pie, and holiday cookies add up by the end of the holiday season. The best way to lose weight is to exercise! By working out just 30 minutes a day, 3 - 4 days a week, those extra pounds can fall off in a short amount of time.
Easier said than done, right? It's easier than you think. First of all, find something that you enjoy doing. If you walk on a treadmill and dread it because of boredom, then try a low impact aerobics class, or doing a nature walk or hike. You'll be surprised how much more you will exercise when you enjoy what you're doing.
Secondly, make your work out part of your daily routine. If you find yourself saying you are too busy to exercise, you need to make time for it:
- Getting up 30 minutes earlier in the morning.
- Cutting out an hour of TV at night.
- Not sleeping in on a weekend morning.
You will find that if you do this, working out will become a regular habit, rather than an inconvenience. You'll also find that most gyms have daycare hours, so you can bring your kids with you while you work out.
Stop looking for excuses and start today. Exercise is one of the 5 major aspects of maintaining good health, and can contribute greatly to your overall health and well being.
FIBROMYALGIA
"I hurt all over, I can't sleep well, I'm depressed and anxious, I have frequent headaches, I have pelvic pain/gut pain, and I'm losing control of my life." If this sounds like you or someone you know, it may be more than just the stress and craziness of everyday life. You may be suffering from Fibromyalgia Syndrome (a.k.a. Fibromyalgia).
In the past decade, the number of fibromyalgia cases has grown, affecting 6 million people, 4 million of which are women from the age of 25 - 50. Most of these patients complain of associated fatigue and interrupted sleep, claiming they feel more tired when they wake up than when they went to bed the night before. It is a chronic disorder involving the entire body.
Fibromyalgia is defined by the Merck Manual as "A group of common nonarticular rheumatic disorders characterized by achy pain, tenderness, and stiffness of muscles, areas of tendon insertions, and adjacent soft-tissue structures. These may be primary and generalized or concomitant with another associated or underlying condition, or localized and often related to overuse or micro-trauma factors."
For a proper diagnosis, pain must be present on digital palpation (touch) in at least 11 of the following 18 tender point sites:
Occiput (base of skull) - Right & Left
Low cervical (bottom of neck) - Right & Left
Trapezius (area between shoulders and neck)- Right & Left
Supraspinatus (shoulder blades) - Right & Left
Second rib - Right & Left
Lateral epicondyle (inner elbow) - Right & Left
Gluteal (buttock region) - Right & Left
Greater Trochanter (hip region) -Right & Left
Knee - Right & Left
Some other common symptoms of fibromyalgia include headaches, anxiety, morning stiffness, irritable bowel syndrome, prior depression, and urinary urgency.
Many people with this condition seek the help of health care professionals, but are misdiagnosed time after time with thyroid and hormonal malfunction, as well as depression. This may be due to the fact that all laboratory tests show normal results. In most of these cases, the patient is put on medication or referred from one health care provider to another, never really having a proper diagnosis, and therefore, never really receiving the proper treatment. Low back pain is a common complaint of these patients, which eventually brings them into our office. Fibromyalgia has no known cure, and though it is not life threatening, it can be harmful, and interferes with lifestyle, work and activities of daily living.
Chiropractic treatment consists of physical therapy, myofascial release, and adjustments. This has been found to give patients suffering from fibromyalgia relief from their symptoms. Exercise has also been found to be very helpful. Aerobic activity helps by raising the body temperature, helping to induce oxygen intake, assisting in tissue saturation. Deep breathing exercises and setting proper sleep patterns have also been found to help tremendously.
Unfortunately, this syndrome is often misdiagnosed or brushed off. Fibromyalgia is a real ailment that needs a real diagnosis. It is important that health care professionals work together in approaching every aspect of the condition. If you or someone you know is suffering from these symptoms, it is important to take action quickly. It has been found that the faster the treatment is applied, the more likely the person can get back to living life pain free.
November, 2000
DR. HORWITZ TO BE CERTIFIED IN A.R.T®. LOWER EXTREMITIES
I will be taking the very first Active Release Techniques® lower extremity course in January 2001. This course will cover the muscles of the buttock, hips, groin, thighs, legs, and feet. A.R.T. ® in these areas will be great for conditions like buttock pain, piriformis syndrome (one cause of radiating pain down the leg), hip pointers, hamstring strains (pulls), groin pulls, ilio-tibial band syndrome, calf strains and cramps, achilles tendonitis, plantar fasciitis, and nerve entrapment syndromes in the lower extremities.
POWERLIFTING MEET
Here I go again - I will be competing in a powerlifting meet on Saturday, December 9, 2000 at Wilson High School in Washington, D.C. Wilson is on Nebraska Ave. in between Connecticut and Wisconsin Avenues. The lifting will begin at 9:00am. Thankfully, I have Dr. Strahl to put my body back together after the meet! See our website for more information.
BACKPACKS - ARE YOUR CHILDREN AT RISK FOR BACK INJURIES?
Every school day, millions of students are racing off to class with overstuffed backpacks slung over one shoulder, never giving a second thought as to what this could be doing to their bodies.
Carrying a backpack can cause painful problems in both the neck and back for those who don't use them properly. A recent survey found that more than 96% of children will carry a backpack to school this year, and 30% of these children will carry their backpack improperly. With the prevalence of low back problems in this country, bad habits formed in early years can be a major contributor to problems later in life.
WHAT CAN YOU DO?
The American Chiropractic Association recommends the following tips:
- Make sure your child's backpack weights no more than 5 - 10% of his or her body weight to prevent bending forward.
- The backpack should never hang more than 4 inches below the waistline to prevent forward leaning when walking.
- Backpacks with individualized compartments can help with distributing the weight most effectively.
- Bigger is NOT better. Buy the best- designed backpack for your child.
- Make sure your child wears both shoulder straps to ensure even weight distribution throughout your child's body.
- Padded straps are important for comfort.
- The shoulder straps should be adjustable to fit to your child's body.
LOW BACK PAIN - CAN YOU PREVENT IT?
Approximately 80 % of the population in the western world will experience low back pain during their lives. Low back pain represents the single greatest expenditure of health care resources in our society today. It results in millions of dollars of lost work every day.
Most low back pain is preventable. It is often caused by lack of exercise, overuse, poor posture and poor work or exercise positioning. Obesity causes low back pain by increasing weight and pressure on the spinal discs in the lumbar region. Smoking also contributes, causing decreased blood flow to the spine and decreased bone density.
HOW DOES ARTHRITIS CONTRIBUTE?
Understanding the anatomy of the spine is necessary to understand the cause of pain. The spine is composed of 24 moveable bones called vertebrae, 5 of which make up the low back region called the lumbar spine. The function of these vertebrae is to bear weight, as well as to provide a protective covering for the spinal cord. Between each pair of vertebrae are cushions called discs, which help absorb compressive forces and contribute to the movement of each joint segment in the spine.
These vertebrae and discs work together to create motion in each spinal segment. Because they do move, the joints can move out of alignment and cause irritation and pain. If these misalignments are not corrected over time, spinal arthritis may develop due to the wear and tear caused by the improper motion of the segments. Chiropractic adjustments remove these misalignments and restore proper function, thereby helping to prevent the process of arthritis from occurring in the spine.
HOW DO DISC INJURIES CONTRIBUTE?
Between each vertebra are shock-absorbing cushions called discs. The spinal cord runs behind the discs and is encased within each vertebra. Between each vertebra is a hole on either side through which the spinal cord branches to communicate with the rest of the body. In the lumbar spine region, these nerves go down the legs, as well as to several organ systems including the reproductive systems, the colon and the bladder.
The outer portion of the disc is formed by a strong material called the annulus fibrosis, which is composed of concentric rings of cartilage. These rings receive nutrients through osmosis, as they have no direct arterial or venous supply. The nucleus pulposis is the center, gelatinous portion of the disc. It can be pushed outward when compressive forces are applied to the spinal column. As the body changes positions, the discs change their shape constantly.
Over a lifetime, the disc can be damaged by acute injuries (car accidents, falls, etc) or chronic problems (poor posture, incorrect body movements, etc.) which cause the outer annulus portion to weaken and eventually tear. When this occurs, the nucleus pulposis begins to bulge out, which may cause pressure on an adjacent nerve. This creates pain either in the direct area of the spine, or along the path of the compressed nerve (i.e.: down the leg or into the groin region).
HOW DO YOU PREVENT LOW BACK PAIN?
The key to low back pain is prevention. Smoking and obesity both are contributors to low back pain. A proper warm-up before exercise, along with a period of time for stretching after exercising will help to prevent injuries. Stretching and strengthening of the core (abdominal, lower back and oblique muscles) is essential to prevention of low back pain.
Always be aware of posture at work, as well as with every day activities in order to avoid injuries over time. Something as small as this can make a huge difference.
Finally, make sure your back is in proper alignment - GET ADJUSTED!! Chiropractic care can prevent arthritis from forming in the spine and prevents low back injuries - both acute and chronic. Make your appointment TODAY!!!
September, 2000
OFFICE HOURS
Monday: 9am - 12noon & 3pm - 6pm
Tuesday: 7:30 am - 12noon & 3pm - 6pm
Wednesday: 9am - 12noon & 3pm - 6pm
Thursday: 8 am - 12noon
Friday: 8 am - 12noon & 3pm - 6pm
Saturday: 8 am - 11am
CHIROPRACTIC AND KIDS
The benefits of chiropractic care for children have become increasingly evident as the number of children receiving chiropractic care continues to rise. Chiropractic research has overwhelmingly shown the benefit of chiropractic care for children. Here are two wonderful success stories.
We have all seen and heard the warnings in the news about the overuse of antibiotics, especially when treating ear infections in children. Approximately 30 percent of children under age three receive antibiotics for acute earache each year. In 1998, a group of eight international researchers from Britain, the Netherlands and the United States reported their review of the scientific literature on the use of antibiotics for the treatment of otitis media. The researchers found that "that existing research offers no compelling evidence that children with acute otitis media routinely given antimicrobials have a shorter duration of symptoms, fewer recurrences, or better long-term outcomes than those who do not receive them."
Emily was brought to our office by her mother when she was eight months old. She had suffered from four ear infections in the prior three months and had four rounds of antibiotic treatment to no avail. Tubes had been suggested as the only other option. She began treatment eight months ago and since that time she has had only one recurrence (four months ago) which was resolved in one week.
Another common childhood problem is nocturnal enuresis or bed-wetting. Many children wet the bed for the first few years of life, but this is usually self-limiting and resolves by age four or five. In the U.S., 2-3 million children are afflicted with this disorder and the cause is unknown (pathology is extremely rare). There is a hereditary correlation.
Tom is an almost six year old boy who was wetting the bed daily. He recently began treatment in our office and was found to have malfunctioning and misaligned vertebrae in the lower back and in the sacral segments as well. He has had nine treatments over a six-week period and only wet the bed once after the first treatment and has not wet the bed since. Tom's mom now has a much lessened laundry load!
CHIROPRACTIC - THE BEST CARE FOR WHIPLASH INJURY
WHAM! You have just been rear-ended. Every 5 seconds, someone is involved in an automobile collision. Initially, you experience minor neck pain and tightness, but your car looks fine. You decide your neck can't be that bad, so you wait a few days to see if the pain will "go away on it's own." The fact of the matter is that it takes a collision speed of 8 - 12 mph to cause damage to a bumper system, but soft tissue injury in the neck starts to occur at 5 mph. Although your car may look intact, your neck may be a different story.
You wake up the next morning with symptoms ranging anywhere from headaches to neck pain, back pain, dizziness, nausea, blurred vision, interscapular pain (pain between your shoulder blades) and related extremity pain with numbness and weakness in your shoulders, arms and hands.
These are all symptoms of whiplash - an injury which occurs when the neck is whipped rapidly in a backward motion as the car lurches ahead, followed by a rapid forward motion as the seatbelt grabs you when the car slows down.
Recent research has found that "the lower part of the neck goes into hyperextension (backwards), while the upper goes into flexion (forward) the bottom and top parts of the neck are going into opposite directions which forms the letter S". (1) "The neck's S-shaped configuration puts great stress on the facet joint capsules and the annulus of the disc. Chiropractors treat facet-joint capsules and treat the disc biomechanically when they do spinal adjusting"(1) The very nature of what chiropractors do with spinal adjustments and soft tissue manipulation is what has been found to be most effective in treating the tissues injured during an auto accident.
A recent study published by the Journal of Orthopaedic medicine found that chiropractic care was the superior treatment for patients with whiplash. "chiropractic treatment benefited 26 of 28 patients suffering from chronic whiplash syndrome the results from this study provide further evidence that chiropractic is an effective treatment for chronic whiplash symptoms."(2)
After a whiplash injury, healing of nerves, ligaments, muscles and tendons occurs with scar tissue formation rather than by regeneration of the damaged tissue. Scar tissue is weaker, less elastic, less pliable and more pain sensitive than healthy tissue. Removal of this scar tissue using ART (Active Release Techniques- see website) is essential to promote prompt healing. "The biomechanics associated with whiplash are very different from almost any other condition. It's one of the worst neck injuries, in terms of poor outcome, and it requires a very specialized approach." (1). The combined approach of chiropractic adjustments, ART, exercise and nutritional support (OPC, glucosamine, minerals) will resolve these injuries.
Anyone who lives in the Washington D.C. metropolitan area knows that to live here is to live with the traffic. Most likely, if you haven't had an accident, you probably have a friend or loved one who has. What was done to treat the injuries? "Today the largest single contributor to chronic neck pain and overall spine pain is motor vehicle crashes."(1) Taking drugs month after month does not promote healing and will increase the likelihood of chronic problems. The longer you wait to treat the injury, the more likely you will be dealing with chronic pain in the months and years to come. Immediate chiropractic care is the way to avoid these chronic problems - Make your appointment today!!
July, 2000
NEW OFFICE HOURS!!
Monday: 9am - 12noon & 3pm - 6pm
Tuesday: 7:30 am - 12noon & 3pm - 6pm
Wednesday: 9am - 12noon & 3pm - 6pm
Thursday: 8 am - 12noon
Friday: 8 am - 12noon & 3pm - 6pm
Saturday: 8 am - 11am
NEW FDA REGULATIONS
Effective May 9, 2000, the Food and Drug Administration (FDA) established new regulations for all medical electrical equipment. The actual law is a safety standard effecting any and all electrical wires connecting patients to medical devices.
The new wires have adapters that connect them to medical devices. This is done to prevent any accidental plugging into electrical outlets, which was occurring mostly during patient home use of the equipment.
This has an effect on our physical therapy patients who receive electrical stimulation treatment. Our office has complied with the law, and we are now using these adapters with all of our patients who receive physical therapy in addition to chiropractic treatment.
It is important to be aware of this - if you need to use a cardiac monitor, an electrocardiograph, an arrhythmia detector, breathing frequency monitors, or ventilators ask your health care professional if he or she is aware of these new regulations for your own protection.
If you have any questions on this, please don't hesitate to contact our office.
AN ANNOUNCEMENT FROM MARY JANE VIRTUE
I will be leaving my massage practice at the end of July. I am moving to Rhode Island to attend Graduate School at Salve Regina in Newport, Rhode Island. I want to thank Dr. Horwitz for the privilege of seeing his patients and allowing me to work with them in conjunction with his chiropractic care. It has been a pleasure to work with each and every one of you and I wish you well in your pursuit of wellness.
The massage practice in Suite 406 will continue to function as usual. David Cockrell CMT will be available to meet your massage needs and he will also assist you seeking out referrals. He can be reached at 301-565-1251.
Mary Starich, Ph.D., CMT will be the new massage therapist in Suite 406. Athletic and Post Rehab Massage are her specialties. Mary can be reached at 301-437-2825.
GET RID OF HEADACHES!!
It's summertime! That means warm-weather, fun-in-the-sun, well-deserved vacations, weddings and graduations. Although the summer is supposed to be relaxing and loaded with fun, these months can be extremely hectic and stressful. This can mean headaches for the people who do not get them and can mean more frequent and more severe headaches for those people who already suffer from them. Do not suffer from headaches any longer! Let chiropractic care get rid of your headache.
Are you one of the millions of people who suffer from headache? You're not alone! Headache has been identified as the fifth most common reason for an astonishing 42 million Americans seek care each year. Did you know that headache is a common problem affecting 16 percent of the population at any given time? Headaches originating from the neck accounts for 2.5% of the general population and 17.8% of headache sufferers (headache greater than 5 days/month)1.
A cervicogenic headache is a condition that originates in the cervical spine (neck). It is also defined as pain perceived as arising in the head, but whose actual source lies in the cervical spine. The most important cause of this headache is improper biomechanics of the skull sitting on the first cervical vertebra.
What are the signs and symptoms of a cervicogenic headache? Well, for those of you who suffer from this type of headache, this is common knowledge. Some of the signs and symptoms are: pain that starts in the back of the head and spreads toward the front of the head; pain associated with neck movement and/or sustained awkward head positioning; and/or by external pressure over the upper cervical region. You may have other signs and symptoms associated with this type of headache such as throbbing, vise-like tension, head pressure, nausea, phonophobia (fear of sound/noise) and photophobia (intolerance to light), dizziness, blurred vision and eye pain. This headache is not hallmarked by the above symptoms, but may be present and somewhat mild.
Headaches in general may be caused by: spinal misalignment, impaired nerve function, limited range of motion, stress, tension, trauma, TMJ problems, missed meals, over-exertion and eye strain.
So now that we have identified the signs/ symptoms and causes of a cervicogenic headache, how can we get rid of it? Chiropractic adjustments can help re-align the spinal joints so they are not limited in their range of motion. Adjustments also help decrease inflammation in and around the muscles and nerves of the cervical spine. Utilizing soft tissue manipulation and Active Release Techniques® (A.R.T.®) to the muscles of the cervical spine helps to break down scar tissue and fascial adhesions, which corrects joint and muscular imbalances. See the May newsletter about A.R.T.® on our website.
Improving joint mobility removes nerve interference and reduces pain and muscle spasm. Restoring function of the cervical spine is one of the most effective and least intrusive ways to end your headache cycle.
Whether you suffer from migraines, tension headaches, cervicogenic headaches or whiplash-related headaches, chiropractic care can help you rid yourself of headaches!
Stop suffering! Begin your life headache free! Call us today to schedule a comprehensive headache work up!
References:
1. Gemmell, HA , et al. Toftness spinal correction in the treatment of Migraine: a case study. Chiropractic Technique, May 1994;6(2):57-60.
2. Bogduk, N. The anatomical basis for cervicogenic headache. JMPT, January, 1992;15(1): 67-70.
May, 2000
DR. STRAHL
In April, Dr. Strahl became a credentialed provider of Active Release Techniques® in upper extremities. We are now the only multi-doctor office certified in ART® in Maryland. She recently has begun to lecture to the beginning women's runners group of the Montgomery County Road Runners Club and will be writing articles for their magazine The Rundown.
FITNESS TIP: WELCOME JILL BARTEK
While we are sad to say goodbye to Neal (he has opened his own personal training service in Kensington, MD and can be reached at 301-933-7900), we welcome Jill Bartek to our office. Jill is certified as a personal fitness instructor by the National Sports Performance Association and is certified as an aerobic kickboxing instructor. She was a gymnast at the University of Maryland and is the proud mother of two boys! Jill will be providing both rehabilitative exercise and personal training instruction. She will be available for rehabilitative exercise instruction on Tuesdays from 9:00am - Noon and Wednesdays from 3:00pm to 6:00pm. Personal training sessions will be by appointment.
STRENGTH TRAINING IS FOR YOU, TOO!
As many of us know all too well, getting older can mean an increase in body aches and pains. Unfortunately, this can be due to decrease in our overall coordination, flexibility, power, and strength. Many of our patients want to know what they can do on their own to prevent injuries and to decrease the chances of chronic problems from "flaring up."
Our advice to you is to start strength training! This will increase your strength and flexibility, which will help to increase your power, endurance and coordination. If you do this as you age, you will find that you will be complaining less and less about aches and pains, and having more energy and drive to really enjoy your "Golden Years."
Most people associate getting old with illness and deterioration. After age 25 we can lose 5-15% of our cardiovascular capacity and 7% of our muscle mass each decade. 40% of women between ages 55 and 64 are unable to lift 10lbs! It does NOT have to be that way! Strength training is no longer just for athletes. As long as proper lifting techniques are practiced and the exercise is done safely, strength training will be a benefit for anyone. Start today!
ACTIVE RELEASE TECHNIQUES®
Active Release Techniques (A.R.T.) is a successful manual hands-on therapy that was invented by Dr. Michael Leahy, a chiropractor who practices in Colorado. A.R.T. corrects muscular and soft tissue problems. Soft tissues include nerves, muscles, ligaments, tendons and the connective tissue that contains or surrounds them.
Several patients present to us with Cumulative Trauma Disorder (CTD), which are problems arising from acute injury, repetitive injury, or constant pressure or tension.
When these problems are left uncorrected, inflammation, adhesions/fibrosis, weak and tense tissues, and decreased circulation all contribute to form Cumulative Trauma Disorder. Some examples of CTD are Carpal tunnel syndrome, rotator cuff syndrome, achilles tendonitis, bursitis, chronic low back pain, whiplash injury and poor posture. Symptoms of CTD can include numbness, tingling, burning and/or aching.
HOW DOES A.R.T. WORK?
A.R.T. is applied with the doctor's hands by using a specific pressure and tension on the muscle or tissue involved while the muscle moves underneath the hand contact. "The affected tissue is trapped while the body part is moved, taking the tissue from its shortened to elongated position. Relative motion between tissues is introduced in order to restore gliding between those tissues" states Leahy.
This method optimizes healing through softening and stretching scar tissue, thus increasing range of motion, increasing strength and improving circulation.
HOW ARE DOCTORS CERTIFIED WITH A.R.T?
Active Release Techniques is a post-graduate course given in seminar form. Doctors attend these seminars usually over a four to five day period where they spend eight hours a day in class. To be certified in A.R.T., the Doctor MUST complete the A.R.T. course and pass the national certification exam. We are the only multiple doctor practice in the Washington D.C. Metropolitan region certified in A.R.T.
ARE YOU A CANDIDATE FOR A.R.T.?
A.R.T is not a cure-all, but can and should be considered for any problem consisting of burning, aching, numbness or tingling. It is a non-invasive, very safe technique with a record of excellent results.
Performance can be greatly improved with A.R.T, whether you are a golfer, a runner, or sit at a computer all day, you will find significant improvements your daily regime.
The major goals of Active Release Technique are to:
- Restore free and unimpeded motion of all soft tissues.
- Release entrapped nerves, vasculature and lymphatics.
- Reestablish optimal tissue, texture and function of soft tissues.
If you have questions regarding A.R.T., please don't hesitate to contact the office. One of our A.R.T. certified doctors would be happy to consult with you today!
March, 2000
MAINTENANCE CARE WORKS
A recent study was performed on chiropractic patients to determine the long-term effect of chiropractic maintenance care on overall health and aging. The study included patients 65 years of age and older who had received maintenance and preventative care for at least five years, with a minimum of 4 visits per year. A total of 73 chiropractors participated in the study and six diverse geographical locations across the United States were used.
It was concluded that the patients investigated made only half of the average number of visits to medical providers (4.76 visits per year) compared with that of the patients who did not get regular chiropractic care (9 visits per year). Chiropractic keeps your body moving better and functioning healthier as you age - so keep up with your care!
ERGONOMICS ADVICE FOR YOUR JOB
It is a fact that musculoskeletal disorders account for 34% of all occupational injuries and illnesses that are serious enough to result in significant time away from work. Over 600,000 employees miss work due to musculoskeletal disorders every year - injuries costing businesses over $15 billion in workers compensation each year. Until May 1st, Dr. Horwitz and Dr. Strahl will come and speak to your company on proper ergonomics in the workplace at no charge. Avoid these costly problems before they can start -Call our office and sign up TODAY!
NEAL'S FITNESS TIP:WALK TALL!
One simple thing that I tell patients in regards to having good posture is to walk, stand and sit as tall as you can. Your low back will thank you for sitting tall. When sitting, your feet should be flat on the floor. Ideally, your seat height should match your leg length so that when seated your legs are at a ninety degree angle. That way your legs bear some of your bodyweight, not just your glutes. Crossing one's legs is not good for your muscles and spine because it shifts more that half of your bodyweight to one side. Remember to not walk with your head down. It is not good for your neck and upper back muscles.
Bad habits are hard to break. One is never going to have perfect posture all the time. However, the more often that one can remember to keep good posture, the better it will be for your body (spine).
When one gets stronger through strength training it will be easier to keep good posture. Exercises and stretches for the low back, mid-back, shoulders and neck are particularly important to helping improve your posture. So feel good about yourself and walk tall!
OSTEOPOROSIS
Osteoporosis is defined as a reduction in the quantity of bone during aging without any change to the bones chemical composition - in other words, our bones are made up of the same materials they always have been made of, we just have less of it.
Women start this process of losing bone mass after the age of 30, while men don't start until after 45 - 50 years of age. This loss of bone mass does not produce symptoms initially, but it does eventually lead to a loss of skeletal strength which makes bones more susceptible to fractures or breaks. Two of the most common sites for osteoporotic fractures are the vertebral bodies (the bones that make up your spine), and the hip which is most commonly fractured from falls in the elderly.
Some of the risk factors of osteoporosis include early menopause, sedentary lifestyle, lack of weight-bearing exercise, cigarette smoking, and poor diet (low calcium intake, low vitamin D intake, increased alcohol consumption, and high protein diet). In postmenopausal women, a decrease in estrogen can play a role in osteoporosis.
IS HORMONE REPLACEMENT THERAPY THE ANSWER?
Today, estrogen and progesterone are two hormones used together in replacement therapy to decrease the loss of calcium in bone in postmenopausal women. However, a recent study by the University of Massachusetts and researchers at the National Cancer Institute has found an increased risk of breast cancer in women who take these hormones to fight osteoporosis.
Initially, estrogen was used on its own as the hormone of choice to prevent fractures in osteoporotic women. However, the estrogen alone was found to be a cause of uterine cancer in women taking it, and is now used only in osteoporotic women who have had hysterectomies. Estrogen used with the hormone progesterone has been the treatment of choice most recently, which now has been shown to increase the risk of breast cancer in women taking the combination therapy for a long period of time.
The newest study performed showed that women taking the hormones within the previous four years were 1.4 times more likely to be at risk for breast cancer than non-users. The point was stressed that the results should not discourage women from short-term usage of the therapy, and that the long-term users are much more at risk. If you are a woman using these hormones together on a long-term basis, ask yourself, "why am I taking these hormones?" Contact your gynecologist if you feel that you may be at risk.
WHAT CAN YOU DO TO PREVENT OSTEOPOROSIS?
Exercise! "Lifelong physical activity is essential in reducing the risk of falls and fractures in older adults resulting from osteoporosis," states a Finnish physician from the British Medical Journal. Weight bearing exercises reduce the risk of osteoporotic fractures from occurring, and the younger you are when you start, the better your chances are of having healthy bones in later years.
Not only will exercise help to make your bones stronger, it will improve your gait, balance, coordination, reaction time, and muscle strength. It is a fact that, especially if started in childhood and adolescence, regular physical activity is the cheapest and safest way to both improve bone strength and reduce the likelihood of falling.
A lifelong commitment to exercise is the surest and safest way to prevent osteoporosis.
- Okie, S. Study: Hormone Therapy's Cancer Risk Understated. The Washington Post. January 26, 2000. A1 & A14.
- Wolfe, S. Preventing Osteoporosis, Falls and Fractures in Older Adults. Worst Pills, Best Pills News.April 1999. Volume 5, #4. P. 30 & 32.
January, 2000
WELCOME KAREN B. STRAHL, D.C.
Dr. Strahl is a native of Rockville, Maryland. She received her Bachelor of Science degree from Lynchburg College in 1993 and her Doctor of Chiropractic degree in 1998 from Logan College of Chiropractic in St. Louis, Missouri.
Dr. Strahl is a Certified Conditioning Specialist (CCS) through the National Strength Professionals Association (NSPA), and has 100 hours of post-graduate studies in Acupuncture. She worked as a personal trainer at the Washington Sports Club and taught aerobics throughout chiropractic school.
She is an avid athlete and has participated in dance, gymnastics, swimming, diving and running.
NEAL'S FITNESS TIP: WEAK POINTS
Weak point training is very simple. Identify which of your muscle groups are not as developed or as strong and spend more time and energy on these muscle groups then you had been doing. That may mean performing more sets for those muscle groups or experimenting with new exercises for those muscle groups. Many of us realize which of our muscles are not as developed or as strong as our other muscles, yet surprisingly many people refuse to modify their routine accordingly. The common example is the person with a large upper body and small legs. An unbalanced physique does not look as good, which combats at least part of the reason most of us strength train to begin with. Also, when the strength of our muscle groups becomes unbalanced, injury is more likely to occur.
CHIROPRACTIC AND COLIC
A recent study performed in Denmark compared the effects of daily doses of the drug dimethicone to chiropractic adjustments for purposes of treating infantile colic. The study included 50 infants who met the criteria for colic and after 2 weeks of treatment, researchers concluded, "spinal manipulation has a positive short-term effect on infantile colic."
Infantile colic is a condition effecting an average of 22.5% of all newborns. The condition causes uncontrollable crying in infants from 0-3 months of age, and usually occurs "more than three hours per day, more than three days a week for three weeks or more ." Colic can last up to the age of 12 months in some babies.
After being screened for colic, the infants were randomly divided into 2 groups over a two-week period. One received the drug dimethicone daily, while the other received spinal manipulation by a local chiropractor. On average, the second group received 3.8 adjustments over the two-week period, and most misalignments occurred in the upper and mid-thoracic region of the spine.
The infants who received the drug decreased from 3.4 hours of colic per day to 2.4 hours per day. Infants who received the chiropractic manipulation treatment started with approximately 3.9 hours of colic per day that was reduced to 1.2 hours per day. This dramatic decrease in the occurrence of colic demonstrates the fact that chiropractic care is effective for more than just back pain, and can be useful in treating systemic, as well as musculoskeletal conditions.
WHAT IS F.A.T.?
Many women who participate in sports strive for thinness in hopes of performing better, or looking better while performing. These women are overly concerned with weight, food, and body shape. Female Athlete Triad (F.A.T.) can be a result of this behavior and consists of the following interrelated health problems, that occur in three stages:
- Excessive exercise and disordered eating habits in women can cause an energy deficit, thus stressing the body and changing the body's hormone levels.
- As a result, the reproductive system can shut down and potentially disrupt the normal cycle of menses. This is called amenorrhea.
- If the hormones are not brought back into balance, the body begins the silent process of destroying bone. This is called osteoporosis.
In addition to overexercising, stage 1 can include any one or combination of the following:
- Food restriction
- Bingeing and purging
- Diet pills or laxatives
- Rigid food patterns
- Preoccupation with food
This can lead to deprivation of needed proteins and calories, which is detrimental not only for energy and performance, but for strong bones and overall health.
Amenorrhea is the second stage that is the absence of three consecutive menstrual cycles in women who have already begun menses. Unless pregnancy is indicated, this is a warning sign that the body's hormones are seriously out of balance. If the hormones aren't brought back to normal levels, premature osteoporosis can result.
Osteoporosis is a disease in which the bones lose calcium and other minerals, thus causing the bones to become brittle. This usually occurs in the elderly and effects women more greatly than men due to the decreased production of the hormone estrogen after menopause. However, during F.A.T., osteoporosis occurs prematurely giving young women a bone density similar to women in their 50's and 60's. Once this occurs in these young women, it may not be possible to replace the lost bone.
HOW TO PREVENT F.A.T
- Establish regular menstrual cycles and proper estrogen levels with your doctor.
- Talk to a dietician about proper chemical balance (i.e. calcium, protein, etc.) and improving energy through good nutrition.
- Practice mental preparation techniques and if you suspect a problem is evolving, talk to a mental health professional who is familiar with eating disorders.
- Don't overtrain or overexercise. If necessary, work with a personal trainer to develop a program that increases muscle mass and strength.
By maintaining these good habits, you can ensure that the bone building process is not disrupted during the critical period from adolescence to the early 30's, and thereby prevent F.A.T. from developing.
- Stur, R. Female Athlete Triad. Metro Sports Magazine. January, 1999; p. 36.
- Wiberg JMM, Nordsteen J, Nilsson N. The Short-term effect of spinal manipulation in the Treatment of infantile colic: A randomized Controlled clinical trial with a blind observer. Journal of Manipulative Physiologic Therapeutics 1999; 22:517 - 522.
November, 1999
WWW.SPORTS-DOC.COM
See our website for updated information on Saturday office hours and upcoming events. Also see our new links page!
NEWSLETTER BY E-MAIL
If you would like to receive the newsletter by e-mail instead of U.S. mail, e-mail us.
ACTIVE RELEASE TECHNIQUES®
See the November, 1999 issue of Men's Health magazine for an article on ART®. Just go to our website's home page and click on ART®.
CPR
I have just completed my CPR Instructor update course at Holy Cross Hospital. I will be teaching a course on Thursday, January 6, 2000 from 1:00p.m. to 5:30p.m. Call Holy Cross 301-754-7160 for more information.
HELP FOR THE FLU
Try an herb called Elderberry. Clinical trials have been done on a product called Sambucol sold by Nature's Way in syrup or lozenge form.
Dr. Andrew Weil's Self Healing newsletter, 11/99.
NEAL'S FITNESS TIP: A Common Question
A common question that I regularly hear from people is, "what exercise can I do to get rid of my stomach?" The answer that I give is, "getting rid of that stomach is combination of four factors: diet, cardiovascular exercise, abdominal exercises and your genetics." In regards to diet, I tell people, as a general rule, eat out less. The majority of the choices on most menus are fatty and salty. If one makes their lunch instead of going out to eat everyday, that alone can make a big difference in one's diet.
As for cardiovascular exercise, choose whatever you like the best or what you dislike the least and do it regularly. Choose an intensity level that is comfortable. Try to vary the type of exercise to combat boredom.
In regards to abdominal exercises, do not use momentum and rock back and fourth. Go slowly when you raise your torso and when you lower your torso. Keep your hands in front of you instead of pulling on your neck, which is what most people do. Pulling on your neck is bad for your cervical spine and allows you to cheat by using your arm and shoulder muscles in addition to your abdominal muscles.
As for genetics, blame your parents! Ignore the abs on the men and women in many magazines and in the exercise infomercials. Their genetics are not that of the average person and their images give false hopes to many. Don't get me wrong, we all are capable of making significant changes in our bodies through hard work, but only a small percentage of people have the genetics to have the "perfect" abs.
Here is something to inspire people to get in shape. I participated in two local 5K (3.1 mile) races in October. In one race a man in his sixties finished the course in under 22 minutes and in the other race a man in his fifties finished in just over 18 minutes. These two people have gotten in great shape and they are a great example of what you can do if you work hard. We all can get into shape and feel better. Individual appointments for personal training can be scheduled with Neal Breen at 301-681-9010.
MESSAGE FOR A NEW MILLENNIUM
As the millennium comes to an end and managed care organizations manage to care more about money than their insured, your best insurance will be how well you take care of yourself or what we like to call the chiropractic lifestyle.
1. Regular Chiropractic Adjustments: It is a widely believed notion that 90% of episodes of low back pain seen in general practice resolve within one month. In a large recent study, while 90% of subjects who consulted a general practice physician with low back pain ceased to consult about the symptoms within three months, most still had substantial low back pain and related disability. Only 25% of the patients who consulted about low back pain had fully recovered 12 months later. The study concluded that since most of these patients continued to have long-term low back pain and disability, effective early treatment could reduce the burden of these symptoms and their social, economic, and medical impact. So, why not take care of yourself on a regular basis and avoid the problems in the first place? How many of you who do receive regular monthly adjustments say you are fine until I place my elbow in one of those "trigger points?" You change the oil in your car every 3000 miles and get your teeth cleaned several times per year to prevent gum disease - you can replace your car and your teeth, you CANNOT replace your spine! . Don't just "Nupe it!" like Jimmy Connors!
2. Do not diet, eat healthfully every day: Many of you wonder why it takes a long time to truly heal. Think about what you eat. Food provides you with the fuel and nutrients that make you run. Eat fruit, vegetables, whole grains, beans, fish and poultry and occasional red meat. Fruit and vegetables Should be organic - try juicing organic and non-organic and you will quickly taste the difference! Eating right means no sugar, pasta, and bread (white flour). Repeat after me, "bagels are bad!" Eat five balanced meals each day and learn what the glycemic index means. For women - eat protein and understand that there is more to being a vegetarian than a lettuce salad! Do a seven-day diet analysis with the following columns: time, food, grams of carbohydrates, grams of fat, grams of protein and total calories. Total each of the last four columns at the end of the day. You won't need me to tell you what was bad, just look at your analysis and look in the mirror and be honest with yourself. A Bulgarian strength coach summed it up when he said, "You Americans have the best food available to you, yet you eat the worst!" Don't just take Pepcid AC and eat what you want!
3. Posture and Ergonomics: STAND AND SITUP STRAIGHT ALL THE TIME! Observe your work place and pay attention to all your body movements. Get a headset for your phone! Buy good shoes; yes, I'm looking!
4. Exercise: No excuses, just make it part of your day! Two minutes here and there is much better than nothing at all. Walk in place while reading this newsletter and then do 5 good crunches! Do it!
5. Find a way to reduce stress: Try learning to meditate, perform Tai Chi, Yoga or Qigong. Do this simple breathing exercise daily - sit comfortably in a chair or on the floor, close your eyes and breath in through your nose for five seconds, hold your breath for one second and breath out through your mouth for five seconds. Perform five breaths first thing every morning and before bedtime at night. Give a hug and smile daily!
Fact: if your take more than 5 drugs, there is a 100% chance of a drug interaction. Preventative medicine? Prevent taking medicine by maintaining a healthy lifestyle!
September, 1999
GOLF'S X-FACTOR = INJURY
In golf the term "x-factor" is used to describe the difference in hip and shoulder position at the top of the back swing. Many instructors advocate that the pelvis should be as stationary as possible while the spine is maximally rotated. It is believed that this maximum rotation allows for a sling shot effect during the downswing thereby increasing power generation and driving distance. For a professional golfer this position is necessary. However, for the recreational golfer this position is dangerous and will lead to injury over time.
Adopting a shorter backswing will enhance control of the club head throughout the swing and reduce spinal rotation and torsional (twisting) stress in the lumbar spine (discs do NOT like violent twisting motions). Research has shown that short backswings achieved the same clubhead speed at ball impact as long backswings. To protect your back, perform stretching and strengthening exercises for the lower extremities and strengthening exercises for the midsection (abdominals, obliques and lower back). Warm-up before you play! See our web site for more articles on golf injuries.
ANTIBIOTICS = CHILDHOOD ASTHMA?
A new study published in the Journal of Clinical and Experimental Allergy (1999,29:766-771) found that a child given antibiotics during the first year of life is over four times more likely to develop asthma symptoms than the child who has never taken antibiotics. One of the authors stated that this study and one published last year "raises the possibility that broad-spectrum antibiotics, particularly in the first year of life, may be assiciated with an increased risk of atopy [hypersensitivity] and asthma. For reasons that have been pointed out in both papers, these results cannot be taken as definitive, but rater as hypothesis raising."
"On the other hand, the results are plausible. Broad spectrum antibiotics came into clinical usage in the 1960's, and their increased use coincides with the time trends for the increasing prevalence of asthma. There is a plausible mechanism, namely that broad-spectrum antibiotics may alter and reduce bowel flora and thus switch off the immunological signals that these gut bacteria send to the developing immune system." Think about this the next time you rush your child to the pediatrician for antibiotics.
NEAL'S FITNESS TIP
Make sure that when you stretch, you do not apply so much tension that it hurts. If you do, your body will initiate a mechanism called the stretch reflex. Anytime muscle fibers are stretched too far by either bouncing or applying too much tension a nerve reflex called the muscle spindle will respond by sending a signal to your muscles to contract. This response is your body's attempt to prevent muscle injury. In other words, if you stretch too far (to the point of pain) your muscles will actually tighten. In addition, overstretching can cause microscopic tearing of muscle fibers that can lead to the formation of scar tissue in your muscles and gradual loss of elasticity. Individual appointments for personal training can be made with Neal Breen at 301-681-9010.
Cervical Adjustments
In recent years there has been much media hype about avoiding manipulation of the cervical spine (neck) because of the risk of stroke. Two new studies of major clinical and legal importance challenge all this hype. In the prestigious journal Spine, a literature review (an exhaustive look at all the published studies on the topic of neck movements and vertebrobasilar artery dissection, i.e., a form of stroke) concluded that "examination of the data fails to show a consistent position or movement of the neck that could be considered particularly dangerous." In other words, no neck position or movement and no form of cervical manipulation has been shown to increase the risk of stroke.
New evidence raises the possibility that certain people simply have "either an inherited or acquired disorder of unknown origin that increases the fragility of the vertebral arteries to trauma." The facts are that strokes "can be associated with mundane common activities of daily living [sneezing, coughing, wall papering, kneeling at prayer, washing walls and ceilings, looking up, sexual intercourse, backing out of the driveway, or a minor fall].
With respect to stroke following manipulation, the potential risk is "reported to be somewhere between 1 in 1.3 million treatment sessions to 1 in 400,000." To put this in perspective, the risk of paralysis from neurosurgery on the cervical spine is 15,000 cases per million. 200,000 to 300,000 people die each year from reactions to medication and unnecessary surgery. 1600 children die per year from allergic reactions to aspirin and over 5000 people die each year from taking non-steroidal anti-inflammatory medications (Motrin, Nuprin, Advil, Aleve,etc.) due to gastrointestinal bleeding.
The second study reviewed the need for pre-manipulative testing before cervical adjustments. The most commonly done test (which we do in our office and the one I was taught in school) is to have the patient tilt the head back and turn to either side. Any dizziness, visual changes, nausea or tinnitus (ringing in the ears) may be considered a positive test. The study found that this type of testing has no effect on blood flow in the vertebral arteries, even with patients where the test is positive. Therefore, even when the test is positive, patients can be safely adjusted with good clinical results and no complications. Dizziness or vertigo may have nothing to do with insufficient blood flow and may have neuromusculoskeletal causes, i.e., from the neck. Patients with this condition respond excellently to cervical manipulation.
To conclude, as long as a proper history is taken and examination performed and the manipulation is performed by a licensed chiropractor, cervical spine adjusting is an extremely safe and effective treatment. Chiropractic works!
Haldeman, S, Kohlbeck FJ, McGregor, M (1999) Risk Factors and Precipitating Neck Movements Causing Vertebrobasilar Artery Dissection After Cervical Trauma and Spinal Manipulation, Spine 24(8);785-794.
Licht P, Christensen HW, Hoilund-Carlsen PF (1999) Is There A Role for Premanipulative Testing Before Cervical Manipulation? Abstract, Symposium Proceedings, 5th Biennial Congress, World Federation of Chiropractic, Toronto, 173-175.
July, 1999
NEW OFFICE HOURS
We have added early morning office hours on Thursdays and Fridays, and added one hour on Tuesdays.
Monday 9am - 12pm and 3pm - 6pm
Tuesday 7:30am -12:00am
Wednesday 9am - 12pm and 3pm - 6pm
Thursday 8am - 12pm
Friday 8am - 12pm
Saturday 8am - 11am
NUTRITION LECTURE
I am very excited to announce the lecture Guidelines for Healthy Eating into the Next Millenium: A Practical Look at Today's Choices will be given by Dr. Mary Enig as part of her Saturday Morning Series on July 31st and August 21st, 1999 at 10:00am at Enig Associates, 12501 Prosperity Dr., Suite 340, Silver Spring. Dr. Enig is a nutritionist and biochemist of international renown. Call her office at 301-680-8600 to register. There is a registration fee of $25. Do not miss this opportunity to learn the truth about carbohydrates, fats, proteins and supplements!
2-DAY FOOTBALL CAMP
On July 24th and 25th, our patient and former NFL player Terry White will be leading an instructional camp for kids (ages 6-14), coaches and parents. Randell Jones, University of Maryland quarterback, High Point Coach Castro and a NFL guest will speak and show drills. I will be speaking about injury prevention, stretching and nutrition on Sunday, July 25th from 2:00pm - 3:30pm. Phone 301-937-3966 [then press 5] for more information.
ACTIVE RELEASE TECHNIQUES®
I have completed the second part of the course and am now certified as an intern practitioner in upper extremities and spine. The lower extremity course will be given early next year and I will be there. This is the technique that Donavon Bailey (Olympic 100m Gold Medallist) says helped him to recover from multiple musculoskeletal injuries.
NEAL'S FITNESS TIP: COOL DOWN!
Utilize a proper cool-down after your cardiovascular workout. For example, after a run or jog, just walk for a few minutes. This will prevent your heart rate from dropping too suddenly. One general rule is to continue your cool-down until your heart rate is no more than 90 beats per minute. If your aerobic workout is stopped suddenly, your blood pressure can suddenly drop and that can cause fainting. Not cooling down often explains why a person may feel nauseated, dizzy or particularly fatigued after an aerobic workout. A cool-down also facilitates the removal of waste products in the body and will shorten your recovery time. Cooling down is easy and you will feel better after your workout. Individual appointments for personal training can be made with Neal Breen at 301-681-9010.
MASSAGE: Mary Jane Virtue 301-593-7538
WEIGHTLIFTING INJURIES
As you know, weightlifting is an activity that is near and dear to my heart. Unfortunately, going to the gym causes too many injuries. This is an activity that is supposed to prevent you from coming here, not cause it!!! On July 24th I will be speaking to the members of the North Carolina Chiropractic Association on this particular topic.
Most injuries are caused by poor posture, improper form, overuse, infrequent training, and improper foot wear. Proper standing and sitting posture is essential to prevent injuries. Stand or sit up straight before you start the exercise movement. Do not turn your head from side to side while performing any movement.
Whenever I workout I cringe at the terrible form people use. The most common problems are:
- Behind the neck pull-downs and behind the neck shoulder presses. Do NOT do these exercises as they do damage to both the neck and the shoulders. The pull downs (pull the bar to your collarbone) and shoulder presses should be done to the front,
- Wrist position and hand placement on bar during pressing movements. Keep your wrist straight - do not let them bend backwards as you press up the bar as this causes wrist, elbow, and shoulder problems,
- While performing a side or lateral raise with dumbbells, keep your wrists straight. This goes for all exercises that require gripping of a bar or dumbbell. "Tennis elbow" will occur if you let your wrists drop,
- Poor body mechanics while lifting the weights off the floor or out of a rack - pay attention to what you are doing,
- Knee position while squatting or performing leg presses. Keep your knees over your toes; do not let your knees wiggle inward (together) while coming up from the bottom of the squat or pushing the weight up while doing a leg press,
- Unequal loading of the bar - make sure the same amount of weight is on each side of the bar and the weights are locked in with a collar. When using dumbbells, grab two of the same weight (this may seem silly, but I see it all the time),
- Lifting without a spotter - always have a spotter when using free weights!
Training too frequently or irregularly can be problematic. For those fitness fanatics, each body part should be trained once every three days at most. On the flip side, training once per week will maintain strength for about 10-12 weeks and then a significant drop off will occur. Weight training should be done at least twice per week.
Finally, no flip-flops, dock siders, running shoes or bare feet (more than a few have dropped weights on their feet) in the gym. A good pair of cross trainers or walking shoes is necessary.
Another reason for those "I didn't do anything" injuries is months or years of imbalanced training. I have had many patients who have weight trained for years, that are still making the same mistakes. For instance, many men focus on chest and bicep exercises and leave out back and triceps exercises. Many women perform lower body exercises and do little upper body exercises. A frequent omission is lower back exercises. Performing only abdominal exercises is not enough to protect the lower back. If you have any questions about your workouts, please ASK!!!!!!
May, 1999
SPORTS-DOC. COM
Within the next six to eight weeks, our new web site: www. Sports-doc.com should be up and running. On it will be over 5O articles on different injury and health topics. Stay tuned to more in the next newsletter.
ACTIVE RELEASE TECHNIQUE®
"Active Release Technique® is a new and highly successful hands-on approach to injuries of muscles, tendons, fascia, nerves and the surrounding soft tissues." "It is similar to some massage techniques, only it's more aggressive. 'The art of it all is being able to know where to look for adhesions, how to feel for them and how to usc active motion of the body part to break them up,' says inventor Mike Leahy, D.C." The technique is extremely effective on injuries like muscle strains, rotator cuff tendonitis, tennis elbow, achilles tendonitis and carpal tunnel syndrome.
The technique is taught in three sections: upper extremities, spine and lower extremities. I have just completed the upper extremity class and will be taking the spine class in June, 1999. This treatment is rapidly becoming popular with the world's best athletes.
NEAL'S FITNESS TIP: Work all of your muscles!
Remember to incorporate exercises for all major muscle groups as part of your strength training routine. Many people leave out exercises for some of the muscle groups. Be sure to include exercises for your: shoulders, chest, back, abs, biceps, triceps, trapezius, low back, hamstrings, quadriceps, and calves. Common mistakes include: not performing leg exercises, doing biceps exercises and no triceps exercises and doing too many sets of chest exercises. One way to find out exercises for each muscle group is to purchase a bodybuilding/strength training book. An even better way is to meet with a personal trainer who can go through a routine that works all of your muscles. That trainer will be able to give you multiple exercises for each muscle group to ensure progression of your strength though variety and to eliminate the boredom that occurs from doing the same exercises every time you work out. Individual appointments for personal training can be made with Neal Breen at 301-681-9010.
MASSAGE: Mary Jane Virtue 301-593-7538
SPRINGTIME ALLERGIES:ALTERNATIVES TO MEDICATIONS
The Washington area can be a nightmare for allergy sufferers. Airborne pollens of different plants and trees can trigger spring and summer allergies. These pollens cause theimmune system to react by releasing a substance called histamines, which cause typical symptoms like an itching throat, eyes, nose and ears; sneezing; and a runny nose.
An estimated 33 million American suffer from sinus disease every year. To self-medicate, they spend $1.5 billion a year on over-the-counter drugs. Medical treatments for allergies are unsatisfactory. Most people use anti-histamines which can be toxic and can cause side effects like drowsiness, dizziness, dry throat and mouth and interact unfavorably with other medications like antibiotics and antifungals (the newest antihistamines have fewer side-effects). The shots often given are expensive, time-consuming and, by and large, ineffective.
Oral corticosteroids are very dangerous and should only be used in extreme cases. The long-term effects of nasal spray steroids are still unknown. There are natural alternatives, which work well. Stinging nettle (urtica dioica) is a non-toxic herb which gets its name from the presence of stinging hairs on the leaves and stems, which when touched, inject formic acid and histamine into the skin and cause urticaria, an irritation and inflammation of the skin. Stinging nettles contain many biochemicals, which endow it with anti-inflammatory properties. It is supplied in capsules of extract of the leaves.
Another effective treatment is the use of the bioflavinoid called quercetin. This is obtained from foods like citrus fruits and buckwheat. A dose of 400mg twice per day until the season ends is effective. Pregnant women should not take this supplement. Also, take your typical anti-oxidants vitamin C (2000-6000mg per day), beta-carotene (5000 I.U. per day) and vitamin E (400 I.U. per day). Avoid milk products.
Another natural alternative is nasal irrigation - simply rinsing the nasal passages with a warm salt-water solution. Nasal inigation is recommended for the treatment of ear infections, post-nasal drip, and nasal pharyngitis. Here's how to perform the irrigation. First you need a nasal cup which can be purchased through Essential Products Alliance, Inc. at 800-817-8740. Fill the cup with warm water and mix in one-quarter teaspoon of salt. Tilt your head to the side and pour the water into the upper nostril. It will come out the lower nostril. Then, switch sides. Everyone should really do this daily to remove the dust, pollen and pollutants we breathe regularly (References available)
CYCLING HINTS: AVOID INJURIES!
Buttock Pain: Use a gel pad over the seat and stand up periodically. Wear shorts specifically made for cycling to prevent chafing.
Low Back Pain: Stretch before and after you ride. Sit up and lean back every so often while you ride. Make sure your stem height is correct- a low stem causes you to lean too far forward stressing the low back - raise the stem to within a few inches of saddle height.
Knee Pain: Make sure your saddle height is proper, it should be set so that your knee is bent at a 10- 15 degree angle at the bottom of a pedal stroke when you pedal normally with the ball of the foot on the pedal. Check your cleat position- your toes should point slightly inward. Pedal at a high rate in low gears. Don't overdo hill training Strengthen your thigh and leg muscles- quadriceps, hamstrings, adductors, and calves. Don't wear shorts in cold weather (below 60 degrees F). Keep those knees warm by wearing tights and wind repellant pants.
Groin Pain: Stand up periodically. Check the seat height, as it may be too high. Tilt the seat slightly downward.
Neck and Shoulder Pain: Check your stem- a short stem may cause you to ride too hunched up. Alternately tilt your head from side to side while riding to prevent stiffening. Ride relaxed. Keep your elbows relaxed and don't hunch your shoulders. Strengthen your neck muscles. Hand Pain: Change your hand position often while riding and get a pair of good gloves.
Foot and Ankle Pain: Beware of tight shoes-loosen laces at first sign of discomfort. Keep straps loose until you need extra help.
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