Sitting Is The New Smoking: Inactivity & Poor Posture Cause Health Problems

Tech neck: Sitting is the new smoking
Increased use of electronic devices can lead to poor posture and sedentary lifestyle negatively impacting your health. Tech neck is a real killer.
Sitting Is The New Smoking…

Sitting can have far reaching implications into aspects of your health that may surprise you including: cardiovascular & respiratory health, gastrointestinal health, fall injury risk, increased risk of cancer, psychological health, and as broad as “all-cause mortality”. Think that is a bit of an exaggeration? Keep reading!

Sitting is a sedentary activity. In other words, you’re not moving. It’s probably not surprising to hear that inactivity is bad. However, you may not know just how bad it can really be. A study in 2015 published in Annals of Internal Medicine (Sedentary time and it’s association with risk for disease incidence, mortality, and hospitalization in adults) found that with 6-12 hours/day of sitting there was a more than 91% increase in type II diabetes with overall mortality increase of up to 24%. Heart disease mortality went up 18%. Cancer mortality went up 17% and chances of developing cancer up 13%.

Sitting is bad for your posture, which is a broader part of health and wellness than you might have considered. This is actually a very old concept. Charles Darwin (1872) said it very well…“proud and successful human beings are likely to display an upright and erect bearing”. Similarly, Dr. Steven Weineger said, “Posture is a mark of character and strength: both structurally and personally”. Just take a second to think about how healthy/happy a person appears when they have an erect posture versus the forward leaning posture and rounded back that we associate with old age. Sitting at a work station with poor ergonomics is even worse. A 2014 study published in Arthritis and Care Research found an 8x increased risk of low back pain in people working in an awkward or asymmetric position. This is echoed by the finding that 3/4 of dentists have neck pain (Journal of Clinical Diagn Res 2013 Oct.7(10) 2261-4). Another study found that reducing forward head position by neck retraction exercises improved neck tension demonstrating posture’s roll in developing neck pain (Spine 1995 Jun 1;20(11):1245-50).

Posture is an acquired habit. We are what we do all day, and if that is sitting and working, our heads and bodies begin to follow the direction of our eyes towards the screen resulting in a forward leaning position. It is a pattern that sticks with you even when you stand up and begin a different activity. Pretty soon, you could notice that you are positioning that same way even when you are standing, walking, or exercising. Our brains love patterns and will return to a pattern automatically if we repeat it frequently. This is actually how we learn to crawl, walk, ride a bike, or swing a golf club. It’s what you might call “motor memory”.

These patterns can work for us: like being able to perform tasks or play sports. They can also work against us causing body distortions that lead to imbalance and undue stress on our bodies. Envision the body as being made of regions of blocks. There is a block for your head/neck, torso, pelvis, and legs. If those blocks aren’t stacked and balanced on top of each other, then the body has to work harder to keep it upright against gravity. A simple demonstration can prove the point. Hold a broomstick upright in your hand. If the broom is balanced straight, then it is easier to hold. As you begin to tilt the broomstick at an angle, you can feel the muscles in your wrist/forearm having to work harder to keep it from falling over towards the ground.

Take the forward head position for example. As you move your head forward of your shoulders, it makes the muscles in the back of the neck and shoulder blades work harder to keep the head level. Even after a few minutes, those neck muscles become tense and fatigued. Over longer periods it causes a considerable amount of stress. You may notice achy pain in the neck and upper back. You may notice knots developing. If left unchecked, damage to the joints could lead to arthritis, or pinching of nerves.

The neck & upper back isn’t the only place we can develop problems from sitting. It can also happen in your mid & low back or even your hips. Sitting in a flexed forward position rounds the back and causes tight hip flexors. It’s another pattern that tends to stick. We’ve all seen that person at the grocery store who is stooped forward, takes short steps, moves slow, and just seems like they are in pain. That is essentially the result of a longstanding postural distortion and it’s effects on that person’s body. When the body is not well balanced, the muscles of the body have to work harder. Tight hip flexors and rounded back can prevent you from standing up straight and pitch the torso forward (remember the broomstick). That will cause the low back muscles to be strained, the discs to be under greater pressure, and increase the impact on joints. This leads to damage and early degenerative changes just like the neck situation above.

Sitting is linked to muscle weakness, postural changes and pain. An interesting study found a link between low back pain and errors in postural control due to impaired processing of sensory information (Exp Brain Res 2017 Mar 177(3), 411-418). A June 2014 Study published in the Manual Therapy Journal found that patients with low back pain did not activate their core during sitting and standing. Your posture affects how you move and your ability to balance, and this in turn makes you vulnerable to injury. A 1977 study published in the Journal of American Geriatrics Society found that adults who where not able to balance on one leg for more than 5 seconds were 2.1x more likely to suffer an injury from falling in the next year.  

Maybe the most surprising effects of poor posture is it’s association with increased risk of death. A 2004 study published in the Journal of American Geriatrics found that females 65 and older with forward head carriage had a 1.44x increased risk of dying in the next 4 years. The study defined the forward head position by patients who could not lay flat on their backs and touch their head to the table. A publication from S. Goya Wannamethee out of UCL Med School in London reports on effects of posture…”Resulting height loss can affect the normal functioning of the respiratory and GI systems, which in turn may lead to early satiety, poor nutritional status, and weight loss. Height Loss (from postural distortion) of more than 3cm in older men is linked to risk for all-cause mortality and heart disease (Arch Intern Med. 2006;166(22):2546-2552).

So, at this point, I’m sure you’re wondering what can be done to avoid sitting. Here are some tips.

  1. Microbreaking: For every minute of sitting, take one second to stand up and move around. For example, sit for 30 minutes, then get up and stretch/move for 30 seconds. You can also do 1hr/60min increments. Set your watch or phone to chime if you need. You can do neck retraction exercises, spinal extension exercises, hip flexor stretches, and other things to break up that postural habit developed during sitting.
  2. Standing Desks: This has really been taking off in popularity as of late. Though, standing static might produce problems also. That’s why the treadmill desk has been invented. An easier thing to do is simply to switch between seated and standing work with an adjustable desk. This can be an expensive investment and impractical for some jobs.
  3. Yoga Ball: This is one of my favorites. It is cheap, it is effective. It allows you to be mobile and shift positions, and best of all… you can use it to do rehab when microbreaking as described above.
  4. Ergonomics: Improving the ergonomics of your work station can do wonders for your posture. Monitor height, keyboard height, seat height, and distance from the station to your body are all important factors to balance out. The monitor should be placed at a height level to the eyes or just slightly above. Your keyboard/mouse should be reached with a comfortable bend of the arm. An arm pad can be added to take stress off the wrists. Seat height should be accommodated to be able to place the feet on the ground while maintaining eye level monitor height. Distance from your body should be set to allow easy reach to your keyboard and mouse.
  5. Get adjusted. Getting your spine aligned and moving properly again is one of the best ways to combat bad postural habits. Most patients can tell a difference immediately. It’s also a great opportunity to ask your Chiropractor about exercises and ergonomics.

For more advice or to begin the process of correcting postural distortions, please contact our clinic at (918) 600-2969. Alternatively, you can set up a free consult at We’re here to help!

Foods That Reduce Pain and Inflammation

The DeFlame Diet from Dr. Seaman

Having been a practicing Chiropractor for over a decade now, I’ve run into many difficult cases where there seems to be something underlying the patient’s pain that goes beyond simple biomechanical explanation. Some patients would present with pain in multiple areas of the body. While the usual means of targeted manipulation, soft tissue therapies, and rehab improved their conditions, pain would seem to return or spring up in new places. Some of them had legitimate auto-immune diagnoses such as rheumatoid arthritis, but many others appeared to have an underlying systemic inflammation that was not diagnosed. Inflammatory markers might be found in the blood (ESR, CRP, etc.), but no specific disease was found. Thus began my journey into exploring causes of generalized inflammation. It turns out, what we eat has everything to do with inflammation and pain.

Back in the 1980’s, scientists knew little about the connection between our food choices and inflammation. The proposal that diet could be connected to inflammation was just a theory. Fast forward 30 years and the connection is no longer questioned: It is accepted as absolute fact. The foods that we eat have a profound effect on the inflammatory states of our bodies. The effect is not just about specific illnesses; our dietary choices are associated with just about every disease process you could think of as well as having a direct connection to our pain. A major part of this forefront of science was pioneered by a famous Chiropractor and scientist by the name of David R. Seaman. He came up with an eating regimen he called “The Deflame Diet” which is also the title of a popular book he wrote (I highly recommend this book for healthcare professionals and laypeople alike). Pretty soon, his terms pro-inflammatory and anti-inflammatory foods, were used throughout the healthcare field to describe the types of nutrition that increased inflammation and reduced inflammation, respectively. Today, he is considered one of the foremost experts in diet and nutrition.

Dr. Seaman points out that a major source of pro-inflammatory foods comes in the form of refined omega-6 oils (corn oil, sunflower seed oil, safflower seed oil, cottonseed oil, peanut oil, and soybean oil). They are typically called “vegetable oils”, but that is a misnomer: they are legume/bean/seed oils. Additionally, omega-6 fatty acids are often converted into trans fats which are oils used in deep fryers. Omega-6 fats are not bad by themselves. Your body actually needs Omega-6’s to function normally. It is more the ratio between omega-6/3 that is important. Today’s diet weighs heavy in Omega-6 without enough Omega-3.

These oils have a profound effect on our body’s chemistry. The two different types of fatty acids (omega-6 & omega-3) are processed by the same set of enzymes in our bodies, but with two very different outcomes. Omega-6 oils produce chemical signals that cause inflammation while omega-3 oils produce chemical signals that reduce or suppress inflammation. The products of this cascade of reactions influence the bodies tendency to inflame or deflame. Take a quick peek at the diagram below to get the idea (condensed version of the chemistry).

These pro-inflammatory oils, refined sugars, and flours make up about 60% of the caloric intake of the average American diet and have no nutritional value. The foods made with these ingredients are addictive as well hence Dr. Seaman calls them “Dietary Crack”. He points out the irony that we are addicted to the foods that injure our bodies causing chronic inflammation, pain and disease. On top of this, we are also consuming meats and proteins from grain fed (pro-inflammatory) animals living in feedlots, not to mention the hormones, antibiotics, and other chemicals designed increase productivity. Even the fish we consume are often from a farm-raised feedlot environment. Farm-raised catfish and tilapia are known to have an omega-6 fatty acid profile unlike wild caught fish.

Most people hate the notion of a diet. They envision eating sprouts and cutting out all of their favorite foods. This is why diets often don’t work. We feel like we are having to restrict and starve ourselves. Instead of thinking in terms of limitations, think in terms of simply making different selections. In this way, DeFlame isn’t a diet, but a lifestyle choice. By choosing foods that are anti-inflammatory, not only will you have the health benefits, you will feel satisfied and full. For example, instead of using vegetable oil to cook, use avocado or olive oil or even coconut oil. Eating more plants is also a great idea. Many people find that they love vegetables and fruits when prepared in a way they enjoy. Using the right spices not only improves flavor, but the spices themselves are anti-inflammatory (ginger, tumeric, oregano, etc).

You may be surprised to hear that foods like butter, cream, and even bacon can be anti-inflammatory as long as they are not overconsumed and from the right source. So animal products are NOT off the list. In fact, Dr. Seaman points out that the Inuit and Masai people live almost entirely off of animal products that are high in fat and yet live free of diet-induced diseases indicating that animal products like meat, milk, and cheese are not pro-inflammatory in and of themselves. It may be a little more expensive, but meats, dairy products, and eggs that come from grass-fed, free-range, organic animals are a much better alternative than their feedlot counterparts. If these products are not affordable, either eat less of them or substitute with other anti-inflammatory foods.

Another surprise may be that certain alcohols consumed in moderation can have an anti-inflammatory effect such as red wine and stout beer. The most important part of the “De-flame” diet is to cut out the refined sugar, flour, and oil products (the dietary crack). The best part of this diet is that you don’t have to pay somebody for meals or shakes. You just have to take some time to make better decisions about the types of foods that you eat.

Dr. Seaman’s list of pro-inflammatory foods to avoid:

  • Refined Sugars
  • Refined Grains
  • Grain Flour Products
  • Trans Fats
  • Refined Omega-6 seed oils
  • Farm-raised/Feed Lot Animal Products

Dr. Seaman’s list of anti-inflammatory foods to consume:

  • Grass-fed meat and wild game
  • Wild caught fish
  • Shellfish
  • Free-Range Chicken
  • Omega-3 eggs
  • Cheese
  • Vegetables
  • Salads
  • Fruit
  • Tubers/roots (potato, yams, sweet potato)
  • Nuts
  • Omega-3 seeds (hemp, chia, flax)
  • Dark Chocolate
  • Spices (all types)
  • Olive/Coconut oil
  • Butter/cream
  • Avocado
  • Bacon
  • Red Wine/Stout Beer (in moderation)
  • Coffee and Tea

Happy eating. For more information, check out Dr. Seaman’s Book: The Deflame Diet.

Balance Posture and Muscle Control in Low Back Pain

Balance in Low Back Pain
Studies show postural balance is important in low back pain


Low back pain (LBP) has always been a bit of a mystery for medical researchers. Why does it develop in certain people, What are the contributing factors, and What can be done about it? Even scoliosis, a condition discovered by Hippocrates over 2000 years ago, is considered to be idiopathic (unknown cause) in most cases. Even giving a specific diagnosis for low back pain can be challenging. Consider that many times, not just one, but several irregularities show up on imaging: arthritis, stenosis, disc herniations, etc, so nobody knows which finding is responsible for the pain. There are also many instances where there is significant pain, but there are no abnormal findings on X-ray or MRI. There is also the opposite: A patient has no symptoms, but the images show many abnormalities including significant disc herniations and degenerated joints. It is also common to have findings on one side of the spine (like a herniated disc pressing on a nerve), but the patient has pain on the other side of their body. The clinical picture is not clear because symptoms are not reliably associated with findings on imaging or other physical findings.

However, that may be changing. Research in the past few decades seems to be indicating a clear pattern in patients with low back pain. There is a strong correlation with pain/symptoms and dysfunction in muscle control that affect balance and posture. In other words, it looks like the clear answer to “Why does this person have back pain?” is that their muscles are not able to correctly stabilize their spines. This lack of balanced support causes uncontrolled movement that damages the spine as it attempts to remain vertical against gravity.

Researchers back in the 1990s found that LBP is caused by spinal instability that results in injury to embedded mechano-receptors. In individuals with LBP, there is disturbed motor control patterns and changed physiologic properties. Panjabi theorized that spinal stability relies on 3 interconnected systems:  1. Passive Articular 2. Active Muscular 3. Neural Control. Bergman divided muscular system into local for fine movements and global that ties it all in.

Vikari-Juntura published their findings in Spine in 2000. They discovered that patients who had lack of balance and/or symmetry on a one-leg standing test tend to have more back problems.

Rupal Metha and Sheri P Silfies of Drexel University Research in 2006 found that Chronic LBP patients move differently. They sequence and time muscle activation patterns differently. An experiment with EMG on core muscles showed that chronic LBP patients had delayed recruitment, and less symmetry in recruitment.

A meta study published in Spine in 2013 showed that specific motor control exercises targeting symmetry in balance and posture was more effective than traditional Physical Therapy and Spinal Manipulation.

Arthritis & Care Research 2014, D Steffens, et al found an 8x increased risk for LBP for people working in “asymmetric and biomechanically awkward labor”.

Silva et. al in a 2018 publication in the Journal of Disability & Rehabilitation found that people with chronic LBP have poor balance control.

Hlaing et al in 2020 in the Journal of Pain Research found patients with low back pain (LBP) have poorly coordinated neuromuscular control, which may alter the normal postural stability of the spine. Altered movement control may occur at any stage of LBP.

This is just a sampling of the evidence. The message seems to be clear: balanced motor control of the core stabilizers of the spine is extremely important to spinal health. In short, If you have low back pain, despite your medical diagnosis, the reason is likely faulty muscle control. That lack of control has likely led to repetitive damage to spinal structures such as discs, ligaments, muscles, joints, or even nerves.

If you are interested in getting more information or want help with your back pain, please do not hesitate to reach out to our clinic at 918-600-2969.

Chiropractic for Headaches: What Studies Say

Headache and Migraine

Headaches are one of the most common reasons patients visit our clinic. In fact, it is estimated that 9/10 Americans suffer from headaches. About 5 percent of all headaches are warning signals caused by physical problems that require serious medical intervention. The remaining 95 percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. Needless to say, it is important to get checked out by your Chiropractic physician to make sure your headaches are in that 95 percent and it is in fact a primary headache not caused by something more sinister.

The greatest majority of primary headaches are associated with muscle tension in the neck. Today, Americans engage in more sedentary activities than in the past, and more hours are spent in one fixed position or posture (such as sitting in front of a computer). This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache. It is particularly the muscles at the base of the neck that tend to develop knots called trigger points. These trigger points cause radiating ache and pressure-like pain to the base of the skull, eyes, forehead, and/or scalp area depending on which muscles are affected. Check out this link for a diagram of tension headache patterns.

A simple at home test you can do yourself is to rub the back and sides of your neck near the base of the skull. You may find knots back there. If you press into those knots and this causes pain to travel to your head, you can be pretty sure that this is a tension headache caused by tight muscles. Try rubbing out these knots and see if this helps to relieve your headache. If so, your headache should respond to Chiropractic care as numerous studies have shown.

In 2001, Duke University Center for Health Policy Research completed their evidence report on treatments for tension-type and cervicogenic headaches. They concluded that Chiropractic care had markedly superior long-term results compared to traditional medical treatment, and that Chiropractic manipulation sustained improvement longer in headache frequency and severity compared to other treatments. The Cochrane Collaboration, a systematic review of evidence, reached a similar conclusion to the Duke study in 2004. In 2011 a study published in the Journal of Manipulative and Physiological Therapeutics  found that chiropractic care, including spinal manipulation, can improve migraine and cervicogenic headaches.

If you are among the 9/10 Americans suffering from headaches. Get in touch with your Chiropractic Physician. If you don’t have one and live in the Tulsa area, give us a call at Reactivate Therapy. We would be happy to help.

Knee Pain Tips and Tricks

Knee Pain
Causes of Knee Pain

Knee pain is typically caused by mechanical dysfunction related to altered position and movement. The most common cause for knee dysfunction is a tracking or alignment disorder. We are concerned with how the knee moves and if the knee shifts inwards or outwards throughout its motion. Imagine the hinges on a door. They need to line up straight in order to function correctly. If not, every time you use the door, the hinges will grind. The same thing can happen with the knee. If the knee begins to travel inwards, then the outside of the knee is compressed while the inside of the knee is under tension. This also causes the kneecap to travel to the outside of its normal groove in the leg bone. The dysfunction puts stress on the meniscus, ligaments, cartilage, tendons, and other structures in the knee. Over time, the damage adds up. One could expect to develop osteoarthritis and other problems if the issue isn’t corrected.

So why would the knee begin to move and track differently? I often tell my patients, “You’re not just what you eat…You are what you do”. If you tend to sit with your right leg crossed over the left for hours a day at your desk, or if you have poor form squatting, then you are likely training an altered movement pattern or muscle imbalance. The muscles of the leg are designed to coordinate together acting to keep the joint in line throughout it’s range of motion. Weak or overactive muscles alter the coordination resulting in poor tracking.

Another issue may be down in the foot and ankle. Those who have fallen arches or “pronation of the foot” will tend to shift the knee inwards. Of course, there can always be an acute trauma like a sports injury or car wreck that damages tissues upon one dramatic event. Even so, the mechanics will be altered and lead to further degenerative changes if not corrected. Hence the reason you do rehab after surgical repair.

Does knee pain go away on its own?

Most Knee pain will go away on its own if the offending activity is stopped. However, knee pain usually comes back when people become active again. Most patients experience a pattern of remissions (it gets better), then exacerbations (it gets worse), with a general trend of more severe episodes over time. This is because the bad mechanics causing knee pain are not resolved without corrective treatment and the damage accumulates weakening structures in the knee.

When to see a Doctor

Knee pain that does not go away after two weeks of rest, or knee pain that returns after resuming normal activities is a big warning sign that something is not working right in the knee. Though the cause is usually mechanical in nature, there are some other more serious reasons for knee pain that could be disastrous to ignore. Better to be safe than sorry. If your knee pain doesn’t go away in two weeks, you need to see a doctor…preferably one that is familiar with musculoskeletal conditions. You may receive a referral from your family doctor to see a Chiropractor and/or physical therapy.

Product Recommendations

If your day involves a lot of kneeling, try a foam knee pad. Place the pad under your knees when kneeling on hard surfaces: like gardening or cleaning or repairs at home. If you are moving around a lot, you may want to consider knee pads that stay on your knees. Make sure and get strap-on knee pads with Velcro for easy attachment. If your profession requires a lot of work kneeling on hard surfaces, it would be wise to invest in nicer pads. Otherwise, you can find them for less than $10 online.

A simple knee strain or tendinitis may benefit from a compressive brace. These types of braces can improve support stabilizing the joint during activities. It can also help to create compression that will reduce swelling. These braces are more for mild injuries that require support when you are active. To use a compressive brace, simply slide the brace on with the hole over the knee cap. There’s usually no left or right sidedness to these items.

For patellar tendinitis, one may try patellar straps. These devices go below the knee cap to take stress off the tendon during activity. A similar idea is the ITB strap to support the iliotibial band for “runner’s knee”. The strap easily fastens above the knee far enough not to contact the knee cap and features a gel pad that is placed on the outside of the thigh.
In cases of instability such as a moderate to severe sprain, ligament tear, or meniscal injury, a hinged brace may be favorable. The action of the hinge limits any side-to-side motion and keeps the joint in check. In these cases, a patient would not want to be doing any strenuous activity and the brace simply functions to help someone to walk so they can go about their day-to-day business with less limitations. Use this type of brace by positioning the hinge at the level of the knee between the two bones of the upper and lower leg with the knee slightly bent. Secure the bands around the top then bottom. Ensure it is firm, but not so tight to cause decreased blood flow. This should be comfortable enough to wear for 1 or 2 hours. While still seated, bend and straighten the knee to ensure it feels right and the bend is occurring in the correct place. Get up and take a few steps. Do any readjustments as needed.

Further adjustments may need to be done throughout its use to reposition and to relieve pressure caused by the brace.

In more severe cases, when a patient has advanced osteoarthritis or is post-surgical, a ROM hinged brace may be the solution. This type of brace is fitted and calibrated to limit the range of motion of knee flexion and extension. The purpose is to prevent specific end ranges of motion that may damage the joint as well as provide control of side-to-side movement in the knee. Ideally, the movement range of the brace would be increased over time as you progress through a course of treatment and the joint improves. To use this brace properly, you should have it fitted by a professional. The instructions are essentially the same as above with the additional step of calibration specific to your condition. Only a doctor or therapist should do this part.

Braces are not meant to be a long-term solution. They are a preventative measure against reinjury to allow you to heal. They should not be worn all of the time: only when performing tasks that require knee support. There are many online companies out there providing quality durable medical and rehab equipment. Your local drug store likely carries a variety of simpler items. If the problem persists, you need to seek the help of a professional.

When to Use PRICE

The mnemonic PRICE stands for Protection, Rest, Ice, Compression, and Elevation. Traditionally these methods are used for the first 72 hours after an injury. Protection & Rest so you don’t irritate/reinjure. Ice to bring down the temperature. Compression to combat swelling. Elevation to decrease the blood pressure to the affected limb. All of this works to reduce the natural inflammatory response that your body mounts to an injury. 

This once traditional method is now being challenged and could even be said to be controversial. The idea here is that the body responds with inflammation for a reason: to promote healing and repair. There is an increase in blood flow and capillary dilation so that the body can bring in more nutritional/healing factors and likewise get rid of waste products. This of course results in swelling and warmth that speeds up metabolism: which can be a good thing. However, the argument can be made that our modern-day bodies tend toward too much inflammation to the point where it can be harmful. A little swelling might be OK, but if the swelling seems substantial, PRICE is probably best. I coach my patients to use PRICE briefly after re-exacerbations or reinjuries. 

The 20/20 rule is usually a good strategy for icing a knee. Put ice in a plastic bag and wrap in cloth. Place on area for 20 minutes, then spend 20 minutes with it off, then 20 minutes on again. You can cycle through this several times. Instead of ice in a bag, peas or frozen vegetables work great. There are also plenty of form fitting gel packs on the market. You freeze them and reuse them. Never place and keep a frozen item directly on the skin, you need to use a cloth buffer.

An alternative to the above is an ice massage. Simply take a piece of ice and put it directly on the skin continuously moving it for about 10 minutes. Make sure and slide the ice so that it is completely off an area then back on again. The movement is important to ensure the tissue doesn’t get damaged. An Ice massage is great for getting in the contours along the knee cap. It also works excellent for muscle spasms.

There are devices for more severe knee inflammation that cool and compress at the same time. Some of them have a feature that pumps and cycles chilled water into the compress like the Polar Active Ice and Aircast Cryo Cuff. These devices are a little on the expensive side, but can be worth it if your condition is severe enough.

Do These Knee Exercises Before a Workout

If you are having mild knee problems, then there are some things you can do to improve the joint mechanics before your workout or activity. Try these simple warmups even before stretching. All you need is a resistance band (flat is best). This 5 to 10-minute routine is designed to loosen up your joints and activate muscles that will help to stabilize the knee ensuring proper tracking during your next activities. If you experience pain during any of these maneuvers, do not continue. Modify by reducing the amount of movement or do the easier version. While a muscular burning sensation is OK, joint pain or sharp pain is not acceptable. If all fails to relieve pain, discontinue the maneuver.

Marching knee taps:
March in place for 30-60 seconds with high knees tapping opposite hand to knee. Make sure to keep chest over pelvis and do not bend forward to tap knee. If pain, avoid twisting your torso too much. You can also tap same side hand to knee or avoid raising your knee so high. 

Heel to Butt March: 
Stand on one leg bringing the opposite heel towards the butt. The standing leg should remain slightly bent at knee. Attempt to hold for about 2 seconds then switch. This should be gentle. If you experience pain or cramping, don’t raise your heels so high. Alternate feet for 30-60 seconds.

Lunge steps w/ side bend: 
Put your hands on your hips. Take a big 2 or 3-foot step forward making sure to keep both feet pointing straight and thighs in line with feet. The back heel should come up with toes pointing forward. The front foot should be flat with toes forward. Keep your chest over your pelvis. Reach the hand opposite your front leg up over your head and bend gently to the side until you feel a slight stretch. Slowly come out of the bend. Step the back foot forward even with the other foot so your are again standing. Alternate left and right stepping forward with bending for 30-60 seconds. If painful, ensure you are keeping your knee over your feet and try reducing the size of your steps.

Sidestep w/ Knee Band: 
Place an exercise band around your knees. Stand with feet slightly wider than shoulders while maintaining slight knee bend. Step to the left about one foot pushing the knee against the band and pause when both feet are firmly planted. Then bring feet back together returning to the start position. Alternate stepping (left, center, right, center) in this one-two-one-two motion for 30-60 seconds. You can also take multiple steps left, then multiple steps right once you get the hang of it. If pain, make sure knees are over feet throughout the motion or take smaller steps.

Knee Band Squat: 
Place band around knees. Place feet slightly wider than shoulder width apart with feet turned out about 15 degrees. Push knees outward against band keeping knees over feet. Put your hands out it front with shoulders back. Slowly start to drop your pelvis bending from the hips and knees. Keep your chest over your pelvis lowering your body only about a foot. Hold for 2 seconds and return. Repeat for 30-60 seconds. If pain, ensure knees over feet and toes not turned out too far. Don’t over-arch your back. Also try lifting hands up as you lower your body. Don’t look down, slightly lift chin instead and look forward.

Marching Bridge w/ Band: 
Lay on your back. Place band around knees. Place feet flat with knees bent to about 90 degrees. Push against the band and raise your pelvis off the ground: this is the starting position. Now, lift one foot about an inch off the ground and hold for 2 seconds. Place the foot on the ground returning to start position. Alternate sides for 30-60 seconds. If this is too much, try placing your heels closer to your buttocks. Ensure you aren’t pushing your knees outwards too far. You can also just raise and lower the pelvis without the march or put less pressure against the band to reduce stress.

If Pain Continues with Workouts or Activities

It is generally a good idea to discontinue your more aggressive activities after a knee injury. Two weeks of avoiding the use of the knee is standard. When you return to activities, go slow and careful. Build stepwise using caution and control, then move to more aggressive maneuvers. Check your form. You might benefit from having a trainer take a look at your routine to make sure your form is good and suggest alternative exercises should the pain persist during a particular movement. If you are still experiencing pain, it is time to see an expert like a Chiropractic Physician.

Plantar Fasciitis Solutions

Plantar Fascia

A sharp pain in the bottom your foot with the first step out of bed in the morning is an almost sure sign that you have plantar fasciitis. This is a problem with the connective tissue that runs from your toes to the back of your heel and ties into the calf muscles. This tissue can become damaged and inflamed causing that debilitating foot problem that you can no longer ignore. So what do you do about it?

Let’s talk about possible plantar fasciitis treatment. Maybe you tried rubbing it. Maybe you tried heat or cold packs. Maybe you tried rolling it out with a tennis ball or even a frozen bottle of water. Is the pain still there? You’re going about it all wrong.

Plantar fasciitis often doesn’t respond well to massage techniques alone simply because the problem isn’t that it needs stretched or massaged. It needs to destress so it can heal. It’s overstretched and taking the brunt of the force at impact from walking or running. The plantar fascia really is a last resort barrier much the same as a ligament and is not meant to be under constant repetitive tension. The muscles and shape of the foot are designed to absorb the impact during gait like a spring or shock absorber. The muscles in your foot are meant to hold the bones in such a way to form arches. These arches are nature’s design to withstand repetitive impact while walking or running. If the intrinsic foot muscles responsible for forming these arches weaken, this results in loss of arches and the plantar fascia is pulled to tension. Now with each step, the plantar fascia is put under more stress than what it can handle. The result is progressive damage to the fibers.

The point is, until you reshape the foot and strengthen those muscles, you will continue to do damage to the plantar fascia and your condition will worsen. So how do you reshape your foot? One cheap and easy solution may be to grab yourself a pair of orthotics (shoe inserts) from the store. This will help to mold your foot and support your arches. However, one size does not always fit all and you may need to consider custom orthotics which can be quite expensive. You are also going to need to retrain the muscles in your foot with specific exercises. One of my favorites is the short foot progression. This is a complicated exercise, so it may be easier to start with the Pen & Penny exercise. Additionally, any tightness along the kinetic chain in the leg will need to be addressed, especially the calf and hamstring as these muscles have fascial plane connections to the plantar fascia. it is also  important to make sure the joints of the foot themselves have good motion and alignment, so manipulation of the foot bones can help profoundly. Lastly, therapeutic modalities like soft tissue manipulation, and ultrasound can help with proper fascial healing. But again, soft tissue modalities alone will not solve the problem if the foot is not retrained to hold the proper arch and reduce the tension on the plantar fascia.

If you think you have plantar fasciitis, you’ll want to get checked out by an expert in biomechanics like a Chiropractic physician. Feel free to give our office a call if you have questions or want to set up an appointment.

Chiropractic and Athletic Performance

Over the past couple of decades, a mountain of research is showing how Chiropractic care improves athletic performance. Chiropractic makes athletes more efficient and heal from injury faster. From football teams to professional body builders, more and more athletes are turning to Chiropractors to be at the top of their game. Why?

In competitive sports performance, the difference between winning and losing is sometimes measured in microseconds. Athletes need every little bit of strength, speed and flexibility they can muster. A Chiropractic Physician’s focus is improved biomechanics. In other words, this type of doctor is concerned with how the body moves. You may not know it, but many Chiropractors work not only on the spine, but any musculoskeletal problem. Chiropractors can improve range of motion, strength, flexibility, coordination, reaction time, and the ability of the body to recover and resist injury. This not only means improved performance, but the ability to recover from injury faster and even prevent injuries.

According to Palmer College of Chiropractic, an estimated 90% of all world-class athletes routinely use Chiropractic care to prevent injuries and boost their performance. All NFL teams employ on-staff chiropractors, as well as 72% of PGA golfers and the majority of NBA, MLB and NHL teams.

Many famous athletes have used Chiropractic to stay on top of their game including: Tiger Woods, Arnold Schwarzenegger, Tom Brady, and Evander Holyfield. These athletes recognize that Chiropractic has significantly improved recovery times and helped to improve performance.

The ultimate goal of Reactivate Therapy is to get our patients back to the activities that they love. We recognize that the more active you are, the healthier you will be. Exercise doesn’t just improve cardiovascular health, it also helps to regulate hormones, improve your immune system, decrease stress, maintain a healthy weight, and generally keep you living a longer and happier life. We want our patients to be able to live an active lifestyle because it improves overall health, and we know just how much pain and injury can be a barrier to that goal. 

So, if you are an athlete, or you are an on-the-go weekend warrior, you can look to Chiropractic to improve your game and stay active. Feel free to give us a call if pain or injury is getting in the way of your active lifestyle.

Evidence Based Chiropractic in Modern Medicine

Scientifically proven to improve function and performance

Chiropractic has had a history of riding on the outskirts of mainstream healthcare, but all this is changing with evidence based chiropractic. More and more people are coming to Chiropractors now than ever before and are realizing the benefits of the physical treatments that Chiropractors can provide for relief of their aches and pains. With more and more chiropractic effectiveness studies appearing, Chiropractors have now moved into mainstream healthcare with an evidence-based approach. Consider the following:

  • Nearly every healthcare insurance in the U.S. offers Chiropractic benefits.
  • Chiropractic has been endorsed by The Agency for Health Care Policy and Research under the U.S. Department of Health and Human Services.
  • 90% of professional athletes utilize Chiropractic to stay at the top of their game with almost all professional teams having a Chiropractor on staff.
  • Chiropractic has been recommended by The American Pain Society and The American College of Physicians.
  • Chiropractors have earned physician status in most states.
  • Chiropractors attend 8 years of college education to earn their doctorates with total credit hours equivalent to that of MDs and DOs.
  • Medicare reform is occurring in an effort to include all services provided by Chiropractors.
  • Hospitals have been implementing Chiropractic care as part of their treatment options and some Chiropractors have hospital privileges.
  • The effectiveness of manipulation has been established with chiropractic and headaches research.
  • Other health care professionals are utilizing joint manipulation like Chiropractors in their treatment of musculoskeletal conditions including Physical Therapists and Medical Doctors. In truth, osteopaths have been manipulating joints and muscles since the profession’s conception and before the advent of Chiropractic.
  • Many Chiropractors have integrated practices that include medical staff such as MDs, DOs, PTs, and Nurse Practitioners.
  • In some states, Chiropractors have prescription rights.

So, what is it exactly that has changed? In a word…research. Funding for Chiropractic research has grown tremendously along with its increased demand, and this has allowed the profession to show its effectiveness in treating a multitude of conditions. And, as the profession grows, more Chiropractors are using the evidence-based approach to care. That is to say that more of the profession is adopting a style of practice that utilizes treatments that have been proven by scientific research to be effective. This change probably explains why more medical professionals are not only referring to Chiropractors but are also Chiropractic patients themselves. Chiropractors use the same physical examination procedures used by mainstream medical professionals using the same terminology to make communication easy. Many Chiropractors no longer ascribe to the philosophy that a subluxation or misalignment is to blame for organic disease. Rather, as the evidence shows, they believe improper alignment and movement is at the root of the majority of joint and muscle pain.

Essentially, the evidence-based view of musculoskeletal conditions is this: Due to acute trauma, repetitive trauma, or bad habits, our position and movement becomes altered. Big or small, further changes in our body’s mechanics occur over time. Joints misalign. Muscle tone imbalance occurs. The shape and character of our soft tissue and bones is altered. Eventually the changes lead to increased stress, wear and tear on our tissues. Our muscles become tight and contracted and dysfunctional. We develop arthritis, tendinitis, ligament damage, nerves become entrapped or irritated, and we are in pain. Therefore, treatment by an evidence-based Chiropractor focuses on normalizing those mechanical dysfunctions with goals like improving range of motion, tenderness, tightness, inflammation, nerve function, and of course pain.

Patients suffering from joint, muscle, and even nerve pain can consider Chiropractic as an alternative to medication or surgery. Typical treatment from Chiropractors includes: manipulation of joints and soft tissue; physiotherapies such as electro-muscle stimulation, therapeutic ultrasound, traction, and decompression; and rehab like targeted stretches and exercises. In Oklahoma, Chiropractors also have the option to advance their scope of practice to perform injectable therapies with vitamins, minerals, and neutraceutical medicines effective to decrease inflammation, help repair joints and soft tissue, and decrease pain. If you are suffering from any of the above symptoms, chances are, there is a Chiropractor close by that can help.

Alternative Pain Solutions

Consider something else

Humans have come a long way. We have people out there walking around with surgically implanted 3-D printed organs. We have antibiotics for infections that might otherwise kill us. I shattered my foot when I was a young man, and a skilled orthopedic surgeon put me back together almost as good as new. I got LASIK and now I see 20/20. I will be the first to say that I feel very blessed to be living in a time of such advancement in medical technology. We are also lucky to be living in a time where we are beginning to recognize the benefits of other alternative options for care.

There exist many reliably effective drug free pain solutions which are grouped together in a category we call “Alternative Medicine”. Though some really shouldn’t be considered alternative. Mainstream medicine is classically drugs and surgery. Unfortunately, many effective treatments that fall outside of that standard approach are generally regarded as less effective or even placebo. That term, Alternative Medicine, carries negative connotations: like it is somehow secondary or less valuable. Calling these treatments alternative would seem to imply these methods are only useful if standard medical treatment fails or is contraindicated…as if it were a Hail Mary Play. However, I would argue that, often times, the alternative medical approach is actually the best first plan of attack simply because it carries less risk.

I think we can all agree that mainstream medicine carries significant risks of unwanted results like short-term and long-term side effects from drugs and the inherent risks of surgical procedures. Even over the counter NSAIDs like ibuprofen and acetaminophen can cause serious damage over time including gastrointestinal bleeding, cardiovascular problems, and kidney failure. This is why we trust our doctors to help us weigh the risks vs the benefits of a treatment and why it takes so long to become a doctor.

My question is this: If there were other options out there, which have been proven to be effective in many cases, and with less risks and side-effects, then wouldn’t you want that on the table as an option? In fact, wouldn’t you want to try it first? Why then call it Alternative? Why go with an aggressive approach first? Go from the most conservative to the most aggressive instead. It will save millions in health care costs, and it will be better for the patient.

In the face of an opioid epidemic and an aging population, our country needs to reconsider the traditional avenues for addressing the management of pain in the United States. Here are some conservative approaches to pain management to consider as an alternative to the traditional medical treatments such as drugs and surgery.

  • Chiropractic Manipulation                     
  • Naturopathic/Homeopathic Medicine               
  • Massage Therapy    
  • Weight loss      
  • Anti-inflammatory Diet                         
  • Acupuncture        
  • Physical Therapy                        
  • Meditation
  • Yoga                                    
  • Pilates                                          
  • Tai Chi
  • Water Aerobics           


It has come to my attention that many of my patients have been told they have arthritis, but don’t know which kind or what really causes it. First off, there are many different kinds of arthritides (plural for arthritis). There are metabolic arthritides such as gout where too much uric acid builds up in the joints and forms crystals that damage the joints; there are autoimmune diseases like rheumatoid arthritis that tricks the body into attacking the connective tissue in joints; there is the possibility of an infection in the joint that leads to arthritis; but the most common type of arthritis is osteoarthritis, and this is usually what a doctor means when he/she tells you that you have arthritis.

So, what is osteoarthritis? This type of arthritis is known by many names: spondylosis, degenerative joint disease, degenerative arthritis, degenerative arthrosis, arthrosis, and several more uncommon terms. Osteoarthritis (OA) is nicknamed the wear-and-tear disease of the joints. This is because OA is the result of excessive stress in the form of tension, friction, and compression that repetitively occur over time causing degeneration of the elements of the joint that keep it moving smoothly. This degeneration leads to stiffness, pain, swelling, and those grinding/clicking/popping noises called “crepitus”. Osteoarthritis is often found along side other types of problems related to excess physical stress like degenerative disc disease, herniated discs, tendinitis, and bursitis. Each joint in the body is susceptible to OA, but as you can imagine it shows up more often in joints that bear more weight and stress like hips and knees. Typically a doctor will diagnose you with OA by X-ray. Changes we look for are: loss of joint space (which indicates erosion and damage to the cartilage), pieces of bone loose in the joint, bone spurs, enlargement or thickening of the bone around the joint, alteration of the alignment of the joint, deformity of the joint, and a handful of other findings. Doctors may use the term “bone-on-bone” when it gets bad enough that there is no more cartilage.
The most important thing to remember here is that osteoarthritis is the result of excessive wear and tear from bad joint mechanics. Many of my patients will say something like “Well Doc, I’m just getting old”. My reply is usually to ask if one of their knees is older than the other. Because, if OA is truly due to age, then why does one side typically start to have problems before the other? It is true that the older a body is, the more opportunities it has had to undergo wear and tear, and the more likely that damage will result in OA. But, time and old age by itself does not produce OA. The alteration of the mechanics of the joint results in OA. There has to be a problem with the joint, and this problem leads to damage over time that finally culminates in this type of arthritis.
Attributing arthritis to old age is associated with falsely accepting that there is nothing that can be done about the problem. Nothing could be further from the truth. It may be true that the more advanced the OA, the harder it can be to treat, but this does not mean that the problem should be ignored. In the medical world, this mind-set is called “taking on the sick role”. Don’t take on the sick role! If you decide to do nothing about the problem, it will continue to get worse. It is much better to nip OA in the bud rather than let it get so bad that the only realistic solution includes joint replacement surgery. Once you have that surgery, things will never be the same. The biomechanics in the area will permanently be altered, not to mention the risks of surgery or the recovery/rehab or the expense. The point is, don’t let it get to the point of surgery. That old trick knee or a past accident/injury can be the beginning of OA, but it doesn’t have to end in full blown OA. Even if the osteoarthritis is advanced, and even if a surgery needs to be performed, the underlying dysfunction that caused the arthritis is still there and needs to be corrected, or problems will continue/reoccur. So, you are going to have to address this no matter which way you go. Better to correct it sooner than later.
I want everybody to understand something. Every joint in the body is meant to be in a certain position and move a certain way. As the two joint surfaces move relative to one another, they are meant to remain congruent, or flush against each other. Imagine a ball and socket joint. If the ball is not centered in the middle of the joint as it goes through it’s motions, then the ball rides up on one side of the cup grinding and causing excessive friction. This damages the joint and leads to further changes. Alterations in the balance of the muscles and/or ligaments around the joint result in bad joint mechanics. This can be from an injury or a bad habit like improper posture. Muscles are important because they keep that joint centered in the correct position as the joint goes through it’s movement. If the muscles are not balanced, then the joint capsule becomes stretched and altered. These joint capsules are made up of ligaments that connect one bone to another. It is composed of fibrous material that ensures that the bones are held together tightly and keep the bone from sliding too far in any direction. If you have ever heard of an ACL tear, then you know that this important ligament keeps the knee from shifting forward, and if damaged, the knee becomes unstable because there is nothing to keep the motion in check. These ligaments/joint capsules can actually become stretched and warped with repetitive damage. The capsule will be tight and shortened on one side and stretched long on the other. If this happens, they no longer do their job and the joint rides out of place. If left uncorrected, these types of abnormal joint mechanics will lead to OA.
Now that you understand how these alterations can lead to damage ultimately resulting in OA, you probably want to ask…How do we fix this? Well, it’s not easy–you are going to need an expert (and I’m not talking about a personal trainer). It all comes down to re-balancing the joint: this includes the muscles and the ligaments. The first thing we need to do is get the tension of that joint capsule equal again. We need to stretch the shortened side. This is the side(s) where there is a restriction in the range of motion (ROM). This can be done with manipulation or adjustment. The next thing we need to do is stretch the tightened muscles. This can be done by a health care provider or by the patient themselves; preferably a combination of the two. This takes time, but once the ROM has been normalized, it is time to strengthen the correct set of muscles around the joint. If you try to strengthen the muscles first without normalizing the ROM, it is possible that you will be doing more damage by reinforcing the bad pattern. It would be like running after you sprain an ankle. Once those muscles are correctly stretched and strengthened in the right pattern, this will keep the joint centered and eventually the capsule will heal and normalize again because the capsule/ligament fibers shrink up over time if they are not always being stretched out. So if the muscle does its job keeping the ROM of the joint in check, then the ligament/capsule has an opportunity shorten back up to it’s normal length thereby re-establishing it’s ability to correctly stabilize the joint.
This process takes time. Treatment should be approached as a coordinated effort between the physician and the patient working as a team. Furthermore, both physician and patient should be patient, expecting progress to happen slowly over time: especially if the problem has existed for a long time. It is also important to understand that pain is not a good indicator of when the problem has been fixed, but rather by the ROM and balance in the joint. This is because it typically takes quite a bit of dysfunction and damage to start producing painful symptoms. So when treatment alleviates the pain, this is usually only about 20% progress. The joint is still dysfunctional and if the joint does not get properly balanced and stabilized, then the condition will return. At this point, the patient will have lost a lot of progress. Don’t throw away your time and money: finish the treatment just the way you would finish out your antibiotic even if you are feeling better.
If you have arthritis, or a painful or stiff joint that isn’t getting better, or if you have had a recent injury, then please seek out a Chiropractic Physician. This is our bread and butter. A Chiropractor treats OA like a dentist treats tooth decay: it is our main work. If you have any questions, please contact our clinic.