A Twisted Tibia

The knee is a hinge joint, meant mainly to move back and forth in one geometric plane. It will accommodate only minimal medial or lateral torquing (circular, or twisting, back-and-forth movement).

Torquing, or twisting, is a common cause of injury to the knee. Twisting the lower extremity on a “planted” foot, while one’s body weight is bearing on the foot, can torque the knee past its tolerance. Pain and inability to bear weight on the knee after this kind of injury often bring patients into my office.

        Usually, the tibia is most severely affected, as well as the kneecap, but the fibula, as well as the femur may also need adjusting.

I have specific, precise, and comfortable adjustments to alleviate this problem, returning the involved knee to its normal articulation and relieving the pain.

Doorway or Corner? Which is Better?

 Patients are frequently advised by other caregivers to stretch the front of their upper body / arms / shoulders / chest by standing in a doorway, placing the hands out on the door frames on each side, and leaning forward.

This will effectively give a good stretch, but I have found that people can easily overstretch due to loosing their balance, lack of control, or over-enthusiasm, and end up hurting themselves.

Instead, I advise my patients to stand facing a corner, place their hands on the walls on both sides, and lean into the corner. I have them change the height of their hands, up and down, which effects the stretch in slightly different parts of the chest, shoulders, and arms. Changing the distance from the feet to the corner can lessen or increase the stretch.

This is a safer way to do this stretch; patients are much less likely to hurt themselves.

Bone Broths

  Nutrient-rich bone broths were traditionally prepared by our mothers, grandmothers, and great-grandmothers as an inexpensive way to support the health of their families. 

Bone broth, rich in absorbable calcium, magnesium, phosphorus, & other trace minerals, is made by slowly boiling bones (preferably organic), for up to 12 hours in water slightly acidified by addition of vinegar.   

Including attached cartilage helps add to collagen content in the broth. The fats in bone broth contribute to the health of our intestinal tract, thus helping the absorption of minerals in the broth. In Traditional Chinese Medicine, bone broth nourishes the kidneys, supports the vital essence (chi) and builds blood.  http://nourishedkitchen.com/bone-broths-adrenals-bones-teeth/ 

Here is how to make Rich Bone Broth:

Bones, with cartilage, from organic chicken, turkey, or beef 

2 - 3 quarts filtered water, enough to generously cover the bones

2 Tablespoons cider vinegar

Bring to boil, then reduce heat & simmer, lid on, for at least 6, & up to 12 hours, adding water periodically as it cooks down

Prior to about the last hour of cooking, add, for flavor:

1 carrot

1 stalk of celery

1 onion, chopped

2 - 3 cloves of garlic, whole or chopped

Salt & pepper to taste

Seasoning herbs (your preference; you can make a bouquet garni of thyme, oregano, sage, etc.)

Cool, then strain into portions for the freezer & / or refrigerator

Trigger Finger

         A common condition when a finger, or thumb, gets stuck in a bent position, and straightening it causes a painful “snap.”

This happens when inflammation develops around the tendon inside the tendon sheath (a tissue “tube” surrounding the tendon), and is called tenosynovitis. The inflammation narrows the space between the tendon and its sheath, and the thumb or finger gets “stuck” in the bent position.

This painful condition often results from repetitive gripping motions with the hand(s).

My treatment plan includes gently adjusting the involved finger, anti-inflammatory management, and splinting of the finger in a straightened position while the inflammation resolves.  

Ventana Wilderness Alliance

    

     As an avid hiker and backpacker for many years in the Central Coast and the Sierra, my support of wilderness preservation is very personal. Early on, John Muir’s words touched my soul: “Climb the mountains and get their good tidings. Nature’s peace will flow into you as sunshine flows into trees.” 

     Climbing trails into the rugged Santa Lucias with breathtaking views of the Pacific at my back, sleeping on the ground in coast live oak woodlands, waking to the raucous chatter of acorn woodpeckers—these are vivid and cherished memories. My grandchildren have been my camping and hiking companions throughout their childhoods, and I have taught them to be safe hikers and careful stewards of wilderness in our many adventures together.

     I care deeply that public lands be protected, be preserved, and remain available for all to enjoy, and I applaud and support the work of the Ventana Wilderness Alliance. 

Donations made to VWA via Monterey County Gives!--now through Dec. 31, 2018--will be matched up to $30,000 by a Challenge Gift  https://www.montereycountygives.com/nonprofit/ventana-wilderness-alliance/            

Founded in 1998, the Ventana Wilderness Alliance (VWA) is a CA nonprofit corporation with 501(c)(3) tax-exempt status, dedicated to protecting the wildlands of California's northern Santa Lucia mountain range www.ventanawild.org

Retrolisthesis

      Retrolisthesis is a slippage backwards of one vertebra along its neighboring disc above or below. It is most common in the lumbar (low back) or neck regions.

     Often this is part of a general degenerative process in the spine, sometimes associated with aging, or it may be a sequela of injury.

     The condition often causes pain at the site, and may also cause radicular symptoms down the leg(s), such as pain or paresthesias (e.g. numbness, tingling).

     Chiropractic management in my office includes careful, gentle adjusting with the Activator instrument, exercises to strengthen the low back and abdominal muscles, and nutritional counseling for supporting a healthy body.

          

Toxic Oils

     "Designer oils" such as rice bran oil and grapeseed oil, often promoted as "healthy," are, in fact, highly toxic. Here's why: these oils are highly PROCESSED.

     Also beware canola oil, which is popularly touted as a healthy oil. It is also in the HIGHLY PROCESSED category. 

     Processing is necessary to extract the oil from rapeseed (canola), rice bran, and grape seeds, and may include extraction with heat and solvents, as well as chemical bleaching, degumming, and deodorizing. 

     Because the raw oils have monounsaturated and polyunsatured components, when exposed to heat, they readily oxidize. Oxidized oils are toxic and highly inflammatory.

     Avoid these oils, and use extra virgin olive oil (the highest grade olive oil, extracted with cold pressing without the use of solvents) instead.   

Sinus Congestion

Congestion in the sinuses can often be alleviated by balancing the cranial rhythms. This gentle balancing is something I include with every treatment in my office.

     The rhythms of the bones in the head are very subtle, and are related to the circulation of the cerebrospinal fluid. Correcting aberrances in these rhythms can relieve headaches, sinus congestion, or vertigo. 

     I also have an effective direct adjustment for the sinuses with my Activator instrument. The adjustment is gentle, and is often followed by immediate sinus drainage. 

Side Sleeping

        Patients often ask if they must sleep on their backs, for the sake of their necks, even though they are more comfortable on their sides. The answer is a qualified “No.”

It depends on the pillow you use under your head and neck.  A pillow that adequately supports your cervical curve and maintains your spine in proper alignment is essential for healthy side sleeping.

I recommend an orthopedically designed pillow. I am a side sleeper, and this is what I use. I have orthopedic pillows in my office for my patients, and although the particular configuration may not be comfortable for a small percentage of patients, it works beautifully for most.

Side sleeping is OK if you have the right pillow.

Bunions

      Bunions commonly form at the base of the big toe, as a result of abnormal biomechanical stresses in the foot. The body's autonomic response to these stresses is to build extra bone in the enlarging joint.

     A fallen arch, especially if combined with pronation of the foot (bending inward of the inside of the foot), can cause development of a bunion. The process is slow, and may not be noticed until the toe starts to hurt, or shoes don't fit well.

    Problematic changes in our body's biomechanics can develop at any age, and are almost always a complex interplay of forces and effects.

    Bunions can be treated effectively without surgery. Here is my treatment plan:

    As an Advanced Proficiency Rated ACTIVATOR chiropractor, I check the status of the arch, assess for pronation, and check & adjust all the joints of the feet. I advise the patient if orthotics are necessary to support the feet, and I prescribe exercises to strengthen the arch.

    Prescription orthotics may be needed, but patients can usually start with a good over-the-counter orthotic, properly fitted.

    Every aspect of my treatment plan is designed to relieve or counteract the stresses that caused the bunion. I have found this approach successful many times in my practice. 

A Distorted Rib Cage

  Did you know that your whole rib cage can get torqued, or twisted? I often see this when a patient has been sick with a cough, has fallen, or has lifted something in an imbalanced way. 
      Recently a patient who had fallen off her motorcycle complained of shortness of breath, discomfort with deep breaths, and a “sense of pressure” at the level of her diaphragm.
      I found her rib cage distorted---ribs on one side stressed upward, while ribs on the other side were stressed downward. After correcting this, I found several ribs jammed at the spine, and some likewise in front at the sternum, which needed gentle adjustments to release the pressure at the articulations.
     Gentle adjustments high in the abdomen, at the level of her diaphragm, finished bringing her relief and restoring her breathing to normal.

One Leg Shorter

 

     Leg length inequality can be due to an anatomical short leg---one leg literally shorter due to an anomaly or after a (healed) fracture in the leg---or due to a  functional short leg. 

  A functional short leg means one leg is shorter due to disturbances or aberrance in one’s frame (bones & joints). This could be a distorted, tilted pelvis, misalignments in the spine, etc. The sum total of the imbalances & disequilibrium in the frame results in one leg shorter than the other.

  I commonly see a functional short leg in my practice; it is obvious as soon as the patient is on the adjusting table. After full-body balancing via Activator Chiropractic, the patient’s legs are even again. 

A Shallow Fit, A Joint "Complex"

         Unlike the hip joint, which has the tight fit of a "ball-and-socket," the shoulder is more like a "ball-and-saucer"---the fit is more shallow. While this allows for a wider range of motion, it also makes the shoulder more vulnerable to misalignment or dislocation.

The shoulder is made up of several interacting articulations; it is not just one joint; it is a joint “complex.” The upper bone of the arm, the humerus, articulates with a shallow “cup” that is part of the scapula. Another projecting part of the scapula makes a joint with the outer end of the collarbone.

Many ligaments and muscles connect & attach to parts of the shoulder complex. These also contribute to the multiplicities of motion of which our shoulders are capable. But, like the “ball-and-saucer,” they contribute to the vulnerability of the shoulder to injury. 

As an ACTIVATOR Chiropractor, I am trained to evaluate the multiple parts of the shoulder complex, and to make precise adjustments as needed to relieve pain and restore normal function.

Open Farm Tours--This Weekend!

     I am delighted to be a business sponsor for the annual Open Farm Tours--- free, self-guided visits to local, organic family farms.  http://www.openfarmtours.com/sponsors/
     Farms on the tour are all within about a 10-mile radius, and use sustainable agriculture. You can tour at your own pace, meet the farmers, learn how foods are produced, sample local foods,  & kids can meet farm animals.

    Go to http://www.openfarmtours.com  for more details.

Opening Reception, Mountain Art Center

      Santa Cruz Mountains Art Center, Ben Lomond

OCTOBER 3 – 27, 2018 
Opening Reception Friday, October 5,  6 - 8 pm

Featured Artists:  Linda Levy, Pat Worley & Larry Worley

Basketry, Ceramics, Digital Paintings, Jewelry, Fiber Art & more!
  http://www.mountainartcenter.org

(I am delighted to be a business sponsor for this event)

ART INSPIRED BY FRIENDSHIP

      Santa Cruz Mountains Art Center, Ben Lomond

OCTOBER 3 – 27, 2018 

Featured Artists:  Linda Levy, Pat Worley & Larry Worley

Basketry, Ceramics, Digital Paintings, Jewelry, Fiber Art & more!    http://www.mountainartcenter.org

(I am delighted to be a business sponsor for this event)

Open Farm Tours

     I am delighted to be a business sponsor for the annual Open Farm Tours--- free, self-guided visits to local, organic family farms.  http://www.openfarmtours.com/sponsors/
     Farms on the tour are all within about a 10-mile radius, and use sustainable agriculture. You can tour at your own pace, meet the farmers, learn how foods are produced, sample local foods,  & kids can meet farm animals.
    Go to http://www.openfarmtours.com  for more details.



   

http://www.openfarmtours.com/sponsors/

How Long, How Often?

Patients who come into my office usually want to know:  "How often do I have to come in, and for how long?" 

In my chiropractic practice, each patient's Treatment Plan is tailored to the individual. I have no set formulas or requirements. Some patients come in for their initial treatment and their follow-up visit, and they're done. Some people need more. 

Each person’s course of treatment depends on what their problem is, their general state of health & whether they take good care of themselves, whether they have a heathy diet, whether they've been injured, their lifestyle and what they do physically with their bodies, etc. 

My goal is to help bring each patient relief from pain and restore them to normal functioning.  As soon as they are sufficiently improved and able to continue healing on their own, I release them from active care.

        I am always available to support them, should they need me again.

Suboccipital Tension

Chronic tension at the base of the skull is a very common cause of discomfort and often a prelude to headaches.

       The occiput is the bone across the lower part of the back of our head, just above the top of our neck. Along its lower edge are the suboccipital muscles, which help support our head, help us move and turn our head, and often bear the burden of stressful postures, especially related to computer use.

I often find a patient’s suboccipital muscles so tight that the occiput itself is stressed abnormally downward on one or both sides. This is relieved by a gentle, precise adjustment with the Activator.

Activator Chiropractic adjustments combined with ergonomic counseling and stretches are an effective solution to this problem.

The Fabulous Fibula

There are two bones in the lower leg, the larger, heavier tibia and the smaller fibula, which is a long, slender bone parallel to the tibia, and on the outside of our leg. Ligaments connect the top of the fibula to the upper tibia just below the knee. The lower end of the fibula forms the “bump” on the outside of our ankle.

     Although the fibula minimally participates in weight-bearing, it provides attachment points for muscles and ligaments.  Between the tibia & the fibula is connecting tissue called the “interosseous membrane.”

What does this “extra” little bone do, besides hold onto muscles & ligaments? Quite interestingly, it is integrally involved in the biomechanics of the lower extremity and in the gait cycle. In my practice, I often find the upper and / or lower parts of the fibula misaligned, causing pain when sitting or walking. Precise adjustments with the Activator instrument correct the problem & bring relief.  

Jaw Pain

 Pain in the jaw is often due to problems with the temperomandibular (TMJ) joints---the right and / or left joint(s) may be misaligned or abnormally stressed. An example of abnormal stress is TMJ compression on one side and TMJ distraction on the opposite side.

Jaw pain can also be related to disturbances in the temporal cranial rhythms. The temporal bones are just above the TMJ on the sides of the head.

Treatment in my office includes careful assessment of the jaw complex and, if necessary, gentle adjustment with the Activator Instrument. If the temporal cranial rhythms are abnormal, I make gentle corrections with my hands.

Summer Art Series

"Each month in the summer, the Museum features a different local artist who is inspired by the natural world of the Santa Cruz region."

     I am pleased to support my community by sponsoring the 2018 Summer Art Series at the Museum.
     
     Go here to learn more:    http://www.santacruzmuseum.org/exhibits/summer-art-series/

Consequences of Whiplash

Among the common sequelae of an acceleration / deceleration injury (whiplash), including pain, are a feeling of weakness in the neck, temporary loss of the cervical curve, and development of thoracic outlet syndrome (TOS).

These may not be immediately noticeable, but may appear slowly following the injury.

A feeling of weakness after this trauma is normal, and often the patient is given a foam neck brace, which helps support the head and relieve the cervical muscles.

Loss or straightening of the normal, forward-facing, cervical curve commonly appears on lateral X-ray, and may persist over months or even years. Proper rehabilitation, including chiropractic adjustments, can help restore the curve.

Numbness or tingling or pain down the arms or hands may develop after this trauma as the nerves exiting the spine in the cervical region become impinged between cervical muscles or in passage under the collarbone. This is called thoracic outlet syndrome. Resolution of TOS can take time, but is assisted by precise chiropractic adjustments, proper stretches, postural corrections, and focused soft tissue therapy.  

Shoulders Rolled Forward

 This is a common component, along with head-forward postures, of what’s called an upper thoracic kyphosis. The upper part of the back, and the shoulders and neck, become bent forward and over. In advanced stages, as with some elders, the condition has become so chronic it becomes impossible to straighten up. 

Strain on the neck and upper back, discomfort, compression of the anterior chest and lungs, shortening of the anterior cervical muscles, and medially rotated upper humerus (bone in the upper arm that articulates at the shoulder) are some of the results.

Early awareness and proaction can prevent this. Be aware of your posture---if you find your head is out in front of the center of gravity of your body, gently bring it back. If you spend lots of time on a computer, take frequent breaks to stretch, bring your shoulders back, roll and drop them to release tension.

An excellent stretch that counteracts development of this condition is simple and easy. Find and face into a corner, place your hands on the wall, keep your head up, and lean in. The stretch to the front of your chest and shoulders feels great! Change the height of your hands, and notice how you feel the stretch in different parts of your upper body. 

Sometimes this stretch is advised in a doorway, but I caution that it’s better to do it in a corner. You will be much less likely to lose your balance and overstretch.

Appropriate chiropractic adjustments help prevent the condition, as well. As an Activator doctor, I have precise, comfortable protocols for aligning and balancing the upper body. 

Medicare & Exercises

     Your Chiropractor may give you exercises or stretches to facilitate your healing and help keep your condition from recurring.

     Since for Chiropractic care, Medicare only pays for adjusting the spine, they will not reimburse for exercises, so the Medicare patient must pay for this often essential adjunct to their Chiropractic adjustments.

     The profession of Chiropractic is working with Medicare to change this, and hopefully, in the not-too-distant future, Medicare will agree to pay for this important part of a treatment plan.

Tight Psoas

     The psoas is a major postural muscle which attaches to the lumbar vertebrae and goes diagonally down and out to attach at the hip to the trochanter, or upper part of the femur.

     If the psoas is in spasm, it can pull the pelvic girdle into distortion, causing a short leg, and a myriad of other problems. 

     The spasm and resultant distortion cause discomfort, and can impact the gait.

     With my Activator instrument, I can correct the distortion, and reset the tension in the psoas. Then I'll show the patient how to stretch the psoas muscle at home on their own to help keep this from happening again.

Headache "Scrunch"

     Chronic extension of the neck---leaning the head backward---for example, to better see a computer screen when wearing bifocals or graduated corrective lenses---is a common cause of headaches. 

     It causes tension in the suboccipital muscles along the base of the skull, compression at the occiput, and can result in an upward tilt of the posterior part of the C2 vertebra.

     This combination is a reliable headache producer.

     Watch out for this posture, and if you do get in trouble because of it, my gentle, precise adjustments with Activator Chiropractic Method can correct the area and bring relief.

Memory Foam Pillows

     Some patients use them, and love them. In that case, I don’t try to talk them out of their pillow. But I’m not a fan of memory foam pillows, and here’s why:

     A good pillow, in order give adequate proper support to the cervical spine, should provide consistent resistive support.

     Is this what memory foam does? No, in fact the converse is true---it provides little to no such support. When you lie down on it, it squashes down as the weight of your head & neck contact the foam, creating an indentation which offers minimal, at best, support.

           

Calling All Birds

Attracting birds to your yard & garden is easy with native plants, which are adapted to your local climate, and require little special care in order to flourish.

The National Audubon Society offer a “native plant database,” where you can find your native plants, and how to grow them, by putting in your zip code  

https://www.audubon.org/native-plants?ms=digital-eng-email-ea-plants-20180505_native-plants_medium&utm_source=ea&utm_medium=email&utm_campaign=20180505_native-plants&utm_content=medium

Native plants will lure the birds you love to watch, help them to thrive, and support other beneficial pollinators in your area.

Numbness---Which Fingers?

   

     Numbness and tingling in the hand & fingers is often originating from impingement of nerves in the neck.

     The particular part of the hand or the finger(s) where the patient feels the numbness / tingling helps pinpoint the location of the impingement.

     Fortunately we have a "map" of the areas of skin (called "dermatomes") in different parts of the body that tells us which spinal nerve provides sensory innervation to each area. With minor individual variations, this dermatomal "map" is applicable to every patient.

     By comparing the patient's area of symptoms with the "map," the doctor can discern which nerve is being impinged. 

     As an Advanced Proficiency Rated Activator Chiropractor, I can make precise, gentle adjustments at the site of impingement, in this case in the neck, to relieve the symptoms.   

Glycemic Index

     The Glycemic Index (GI) is a relative ranking of carbohydrate foods according to how they affect blood glucose levels. The lower the relative value, the slower the metabolism of the food, and thus the slower the food causes an increase in blood glucose.

     Any rise in blood glucose, of course, affects insulin levels, a critical consideration for people who are diabetic or pre-diabetic.

     However, attention to the GI is a good idea for everyone, because spikes in blood sugar due to what we eat can lead, over time, to ever-increasing proximity to a diabetic state.

     So---it's not just about sugar! 

     Ultimately it's about how rapidly any food raises our level of blood sugar. 

     Find out more at   https://www.gisymbol.com/about-glycemic-index/ 

     

Arthrokinematics

     Combine "arthro" meaning "of a joint," and "kinematics," meaning "properties of motion of objects" and you get a cool new word, "arthrokinematics"---which is applicable in describing the motion of any joint in the body.

     For example, the "roll and slide" movement of the lower end of the thigh bone, the femur, moving against the top of the larger bone in the lower leg, the tibia, when bending the knee.

     Whether kicking a soccer ball (the femur is stable & the tibia is rolling & gliding)  or squatting (the tibia is stable & the femur will roll & glide), the arthrokinematics are crucial to maintaining stability of the knee throughout its range of motion.   

      

"The Straw That Broke the...

     .......Camel’s Back."  As the saying goes, when a seemingly insignificant action or event results in sudden, extreme pain. 

     What’s going on here?

     Patients often tell me, "All I did was bend over to pick up the newspaper," or "I just got up out of a chair." Simple actions that should not be expected to cause the pain that followed.

     In fact, 90% of the time, dysfunction has been building, often becoming more complex, but not yet symptomatic, or maybe the little twinges you felt were easy to ignore. 

     Then a simple movement, change of position, or event, suddenly pushes things over the edge into pain. What has been lurking becomes painfully impossible to ignore.

     When you feel those little twinges, or sense that maybe something in your underlying structure isn't right, come in and get your body balanced, and you're much less likely to get into that place of severe pain.

To Sit or Not to Sit

  Widely available in different configurations, the standing desk can be an ergonomic blessing to people whose work keeps them desk-bound for long periods of time. 
     Most advantageous are the adjustable types, which can be raised for working while standing, or lowered for sitting to work. The flexibility allows for changing positions throughout the work day, a good antidote to chronic unhealthy postures.

  Whether you sit or stand, or mix it up, it is still wise to take frequent breaks---at least once an hour, walk away from your desk, move around, get some motion in your body, do some stretching, rest your eyes.  
     If you decide to use a standing desk, it’s a good idea to have a cushioned pad to stand on.  

Rotated Scapula

The shoulderblade (scapula) often rotates abnormally, or becomes stressed, in a clockwise or counterclockwise direction. Another way to conceptualize this is to imagine the bottom angle of the scapula moving in direction toward, or away from, the spine.

Because of how the scapula articulates at the shoulder, these rotations can affect the upper extremity all the way down to the wrist.

In my Activator Chiropractic protocol, after I find a rotated scapula and correct it, I then check the humerus (the bone in the upper arm), the radius and ulna (the two bones in the forearm), and the carpals (bones in the wrist).

This is a good example of the thoroughness of Activator Method when assessing and adjusting the  body.

As A Doctor Serving Medicare Patients

        Sadly, Medicare fraud is apparently rampant and on the rise. According to the April, 2018 edition of the AARP Bulletin, ways that fraudsters have figured out how to “bilk the system” include:

---”charging for services never delivered,

---falsifying patient records,

---inflating claims,

---stealing your ID,

---filing duplicate claims,

---providing unneeded equipment,

---buying off doctors / patients, (and)

---shortchanging your care.”

As a Doctor Serving Medicare Patients, I take my responsibilities to you and to the Medicare system very seriously. I work hard and pay careful attention to:

 ---giving you honest, clear, and complete information about your care in my office,

---inviting questions about anything, anytime, including my services, fees, what Medicare covers and does not cover, 

---guarding your personal records and information carefully,

---keeping complete & legible records about your diagnoses, your treatment, and your progress,

---being vigilant, careful, and compliant about Medicare rules,

---treating you only as frequently & for as long as is reasonable & necessary for your recovery from pain & resumption of acceptable functional status, and

---reporting accurately to Medicare on your behalf about the care you receive here.