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.

Ventana Wilderness Alliance

     I am proud to support this local group, which is dedicated to preserving, protecting, and restoring the wilderness public lands of the northern Santa Lucia Mountains and the Big Sur coast. 
     From their website  www.ventanawild.org :
     "Founded in 1998, the Ventana Wilderness Alliance (VWA) is a California nonprofit corporation with IRS 501(c)(3) tax-exempt status. It is dedicated to protecting the wildlands of California's northern Santa Lucia mountain range. VWA is composed of people from all walks of life who share a love of Wilderness and a goal to ensure it remains wild in perpetuity."
     See page 6 in their Spring, 2018 newsletter  http://www.ventanawild.org/images/docs/newsletters/Spring_2018_Ventana_Wilderness_Watch.pdf   for my personal statement of support.

A Real "Pain in the Neck"

 Over my 25 years in practice, I have found that many cases of severe neck pain involve counter-rotations of cervical vertebrae. 

A vertebra will be abnormally rotated in one direction, clockwise or counter clockwise around a vertical axis, and its neighbor will be rotated in the opposite direction.

These misalignments are precisely corrected with the Activator instrument, placed strategically on each vertebra and appropriately vectored.

The patient feels instant relief.  

Rotator Cuff

  Patients are sometimes confused about this, and wrongly think of it as part of their bones. 

But the rotator cuff consists of four MUSCLES that attach from the front, back, and side of the shoulder blade, and grip the head of the humerus (the bone in the upper arm) like a hand would grip a baseball.

These muscles stabilize the humeral head, or “knob” at the upper end of the bone, near the shoulder. They also act on the humerus to cause different movements, such as when we lift our arm out and up (abduction), turn our arm in (internal rotation) or out (external rotation).

The tendons attaching these muscles to bones act as mechanical “blockers” to excessive movements, helping to keep movements of the arm at the shoulder within normal range.

If the arm is taken beyond these normal limits of movement, tears in the tendons or muscles of the rotator cuff often happen.

A Lateral Sacrum

 Sometimes when everything---all misalignments and fixations---has been cleared,  and abnormal stresses have been detected, adjusted, and the pelvis balanced back to equilibrium. there is still discomfort in the sacrum or sacroiliac joint(s).

In this case, I have the patient, who is lying face down, lift each leg, without bending the knee, as high off the table as they comfortably can.

99.9% of the time, if one leg is harder to lift, or can’t be lifted as high, the sacrum is stressed laterally on that side.

A precise, directional adjustment with the Activator instrument fixes the problem and brings relief. 

Magnificent Magnesium

 One of the most abundant minerals in the body, magnesium is involved in a multitude of essential biochemical processes. 

It is important for the heart, brain, function of the mitochondria (tiny energy producing centers in our cells), cell health & function, metabolism of other essential minerals, regulation of blood sugar, muscle & nerve function, secretion of neurotransmitters, and blood pressure. 

An RBC (red blood cell) magnesium test measures your magnesium level.

Some common signs of magnesium deficiency include muscle spasms (such as “charley horses” in the calf muscles), eye twitches, numbness or tingling in the extremities, frequent headaches or migraines, heart arrhythmias, low energy, and fatigue.

Some foods high in magnesium are avocados, raw cacao, and seeds and nuts (pumpkin, sesame, and sunflower are highest). Herbs & spices---chives, parsley, mustard seeds, fennel, basil, cloves, and cumin seeds---are another good source.

Hyperextension of the Knee

Extension of the knee beyond its normal limit is a common cause of knee pain. Patients may be aware of what happened if it occurred during sports activities, a misstep, or a workout, but other causes of hyperextension may not be so obvious to them. 

For example, one common troublemaker is resting one’s foot up on an ottoman while sitting, resulting in extension stress at the knee.

Activator Chiropractic adjustments can correct the problem quickly and precisely, and bring relief. 

Functional Impairment

     How is your condition affecting your ability to function in your life activities? 

     This is now the standard criterion used to determine a course of care, and how long that care will be covered by health insurance. 

     Doctors, Physical Therapists, and other caregivers are expected to measure patient status and effectiveness of their treatment plan by “Outcome Measures”----tools that reflect how well the patient is returning to normal life functioning.

Posture - Induced Headache

     “Craning” the neck to look upward toward a TV or computer monitor, or tilting the head backward to see a monitor through the near-focus part of bifocals, is a common cause of headache. 

     This posture causes the occiput (the bone across the back of the head, just above the spine) to be stressed inferiorly. This inferiority may be more on one side or the other (unilateral) or global (bilateral). 

     When I see this in patients in my office, it  is often in combination with a superiority of the back part of the second cervical vertebra, which makes the headache even worse.

     My Activator Chiropractic Method has focused, precise adjustments that correct the problems without discomfort to the patient, and I offer ergonomic counseling to keep it from happening again.   

New Medicare Allowances

Medicare has increased allowances for Chiropractic care of the spine for 2018. This good news means smaller copays, or more money back from Medicare if patients pay at time of service.

In my office, all patients pay at the time of visit, including Medicare patients. I report the diagnoses and services to Medicare, and Medicare then reimburses the patient directly.   

Homeless Garden, Santa Cruz

Now in its 28th year of providing “job training, transitional employment, and support services” to homeless people in an organic urban farm setting, the Santa Cruz Homeless Garden Project is a successful, inspirational prototype for helping people lift themselves out of homelessness.

New work skills develop in the healing process of growing organic foods, social relationships are built with other workers & volunteers, and self esteem is nurtured by producing and sharing healthy foods.

Workers and volunteers enjoy 4 hot meals a week together from the garden. Customers can shop the Garden’s bounty at the Farmstand, which is open Tuesday - Sunday, 10 - 4, or sign up to get regular food boxes from the Garden. 

     To learn more, volunteer, or find out how to visit the Garden, go to: http://www.homelessgardenproject.org/index.php   

Kinematic Chain

      The shoulder, arm, wrist and hand function as what is known as a “kinematic chain.” 

     Think of this as an anatomical “connected movement” chain. Functioning of each part is connected to, symbiotic with, and consequential with, the other parts.

     In-other-words, what's happening at the shoulder may reverberate down and affect the elbow, wrist, and hand. Or in the reverse, dysfunction or injury at the hand, wrist, or elbow can affect the functioning of the shoulder.

      This is why, as an Activator Chiropractor, my precise adjustments to correct a problem anywhere in the upper extremity often include adjustments all the way up or down the arm to include all the component parts.