Reading an article this month in Money magazine sheds some light on what we are moving toward. I recommend everyone read the article. While I will not go into the ” insurance exchanges”, higher premiums for younger adults and tax credits. I do  see some benefit to this type of coo- coo action. How?

Well, it is going to push us(health-care facilities) toward a boom of non-profit organizations delivering health-care. “You mean like in the 1950′s when health-care worked?” Yep. When hospitals were not for profit but ran on donations from large capitalistic companies and Churches with the added benefit of not paying taxes. Why would the companies do this? Simply because it will cost companies less to invest(own) non-profit facilities delivering health-care to their workforce than continuing to buy overpriced insurance. Sure, it may take a few years!

My advice to young people heading into college would be to get a communications degree and learn how to start non-profit organizations. I am sure some large companies could really see some tax advantages to donating generously to a non-profit health-care company. Just pick mine would ya!

Of course this plan is subject to the Government of the United States giving out non-profit status to health-care companies. Can you say November!

Come on all you capitalistic pigs let’s get it started!

GETTING YOURSELF IN SHAPE FOR THE BIG EVENT

What can I do to get my body ready for labor and delivery?

If they’re truly honest with themselves, most women will admit they aren’t in shape for the ordeal their body is about to experience when they learn that they are pregnant. It’s time for a little self assessment. I need for you to evaluate your established exercise routine, not the one you were planning to start someday soon, but what you actually do:

• o I exercise everyday and I’m in great shape
• o I exercise at least three times a week and I’m happy with my muscle tone
• o I work out when I can
• o I prefer not to answer this question

As we discussed in an earlier chapter, it’s best to bring in some experts for help with your physical conditioning. Any member of your healthcare team will be able to offer you some names of physical therapists or personal athletic trainers he or she would recommend. Regardless of your current exercise routine, you should consult with a trained individual. Especially if you have an undefined workout regimen, it’s critical that you get some help.

Don’t be intimidated by the process. Learn how to exercise for your own benefit and for the good of your baby.

Here are some general guidelines to follow:

1. Check with your primary healthcare professional. This is probably your Ob-Gyn. Make sure you don’t have any complicating issues with your pregnancy that would impede or impact certain workout activities.

A good physical therapist is going to ask whether you are cleared by your doctor, so you might as well have that answer covered before your appointment.

1. Stay away from dangerous exercises or activities. Few women will take up boxing or bronco busting while pregnant, but I’m often surprised by what some moms-to-be think are fine, safe pursuits in their condition. Check with your doctor.

I always say that you can’t stop a bowler from bowling or a runner from running or a horsy person from riding off into the sunset. All I can do is urge you to use caution and to keep moderation in mind at all times.

1. Modify your activities for nine months. Your body is going to go through many changes that will leave you susceptible to ligament and/or muscle damage. Hormonal changes alone can compromise the muscles and ligaments you’ve come to rely on. Even if you’re a world class athlete, you don’t have the same body you had just a few months ago.

__________

“Your body is going to go through many changes that will leave you susceptible to ligament and/or muscle damage.”

__________

1. Drink, drink, drink . .  . water. As a pregnant woman, you’re more vulnerable than normal to dehydration when you participate in any sort of physical activity. Lack of fluids can lead to an elevated body temperature and uterine contractions—neither of which is good.

When you’re working out, you need to hydrate continually. If your cheeks are red and rosy after exercising, it won’t be the proverbial “glow” of pregnancy; it will indicate that you’re dehydrated.

I’m a bit obsessive when it comes to water. I believe you should drink a twelve (12) ounce bottle of room temperature water before you exercise and another twelve (12) ounce bottle for each half hour of activity, regardless of how strenuous. When you’re done, have another bottle. If it’s hot and humid, drink even more!

When I ask expectant moms if they’re drinking enough water, they always believe they’re glugging down plenty. One pregnant patient responded, “If I pour any more water down my throat, I’ll qualify as lakefront property.”

Check your water intake and make sure your Ob-Gyn is aware of what’s happening with your body.

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1. Avoid getting overheated. Please wear proper clothes when working out to help alleviate the risk of over heating. Especially when the temperatures rise, don’t shroud your pregnant body. Be proud of it. Wear cool, loose fitting clothes of natural fibers like cotton.

If you sense dizziness or if you feel flush or warm to the touch, STOP whatever you’re doing and cool down.

__________

“If you sense dizziness or if you feel flush or warm to the touch, STOP whatever you’re doing and cool down.”

__________

My wife had two August babies (hey, it’s cold in Colorado in December, okay?) and I got sweaty just watching her walk out to the car.

Fortunately, today’s clothes are better designed and offer better materials to keep you modest and cool at the same time compared with what your mom had to wear.

1. Eat more. Yes, you read that correctly, eat more. Our culture has you freaking out because you’re getting bigger, but that’s the whole idea. You’re burning calories with exercise and you’re nourishing your baby.

You especially need to keep your calories up when you exercise often.

And remember that quality is just as important as quantity. If you don’t plan on feeding your baby fries and a chocolate shake after the birth, why would you do it now?

When you exercise, you should also have a snack such as fruit or yogurt after you have completed your workout to keep your glucose levels up.

According to the American Pregnancy Association, a good rule of thumb is three hundred (300) extra calories of wholesome food daily with moderate exercise.

1. Don’t over exercise. If you can carry on a conversation while you’re working out, you aren’t excessively exerting yourself. If you can’t talk, you’re pushing too hard: slow down or stop completely and reevaluate your activity. If you don’t have a workout partner, just talk to yourself. Just tell people you’re not nuts, you’re pregnant. Trust me, they’ll understand.

If you find yourself getting short of breath, take a break.

I find it’s usually in the first trimester that women overdo exercise. There are two reasons for this phenomenon:

1. i.     They are trying to hurry to get in shape.
2. ii.     They aren’t showing enough to be reminded that they need to use moderation.

You need to understand that the first trimester is critical to the development of your baby. Your body is doing extra work to make that beautiful little boy or girl. When you are pushing it, you’re actually overexerting your developing baby, too. If you’re tired, take a nap. Doctor’s orders!

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1. Warm up and cool down properly when exercising. Start slowly each time you work out. The warm up can be just as beneficial as the actual workout session.

Stretching and breathing prior to starting your exercise regimen can help increase O₂ (oxygen) to the lungs and muscles and can help you relax, preparing your body and mind. Put some love into your warm up and increase the effectiveness of the workout.

1. Don’t lie on your back. There’s a reason the back of the table props up in your doctor’s office and why the nurse will put a pillow behind your back.

If you lie flat on your back for a few minutes or more during the later months of the pregnancy (after about twenty-fourth [24^th] week), you may start to feel light-headed, dizzy, and possibly breathless. That’s because your growing baby is putting pressure on one of your major blood vessels called the vena cava. The vena cava lies on the right side of your body. During pregnancy your enlarged uterus also naturally leans toward your right side (as it moves up and out of the pelvis after twelve [12] weeks). This can make the vena cava blood vessel prone to becoming compressed while lying on your back. Learn to lie on your side, preferably your left side so you uterus is moved away from your vena cava.

10.  Include the dad whenever possible. Pregnancy isn’t an individual sport. It took two of you to get into this condition and getting out of it is best when it’s a team event.

I always urge dads to get involved with your walks or other physical activities a couple of times a week over all forty weeks. Every coach your significant other has ever heard of goes to all of the practices and workouts. There’s no coach around who would ever think to just show up for the main event. It’s a terrific opportunity to share communication and motivation.

__________

“I always urge dads to get involved with your walks or other physical activities a couple of times a week over all forty weeks.”

__________

11.  Listen to your body. Pace yourself. If you work a full eight hour day, adapt your workouts. If need be, some days limit your activity to just your stretches if that’s what your body is telling you.

If your body tells you to stop exercising completely, though, you probably misunderstood. Ask it to repeat itself and listen more carefully. Rest now and then, but keep working out for your own good and for the good of your baby.

12.  Stretch before working out. Slow, steady stretching will help muscles stay loose and flexible. This is important at all times, but especially when you’re pregnant. Along with improving flexibility, stretching will allow your body to relax and unwind after a tough day, while warming up your muscles. Stretching at the end of your workout will also improve your flexibility.

13.  Watch for swelling. Or edema (sometimes known as dropsy or hydropsy). Edema is the increase of interstitial fluid in any organ. If you notice swelling of your ankles or fingers, for example, that last after you’ve finished cooling down at the end of your work out, you’ll need to make some modifications to your regimen.

What are obvious signs of swelling? Your rings are too tight or your socks leave an indentation around your ankle. As soon as you get home after any sort of workout, elevate your feet.

If the expectant dad is available, put him to work rubbing your feet to flush pooling blood. Give him the, “It’s for the baby,” routine. It works every time in my house.

Part of the solution to the posture challenge in pregnancy comes from the members of your healthcare team. You need passive intervention. Your body needs to be stretched, strengthened, moved, touched, kneaded, and treated.

Your team needs to alter and coordinate the proprioceptive receptor signals governing your spine. Using their skills, they will essentially reboot your receptor-to-posture mechanism so your upper motor neurons can accept your signals of shifts in your center of gravity that will initiate appropriate alterations to the curves in your spine.

__________

“Your body needs to be stretched, strengthened, moved, touched, kneaded, and treated.”

__________

Because these members of your team work with skeletal muscles and connective tissues in different ways, they can each play a role in helping your back compensate for your pregnancy.

1. Your massage therapist. Getting the muscles and ligaments passively worked while in a prone position is one of the best ways to allow down time for the brain to receive new information about the pressures on your spine. In effect, you’ll trick your body into changing its neurologic firing to accept your new reality.
2. Your acupuncturist. Focusing your nervous system to accept a new reality of posture. This therapy maybe longer lasting due to stimulation time of the muscles and ligaments.
3. Your chiropractor. Working specifically with the spinal column where most of the input is exchanged, your chiropractor will essentially recalibrate the joints and surrounding muscles and ligaments by realigning the spinal column.
4. Your physical therapist. By starting a stretching program or low impact strengthening program recommended by your physical therapist, you will start firing more receptors in your body so your brain and spine can better calibrate what’s happening with your body.
5. The baby’s dad. Finally, something for him to do! Touch is a significant factor when dealing with the spinal column’s impact on posture. Your partner needs to diligently and effectively stimulate the largest organ in your body: your skin. This will require him to do things like apply lotion to your back and legs. He’ll need to rub your feet. He’ll have to do whatever he can to refresh your stimuli receptors and start sending renewed signals to your brain. His concentrated touch is a process that you can do on a daily basis to clear out all of the confusing signals your brain has had to deal with throughout your day and update your center of gravity database.

How does a cavity start? If you ask your dentist this question he/she will tell you about sugars, bacteria and acid formation or something to that effect. In other words he/she would have a straight forward answer.

Ask a MD, DO or DC about how back pain begins and watch out! You will get so many different answers that you will not be able to draw one conclusion with all the information given.

So, are you ready for my explanation?

Well, before I give my answer I was told in a very nice way today that I get preachy, opinionated with a touch of anger in my blogs. I apologize. This is my soapbox and I love to vent! You of course could give your opinion at anytime.

The answer= disc or inter-vertebral disc damage is were back pain begins.

What? Think of it this way. If you buy a new car right off the lot what is the first car part you will most likely have to replace? Tires. Think of your inter-vertebral discs as tires. Does your tire just explode when you drive it off the car lot or even if you drive them 5,000 miles? No, it better not. If your tires do get damaged or blow out is it not due to a pot-hole or because they have worn down treads? If you drive on gravel or pavement(environment) would this effect those tires?

This is a very simple analogy to what occurs with ligaments and the inter-vertebral discs of the spine. Today many of the cars we drive have sensors that will tell you if your tires are going bad, going flat or need to be replaced. Your car does this through computer pressure sensors. Well guess what also has pressure sensors? Your inter-vertebral discs. The sensors in your body are nerves that connect the outer third of the disc to muscles, skin and ligaments. These sensors send information to your spinal cord and brain.

When your discs show signs of wear and tear (degenerative disc disease) they send an alarm and alter function to your body in the form of symptoms. The small nerves that innervate the disc with connections to muscles, skin and ligaments send signals of; stiffness, aching and/or sharp pain. The pain can be radiating (really all nerve pain is radiating) or “localized”. The signals from the “bad” disc will also change contractility of muscles or shut them off completely.Why? To stop further damage I presume. Just like a cavity stops you from chewing on the bad tooth. Disc symptoms or degenerative discs are silent just like a cavity until blow out time.

When you get a cavity in your mouth does it just cause shooting pain in your jaw all at one time? Or in one day? No. First, you notice your cavity when you bite down or with hot or cold. Same thing with the inter-vertebral disc innervation.

These disc symptoms are often first diagnosed as a sprain or strain (muscle/ligament problem). Again, these “muscle problems” are really nerve problems from a disc going bad telling the body to stop moving around. While I do consider the disc tearing a sprain. I also recognize that it is a sprain with neurological repercussions also known as a chiropractic subluxation. Did I mention that the small nerves from the inter-vertebral disc supply signals and function to the muscles of the back? Ever heard “you got a weak back.” Is it weak or flaccid? see earlier blog on core strength.

At what age to most people have back surgery? In their late 30′s early 40′s. When does degenerative disc disease show up? About late 30′s early 40′s.

Man, should have gotten my tires checked sooner! What is the average patient of mine? About 40.

WARNING!!! PREACHY PART COMING…….

Just because your “doctor” says, “You can’t have a disc problem, because if you did your leg would have pain, be numb and your foot would tingle.” Does not mean that you don’t have a disc tear, herniation or both.

If you have a tingling foot, numb leg or loss of function in your leg you hardly need an educated doctor to diagnose that problem. I could get your diagnosis on WebMD pretty quick. Of course there are other differentials and I am not suggesting you just use WebMD for your diagnosis. What I am saying is do you want to take medical advice from someone who is reactive or proactive with your back pain?

Do you want to rotate your tires or just wait until they blow? I know what you are thinking. How can a chiropractor help a disc or soft tissue problem? As I just defined how back pain starts, I do have the solution.

I just don’t have the energy to answer that question today. Maybe some other time.

Dr. Trenton Scott D.C.

Low back pain is so prolific that everyone seems to be an “expert”. I happen to work with lower backs all day long, everyday. I have looked at and studied spine physiology from neurophysiology to muscle physiology. What people want me to say is that just “stretching and strengthening” your back is enough, this would be speaking partial truth. A good chiropractor or a good physical therapist will tell you their are people with lower back pain that we just didn’t help. So, it would stand to reason that just exercising is not going to be a magic fix for your spine. As I wrote in my last blog “Core strength…Hogwash” the ligament system of the spine is far more important than the neuromuscular system.

How do I strengthen my ligaments? You don’t so take care of them. But how? Diet, Diet and better Diet. Don’t traumatize your back like jumping out of airplanes or running on pavement for 12 miles a day. And if you do these things turn to organ system balance with acupuncture, chiropractic, diet and stretching. Don’t just take my word for it. Do some research. I mean real research not the B**lsh*t being handed out on TV.  Buy books on the subject and make up your own mind about it…..think.

I love my patients. I have to speak the truth. I only wish I could spend more time speaking with each one of them. That is the gold in my day. Stay gold.

Trenton

38-55 Stay Gold

They ask me, “why is my back hurting I have been working on my “core”. First we have to break down the anatomy and physiology of the spine as to what the problem is with your lower back. Guess what! Your back does not hurt because you have weak “core” muscles (myth). In fact your weight has much more to do with back pain than weak core muscles.

Wait,  I am getting ahead of myself. What are the “core” muscles? If you ask your trainer at the gym he/she would probably be wrong. That is unless they read peer review journals such as Spine. I won’t bore you with the few muscles important to spine stabilization, but those muscles responsible are mostly out of cognitive control. In other words they are hardwired to fire consistently all the time so you can sit, walk or jump at a moments notice. These deep muscles are endurance muscles with a set tone, your not going to back bend or crunch them into shape. More important than the deep stabilizing muscles of the spine are the back LIGAMENTS!! Not as cool a buzz word as CORE, but true. Basically, your posterior ligaments that wrap your spine give your back tensile strength…a kinda fulcrum, like your knee cap.

Well as we get older, sit all day for a job, have a few kids, carry 20+pounds for few years and have numerous micro or macro traumas to the spine your ligaments start to show some wear and tear(aka degeneration). Degeneration comes to us all and our spines destabilize.

So, you see the Biggest Loser on TV and with your unknowing destabilized and asymptomatic back you start kettle balling everyday……yeah!, whooo hoooo…..ouch. Now what I did not tell you before is that pain is a neurological problem. Or more specifically a neuromuscular problem in this example. When ligaments (discs included) become inflammed from tearing (sprain) from degeneration and kettle balling we get pain. Your hardwired muscles are now “offline” due to the neurological irritations of the sprain and the deep hardwired muscles are now atrophying(weakening) at an alarming rate. They are now flaccid not “weak”. What is the difference? “Flaccid” is not getting neurological signals causing deterioration or degeneration. “Weak” muscles are neurologically plugged in but full of marbled fat causing a contractility problem.

I work on professional athletes weekly and they all have chiseled abs and backs that rival The Hulk. Guess what, they are in my office with back pain.

Out the window with “core” strength! In with damage to the ligament structures of the back. Due to macro trauma.

What can I do to help my back?

As I just explained you have back pain due something a hell of a lot more complicated than weak core muscles or a “weak” back. Look at your life, work and home.

Work on your bodyweight and food you are eating. Start with endurance and center of gravity exercises as in Tai Chi. Light workout with dumbells and walking. Remember to take it slow and listen to your body.

Forget what you are seeing on TV! That is just good TV ……not good for you.

Cook, bottle washer and chiropractor (theory number one)=

Have you ever seen a chiropractic hospital? Or a clinic with more than ten chiropractors in it? No. At least not around these parts. Why is that? Well it boils down to the fact that chiropractors are basically forced into running a business from top to bottom and having to be the best chiropractic doctor as well. Running a business is HUGE! There is the marketing, demographics, hiring, firing, accounting, billing, clerking, computer work, chart filing etc….
Whoa! Something has to give. What gives? Very often the doctoring of chiropractic gets watered down. What I mean is that they are so focused on the bottom line they forget whom they serve. What terrific clinical knowledge they should use to help the world is shelved as they are figuring out how to be a businessman. No hospitals or large clinics for chiropractors to go to and make six figure salaries. Just tough streets and a sign to hang. Now you know why you see a chiropractor on every corner.
Things start to get tough with the business and the chiropractor starts to outsource the marketing, accounting and really the direction of the company so they can try and focus on the patient.
Soon the marketing firm is coming up with pitchy sales and canned approach to making money. So tired at this point, the chiropractor starts to take direction from the marketing firms on how to be a chiropractor! Soon the chiropractor is treating according to the marketing firms and really upsetting patients with bad service and half-truths. To paraphrase Yoda, “Fear leads to anger, anger leads to hate, hate leads to suffering.”
A person comes into chiropractic office already fearful and usually in pain and leaves sometimes in anger while still suffering.

to be continued……..

By Shelley Widhalm
Loveland Reporter-Herald

Loveland resident Trenton Scott has been asked how, as a man, he can write about pregnancy in his book “The Other Side of Pregnancy,” published in 2008.“I felt there was a story to be told about what I do for a living,” said Scott, a chiropractor and acupuncturist who wrote the book with the assistance of Rick Sawyer of Loveland.

In his book, Scott wrote about the neck and back pain pregnant women can experience from carrying a child, which can weaken the ligaments supporting the spinal column.

He explains the causes of back, neck and head pain specific to pregnancy and looks at the importance of posture, while covering what women can expect during and after pregnancy.

Scott says he understands back pain, having experienced a disc herniation more than a decade ago, along with caring for patients at Scott Family Chiropractic, a Loveland-based clinic he and his wife, Gina, also a chiropractor, own and founded 14 years ago.

Trenton Scott wrote the book from an informative and practical perspective, providing real-case anecdotes, he said.

“I didn’t want to get real technical,” he said. “I want to give (my readers) entertainment and thought-

provoking ideas when and if back pain strikes.”

Trenton wrote from a coach’s perspective, he said.

“To be a great coach, you need to be a keen, well-schooled observer, not a star participant,” he said in the introduction to his book.

He planned to write his book 11 years ago when Gina gave birth to their first of four children and experienced back labor, something he wished he knew more about.

_

At the same time, several of his patients were complaining of back and neck pain and telling him they did not realize they could see a chiropractor during pregnancy.

Trenton began a search on treating back pain during pregnancy and saw a void in information about how to manage the pain, such as through chiropractic care, acupuncture and massage therapy. He read several books on pregnancy and noticed the sections on back pain were small.

Many of the books on the topic recommended stretches and exercises during pregnancy as a way to get rid of back pain, Trenton said.

“Let’s give these moms a break,” he said. “More can be accomplished through appropriate diagnosis and treatment than giving them a bunch of stretches.”

Trenton found that more than 50 percent of women experience back pain during pregnancy, which can be avoided or, at worst, managed, he said.

“They’re not finding their center of gravity. Their body is changing so rapidly,” Trenton said, adding that muscles and ligaments can become fatigued from carrying a baby.

Massage can help with the resulting poor posture and back pain, he said.

“By working the muscles, you’re working the neurological messages to the brain through the spinal cord,” he said.

Trenton plans that his next book will focus on the father’s point of view of pregnancy.

“I want them to be more empathetic toward their wives, more proud of their wives,” he said.

First, Injury= damaged tissue and inflammatory enzymes (cytokines) are released at the site of injury. This opens blood vessels to rush healing oxygen and nutrition to the site. This reaction also causes swelling and pain!

Second, temperature and pain both use the spinothalamic tract to communicate both types of sensations(temperature/pain) to the brain. Using heat or ice essentially “masks” the pain in delivery to the brain. Ice however will cause your vessels to constrict at least initially to stop swelling. The flushing sensation of dilation to constriction will flush the injury and many protein causing pain chemicals will be removed. Cold also with take your pain level up until numbness takes hold. This makes it much harder to over ice your injury.Not so with heat.

Using a heating pad increases the vasodilation and swelling to the injury site- causing more damage. It feels ‘good’ because you are over-riding or confusing your brain to feel only heat and not pain due to the same neurologic pathway.

So I always recommend my patients to ice until numb (about 20 mins) twice daily with injury. Heating does work usually after day or two post injury. You may use hot epsom salt bath or hot shower.

You need an hour at a time for several sessions throughout your pregnancy with a trained specialist. In many cases, the massage therapist is second in importance only to your Ob-Gyn during your pregnancy.