Cluster Headaches

Cluster headaches are typically very short in duration, excruciating headaches, usually felt on one side of the head behind the eyes.  Cluster headaches affect about 1 million people in the United states and, unlike migraines, are much more common in men between the ages of 20 and 40.

This is the only type of headache that tends to occur at night.  The reason that they are called 'cluster' headaches is that they tend to occur one to four times per day over a period of several days.  After one cluster of headaches is over, it may be months or even years, before they occur again.  They come on abruptly, with intense throbbing pain arising high in one nostril and spreading behind the eye on that side of the face.  Without apparent reason, the cluster may subside as quickly as it began.

• Affect only 1% of the population, with a ratio of 85% men to 15% women.
• Referred to as “suicide headaches” because of the intense pain. Women describe the pain as “worse than giving birth”.
• Usually will begin slowly and gradually.
• Can last from 30 minutes to several days. In chronic cases, may persist for many months.
• Immediate onset, with no “early warning” signs
• Frequent attacks during a “cluster period”, occur several times a day for weeks and months at a time. One to two cluster periods a year. Duration 15 minutes to three hours
• Excruciating pain affects one eye; may extend to forehead, cheek, head, and neck.
• Swelling, drooping, redness, sweating and/or tearing in or around affected eye.
• Stuffy or runny nose on same side as affected eye. Nausea/vomiting
• May shift between eyes during the same cluster period.
• Unlike Migraine sufferers, Cluster sufferers prefer to sit up, stand or pace.
• No one is sure of exact cause. Because of the cyclic regularity, may be tied into the body’s “biological clock” located deep in the brain in the hypothalamus.
• Other areas of interest include changes in levels of brain neurotransmitters, s.a. serotonin and changes in levels of certain hormones s.a. cortisol and melatonin.
• Drinking alcohol during a cluster period often triggers a headache.

Sinus Headaches

Sinus headaches cause a dull, deep, throbbing pain in the front of your head and face.  They are caused by an inflammation in your sinuses (air-filled cavities around your nose, eyes, and cheeks).  Bending down or leaning over generally makes the pain worse, as does cold and damp weather.  Sinus headaches often begin as soon as as you get up in the morning, and may be better by afternoon. Sinus headaches can be difficult to diagnose, however, because symptoms are similar to tension headaches and migraines.

• Pressure like pain in one specific area of face or head
• Face is tender to touch
• Sudden temperature changes, like going into cold from a warm room may worsen pain.
• Headache starts when you have a bad cold or just after.
• May be caused by anything that keep the sinuses from draining.
• Risk factors may include: history of allergies or asthma, nasal polyps, climbing or flying to high altitudes, frequent swimming and/or diving.
• Other symptoms related to sinus inflammation:
• Postnasal drip with a sore throat.
•  Yellow or green discharge from your nose.
• Red and swollen nasal passages.
• Mild to moderate fever.
• General sense of not feeling well.
• Fatigue

 We are continuing our discussion on headaches for the month of August. This week we are discussing migraines. Be sure to check out our blog , if you missed it, on last week where we discussed tension headaches.

Migraine Headaches

Each year, about 25 million people in the U.S. experience migraine headaches, and about 75% are women. Migraines are intense and throbbing headaches that are often associated with nausea and sensitivity to light or noise. They can last from as little as a few hours to as long as a few days. Many of those who suffer from migraines experience visual symptoms called an "aura" just prior to an attack that is often described as seeing flashing lights or that everything takes on a dream-like appearance.

Migraine sufferers usually have their first attack before age 30 and they tend to run in families, supporting the notion that there is a genetic component to them. Some people have attacks several times a month; others have less than one a year. Most people find that migraine attacks occur less frequently and become less severe as they get older.

Migraine headaches are caused by a constriction of the blood vessels in the brain, followed by a dilation of blood vessels. During the constriction of the blood vessels there is a decrease in blood flow, which is what leads to the visual symptoms that many people experience. Even in people who don’t experience the classic migraine aura, most of them can tell that an attack is immanent. Once the blood vessels dilate, there is a rapid increase in blood pressure inside the head. It is this increased pressure that leads to the pounding headache. Each time the heart beats it sends another shock wave through the carotid arteries in the neck up into the brain.

There are many theories about why the blood vessels constrict in the first place, but no one knows for sure. What we do know is that there are a number of things that can trigger migraines, such as lack of sleep, stress, flickering lights, strong odors, changing weather patterns and several foods; especially foods that are high in an amino acid called ‘tyramine.’You can reduce the likelihood of migraine headaches by making some lifestyle changes.

HEADACHES:

Numerous research studies have shown that chiropractic adjustments are very effective for treating tension headaches, especially headaches that originate in the neck.

A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that "spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than commonly prescribed medications." These findings support an earlier study published in the Journal of Manipulative and Physiological Therapeutics that found spinal manipulative therapy to be very effective for treating tension headaches. This study also found that those who stopped chiropractic treatment after four weeks continued to experience a sustained benefit in contrast to those patients who received pain medication.

Each individual’s case is different and requires a thorough evaluation before a proper course of chiropractic care can be determined. However, in most cases of tension headaches, significant improvement is accomplished through manipulation of the upper two cervical vertebrae, coupled with adjustments to the junction between the cervical and thoracic spine. This is also helpful in most cases of migraine headaches, as long as food and lifestyle triggers are avoided as well.

Throughout August, we will be discussing the following types of headaches:

· Tension

· Migraine

· Cluster

· Sinus

We will also discuss Chiropractic care for headaches, headache trigger points, and how to avoid headache triggers.

TENSION HEADACHES

Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. Most people describe a tension headache as a constant dull, achy feeling either on one side or both sides of the head, often described as a feeling of a tight band or dull ache around the head or behind the eyes. These headaches usually begin slowly and gradually and can last for minutes or days, and tend to begin in the middle or toward the end of the day. Tension headaches are often the result of stress or bad posture, which stresses the spine and muscles in the upper back and neck.

Tension headaches, or stress headaches, can last from 30 minutes to several days. In some cases, chronic tension headaches may persist for many months. Although the pain can at times be severe, tension headaches are usually not associated with other symptoms, such as nausea, throbbing or vomiting.

The most common cause of tension headaches is spinal mis-alignment in the upper back and neck, especially the upper neck, usually in combination with active trigger points. When the top cervical vertebrae lose their normal motion or position, a small muscle called the rectus capitis posterior minor (RCPM) muscle goes into spasm. The problem is that this small muscle has a tendon which slips between the upper neck and the base of the skull and attaches to a thin pain-sensitive tissue called the dura mater that covers the brain. Although the brain itself has no feeling, the dura mater is very pain-sensitive. Consequently, when the RCPM muscle goes into spasm and its tendon tugs at the dura mater, a headache occurs. People who hold desk jobs will tend to suffer from headaches for this reason.

Another cause of tension type headaches comes from referred pain from trigger points in the Sternocleidomastoid (SCM) or levator muscle on the side of the neck. These are much more common in people who suffer a whiplash injury due to the muscle damage in the neck region.

Study: Prevent high blood pressure by eating blueberries

by Ethan A. Huff, staff writer

(NaturalNews) Researchers from the University of East Anglia (UEA) and Harvard University have discovered that eating blueberries helps to prevent the development of high blood pressure. According to their report, which will be published in the American Journal of Clinical Nutrition, eating at least one serving of blueberries a week helps reduce the chances of developing high blood pressure by ten percent.

Blueberries are rich in anthocyanins, which are powerful antioxidant pigments in the flavanoid family known to reduce the overall risk of cardiovascular disease. But thanks to the new research, it is now known that high blood pressure in particular is targeted by these important nutrients.

The team evaluated 134,000 women and 47,000 men as part of their study, none of which had high blood pressure at the start of it. Over the course of 14 years, participants filled out questionnaires every two years about their dietary habits, and researchers analyzed this data to see how flavanoids affected overall health.

Throughout the duration of the study, 35,000 participants developed high blood pressure. But researchers noted that those who consumed the mostanthocyanins throughout the course of the study were eight percent less likely to develop high blood pressure compared those who consumed the least amount. And those who ate at least one serving of blueberries per week were ten percent less likely to develop high blood pressure than those who consumed no blueberries at all.

"Our findings are exciting and suggest that an achievable dietary intake of anthocyanins may contribute to the prevention of hypertension," said Prof. Aedin Cassidy, lead author of the study and faculty member from the Department of Nutrition at UEA's Medical School.

Sources for this story include:

http://timesofindia.indiatimes.com/...

Breast cancer breakthrough: vitamin D in combination with sun exposure is key to prevention

by S. L. Baker, features writer

(NaturalNews) As NaturalNews has covered for years, researchers have found a profound link between breast cancer and low levels of vitamin D (http://www.naturalnews.com/023264_V...). Women with the lowest blood levels have the highest breast cancer risk and those dying of metastasized disease are the most vitamin D deficient of all. Scientists have theorized vitamin D has anti-cancer properties that influence cell growth, healthy cell differentiation and programmed cell death (apoptosis).

However, when researchers have looked only at levels of dietary vitamin D intake and breast cancer risk, their findings have been sometimes inconsistent. So what is going on here? Does vitamin D definitely have the potential to prevent breast malignancies or not? A large and potentially groundbreaking French study appears to have the answer: the key to breast cancer preventionmay well be taking higher amounts of vitamin D through diet and supplements combined with regular, direct sunshine exposure.

The new research, headed by Dr. Pierre Engel from INSERM (Institut National de la Sante et de la Recherche Medicale, which is France's equivalent to the National Institutes of Health in the U.S.), investigated data combined from a large, decade long study involving 67,721 post-menopausal French women. The analysis came up with clear, startling evidence that while vitamin D plays a role in reducing the risk of breast cancer, the addition of adequate sunshine exposure is the factor that substantially drops the risk even more.

The scientists found that women living in the sunniest places in the south of France, such as Provence, had only about half the risk of breast cancer of women residing in less sunny latitudes, such as Paris. Even women who had the lowest vitamin D intake but who got lots of sunshine had a 32 percent lower risk of breast cancer than their counterparts living in less sunny latitudes of France. What's more, the women who consumed the most dietary vitamin D from foods and supplements and who had regular, generous sun exposure had the most significant protection from developing breast cancer.

In their research paper, which was just published in the journal Cancer Epidemiology Biomarkers and Prevention, the French team concluded that a minimum threshold of vitamin D obtained from both sunshine and diet "..is required to prevent breast cancer and this threshold is particularly difficult to reach in postmenopausal women at northern latitudes where quality of sunlight is too poor for adequate vitamin D production."

They also noted that the minimal intake of vitamin D to reduce the risk of breast cancer is likely to vary with an individual woman's ability to metabolize or synthesize the vitamin from both diet and sunshine exposure. Adding that the average American and French woman has relative low levels of vitamin D and tends to get little exposure to sunshine, the scientists recommended "...an increase in overall vitamin D intake should be encouraged by food and health agencies."

For more information:
http://www.ncbi.nlm.nih.gov/pubmed/...
http://www.ncbi.nlm.nih.gov/pubmed/...

Align Chiropractic and Wellness is now open in Tempe, AZ!

We offer Chiropractic, Massage, Acupuncture and Physical Therapy.  We help people with neck pain, back pain, shoulder pain, knee pain, headaches, allergies, prenatal care, pediatric care, digestive issues, stress, anxiety, nutritional counseling, weight loss, post-op care for musculoskeletal injuries, fitness, and exercise...just to name a few!

We are open Monday-Saturday, please contact our website for specific dates and times. www.alignchiropracticandwellness.com.

 Contact us today for our GRAND OPENING SPECIALS and to make an appointment!

480-264-6181

 In health,

Dr. Patricia Marquez 

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
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Strong Bones and Core Strengthening - Good Tips for a Healthy Lower Back

Core Strengthening

The benefits of core strengthening include support for your lower back, improved heart and lung function, and improved coordination and stability. This miracle set of exercises even helps reduce your waistline! A basic core exercise starts with you lying on your back on an exercise mat. Your arms are extended to the side, perpendicular to your torso. Your thighs are flexed - perpendicular to the floor, and your knees are bent so that your calves are parallel to the floor. Focusing on your deep abdominal muscles - visualizing these muscles working - gently lower your thighs to the floor on the right side. Your spine stays straight, maintaining contact with the floor, so the effect is that you're twisting your legs against the line of your trunk. Using your abdominals to initiate the movement, return your legs to center and gently lower them to the left side. You've now done one repetition. Start with six total reps, moving your legs gradually and making sure the movements originate in your abdominal muscles. Build up to 10 reps over a period of several weeks. You could include this valuable exercise into your regular pre-workout routine.

Strong bones are important for all of us, not only for the aging baby boomers about whom we're hearing so much lately. And, "strong bones" are much more than a marketing ploy cooked-up by the dairy industry and pharmaceutical companies.

Bones are incredibly dynamic, constantly reshaping themselves in response to physical forces. Bones provide structure for our bodies, and they carry our weight around as we move from place to place. Long bones such as the thigh bone act as factories to produce blood cells. So, bones are an important part of our overall health and well-being.

Lots can go wrong when your bones aren't strong. If you suddenly fall onto an outstretched arm, you'll probably be OK if your bones are healthy. If not, you'll probably be in a cast for four weeks to help repair a wrist or forearm fracture.

If an older person falls, hip fractures are the main concern. A fit, healthy person can usually walk away. With weakened bones, hip fractures can result in many other problems, both immediately and long-term.

Bones lose their strength due to a calcium imbalance and/or not enough physical exercise. For most of us, these factors can be corrected. The best approach, of course, is to be proactive and ensure enough calcium in the diet and regular exercise.

How much calcium and how much exercise? Recommended daily calcium requirements¹ vary, and 1000 mg per day is a good ballpark amount. Dairy products are the best natural source of calcium, and dark leafy greens such as spinach and broccoli, as well as dried beans, are also good sources. Vitamin/mineral supplements typically provide 25-50% of the daily calcium requirement.

Regarding exercise, both the American Heart Association² and the American College of Sports Medicine recommend 30 minutes of exercise, five days a week. This takes some effort and planning, particularly if regular exercise is a new addition to one's routine. By making the effort and spending the time, we're saying "yes" to health and wellness, empowering ourselves as well as our family and friends.

Importantly, regular exercise in combination with sufficient dietary calcium is the key. Taking calcium alone will not be effective in maintaining strong bones. Unless long bones are undergoing consistent mechanical stresses, as with exercise, there's no need for them to use the calcium that's available. Exercise plus calcium makes the difference!

Core strengthening³ is a hot topic in the world of fitness - Pilates training and its offshoots. But the principles of core strengthening have been around for many decades - dancers, gymnasts, boxers, and wrestlers have been doing these things all along. Only the term "core fitness" is new.

Core fitness turns out to be critically important for all of us. By adding a handful of core exercises - 10 minutes at most - to your regular routine, you will profoundly improve the mechanics of your lower back, hips, and pelvis. And, these remarkable exercises improve the efficiency of your heart and lungs. A very big "bang" for your exercise "buck"!

Your chiropractor will be able to provide expert advice and guidance on these nutritional- and exericise-related topics.

 

¹Daly RM, et al. Long-term effects of calcium-vitamin-D3 fortified milk on bone geometry and strength in older men. Bone 39(4):946-953, 2006.
²Haskell WL, et al. Physical Activity and Public Health. Updated Recommendations for Adults from the American College of Sports Medicine and the American Heart Association. American Heart Association, 2007.
³Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil 85(3 Suppl 1):S86-92, 2004.

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-264-6181 f: 480-264-7152

 Questions About Cancer

Foods for Cancer Prevention

Healthy eating is an important factor in cancer recovery. And, healthy eating can go a long way toward cancer prevention. There are lots of nutritious, delicious foods that provide dynamic resources for your body to achieve peak physical conditioning. Fruits and vegetables are packed with phytochemicals, chemical compounds that have powerful disease-fighting capabilities. Many recent studies have demonstrated that phytochemicals provide significant reductions in the risk of developing cancer and heart disease. These wonder nutrients are found in broccoli, spinach, cauliflower, kale, and tomatoes. Tomatoes contain the important phytochemical, lycopene. In clinical trials, lycopene has demonstrated effective anti-prostate cancer activity and also improved cardiovascular blood flow. Blueberries, cranberries, and apples are all rich in phytonutrients. Phytonutrients found in blueberries help prevent cancer and also help reduce inflammation. Fruits and vegetables have hidden powers that enable us to live longer and live healthier

Cancer is a health issue for many families. It's important to understand that there are different kinds of cancers. Not all cancers are life-threatening. Some types may be very serious and some may be dealt with relatively easily.

First, it's important to distinguish between benign and malignant tumors. The words "tumor" and "cancer" are usually interchangeable.

Tumors (or cancers) affect how cells reproduce. Normal cellular reproduction is tightly regulated. Normally, cells reproduce at regular intervals. In a tumor, cell reproduction is unregulated - cells reproduce on their own schedule, rather than based on the needs of the body. The result is a mass of cells that is growing unchecked. The tumor mass "doesn't belong" - it's like it exists within its own world. But the tumor uses the body's precious resources to maintain its own existence.

Benign tumors are usually slowly growing. The benign tumor mass is surrounded by a membrane and is "well-encapsulated". A benign tumor may cause health problems when it reaches a size big enough to create pressure effects on the surrounding tissues. Such a tumor mass may create pressure on an important blood vessel, or it may kill nearby cells and tissues by the pressure it's exerting on them. Basically, the tumor isn't supposed to be there. There's no room for anything "extra" in the body.

Malignant tumors have more dangerous characteristics. In general, malignant tumors are more rapidly growing than benign tumors. Malignant tumor cells have the ability to make their way into the capillaries, traveling through the bloodstream until reaching suitable locations for new growth.^1,2 A metastasis is a new malignant mass developing in a new location from that of the original tumor.

Also, malignant tumors have the unique ability to cause the body to build an individualized, extensive blood supply for the tumor. This process is called angiogenesis. This complex network of blood vessels supplies the malignant tumor with extra oxygen and nutrients to fuel its rapid growth. So, essentially, malignant tumors highjack the body's resources for the tumor's own benefit. Malignant cells are highly adaptive and deadly.

Medical treatment for malignant cancers includes

• Chemotherapy
• Radiation
• Surgery

Where does chiropractic treatment come in? Chiropractic care may be an important component of supportive care in cancer treatment. Your body needs to use all its available resources and energy to help fight cancer and assist in recovery. Gentle chiropractic treatment helps your body work more efficiently, improving overall mechanical function and easing stress on muscles and joints.³ These chiropractic benefits help make more energy available to assist your body in returning to a healthier state.

Chiropractic treatment helps support the process of recovery and the transition back to maximum health.

¹Gavert N, Ben-Ze'ev A: Epithelial-mesenchymal transition and the invasive potential of tumors. Trends Mol Med 2008 (in press)
²Guarino M, et al: The role of epithelial-mesenchymal transition in cancer pathology. Pathology 39(3):305-318, 2007
³Demark-Wahnefried W, Jones LW: Promoting a healthy lifestyle among cancer survivors. Hematol Oncol Clin North Am 22(2):319-342, 2008

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Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
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What Do Lab Tests Really Mean?

Lab Test Analysis

All forms of health care practice have made great advances in the last thirty years. Laboratory testing has also improved, both in the range of tests available and the rapid turnaround-time of results. But no lab test is perfect. Tests may miss the presence of the disease or may falsely suggest a patient has a particular disease. Either situation may create serious problems. For example, MRIs are an important tool. They reveal more information than ever before. But this comes with a price. Not every suspicious shadow on an MRI means something. Experience in interpreting MRI images is gained over time. Often technology becomes available well in advance of our ability to accurately interpret the results. Lab tests need to be interpreted with caution. Accurate diagnoses need supporting evidence - in terms of patient history, physical signs, and symptoms - in addition to lab results.

You're at the doctor's office because you think something might be wrong. Rationally, you know tests are probably necessary, but getting the tests done sometimes provokes a lot of anxiety in all of us. We want to know the results, but are very concerned about the outcome."You need blood work" your doctor remarks casually. Your insides do an immediate flip-flop and you feel as if you've just begun hurtling down a very steep roller-coaster.

And when the results come back,  it's tough to understand the medical jargon, particularly if the tests are "positive". We've all had the experience of "going south" and not listening to another word that's said after the initial "your test results are positive". Our minds are racing ahead, imagining all the awful possibilities.

Rarely, a considerate physician will be able to put the lab results in a less-worrisome perspective for the patient. For patients, it's important to know some key facts - facts that will empower you any time you need lab tests done.

First, statistically one out of every 20 tests performed will be reported as "abnormal" - even though the result is "normal" for the person being tested. If you are perfectly healthy and have 20 tests done on your blood sample, one of those 20 test results will be "out of the normal range" based on statistics alone.¹

This is because a normal test range is calculated by eliminating the top 2.5% and the bottom 2.5% of results for a large group of  normal people. This leaves the "normal range" as 95%. So if 20 tests are done, statistically one will be "abnormal", because its results fall in the top or bottom 2.5%. The result is normal for you, but reported as "abnormal".

Other factors to consider are the sensitivity and specificity of the lab test.² Sensitivity relates to the test's precision in detecting the disease when the disease is present. If a test for colon cancer was 90% sensitive, it would miss ten cases of the disease out of every 100 cases. Specificity relates to whether a positive test actually indicates the presence of the disease you're being tested for. If a test is 90% specific, in ten cases out of 100 positive results, the patient does not actually have the disease.

So if a test has low sensitivity, actual cases of the disease may be missed. If a test has low specificity, test results reporting the presence of the disease may be wrong. All these factors need to be considered in accurately interpreting test results. Things are not always as they seem.³

Bottom line - test results always need to be evaluated in the specific context of the patient. An isolated lab result - or set of results - needs to be related to the patient's condition and circumstances. An accurate diagnosis is not based on lab results alone. That could be a big mistake. Similarly, x-ray, ultrasound, or MRI results need to be interpreted in context also.
Trying to interpret an x-ray without any clinical information is likely to lead to a wrong conclusion. Context is everything. If you have questions, we will be able to explain why certain tests are necessary.

¹Thomas SL, et al: How accurate are diagnoses for rheumatoid arthritis and juvenile idiopathic arthritis in the general practice research database? Arthritis Rheum  59(9):1314-1321, 2008
²Friston KJ, et al: Classical and Bayesian inference in neuroimaging: theory. Neuroimage 16(2):465-483, 2002
³Kobayashi M, et al: Intraindividual variation in total and percent free prostate-specific antigen levels in prostate cancer suspects. Urol Int 74(3):198-202, 2005

www.alignchiropracticandwellness.com

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-264-6181 f: 480-264-7152

When Parents Get Older

Baby Boomer Vitamins and Minerals

We all need to ensure we're getting our daily vitamin requirements. Baby boomers have additional concerns, relating to maintaining A strong immune system Strong bones A quick memory Good nerve function Various vitamins and minerals support these functions and activities. Vitamin C specifically helps strengthen the immune system. Vitamin C and vitamin E are powerful antioxidants, helping protect against a variety of serious diseases and disorders, including cancer and heart disease. B-complex vitamins help support nerve system function. B-vitamin deficiencies have been specifically linked to memory loss and other neurologic disorders. Calcium and vitamin D are necessary for healthy, strong bones. In combination with regular exercise, these vitamins and minerals can help prevent untimely loss of bone mass. Good nutrition includes making healthy food choices as well as paying attention to our daily vitamin and mineral requirements. This is all pretty easy to do once we've learned the basics.

The average age of Americans is increasing year-by-year. Approximately 77 million babies were born in the United States during the boom years of 1946 to 1964. In 2011, the oldest will turn 65, and on average can expect to live to 83. Many will continue well into their 90s.¹

Most people continue to retain the habits they developed as children and teenagers. For many Americans, these habits included lack of regular exercise, sedentary activities, and poor nutrition.

As adults we no longer possess the free pass we had when we were kids. If we continue to eat high-fat and high-carbohydrate foods, we'll gain more and more weight. If we persist in viewing regular exercise as an unnecessary indulgence, we'll continue to experience high blood pressure, heart disease, and weakened immune systems.

Older adults who resist the importance of good nutrition and regular exercise are also missing the thrill and sheer joy of having a vibrantly healthy, high-efficiency body. In contrast, older adults can achieve high levels of fitness, or even satisfactory levels, and feel much more youthful than they have in years.

How to get there?

Young adults who are the children of older adults can set a good example. Of course, this strategy is the reverse of what we're used to - our parents setting the example for us. But good examples work both ways, and smart parents may be willing to take a tip from their kids.

The first good example is regular exercise.^2,3 The U.S. Department of Health and Human Services recommends 30 minutes of exercise five times per week. Most Americans do no exercise at all. Get your parents into the routine by inviting them to go for a walk or bringing them to the gym and showing them a few basic exercises.

For our parents, the key is to get them started. Keep encouraging them - not as something they "should" do, but rather as something they could bring into their lives as a "choice". No one wants to do what they "should". Make it an invitation - make it fun.

Also, begin to set a good example with nutrition. Take your parents out to dinner at a healthy place - talk to them about eating smaller portions, avoiding fried and processed foods, and food combining. Food combining means eating a portion of protein and a portion of carbohydrate at every small meal.

For most people, altering their food habits-of-a-lifetime is pretty radical. Help your parents learn how to take small steps in the direction of healthy nutrition, rather than attempting to change everything at once. Again, help them have fun with it. Good nutrition is a choice.

For all of us, it's important to walk the talk. Our kids - and even our parents sometimes - will mimic what we do. We want our own lifestyle choices to be healthy and life-promoting, so our kids and our parents have a good example to follow.

Your chiropractor is an expert in using exercise and nutrition as a means of helping patients restore good health. We will be glad to provide valuable information on both of these topics for you and your whole family.

¹MetLife Demographic Profile. MetLife Mature Market Institute, New York, NY, 2006
²Howard RA, et al:Physical activity and breast cancer risk among pre- and postmenopausal women in the U.S. Radiologic Technologists cohort. Cancer Causes Control October 21, 2008
³Leitzmann MF, et al: Physical activity recommendations and decreased risk of mortality. Arch Intern Med 167(22):2435-2460, 2007

www.alignchiropracticandwellness.com drmarquez@alignchiropracticandwellness.com

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-264-6181 f: 480-264-7152

Ten Tips for Smart Stretching

­

Stretch Before or After Exercise?

There's been a lot of discussion lately about the best time to stretch. Ultimately, there's no right or wrong here. What works for you works for you. The main point is to be sure to stretch. Recent exercise physiology studies do show that static stretching (slow, easy stretching) actually reduces muscular power and strength in the short-term. So, for competitive, high-level athletes, static stretching is best done AFTER exercise. For people in their thirties and beyond, many of whom have had back issues at some time, it may still be a very good idea to do static stretching before exercise. The primary value here is to prepare the muscles, ligaments, and joints of the lower back for work. Static stretching of the big muscles of the legs - the hamstrings, calves, and quads - reflexively loosens and elongates lower back muscles and supporting structures. So, for many of us, doing our regular stretching routine first, followed by five or ten minutes of a dynamic warm-up, is still the best preparation for a safe, enjoyable, fulfilling workout.

1. Why stretch? Stretching lengthens muscles and improves flexibility.^1,2 Also, stretching the big leg muscles - the hamstrings, calves, and quads - simultaneously loosens and lengthens the muscles of your lower back. So, when you stretch, you're helping your back!

2. When to stretch? Recent exercise physiology studies show that static stretching is best done after exercise.³ Pre-exercise "dynamic warm-ups", such as torso twists, arm circles, and light jogging, prepare the body for work. Importantly, for those of us with back issues, it's still a good idea to do the familiar static stretches even before the dynamic warm-up!

3. Don't rush! Stretching is as important as what you're going to do after you stretch. And, if you rush, you might pull a muscle or worse. Be sure to include 10 to 15 minutes of stretching as part of your exercise time.

4. Stretch gently and slowly. You're not trying to accomplish anything while stretching. In other words, you're not trying to stretch "this much" or "this far". Nice and easy does it. Stretching is a Zen activity. There should be nor "effort".

5. Pay attention! If your mind drifts, you're headed for a pulled muscle.

6. Visualize! See (in your mind) what you're doing. Hold a mental visual image of the muscle group, where it comes from, where it goes. Visualization helps establish a brain-muscle connection, making your muscles much smarter!

7. Stretch your hamstrings first. Lie on your back with one knee bent [start with the left leg bent; you'll be stretching the right hamstring]. The left foot is on the floor and the left knee is bent approximately 90 degrees. Holding behind the right knee, gently bring that knee to your chest. Alternate this chest movement with a movement that begins to straighten the right leg in the air. The eventual goal on straightening is to achieve a 90 degree angle (or close to this) between the leg and your torso.

8. CAUTION - Progress may be quite slow. Remember - you are where you are. Stretching is gentle and slow. Alternate the bending and straightening movements gently, achieving a slightly greater straightening each time. You should work each leg for between three and five minutes.

9. Calf stretches - face a wall and place both hands lightly on the wall. Keeping both feet facing front, bend the front knee and place the foot of the leg to be stretched directly behind you. Your weight is being supported by the front leg. The back knee is pretty straight and the back heel is on or close to the floor. Maintain the stretch for 10 seconds, feeling the stretch in the calf as the back heel reaches toward the floor.

10. Quad stretches - stand on your left leg, placing a hand lightly on a wall to support the upright posture. Grasp just above the right ankle with your right hand and bring that heel close to the right buttock. The quadriceps is stretched by bringing the right thigh in line with the left thigh, just as if you were standing on both legs. The knees should also be close, in a line. You should feel a stretching sensation down the right thigh. Imagine a straight line running from your right hip socket all the way to the floor.

¹Ferreira GN, et al: Gains in flexibility related to measures of muscular performance. Clin J Sport Med 17(4):276-281, 2007.
²Peeler J, Anderson JE: Effectiveness of static quadriceps stretching in individuals with patellofemoral joint pain. Clin J Sport Med 17(4):234-241, 2007.
³Behm DG, et al: Effect of acute static stretching on force, balance, reaction time, and movement time. Med Sci Sports Exercise (36(8):1397-1402, 2004.

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E. Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-455-9899

Chiropractic and Reducing Stress

Take a Break!   Pop quiz - how long have you been sitting in that chair? Half-an-hour? An hour? Two hours? More?!!! Or, basically, how long have you been working at the same task without taking a break? Most likely, the answer is "too long"! Everybody's in the same boat. There's so much to do and so little time. That may not be the real reality, but it certainly is our experience. We drive ahead, force ourselves to keep going, and forget to "stop and smell the roses". But "smelling the roses" is critical to our health and well-being. Taking a break, relaxing for just five minutes every hour, makes all the difference.

We certainly live in stressful times. It's not easy to assess whether our era is the most stressful, but we do have plenty of daily stress. The job, the home, the kids, the relatives, and the economy - all these stresses add up and yet we wonder why we have so many aches and pains.

So many ailments are stress-related. Americans are notoriously overweight. Overeating is a stress-coping mechanism.¹ Headaches and backaches are often associated with increased stress. There's a strong correlation between high blood pressure and stress, ulcers and stress, and even cancer and stress.

What can we do? The external stresses in our lives aren't going away. Our activity-filled lives are busy and complex - there's always going to be stress. The key is to help avoid or ease the physical effects of stress. Interestingly, chiropractic treatment can be of great assistance in reducing the effects of stress on the body.

In general, stress causes muscles to tighten. This is an unconscious reaction. Tight muscles cause a cascade of further muscle tightening, shortening of muscles and ligaments, and a resulting decrease of mobility in joints, particularly shoulder joints, hip joints, and joints of the spine.^2,3

This overall mechanical effect of stress has a number of additional consequences. All the extra unconscious muscle activity wastes precious nutritional resources and uses up energy needed for critical body functions. Lactic acid accumulates, irritating nerve endings and further increasing muscular tightness. And, importantly, the losses in spinal joint mobility lead directly to increased levels of pain. This, of course, leads to more stress.

This vicious circle of stress, muscular tightness, and pain can be relieved and reduced by chiropractic treatment.⁴ Chiropractic therapy is specially designed to improve joint mobility of the spine and pelvis. This gentle, effective treatment gradually restores maximal spinal motion. Muscle tightness is alleviated, metabolic processes begin to return to normal, and nutrients become more available to help maintain healthy functioning. Levels of pain are reduced, and we become better able to withstand the physical effects of stress.

Your chiropractor will explain the many benefits of treatment, and will provide instruction in stretching techniques and specific exercises that help maintain the positive results of therapy.

There will always be stress. We can learn how to reduce the physical effects of stress, and become stronger, healthier, and happier in the process.

Take a Break! A few quick tips -

• Get up out of your chair or leave your workbench and walk over to an open window. Change your point-of-view. Breathe some fresh air.
• Go for a five-minute walk, either in the corridors of your building or out-of-doors.
• Call a friend and chat for five minutes.
• Close your eyes, clear your mind, and take an imaginary vacation - relaxing on a warm beach, deep-sea fishing on a beautiful yacht, or skiing down a gorgeous mountain.

These short, focused breaks will help reduce muscular tightness and physical stress, and also help your brain recharge so you can be more creative and productive!

¹Marchesini G, et al: Psychiatric distress and health-related quality of life in obesity. Diabetes Nutr Metab 16(3):145-154, 2003
²Weickgenant AL, et al: Coping activities in chronic low back pain: relationship with depression. Pain 53(1):95-103, 1993
³Burns JW: Arousal of negative emotions and symptom-specific reactivity in chronic low back pain patients. Emotion 6(2):309-319, 2006
⁴Hurwitz EL, et al. A randomized trial of chiropractic and medical care for patients with low back pain. Spine 31(6):611-621, 2006

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-264-6181 f: 480-264-7152

Effectiveness & Popularity of Chiropractic Care

80 Percent of Insured American Workers Have Coverage for Chiropractic Services

WASHINGTON--A critical mass of recent surveys and studies document the fact that the public, and conventional health care providers and payers, have come to recognize that traditional medicine can't answer all of consumers' health care needs. In particular, more people are turning to chiropractic services.

• A study published in the July 1, 1998 issue of the Annals of Internal Medicine shows that chiropractic treatment is appropriate for low-back pain in a considerable number of cases. This study by the Rand Corporation found that 46 percent of a sample of low-back pain patients received appropriate care from doctors of chiropractic - an appropriateness rating similar to that of common medical procedures.
• Poll results released in January 1998 by Landmark Healthcare, Inc., showed that one in every five adults ages 55 to 64 has used chiropractic care.
• A December 1997 report from the Federal Agency for Health Policy and Research (AHCPR) notes that the chiropractic profession is now the third largest group of doctoral-level providers in the United States (after medical doctors and dentists).
• That same AHCPR report shows that fully 80 percent of American workers in conventional insurance plans, preferred providers organizations (PPOs), and point-of-service plans now have coverage that pays at least part of the cost of chiropractic care.

As the recent AHCPR report states, "In the areas of training, practice and research, chiropractic has emerged from the periphery of the health care system and is playing an increasingly important role in discussions of health care policy." And, notes a March 1998 article in Business and Health magazine, "Many companies say chiropractic coverage has lowered their medical and workers' comp costs, while raising overall health and productivity. 'It's one of the best benefits possible from a quality, quantity and pricing perspective,' says George McGregor, president of [a firm that is a third-party administrator]." The article also cites an Oregon study, which found that median work time lost for employees with back injuries who used chiropractic care was only 9 days as compared with 34.5 days for workers who used medical care.

Quick relief of symptoms and sustained effectiveness have long attracted consumers to chiropractic care. In fact, in just one year -- 1997 -- more than 20 million adults used chiropractic services. The 1994 AHCPR guidelines for low-back pain concluded that spinal manipulation, chiropractic's primary treatment technique, is one of only three treatments whose effectiveness is substantiated by rigorous research. According to a 1992 RAND Corp. study, patients see a chiropractor primarily for low back pain and neck pain, though many seek chiropractic care for mid-back pain, extremity problems, headaches and other symptoms as well.

Because back pain is so pervasive in our society, a recent study published in the British Medical Journal pointing out that back pain doesn't go away that easily confirmed what chiropractors have always known. Only 25 percent of low back pain sufferers had fully recovered 12 months after their first visit to a general practitioner, the study said. This low number is in conflict with the commonly-held notion that low back pain episodes go away by themselves after a month. "This hardly comes as a surprise to low back pain sufferers who have been told by their medical doctors not to worry - the pain will go away on its own," said Dr. Michael Pedigo, president of the American Chiropractic Association. "In many cases, further treatment is necessary."

Doctors of chiropractic have long understood the cyclic nature of low back pain, and perhaps this is one of the reasons they consistently rate higher than MDs in patient satisfaction in this area. In a recent Gallup poll, 90 percent of all people who visited a chiropractor agreed that their care was effective.

Successful outcomes in both effectiveness and patient satisfaction, have paved the way for chiropractors to enter the mainstream of health care services. Some have even begun to collaborate with medical doctors in integrated health care practices. As reported in the May/June 1998 issue of Health magazine, the prestigious Texas Back Institute (TBI) at one time included only surgeons and other M.D.s. Then, about ten years ago, when TBI's medical doctors discovered chiropractic's success with lower back pain, they hired their first chiropractor. Now, according to one administrator quoted in the article, about 50 percent of the Institute's patients see a chiropractor first when beginning their treatment. Also, the Washington Post recently reported on the success of the 5-year-old company, American WholeHealth, whose clinics incorporate a consumer-driven mix of traditional medical and alternative health care including chiropractic.

Due to years of criticism -- and even an illegal boycott by the American Medical Association -- chiropractic training was sometimes called into question. However, the fact remains, chiropractors must complete a minimum of 6 and, on average, 7 years of college and post-graduate study to earn their degrees. Their education includes at least 4,200 hours of classroom, laboratory and clinical experience, and as much -- and sometimes more than -- course work in anatomy and physiology as most medical doctors. After they receive their degrees from one of the nation's 17 accredited chiropractic colleges, they have to pass rigorous exams and be licensed by the state before they can open a practice. The practice of chiropractic is licensed in all 50 states, and in 1994 there were approximately 50,000 chiropractors licensed in the United States. This number is expected to double by the year 2010, according to the 1997 AHCPR report.

"These recent surveys and reports finally vindicate the chiropractic profession after years of enduring doubt, questions and criticism about our training and practices," said Dr. Pedigo. "What the health care and medical communities are just beginning to accept is what our patients have known all along -- that our treatment is safe, effective and highly successful at improving their quality of life."

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-264-6181 f: 480-264-7152

Keeping Athletic Kids Healthy & Fit

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E. Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-264-6181

 Backpack Misuse & Chronic Back Pain

Back pain is pervasive among American adults, but a new and disturbing trend is emerging. Young children are suffering from back pain much earlier than previous generations, and the use of overweight backpacks is a contributing factor, according to the American Chiropractic Association (ACA). In fact, according to the U.S. Consumer Product Safety Commission, the use of book bags or back carriers resulted in over 6,500 injuries in 2000 alone.

Over the past 10 years, the chiropractic profession is noticing a marked increase in the number of young children who are complaining about back, neck and shoulder pain. This new back pain trend among youngsters isn't surprising when you consider the disproportionate amounts of weight they carry in their backpacks— often slung over just one shoulder. A 2002 study conducted in Italy found that the average child carries a backpack that would be the equivalent of a 39-pound burden for a 176-pound man, or a 29-pound load for a 132-pound woman. Of those children carrying heavy backpacks to school, 60 percent had experienced back pain as a result.

Other studies have shown that slinging a backpack over one shoulder could exacerbate the curvature of the spine in scoliosis patients.

According to the ACA, preliminary results of studies being conducted show that the longer a child wears a backpack, the longer it takes for a curvature or deformity of the spine to correct itself. The question that needs to be addressed next is, Does it ever return to normal?

The results of these types of studies are especially important as more and more school districts— many of them in urban areas— remove lockers from the premises, forcing students to carry their books with them all day long.

What Can You Do?

• Make sure your child's backpack weighs no more than 5 to 10 percent of his or her body weight. A heavier backpack will cause your child to bend forward in an attempt to support the weight on his or her back, rather than on the shoulders, by the straps.
• The backpack should never hang more than four inches below the waistline. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking.
• A backpack with individualized compartments helps in positioning the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your child's back.
• Bigger is not necessarily better. The more room there is in a backpack, the more your child will carry— and the heavier the backpack will be.
• Urge your child to wear both shoulder straps. Lugging the backpack around by one strap can cause the disproportionate shift of weight to one side, leading to neck and muscle spasms, as well as low-back pain.
• Wide, padded straps are very important. Non-padded straps are uncomfortable, and can dig into your child's shoulders.
• The shoulder straps should be adjustable so the backpack can be fitted to your child's body. Straps that are too loose can cause the backpack to dangle uncomfortably and cause spinal misalignment and pain.
• If the backpack is still too heavy, talk to your child's teacher. Ask if your child could leave the heaviest books at school, and bring home only lighter hand-out materials or workbooks.

What We Can Do for You...

If you or your child experiences any pain or discomfort resulting from backpack use, call your doctor of chiropractic. Doctors of chiropractic are licensed and trained to diagnose and treat patients of all ages and will use a gentler type of treatment for children. In addition, doctors of chiropractic can also prescribe exercises designed to help children develop strong muscles, along with instruction in good nutrition, posture and sleeping habits.

www.alignchiropracticandwellness.com     drmarquez@alignchiropracticandwellness.com

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-264-6181 f: 480-264-7152

Experiencing Headaches?

If you have a headache, you're not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea.

What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.

Research shows that spinal manipulation - the primary form of care provided by doctors of chiropractic - may be an effective treatment option for tension headaches and headaches that originate in the neck.

A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.

Headache Triggers

But to get to the bottom of the problem, you first need to find out what is causing your pain. Headaches have many causes, or "triggers." These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems.

Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease. The headache itself is the primary concern.

What Can You Do?

• If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
• Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
• Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) - the two joints that connect your jaw to your skull - leading to TMJ irritation and a form of tension headaches.
• Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

In addition, the ACA and its Council on Nutrition suggest you avoid the following food "triggers":

• Avoid caffeine. Foods such as chocolate, coffee, sodas and cocoa contain high levels of the stimulant.
• Avoid foods with a high salt or sugar content. These foods may cause migraines, resulting in sensitivity to light, noise, or abrupt movements.
• Avoid drinking alcoholic beverages. These drinks can dehydrate you and cause headache pain.
• Other headache sufferers may want to avoid not only caffeine, but also high-protein foods, dairy products, red meat and salty foods.

What Can a Doctor of Chiropractic Do?

Chiropractors may do one or more of the following if you suffer from a primary headache:

• Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
• Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
• Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

Doctors of chiropractic undergo extensive training to help their patients in many ways - not just back pain.

If your headache is symptomatic of a health problem that needs the care of another discipline, your doctor of chiropractic will refer you to an appropriate specialist.

Align Chiropractic and Wellness
Dr. Patricia Marquez
227 E Baseline Rd. Ste. J-1 Tempe, AZ 85283
p: 480-264-6181 f: 480-264-7152

Prepare for Winter Sports Activities

When snow, ice and frigid weather blast into town, watch out, says the American Chiropractic Association (ACA). Winter recreational activities and chores can pose problems for the outdoor enthusiast whose body is not in condition. Winter sports like skating, skiing and sledding can cause painful muscle spasms, strains or tears if you're not in shape. Even shoveling snow the wrong way, clambering awkwardly over snow banks, slipping on sidewalks and wearing the wrong kinds of clothing can all pose the potential for spasms, strains and sprains.

Simply walking outside in the freezing weather without layers of warm clothing can intensify older joint problems and cause a great deal of pain. As muscles and blood vessels contract to conserve the body's heat, the blood supply to extremities is reduced. This lowers the functional capacity of many muscles, particularly among the physically unfit. Preparation for an outdoor winter activity, including conditioning the areas of the body that are most vulnerable, can help avoid injury and costly health care bills.

"Simply put, warming up is essential," says Olympic speedskating gold and silver medallist Derek Parra. "In fact, when pressed for time, it's better to shorten the length of your workout and keep a good warm-up than to skip the warm-up and dive right into the workout. Skipping your warm-up is the best way to get hurt." Parra, who took both the gold and silver medals during the 2002 Winter Olympics in Salt Lake City, Utah, adds that, "You can complete a good warm-up in 15-20 minutes. And believe me, it will make your workout more pleasant and safe."

Derek Parra and the ACA suggest that you start with some light aerobic activity (jogging, biking, fast walking) for about 7-10 minutes. Then follow these tips to help you fight back the winter weather:

• Skiing - do 10 to 15 squats. Stand with your legs shoulder width apart, knees aligned over your feet. Slowly lower your buttocks as you bend your knees over your feet. Stand up straight again.
• Skating - do several lunges. Take a moderately advanced step with one foot. Let your back knee come down to the floor while keeping your shoulders in position over your hips. Repeat the process with your other foot.
• Sledding/tobogganing - do knee-to-chest stretches to fight compression injuries caused by repetitive bouncing over the snow. Either sitting or lying on your back, pull your knees to your chest and hold for up to 30 seconds.
• Don't forget cool-down stretching for all of these sports - At the bottom of the sledding hill, for instance, before trudging back up, do some more knees-to-chest stretches, or repetitive squatting movements to restore flexibility.

Shoveling snow can also wreak havoc on the musculoskeletal system. The ACA suggests the following tips for exercise of the snow shoveling variety:

• If you must shovel snow, be careful. Listen to weather forecasts so you can rise early and have time to shovel before work.
• Layer clothing to keep your muscles warm and flexible.
• Shoveling can strain "de-conditioned" muscles between your shoulders, in your upper back, lower back, buttocks and legs. So, do some warm-up stretching before you grab that shovel.
• When you do shovel, push the snow straight ahead. Don't try to throw it. Walk it to the snow bank. Avoid sudden twisting and turning motions.
• Bend your knees to lift when shoveling. Let the muscles of your legs and arms do the work, not your back.
• Take frequent rest breaks to take the strain off your muscles. A fatigued body asks for injury.
• Stop if you feel chest pain, or get really tired or have shortness of breath. You may need immediate professional help.

After any of these activities, if you are sore, apply an ice bag to the affected area for 20 minutes, then take it off for a couple of hours. Repeat a couple of times each day over the next day or two.