Wednesday, December 31, 2008

New Years Resolutions and Your Workout

This is the time of year when everyone spends their hard-earned money at the gym. There are some that are the unfortunate few that will end up in my office in February. There are many ways to avoid overdoing it. First of all…stop overdoing it.

Some people will join the gym and spend up to 2 hours a day in there. How anyone can spend that much time in there blows my mind. After finding out that 40 minutes was spent in the sauna and another 20 minutes was spent cooling down, it’s still an hour. If you’ve spent 20 minutes warming up, then you are getting 40 minutes of exercise. When you factor in that you might be waiting for a machine, it’s no wonder that it takes so long.

When you begin to spend a good portion of your life in the gym, it’s easy to lose weight. Almost anything you do will burn some calories. Even the sauna will make you lose some water weight. After about a month most people start to plateau on the weight loss. The secret is to not spend more time in the gym, but rather make the time spent there more efficient.

There’s really no reason why a person should spend more than one hour at a time in the gym. The typical workout that most people do is 20 minutes of “cardio” which can mean a treadmill, elliptical, or stationary bike. Then they hit the machines for about 20 minutes, then do a different machine to cool down. This is universally accepted as to what is supposed to happen in the gym. All the fitness centers are organized in this manner.

But what do you do once you’ve stopped losing weight? Do you add more time to each section? Do you double it? Do you eat less?

One option is to divide the workouts. Sports training research has found it beneficial to do strength training separately from endurance training. In other words, you could do weights/machines on Monday, then Tuesday do all endurance/cardio. Wednesday could be a day off and then Thursday and Friday are similar to what you’ve already done. The different exercise routines demand different forms of energy in the muscles and stimulate different hormonal responses in the body. That’s why it’s better to separate the two styles of workouts.

If you are totally addicted and want to go to the gym 6 days a week, then on Wednesday and Saturday you would do another cardio workout that is not stressful to the joints like the stationary bike. Do these days for only ½ hour because you need to be ready to exercise hard the following day.

I would recommend that you not workout 6 days a week. Four times for most people is enough, especially in the beginning. Lots of people get injured from doing too much too soon.

Seven hours a week is more than enough to reach most peoples’ goals. It’s not necessary to spend 14 hours in the gym per week. That’s how people end up with injuries, burnout, and missed workouts.

Tuesday, December 2, 2008

FAQ's

Q: Am I out?

A: I get this question a lot. What you are asking is, “do I need an adjustment?” Patients have a general understanding that bones go “out of place” and chiropractic can put them “back in place.” In other words, You’re “out” and I put it back “in.” Gosh I wish it were that simple.

Q: I don’t get it, what’s wrong then?

A: Muscles and ligaments can become chronically tight, weak, and damaged. These structures surround the spine and restrict proper movement. This lack of movement is what you feel as stiffness. The damage to the ligaments and muscles is what you feel as pain. Adjustments as well as other therapies allow this damage to be minimized.

Q: So you aren’t popping bones back in?

A: No, we’re not.

Q: Then what’s the popping sound?

A: The joints have a vacuum type of negative pressure in them. By stretching the soft tissue that surrounds the joint, the pressure is released and there is a noise.

Q: So my bones aren’t grinding?

A: No.

Q: Then why do doctors say this?

A: Because it’s an easier way to shorten the appointment. It’s much easier to explain a simple concept than a complex one. If a doctor sees 12 people per hour (or more in some cases) it’s easier to say that they’re out and that bones are touching bones. Patients “get it” quicker and the doctor can move on. The problem is that that explanation doesn’t really give you the true appreciation of your condition.

Q: My insurance company sent me a letter asking if my pain was caused by an accident or an injury at work. What should I say?

A: They want to know if you were in a car accident or a work injury. It is important that you answer the question and send that letter in. Please give us a copy for our records. If you don’t send the letter in, the insurance company won’t pay us and you will be responsible for the entire bill.

Q: I want to take your Trigger Point Class. Why haven’t you had one recently?

A: In November and December I’ve noticed that people have good intentions, but will no-show because they are busy with other holiday activities. It’s not worth doing during these months.

Q: My personal trainer is always changing the routine and I never know what exercises I’m going to do until I get there, but I never feel that I’m improving. I read that you should do the same exercises for 6 weeks before changing. What should I do?

A: It depends upon your goals. It’s good to never do the same exercises every workout because it never gets boring, it’s always challenging, and it develops fitness pretty quickly even though you feel like you’re not getting anywhere. To gain strength in one particular exercise however, it’s best to stick with the same exercise over a period of time and continuously increase the weight, number of sets, or repetitions.

Q: I took your trigger point class, but what happens if I can’t find a trigger point in my body?

A: Lucky you.

Q: It seems like you can’t eat anything. I read on the internet how bad food is. It’s like everything is bad for you. I’m confused about what to eat. What should I do?

A: First of all, stop reading stuff on the internet. Some people can be taking 10 supplements a day, yet be confused about FOOD. With internet sites scaring the day-lights out of us about everything it can be very confusing…but it really isn’t. Eat lean meat, chicken, fish, eggs, salads, nuts, milk, all vegetables and fruit. Do not eat breads, sodas, coffee, candy, pastas and sugar. Drink water. Start with that. If you’re allergic to something, eliminate it. Modify and repeat. It’s simple.

Q: You referred me to a doctor, but they’re not on my insurance plan. What should I do?

A: Bring in a list of doctors on your plan, and we’ll choose one from there. Or you can go to a doctor and pay a higher copay.

Q: Do you think national health care is the answer to America’s medical system?

A: Well, most people under the age of 65 don’t even realize that we already have a national health care system called Medicare. Unfortunately, it’s financially not stable and many seniors complain about the benefits. Many doctors simply won’t see a person over the age of 65 because Medicare pays so little and it’s so restrictive. What’s the point of working for 25 cents on the dollar, right? So if America has already developed national health care for the seniors and it isn’t working, how will the system work if everyone is included? I’m not sure.

Q: Do you do high school physicals?

A: Yes. The fee is $25 or if you have insurance, then we will bill that.

Q: Dr. Story, did you read the bad news (insert depressing traumatic story here) in the newspaper?

A: No. Please do not tell me depressing information prior to me adjusting you. I had one person tell me about the triathlete that was eaten by a great white shark in Southern California when she learned that I was going to compete in a triathlon in June. Don’t tell me these things. Let me focus on helping you. P.S. I swam very fast in June.

Q: If I can’t make it to all the appointments, should I just quit or come in less?

A: In most circumstances if you get adjusted less you will still gain the improvement over time. It may take a longer period of time but the results will be no different. Think of chiropractic changing the internal body as working out is to the muscles. Whether you lose 10 pounds over 6 weeks or 9 weeks doesn’t really matter. Ten pounds lost is 10 pounds lighter. Our recommendations are based upon getting the best results in the quickest time period but for some people that’s impossible.

Q: I’m going on a long trip. I’ll be on the plane for hours, driving a rental car, sleeping in hotels, and eating at restaurants for every meal. Since I have a herniated disc, how can I make sure that my back doesn’t end up killing me by the time my trip is over?

A: On the plane and while driving, the only thing you can do is to stand up and stretch every ½ hour. The best stretch is the “fencer” type of stretch where you extend your leg backward as if you were an Olympic fencer. It’s also a yoga-type of stretch. If you can upgrade to first class and get a better rental car that has better seats, do it. Most hotels have a token exercise room with a 1974 treadmill. Use it. Walk at night for 20 minutes. In the hotel you can take a trash bag and fill up the ice container and make yourself an ice pack. Put it on for 20 minutes every night before retiring. If you can bring some biofreeze, use it throughout the day. I’m not sure if airlines like finding a bottle of BIO-FREEZE on your walk-on luggage, as I don’t travel much myself, but others have told me it’s not a problem. I would think and hope that the security would be at least suspicious of something with BIO- in it. Anyways, you can always go to a store and buy something off the shelf. Lastly, make an appointment right before you go (to late now, right?) and the day you come back. That will help minimize the pain.

Q: My child has scoliosis. Can you help that?

A: Yes. The earlier the introduction of therapies, the better. I’ve noticed that some doctors will recommend to X-ray children every 4 months, but do nothing in-between those x-rays to alter the scoliosis. The feeling is that if it gets worse then they’ll have the child wear a brace 23 hours a day or use Harrington rods to fuse the spine (by the way, they don’t straighten it before they fuse it because that’s not possible). The million dollar question is “why don’t we try something…anything (chiropractic)…during the waiting period?” That’s where we come in. If the scoliosis is likely to get worse, then that means it’s able to change. Why not try to change it for the better? WAITING until the next x-ray in 4 months is not a treatment and will not change the curve.

Q: My friend is going to give up on chiropractic. It’s mainly because the insurance won’t pay anymore. What should he do for his pain?

A: Obviously if he’s going to make decisions based upon insurance coverage, he’s going to be very limited. Just like going to a restaurant with a “buy-one-get-one-free” coupon you don’t always get the healthiest or tastiest choice. Some companies pay for surgery but not chiropractic. For those patients that let their limited insurance coverage dictate their care, they will have to do only what the insurance company says.

Q: My shoulder always clicks when I move it. Is this a problem?

A: In most cases, the answer is no. If you hear little clicks when you rotate your shoulder but it does not cause sharp pain, it is not a problem. Stress in your shoulders and neck cause joints to get tight and the clicking is often just a release of pressure in the joint similar to an adjustment. Some clicking occurs in thin people whereby a tendon or ligament will move over another structure and make a noise. Regardless of the cause, if it’s not causing sharp pain don’t worry.

Q: How come you don’t hire massage therapists?

A: I don’t want to deal with the hiring/firing/managing/dealing with of too many employees. It also seems like every nail/hair salon/spa/country club/gym has them anyways. In the past many chiropractors did have massage therapists in their office. They would bill your insurance and everyone was happy. It doesn’t work that way anymore. If you want a massage, I can give you the name of someone good in the community.

Q: How long does it take for a sprained ankle to heal?

A: The swelling usually is gone within and week. Within 3 weeks you’ll be walking normal but it will feel weak. Within 6 weeks you’ll forget you had it. That’s for a simple, uncomplicated sprain.

Q: What’s the best drug, Tylenol or Advil?

A: If there was a “best” drug, then the other one would soon be out of business wouldn’t it? Why I get asked this question, I’ll never know. Isn’t the point of going to a chiropractor to heal naturally without drugs?I often wonder if medical doctors get asked, “Hey doc, which is the best chiropractic technique, Gonstead or Palmer?” Their blank stare probably looks the same as mine when asked to compare drugs.

Q: What’s a good way to prevent the hump-back? My grandmother has a major hump and it looks terrible. I’m afraid I will look like her.

A: First of all, there are exercises that you can do and certain stretches. Rowing types of exercises and back extensions work particularly well. Lying on a foam roller is awesome and you will feel an immediate difference in the posture.We can do adjustments for the hump. There is actually a pattern of restrictions that cause our body to cave in. It involves adjusting the first three vertebrae in the top of the back and the rib cage. People often notice a difference in how much they can inhale right afterwards.Unfortunately some people lose so much calcium and protein from their bones that they have fractures in their spine that forms the “hump.” You must supply enough calcium, vitamin D, and protein early on in life to avoid this.

Q: I’ve never been able to do the splits. Can you give me some stretches that will help me?

A: There is no value in doing the splits unless you compete in a sport that requires the splits (gymnastics, karate, etc). I do not recommend a person try to do the splits.

Q: Where can I learn about sports nutrition?

A: It makes sense that a marathon runner would require different nutrients than say a powerlifter. Therefore, the best place is to thumb through books that relate to the sports you are interested in. Good websites for endurance-based sports are planetultra.com, crossfit.com, and zonediet.com

Q: Should I do sit-ups to lose my pouch (the patient usually points to the area below the navel)?

A: The bad news is that the fat that makes the pouch is outside from the muscle. People are under that assumption that if they tighten their muscles, it will somehow suck the fat inward. People also believe that if they exercise their stomach, the fat in that location will disappear. This is known as spot-reduction. The thing that makes that pouch go down is lowering your percentage of body fat. You can have extremely strong muscles, but if they are covered by fat, you’ll never see them. So the answer to losing the pouch is really a body fat percentage problem, not a sit-up problem. So don’t waste your time doing sit-ups, do more aerobic activity.

Q: Why do I get bills from your office two months after I see you?

A: When you receive treatment, we will send bills immediately to the insurance company. The insurance company legally can sit on the bills for 30 working days (that’s about 45 days in real terms). Once we get the information back from the insurance, we enter it into our computer and immediately send a bill to you. That’s a quick response. When the insurance company requests information it can take even longer. It’s not uncommon for some claims to take 6 months. Last year I had a claim that took 11 months from Medicare (the check was for $7). The explanation? “We’re behind” You gotta love that.

Q: I decided to do more “core” exercises and I did them first in my workout. Now my back is hurting worse. What’s happening?

A: You broke the rule of never exercising a muscle that is needed for stability muscles prior to exercising muscles that are needed for major movement. If you fatigue the muscles of your “core” prior to your other exercises, they will be too tired to support your back and then you’ll get pain. It would be wiser to perform those exercises last in your routine.

Q: What’s the short term solution to my problem? I don’t really want to come in a lot.

A: The short term solution is to take an aspirin. If you don’t want to come in, then don’t.

Q: I want to come in, my back is killing me, but I don’t want to come in there and wait in the waiting room. I want to just walk in when I want and get right in. Can I do that?

A: We try to run our office and not double book, but there’s only so much time in the day. Nobody wants to wait, but you can’t just can’t walk in and expect us to stop seeing the patients that have made appointments to see you. If someone comes in, we are happy to get them in, but not expecting to wait is unfair to others.

Q: How can I get my back to not need so many adjustments?

A: The key is to strengthen the muscles while they are free from joint fixations. If the joints are locked and restricted by fixations then any strengthening exercises will only be aggravating to the back. Deadlifts, hyperextensions, and crunches in that order can take less than 10 minutes done twice per week are all that’s needed in many cases.

Q: If I miss an appointment, are you going to charge me?

A: No. I’m not that mean. I’d like to though, but I won’t.

Q: Should I get orthotics for my running shoes?

A: In most cases no. Running shoes are made with arch supports whereby you shouldn’t be inserting further arch supports. There are some cases where there is a special need, but I’ve found that most people have the wrong type of shoe with an orthotic to try to correct for it.

Q: What’s the perfect diet?

A: I don’t believe there is one. How can one diet be good for the 95 year old diabetic as well as the 250 pound weightlifter? Doesn’t a strength athlete eat differently than a cyclist? Aren’t women different than men? Does a woman nutritionally change during pregnancy? While I think there are common traits of what’s considered healthy, individual needs vary. Having said that if you eat lean meat and vegetables together and fruit for snacks and never eat sugar or starches, that’s as close to perfect as you’re going to get.

Q: My doctor said I’ll probably need surgery so he ordered an MRI. He told me to stop seeing you.

A: He told you that you needed surgery and hasn’t even seen the MRI yet? Did he examine your (insert painful area) or is he making this determination based upon what he thinks he’ll see on the MRI? If over 60% of the pain-free population has herniated discs on MRI, how will he determine if your case is a surgical one?I’ve had numerous patients come in with the diagnosis of “herniated disc” and pain down the left leg, yet when reading the MRI report; the herniation is on the RIGHT SIDE. Patients usually know they have a herniation and will hold onto that diagnosis almost like a pet. Yet nobody told them that the herniation was on their pain-less side. Now here’s what I want you to think about: if it turns out that this is your case, what structure will they be doing the surgery on? You should ask.As far as not seeing me, I understand that when another doctor says “don’t see the chiropractor” that it’s the end of our relationship, but ask him why you should stop seeing a chiropractor if there’s no diagnosis yet and the MRI hasn’t even been done. If he’s planning on doing surgery anyway, what’s the harm of a little drug-free natural pain relief given by a chiropractor?

Q: My friend wants to see you but doesn’t have insurance. What will you charge him?

A: We have a coupon for family and friends that do not have insurance. We normally charge $100, but if you refer someone, we charge a flat rate of $50 for the first visit. That includes the consultation, examination, and any treatment that day that’s necessary.

Q: How long should it take for a swollen ankle to improve?A: The swelling will reduce within two weeks and may take another two weeks if the condition is severe.Q: Do you recommend any good books for stretching?

A: The original stretching book called Stretching by Bob Anderson was written in the 1970’s and is still one of the best books on stretching. More current books on stretching have better looking pictures and a nicer cover, but the material isn’t much different.

Q: My child wants to do gymnastics. He’s 5 years old. I’m afraid he’s going to get hurt. Should I let him do it?

A: That’s a hard decision. A sport such as gymnastics is “healthy” to a point. The injury rates are high, so it’s a decision only you can make. You don’t want him to develop lifelong injuries, so have some balance in his life by allowing him to do gymnastics for say, 6 months, and then stopping when it’s soccer season. Let him play one season of soccer and then let him play baseball. Most kids shouldn’t be playing only one sport year round. They should develop a well rounded base of skills. Most kids at 5 years old are not thinking of Olympic medals. They just want to have fun. Making sports fun prevents the seriousness that usually results in the injuries.

Q: What do you recommend for a child with scoliosis?

A: Most people discover that their child has scoliosis and are told to have x-rays every six months to monitor the progression. If the scoliosis gets worse, surgery is recommended. I would recommend that chiropractic be part of this “waiting period.” Why not try to alter the curve? While the child is growing is the best time to try to alter the curve, not later.

Q: Why do you discourage the use of home exercise machines?

A: Most people purchase machines with good intentions but later find that the machine takes up too much room in their garage. The exercise equipment becomes an expensive shelf to place things on. I would rather encourage people to learn to use natural movements such as squats, lunges, push ups, pull ups, rows, walking/running, crunches, and such. If you’re going to USE the machines, then machines are worth the money but the majority of people don’t use them two months after the purchase.

Q: How long does it take to be a chiropractor?

A: It took me 5 ½ years to get my bachelors from C.S.U.N. I majored in biology. Then it was 4 years at L.A.C.C. (chiropractic school). Then I began my true education from the school of hard knocks. I’ll let you know when I graduate.

Q: What’s more important, exercise or eating right?

A: Thinking right.

Q: I’ve heard you mention that you shouldn’t drink cold drinks. Why?

A: Our body temperature is 98.6 degrees. Pouring cold drinks into our body requires a strain on our internal organs to warm up the liquid. Drinking luke warm water is healthier because it requires less energy of our body to utilize the drink and is absorbed much better. If you think about it, when you go to the doctor, they measure your temperature as if it were something vital. That’s why they call it your vitals. When it comes to nutritional information, we almost throw away common sense. Your body should not be constantly fighting to maintain its core temperature every time we drink.