Thankfully that day in Jericho was just one race of many, and one that I don’t ever plan to repeat!  This past weekend things came together much better for me.  I raced in nearly my backyard, in Fort Kent, Maine.  The 10^th Mountain Ski Club hosted the North American Cup #3 there.  We had two races over two very cold days.  It was a beautifully run event by all the great people of Fort Kent.  I am happy to report that I was standing on the podium both days.  Good skiing and, for the most part, good shooting put me in second place in both Saturday’s sprint race and Sunday’s mass start race.  It felt good to get back in the groove of racing after my rifle mishap the week before.  It was also a lot of fun to be racing on a home course, in front of many people that I know. 

This past weekend wraps up all the racing I will be able to do in Maine this winter.  I am off to Quebec in the week ahead for more biathlon races.  February is going to be another busy month of racing through the Mid-West, including the biggest Cross Country Skiing event in the U.S., the American Birkebeiner.   I am looking for a personal best in this race this year.  I am ready to break the top ten!  Day one of Birke training began today with a 60km distance skate workout this morning.  Thing are just starting to warm up here in the racing season of 2012!  Stay tuned for more updates!

A skeletal asymmetry, including a shorter leg and a small hemipelvis (the part of the pelvis you sit on) can be corrected with shoe lifts and butt lifts. In this book-on-CD, reference to a shorter leg refers to a true leg length inequality where the bones are shorter on one side, rather than the “shorter leg” caused by a spinal mis-alignment, which is a term chiropractors use. A skeletal disproportion, such as a long second toe can be corrected with shoe orthotics, and short upper arms can be corrected with ergonomically correct furniture. Vertebral subluxation and other bones-out-alignment can be adjusted by a chiropractor or osteopathic physician, especially if the muscles are also first relaxed by an acupuncturist or massage therapist.

Mis-fitting furniture is a major cause of muscular pain, particularly in the work place. There are companies that specialize in coming into your work place and correcting your office arrangement, and fitting you for furniture that fits your body. Your employer may balk at the cost, but if they don’t change your mis-fitting furniture, they will end up paying for it in lost work time and worker’s compensation claims.

I see a lot of what I call “mouse injuries” — arm and shoulder pain due to using a computer mouse for extended periods of time without proper arm support. The keyboard should be kept as close to lap level as possible. When not using your computer, your elbows and forearms should rest evenly on either your work surface or armrests of the proper height. Your computer screen should be directly in front of you, and the copy attached to the side of the screen, so that you may look directly forward as much as possible. Your knees should fit under your desk, and the chair needs to be close enough that you can lean against your backrest. A good chair will have a backrest with a slope of 25 to 30-degrees back from the vertical which supports both the lumbar area and the mid-back. The seat should be low enough that your feet rest flat on the floor without compression of the thigh by the front edge of the seat, high enough that not all the pressure is put on the buttocks, and slightly hollowed out to accommodate the buttocks. The armrests must be high enough to provide support for the elbows without having to lean to the side, but not so high as to cause the shoulders to hike up. The upholstery needs to be firm and casters should be avoided. I highly recommend headsets for phones to solve neck and back pain.

A lumbar support helps correct round-shouldered posture. It seems, oddly enough, that most car seats actually curve the wrong way in the lumbar area. Most chiropractic offices carry lumbar supports of varying thickness. I recommend getting one for the car and your favorite seat at home, and investing in a good chair for the office, even if your employer won’t. Try to avoid sitting in or on anything without back support, which causes you to sit with your shoulders and upper back slumped forward. When going to sporting events, picnics, or other places you won’t have a back support, bring a Crazy Creek Chair™ (or something similar) to provide at least some support. You can get one through most of the major sporting goods suppliers, and they cost about $33, a good investment in your back, and they are very lightweight for carrying. Or consider a lightweight collapsible chair, also available at sporting goods stores. Sleeping in a sagging bed can cause back and hip problems. (See the section on Sleep Problems). But properly fitting furniture won’t help as much if you are not also conscientious of avoiding poor posture.

If you slouch at your desk or on your couch at home, or read in bed, for example, your muscles will suffer. Abuse of muscles includes poor body mechanics (i.e., lifting improperly), long periods of immobility (i.e., sitting at a desk without a break), repetitive movements (i.e., computer use), holding your body in an awkward position for long periods (i.e., dentists and mechanics), and excessively quick and jerky movements (i.e., sports). Learn to lift properly and take frequent breaks from anything you must do for long time periods .

Be sure to sit while putting clothing on your lower body. Don’t wear high heels or cowboy boots. If you have a habit of immobilizing your muscles to protect against pain, you will need to start gently increasing your range of motion as you inactivate trigger points. Don’t keep stressing the muscles to see if it still hurts or to demonstrate to your treating professionals where you have to move it to in order to get it to hurt — if you keep repeating this motion, you will just keep the trigger points activated. If you carry a purse, get a strap long enough that you can wear it diagonally across your body, rather than over one shoulder. If you use a day pack, put the straps over both shoulders. Without realizing it, you are hiking up one shoulder at least a little to keep the straps from slipping off no matter how light your purse or pack may be. Notice whether you hold your shoulders up or are tightening muscles such as your butt, arms, or abdomen when you are under stress. You will need to re-train yourself to break this habit.

If you are clenching your jaw or grinding your teeth, see a Dentist for help. The soft plastic bite splints found over-the-counter in pharmacies are too soft and do not help temporomandibular joint dysfunction. You need to be fitted by your dentist for a hard, slippery acrylic night guard.

Constricting clothing can lead to muscular problems. My rule of thumb is, if the clothing item leaves an elastic mark or indentation in the skin, it is too tight and is cutting off proper circulation. Check your bras, socks, ties, and belts to see if they are too tight.

Valerie DeLaune, LAc. is a Licensed Acupuncturist, Diplomate in Acupuncture, Master of Acupuncture, Certified Neuromuscular Massage Therapist and Certified Massage Therapist in Ancorage, Alaska. Valerie says, “My intention is to aid patients in their self-healing. I assist patients by teaching them self-help techniques that will empower them to make positive changes in their lives and their health.” Visit her website at http://triggerpointrelief.com/.

Note: Only one of article section has been included in this excerpt. The full text can be obtained by visiting (www.triggerpointrelief.com)

image by Jeff Lutz of Muscle Pain Help

The incidence of wrist pain (and hand pain) has been the most common complaint involving the upper extremities ever since we all started spending so much time using computers (and therefore keyboards and mice), according to the American Academy of Family Physicians. Take a simple 3-part test to see if your pain is caused by something that may have even fooled your doctor … and try these simple solutions!

Computers, of course, are not the only things to blame for Americans’ painful wrists. It may simply be that our wrists (all nine tendons, six bones, two nerves, tissue and more) are just not cut out for the rigors of daily life.

“We’re taking an anatomy that has evolved over hundreds of millions of years,” said Mayo Clinic hand expert Peter Amadio in an NPR article, “but not necessarily for the purposes we’re putting it to at the moment. The human hand is doing lots of different things, using lots of different positions, and lifting heavy things, doing fine manipulations, a variety of different activities, and so these tissues need to adapt. And it’s not unreasonable that the adaptations might fail in certain cases.”

This failure, along with a number of other factors, has left many people searching for answers when it comes to their aching wrists.

Wrist Pain: Commonly Misdiagnosed?

Dr. Justin Tossing, Clinic Director of North Glen Physical Medicine, states, “Most patients with wrist pain are given misdiagnoses to fit the treatments the doctor administers, i.e., drugs and/or surgery, neither of which are appropriate or necessary in majority of cases. Simple noninvasive techniques to alleviate wrist pain treat the cause, eliminating the need for a cure. Myofascial Trigger Points [painful knots in muscles] in the wrist, arm, shoulder, and neck are the true cause of most wrist and hand pain. These [trigger points] can be treated easily even by the patient themselves.”

Dr. Tossing goes on to explain that outside of obvious injuries, wrist pain can be difficult to diagnose, and are often misdiagnosed, as follows:

• Carpal Tunnel Syndrome (CTS): “Used by many doctors as a catch-all diagnosis when symptoms are generally described as nerve pain, numbness, and/or tingling in the hands. Most diagnosed cases are NOT true CTS, but rather myofascial dysfunction, such as trigger points [muscle knots].” Other factors that can contribute or aggravate this condition include repetitive movements, being overweight, and injury to the wrist.
• Tendonitis: “Most doctors simply recommend rest, a temporary solution at best. Treating trigger points can solve most of tendonitis cases with no drugs or surgery within 2 weeks or less.” Tendonitis occurs when the tendons surrounding the wrist joint become inflamed, causing pain and swelling. Like CTS, tendonitis can be aggravated by repetitive movements. “[This] occurs because trigger points tighten the muscles and pull on the tendons, causing them to become sore and inflamed.”
• Arthritis: If you’re over 20 years old and have pain in a joint, you’ve probably been told you have “arthritis.” Arthritis of the wrist can take on several forms:
• Osteoarthritis is degeneration of the wrist joint caused by wear and tear. This form of arthritis can be caused by trigger points [muscle knots] that go untreated for years. Eliminating trigger points [muscle knots] through gentle hands-on techniques can greatly alleviate this pain and prevent further destruction of the joint.
• Rheumatoid arthritis (RA) is a condition that affects the entire body, wherein the immune system destroys the joints, causing pain, swelling and stiffness in the wrists. There are many proven successful alternative treatments for RA that involve nutritional and lifestyle changes, which will be addressed in future Sixwise articles.

According to Sharon Sauer, Certified Myofascial Trigger Point Therapist and wrist pain expert: “Trigger Points are the Most Often Missed Cause of Wrist Pain!”  Whenever performing a repetitive movement, such as typing, sewing, or painting, take frequents breaks to give your wrists a rest.

Wrist Pain: Trigger Point Tests & Treatment Step-by-Step

Treatment of Trigger Points can be performed easily yourself using simple self-care tools, or by specially trained practitioners (myofascial trigger point therapists). Here is the process: Myofascial Trigger Points are painful knots in muscles where blood flow has decreased and lactic acid has built up. These knots cause tightening of the muscle that increases the pulls on tendons and joints, causing damage and pain. The most amazing fact about trigger points is that they refer pain to areas distant from their own location. Severe pain in the wrist, for example, can be caused by a trigger point in the muscles of the neck or shoulder, explaining why wrist pain is so often misdiagnosed.

1. Perform a simple test to identify which muscles have the trigger points.
2. Warm up the area to be treated (where the trigger points are)
3. Use a simple tool to compress the trigger points for 3-7 seconds each
4. Stretch the muscle that you just treated
5. Perform the simple test again to see if the treatment was successful

While there are many tests to determine which muscles have trigger points causing your wrist pain, here are three you can easily perform to determine if trigger points are causing your wrist pain.

For each test that you fail, you need to perform the corrective self-care techniques associated with that test in order to achieve lasting wrist pain relief. You will know if you treated the right areas by decreased pain and better self-retesting. If you do not achieve relief or better self-test results, you are advised to seek further evaluation from a physician or therapist trained in myofascial trigger point therapy. Myopain.com can help you find a practitioner in your local area.

Test #1: Wrist and Finger Flexors Test

Test: Bring your arm in front of your body to shoulder level with the elbow straight. Use your other hand to pull your upper palm and fingers back in towards you.

Results:  If you cannot bend the wrist up to 90 degrees or if there is any pain, this indicates you may have trigger points in the muscles that flex your wrist and/or fingers causing wrist pain. Congratulations! Your wrist pain may be easy to fix.

Warm-up: Gently massage the forearm or wrap in a moist warm towel for 5-10 minutes.

Compression Technique #1: Here is the compression technique that will deactivate trigger points (irritable tight spots) in your hand flexors.

Stand facing the wall. Rotate the hand and arm so that your palm faces the wall. Let your arm rest against your torso. Place the Jacknobber II tool just at the elbow crease. Lean your body towards the wall, compressing with mild to moderate pressure your arm into the tool. If the spot is tender and/or you feel pain radiate into the wrist, you are pushing on a trigger point! Continue to apply pressure for 3-7 seconds. Pain level should be mild to moderate. Take two or three deep slow breaths. Focus on being relaxed. Then move the ball or Jackbobber II tool down the forearm and repeat. As the ball or Jackbobber II tool gets closer to your wrist, allow your arm to rest against the hip and thigh.

Stretch Technique #1:  Now that your muscles are properly warmed up and have been pressed on (compressed), they are ready to be gently stretched and encouraged to return to their normal resting length and function. Always follow the compression technique above with the following stretch:

Pull the palm back. Vary the stretch by deviating to the each side of the hand (ulnar and radial). To stretch the finger flexors, pull each finger back individually. Hold for 2 seconds.

An alternative is to put your fingers together as if you were, “praying,” Then use the fingers of one hand to push and stretch the flexors of the opposite hand.

Test #2: Wrist and Finger Extensors Test

Test: Bring your arm in front of your body to shoulder level with the elbow straight and the wrist flexed down.

Results: If you cannot bend the wrist down to 90 degrees or if there is any pain, this indicates you may have trigger points in the muscles that extend your wrist and/or fingers causing wrist pain.

Warm-up: Gently massage the forearm or wrap in a moist warm towel for 5-10 minutes.

Compression Technique #2: Here is the compression technique that will deactivate trigger points (irritable tight spots) in your wrist and finger extensors:

Rest your arm on a flat surface such as a table with your palm facing down. Holding the Jacknobber II tool with your opposite hand, press the tool into the muscles of the forearm just at the elbow crease. As in the above example, search for a spot that is tender and/or causes pain to radiate into the wrist. Hold it for 2-3 deep slow breaths while relaxing. Move the Jacknobber II tool down the forearm and repeat.

Stretch Technique #2: Always follow the compression technique above with the following stretches:

Gently stretch your hand extensors by using one hand to press the other hand into downward (into flexion). Modify by stretching the hand toward each side.

Then make a light fist. Using the opposite hand, gently flex the wrist and vary the stretch by giving deviation to each side.

Test #3: Cervical Lateral Flexion Test

Test: Try to press your ear to your shoulder without raising your shoulder. How close to your shoulder can you get? Do you experience any pain when doing this test?

Results: If you cannot bend your neck to the side to 3 inches from your shoulder, or if there is any pain, this indicates you may have trigger points in the scalene muscles on the side of your neck that stabilize your spine at the neck. When the scalene muscles have trigger points, they often send pain down to the wrist. Whichever wrist has pain, the scalene muscle on the same side must be treated.

Warm-up: Gently massage the side of the neck or wrap in a moist warm towel for 5-10 minutes.

Compression Technique #3: Here is the compression technique that will deactivate trigger points in your scalenes:

Press the Backnobber II tool into the muscles along the same side of the neck that you are having wrist pain (see photo). Start at the base of the neck and work upwards towards the just under the ear. Apply just enough pressure to feel mild to moderate tenderness in the muscle you are compressing. When you find a trigger point, as noted by tenderness and/or radiating pain into the hand/wrist, hold the compression for 2-3 deep slow breaths while relaxing. Then move to the next spot and repeat.

Stretch Technique #3: Always follow the compression technique above with these stretches:

First, pull your chin in and move your head back.

Next, place your hand over your head just above the ear. Pull your head slowly down towards your shoulder. Breath, relax and feel the muscles in the side of your neck stretch.

Now, vary this stretch by looking up slightly as you do it.

Repeat while looking slightly down.

Other Techniques

Did you pass all three tests above but still have wrist pain? If so, your wrist pain may still be caused by trigger points in yet another muscle. There are 11 other muscle groups that also refer pain to the wrist! You may need to get a myofascial trigger point evaluation by an experienced practitioner. Don’t give up!

Note: If any of these self-treatments cause increased pain or problems, do not continue performing them and see a qualified physician. Increased wrist pain is a sign that trigger points are a part of your problem, but they may need to be further evaluated by a practitioner trained in myofascial trigger point therapy. Myopain.com can help you find some of the best myofascial trigger point therapists in your area.

Recommended Reading

How to Sit at a Desk All Day and Still be Healthy

What are the Top Injuries in a Typical Office (and How Can You Avoid Them)?

Sources

American Academy of Family Physicians

MedlinePlus

NPR.org

Science Daily

About.com: Ergonomics

About.com: Orthopedics

Reprinted with Permission from the SixWise.com

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Conversely, poor posture is very often related to poor self-image. You have probably noticed that many people with slumped posture have a tendency to look helpless, weak, and tired.  Some people seem to literally carry the weight of the world on their shoulders. There are many causes of poor posture, including structural and biomechanical problems that should be treated by a qualified professional. Some of the possible negative effects of poor posture are much more than a cosmetic concern and can include muscular pain, headaches, neck and back pain, fatigue, reduced lung capacity, and reduced levels of blood and oxygen supplied to the brain. Since some spinal conditions can only be detected by x-rays or by thorough physical examination, I personally believe that it is a good idea to consult a qualified Doctor of Chiropractic for a spinal checkup, even if you are not currently experiencing pain or symptoms.

As far back as 1250 B.C., the ancient Greeks were looking to the spine as a cause of dis-ease in the human body. The nerves exiting the spinal cord through the openings of the spinal column directly supply the pure energy that regulates and controls every system of your body. A healthy spine positively affects the free flow of pure energy throughout all the systems of your body, including the digestive, reproductive, respiratory, and immune systems.

As a chiropractor who has treated thousands of patients over the years, I have personally witnessed the phenomenal healing and energizing power of the human nervous system on a daily basis.  Consequently, I truly believe that maintaining a strong, healthy, properly aligned spinal column is essential to achieving overall health and optimal well being in your daily life.  A healthy spine is the strong foundation of a healthy body.  Strengthening the muscles of the back increases the stability of the spinal column and can help prevent serious problems caused by musculoskeletal imbalance. By balancing the strength in the front and the back of your body, you will have less chance of injury in your daily activities.

Usually, the most under exercised muscles in the body are in the back.   Building up some muscles, while ignoring others, may pull your body out of balance. For example, if you develop strong chest and abdominal muscles without working on strengthening your back, you will eventually start to slump over. Strengthening the hamstring and abdominal muscles also helps stabilize the spinal column, due to the connection of these muscles to the pelvis.

Exercising both sides of your body evenly can prevent imbalance of muscle strength on either side of the spine.  Muscular imbalance can be a result of overuse of the muscles on one side, and underuse on the other and can eventually lead to structural imbalance of the bones and joints. Musculoskeletal imbalance can also be caused or aggravated by the type of work that you do, by unilateral sports such as tennis or golf, or by always favoring one side when you carry a briefcase, handbag, child, or other heavy object. Whenever possible, change sides or positions to prevent muscular imbalance and subsequent structural imbalance.  Most of us favor one side or the other for certain activities in our daily lives without being consciously aware of our patterns.

Another example of a repetitive physical activity that negatively affects the musculoskeletal and nervous system over the years involves the cervical (neck) portion of the spinal column. Any activity that requires you to look down for long periods, especially reading, computer use, and deskwork, can produce a chronic forward head position. Eventually, this repetitive strain can lead to a decrease of the normal C-shaped curve in the neck, which makes it difficult for the neck to support the heavy weight of the head. Biomechanically speaking, the normal C shaped curve in your neck makes it stronger, and with a decrease of that natural curve, (which is sometimes the case after whiplash type injuries and ligament damage caused by trauma) the neck loses some of its weight-bearing strength.

Fortunately, one of the most effective ways to improve your posture is simply to become more aware of it. Seeing yourself as others see you is often the first step to making improvements in your posture. I recommend evaluating your body in a full-length mirror from the side view — a position in which you rarely see yourself — viewing your posture while using a hand held mirror. You may even want to have a friend take a picture of you from the side, standing as you normally stand.

With correct posture, when viewed from the side, your ears are balanced directly above the arches of your feet, and your head is only slightly forward of the neck, shoulder blades, and lower back. A plumb line dropped from overhead should pass through the ear, shoulder, hip, knee, and ankle. Your head should not tilt to one side or the other.

To help you become more aware of your posture, try the following exercise while standing in front of a mirror.  Imagine two gentle hands on either side of your head pulling you upright, and a light helpful hand at your back pushing your shoulder blades together. Think tall, lengthen your neck, and let your head move upward, with the chin slightly in. Concentrate on lengthening your spine, still imagining the top of your head reaching toward the ceiling. Keep your stomach in and buttocks tucked.  Slightly bend your knees without locking them, since locking your knees puts unnecessary stress on your lower back.

Now, visualize yourself walking with a certain presence, a way of carrying your body that projects self-confidence and inner strength. Picture yourself with regal posture, head held high, shoulders back, feeling tall, proud, and self-assured.  With continued practice you will start looking and feeling like the self-confident person that you have always known you are.

I have always loved the old saying “To be, act as if.”  When you assume the body posture of a strong, energetic, and confident person, walking with a spring in your step and a smile on your face, you will find that the physiological changes also positively affect your mind and soul –lifting your spirits and sometimes even changing your whole outlook on life.

Taking some time to pay attention to your posture and take care of your spine is an integral component of achieving optimal health and expressing your pure life energy.  Remember, it is how you carry yourself that counts.  Think strong, energetic, and confident!

Dr. Suzy is a retired Doctor of Chiropractic and active Health And Fitness Educator.  The information and suggestions that she shares on this website are for reference purposes only and not intended to be diagnostic in any way nor a substitute for consultation with a physician or other licensed health-care professional. Always obtain a complete physical examination and discuss your specific conditions, limitations, and health history with the qualified health care provider of your choice before making major lifestyle changes. Information and statements regarding dietary supplements have not been evaluated by the FDA.