Why muscle relaxers are not the answer to your back or neck pain

This week I’ve had two patients ask for muscle relaxers to help them sleep.  They didn’t even request it to help calm a muscle spasm.  It’s not in the scope of practice for a chiropractor to prescribe a muscle relaxer.  But honestly, why would you ever want one? If your back hurts that bad, even after your chiropractic appointment, and you really need to take something…I would recommend an over-the-counter to help with some pain relief.  Or if you’re in the state of Colorado, go find a dispensary.

Why do muscles spasm? I like to refer to the analogy of the chicken and the egg.  Did the joint stop moving properly and cause the surrounding muscle to spasm, or did the muscle tighten up and cause the joint to lock up?  In either case, you want to treat both the joint and the muscular dysfunction.  Improper movement, poor posture, repetitive movements are all things that can cause dysfunction.   Doesn’t it make sense to spend the time addressing the real issue than attempt to get the muscle to relax with a pill?

Muscle relaxers cause all the muscles in your body to relax, including the ones that create stability along the spine.  Once you take away that stability, how can you ever expect those muscles to work properly and engage throughout your daily movements.

One of the worst things I see patient do when their back hurts is to take a muscle relaxer, rest on the couch (usually in a poor spinal position) and then try and get up hours later.  Quite frankly, they just can’t.   This is usually the moment that their spine gives out and they start calling the office because they cannot move.

Movement is medicine.  Movement is my prescription for every ailment the body may have.  Even when your back hurts, you should be able to go for a walk or do some basic core strengthening exercises.  If you want to find out the real reason your back hurts, then call us at Denver Sports and Family Chiropractic Center.  We promise not to just put a Band-Aid on the problem, but to keep it from coming back for good.

Alternative methods to treatment, other than surgery


            Most people assume that chiropractors just treat backs.  Others are aware that we also treat extremities such as knees, shoulders and ankles.  Those that have experienced chiropractic care understand that what I actually do is improve my patients’ quality of life. 

            Joan came into the office complaining about pain in both of her shoulders.  Eight months prior to this visit, her MRI demonstrated a full thickness rotator cuff tear on the left and a partial thickness tear on the right.  She underwent surgery to repair the left, which involved resurrecting a portion of her clavicle, and injections were placed into the right to help avoid a surgery there.  The surgeon sent her home without any instructions and told her to wait a few weeks before beginning physical therapy.  During that time, the local inflammation in her shoulder caused adhesions to develop in her joint capsule, known as adhesive capsulitis, or frozen shoulder.  When she returned to the surgeon’s office, the surgeon began crying and apologizing for not performing the surgery correctly.  A post-surgery MRI revealed that there was still an osteophyte remaining that had not been removed and swelling inside the glenohumeral joint.  The surgeon even offered to do another surgery at no cost, but Joan insisted on another doctor’s opinion.  The other surgeon agreed that another surgery was necessary, but Joan was too preoccupied to have another surgery at that time.  She started doing some stretches and swimming on her own, showing vast improvement before beginning treatment with me.

            During her first exam, nearly every motion was limited.  In order to lift her arm to the side, she would have to use her entire body to do it, and the motion itself was extremely painful.  With each treatment, Active Release Technique was performed to the muscles of the rotator cuff, as well as the joint capsule.  Gentle mobilizations were performed to her scapula, upper back, and neck to ensure proper movement.  To supplement her treatments, rehabilitation exercises were given to help strengthen the area and her core. 

            At her eighth visit, her range of motion was 90% improved and she was beginning to get strength back.  On her tenth visit, muscle definition was becoming obvious and she was extremely strong and pain free.  Joan confided in me that the reason she had short hair was because she had difficulty washing it herself, due to the limited motion in her shoulders.  Due to our sessions in the office, she was also swimming better and more consistently, had less pain at night while sleeping and was able to play with her grandkids.  I improved the quality of her life. 

            The intention of this story isn’t to condemn the medical field or the work that surgeons do.  After running the Chicago marathon, I developed knee pain that eventually led to an extremely successful surgery.  However, being the stubborn sports chiropractor that I am, I spent over a year and a half trying to fix the pain myself first. 

            I want to bring awareness to the fact that there are alternative methods to conservatively treat injuries that should be tried before surgery.  Chiropractic adjustments enable proper movement and biomechanics; ART allows proper muscle movement; rehabilitation helps strengthen the muscle imbalances.  Together, there are very few injuries that can’t be treated this way.  From my experience, before electing surgery, conservative care should always be attempted first.  Even if you need to go in for the surgery, you will recover quicker from the strengthening done beforehand.

How Does Chiropractic Help Increase Range of Motion and Flexibility

When we’re younger, it’s easy to take our extensive range of motion and flexibility for granted.  But as we age, a number of health conditions and the cumulative effects of wear and tear can affect our ability to move the way we used to.  When this happens it can be difficult to carry on the activities of daily life.  Even things as simple as picking something up off the floor or tying your shoes can be challenging activities when your movements are curtailed.  Luckily, regular chiropractic care can help increase both range of motion and flexibility.

flexibility chiropractic denver

A study performed in 2001 by researchers at the Phillip Chiropractic Research Centre of RMIT University in Melbourne, Australia, and published in the Journal of Manipulative and Physiological Therapeutics found that chiropractic adjustments increased range of motion in the 105 patients who participated in the study.  There were three phases of this study, in which each of the participants was given no adjustments, fake adjustments or true adjustments.  In each phase, the patients who were given the true adjustments showed a significant improvement in range of motion, which was not the case for the other two groups.

A decrease in range of motion and flexibility can result in a downward spiral of disability.  An injury or degenerative condition can cause pain, swelling and stiffness, limiting flexibility and range of motion.  So we avoid activities that involve the affected body parts, either consciously or unconsciously.  This then becomes a classic case of “use it or lose it”.  Without regular exercise, the muscles and joints stiffen, adhesions and scar tissue can form, and mobility is further reduced.  Eventually, a person can become completely incapacitated.

A chiropractor uses spinal adjustments and manipulations to other parts of the body to realign the bones and joints so as to reduce pain, restore range of motion, and improve flexibility, balance and coordination.  These adjustments may be performed manually, or other techniques may be used to increase circulation and improve function, such as Active Release Technique.  Dr. Carly May can also recommend specific exercises that can be done at home to increase your strength and flexibility so that you’re able to maintain and build upon the gains from your chiropractic adjustments.

Many people restrict their activities due to back pain, which is the most common complaint of those who enter a chiropractor’s office.  Regular chiropractic care can reduce or eliminate the source of your back and joint pain, allowing you to resume your normal activities and to remain more flexible into your golden years.

1720 South Bellaire Street, Suite 406 | Denver, CO 80222 | Denver Sports and Family Chiropractic Center LLC 2012

Proper Form is Key to Safer Soccer Headers

The question of whether repeated headers in the game of soccer have a long-term impact on the brain or cognitive function is a raging debate among experts with no clear answer one way or another. An LA Times article on the subject makes this clear in its opening line… “Like a loose ball in a kids' game, argument over the safety of heading in soccer has parents, coaches and scientists scrambling all over.”

The one place where there is solid agreement is that proper form is the key to preventing injury. Even if your child plays in a league where heading isn’t allowed, kids will emulate in the backyard what they see the top soccer players doing on TV. Take a moment to learn the basics of proper form so you can double check what you, your child and your child’s coach are doing. Here are a few dos and don’ts to look for:

Do strike the ball with the head. Don’t allow the ball to hit you in the head

The main thing to remember is that the player should actively ‘strike the ball with the head’ rather than allowing the ball to ‘hit them in the head’.  It is very hard to learn the skill of intentionally hitting a flying object with your head!  The player needs to be active and purposeful in heading the ball, not passive.

Do keep your eyes open and locked on the ball. Don’t close your eyes when heading a soccer ball.

The most common mistake that young players make is closing their eyes. Instead, keep the eyes open and locked on the part of the ball you want to head.

Do use the whole body to generate your power. Don’t try to use your neck muscles.

Another mistake is believing that the power in a soccer header comes from the neck muscles. It doesn’t. In a traditional header, the power comes from the upper body. The back is arched in preparation for the header and the torso is trust forward to contact the ball. All the while, the chin is tucked toward the chest.  This stabilizes the neck.  In a diving header, the neck position is locked and stabilized and the entire body is propelled forward to contact the ball. The power comes from the jump and gravity, not the neck.

Do use a ball that is age-appropriate. Don’t use a wet ball for practice.

Soccer balls come in different sizes for a reason. When practicing headers, make sure you are using the right size ball for your age and not a ball that is too large and heavy. Also, as a soccer ball gets wet, the weight increases by 20% or more, so for practice, choose a dry ball.

As we stated at the beginning of the article, the debate about whether heading a soccer ball is safe for children (and adults) rages on. What we do know for sure is that kids will do it with or without proper instruction and that proper technique is the key to injury prevention. As adults, our job is to provide the proper instruction to keep our kids safe playing ‘the beautiful game’.

Good health is a combination of many factors including your nutrition, preventative care, appropriate corrective care and the small choices you make every day in the course of living. If you have questions about this article, or have an injury, contact Dr. Carly May at Denver Sports and Family Chiropractic Center. 

High Heels and Your Back

While women have worn high heels for decades in the effort to look sexy, it is increasingly having a bad effect on their back, not to mention their knees and feet. Those pricey Manolo Blahniks may look great, but is the price your back pays really worth it?

When you wear high heels, they throw off your center of gravity, causing your pelvis to tip forward and forcing the muscles in your hips, thighs and lower back to work harder, which can lead to tightness and occasional spasms. They also create a greater curvature in your lower back, which makes the buttocks more prominent and lengthens the appearance of the legs (which is what makes high heels “sexy” looking).

If you wear high heels for any length of time, your body posture adapts to it, making some muscles work harder than they should and letting other important ones become weak. For instance, the gluteal muscles weaken and the hip flexors, which are responsible for raising your knee toward your chest, become unusually tight, causing back pain. Your hip flexors extend from the front of your thigh bone, through the hip joint, to end at the lower back. Therefore, if the muscle is tight and shortened it pulls on the lower back. High heels combined with a desk job are the worst of all, as the hip flexors become shortened from being in a sitting position all day.

If you don’t want to give up your high heels there are a few things you can do to reduce long-term damage to your back:

1) Stretch your hip flexors regularly – You can reduce back pain by keeping these muscles stretched. To do this, kneel on one knee on the floor with the foot of the extended leg slightly forward of the knee. Then move your hips slowly forward so your knee is over your foot. You should feel a gentle stretch in the hip of the kneeling leg as you do this. Hold for 20-30 seconds and do twice on each side.

2) Choose a lower heel – Try to buy shoes with a heel no higher than 2 inches. This will still achieve the elegant effect you are looking for without putting excessive stress on your musculoskeletal system.

3) Tighten your abdominal muscles – Strengthening “core” muscles in your abdomen by practicing yoga or pilates will help you maintain good posture while walking in heels and take some of the load of your upper body weight off your lower back.

4) Have regular chiropractic treatment – An experienced Denver chiropractor can realign a spine pulled out of alignment by high heels and can suggest appropriate exercises to help strengthen weak muscles.

Good health is a combination of many factors including your nutrition, preventative care, appropriate corrective care and the small choices you make every day in the course of living. If you have questions about this article, your general or spinal health, please ask. We are here to help!

Boulder Ironman 2014

Dr. Carly was at the Ironman Finish, providing care for finishers in the medical tent.

Chiropractic for Triathlon Performance

A triathlon is an athletic event incorporating back-to-back running, cycling and swimming. Triathlons exert great strain on the body, which may challenge athletes on both physical and mental levels. The extreme training a triathlete must endure can put the body under great cumulative stress, and it’s not uncommon for the athletes to suffer from a broad range of injuries and overuse stresses.

There are numerous worldwide triathlon events, such as Ironman70.3 Half-Ironman, Olympic and Sprint. The majority of these events advocate the use of chiropractic care to aid not only in treating injuries, but also to improve performance. Chiropractic care offers the possibility of enhanced finishing times and a greater likelihood of triathletes finishing events.

Chiropractic treatment is a practice that focuses on the neuromuscular skeletal system and its use optimizes biomechanics. For these reasons, chiropractic care is ideal for athletes looking to treat or prevent injuries.

One type of chiropractic treatment used by many triathletes is the “Active Release Technique,” which is a form of soft tissue treatment based on an advanced movement massage system. It is very effective in locating and treating the cause of soft tissue conditions. Active Release Techniques are used in most of the large name triathlons, including the Boulder Ironman.

Many triathletes suffer from injuries attributed to repetitive strain and stress, since excessive training can result in muscle restrictions due to adhesion formation. Before treatment takes place, a biomechanical analysis of the athlete is conducted to determine the exact location of restrictions in the body along the kinetic chain. Active Release Techniques focus on specific tissues that have become restricted physically, and are then manipulated back into their original texture, tension and position. Once the soft tissues are repositioned, specific exercises are then carried out in order to aid the recovery of damaged tissues.

denver triathlon sports injury

Unlike most treatments, treating the injured triathlete with chiropractic care does not require extended rest periods before improvements are seen. It is very common that injured athletes who receive the Active Release Technique show signs of improvement in just a few sessions. For those who are looking to invest only in preventive treatment, improvement in performance is also achieved in the span of a few sessions.

A possible reason that chiropractic care prior to an event can result in performance enhancement may be that spinal adjustments improve the body’s maximal oxygen consumption ability. Since prevention is easier than treatment of an injury, many professional athletes invest in preventive and performance enhancing chiropractic treatment.

Every body is different. If you have questions about this article or whether chiropractic is an appropriate choice for your specific situation, please ask. Dr. Carly May is certified in Active Release Technique and will be a treating provider at the 5150 and Boulder 70.3 in summer of 2013.

How Does Chiropractic Help Relieve Pain?

The impetus for many people to seek chiropractic help is acute or chronic pain, most commonly in the lower back or neck and shoulders.  Although patients want the chiropractor to help with the underlying problem, lessening their pain is a very important part of allowing them to get on with life in some degree of comfort.

Chiropractic treatment for pain rests on the principle that healing will occur as a natural function of the body once it is in correct alignment.  Conversely, misalignment will lead to excess strain and wear on the body, resulting in pain.  Misalignment can occur over time as the result of bad posture, repetitive activities (such as performing certain sports or occupations) and degenerative disease.  It may also happen suddenly due to trauma from a road accident, a fall or a particular sports injury.

In addition to pain relief, chiropractic treatment aims to restore natural functioning and range of motion to the problem area.  In practice, the two go hand-in-hand.  Pain occurs in the shoulder, for example, because of a lack of movement from an injury or strain, and once this is treated, the shoulder will be both pain-free and able to move normally.

 The body is comprised of many muscles, tendons, ligaments and nerves, all of which have the potential to cause pain when stressed or damaged.  Muscle strain and spasm can occur on its own or as the result of a postural problem.  In the latter case, a spasm may not only be causing pain but may also prevent the body from returning to its natural alignment.  In this case, Active Release Technique is used by Denver chiropractor, Dr. Carly May, to ease muscle spasms and relax the spine back into position.  At this point, pain should be considerably lessened, if not relieved completely.

In addition to the Active Release Technique, manipulation helps the spine and joints to resume their natural position and eases the muscle strain associated with being out of balance, thus relieving pain.  Trapped nerves, which may also cause considerable pain (as in the case of sciatica), are often released through spinal manipulation and active release technique.

Some painful injuries may require time to heal, such as shoulder rotator cuff injuries and slipped discs.  In these cases, spinal manipulation and active release technique are important in order to give the injury the best possible conditions for repair to take place.  Patients will often involuntarily tense their muscles around an area of pain, which can both prolong the healing time and increase their discomfort.  In these cases, chiropractic treatment is important to both relieve the pain felt by the patient and to promote natural healing in the affected area.

The ultimate aim of chiropractic care is to restore function to the body, relieving pain is an important part of treatment and your denver chiropractor Dr. Carly May will do her utmost to provide relief.

Ice or Heat - How to Decide

Most everyone has experienced an injury of some sort that requires extra care in order to relieve pain, reduce inflammation and speed healing. Usually either ice or heat is recommended to help achieve these goals, but how do you know which to choose? Both heat and cold can be beneficial in certain circumstances, but each can also cause more harm than good if applied at the wrong time. Following are a few guidelines to help you decide on the best course of treatment.

ice or heat

The first general rule is to ice an acute injury and apply heat to a chronic injury. Swelling and inflammation is your body’s natural first response to injury - your blood vessels expand in order to rush more blood to the area to begin the healing process. So the best thing to do within the first 24 hours of an acute injury is to apply ice. This will allow the blood vessels to contract, reducing inflammation and bringing down the swelling, in addition to acting as a pain reliever by helping to calm irritated nerves.

Ice or cold packs should never be applied directly to the skin, as this may cause frostbite. They can be wrapped in a damp washcloth or towel, or even simpler is to use a bag of frozen peas. Ice should be applied to the injury for 10 to 20 minutes every two hours within the first 72 hours after injury. If the injury involves your hands or feet, these can be submerged in ice water for 10 minutes every 2 hours for the same effect. Cold therapy should generally not be continued beyond 72 hours, unless it is used to aid recovery after a strenuous athletic workout, or to help reduce inflammation after an instrument assisted soft tissue mobilization (IASTM) treatment .

Heat treatment is most useful for chronic injury, as it increases blood flow, allowing additional oxygen and nutrients to speed healing and helping to relax tight and injured muscles. Heat should not be used immediately after an injury, as it may ultimately increase pain and swelling. For example, sitting in a hot tub may feel good, however, the following day you will likely feel more pain and stiffness due to the increased inflammation it has caused. Heat can also reduce joint stiffness and muscle spasms.

Heat may be applied beginning 72 hours after an injury, assuming there is no inflammation in the area. Though a heating pad may be used, moist heat is the most ideal for healing, so you can apply a warm, wet towel or submerge yourself in a warm bath or hot tub for 10 to 30 minutes between two and five times a day. Warm rather than hot treatments should be used to avoid the risk of burns, and heat should never be applied for an extended period of time or while you are sleeping. Heat treatment is also useful in cases of chronic injury, such as overuse injuries in athletes, shoulder impingement syndrome, bursitis and tendonitis.

If you're still uncertain which treatment to use, consult with a qualified physician.  At Denver Sports and Family Chiropractic Center, we are trained in treating acute injuries and getting you back on your feet as quickly as possible.