Information on our April Raffle
Summer is right around the corner and for many of us that means our calendars are about to get jam packed with fun activities, events, and vacations! This summer we have something else to look forward to: The Traveling Shirt Contest!
Next time you're getting dressed for one of your summer activities, we'd like to encourage you to wear your Morrison Chiropractic t-shirt. Why? We're glad you asked!
From June 1st through Labor Day we're holding a contest to raffle off 3 amazing prizes:
1st Prize: A $100 Gift Certificate to Manor Hill Tavern in Historic Ellicott City
2nd Prize: A Pair of Sole Flip Flops
3rd Prize: A Morrison Chiropractic Hot & Cold Pack
Simply follow these steps to receive an entry in the raffle:
- Take a picture of yourself or a buddy wearing a Morrison Chiropractic T-Shirt
- Post the picture on Facebook, Instagram or Twitter using the Hashtag #MorrisonChiroWinner AND tag Morrison Chiropractic in the photo.
Voila! For each photo you post you receive an entry into our giveaway...so post early and post often!
Don't Have a Morrison Chiropractic T-Shirt? No problem! You can get a t-shirt for FREE by referring a patient to our practice OR you can stop by our front desk and purchase one for $15.
We can't wait to see all the fun things you're doing this summer while wearing your Morrison Chiropractic swag!
Witten By: Kelly Scott, Owner of ForeverStrong
Do you need to tone up, trim your waistline, strengthen your core and become stronger while burning off fat? You aren't 100% certain that lifting weights is helping you get the body you want and you need to get in shape in the fastest time possible?
Consider that, occasionally, life happens and there are times when you can only hit the gym two or three times a week. Or, if you find it simply too hard to stick to a workout plan, why not try a full body workout program?
Getting into shape, becoming stronger, more fit, have more muscle tone, trim inches from your waistline AND strengthen your core is all about spending hours at the gym, right?
Yes, hard work is still needed. Like anything in life, you get out of your workouts what you put in. The full body workout can help you progress and is easy to fit into your schedule.
Full body training is vastly underappreciated. Too bad, because it works exceptionally well. With full body training you burn more calories in less time.
This method of training focuses on major muscle groups working together in compound exercises. Because of this, a greater energy demand is placed on your metabolism than with isolation exercises. It takes more energy to require a group of big muscles to work together. More energy expended equals more calories burned.
Let's find out what full body workouts are all about and what the difference is between full body strength training and body part training.
At ForeverStrong Health & Fitness we use the ForeverStrong Full-Body-Five Method. Instead of working out individual muscle groups we strategically use exercises that require as many muscles as possible to work together to lift the weight. We design a workout based on movement, not muscles. This method requires a greater amount of effort to execute the lift which results in an increased amount of work performed during the workout. The Full-Body-Five Method incorporates five functional movements:
An Upper Body Push
An Upper Body Pull
A Lower Body Pull
A Lower Body Push
A Tension Drill or Carry
If your workout includes one exercise from each category, you have a complete Full Body Strength Training Workout. Additionally, performing full body movements requires core engagement during every lift. By utilizing high tension techniques - your entire core is being worked without having to do extra crunches.
At ForeverStrong, each client’s program consists of combined movements that include, but are not limited to:
Lower body pull (hinge) & Upper body pull (row),
Lower body push (lunge/squat) & Tension drill or carry (suitcase walk or plank),
Upper body push (pushup) & Lower body push (lunge/squat)
Upper body pull (curl) & Tension drill (plank)
At ForeverStrong a customized movement combination is incorporated into a personalized training plan for each client. At each training session the client focuses on a number of combined movements to perform that day. Each client’s program is personalized to his/her goals and the amount of work is determined based on those goals. The amount of work progressively increases over the eight week period.
In short, If your workouts target just one or two specific muscle groups each session that is body part training. Body part training is a time-waster for most people and requires 3-5 days a week of strength training plus another 2-3 days a week of cardio. Do you have 10+ hours a week to spend in the gym? Body part training doesn’t make as significant of a contribution to fat loss. It also won’t create a great enough energy expenditure to help you burn stubborn body fat.
So, what are the top reasons to use full body workouts?
Lower time commitment. Training just three days a week can produce beautiful results,
Increased Muscular Recovery Rates,
Prevents repetitive stress injuries that can occur when you only work one area of the body over and over,
Ideal for fat loss, burn more calories in less time,
Create lean body mass faster,
Everyday tasks will feel easier,
Greater Allowance For Additional Sports Or Activities, and
Lower levels of boredom.
At ForeverStrong, we want each client to Invest time in learning the proper form. Lifting heavier weights requires skill and takes time for you to become proficient. Look for a coach who focuses on technique, not just hard work. In some cases, a corrective movement strategy can supplement your workout routine to help you reach your goals faster.
We believe in our Full-Body-Five method and would like you to experience it for yourself. If you are unable to sign up for an 8 week ForeverStrong program, we would like to send you a complimentary full body workout. If you are interested, please send an email to email@example.com to get your copy. Please reference this article.
Our Personal Trainers have helped hundreds of people in Howard County and the surrounding areas lose weight, tone up, and become stronger. Our neighbors in Highland, Clarksville, Columbia, Burtonsville, Olney, Ashton and Silver Spring love their personalized training program. Please visit our website: www.trainforeverstrong.com to see for yourself.
Don't forget that Kelly Scott will by giving a seminar at our Clarksville location on Tuesday May 2nd at 7:30pm. For more information, please visit the event page!
Written by: Jason Schreiber, Owner of Top Tier CrossFit
We’ve all experienced soft tissue injuries. Maybe it was your hamstring during a run. Maybe your shoulder went out during your bench press, or when you were throwing a ball with your children. You go to your primary care physician, and what advice do they give you? It probably went something like this, “take this 800 milligrams of Ibuprofen 3 times a day, and rest and ice your injury until it feels better.”
You likely got better, but it took 4 weeks before you really felt 100%. What if I told you there was a better way? What if resting and icing was slowing down your healing? What if it’s all been a myth perpetuated over the last several decades?
The man credited with creating the R.I.C.E. (Rest, Ice, Compression, Elevation) protocol for soft tissue injury is Dr. Gabe Mirkin in his 1978 publication, “The Sportmedicine Book.” Then in March of 2014, he shocked the medical and fitness world by recanting his statement. In his self published article on his website he revealed, “There really wasn’t too much science and no one understood very much [about icing]. Since then, I’ve noticed that several studies have come out that showed the ‘R’ and the ‘I’ are just incorrect.”
Dr. Mirkin went so far as to write the foreword to Gary Reinl’s book, “Iced!: The Illusionary Treatment Option.” Gary Reinl was a journalist who set out on a mission to uncover how best to use ice for healing, because he was frustrated with the observation that there was not a medical consensus on how, when, and why to use ice after injury. In his book, Dr. Mirkin and he both explain that not only does icing not speed up healing, but that it actually slows down the healing process and causes further tissue damage. They explain that icing after injury slows healing in the following ways:
Icing slows inflammation. You’ve probably been told that this is a good thing. However, open any physiology book and you’ll see that the three necessary steps to healing are: Inflammation, remodel, and repair. Icing prevents the release of a hormone called IGF-1 in the localized tissue that is necessary for the remodeling process to start.
Icing prevents healing cells from entering the damaged tissue. Ice is a vasoconstrictor, which means it shrinks the diameter of the capillaries in the tissue, preventing the flow of blood and lymph into that area. A smaller tube means the good stuff can’t get into the area, and it also means the bad stuff can’t get out!
Icing causes additional tissue damage. Bringing the temperature down low in the injured tissue can kill healthy tissue cells around it. It’s like taking a shotgun to the area instead of a sniper rifle. You can’t prevent the collateral damage.
Icing increases swelling. Once you’ve cooled the area and caused the vasoconstriction, the body responds with a rebound effect, shuttling more pressure and fluid into that area in an attempt to raise the temperature and pressure back to homeostasis. In effect, you directly cause an increase in the very thing you were hoping to lessen.
Icing shuts off the body’s signals that alert you to harmful movement. Ice effectively numbs the area, which means you could easily perform movement that damages the tissues without even knowing it until after the local temperature has returned to normal. The analogy is similar to why you need pain signals to prevent keeping your hand in a flame. Pain tells you to stop doing something. If you are numb...you can’t feel those signals,which increases the likelihood of greater acute tissue damage during movement while the temperature is so low.
So if icing and rest are the enemies of tissue healing, what can we do to speed up the healing process after injury? The answer is simple. MOVE! More specifically, move without triggering the pain response. If we cause pain, we MAY be causing more tissue damage (this is debatable, but we'll save that for another article). So the key to healing is frequent, painless, low intensity movement of the surrounding soft tissues and joints.
This painless movement speeds healing in the following ways:
Increased blood circulation. The healing cells are being shuttled to the damaged tissue through dilated blood vessels and capillaries. The wider the vessel diameter, the more soldiers get to the fight. This is literally the opposite of what happens if we ice the area instead.
Increased lymphatic circulation. Your lymphatic system uses your muscle contractions as a pump, while your blood uses your heart as it’s pump. The lymphatic system is used to remove the waste products from the damaged area. Without the muscle contractions happening frequently, you cause pooling of those waste products and delay healing. Resting the area and icing literally causes the pooling of that waste to happen faster, delaying healing.
Increased hormonal activity. We mentioned things like IGF-1 earlier. The more painless movement you perform, the better the hormonal environment to facilitate the recovery process.
But what kinds of movement should we perform? Ideally these movements should be simple, with low levels of skill. This makes them easy to learn and hard to mess up. They should also have very little eccentric contraction, because this is the main form of contraction that causes muscle damage. If we are already injured, why would we want to further damage the surrounding tissues with heavy eccentric contractions? And finally, movements should provide a fluidity in their performance, allowing the person to maintain low intensity, painless movement for longer period of time to encourage healing.
Some examples of low intensity, low skill, low eccentric exercises might be:
Sled push/ pull
Biking/ Rowing/ Swimming
Carries (back, front rack, overhead, unilateral, bilateral)
Drags (sandbags, kettlebells, ropes, etc)
Bodyweight movements (squats, lunges, pushups, bird dogs, 90/90 drill, dead bugs, locomotion drills)
Isometric movements (planks, bridges, holds)
Obviously, it should go without saying that learning and perfecting these exercises should occur in supervision with a qualified personal trainer or strength and conditioning coach. Ideally you find someone who has dedicated their lives and career to prioritizing good technique and intelligent programming. Avoid the hobby trainer who simply has a weekend certification or two. And this coach/ trainer should be eager to coordinate your exercise program with your physician, chiropractor, or physical therapist. Any coach who avoids partnering up with your doctor is not interested in acting on behalf of your best interests.
Visit the links below for more information on this topic:
Written By: Jackie Waters
Chronic pain sufferers often look for a source of their pain so they can make changes and reduce their pain levels. For some chronic pain sufferers, making lifestyle changes is one of the best ways to minimize their pain. We share some tips for changing your lifestyle to address your pain here.
1. Reduce Stress
One of the most significant lifestyle changes you can make to impact your chronic pain is to reduce your stress levels. Pain causes stress, and stress causes pain; with better stress management, you can avoid this cycle and manage your pain more successfully. To begin reducing stress, identify your triggers. For most people, stress triggers include work, relationships, home life, lack of healthy habits, and negative thinking. Once you have identified your stress triggers, work to reduce them.
Your home also may cause stress. If your home is cluttered, you have difficulty focusing and processing information, which can lead to headaches and tension. Sorting your belongings and donating gently worn clothing will reduce some clutter and alleviate some stress; you’ll also feel good about donating your items. Organizing your remaining belongings will reduce your clutter even more and create an environment that is less stressful.
2. Get into Nature
Studies show that our environments affect our stress levels and pain levels. In fact, being in a stressful environment elevates blood pressure, heart rate, and muscle tension in addition to weakening the immune system. Because more than 67% of people opt for a natural setting when looking to reduce stress, people with chronic pain need to include being in nature in their lifestyle.
For people with chronic pain, there are several options for making nature a part of your lifestyle. You can go for nature walks, take hikes, sit outdoors, or make a garden. During winter, you should add plants to your home. Making an herb garden for your kitchen and placing plants in rooms you spend most of your time in will help improve your mood, have more positive thoughts, and reduce your overall stress.
Some people with chronic pain also listen to natural sounds to manage their pain. Studies show that music therapy may have an immediate impact on pain; the reason may be that music works like relaxation and guided imagery techniques to strengthen the part of the brain that controls the body’s healing process. Music therapy improves mood, relieves anxiety, and activates the sensory pathways of the brain that provide pain relief.
3. Improve Sleeping Habits
Proper, restful sleep helps reduce fatigue and irritation and your perception of chronic pain. It is much easier for people who get enough rest to deal with their pain than those who don’t. Strategies for getting better sleep include sleeping in a cool bedroom at around 65 degrees, keeping your bedroom neat and tidy, eliminating digital devices from the bedroom, maintaining a consistent sleep schedule, and using your bed for sleep instead of work.
4. Reduce Alcohol Consumption
Limiting your intake of alcohol is important to managing your chronic pain. Alcohol consumption worsens sleep issues, as drinking alcohol within an hour of going to bed disrupts people’s sleep cycles significantly. Chronic pain sufferers also turn to alcohol as a pain management strategy and increase the likelihood of alcohol abuse and alcoholism. Reducing the amount of alcohol you drink or completely eliminating it from your diet is one way to ease your chronic pain.
5. Eat a Healthy Diet
Some chronic pain is alleviated when people manage their weight and take care of themselves. Eating a healthy diet rich in fruits and vegetables can lead to weight loss that takes stress off your joints and helps you move more easily. Vitamins and minerals in healthy foods also help combat inflammation, which is a source of chronic pain. Most people find that a healthy diet gives them more energy, which prompts them to exercise. Exercising at least 20 minutes a day helps with weight loss and reduces pain and stiffness.
By making a few lifestyle changes, you can reduce your chronic pain. It’s important to take steps to reduce stress, spend more time in nature, get better sleep, avoid alcohol, and eat a healthy diet and exercise if you want to minimize your pain.
Image via Pixabay by kaboompics
Written By: Brian Morrison, DC
Don’t just sit there! “Sitting is the new smoking,” wrote Dr. James Levine in his book, Get Up!: Why Your Chair is Killing You and What You Can Do About It. In an L.A. Times interview, he proclaims: “Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death.”
I am frequently asked by patients which chair I recommend for their office or cubical. My reply? “The one you get out of!”
Thus began the era of the standing desk. Was that really the simple solution, the antidote to sedentarianism? According to a report featured on NPR last spring, not really. “An analysis of 20 studies failed to find good evidence that standing at a work desk is better than sitting.” A researcher quoted in the NPR report stated, "What we actually found is that most of it is, very much, just fashionable and not proven good for your health."
Darn. My staff just convinced me that they absolutely HAD to have standing desks or they would die 1000 deaths. I gave in. The report went on: "I would say that there's evidence that standing can be bad for your health." A 2005 study in Denmark showed prolonged standing at work led to a higher hospitalization risk for enlarged veins.
It’s not sitting or standing that are necessarily good or bad, it is our lack of movement and exercise that’s doing us in. The American College of Sports Medicine has a very ambitious program called “Exercise is Medicine” that seeks to educate physicians and bring personal trainers, athletic trainers, exercise scientists, kinesiologists and others into the realm of medicine and health care. Turns out, exercise along with smart dietary choices are probably the most positive changes you can make to benefit your health. Regular exercise prevents ameliorate or even reverses the effects of many degenerative conditions and diseases. Often medication can be reduced or eliminated.
Exercise has been shown to improve your general physical preparedness (G.P.P.). Simply put, regular exercise can maintain or even increase your capacity to perform activities without sustaining injury. As we become sedentary and “age in place,” we lose our capacity to do things. Every summer I see patients who return from their European vacations, having walked the streets of Rome, ascended the steps to the Acropolis r toured the castles of the British Isles with all kinds of “over use” syndromes of their musculoskeletal system. Name an “–itis” – bursitis, tendinitis, fasciitis, myofascitis – and they have it. Many have spent 8-10 hours of the 250 work days a year at a desk then commute an hour home to slump into the couch and watch TV for the evening. That’s how you lose your GPP. People expect their body to behave as it did when they were 25. On vacation they may walk 20,000 steps in a day, lug suitcases and climb stairs. Something has to give….
Beyond GPP, exercise also has remarkable benefits for just about every ailment.
The American College of Sports Medicine tells us that regular physical activity:
- Reduces mortality and the risk of recurrent breast cancer by approximately 50%. Physical activity and survival after breast cancer diagnosis. Holmes MD et al. JAMA 2005; 293:2479; A Prospective Study of Cardiorespiratory Fitness and Breast Cancer Mortality Peel JB, Sui X, Adams SA, Hébert JR, Hardin JW, Blair SN. Med Sci Sports Exerc. 2009 Apr;41(4):742-8.
- Can lower the risk of colon cancer by over 60%. Physical activity and colon cancer: confounding or interaction? Medicine & Science in Sports & Exercise: June 2002 - Volume 34 - Issue 6 - pp 913-919
- Reduces the risk of developing Alzheimer’s disease. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Larsen EB et al.Annals of Internal Medicine 2006; 144:73-81.
- Reduces the incidence of high blood pressure and heart disease by approximately 40%. Cardiorespiratory fitness is an independent predictor of hypertension incidence among initially normotensive healthy women. Barlow CE et al. Am J Epidemiol 2006; 163:142-50 Exercise in the prevention of coronary heart disease: today's best buy in public health.Med Sci Sports Exerc. 1994 Jul;26(7):807-14.
- Lowers the risk of stroke by 27%. Physical activity and risk of stroke in women. JAMA. 2000 Jun 14;283(22):2961-7.
- Reduces the incidence of diabetes by approximately 50%. The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men. Wei M et al. Annals of Internal Medicine. 1999; Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. DPP Research Group. New England Journal of Medicine 2002; 346:393-403; The Diabetes Prevention Program Research Group: Within-trial cost-effectiveness of lifestyle intervention or metformin for the primary prevention of type 2 diabetes. DPP Res Group. Diab Care 2003; 26:2518
- Can decrease depression as effectively as Prozac or behavioral therapy. Exercise treatment for depression: efficacy and dose response. Dunn A et al. American Journal of Preventive Medicine 2005
- Reduces cancer-specific specific mortality in adults with higher levels of muscle strength. Muscle strength decreases mortality risk Association between muscular strength and mortality in men. Ruiz JR, Sui X, Lobelo F, Morrow JR, Jackson AW, Blair SN. BMJ 2008; 337:a439. Better to be fit and fat than unfit with lower percentage of body fat. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. Sui X, LaMonte MJ, Laditka JN, Hardin JW, Chase N, Hooker SP, Blair SN. JAMA. 2007 Dec 5;298(21):2507-16.
- Leads to higher academic performance in children and adults. Increased SAT scores. California Dept. of Education Study, December 10, 2002. Fewer disciplinary incidents and fewer out of school suspensions. PE 4 Life Woodland Elementary School, Kansas City PSD #33
- Slows the progression of neurodegenerative diseases like Parkinson’s disease and in some cases medication can be reduced. Ahlskog, J, “Does Vigorous Exercise Have A Neuroprotective Effect in Parkinson’s?” Neurology 77:3, 2011: 288-94.
- Can have a significant impact on chronic pain. Mior, S Exercise in the treatment of chronic pain.Clin J Pain. 2001 Dec;17(4 Suppl):S77-85.
Ok, so how do I start? As Nike says, “Just Do It”. Actually brisk walking up to 40 minutes 3-4 times per week is a good goal. If you can only do 10 minutes, don’t sweat it. Start there. Measure how far you can go in 10 minutes. Try to go farther in the same amount of time after you feel comfortable. After that, you can start adding a minute here and there until you reach 40 minutes 4x/week. I highly recommend seeking out a personal trainer, chiropractor or PT who understands any health issues you might have and work with them one on one in a comfortable environment to develop a program and accountability system that works for you. The jury is out about what exercises are best, but you need to break a sweat and feel your breathing rate increase. One of my mentors stated that the best exercise is the one that you’ll do, so find something that attracts your interest and start there.
Prolonged sitting or standing, both can rob us from our health and vitality. Time to move into the new year!
Here is a perfect soup recipe for this time of year provided by Gina Rieg, owner of Simplified Wellness For you. Enjoy!
No gluten, no grains, no sugar, GAPS-friendly, SCD-friendly, Paleo-friendly, AIP-friendly (optional toppings)
- 1 large butternut squash
- 1 yellow onion
- 1 can whole, organic coconut milk (whole organic Native Forest, whole organic Thai Kitchen or organic Natural Value (no organic guar gum) (In BPA freecans)
- 2 – 3 medium carrots (or sub more squash, or other root veggies like rutabagas).
- 2 tsp celtic sea salt, Himalayan sea salt or Real salt (add more to taste)
- 2 cups homemade broth (beef, chicken or vegetable broth). (If you don’t have homemade broth on hand, the only store-bought broth that I feel is 2nd best to homemade broth is Pacific organic vegetable broth only (not AIP friendly)
- Spices – Here are 2 possible versions (choose one):
- 1.5 tsp ground nutmeg, 1.5 tsp ground cinnamon and 1 tsp ground clove (add more if desired) (THIS VERSION IS NOT AIP-FRIENDLY)
- 2 TBSP ground marjoram + 2 TBSP ground sage + 2.5 tsp garlic powder or 4 cloves fresh minced garlic (THIS IS AIP-FRIENDLY)
- Peel the butternut squash, cut it in half and de-seed it. Then cut into chunks – about 1 inch. This will be about 6 – 7 cups.
- Cut the carrots into about 1 inch coins.
- Peel and cut the onion, into about 1 inch pieces.
- Put the squash, carrots and onions in the slow cooker or Instant Pot. Add the broth, coconut milk, salt and herb/spice blend of your choice.
- If using a slow cooker, turn on LOW for about 6 hours OR on high for about 4 hours.
- If using the Instant Pot, use the “soup” function and make sure it displays 30 minutes and normal pressure. Safely quick release when the time is up.
- Once everything is cooked, use a stick blender in order to puree the soup to your desired smoothness or chunkiness. You could also use a blender and blend in batches.
- Once the soup is in your bowl, you can add toppings if desired. For example:
- nuts/seeds (such as Brazil nuts and/or pumpkin seeds) (Not for AIP)
- raw organic sour cream (Not for AIP)
- raw cheese (Not for AIP)
- shredded coconut
- plantain chips
- pastured meats (su ch as organic pastured 100% grass-fed beef, pork/sausage or chicken)
Simplified Wellness for You
Gina Rieg, CHC, NTP, CGP
Certified Health Coach, Certified GAPS Practitioner
The American Chronic Pain Association reminds us that the month of September has been declared Pain Awareness Month. “Pain Awareness Month is a time when various organizations work to raise public awareness of issues in the area of pain and pain management.”
Chronic pain treatment has been in the spotlight recently due to rising concerns about the dangers of taking opiate medications in an attempt to manage it. Issues include addiction, over-dose and death, gateway to illegal drugs and “opiate induced hypersensitivity” whereby exposure to opiates causes the patient to become more sensitive and experience more pain.
Chronic pain also presents a substantial economic and public health burden. The following map, based on current figures and census data on state populations, estimates that 116,000,000 Americans experience chronic pain.
Imagine every human being in the shaded states experiencing ongoing pain. (1) Imagine the entire shaded region, 116 million people, where every single individual experiences ongoing pain every day. Every person you see on the street, on a bus, at home, at work… including you, is in pain almost all of the time. I think we need more than a Pain Awareness Month to address this, but it’s a start!
Chronic pain creates a major economic burden, at a cost of $560-635 billion annually in direct medical treatment costs and lost productivity. By comparison, the entire annual US 2015 Military Budget was $601 billion. By definition pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. (2) When an injury first occurs and pain is experienced we call it “acute”. Acute pain is a message from our internal alarm system, using pain to protect the injured area and create actions that get us out of danger. The amount of pain we experience is NOT directly related to the amount of tissue damage, rather it is influenced by perception, thoughts, beliefs, fear, society, health care system, culture. Our alarm is activated!
Chronic pain is pain that persists longer than the normal time required for tissue healing – about 3-6 months. In other words, the body’s alarm system stays in alarm mode after tissues have healed. MRI and other brain studies show that changes occur in the brain’s form, electrical activity and neurochemistry that perpetuate the pain sensation. (3)
The truth about opioids.
Currently, opioids are the intervention most often used for management of chronic pain in the United States. The idea is to inhibit the signals associated with pain in the brain.
There are many problems associated with opioid use and abuse. A recent article in the New England Journal of Medicine highlighted the current problems in detail: “We at the Food and Drug Administration (FDA) continue to be deeply concerned about the growing epidemic of opioid abuse, addiction, and overdose – an epidemic directly related to the increasingly widespread misuse of powerful opioid pain medications.” (4) And opioid overdose deaths have quadrupled in the US between 1999 and 2014 with 165,000 people dying over this period. Ironically, taking opioids can actually make a patients pain worse. “Opioid-induced hyperalgesia (OIH)” is defined as a state of nociceptive sensitization caused by exposure to opioids. (5)
What is being done to better address the issue of chronic pain?
In the past, medicine has viewed pain as a 16th century “cause and effect” relationship between the noxious stimulus, tissue damage and the experience of pain. This is incorrect. A new model that addresses many of these concerns has emerged:
By permission: Anoop Balachandran, MS. 01/08/2014
Unfortunately traditional medical education does not adequately prepare physicians for handling the complexities of chronic pain. “One in 3 patients sees a primary care physician (PCP) for chronic pain yet most PCPs receive no training in this field.” (6) More medical schools are offering courses that provide advanced pain education.
In reality, chronic pain has social, psychological and physical (genetic, biological, nutritional, etc.) components each contributing in varying degrees to the experience of pain and whether or not the person will go on to develop chronic pain. Patients, health care providers and society need to become educated about all these aspects of chronic pain in order to create meaningful change, improve outcomes and curtail costs.
Treating a pain patient can be like fixing a car with four flat tires. You cannot just inflate one tire and expect a good result. You must work on all four. —Penny Cowan, American Chronic Pain Association, an advocate for people with chronic pain
So, what can you do about it?
I recommend all persistent pain patients visit http://www.neuroplastix.com/, pick up the Neuroplastic Transformation work book, and get a guided self-care program to follow along with the workbook at the website. Lots of self-soothing techniques, activities and exercises in a concise, understandable format. Other excellent resources I use with patients:
You could watch this 5 minute cartoon video or this awesome 14 min TedTalk with the entertaining Lorimer Moseley. You can try to identify which of these pain modulators (below) is most likely a contributor or trigger for you and visit a practitioner who can address these problems:
- Fear avoidance of movement/exercise
- Personal beliefs about pain
- Poor Sleep
- Physical Triggers like certain movements or postures that increase pain
- Social/Family triggers
- Cultural beliefs about pain
- Poor diet/nutrition
At the Center for Integrative Health and Healing, we have the opportunity to assist many patients with chronic pain problems. The vast majority of these patients have what is termed chronic musculoskeletal pain. These patients do not have underlying nerve or spinal cord damage following a surgery, trauma or disease which is termed neuropathic pain nor do they have cancer related pain. Typically their pain problem started as some form of acute muscle or joint injury or persistent biomechanical stress or some times for no reason at all and now their pain persists well beyond the normal tissue healing time of a few weeks to a few months. This pain can be unrelenting, spreading and quite severe.
We help pain patients by:
- Providing comprehensive, understandable pain education to overcome fear and learn self-efficacy.
- Identifying and addressing movement, positional, postural pain triggers and work to calm these and allow the tissues to become less sensitive
- Cognitive Behavioral Therapy
- Integrative Medicine to address social, family support
- Addressing GI disorders and nutritional deficiencies
- Assess and eliminate possible dietary and environmental toxins
- Medication evaluation
- Genetic factors, ie “personalized medicine”
- Diagnose and treat endocrine imbalances
- Use of acupuncture to address energy system
- Other healing touch modalities such as Reiki, Massage and Rolfing
To make an appointment for a consultation to help manage your chronic pain, please call 410-465-0555 for our Ellicott City office, 410-531-9985 for our Clarksville office, or email us at firstname.lastname@example.org
“It made no sense to me that with all the modern miracles in medicine there was no way to relieve my pain. What I did not realize then was how complex chronic pain is. I did not know how many areas of my life and my family’s lives the pain invaded.”
— An advocate for people with chronic pain
- IOM (Institute of Medicine). 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press
- IASP, 1994. IASP (International Association for the Study of Pain). 1994. Part III: Pain terms, a current list with definitions and notes on usage. In Classification of chronic pain, 2nd ed., edited by H. Merskey and N. Bogduk. Seattle, WA: IASP Press. Pp. 209-214.
- Louw, A., Butler, D. S., Diener, I., & Puentedura, E. J. (2013). Development of a preoperative neuroscience educational program for patients with lumbar radiculopathy. American Journal of Physical Medicine & Rehabilitation, 92(5), 446-452
- Califf R, Woodstock J, Ostroff S. A Proactive Response to Prescription Opioid Abuse. February 4, 2016. DOI: 10.1056/NEJMsr1601307.
- Angst MS, Clark JD. Opioid-induced hyperalgesia: A qualitative systematic review. Anesthesiology 2006; 104:570- 587
- Clin J Pain. 2013 Mar 1.
Dr. Brian Morrison has spent many years working with the University of Maryland School of Medicine to teach 4th year medical students about pain management. Specifically he has spent much of his time teaching his student alternative treatment methods to decrease the over-prescription of opiods, given that our country is currently facing incredibly high fatality rates due to the current opiod epidemic.
Earlier this week Dr. Morrison was interviewed on ABC-2 WMAR's In-Focus segment about the impact that this epidemic is having and the other options that physicians have when treating patients with chronic pain. To watch the interview click HERE!
Last month our very own, Dr. Brian Morrison, was shown in a PBS NewsHour segment (his cameo can be seen at 7.5) that focused on the treatment of pain and the worsening opiod epidemic in the United States.
NewHour's Christopher Booker reported that "Pain is the most common reason that people go to the doctor. Yet physicians and medical students have limited training in pain management and prescribing opiods." Between 1998 and 2013 opiod prescriptions doubled specifically for the use of treating chronic pain, which has yielded almost a five fold growth in the number of deaths from prescription opiod overdose in that same time frame.
For many years Dr. Morrison has been working alongside a team of clinicians at the University of Maryland School of Medicine's Center for Integrative Medicine to help teach 4th medical students about more comprehensive pain management programs. The CFM team is working to foster a new generation of doctors that will be able to treat chronic pain more effectively while simultaneously addressing the opiod epidemic. Specifically, Dr. Morrison has dedicated much of his time to encouraging these new batches of doctors to "decatastrophize" their patient's pain. By reducing the patient's fear surrounding their pain, doctors are able to employ more holistic treatment options such as diet changes, manual therapies, and exercise while yielding long lasting symptom relief. Here's an interesting fact; in 2011 a study showed that during 4 years of medical training, only 9 hours were spent learning about pain.
The director of the CDC, Dr. Tom Frieden, said in March of 2016, "The science of opiods for chronic pain is clear: for the vast majority of patients the known, serious, and too often fatal risks far outweigh the unproven and transient benefits." Both Morrison Chiropractic locations frequently host 4th year medical students for interactive shadow days in which they are able to see first hand the benefits of comprehensive pain management.
Regarding the feedback he gets from the students that visit his practice, Dr. Morrison said, "It is an incredibly rewarding experience to be able to provide these students with the opportunity to see, first hand, that there are other options for pain management that may equal or surpass the efficacy of opiod prescription."
This happy, healthy recipe is brought to you by Gina Rieg of Simplified Wellness for You.
This Chocolate Zucchini Loaf is an amazing way to satisfy that sweet tooth, but also keep to your well-balanced food lifestyle. Zucchini is a great baking ingredient because it adds moisture to your recipes and it's a vegetable to boot! This loaf is totally guilt-free, but so yummy, leaving you to question how there possibly could be vegetables in there! So, here it is! (Recipe adapted from http://www.healthy-holistic-living.com/chocolate-zucchini-loaf-recipe)
- 1/4 cup raw cacao powder + 1 cup of almond butter + 3 tbsp maple syrup/honey (this mimics "nutella" but this is a real food version)!
- 2 large eggs
- 2 tbsp pure maple syrup/honey
- 1 tbsp pure vanilla
- 1 tsp apple cider vinegar (ACV)
- 1/4 cup chocolate chips (optional). If you don't use chocolate chips, I recommend adding an additional 1/2-1 tbsp of maple syrup/honey. If you are choosing to use chocolate chips, I recommend the following: Enjoy Life, Semi Sweet Chocolate Chip, 10 oz OR SunSpire Organic Fair Trade 65% Cacao Bittersweet Baking Chips, 9 oz bag OR TO AVOID SUAGR OR FOR GAPS: PASCHA Organic Dark Chocolate Baking chips - 100% Cacao, Unsweetened 8.75 oz
- 1 cup zucchini - shredded then squeezed with a kitchen towel in order to remove the zucchini juice
- 1/2 tsp baking soda
- 1/2 tsp sea salt
- Preheat the oven to 400 degrees F
- Mix the cacao powder, almond butter, eggs, maple syrup, vanilla, and sea salt until smooth
- Add baking soda and ACV, mix
- Add shredded zucchini
- Scoop into greased loaf pan, bake for 35-30 minutes (for one large loaf pan) or 28-24 minutes (for 2 small loaf pans). It's done when a toothpick inserted into the middle comes out clean
- Allow to cool for several minutes, then enjoy!
Note: You could also make these as muffins! Bake for 12-16 minutes.
Simplified Wellness for You
Gina Rieg, CHC, NTP, CGP
Certified Health Coach, Certified GAPS Practitioner
Gardening season is upon us! And you know what that means, right? Low back pain! Let's review a few tips to help get you through the season without difficulty.
1) Start each session with 5-7 repetitions of the cat-camel (or cat-cow) exercise. This exercise is performed from the quadruped position, or the on-all-fours positions, with your hands placed directly under your shoulders and your knees directly under your hips. Then begin to slowly alternate between flexion and extension of your spine. Do so by arching your back towards the ceiling and lowering your head towards the floor, then lower your belly towards the floor and look up towards to ceiling. Avoid extremes of motion if they cause pain. This is not a stretch, rather a continuous movement though the range of motion.
2) Warm up with a 5-10 minute brisk walk to get the blood flowing. This is a great way to dynamically warm up instead of stretching. There is no evidence that suggests stretching before an activity prevents injury. Actually, the common stretch of bending over and touching your toes can increase the likelihood of injury before activity.
3) Vary your gardening tasks, pruning, raking, digging, etc. Do not continuously perform any particular activity for a long period of time. Planning your tasks ahead of time can help with this, as well as placing your tools in a bucket for easier transport. When you do need to be in a kneeling position, try to use a kneeling pad or a kneeler equipped with handles to help with getting up and down from the ground. You can also consider using tools with an adjustable length handle to allow working from a standing or seated position.
4) Bending and lifting should be performed using the hip-hinge bend technique with all of the movement coming through your hips instead of your low back. Add a bend to your knees and keep your back in a neutral position to minimize stress on the lumbar spine. The power of your lift should come from your buttock and legs. It is also critical to abdominally brace (tense the abdominal wall as if you were anticipating being struck in the gut) during the lift to increase the stability in your low back.
5) When shoveling, spread your feet to give create a wide supportive stance and avoid twisting your body. Instead, picot and re-position with your feet.
Another option is to hire the kids around the neighborhood to assist you. Gardening is a physical activity, and you will protect your back if you exercise regularly and follow the tips listed above. Just as an athlete would train and condition for his or her sport to avoid injury. If you need to improve flexibility, gently stretch AFTER gardening or exercise. Consider the cat-camel, sphinx, child's pose etc. for stretching.
Good luck out there and happy gardening!
Ross Dubin, D.C.
I recently watched a webinar on auto accident injuries. I wanted pass along a few pieces of information that can help minimize your injuries in the unfortunate event that you are involved in an accident.
- Keep the top of your headrest set at a height that matches the top of your head. When the headrest is too low, your neck and head can be propelled upward and backward, over the top of it, increasing injury to the neck.
- If you see a vehicle approaching from the rear and it looks like an accident is going to happen, firmly grasp the wheel and brace your torso and head backwards into your seat with stiff, but not locked, arms. Minimizing your body's movement reduces injury, generally speaking. It is thought to be a wives tale, the story of the drunk in the accident that walks away unscathed because he was so relaxed.
- Also, keep your foot firmly on the brake. In this was you keep your car from accelerating rapidly and out of control in the case of a collision from the rear.
Even low speed accidents can injure muscles, joints, and nerves. Chiropractors are experts in managing these types of injuries and we can take fast action to alleviate your symptoms. As always, these are thoughts to consider if you're involved in an auto accident, but they should not be taken as a substitute for your primary care doctor's advice.
Brian Morrison, D.C.
A huge thanks to my good friend, John Kibby, a great chiropractor in Crofton, MD for sharing this information!
We've learned in recent years that taking a nap every day is beneficial for overall health. However, our hectic and ever changing schedules rarely work out to allow the perfect 20 minute 'power nap'. Are there still health advantages if you only have 10 minutes to nap? Is napping for 1 hour unhealthy? Keep reading and all your questions about napping will be put to bed.
According to a study conducted by Cornell University a 10 minute nap, "had the greatest immediate improvement in alertness and cognitive performance." Another study found in the PLOS ONE Journal concluded that a 30 minute nap following lunch will help increase your ability to switch between tasks more efficiently.
Make sure to set an alarm for 60 minutes or less, as a 2012 study in the Sleep Journal found napping at midday for greater than 60 minutes correlates to increased risk of suffering from a cardiac event.
If naps don't bring you joy or you rather fill the day with more productive tasks; please put down your phone, push back from your computer, and set an alarm for 10 minutes to perform one of the following activities:
- ake a brisk walk
- Listen to music or a podcast
Kate Bodenberg, D.C.
School is closed again, traffic is creeping along, and the roads are not in the best of conditions. Even though today's snow storm doesn't really compare to our most recent blizzard, we have definitely noticed people wanting to just stay in and avoid all of the craziness. We're glad that everyone is being safe and smart and we hope that you all stay warm today. We do however want to get a timely message out to you and your family. A majority of auto-accidents happen within a 5 mile radius of where you live, so even if you have cut back on any major commutes today, safety on your trips around town is still very important. If you or a family member or friend has been in a car accident due to this snow storm reading the rest of this letter may help you save a lot of time, money, and pain.
You might be asking yourself how this is possible. There are countless thoughts that fly through a person's mind after an auto-accident but the common ones are:
- Whas that my fault or theirs?
- What's the condition of my car?
- Who will pay for the repairs and the medical bills?
- What's the first thing I need to do?
We've been treating auto-accident related injuries for over 27 years. We know how much of a hassle it is to get your life back in order after something like this happens. Filing a police report, not only dealing with your auto insurance but the other person's auto insurance as well, finding temporary transportation, and medical bills....ugh, the medical bills. Even if you know what needs to be done, actually working through all of these steps can be a pain in the you know what.
One thing that we've noticed through treating so many of these cases is that people tend to worry more about their car, or getting to work, than they worry about their own health! You might notice a minor neck or back ache at first, but you shrug it off while you handle everything else. By the time all of the dust settles that minor pain, having gone untreated, could turn into something more painful and in some cases the insurance companies wont pay for the treatment because an initial evaluation wasn't done immediately after the accident. They are going to err on the side of less liability and claim that the pain might not have anything to do with the accident because an immediate exam wasn't filed - that leaves you responsible for the medical bills.
Avoid this and prioritize yourself!!
If you, a family member, or friend has been in a car accident call us immediately! We'll do a thorough exam to catch any minor injuries that have the potential to develop into something bigger if left untreated. Mention this blog and we'll also give you 10% off either a ice/heat pack or a nutritional supplement of your choice (the Inflavanoid Intensive Care is a great way to reduce inflammation after acute injuries). Save yourself the headache (pun intended) of dealing with prolonged injuries or stubborn insurance companies, we are here to help!
Ellicott City: 410.465.0555
Kick inflammation to the curb by drinking a cup of turmeric milk also known as 'golden milk'. The health benefits of all the listed ingredients are many, however, the stars of this recipe are turmeric and ginger. Turmeric has strong anti-inflammatory and antioxidant properties. Ginger helps digestion, soothes gastrointestinal upset, and also combats inflammation. Blend, heat, and enjoy!
- 2 cups of unsweetened alternative milk (almond, brown rice, hemp, oat, or coconut milk)
- 1 teaspoon dried turmeric (or one-half inch fresh turmeric thinly sliced)
- 1 teaspoon dried ginger (or one-half inch fresh ginger thinly sliced)
- 1/2 to 1 teaspoon ground cinnamon (optional)
- 1 grind of black pepper
- 1 teaspoon honey or to taste
- Dash cayenne pepper
- Throw all ingredients into a blender
- Blend until smooth
- Pour into saucepan
- Heath through over medium-low heat
- Do not boil!
- Strain if pulp is undesirable
- Pour into favorite mug and enjoy!
Let me know what you think about this recipe in the comments below!
-Dr. Kate Bodenberg
What is Upper Cross Syndrome?
How many of you star your day with a long car ride followed by sitting at a desk for 8-10 hours? Then cycling through this 5-6 times a week? Sitting and a sedentary lifestyle are major culprits of neck and upper back pain, most commonly called Upper Cross Syndrome (UCS). In UCS we see patterns of muscles imbalance and poor posture. Muscles imbalance is seen with alternating groups of tight and weak muscles. The tight muscles could include upper trapezius, levator scapulae, suboccipitals, and pectorals. The weak muscles could include rhomboids, lower trapezius, and neck flexors. This means there is weakening and lengthening of the posterior upper back and anterior neck muscles along with tightening and shortening of the opposing posterior neck and chest muscles. This imbalance can accelerate poor posture leading to anterior head carriage (AHC) and internally rotated shoulders. Thus, sitting like this for however long throughout your day can equate to pain and/or dysfunction. Particularly at major segments in your cervical spine (neck), mid-thoracic spine (upper back), and gleno-humeral (shoulder) joint.
How can we fix the problem?
First, we basically want to strengthen what is weak and relax what is tight. Part of this process is made simple by learning a few strengthening exercises and relaxing stretches you can do at home or even in the office. The strengthening exercises include Deep Neck Flexor Activation, Seated Rows, and Standing Pulls, and the stretches include, Bruggers, Seated Thoracic Extension/Thoracic Extension with a foam roller, and Doorway Pec Stretch. If done regularly and properly, these exercises can have positive, long term effects on your symptoms, and the great news is that we teach patients how to do these exercises everyday in our offices! In conjunction with strengthening and stretching, spinal manipulation can be a useful tool for relief of UCS. It will help release those restricted areas, increase range of motion, relax the soft tissue, and inhibit pain. The combination of proper exercises and spinal manipulation has been proven to be very effective in countering the effects of UCS.
Strengthening and stretching will help assist your posture while driving and sitting at work, but not 100%. It is important to be mindful of your body and workstation positioning. I like to tell people to imagine "putting your shoulder blades into your back pocket." Meaning, keeping your shoulders back and down. Use of low back support to maintain that normal curvature in your lumbar spine should be used at all times. If you don't have a lumbar roll/support (which can be purchased in our offices), rolling up a towel and placing it in the small of your back should do the trick. Looking down with your eyes instead of looking down with your neck will help reduce the stress placed on your spine. Refrain from having the screen off to the side, and turning your neck in one direction for extended periods of time. Standing desks are becoming more and more common in the work place and should be taken advantage of if available. Avoid sitting for longer than 20-30 minutes by taking frequent postural breaks and walk around for 1-2 minutes, providing your body with a change in prolonged positioning.
Bringing it all together
UCS is becoming more common with the amount of time people spend sitting throughout their day. We need to move more. Aside from a change in career - which is not likely for most people, these tools can help with relief. We see the effects of sedentary lifestyles ever day in our offices; headaches, neck pain, back pain, fatigue, joint dysfunction, weight gain, the list goes on; and we know how important increased movement is in relieving the symptoms. It's time to make a change and to prioritize feeling better. We can help. We want to get you back to your favorite activities and to get you feeling your best. You just have to take the first step - give us a call!
Yours in Health,
Ross Dubin, D.C.
Morrison Chiropractic, P.A.
Ellicott City, MD
Hey Everyone, Crystal here!
We tell so many of our patients to slooowww down while doing their exercises. Why? Think about it this way....if someone is trying to instruct you how to do a new task, but they're talking wayyy to fast for you to understand the directions they're giving, how well do you think you'll be able to perform that task? Probably not very well, right?
Okay, well the same thing goes for your body. If you move too fast, your brain doesn't have enough time to instruct your body how to do the movement properly...and that right there is the key, doing it properly! The combination of your nervous system and your muscles working together to produce movement is called your neuromuscular system. This system communicates at a certain speed, which varies among individuals and even specific movements. So, for example, if you are squatting faster than the rate of that communication the margin for error in that movement pattern increases.
So slow down, enjoy the movement, and give yourself (and your body) enough time to make sure that you are doing your exercises properly! Not only does this create healthy and proper neuromuscular movement patterns, but it helps you get the maximum benefit from your exercises, too!