Whole Body Health

Postural Alignment
Scar Tissue & Adhesions
Optimizing Fitness
Ergonomics: at Work
Orthodics: All about your Feet

Postural Alignment
What is posture? Posture is defined as a person’s physical alignment and stance. The way in which one holds and carries one’s body is due to many factors both intrinsic and extrinsic that can be either productive or counterproductive to one’s health. Our posture begins to form at an early age when we first start standing on two feet and gravity begins to pull down the length of our body. If you were to ask ten people what constitutes good posture, you would probably get ten different answers. Most people think good posture is simply pulling back the shoulder blades and head. Although this “military” stance addresses two components of good posture, it falls short in providing optimal full-body alignment. Optimal posture aligns our joints in the most biomechanical efficient manner. Biomechanically efficient posture takes the least amount of energy to maintain and move our joints.

In describing postural alignment, it is helpful to talk about an imaginary line that passes through the center of the body. This line is referred to as the body’s center of gravity line. Proper postural alignment occurs when this line passes through the ear, shoulder, hip, knee and ankle. When such body alignment is maintained, the muscles on the front and the back of the body share equally in counter-balancing gravity and keeping our bodies in an upright position. Good biomechanical posture allows our joints and muscles to function at their full potential and reduces the risk of injury and stress.

Maintaining proper postural alignment is not easy. There are many internal and external factors that can affect good posture. One of the common extrinsic factors affecting our posture is gravity. Gravity has a downward, compressing effect on the body, which contributes to rounding of the shoulders and anterior (forward) placement of the head in relation to the shoulders. Such posture is a common cause of chronic upper back, neck and headache pain. Another extrinsic factor affecting our posture is poorly designed workstations. As a result of poor workstation design, people often work in unhealthy, abnormal postures. This places the body’s joints in abnormal positions and over time may result in chronic pain or injury.

Other factors responsible for poor postural alignment are things that are intrinsic to our own body. One of the most common of these factors involves being overweight. As one gains weight, gravity tends to pull us forward. To compensate for such weight gain, an increase in the lower back’s curvature is created. Such compensation results in a “sway back “ posture that leads to further compensational changes of the upper back and neck areas.

Strength imbalances of the muscles needed to maintain proper postural alignment are another internal factor causing poor posture. Oddly, such muscular imbalances are not only seen in individuals who do not exercise enough, but also in individuals who exercise regularly. The latter is commonly seen in individuals who lift weights regularly, but do not work to maintain the normal balance of the body’s strength and flexibility from front to back. Therefore, when lifting weights or doing any kind of strengthening exercise, it is also important to strengthen the opposing or antagonist muscles in order to maintain proper balance and posture.

The “wall test” can be used to assist in the evaluation of your own posture. Standing with your back and heels two inches away from a wall begins this test. Next, press your lower back, shoulders and neck to the wall. While maintaining this posture, move away from the wall and hold this position for a few seconds, then relax back into your “old” posture. If, upon relaxing, you maintain approximately the same body alignment, then you already have fairly good posture. However, if you experience a large change in your alignment, then you have some work to do. Poor posture is the most common cause of chronic back pain. If left untreated, it can lead to other problems including headaches and shoulder pain and even premature degenerative joint problems.

Scar Tissue and Adhesions
When soft tissues (muscle, ligaments and tendons) are injured, an inflammatory response occurs which involves a cascade of events resulting in tissue healing. This healing process rarely results in 100 % restoration of the tissue to its pre-trauma status. Consequently, there is a permanent loss of the tissue’s strength, flexibility and elasticity.

Loss of “healed” tissue strength and flexibility is due to the repair process that lays down a “cheaper grade” of tissue (scar tissue and adhesions) than was the original tissue. Additionally, the tissue’s elasticity, its ability to stretch then rebound, is compromised. This is due to the random fashion in which the new tissue is laid down during the healing process. Instead of the fibers of the tissue being aligned in a parallel fashion, they are arranged in a crisscross pattern that compromises the elastic capabilities of the tissue. This loss of elasticity to a muscle, ligament or tendon severely compromises its function and also puts it at a higher risk of injury. This is due to the decreased ability of the tissue to acclimate to traumatic forces imposed upon it. When re-injury occurs, the inflammatory response produces additional scar tissue formation often leading to chronic pain.

Chronic pain due to scar tissue formation may also be the result of non-traumatic injuries. This is commonly seen in post- surgical patients who experience pain in the area of their healed incisions.

At the Chiropractic and Sports Injury Center of Jackson Hole, treatment of chronic pain due to scar tissue and adhesions includes the GRASTON Technique®. The GRASTON Technique® is a new and effective, non-surgical technique for breaking up muscular adhesions and scar tissue in order to eliminate chronic pain. In addition to breaking up adhesions and scar tissue, an emphasis is placed on stretching and strengthening exercises to restore soft tissue flexibility, strength and elasticity. For more information of GRASTON Technique® visit the website www.grastontechnique.com.

Optimizing Your Physical Fitness and Performance for Weekend Warriors or Professional Athletes
At the Chiropractic and Sports Injury Center of Jackson Hole we understand that whether you are a professional athlete or a weekend warrior your athletic endeavors are important to you. We also know that meeting those goals sometimes takes more than just hard work and determination. Your ability to compete, achieve your goals and stay injury free depends upon your body being biomechanically sound. It does not matter how good your nutrition is, how much you train or how strong or flexible you are. If you have an underlying biomechanical imbalance your performance will suffer and you will be at risk for injury.

Every sport has its own specific biomechanics. The biomechanics of a sport refers to the body/joint movements that are involved in performing a particular activity. In order for an athlete to perform at his or her top potential and minimize the risk of injury, proper joint alignment, muscular strength and flexibility is critical. If any of these three components are compromised, the joint and its muscles and ligaments will be susceptible to injury. Permanent injury may result if such compromised joint structure, stability and biomechanics are left untreated Biomechanical problems can result from many different origins. Some are developmental due to genetics and the way the body developed. Other problems are acquired from past injuries sustained. Developmental problems may include a leg length deficiency where either the thigh or lower leg bone is shorter on one side of the body. Large Q-angles (the angle of the thigh bone to the lower leg) causing knee alignment problems is another developmental abnormality seen commonly in women. Lastly, abnormal spinal structure is another common developmental problem. Whether there be an accentuation or lessening of the back’s normal curvatures or underlying scoliosis, spinal biomechanics are compromised and can predispose one to injury.

Acquired biomechanical problems typically result from past injury that has compromised a joint’s structure, stability or alignment. Other acquired biomechanical problems are compensations of normal body and joint mechanics in attempts to limit pain from a past injury. These types of compensational biomechanics are commonly seen in athletes who return to their training and competitions too soon without receiving adequate rehabilitation of their injuries. In these athletes, it is not uncommon for them to experience repeated aggravation of their initial injury. Additionally, new injuries may result from compensation of normal biomechanics placing stress on other joints and tissues.

So, if you suffer from a chronic injury that has limited your athletic performance and prevented you from reaching your goals, seek evaluation and treatment by a professional trained in sports injuries. Dr. Zendler is Jackson Hole’s only Certified Chiropractic Sports Physician (CCSP). He has extensive training and clinical experience in the biomechanical evaluation and rehabilitation of sports injuries. The initial evaluation of an injury begins with a history of the injury followed by an in-depth orthopedic-neurological examination, evaluation of structural alignment, flexibility and strength measurements and gait analysis. Remember, accurate diagnosis and timely treatment of an injury is critical in the prevention of future and permanent injury!

Work Body Smart: Ergonomics
For many people who spend their day at a desk working at a computer, their work can be literally a “pain in the neck”. In today’s world of ever increasing technology, we have become slaves to our computer. As a result, we spend prolonged periods of time sitting at workstations that often distort the normal posture of our bodies and place our joints in positions of high stress. Work place injuries have become a common cause of lost time from work and cost employers and employees billions of dollars every year.

The science of ergonomics has evolved due to the escalating cost and number of work related injuries. According to the United States Department of Health and Human Services, ergonomics is the science of fitting workplace conditions and job demands to the employee. Ergonomics has played an important role in the prevention and reduction of work place injuries. Before the debut of ergonomics, workers were forced to sustain often unhealthy positions and activities in the work place. Repetitive stresses and poor postures over time culminated in injuries such as carpal tunnel syndrome, and chronic neck, arm or lower back pain.

When evaluating the ergonomics of a workstation certain things should be considered in order to reduce the risk of injury:

Chose a desk that is the proper height. Desks that can be raised and lowered offer the best fit.
Your feet should always touch the floor with your thighs parallel to the ground or slightly angled The ankles should always be forward of the knees with a 3 finger gap between the back of the knees and the chair’s cushion.
Maintain proper posture by sitting to the very back of your chair allowing support of the lower back by the chair’s lumbar support. When the lordosis (curvature of the lower back) is properly maintained it becomes more difficult to slouch.
Adjust the height of your monitor. Your eyes should be at the top of the monitor when looking straight forward.
When using the keyboard, keep your wrists straight, your forearms parallel to the floor and your shoulders perpendicular to the floor.
When talking on the phone, never cradle the phone between your shoulder and ear.
Never sit for periods longer than 20-30 minutes without standing up to stretch or take a short walk.

The ergonomics of how we use our bodies to perform certain tasks is also important to consider in the prevention of back injuries. This is especially important in the prevention of lower back injuries associated with lifting.

When lifting items from the floor, always keep your back straight and lift with your legs.
Never bend over at the waist and lift with your lower back.
When lifting and carrying, especially a heavy item, keep it as close to your body as possible.

By considering these simple suggestions in customizing your workstation and proper mechanics of lifting, you can become more productive in your work and limit your chance of injury.

Foot Orthotics: Gait Analysis
Your feet have a direct impact on the alignment and function of the entire body. This is because the feet are the foundation of the body and support its entire weight. Small changes in the foot’s structure can result in changes in the alignment of the ankle and knee. As a result, a chain reaction of compensational adjustments may occur which can change your posture and your gait (the way you walk). If these changes in body mechanics are not corrected, they can result in stress to joints higher up in your body resulting in hip pain, lower back pain and even neck and headache pain.

What Are Orthotics And What Do they Do?
Orthotics are custom made insoles that are worn in your shoes to provide correction of abnormal foot structure and to restore normal foot function.

How Do I Know If I Have A Foot Problem?How Are Orthotics Made?
Orthotics can be made in a variety of ways including making plaster casts of the feet, having a patient step into a foam mold or taking a non-weight bearing foam mold of the feet. At the Chiropractic & Sports Injury Center Of Jackson Hole we use Gaitscan™, a state-of-the-art computer hardware and software technology, to assess and analyze foot mechanics.

What Is Gaitscan™ And What Does It Do?
Gaitscan™ is the gold standard of the orthotics industry providing the most technological and object assessment of real-time foot biomechanics. A Gaitscan™ assessment involves:

Scanning of feet: The feet are scanned as the patient walks across a pressure plate composed of thousands of sensors that capture pressure recordings of the foot in real time.
Mapping of foot pressures: Gaitscan™ state-of-the-art software displays 2D and 3D visual images of the pressure recordings captured of the feet throughout the gait cycle.
Information recorded is summarized in a numerical report. Upon your physician’s review of the report it will be determined if your foot complaints are due to faulty foot mechanics and if you’re a candidate for orthotic therapy.

Foot Facts: Did you know?

25 % of the bones of the body are in the foot
The average person takes 8,000 to 10,000 steps per day.
The average person will walk over 100,000 miles in a lifetime, or more than 4 times around the world.
Women have four times as many foot problems as men due to fancy and poor fitting footwear.
More than 75% of people will experience foot problems in their lifetime.

For more information about Gaitscan™ and The Orthotic Group visit their website at www.theorthoticgroup.com.