Weekly Health Update by Toronto Chiropractor Dr David Koivuranta in Davisville.

Hello everyone, it's Dr. Dave. Hopefully you're doing well, you had a nice week, you're looking forward to your weekend. Coming at you on behalf of the Toronto Neck and Back Pain Clinic with your weekly health update for the first week of October, starting Monday, October 4th. Gonna look back at some of the more relevant perhaps, or interesting health and wellness articles, and, uh, purpose being of course to get you thinking about your own health and wellness each day and some things you can perhaps implement based based on what we talk about to at least get you again focused and thinking, keeping it on your radar on a daily basis. Not going to treat, diagnose, prevent, or cure any illness or disease with our time together. However, you never know what small change, what little step you can take today to keep that health and wellness of yours headed in the right direction. And you just never know what can improve or what you can so-called heal from when you change some of the things you do every day, including what you look at and what you hear, which is what we'll try and support you with, with our weekly health update. So some fitness-related things. Of course, fitness and keeping our body moving, uh, is one of the key things that we can do for our health and wellness. They looked at the brain imaging of nearly 6,000 primary school-aged children, and it showed an association between regular physical activity and more organized, robust, and flexible brain networks. So it didn't matter the kind of physical activity that the children were involved in, it only mattered that they were active. In preteens, a number of brain functions are still developing, and they can be altered by a number of risk factors. Our results— the The results of the study suggest that physical activity has a positive protective effect across the brain regions. So we know that exercise and fitness is good for our heart, our lungs, our muscles, and can get some energy and stress out, but it's also good for impacting our fun— the function of our nervous system, not just in our body but also in our central nervous system or our brain. So getting moving every day regardless of age is very important. So interestingly, to support that concept, another study that was from the Cerebral Cortex report 2021. Then the Journal of Speech-Language and Hearing Research, July 2021, looked at engaging in light physical activity like swimming and how that appeared to help children better recall words they had just learned. So the authors note that physical activity increases expression of brain-derived neurotrophic factor, which stimulates the growth of neurons and the synapses that connect them. So while you're learning, you stimulate that brain with physical activity, and it seemingly makes whatever you're learning stick better because your brain is constantly creating those connections to associate what you're being impacted by or interacting with or adapting to in the environment, including those things that you may be trying to learn. So very, very interesting connection between that activity as well as learning or improving language. Another area we'll look at is typically somewhere along the spine with neck, back, pelvic, and other joint pain, which is what we deal a lot with here in the clinic. One of the most overlooked regions when it comes to low back pain is something called the sacroiliac, or SI, joint, and it can be particularly problematic during pregnancy. So the Acta Radiologica report from May 2021 looked at a group of 320 new mothers, and the researchers found that those who experienced low back pain during pregnancy were more likely to have sacroiliac joint dysfunction. Past studies have shown that the SI joint is a common sole or contributing cause of back pain and should be evaluated in patients with low back pain. Of course, that's what a lot of manual therapists, including doctors of chiropractic, look for. And it'll be involved with function with the lower back or the lumbar vertebrae, as well as the hip joints and the pelvis itself, of course, making up 2 of the 3 joints in that pelvis, those sacroiliac or SI joints. I've talked to a lot of my colleagues, I've looked at the research, I've dealt with a lot of day-to-day patients and a lot of higher level athletes in all kinds of disciplines, and it's rare that to check someone or find someone, whether they have symptoms or not, that they have equally functioning sacroiliac joints. Whether it's a byproduct of our dominance or just having lived life, there typically is some dysfunction in one sacroiliac joint or the other. So very important to get those joints along with the rest of your joints in your body, because the question becomes, how long do you want to live without all your joints doing as much as they can possibly do to help keep you moving? And the answer is probably probably forever, or as long as possible. So getting them checked and making sure that they're functioning well will help reduce the likelihood of dysfunction in the future that may go unchecked. You may not have any symptoms until that day that symptom comes, but like so many other health problems, that joint could have been dysfunctional for long enough that now, either because the habit is so ingrained and/or there's been structural damage to that joint or that part, the recovery becomes more difficult. But proactively, you can have those joints checked if it makes sense for you or those in your life, and you want to preserve the quality of movement or function in those joints. Another knee joint— another joint which would be the knee joint that we commonly see problems with in the clinic. They talked about it in Arthritis Care and Research in August of this year, 2021. They looked at 94 older adults with osteoarthritis of the knee, wear and tear in the knee joint, and those who lost weight as a part of a diet and exercise intervention experienced a reduction in their knee pain, possibly due to the combination of reduced inflammation and less mechanical stress on the affected joints. So there's 3 important points with this study. We often hear this from patients who have gone to see another healthcare provider, whether it's for back pain, hip pain, knee pain, those load-bearing joints, ones that help keep us upright, uh, that indeed, if we are not closer to our ideal body weight, then perhaps that excess weight is not doing justice to those joints. However, a normally functioning joint, a joint that is sitting and moving well, can handle a lot way more than our ideal body weight as long as it stays functional. So the weight gain itself will not necessarily contribute to the wear and tear. It's more likely a dysfunction, that joint not sitting and moving right, that we repeatedly use over time, either through microtrauma or through macrotrauma, that will create some wear and tear. Now, if we put excess weight or pressure on a joint that's not sitting or moving right, is dysfunctioning, and/or has wear and tear, that will contribute to not only the symptoms but perhaps a more rapid, uh, demise of that joint, more wear and tear, and eventual degeneration to the point where it may be hard to get relief. So the mechanics of that are true. Then interestingly, the third point to go along with that is that an improved diet will not only help with the weight loss but will also decrease inflammation in the body, which is, if not the number one, is very highly involved with the pain that comes from a dysfunctional and/or degenerating joint, and getting that inflammation down can help make it feel a lot better and also help contribute to the slowing, slowing if not stopping of the wear and tear in that joint. All right, so a good thing to review with your healthcare provider is that ideal body weight and the purpose or the reasons that we might want to strive to getting it better. One of the things that could help us do that is of course staying active, but it's hard to do when our joints are in pain, especially if it's chronic pain. But the right amount of activity still, even with dysfunctional joints or joints that are in pain, whether they're acute, recent, new injury, aggravation, or something we've had for a long time, a chronic one, can also be beneficial. So for patients with chronic pain, they did a study in the Journal of Physical Activity and Health, quite appropriately, August 2021, and they looked at 27 studies and they found that routinely engaging aerobic exercise can reduce pain and improve physical function. In people with chronic pain. And it's the type, the duration, the intensity of that exercise that should be customized, individualized, and personalized for that person based on their chronic pain patterns and the nature of the chronic pain, as well as who they are and their current health status otherwise. So there are multiple factors there to look at, and it's good to work with a healthcare provider to work out those details, because even though it seems like movement is not good, it aggravates, there's pain, there's probably some kind of movement still that can be found that is actually beneficial to help with that chronic pain. The journal Spine in July 2021 looked at upper extremity pain involving the shoulder or perhaps the rest of the arm and how there could be a neck problem component with that upper extremity pain. So neck pain sufferers often have problems with how the neck muscles are functioning or firing or working. Some are stronger, some are weaker, some are shortened, some are lengthened. But a recent study using CT scans to measure neck muscle cross-sections found that atrophy, or shrinking, or loss of muscle size of those muscles also are present in patients that have upper extremity pain. And the more that muscle has reduced some of its size, the greater the person's upper limb or upper extremity pain intensity and disability typically is. So those findings suggest that if you have upper extremity discomfort, shoulder pain, or pain in the rest of the arm, it would be a good idea to check those neck muscles muscles to see if any of them are dysfunctional or weak per se, or just not working right, and to prescribe the specific exercises to improve those patterns of muscle function in the neck, your shoulder and/or arm may feel better for it. So again, it's interesting to see how much, uh, our body is connected. Some of that connectedness between the physical and the emotional and the physical and the chemical can be seen in some of the research like and that from the Sport Sciences for Health Report, July 2021. They looked at sitting too much and how that can affect your mental health. New research suggests that sitting for more than 8 hours a day can negatively affect mental health and well-being, even among adults who meet fitness guidelines of 150 minutes per week of moderate-intensity physical activity. So this coincides and segues or dovetails nicely with other research out there that shows that if you are doing repetitive or sedentary work for a certain number of hours per day, it is challenging in any exercise session to undo the damage of that post or after that other sedentary repetitive work has been done. Meaning if you work 4, 6, 8 hours a day at a computer and then you go do an hour of some kind of exercise class or program, no matter what it is, it may not be negating the effects of that 4, 6, or 8 hours. So even though someone is being proactive and doing the right thing, that work or the nature of what we're doing can still be building up or causing more impact than our body can repair from. So what that may suggest is that in real time during the day, you still want to be trying to take some breaks, remind your body that it can move instead of— and it can move more than what you're regularly using it for, and engage it and try to negate in real time the impact or the buildup of whatever it is you could be doing during the day, but then still getting in that exercise. And the research does show that the best exercise to negate the effects of what we might be doing during the day that are not beneficial to us is indeed some form of moderate to intense exercise, almost like a high-intensity interval training session for 20 minutes, give or take, along with other exercise still to meet the neg— the minimum weekly exercise requirement, 150 minutes, which is about 24 plus or minus minutes a day, which I think is possible for most of us. But actually, that's the minimum At some point in time when you can make it happen in your life, you may want to try to double that, in fact. And that will not only negate the effects or try to keep you in the game, but it'll be an investment in your future health and function when you can. So an interesting, uh, uh, report there based on sitting and our mental health and wellness, because not only will there be physical benefit, benefit to your heart and lungs from doing that activity, but it'll benefit all the systems in your body, including your nervous system once again. And another way to support all those systems is getting enough sleep. They looked at that on WebMD, July 2021. And if you get 7 to 8 hours of sleep per night, you will have better cardiovascular health, steadier blood sugar, improved immune function, reduced risk for weight gain, sharper, sharper mental acuity, and more affable mood. Might just generally be a more happier self, more like your disposition should allow for. So adequate sleep might be a bit different for all of us. Definitely minimum of 6 based on most of the research and literature. You don't want to get much more than 9 because there's actually some negative side effects from getting too much sleep. All right, so a little bit longer, uh, video with these weekly health updates, but hopefully there's some aspect in there that resonates with you when it comes to the fundamentals of taking care of your body. Whether we see somebody for neck pain, back pain, headaches, or some other joint dysfunction or health-related problem, the fundamentals in their life are a big part of helping with their recovery. So eating well, getting enough sleep, and staying active are 3 key things. Uh, some spin-offs from that, or corollaries, are helping to deal with and manage stress in your life, adapting to your environment, and of course keeping all your body systems functioning well, including your spine and your nervous system, which is what we do here at the Toronto Neck and Back Pain Clinic. All right, so we'll catch up with you next time with your next weekly health update. If there's anything we can do to lend a hand with some things that you have questions about, you can reach out to us here at the clinic. Give us a call, uh, you can email us, or you can even drop by. We're happy to see you and give you a hand. Always here when you need us. Take care and stay well.