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Welcome to the Wellness Center area of our website!

We've included this section of our website to provide you with valuable, practical wellness information which you can incorporate into your lifestyle to improve the quality of your life and the lives of others close to you.

If there is additional information you'd like us to include in the future, please let us know. We endeavor to meet the needs of our patients and our visitors in person and online.

As always, please be sure to share this site with others by sending your family, friends, coworkers and acquaintances our address on the web - we'd love to have them stop by.

Ergonomics

Ergonomics is the applied science of designing and developing equipment, workstation layout and work strategies to best suit and protect the human body. The goal of ergonomics is to minimize fatigue, discomfort, injury and emotional stress.

It's important to recognize that even the most ergonomically correct environment will not prevent repetitive stress injuries if the body is simply overworked. The body has limitations with what it can withstand. Surpassing those limitations will most definitely result in injury.

Choosing the Right Chair

Prolonged sitting is a frequent cause of back and neck pain. And while extended periods of sitting are best avoided, for many, it's a fact of life.

When sitting, it's important to keep the back straight, knees bent, and head centered over the shoulders. Slouching forward may be comfortable and allow the spinal muscles to relax but gradually overstretches spinal ligaments, leading to back and neck pain among other problems. We always encourage patients to maintain a "neutral spine" position at all time is ideal.

Seat Backrest - The proper chair has a backrest which slightly inclines backwards. This has the effect of relaxing the spinal musculature and decreasing spinal discal pressure.

Armrests - Armrests provide support for the arms which helps to reduce the work load and stress on the trapezius and shoulder muscles. The armrest height should allow the forearms to comfortably rest while being low enough to go underneath tables or desks in the work area.

Lumbar Support - Having a lumbar support either built into the chair or inserting a portable lumbar support helps to maintain your natural lower back curve. These small supports are quite handy, effective and relatively inexpensive.

Seat Bottom Angle - The seat angle relative to the floor is more of a personal preference than an exact science, as long as a neutral spine can be maintained in comfort. In general, the more the seat bottom tilts forward the more extension of youfr lower back will occur to keep you in a neutral position.

Seat Height - The height of the seat should be so that it allows you to sit all the way back in the seat while your feet are still able to reach the floor. If they can't and you're stuck with the chair, use a footrest to remedy the problem.

In addition to the suggestions provided above, it's important to:

  • be aware of your posture throughout the day and be sure to maintain a neutral spine -no slouching
  • take mini breaks on a regular basis when in a prolonged position and remember to stretch
  • have the right equipment and tools for working in a prolonged position, use ergonomically designed furniture and keep a lumbar support in your car for "chair crises"

Adjusting Your Monitor

Maintaining the correct monitor height will prevent many problems with your eyes, neck and upper back. A monitor improperly positioned can irritate neck musculature, alter the normal spinal curves, induce eyestrain and even initiate migraine headaches.

Monitor Distance - The monitor should be located directly in front of the area where you're positioned to view the monitor. The preferred distance from your eyes to the actual screen varies with the size of the monitor and the current resolution settings. A 17 inch monitor should be located no less than 20 inches away. For smaller monitors you may need to be a little closer and for larger monitors a little farther away.

Monitor Settings - In conjunction with setting up the ideal distance between you and your monitor you may additionally need to alter the monitors resolution, contrast and brightness settings. This will allow characters and images to display clearly preventing squinting and eyestrain. The settings will vary depending on the distance you are from the monitor, the background you have on your active screen, the amount and type of lighting at your workstation, and the quality of your vision.

Lighting and Glare - Improperly positioned lighting can also wreak havoc on your ability to comfortably view your monitors display. Solutions include moving your monitor, moving the lighting, closing blinds or curtains, adjusting your monitors brightness setting, installing an anti-glare screen on your monitor, changing your background color to a lighter color, or even taping paper or cardboard along the edges of the monitor to act as a "visor".

Monitor Height - The proper monitor height is vital in preventing gradual neck and upper back strain. The most effective way to determine correct monitor height is to sit correctly in your chair or where ever you view your monitor. Next, close your eyes and position your body and head in a neutral and comfortable position - your spine should be straight and head centered over your shoulders. Then, open your eyes and note at which point your eyes are initially focused on. This area should correlate to the center of your monitors screen or the part of the screen you view most frequently.

Proper Telephone Techniques

Spending prolonged periods of time on the telephone can lead to chronic neck, shoulder and upper back pain disorders. Using the proper techniques and equipment is key in preventing these problems from developing.

Phone Location - The telephone should be located close to the main working area such that it is easily reached without having to twist, bend or overly stretch.

Shoulder Rests - For individuals who like to have their hands free when on the telephone we highly recommend not using a shoulder rest extension on your receiver. This still requires you to cock your head in order to keep the receiver next to the ear. This position places stress on the supporting structures of the neck and can throw the neck out of alignment. Rather, purchase a headset device. They have become plentiful and fairly inexpensive.

Speaker Phone - Using a speaker phone allows for maximum flexibility to work while talking. However, for some this may not be appropriate such as during times that clarity, volume and professionalism are required. If this is the case, look into purchasing a headset.

Headsets - Headsets are the most versatile telephone utility. They enable you to work uninhibited while on the telephone and keep your body in an ergonomically safe position.

Writing Materials - Be sure to keep a pen and pad of paper near your telephone so messages can be immediately taken without changing position or straining to grab the appropriate materials.

Setting Up Your Workstation

Having a well planned, ergonomically designed workstation increases productivity, minimizes repetitive stress injuries, increases employee morale, and increases the bottom line. Since everybody has different tasks and different body types, no one workstation setup is ideal for everyone. There are, however, some basic guidelines that should be abided by when designing a workstation.

Space - There needs to be adequate space for you to comfortably accomplish all tasks required of you. If you're constantly running into others or cannot properly function due to lack of adequate space physical and emotional stress increases while productivity decreases.

Equipment - Having the proper equipment which has been designed for the task at hand is essential. Equipment should be compatible with other equipment and be ergonomically designed to conform to your specific duties. Chairs should move freely in the work area and fit under desks and tables, lighting should fully light all work areas while not reflecting off of monitor screens, and computers and monitors should fit desks properly so screens can be read in comfortable positions and computer discs can be inserted without getting on all fours under the desk.

General Layout - Plan ahead. If you know what tasks you will be performing and what equipment you need, draw a floor plan and include equipment, furniture and accessory placement. Be sure keep those items used most frequently within reach are nearby to minimize strain and twisting. Commonly used equipment and other materials should be within reach from your primary workstation position.

Accessories - Add stackable document holders, have your rolodex nearby, purchase telephone headsets and any other items which can help to organize your workstation and keep all important and frequently used materials within your reach.

Taking Mini-Breaks and Stretching

Taking small periodic breaks doesn't just allow you to have a mini-mental vacation from the constant reins of work, it's also an important opportunity to reduce built-up physical tension by stretching out your contracted and tensed body. Every 30 to 40 minutes your body needs to move, stretch and get out of any position that it's been stuck in.

Assuming that your working position is in the seated posture, the following stretches can be performed throughout the day, every day, to keep your body happy and healthy. All stretches should be held for 15-30 seconds and performed 1-3 times, depending on the amount of time you have. Hold the stretch in a position in which you can feel the muscles comfortably stretch.

Important Note: Do not perform any exercise or stretch without the recommendation of a licensed health care professional. If performing exercises or stretches at the recommendation of a licensed health care professional, immediately discontinue and seek professional medical assistance should unusual or abnormal pain and/or discomfort arises. Any and all exercises, stretches or similar contained within or available from this website are meant only for active patients of our office who have been specifically advised to perform said exercises, stretches or similar.

Basic Neck Stretches

Eyes To The Sky - Extend your head backwards while allowing your mouth to open. Allowing your mouth to open allows for a greater stretch to the muscles of the anterior neck. If you experience any balance problems, stretch the neck in the seated position only.

Ear To Shoulder - With your head centered over your shoulders, drop one ear to the same side shoulder. You should feel the opposite side of your neck stretch. You may increase the stretch by applying pressure to the top of the head with your hand. Repeat on the opposite side.

Chin To Chest - Drop your head forward while tucking your chin in towards your neck. Place one hand on the top of the head and gently apply added pressure if you wish to increase the stretch. This stretch affects the posterior cervical musculature.

Lateral Torso Stretch - While seated, grasp the lateral thigh or armrest of the chair with your opposite side arm and rotate your torso by pulling with the hand. Repeat to the opposite side.

Anterior Torso Stretch - In a seated or standing position with your hands interconnected place them behind your head and neck. Then, squeeze your shoulder blades together and extend your back slightly.

Posterior Torso Stretch - In the seated position with your buttocks on the forward edge of the chair, spread your legs apart and lean your torso forward, between your legs. If your back and hamstring muscles are tight, you will feel them stretch during this movement.

These are just some of the many stretches which can and should be performed frequently.

Proper Lifting Techniques

The Squat Lift - Ideally, objects should be lifted via the squat lift. With the back relatively straight, the knees are bent so that low back stress is minimized. While this does not seem as easy or natural as simply bending forward at the waist it significantly minimizes the lower spinal stress which can lead to numerous injuries including intervertebral disc herniation. Also, keep the feet wide apart when lifting the object and be sure to keep the object as close to your body as possible.

When Bending The Knees Is Difficult - For individuals who cannot fully bend the knees in order to pick up objects some bending of the spine may be necessary. In these cases, be sure the object being lifting is not heavy and most importantly, be sure to keep the object as close to the body as possible. The farther the object is away from the body the greater the stress on the spine.

The Golden Rule of Lifting - As stated above, be sure to keep objects as close to the body as possible during the lifting and carrying of objects.

Repetitive and Heavy Lifting - Even when proper lifting techniques are used repetitive stress injuries to the spine will occur if objects are too heavy or lifting is done continuously to the point that the spinal musculature becomes fatigued. Never lift heavy objects alone - get assistance or use a dolly. Never lifting continuously to the point that spinal muscles become fatigued. This will dramatically increase the odds of sustaining spinal injury.

Fitness and Exercise Programs

Welcome to Fitness and Exercise Programs!

Participating in regular physical activities is a must for all individuals, of all ages. Unfortunately, approximately 60% of all Americans fail to meet their recommended levels of physical activity. Worse yet, 25% of Americans fail to participate in any sort of physical activity. Many studies have shown exercise can significantly increase energy levels. Ironically, the number one excuse for not exercising is a lack of energy or the person being too tired.

We have therefore included a number of beginner to intermediate level resistance training programs linked above to assist you in starting or spicing up your current physical activity regimen.

Resistance training involves the use of resistance, such as through the use of free weights or nautilus equipment, to increase the strength, tone and sometimes size of a muscle. Resistance training is not just for bodybuilders who wish to increase their muscles' size, but rather, is for anyone wishing to keep their body strong, healthy and fit. In addition, resistance training can simultaneously provide a cardiovascular workout. By keeping the rest-time between the sets of exercises minimal, a moderate heart rate can be achieved and maintained throughout the entire workout. This extends the benefits of your exercise training program to the most important muscle of all, the heart.

Note: Please check with us or other health care provider prior to initiating any fitness or exercise routine, especially if you have a pre-existing health condition that you're aware of.

Studies conducted on exercise have shown the following benefits:

  • cardiovascular health
    • reduction in LDL ("bad" cholesterol)
    • increase in HDL ("good" cholesterol)
    • increased heart strength and health
    • increases V02 max (maximum oxygen uptake)
  • emotional health and quality of life
    • anxiety reduction
    • stress lowering
    • increased sense of well being
    • increase in self confidence
  • disease prevention
    • reduced disease and sickness
    • reduction of fall injuries in seniors
    • diabetes prevention in the aging
  • weight management
    • reduction of body fat
    • prevention of obesity
  • size and strength gains
    • increased physical performance
    • increased strength
    • increased speed
    • increased muscle tone
  • functioning and quality of life in the elderly
    • increased mobility and independence in seniors
    • life extension
  • pregnancy
    • increased on-time deliveries
    • increased protection from miscarriages

Midsection Training Program

Nice abs are not difficult to develop, you simply need to attend to your diet and perform a few necessary exercises on a consistent basis. Once you can do that, you'll be well on your way to a chiseled midsection.

Introduction

Midway down your body lies an essential area which will reveal if you've been "naughty or nice" with regards to your workout and dietary regimen. Of course I'm speaking of your midsection. A tight lean midsection is something we all would like to possess, but few of us ever fully complete the mission. This month we'll assist you in acquiring a leaner, trimmer, and tighter midsection.

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Lose the Fat

First things first. If you have excess body fat and wish to have an attractive midsection, drop the extra fat. There are numerous diets on the market that many individuals have utilized with success. Here are some important things to keep in mind:

  • eat 5-6 small meals per day instead of 2 or 3 larger meals
  • drink 8-10 glasses of filtered or bottled water daily and avoid juices and sodas (yes, even diet sodas)
  • limit your fat to 20% of your total caloric intake while increasing your protein intake to approximately 40%
  • limit the majority of your carbohydrate consumption to fruits and vegetables and avoid breads, pastas, and simple carbohydrates
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Target Exercises

This workout is structured to target the upper abdominals, the lower abdominals, and the oblique or lateral abdominal muscles and utilizes three exercises. The first exercise, cable crunches, are exception for developing the abdominal muscles, especially the upper region of the abdominal muscles. The second exercise in our workout is knee rock-backs which place more focus on the lower abdominal muscles while minimizing stress to the lower back. Our final exercise is alternating side crunches. This exercise helps focus on the oblique muscles of the midsection.

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Exercise Sequence

Blasting your abdominal muscles with constant high intensity exercises for a brief period of time will reap maximal benefits. For this reason we will perform giant sets with the three exercises previously mentioned and repeat the sequence twice. So after completing the first exercise immediately proceed to the next exercise, and then immediately to the final exercise. Once you have completed this "giant set", take a 1-2 minute breather and repeat the sequence two additional times. The entire workout should be completed within about 15 minutes. Perform this routine twice weekly as suggested in our "Weekly Workout Routine" after training shoulders/traps during Workout 2 and after training legs during Workout 4.

Exercise 1 - Cable Crunches

This will be the only weight resisted exercise we perform in our midsection workout. To perform this exercise you will need the "rope" handle for the cable pulley machine. Grab the ends of the rope firmly and keep your hands against the top of your head. Kneel on the floor while facing the weight stack and simply hunch your upper body towards the floor until your elbows are a third of the way to your knees. Think of a fulcrum at the bottom of your sternum and avoid pivoting at the pelvis. When you pivot at the pelvis and hips you activate your hip flexor muscles and minimize abdominal musculature activity. So be sure to focus your efforts on squeezing the abs while imagining your pivot point at the bottom of your sternum/top of your abs. Perform 15 repetitions with a weight that provides your abs with a real burn during the last few repetitions.

Exercise 2 - Knee Rock-Backs

This basic abdominal exercise helps to target the lower abdominal musculature. On a clean floor or mat lie on your back with your knees bent. Place your hands under the buttocks with your palms facing down. Roll your lower body towards your head so that your knees touch your chest and your lower back slightly lifts off the floor. Keep your arms and hands flat on the floor to provide you with support. Lower your legs to the starting position in a controlled manner and repeat for a total of 15-25 repetitions (depending on your current conditioning). Again, the only muscles you need to concentrate on squeezing are the abdominal muscles.

Exercise 3 - Alternating Side Crunches

This exercise is an all time favorite. A common mistake I find people making is they perform "ab sprinting". When you view these people performing crunches all you see is a blur because they're crunching so fast. There's no need to look as though you suffer from a neurologic disorder especially when there are minimal benefits involved performing this exercise at ultra-speed. Crunches should be performed very slowly to minimize momentum which can rob your muscles of the work they need to perform in order to successfully develop and grow.

Start by lying on a mat, floor or specialized abdominal bench. Place you calves on a bench or padded roll bar so that your midsection to thighs and thighs to calves each make a 90 degree angle. Next, interlace your fingers of both hands and place them behind your neck (not head). Begin the movement by raising your shoulders, upper back, and right hip of the floor/bench as you twist your trunk to the left and bring your right elbow towards your left thigh. You need only lift your shoulder blades off the floor/bench to complete the movement. Once your shoulder blades are just off the floor/bench, squeeze the abdominals and hold the position for a count of two. There's not a need to touch the elbow to the opposite thighs. This only results in the activation of your hip flexor muscles and places excess strain upon the neck and lower back. The number of repetitions you are able to successfully perform will vary greatly from person to person. For most people, perform enough repetitions to produce an intense burn within the muscle.

Just be sure as you perform the exercise to avoid the tendency to actively flex the neck. If you find this exercise problematic for your neck or already have neck problems you can alter the placing of your hands. Instead of placing the hands behind the neck, place the palm of each hand on the opposite shoulder. Your arms will form a cross and this usually minimizes the tendency to forcefully flex the neck as you perform the crunches.

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Tips

  • Avoid sit-ups. They target your hip flexors which are not visible without a scalpel and place unnecessary stress on your neck and lower back.
  • Maintain a slow and controlled motion and never, never, never bounce. At the end of each repetition squeeze and hold for a count of two.
  • Don't forget the importance of your diet. No matter how much effort you put into training your midsection you won't have wash board abs if you have excess midsection chub!!!
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Weekly Workout Schedule:

  • Workout 1 - Chest & Biceps
  • Workout 2 - Shoulders & Traps & Abs
  • Workout 3 - Back & Triceps
  • Workout 4 - Legs & Abs
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Arm Training Program

Developing appreciable arm size can be achieved by anyone adhering to a sensible and effective arm training program if they can remain focused and committed... then it's simply a matter of time and proper nutrition.

Introduction

With the arrival of spring and the summer months just ahead you may be in need of some additional size and shape on those upper extremities hanging off your shoulders. Most women would agree that given a choice, they would prefer their man to sport a set of muscular arms himself. And most men agree there's a strong sense of power, pride and confidence that comes along with owning an admirable set of guns... especially during the summer months when they can be placed on display for all to see.

The necessary ingredients for admirable arms are brief intense weight resistive workouts coupled with sufficient rest and recuperation time, in addition to proper nutrition which provides the muscles with the means to fully repair and grow. This month's "Take it to the Gym" delivers an extremely effective arm blasting routine to help maximize your sleeve stretch.

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Sets and Repetitions

Since both the biceps and triceps are smaller muscles, at least for most of us, the best rewards will be reaped when 4 sets of no more than 3 exercises per muscle are utilized. Before jumping into those 4 sets, begin each exercise with 1-2 warm-up sets of 15 repetitions using a light weight which allows you to effectively warm up the muscles without causing premature fatigue. Next, perform your first true set for 15 repetitions and decrease the repetitions on subsequent sets as follows: 15, 12, 10, 8. Start with enough weight for your first set to allow you to fully complete your 15 repetitions but so the last few reps are very demanding. Then, add the appropriate weight to each subsequent set making the final few reps of that set difficult to perform, but not impossible. The weight you add to each subsequent set will differ from person to person but will likely be in the neighborhood of 10-20 pounds.

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Biceps

The biceps muscle is the major muscle responsible for flexing the elbow. It also works synergistically with the muscles of the back in various exercises. Because of this, blasting the biceps with maximal intensity will mean avoiding biceps training on the same day your back is trained. And since the biceps is a smaller muscle, 2-3 exercises are optimum for it's successful development. Anything more can lead to bicipital burnout resulting in little of NO growth.

Exercise 1 - Standing Barbell Curls

This is a power exercise, demanding the utmost performance from your biceps. It has been around forever for one reason... it works great! Be sure to avoid swinging the weight as the only thing this will be effective for is getting injured.

Exercise 2 - Preacher Barbell Curls

This is more of an isolating biceps exercise. The preacher bench forces you to fight the resistance to hold the fully contracted biceps and also lets you anchor your body down for the negative portion of the rep. Keep the movement constant and controlled while focusing on squeezing the biceps and pumping the muscle to the max.

Exercise 3 - Single Arm Cable Curls

Perform the curl so that your forearm is about 45 degrees out from your abdomen. This will put your forearm half way between straight ahead and your abdomen; the same angle your forearm making when you reach out to shake someone's hand. This plane of movement is much more natural for the biceps.

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Triceps

Although the triceps muscle often takes second stage to the biceps muscle, in your quest for admirable arms, triceps development mustn't be ignored. This is because the triceps is actually a much larger muscle than the biceps, making up 2/3-s of the upper arm! Also, the triceps muscle is more complex consisting of 3 separate heads. This is what gives the triceps its distinctive horseshoe shape.

Exercise 1 - Lying Triceps Extensions

This exercise is also known as French Curls. The term "Skull Crushers" has also been used! Because of the biomechanics of this exercise, beginners and those without a spotter should be very cautious and begin with a very light weight that they can be easily managed. Be sure to keep the upper aspect of the arms stationary and perpendicular to your torso throughout the entire movement. Avoid flaring out the elbows by keeping the arms in close. Using an EZ-curl bar will minimize the stress placed on the wrists. It's a good idea to wear wrist straps for this exercise especially when you begin to use more weight or have a history of wrist problems or past wrist injuries.

Exercise 2 - Triceps Cable Pushdowns

This exercise is the most popular triceps exercise and also one of the most effective. Using an inverted V bar rather than a straight bar as well as maintaining the wrist in a neutral position while performing the exercise will help prevent wrist injury.

Exercise 3 - Triceps Flat Bench Pushups

This exercise is similar to dips but with this exercise you can place weights on your thighs to provide increased resistance. Be sure to keep your elbows in and perform the movement slowly focusing all your thoughts on squeezing those triceps. Maintaining slow steady motion without fully locking out your elbows will result in maximal blood flow to the triceps.

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Remember these following important points to maximize your gains:

  • Concentrate on proper form while focusing on isolating and maximally squeezing the biceps/triceps. Don't compromise this by using excessively heavy weights or sloppy technique and remember to focus intently on the muscles you're training... this will minimize the chances of injury and increase the stimulation to the muscles you're training.
  • Avoid fully locking out the elbows or pausing in non-stress positions. Keep the weights moving to keep the blood flowing into the biceps/triceps and prevent pausing in positions where the muscles are not under resistance... rest when the set is over, not during!!!
  • Practice proper nutrition. Correct protein, carbohydrate and fat consumption, as well as additional vitamin and mineral supplementation are a must for the weight lifter not just serious about making muscular gains, but also concerned about his/her health.
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Weekly Workout Schedule:

  • Workout 1 - Chest & Biceps
  • Workout 2 - Shoulders, Traps & Abs
  • Workout 3 - Back & Triceps>
  • Workout 4 - Legs & Abs
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Back Training Program

Because the back muscles are the largest and most complex muscles of the upper torso, their development is paramount. Unfortunately they're also one of the toughest muscle groups to "feel" while you train.

Introduction

While the muscles of the back don't face on coming traffic like the biceps and chest do, those in search of more upper body width and thickness will find successful back development paramount. The muscles of the back form the largest and most complex muscle group of the torso. Virtually all pulling movements performed by the upper extremity and shoulder girdle require the use of the back muscles. For these reasons you can't afford not to have your back on track!

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The Back Muscles

While the latissimus dorsi or "lats" is the muscle most commonly associated with the back, other neighboring muscles which assist the lats in a variety of movements include the trapezius, the rhomboids, the 4 rotator cuff muscles (supraspinatus, infraspinatus, teres major, and teres minor) as well as the posterior deltoid muscles. The compilation of these synergistic muscles form a very complex interrelated muscle group which requires a balanced training routine to ensure successful development. In the lower back, the major muscle group is the erector spinae muscle group and is primarily responsible for extension of the trunk.

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A Balanced Approach

Many muscles of the back work together in many movements, there are variations in their trajectories which make them unique. This means different angles of attack are necessary in order to have a balanced training routine. Since the muscles of the upper back are primarily responsible for pulling motions of the upper arm and retraction of the shoulder girdle, performing these motions with the arms in different starting positions provides a more comprehensive back workout. In our first exercise (front pull-ups/pull-downs) the starting position of the upper arm is overhead. In our second exercise (cable rows) the starting position of the upper arm is straight forward. In our third exercise (dumbbell rows) the starting position of the upper arm is downward. Each of these different starting positions means different paths are required to complete the movement. And since each exercise requires a unique path to perform, different muscle fibers of different muscles are forced to center stage with each exercise. The final exercise (hyperextensions) trains the erector spinae muscles of the lower back and does not involve the use of the arms.

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Pitfalls

The most common pitfall and source of frustration involved with back training is not being able to adequately "feel" the muscles of the back work and contract leading many individuals to handle cumbersome poundages in attempts to remedy the problem. This tried correction instead leads to an increased reliance on the biceps further reducing back stimulation. Obviously this isn't the way of the wise. This "feeling" of the back muscles contracting while achieving within them an intense pump is essential for back development and must be achieved. This makes mental concentration and focus mandatory during each repetition. The most valuable concept to grasp and practice while training back is the pulling of the weights using the back and not the arms. Think of your arms as cables providing a connection between your back muscles and the weights.

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Warm-up

As with any other workout, initiate this routine with a minimum 5 minute pre-exercise warm-up including stretches. Grabbing on to the back of a chair, lean back with bent knees and allow your upper torso to flex forward. You should feel the muscles of the back stretching out. Another effective stretch consists of loading the cable pull-down machine with 80-120 pounds and grasping the bar while seated allowing your arms to fully stretch upwards from the resistance of the bar. Hold this position for 30 seconds allowing the muscles of the back to stretch. Finally, prior to starting each new exercise first perform 1-2 light weight sets for 15 repetitions. This ensures an adequate warm-up and minimizes the risk of injury.

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Exercises

Exercise 1 - Front pull-ups or pull-downs

These are two of the most effective mass building back exercises primarily stressing the lats. Switch between these two exercises and between varying grip widths frequently to maintain steady gains. When performing pull-ups, perform 3 sets to failure. For pull-downs, perform 4 sets of 8-12 repetitions. The objective and focus should be on bringing your elbows down and back while squeezing your shoulder blades together. Gripping the bar with the palms facing away helps to minimize biceps involvement. Also, maintaining an arched back will increase the stress to your back.

Exercise 2 - Seated cable rows

This exercise is exceptional for developing the rhomboids, middle and lower traps, as well as the lats. Perform 4 sets of 8-12 repetitions. Your starting position is seated with the knees slightly bent, torso at 90 degrees to the plane of the seat, arms fully extended, and upper back arched posterior. To complete the movement you simply bring the elbows back and squeeze the shoulder blades together. The key to this exercise is to bring the elbows back and squeeze your shoulder blades together using minimal hip and low back motion or swing. Your torso should remain at 90 degrees to the plane of the seat throughout the movement. Also, be sure to gauge your biceps involvement closely as there is a tendency for them to kick in during this movement.

Exercise 3 - Dumbbell rows

This exercise focuses on the middle to lower lats and the middle to lower traps. Begin by holding the dumbbell in your right hand with your left foot forward, right foot back, and knees bent. Support yourself on a flat bench using your left hand. There should be approximately 90 degrees between your torso and your thighs with your torso approximately 30-45 degrees above the plane of the floor. The arm holding the dumbbell should be hanging down towards the floor. Start pulling the dumbbell up by bringing the elbow upwards and back while retracting the shoulder blade back towards the center of the spine. At the end of the movement the upper arm should be at your side in line with the torso, the palm facing in, and a 90 degree angle made between your upper arm and forearm. Again, your main focus is to make and feel the lats and traps contract while minimizing arm use. Perform 4 sets of 8-12 repetitions.

Exercise 4 - Hyperextensions

This is an excellent lower back exercise which works the spinal erector muscle group. Most all gyms have a bench specifically constructed for this exercise with a pelvic pad and padding for the backs of your ankles. Start with the front of your pelvis on the flat pad and backs of your ankles firmly against the ankle padding. Cross your arms and hold them across your chest. Your entire torso above your pelvis should be free to flex down towards the floor until your torso is approximately 120 degrees from your thighs. Once in this down position, extend your torso upwards until you're parallel to the floor. The finished movement should place your torso 10-15 degrees shy of the plane made by your lower extremities. Do not hyperextend during this exercise as the name leads you to believe. Be sure that your back is slightly arched posterior at all times throughout this movement as there is a tendency to hunch your back, especially at the bottom. Keep the entire movement slow and controlled and avoid any bouncing or Indy speeds. A word of warning... this exercise could aggravate lower back conditions. If you have a history of lower back problems or are currently experiencing back problems it's time for a check up from your chiropractic physician, especially before performing this exercise.

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Tips

  • Focus primarily on feeling the muscles of the back work and contract. This means avoiding excessively heavy weights, minimizing biceps involvement, and concentrating during every repetition.
  • Keep the back slightly arched during the back exercises and avoid rounding the shoulders or hunching the back. This allows greater stress to the muscles of the back.
  • Avoid heavy barbell bent-over rows, good mornings, or any other exercise in which you use resistance as you extend backwards with the fulcrum point at your hips or low back. It makes absolutely no sense to ruin your back when there are many safer movements that can mock the effects of these exercises.
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Weekly Workout Schedule:

  • Workout 1 - Chest & Biceps
  • Workout 2 -Shoulders & Traps & Abs
  • Workout 3 - Back & Triceps
  • Workout 4 - Legs & Abs
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Chest Training Program

The experts know that chest training must be planned Failure to structure your chest routine towards overall pec development, as well as failure to work on weak points in your pecs can lead to noticeable imbalances.

Introduction

In the previous two issues, we discussed maximizing the development of the arms and midsection. It seems right that next on our priority list of "showable" summer body parts would be the chest. There should be method in training those pectoralis muscles. The overall shape and development of the chest is a product of the exercises you choose and how those exercises are incorporated into your overall chest workout. Ignoring certain exercises or concentrating solely on one type of chest exercise can lead you to pec imbalances. The most common type of "imbalance" with the chest is deficient upper pec development. This is common in those individuals who fail to incorporate incline bench presses into their training or save them until the end of their chest workout, when the clock has struck twelve and their chest has turned into a pumpkin.

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The Pectoralis Muscle

The pectoralis muscle originates on the sternum, upper 6 rib cartilages, and medial aspect of the clavicle, and inserts on the lateral lip of the greater tubercle of the humerus. Great, what good is that you ask. Well, knowing where the muscle originates and inserts helps you to better understand the movements the pectoralis muscle is responsible for. For practical reasons, you should know that the pectoralis adducts (brings towards mid-line) the upper arm and elbow (think of performing pec deck or fly exercises), forward flexes the upper arm (as in the bench press movements), as well as assists with internal rotation of the upper arm (as in cable crossovers).

There are 3 distinct regions within the muscle that will develop depending upon the exercises you perform. It is important that you train the upper, middle and lower regions of the pectoralis muscle, as well as begin with the exercise which focuses on the weakest area of your chest. For most people that's the upper chest. And for this reason, we begin our workout with the incline movement.

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Sets and Repetitions

As you've probably guessed, our workout will consist of 3 exercises in which each focuses on a different region of the chest. We begin with incline bench press, then go to decline bench press, and end our training with flat bench flys. Begin the workout with 5 minutes of stretching using 5-10 pound weights in each hand. With weights in hand, lie on a flat bench and allow your fully extended arms to dip down to the floor. This stretches out the pecs and prepares your chest for the workout ahead. Then, for each exercise perform 1-2 light warm-up sets of 15 repetitions using a light weight which allows you to effectively warm up the muscles for that particular movement without causing premature fatigue. After the warm-up, perform 4 sets of the exercise with the following repetitions: 12, 10, 8, 6. Gradually increase the weight with each set. The weight you choose should allow you to complete the desired number of repetitions for each set, but the weight should also be sufficient so that the final few reps demand the most out of your pecs. Having a spotter for safety as well as assisting in a forced rep or two is a definite advantage.

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Exercises

Exercise 1 - Incline Bench Press

This exercise will help you develop the weakest area of your chest, at least with most of us... the upper chest. Beginning your workout with this exercise will allow you to use maximum power from your upper chest to force that chest to grow! Keep the movement slow and controlled while getting full movement, bringing the bar or dumbbells all the way down, then all the way to the top. While you press the weight up your primary focus should be on squeezing your chest.

Exercise 2 - Decline Bench Press

This exercise is excellent for developing the lower aspect of your chest. This exercise has a tendency to really work those triceps too so remember to focus on squeezing the chest. Avoiding complete lockout of your elbows will also decrease your triceps involvement.

Exercise 3 - Flat Dumbbell Flys

This is an excellent exercise to finish off your chest workout. It is an isolation movement which places complete focus on the pectoralis muscles. This is because it consists of pure arm adduction which is the primary movement performed by the pectoralis muscles. Start by lying on a flat bench with your arms fully extended above your chest with your palms facing each other and elbows slightly bent. Bring the weights down towards the floor while maintaining the slight elbow flexion. Stop when you feel your arms are close to locking out. Then squeeze your pecs as you bring the weights back to the starting position. The entire movement should be 100% focused on squeezing the pecs together... as if you had an egg between your pecs and you were attempting to crack the shell as you squeezed those pecs together.

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Discussion

You won't be able to help but notice that the incline and decline presses also effectively work the middle chest. Thus, performing these two exercises and finishing with the flat flys not only blasts your upper and lower chest, it also provides the mid pec region with an incredible workout. You should also note that I have not specified barbell or dumbbell for the incline or decline presses. This is because you should change between barbells and dumbbells every 1-2 months, or whenever you feel your gains have slowed down or halted. This is the most effective means of getting continual gains out of your chest, or any other body part. If you have a workout partner some of the time, it would be wise to save the barbell training for the times your partner can spot you. This way you won't get caught alone in pectoralis failure while the barbell is still on your chest. Safety first!

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Remember these important points to maximize your pectoralis gains:

  • Squeeze, squeeze, squeeze the chest and nothing else. On every repetition of your chest routine you must focus on squeezing the chest... do this and the weight will go in the appropriate direction.
  • Be sure to perform a full motion but don't over do it. Getting a good stretch with each exercise is important... however, when you're handling heavier weights don't completely lock out your joints in the down position as this places a great deal of stress on ligaments, joint capsules and other supporting structures.
  • Push-ups are good if you can't make it to the gym or if you're out of town and can't get to a gym. They work the pecs but they are definitely no replacement for the real thing. They simply do not provide the quality and quantity of resistance that free weights give.
  • Never attempt to "max out" or try a new heavier weight without a spotter. Remember this cardinal rule especially when using barbells to prevent a potentially serious injury.
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Weekly Workout Schedule:

  • Workout 1 - Chest & Biceps
  • Workout 2 - Shoulders & Traps & Abs
  • Workout 3 - Back & Triceps
  • Workout 4 - Legs & Abs
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Women's Weight Training Program

Introduction

This article focuses on a no-nonsense weight lifting routine specifically designed for the female weight lifter. And although this routine is designed for women, you will find it very similar to weight lifting routines used by men. Why is that you ask? Quite simply, a woman's physiology is almost identical to that of a man's physiology, with the exception of the reproductive system. However, the average female will not develop size and strength to the degree that the average male will due to genetic factors, more specifically, due to lower levels of growth and strength inducing hormones.

I would first like to address and dispel a common weight lifting misconception lurking in the minds of many women today. This is the belief that should they initiate a weight training program, their muscles will grow faster than spring flowers. Understand, a properly implemented weight lifting program will net appreciable muscle growth in a relatively short amount of time, however, considerable muscle growth making one appear overly muscle bound generally requires many years of discipline, focus and dedication.

Those of you women looking to "downsize" will be delighted to know that weight training will not only make you appear leaner, but will actually make you leaner. Let me explain. First, resistive weight lifting has a toning effect on the muscles. This toning effect is one of firming and tightening of the muscles.

This is seen with individuals who introduce abdominal exercises into their workout routines. They see decreases in their waist sizes even if their midsectional fat content remains the same. This is all thanks to the firming and tightening of the abdominal musculature. Second, weight lifting is an effective fat burning tool. A moderately intense weight training routine will moderately raise your heart rate and thus, provide you with a nice little cardiovascular workout that burns fat. This is especially true when you minimize your resting time between your sets to under 1 minute. And thirdly, since muscle requires extra calories just to have an existence in the body, the more muscles you have, the more total calories your body will need and subsequently burn at rest or play. So whether you're looking to upgrade your muscles, get lean, or just become healthier, weight lifting can get you there.

The first thing we must develop is the infrastructure to our workout routine. By this I am simply referring to the number of repetitions, sets, and exercises we are to do. We must decide how many days per week to weight train and which body parts to train together. We must evaluate the need for any dietary changes to implement and incorporate into our weight training regimen in order to maximize our workout results. We must also address a few other important issues essential for optimal success in the gym.

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Repetitions

The number of repetitions you perform for each exercise will differ depending upon your overall goals. For example, some women wishing to maximize their strength and muscle gains will perform as few as 4-6 repetitions per set. Wow, that's pretty low! However, for those of you ladies seeking modest muscle growth and strength gains, but not seeking the Ms. Olympia title, keep your repetitions in the 8-12 range. For those ladies more concerned with "just" toning up, I suggest sticking in the 12-15 rep range.

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Sets

Most experts suggest 3-4 sets per exercise as being optimum for the female weight lifter. But inquiring minds may ask... Just how did they decide on that number? Is it based on some scientific evidence? Maybe it's in the bible? Actually, this is based on something better... personal experience from hundreds of elite female weight lifters over the past 2 decades. It seems that less than 3-4 sets per exercise is not quite sufficient to most effectively spur the muscles on to new levels. More than 3-4 sets can lead to excessive muscular strain which eventually leads to muscular burn out, and ultimately to muscular injury.

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Weights

To determine the amount of weight you require to most effectively perform each exercise you will simply have to experiment. Let's assume you wish to perform 8-12 reps for a given exercise. Start with a weight you feel that you can confidently and successfully perform 12 repetitions with. Then, gradually alter the amount of weight until you are able to perform 12 repetitions with the last 2 reps being demanding and somewhat difficult to perform. This will be your actual workout weight. Also, be certain to use the assistance of a spotter initially in case you misjudge the weight or your muscles have a power outage!

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Workout Schedule

Your workout schedule will ultimately be determined by your own personal and occupational obligations. Most women find optimal results when working out each main body part once per week on a 3-4 day workout schedule. This allows adequate time to make up any missed workouts later on in the week. More importantly, it allows for adequate time for the muscles to properly and fully recuperate and excel. The actual days you chose for your workout regimen are not crucial. Keep in mind, with only 3-4 actual workout days in the week, it makes sense to not clump them all together. Also, as general rule of thumb, keep the order in which your body parts are worked out consistent. Meaning, if your last workout of the week consisted of the chest and biceps, keep your last workout of subsequent week chest and biceps.

The length of each workout should run 45-60 minutes. This provides adequate time to perform a thorough warm up, and effectively train one larger and one smaller body part. Each body part should take 15-25 minutes depending on the number of exercises you perform. Never train a body part for longer than 30 minutes. The above suggestions allow for optimal recovery of the muscles which is so vital for success in the gym.

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Warm Up

A proper warm up prior to any and every weight training routine is essential to prevent needless injuries. Your muscles are too "cold" for you to grab your usual workout weights right out of the gate. First, do a few sets of basic stretches for all the major muscle groups to be worked out. The stretches should be held statically for a minimum of 30 seconds... no bouncing ladies! The stretching should take about 5 minutes. Next, for each body part to be worked out, perform 2 sets of a light weight exercise. This can be the same exercise you plan to begin your workout with. The exercise should be performed with approximately 25% of your usual workout weight and should consist of 20-25 repetitions for both sets. This is like a trip to Starbucks, but for your muscles. Your muscles and other soft tissues are now primed and ready for business.

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Exercises

The number of exercises that should be executed per body part is mostly determined by the size of the muscle or muscle groups. Larger muscle groups like those in the thigh will generally respond most favorably to 3-4 exercises per workout. Smaller muscles and muscle groups like the biceps muscle will best respond with only 2 exercises.

Picking choice exercises to include in your weight training regimen is extremely important. I'm not a fan of exercises that look as those they were designed from the dance moves of "Saturday Night Fever" by someone who recently experienced a 70's flashback. Women looking to gain muscular size and strength, or perhaps just tone their physique will receive maximal benefits from sticking to those very basic exercises that have been performed by female and male weight lifters for decades. The exercises contained in this month's workout are the most effective basic fundamental exercises that maximally stress those muscle fibers in a relatively neutral and natural bodily position. Now on to our workout.

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Workout 1

Chest

Dumbbell Flat Bench Presses - 3-4 sets 8-12/12-15 reps

This is the best exercise for overall chest development. Start with the weights in line with the center of the chest. Push the weight upwards until the arms are fully extended. Keep the movements slow and controlled.

Dumbbell Incline Bench Presses - 3-4 sets 8-12/12-15 reps

This is the superior upper chest exercise. Begin with the weights directly over the shoulders. Press the weight straight up until the arms are fully extended.

Flat Bench Dumbbell Flys - 3-4 sets 8-12/12-15 reps

This exercise is exceptional for isolating the pec muscles. Start with the arms parallel to the floor and the elbows slightly bent. Concentrate on squeezing the pecs together as you end with the dumbbells together and the arms fully extended. Be sure to keep the palms facing each other throughout the entire exercise.

Tips:

i. Avoid arching the back with chest movements... if you find this difficult, place your feet on the end of the bench.

ii. Focus on squeezing the pec muscles as you push each weight

Biceps

Dumbbell Standing Curls - 3-4 sets 8-12/12-15 reps

Begin this exercise holding the dumbbell with the arms down by your thighs with your palms facing in. As you curl the weight you will rotate wrist so that the palms face up when your arm is fully flexed. Also, be sure to keep the upper arm by your side will curling the weight. There is often a tendency to move the arm forward as you lift the weight.

Dumbbell Preacher Curls - 3-4 sets 8-12/12-15 reps

These curls are excellent for isolating the biceps and minimizing the stress to the low back. Perform one arm at a time. Start with the arm in near full extension and just curl girl!!! Fully extending the arm may be very tough on the elbow... so don't fully extend.

Tips:

i. Keep the wrist in the neutral position at all times... do not allow it to extend back during the curls.

ii. Avoid throwing the weight up. Instead, lift only the weight your biceps can handle. Using momentum to swing like a monkey will lessen the demand on your biceps, increase chances of injury, and make you look like a monkey!

Workout 2

Back

Wide/Close Grip Cable Pull - 3-4 sets 8-12/12-15 reps

This exercise is essential for the back. Begin with a shoulder width grip and the arms fully extended. As you pull the bar to the upper chest area concentrate on squeezing the shoulder blades back and together. Avoid swinging your upper body back while pulling the weight back.

Seated Cable Rows - 3-4 sets 8-12/12-15 reps

Start with the your arms fully extended while in a seated position keeping your back straight. Pull the handle to the abdomen while you concentrate on squeezing your shoulder blades together. Be sure to keep your back in the neutral position throughout the exercise and prevent bending forward as it will produce excessive amounts of stress to the lower back.

Hyper-Extensions - 3-4 sets 8-12/12-15 reps

This is an excellent exercise to work your lower back. Begin by placing the backs of your ankles underneath the roller pad, placing your hips on the padded base, and placing your hands to the side of the head. Your starting position will begin with your body flexed down towards the floor approximately 60 degrees. Complete the movement by extending your lower back until your upper body is parallel to the floor. You should not attempt to "hyper"extend as the name of this exercise implies and do not perform this exercise to the point of fatigue.

Caution: Individuals with a history of lower back problems are encouraged to check with their chiropractic physician prior to performing this type of exercise.

Triceps

Standing Cable Pushdowns - 3-4 sets 8-12/12-15 reps

While being one of the most effective triceps exercises, it is also one of the most popular. Begin with both arms to the side with the wrists pointing down. Push the bar down towards the floor until your elbows are fully extended. Be sure that your upper arm remains by your side during the entire movement.

Seated Machine Pushdowns - 3-4 sets 8-12/12-15 reps

This is also an extremely effective triceps exercise. If the machine is not present in your gym, perform machine assisted dips on the assisted pull up machine. Start with your elbows flexed and with your arms extended back. Push the handles straight down so your elbows are fully extended by your side.

Workout 3

Shoulders

Dumbbell Seated Presses - 3-4 sets 8-12/12-15 reps

This is the primary shoulder exercise. Make sure to perform this exercise on a bench with an extended back to avoid extending your back too far. Begin with the weights at the shoulder level and elbows pointing down and off to the side. Slowly press the weight straight up over your head until your elbows and arms fully lock out.

Dumbbell Side Laterals - 3-4 sets 8-12/12-15 reps

Start with both palms facing your side. Lift the weights out to the side up to about the shoulder level, keeping the elbows slightly bent throughout the entire motion. Also, as you lift the weight keep your thumbs facing slightly down towards the floor.

Standing Dumbbell Shrugs - 3-4 sets 8-12/12-15 reps

This exercise is actually for the trapezius muscles. With both arms to the side and palms facing to the sides of your legs, concentrate on lifting your shoulders straight up. Keep your elbows straight and avoid bending as bending does not work the traps.

Legs

Squats or Leg Presses - 3-4 sets 8-12/12-15 reps

Either of the above exercises maximally works the entire upper leg. You may perform either one or periodically switch between the 2 exercises. For squats, get beneath the bar and lift it off the rack. Step back and place feet slightly wider than shoulder width. As you go down into the squat keep your head looking forward and your back straight. Go down slowly until your upper legs are parallel to the floor and then press back up. Be sure not to lean forward and point your butt too far out as this creates a hazardous amount of stress to the lower back. For the leg press, place both feet on the platform approximately shoulder width apart with the back flush against the support pad. Begin the exercise with the knees approximately 6 inches in front of the chest. Push both legs outward until both knees are almost fully extended then slowly repeat the process.

Machine Leg Extensions - 3-4 sets 8-12/12-15 reps

This exercise isolates the quadriceps muscles on the front of the thigh. In the seated position, place the tops of both feet underneath both roller pads. The machine should be adjusted so that the back of the knees touch the front of the seat and so that the seat touches your lower back. Raise both feet until the lower legs are fully extended, pause briefly and repeat.

Machine Leg Curls - 3-4 sets 8-12/12-15 reps

This exercise isolates the hamstring muscles on the back of the thigh. Begin lying face down with the backs of your ankles underneath the roller pads. Adjust your body so that your knee caps are just off the end of the bench. Curl you legs backwards, attempting to touch your heels to your buttocks. Pause briefly when the roller pad is near the buttocks and repeat. Avoid raising your hips off the bench while performing this exercise.

Standing Calf Raises - 3-4 sets 8-12/12-15 reps

This is the basic calf exercise performed by almost all weight lifters. Stand on the balls of your feet while placing your hands on the available handles and maintaining a straight back. Raise your heels as high as possible, pause and squeeze those calves, then repeat.

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Summing Up

Experimenting with other exercises is fine and there are a number of other exceptional exercises available. Just be sure to choose exercises that effectively work the muscle while you maintain a safe and natural bodily position. Also, periodic weight increase are a must. This will spark new growth and size increases into those muscles and keep them from getting lazy. The idea is to gradually subject the muscles to slightly heavier weights over a period of time. And given adequate time to rest and regenerate, the muscles will be forced to grow and strengthen. You may also wish to periodically switch from dumbbell exercises to barbell exercises. This seemingly benign adjustment in your workout regimen generally results in remarkable muscular gains.

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Weight Training for the Aging

Weight training has a host of positive benefits for the aging individual, many of which help to slow down and even reverse many of the undesirable changes associated with aging.

Introduction

I'm not exactly sure who coined the phrase "fountain of youth", but he or she may have very well been referring to the benefits associated with resistive weight training. Resistive weight training has a host of positive effects for the aging individual. The numerous studies conducted to evaluate the effects of weight training in the aging have shown weight training to be extremely beneficial to individuals well into their 90-s. One such study, published in the New England Journal of Medicine, involved 100 frail men and women in their 80-s and 90-s, all of whom had generalized arthritis, some degree of heart disease, and at least one chronic illness. After 10 weeks of weight training the mean strength increase was near 120%. This and other studies have dissipated the belief that age may preclude one from lifting weights and has brought to our attention the importance of weight training for all ages, especially those over 40.

Maximum muscle size and strength generally occurs between the ages of 20 and 30. Thereafter, there is a progressive decline in muscular size and as a result, strength. Weight training is an effective tool for preventing and recovering some of these muscular losses associated with aging. Many determined older individuals have initiated a resistive weight training regimen later in life and were able to surpass the muscular size and strength they possessed in their youth. Other benefits associated with weight training include increased metabolic rate, increased energy, increased flexibility, increased sense of well being, increased bone density, increased strength of connective tissue, not to mention the positive effects on the cardiovascular system. In fact, these are the very things we are in extreme jeopardy of losing as we age. By simply following a moderate weight training regimen a number of these age related changes can be slowed and even reversed.

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Getting Started

As general rule of thumb, for those of you over the age of 40, those with a known health condition, those taking any medications , or those who have led a sedentary lifestyle for some time should first consult their chiropractor or other health care physician prior to initiating any moderate weight training regimen. Safety first!

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Reality Check

Once you and your health care provider have determined that it's safe for you to begin a weight training program, you must take into consideration that you're no longer in high school or college. Those days of a turbo charged, indestructible body are a thing of the past. The weekend warrior syndrome is now common reality. This is best demonstrated by the middle aged male who suddenly decides to play a weekend sport with the boys after a long period of inactivity and as a result sustains an injury from this seemingly benign activity. As we age, our body's ability to deal with physical stresses, such as exercise and other rigorous activities, decreases. What your body was able to cope with years ago versus what it is now able to deal with is usually very different. To understand this, consider the following. You are fighting two realities as you age. First, your activity level has likely decreased as you've aged due to a number of factors... time for your spouse, children, job, and increasing responsibilities. Second, as you age your body goes through a number of physiological changes which tend to lessen your recuperative abilities. This is especially true for those individuals who failed to remain active over the years.

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Effective Training Means Training Smart

Good news is that resistive exercise can not only allow you to regain some of what you've lost, but it may also allow you to achieve new levels of health. It's never too late to begin reaping its benefits. It is however important that once you reach the age of 40 and beyond, you ease into any new physical activities. Allowing sufficient time for the body to rest and recuperate from the new physical demands becomes increasingly essential. Too much too soon spells I N J U R Y !

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The Workout

The following weight training routine allows you to train each major muscle group once per week based on a four day workout week. The days you choose to workout on aren't that important. Just avoid clumping all four workouts together without rest days in-between. Also, be sure to adhere to any guidelines or restrictions that your primary care physician has given you. Remember, nothing will stop you from weight lifting quicker than an injury.

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General Guidelines

Prior to each workout, it's essential to stretch and perform warm up sets before loading up the weight bar. Start with approximately 5 minutes of stretches for all the muscle groups to be trained. Then, using 50% of your normal workout weight, perform 1-2 warm up sets for 15 repetitions. Once this has been completed, you have primed your muscles and joints minimizing the chance of injury and are now ready for business.

Initially you will have to experiment with different weights to determine how much you can safely use while effectively stimulating the muscles. Be sure to have a spotter especially when using barbells in positions where you may become trapped under the bar. Muscles that haven't been worked out for awhile sometimes power out unexpectedly. Over time you'll find that the weights you normally use become lighter as your muscles grow larger and stronger. When this occurs increase the weight slightly to allow increased stimulation to the muscle fibers. This will allow for continued growth and development.

If your new to weight lifting or haven't lifted for over 3 months, begin with 2 sets per exercise. Increase one set to each exercise each month until you get to 4 sets per exercise.

Patience is key and is essential to prevent injury and allow the body to adapt and grow stronger. The weight that you've chosen should allow you to safely perform 10-12 repetitions for each set. The final few repetitions are generally more difficult to perform than the first few but should not cause excessive strain in order to complete. Generally 60-90 seconds of rest between sets is sufficient, however, be sure you've had adequate time to catch your breath.

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The Cardiovascular Exercise

You'll notice that Workouts 1 through 3 also include a cardiovascular exercise. This will train your heart, which happens to be one of the most important muscles in your body. There is a number of different exercise equipment in most gyms which provide for a great cardiovascular workout. Stationary bikes, treadmills, stair steppers, as well as aerobics are all excellent choices for your cardio exercise. If it's been some time since you've performed any cardiovascular activities, start with 10 minutes of cardio exercise for the first few weeks of the program. Try increasing your cardiovascular activity by 2-5 minutes every couple of weeks until you are able to perform 30 minutes. Again, follow any restrictions given to you by your physician and never push your body too far too quickly.

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The Workout

Workout 1:

Chest:

  • 2-4 sets Incline Presses
  • 2-4 sets Decline Presses

Shoulders:

  • 2-4 sets Shoulder Presses
  • 2-4 sets Lateral Raises

Cardio:

  • 10-30 minutes

Workout 2:

Back:

  • 2-4 sets Cable Pulldowns
  • 2-4 sets Seated Cable Rows

Traps:

  • 2-4 sets Dumbbell Shrugs

Abs:

  • 2-4 sets Crunches

Cardio:

  • 10-30 minutes

Workout 3:

Biceps:

  • 2-4 sets Barbell Curls
  • 2-4 sets Dumbbell Curls

Triceps:

  • 2-4 sets Close Grip Presses
  • 2-4 sets Cable Pushdowns

Cardio:

  • 10-30 minutes

Workout 4:

Legs:

  • 2-4 sets Leg Presses
  • 2-4 sets Leg Extensions
  • 2-4 sets Leg Curls

Calves:

  • 2-4 sets of Calf Raises

Abs:

  • 2-4 sets Crunches

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Tips for Preventing and Minimizing Potential Injury:

  • Those interested in weight training but lacking confidence or experience should seek the expertise of a qualified personal trainer. The job of a personal trainer is to assist you in achieving your fitness goals in a quick and successful fashion as well as to provide support and inspiration for you and your workouts.
  • Listen to your body. Mild to moderate muscle soreness is a common occurrence especially in the early stages of a weight training program. Pain in the area of joints, sharp or atypical pains, or any abnormal feelings many be a sign of a serious or potentially serious problem. Train smart... have it checked by a chiropractor or other health care professional.
  • Don't ignore the other essential facets of health. Weight lifting while wonderful, must be joined by proper diet and nutritional supplementation, adequate rest and sleep, a positive mental outlook, as well as a healthy spine. All are greatly essential for optimum health.

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Infants and Children

Welcome to the section of our site dealing with the health issues of infants, children and teens.

This area provides parents with useful information necessary in raising a healthy family. Healthy habits are formed, or not formed, at a very early age. Thus, we urge parents to take an active role in their children's health and teach their children through healthy examples.

Please feel free to use our website as a reference for your children's / family's health. If you have questions or concerns, do not hesitate to contact us. If you have any suggestions or comments, please send them our way!

Chiropractic Care

Thousands of infants, children and adolescents benefit from the fruits of regular chiropractic care everyday. Chiropractic has become much more than an effective treatment for adult back pain. It has become a safe, effective health resource for all members of the family. Relief from pain, correction of neuromusculoskeletal conditions and overall health optimization for all ages is what chiropractic can provide.

In addition to providing safe, effective treatment for back pain, scoliosis, headaches and the more obvious "chiropractically responsive" treatments in the young, we can also provide effective care for many other conditions. Common childhood conditions such as ear infections, asthma and infantile colic - to name a few - have been shown to respond favorably to chiropractic treatments.

Chiropractic is a holistic approach to the treatment and management of health conditions. Chiropractic care encompasses a wide variety of safe, natural and noninvasive treatments. This includes chiropractic spinal adjustments, exercise and stretching programs, diet and nutritional counseling, soft tissue techniques, to name a few. In experienced hands, chiropractic care can provide your infant, child or adolescent with a lifetime of health and happiness.

We invite you to browse through the links and learn how chiropractic care may increase the health of your child. From scoliosis to back pain, ear infections to infantile colic, chiropractors are leading the way in the natural and safe treatment of common childhood ailments. If you have additional questions, be sure to contact our office to speak with the doctor personally or schedule an appointment.

The Growing Spine

Spinal Length and Growth

At birth, the spinal column comprises 40% of the total length of the infant - identical to the adult. However, the average length of the spinal column in the newborn is just 24 cm or 9.6 inches. The spinal column grows 50% in length during the baby's first year of life. Over the following 4 years the spine will continue to grow another 15 cm reaching a length of 51 cm or 20.4 inches. From ages 5-10, the spine grows an additional 10 cm. Once puberty is reached and until the age of 18 the spine will typically grow another 20 cm in males and 15 cm in females.

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Spinal Curve Development

The shape of the spine at birth is similar to the shape of the letter "C". At around the age of 3 months, as the baby raises it's head, the cervical spine gains it's "lordosis" or reversed "C" shape curve. Around 6 months of age, the infant adopts a seated and standing posture and the lower back - lumbar spine - also becomes lordotic or "C" shaped in nature.

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Spinal Trauma

During the birthing process, there is a relatively small area to pass through considering the size of the infant. During the delivery process, in order to minimize discomfort of the mother and baby, abnormally excessive and unnatural forces are commonly used. This can and commonly does result in injuries to the infant's spine - especially the cervical spine. As the months and years go by, the spine grows and develops at a very rapid pace. When the baby begins to crawl and then walk, a number of seemingly minor falls and collisions will occur as balance and the knowledge of physics is still developing. As the youngster proceeds through childhood, the minor collisions become severe and more frequent. The physical traumas will continue into adolescence especially in the active and athletic youngsters.

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Where is this leading?

Well, it should be evident that from the time of birth all the way through childhood and adolescence the spine is subject to a number of traumatic and injurious stresses. This is why chiropractic doctors also recommend regular chiropractic care for infants, children, and teens. Given the events that typically occur during those growing years, it would be appropriate to say that regular chiropractic care is actually more appropriate for youngsters than for adults. While we don't want to minimize the importance of regular chiropractic care in adults and seniors we do want to highlight the importance of chiropractic care in the young.

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Has your child's spine been checked?

Having your child's spine checked for problems is important - perhaps more so than having your children's teeth checked for cavities. While we do not wish to irresponsibly or unprofessionally scare parents into bringing their children in for spinal checkups, we do feel it is our responsibility to inform parents about the importance and value of appropriate spinal care. If you are interested in scheduling an appointment for your child or perhaps have questions, we welcome you to call and schedule a consultation or request to speak directly to the doctor - we believe your child's health is worth it.

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Scoliosis in the Child

Definition

Scoliosis is the lateral deviation of the spine and affects not only adults, but more commonly affects children and adolescents.

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Prevalence

4% of children aged 10-14 have detectable scoliosis. 60-80% of those affected are girls. While most cases of childhood and adolescent scoliosis stop progressing once spinal maturity is reached, progression of the curve past spinal maturity is not uncommon.

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Types

Infantile - Infantile scoliosis is a lateral spine deviation occurring during the first 3 years of life and is twice as common in males. Approximately 74-97% resolve on their own but those that do progress do so in a severe and disabling manner. This condition is, however, rare in North America.

Juvenile - Juvenile scoliosis refers to scoliosis occurring in children aged 3 until the age of puberty - approximately 10 years of age. Juvenile scoliosis can continue to progress in severity, and thus, monitoring every 3-6 months with radiographs is required. Continual monitoring is performed through adolescence because of the high risk of progression. If progression occurs without appropriate treatment severe spinal deformity and cardiovascular compromise can result.

Adolescent - Adolescent scoliosis is scoliosis detected in those who have reached puberty but have yet to reach adulthood. This is the most common type of idiopathic scoliosis (unknown cause). Like juvenile scoliosis, adolescents should be monitored until spinal maturity is reached to prevent possible progression and future health problems.

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Diagnosis

Since the abnormal curvature may not be obvious upon inspection of the back, even to the trained eye, an uneven shoulder height or clothes not appearing to hang off the body symmetrically may be the first indication. Also, a complaint of back pain, ache, discomfort or fatigue may be present. However, this does not generally occur until later stages after the spinal ligaments and muscles have been chronically irritated.

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Complications

While most cases of childhood and adolescent scoliosis stop progressing once spinal maturity is reached, progression of the curve past spinal maturity is not uncommon. If the lateral curvature continues to progress, cardiovascular compromise can result - ultimately leading to severe disability or death.

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Treatment

Scoliosis treatment in the child consists of:

i. monitoring the degree of curvature for increases,

ii. chiropractic spinal adjustments to minimize spinal stresses, optimize biomechanics and keep the nervous system functioning properly,

iii. therapeutic spinal exercises and stretches to strengthen spinal muscles on the convex side and keep muscles flexible of the concave side, and

iv. soft tissue procedures and physical therapies to assist in symptomatic relief.

The goal is to eliminate discomfort and prevent progression of the lateral curvature. If the curvature continues to progress severe spinal deformity can occur resulting in physical disability and cardiovascular compromise.

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Sports and Fitness in the Child

Sports and regular physical activities not only serve as fun-time for children and teens, but more importantly, improves their overall health and wellness status while promoting a healthy lifestyle which they can carry into their adulthood years.

Exercise and Health Education Cut Kids' Risk of Heart Disease

According to recent findings, vigorous exercise and health education classes in the adolescents can cut their blood cholesterol levels and reduce their risk of developing heart disease later in life.

This comes from a study which is part of the larger continuing Cardiovascular Health in Children study, a unique effort in North Carolina to learn about improving children's - and later adults' - heart and lung health. This study used 600 middle-school students, ages 11 to 14, from five rural North Carolina schools in three counties.

According to one of the researchers, "I don't think most parents realize how little actual physical activity their children get at school nowadays. Most middle-aged and older people in this country were far more active when they were children than kids are now."

In this study, subjects were divided into four groups. During the 1995-96 school year they received both physical activity and classroom training, either one or the other intervention, or neither. Physical activity was vigorous and sustained three times a week but did not require special sports skills. Classroom teaching focused on nutrition, fitness, not smoking, blood pressure and other topics.

Researchers measured fat levels in the blood of children before and after completing the program. Among middle-schoolers in the combined group, total cholesterol dropped an average of 10.6 milligrams per deciliter and LDL dropped 8.7 milligrams per deciliter.

"We conclude that the combination of both a knowledge and attitude program and a physical activity program was highly effective in improving lipid [fat in the blood] profiles in this group of adolescents, Our work is important because the few studies that have been done before on this looked at younger children and none has tested older children the way we did."

American Heart Association Conference, Santa Fe, New Mexico - March 19, 1998.

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Experts Urge Children Need More Exercise

New guidelines from the National Association for Sport and Physical Education (NASPE) recommend that children be physically active for at least 60 minutes per day - and longer if possible.

According to the NASPE, a nonprofit organization for fitness and physical activity professionals, "extended periods of inactivity are not appropriate for normal, healthy children... inactive children and youth are much more likely to be sedentary as adults than children and youth who are active."

The NASPE also stated, "children and youth who have active parents and family members and who do physical activities with them are more likely to be active than those who are not active with family members... 'children' develop skills through involvement in physical activity... only through devoting time to these skills will they become a regular part of a healthy lifestyle."

Other recommendations of the NASPE include:

  • schools need to make time for physical activity in a child's day.
  • youngsters should be exposed to a variety of activities.
  • continue to encourage motor skill development.
  • some of a child's physical activity each day "should be in periods lasting 10 to 15 minutes or more and include moderate to vigorous activity."
  • activities that can be done throughout a lifetime should be encouraged.

1. National Association for Sport and Physical Education (NASPE) in Reston, Virginia.

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Results of Strength Training in Obese Prepubertal Girls

A group of researchers set out to determine the effects of a school-based, low-volume strength training program on energy expenditure, strength, and physical fitness in obese prepubertal girls.

The researchers designed a longitudinal, 5-month strength training exercise program in which 11 healthy, obese girls aged 7-10 years participated.

The girls increased their upper and lower extremity strength, on average, by 20%. However, similar results were not noted when energy expenditure was evaluated.

The researchers concluded, "This long-term, school-based, low-volume strength training program favorably increases strength in obese prepubertal girls but does not increase their daily energy expenditure."

Med. Sci. Sports Exerc., Vol. 30, No. 7, pp. 1130-1136, 1998.

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Diet and Nutrition in the Child

Dietary Considerations:

Caloric Requirements

Experts recommend that from birth to at least age 1, an infant's diet consist of breast milk. Non-formula cow's milk is not recommended especially prior to 1 year of age. This is due to its ability to cause allergies, gastrointestinal tract bleeding, and because it lacks sufficient vitamins and essential fatty acids vital for infant development. If formula must be used, limit it to 1/3 of the day's total caloric intake.

Caloric requirements are:

i. Infants: 80-140 kcal/kg/day

ii. Children: 40-90 kcal/kg/day

iii. Adolescents: 30-50 kcal/kg/day

1. Barnes L. Infant feeding: formulas, solids. Pediatric Clin North Am 1985;32:355-362.

2. The use of cow's milk in infancy. Pediatrics 1992;89:1105-1109.

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Are Children Getting Enough Fruits and Vegetables

A recent study shows that US children are not eating enough fruits and vegetables. In a week long study, eating habits of 168 preschoolers (group aged 2 and 5 years) were recorded. None of the children met the 5 daily servings of fruits and vegetables recommended. According to researchers, most children consumed just 2 servings of fruit and less than 1/2 of a serving of vegetables per day. Also, 1/2 of the total fruit servings generally were in the form of juice, which experts say, in excess can cause diarrhea, growth failure, failure to thrive, and obesity in some children. Researchers wrote, "Low intakes of fruits and vegetables were associated with inadequate intakes of vitamin A, vitamin C, and dietary fiber, in addition to high intakes of total fat and saturated fat." High consumption of fruits and vegetables has been shown to significantly lower the risk of many types of cancers. The researchers urge parents to provide their children with a wide variety and abundance of fruits and vegetables and be role models for their children by also eating moderate amounts of fresh fruits and vegetables.

1. Journal of the American College of Nutrition 1998;17:371-378.

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The Truth Regarding Fruit Juices and Other Drinks

As stated in the "Are Children Getting Enough Fruits & Vegetables" above, fruit juices as well as other drinks can be harmful in the growing child. Fruit and non-fruit juices are high in simple sugars and deficient in complex carbohydrates, protein, fat and fiber. They also tend to be low in vital vitamins and minerals. This can result in the following:

  • diarrhea and intestinal bloating (due to difficulty digesting fructose and sorbitol)
  • caloric deficiencies (fill up on juice and not calorie dense food)
  • nutritional deficiencies (fill up on "nutritionally empty" juice products)
  • dietary imbalances (fill up on juice and do not eat adequate foods containing protein, complex carbs, fat)

Experts recommend adding small amounts of juice (2-3 tablespoons) to water if juice must be given to children. It should be noted that juice prior to bed contributes to the development of dental caries.

1. Smith MM, Lifshitz F. Excess fruit juice consumption as a contributing factor in nonorganic failure to thrive. Pediatrics 1994;93:271-277.

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Food Allergies and Intolerances

Food allergies and intolerances are common in infants and children. Foods that cause the most problems include:

  • dairy products (i.e. cow's milk and eggs)
  • pork and fish
  • citrus fruits
  • wheat and yeast
  • nuts
  • soy products
  • many food additives

Symptoms include diarrhea, vomiting, failure to thrive, runny nose, sneezing, asthma inducement, wheezing, and skin problems such as hives. As identifying foods causing the problems can be very difficult experts recommend slowly introducing infants and children to foods one at a time. This way problematic foods can be identified early on and with little question as to the food culprit.

Most commonly, cow's milk is the cause and should be avoided, especially in those under 1 year of age. Soy or rice milk can be substituted for those allergic to cow's milk.

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Breast Feeding vs. Formula

It's important for the new mother to understand the significance breast milk has on their baby's health. A great number of studies have consistently shown babies fed breast milk (compared to formula) are significantly healthier with a much lower incidence of various infections and diseases.

Breast Feeding Reduces Infant Illnesses - A recent study has shown that breast feeding significantly reduces the occurrence of common infant illnesses such as respiratory tract infections, pneumonia, ear infections, and gastrointestinal disorders. In the 2 year study of 977 babies, a community program was implemented which urged women to breastfeed their infants rather than use baby formula. The program resulted in a significant increase in breastfeed babies - 54.6%, up from 16.4%. During this time, the number of babies who developed pneumonia in the first year of life declined by 33% and the cases of gastroenteritis decreased by 15%.

According to researchers, their results suggest that "breast milk itself or the process of breast feeding provides protection against infant illnesses." The American Academy of Pediatrics recommends that mothers breastfeed their babies for at least one year, "and longer if mutually desired by the mother and child."

1. Pediatrics 1998;101:837-844.

Breast milk is better for premature infants - Experts believe breast milk contains a number of immune-boosting compounds which "jump-start" the infants immune system and assist the infant in fighting off infections. In this study, researchers found that preterm infants fed breast milk developed significantly fewer infections. 212 preterm, very low birth weight infants (under 3 pounds) were fed either breast milk or formula. After adjusting for all other factors, researchers determined that infants fed breast milk decreased their odds of infection by 57% - a dramatic decrease. Also, many immune system agents normally found in breast milk are in higher concentrations in the breast milk of mothers who deliver prematurely compared with mothers who delivery at term.

The American Academy of Pediatrics has long advocated the use of breast milk as the primary food source of newborn, full-term infants. In 1997, this advisory was extended to cover premature infants.

1. Pediatrics Electronic Pages 1998;102:e38.

Breast milk lowers occurrence of diarrhea - Diarrhea is common in infants and small children. When diarrhea is severe or present with other symptoms the child should be evaluated by a doctor. Diarrhea can be naturally and safely treated in many cases by supplementing with either normal flora (the naturally occurring intestinal flora which become depleted with diarrhea and gastrointestinal infection). Also, bovine colostrum can be fed to infants to provide added natural immunity. Both supplements are safe and increase immunity within the infant/child.

Breast milk lowers occurrence of middle ear infections - This infection of the middle ear has been shown to respond to chiropractic care in many cases. Nutritionally speaking, children who breast feed dramatically lower their chances of suffering from otitis media. In one such study, infants breast fed for 4 months or more decreased their incidence of otitis media by 50% compared with non-breast fed infants. Also, in those infants who did suffer from a bout of otitis media, subsequent recurrence was twice as common in non-breast fed infants.

1. Duncan B, Ey J, Holberg CJ, Wright AL, et al. Exclusive breast-feeding for at least 4 months protects against otitis media. Pediatrics 1993;91:867-872.

Breast feeding enhances intellectual development - Research has shown breast feeding can enhance intellectual development. In a study of 229 healthy infants, those breast fed infants consistently scored higher on psychomotor skills.

1. Temboury MC, Otero A, Polanco I, Arribas E. Influence of breast-feeding on the infant's intellectual development. J Pediatric Gastroenterology Nutrition 1994;18:32-36.

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Childhood Obesity

The rate of childhood obesity has been rising significantly over the last 30 years. Studies have shown that obesity in childhood dramatically increases the odds of obesity in adulthood, a condition which compromises health and overall well being. Obesity is a difficult condition to treat as it requires a very high level of self-discipline in order to overcome. It is thus especially important to prevent obesity from occurring during childhood or seeking immediate and effective treatment if it does exist. Obesity is defined as weighing more than 20% of your ideal body weight.

If obesity is present or is becoming increasingly evident, nutritional and fitness counseling should be sought immediately. In addition, parents should be role models for their children - eating healthy and engaging in regular physical activity.

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Nutritional Supplementation

Iron

According to the American Academy of Pediatrics, women should breast feed until at least the age of 1 year and should not feed infants under 1 year cow's milk. Doing this can lead to deficiencies of iron. Generally speaking, iron supplementation is not recommended for infants; excess iron can cause retardation of growth, increased bacterial replication in infections, and can also compete for uptake with other essential minerals in the gut.

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Vitamin A

Vitamin A (retinol) is available in liquid form and is also added to most baby formulas. Occasional supplementation in infants and children is recommended if deficiency is suspected. Research has shown a single dose of 100,000 IU (International Units) in children under 12 months of age and 200,000 IU in children over 12 months of age can reduce the risk of death from measles and, according to a study on Brazilian children, can help treat severe diarrhea.

1. Butler JC, Havens PL, Sowell AL, et.al. Measles severity and serum retinol (vitamin A) concentration among children in the United States. Pediatrics 1993;91:1176-1181.

2. Barreto ML, Santos LM, Assis AM, et. al. Effect of vitamin A supplementation on diarrhea and acute lower-respiratory tract infections in young children in Brazil. Lancet 1994;322(Jul 23):228-231.

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Vitamin B's

Vitamin B is passed to the fetus and to the baby (via breast milk) by the mother. Thus, if the mother is deficient so to can the baby become deficient. In the case of mothers with vitamin B deficiencies (more common in vegetarians and vegans), supplementation may be necessary for mother and child.

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Vitamin D

Vitamin D is another vitamin in which there may be a deficiency. Generally, a deficiency is most common when the mother is a vegetarian and/or lacks adequate sun exposure. In both cases, supplementation of the mother and infant is recommended. Like vitamin K, vitamin D is usually given to infants at the time of birth.

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Vitamin K

In some infants and neonates, including those with certain malabsorption disorders, vitamin K deficiency may occur. This can cause unexpected hemorrhagic disease (bleeding). Almost always, babies are given intramuscular vitamin K shots at birth to prevent this condition.

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Zinc

Zinc deficiencies can occur in infants whose mothers are deficient in zinc or if there exists a problem with zinc uptake from the mammary glands in the mother's breasts. Zinc deficiencies are also common in premature infants and children with malabsorption syndromes. Zinc deficiencies are generally not found in infants who breast feed, assuming the mother is not deficient. Signs of deficiency include:

  • skin lesions (appear as diaper rash or candida)
  • diarrhea
  • growth failure
  • alopecia (baldness)
  • irritability
  • anorexia
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Treatment of Common Ailments

Asthma

Asthma is a highly common and potentially fatal condition affecting almost 5 million under the age of 18. Asthmatics usually experience wheezing, coughing, and shortness of breath, although, the frequency and severity of attacks varies greatly from sufferer to sufferer. Asthma involves a combination of factors including:

  • spasm of airway muscles
  • edema of airway mucosa
  • increased mucus secretion
  • injury to airway surface

Chiropractic care has been shown to provide some benefits in asthma sufferers. In one study, 31 adults taking asthma medication were given either "sham" chiropractic spinal adjustments or "real" chiropractic spinal adjustments for a period of 4 weeks. Although there were no changes in measured lung functions, sufferers experienced a 34% reduction in their subjective asthma complaints. Further studies are needed to determine the extent of benefits, however, most chiropractors find many of their asthma patients obtain extraordinary results while under regular chiropractic care.

1. Neilsen NH, Bronfort G, Bendix T, Madsen F, Weeke B. Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial. Clin Exp Allergy 1995;25:80-88.

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Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder or ADHD is a common disorder in mostly young male children and is characterized by developmentally inappropriate inattention, restlessness, and impulsivity - with or without hyperactivity. Many children are inadvertently diagnosed as having ADHD simply because of hyperactivity and are unnecessarily placed on Ritalin (methylphenidate) as a means of controlling the child. Unfortunately, Ritalin is associated with many common side effects including:

  • sleep disturbances
  • depression and sadness
  • headache
  • stomachache
  • appetite suppression
  • elevated blood pressure
  • reduction of growth

The cause of ADHD is unknown to date but a group of chiropractic researchers has hypothesized that this condition may be caused by or worsened by vertebral fixations and misalignments (subluxations) which result in autonomic nervous system hyperactivity. The researchers performed a small scale study and found chiropractic treatment beneficial in children with hyperactivity disorders.

1. The Merck Manual. 16th ed. 1992.

2. Giesen JM, Center DB, Leach RA. An evaluation of chiropractic manipulation as a treatment of hyperactivity in children. J Manipulative Physiol Ther 1989;12:353-363.

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Back Pain

In a recent study, 1178 school children were surveyed and back pain was found to be cumulatively prevalent in more than 50%. Adolescents who participate in sports experience a higher incidence of back problems due to the excessive spinal loading which accompanies most sports. Similar to adults, chiropractors obtain excellent results treating back pain in children and adolescents. Chiropractic care in children and adolescents is safe, effective, and focuses on treating the cause of their discomfort rather than masking symptoms. Many of our most satisfied patients are children and adolescents.

1. Troussier B, Davoine P, deGaudemaris R, Fauconnier J, Phelip X. Back pain in school children: a study among 1178 pupils. Scan J Rehabil Med 1994;26:143-146.

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Headache

Headaches are a common problem in children and adolescents. A study published in the journal Headache reported that the prevalence of headaches in schoolchildren aged 7 was over 50% (for headaches occurring in the preceding 6 months). Chiropractic spinal adjustments have been compared for effectiveness in treating headaches with the commonly prescribed drug, amitriptyline. The results of the study identified chiropractic adjustments as providing long term reductions in headache intensity and frequency, as well as lowering the need to take over-the-counter medications to treat headache symptoms. Additionally, 82% of those taking amitriptyline reported side effects versus only 4% in the chiropractic group.

1. Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV. Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. J Manipulative Ther 1995;18:148-154.

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Heel Pain

Heel pain in a child is commonly caused by a condition known as, "Severs Disease." It's caused by chronic strain at the achilles tendon attachment on the calcaneus. It is generally found in 8-13 year olds and the complaint is pain in the area of the heel. Chiropractic care focuses on correcting any biomechanical problems, utilizing therapeutic stretches and exercises, manipulating any "locked" extremity and spinal joints, and various manual therapies.

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Infantile Colic

Infantile colic is a common and frustrating condition affecting infants. It involves persistent and often violent crying for no obvious reason. There is also a considerable amount of flatulence present. Typically, it occurs within the 1st month postpartum and spontaneously self-resolves by the 3rd to 4th month. Results from a Danish study involving 316 infants indicate that chiropractic care was successful in treating infantile colic in 94% of the infants.

1. Klougart, Nilsson N, Jacobsen. Infantile colic treated by chiropractors: a prospective study of 316 cases. J Manipulative Physiol Ther 1989;12:281-288.

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Knee Pain

Two conditions commonly cause knee pain in children and adolescents, "Osgood-Schlatter Disease" and "Chondromalacia Patella".

In Osgood-Schlatter Disease, the affected age is from 9-15 years and pain, tenderness and swelling is experienced just below the knee. This is actually the patellar (knee cap) tendon pulling away from it's bony attachment on the tibia. Chiropractors can effectively treat this condition through manual therapies including therapeutic quadriceps stretching and exercises. There is also an Osgood-Schlatter support which helps minimize stress on the tendinous insertion.

Chondromalacia patella is common in adolescent females and young adults. In this condition, the underside of the patella (knee cap) begins to roughen and become painful. There is generally deep knee pain which is made worse by climbing or descending stairs as well as sitting with the knee flexed for extended periods of time. This condition can worsen and it should receive corrective care which focuses on correcting any biomechanical faults and stresses present in the spine, hip, knee and foot.

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Otitis Media

Otitis media is an infection of the middle ear, usually secondary to an upper respiratory infection (URI). It can occur at any age but is most prevalent during the ages of 3 months to 3 years. The most common symptom is severe, persistent earache. Additional signs and symptoms include fever (up to 105-F), nausea, vomiting and diarrhea - especially in young children. Symptoms of headache, sudden profound hearing loss, dizziness, chills and fever can indicate serious complications and should receive immediate evaluation. While the medical approach to otitis media consists of antibiotics, many antibiotics are becoming increasingly ineffective. Furthermore, studies have shown children given antibiotics to treat otitis media increase their odds of having recurrent infections.

Published case studies involving chiropractic treatment of otitis media in children has shown substantial benefits. In one such study, 5 children (5 years and younger) who were under regular pediatric care and who had otitis media for 6 months without resolution were given chiropractic treatment. Chiropractic treatment consisted of gentle cervical spinal adjustments and lymphatic massage. Otitis media resolved in all 5 children - 3 days, 4 days, 8 days, 3 weeks, and 8 weeks. Resolution was determined by otoscopic examination and reduction of fever. None of the children required more than 5 chiropractic treatments in order to achieve resolution.

Fixations and misalignments in the cervical region can cause muscular spasms as well as neurological compromise which are thought to prevent proper drainage of the middle ear. When the middle ear is unable to drain, bacteria can pool and multiply resulting in acute and chronic middle ear infections. By treating the cervical spine and assisting in middle ear drainage, a majority of otitis media cases can be safely and quickly treated.

1. The Merck Manual. 16th ed. 1992.

2. Fysh PN. Chronic Recurrent Otitis Media: Case Series of Five Patients with Recommendations for Case Management. J Clin Chiro Ped 1996;2:66-78.

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Scoliosis

Select the "Scoliosis" link in the links menu.

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Scheuermann's Disease

Scheuermann's disease is a condition which causes persistent low-grade back pain, accentuated thoracic kyphosis (increase in mid back prominence), and a "rounded shoulder" posture. It is most common in the adolescent male. In this condition, there is injury to the surfaces of the vertebrae resulting in a number of wedge shaped thoracic vertebrae. Regular chiropractic care can help reduce symptoms of pain and discomfort as well as optimize spinal biomechanics and stresses. This is important as this condition predisposes the individual to the development of osteoarthritis later in life.

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Spondylolisthesis

This term is applied to a spinal vertebrae which has slipped forward relative to other vertebrae. It almost always is located in the lower back (4th or more commonly 5th lumbar vertebrae). While this condition is usually asymptomatic in children, identification of the "spondy" is important so that the child can avoid sports that cause axial loading on the spine (i.e. weight lifting, football, etc.) so that the slippage does not progress during periods of rapid adolescent skeletal growth. This condition can be identified through the use of x-rays which reveal presence and extent of slippage.

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The Joys of Aging

Welcome to "The Joys of Aging", the section of our site dealing with health issues of the maturing individual.

Included in this section is information on:

  • the spine and changes that occur with aging,
  • how chiropractic can eliminate years of pain and discomfort while simultaneously enhancing health and wellness,
  • many prevalent health conditions such as cardiovascular disease and Alzheimer's Disease,
  • exercise and fitness programs for the maturing individual
  • dietary and nutritional concerns for the maturing individual
  • and much more!

To begin your journey back to health, make a selection from the links menu.

The Aging Spine

A normal part of aging process involves the deterioration of tissues, especially those of the spine. This deterioration occurs with all individuals over time. The degree of the deterioration varies from individual to individual. The reasons for this are not fully clear, however, it seems that a history of spinal stress and abuse (such as years of hard labor or years of prolonged sitting) as well as inadequate spinal hygiene (lack of periodic spinal checkups) accelerates this deterioration process.

The Intervertebral Disc

The intervertebral disc (the cartilaginous pad situated between the spinal vertebrae) is one of the spinal structures most affected by the deterioration process. Normally, movements of the torso draw water into the disc which results in the influx of nutrients essential to maintaining a healthy disc. Similarly, torsal movements assist in flushing out waste products from the disc. This constant movement of water into and out of the disc is what keeps the disc strong and healthy.

As we age, the tissues of the disc fibrose and become stiff. This fibrosis and stiffening reduces the ability of the disc to accept and eliminate water, and thus, obtain vital nutrients and eliminate noxious wastes. Individuals who subject their spines to prolonged stress, have had at least one back/neck/spinal injury, and who do not practice proper spinal hygiene significantly accelerate this process. This "dehydration" of the disc is often visible on x-ray as a loss of disc height, which is identified by a reduction in the distance between adjacent vertebrae. As the disc becomes dehydrated it also tends to bulge outwards, like a tire without adequate air. If severe enough, the bulging disc can compress or irritate nearby spinal nerve roots.

As the discs of the spine undergo these arthritic changes, the biomechanics of the spine are also changed. If the failing spinal biomechanics are left untreated, further degenerative changes occur. Other structures affected by the degenerative processes as well as the alteration in spinal biomechanics include the body of the vertebrae as well as the facet joints.

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Facet Joint and Vertebral Body Arthritis

Both in the margins of the vertebral bodies and in the facet joints calcium becomes deposited. Over time the calcium ossifies which causes stiffness and loss of function in the tissue. This is seen on x-ray as "lipping" and "spurring" and enlargement on the edges of the vertebral bodies as well as facet joints. Frequently, these arthritic spinal changes lead to back and neck pain and stiffness, and are also responsible for extremity pain such as that shooting down the back of the leg. This commonly results from the bony compression or irritation of spinal nerve roots. In essence, relatively small spinal problems can snowball into serious spinal problems later in life.

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Chiropractic Treatments Can Help

Chiropractic treatments maintain motion in the spine which is vital to the health of the discs, joints and other tissues. Our treatments also optimize spinal biomechanics to minimize the stresses associated with the degenerative changes that occur with age. Your spine can be viewed much like any other moving structure in that the better you treat and maintain it, the longer it will freely operate problem free; if you abuse it or don't properly maintain it, it will wear out and break down.

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Chiropractic Care

Chiropractors help millions of maturing individuals regain control of their lives every year. Our treatments are designed to eliminate acute and chronic pain, increase flexibility, improve mobility and function, increase strength, enhance balance, and increase the overall quality of one's life.

Chiropractic care involves spinal and extremity adjustive techniques, physical therapies, soft tissue therapies, dietary and nutritional counseling, exercise and fitness counseling and many other safe and natural methods to improve health and prolong a vibrant and productive life. We can show you how to get the most out of your body so that you can get the most out of life!

Why Is Chiropractic Care So Important For The Maturing Adult?

Chiropractic care is extremely important for the maturing and elderly adult because of the dramatic changes that occur in the spine with increasing age. As we age, spinal discs, facet joints, ligaments, muscles and other spinal tissues become weaker, less hydrated, more fibrotic, and less able to withstand normal stresses. As a result, spinal pain from spinal degeneration (arthritis) becomes more prominent, tissue injury from relatively benign events occurs, and the time to heal from injuries increases.

Chiropractic procedures take into consideration the nature of the aging spine and the many abnormalities present to provide a strategically effective, safe and noninvasive treatment plan. Through the use of gentle adjustive and mobilization techniques, physical therapies, and incorporation of stretching and exercise programs spinal pain is reduced, spinal stresses are decreased, flexibility and mobility are improved, and degeneration is minimized.

Treatment techniques must focus on the underlying problem and involve participation of the patient in order to be truly effective and long lasting. Treatments which solely focus on pain and other "symptoms" only, are far less effective, and are often dangerous since the conditions causing the symptoms remain untreated and uncorrected.

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What Benefits Does Chiropractic Care Provide For The Maturing Adult?

Routine chiropractic care has a number of benefits which are especially important for maturing adults:

  • spinal and extremity pain relief
  • decreased stiffness and muscular spasms
  • increased mobility and range of motion
  • increased balance and coordination
  • increased sense of well being
  • increased energy
  • enhanced tissue healing
  • decreased tissue inflammation
  • increased joint health
  • decreased arthritis and arthritic joint pain
  • minimized spinal stress and subsequent degeneration
  • minimized risk of fall injuries
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Are There Any Studies Showing The Benefits of Chiropractic Care In The Aging?

There are many studies studying the effects of Chiropractic on the aging population. One in particular evaluated the health status of 414 elderly individuals (average age of 80 years) and compared those individuals under chiropractic care with those not under chiropractic care. The researchers found a number of significant findings which included:

  • 87% of those who used chiropractic care rated their health as good or excellent compared with only 68% in the nonchiropractic group
  • 13% of those who used chiropractic care rated their health as fair or poor compared with 32% in the nonchiropractic group
  • 44% of those who used chiropractic care reported having arthritis compared with 66% in the nonchiropractic care group
  • those who used chiropractic care were more likely to do strenuous levels of exercise
  • at 3 years follow-up, less than 5% of those who used chiropractic care used a nursing home while a staggering 48% of those who did not use chiropractic care did use a nursing home
  • at 3 years follow-up, only 26% of those who used chiropractic care were hospitalized compared with 48% of those in the nonchiropractic group

1. Coulter, PhD et al. Chiropractic and Care for the Elderly. Top Clin Chiro 1996;3(2):46-55.

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What Can Chiropractic Care Do For Me?

Chiropractic Increases Spinal Range of Motion

Increasing spinal range of motion can positively influence lives in many ways. For some, an increased range of motion means being able to bend down to pick up the grandchildren. For others, it translates into an extra 30 yards of distance out of their driver on the golf course.

Chiropractic care has a long history of helping individuals like yourself reach these and other goals through increases in spinal range of motion. Best of all, increases in spinal range of motion can occur immediately following chiropractic treatments. This is one of the reasons why many top professional sporting teams have team chiropractors treat the athletes prior to and during sporting events.

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Chiropractic Decreases the Frequency and Severity of Back, Neck and Head Pain

The treatments utilized by chiropractors have been consistently shown to be one of the most effective and safest forms of care to treat the majority of back, neck and head pain complaints. This is because most causes of back, neck and head disorders are related to abnormalities of the soft tissue components within the spine - something doctors of chiropractic are specifically trained to identify and treat.

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Chiropractic Increases Balance and Coordination

As we age, balance and coordination become increasingly impaired. Studies have shown that the receptors located in the joints of the upper cervical spine are largely responsible for providing the brain with essential information important for balance and coordination. Research has also shown that injury to these "neck" receptors is a significant cause of balance and coordination problems in humans.

According to Dr. Caranasos, MD:

Mechanoreceptors in cervical facet joints provide major input regarding the position of the head in relation to the body. With aging, mild defects impair mechanoreceptors function. Loss of proprioception can also involve the legs, especially with diabetes. With decreased proprioception, body positioning in space is impeded and the patient becomes reliant on vision to know the location of a limb. To compensate for the loss of proprioception in the legs, the feet are keep wider apart than usual. Steps become irregular and uneven in length. As impairment increases the patient becomes unable to compensate. With severe loss of proprioception, the patient is unable to get up from a chair or rise after a fall without assistance.

1. Caranasos, MD, Isreal, MD. Gait Disorders in the Elderly. Hospital Practice. 1991; June 15:67-94.

According to Dr. Guyton, MD:

By far the most important proprioceptive information needed for the maintenance of equilibrium is that derived from the joint receptors of the neck.

1. Guyton, MD. Textbook of Medical Physiology. 9th edition. WB Saunders, Philadelphia 1996;714.

Studies have shown that chiropractic care can help restore balance and coordination by stimulating the joint receptors (mechanoreceptors) in the cervical spine. This stimulation is thought to restore or normalize joint receptor functioning which leads to improvements in balance and coordination.

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Chiropractic Can Decrease Fall Injuries, as well as Other Injuries

Fall injuries are extremely prevalent in the elderly population and are one of the most detrimental events that can occur to the older individual. According to the Centers for Disease Control and Prevention (CDC), falls are responsible for 90% of the 850,000 bone fractures which occur annually among Americans past the age of 65.

Chiropractors reduce the risk of falls by (1) utilizing specific chiropractic adjustive techniques in the cervical spine to normalize cervical joint receptors which provide the brain with important balance and coordination information, (2) utilizing stretching and exercise programs to increase strength, flexibility, mobility, balance and coordination, and (3) utilizing diet and nutritional counseling to improve nutritional status, increase energy levels, and increase sense of well-being.

The above benefits also minimize other types of injuries as well as improve the outcome for injuries already sustained.

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Chiropractic Increases Joint Nutrition and Decreases Spinal Joint Arthritis

Spinal discs and spinal facet joints, similar to other joints, receive their nutrition and eliminate their wastes through joint movement. Without sufficient movement, adhesions and scar tissue will soon develop in the joints.

Chiropractic care involves restoring and optimizing spinal and extra-spinal joint motion which brings vital nutrients into the joint and flushes toxic waste products out. This helps keep the joints healthy and minimizes the degenerative joint changes which lead to arthritis.

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Chiropractic Decreases Joint and Tissue Degeneration through Optimizing Biomechanics

Similar to an out-of-aligned wheel on an automobile, a misaligned spine with abnormal biomechanics will wear out prematurely. As all moving parts will eventually wear down over time, it's important to get the maximum "mileage" out of your spine, especially since it's the only one you'll ever get.

Chiropractic care is focused on optimizing spinal biomechanics which reduces spinal stress and, as a result, decreases spinal degeneration and other arthritic changes.

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Chiropractic Increases Health and Well-Being

When you're free from nagging pain, stiff joints and can do the things you enjoy (golf, gardening, playing with the grandchildren, etc.) life is far more enjoyable. Feeling good, staying healthy and doing the things that make us happy are what keeps us looking forward to each new day.

Regular chiropractic care in those over the age of 40 is aimed at increasing the quality of life, and not just the elimination of pain and correction of soft tissue abnormalities. Don't cheat yourself from living life to its fullest... call today and let us get you started on a personalized health plan.

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Back Pain

Back pain or "arthritic back pain" is the most common ailment experienced in the aging population. This is typically the result of many years of uncorrected spinal stresses and injuries which have accumulated to become increasingly symptomatic. However, the risk of more serious disease does exist in the aging population. Thus, we strongly recommend individuals with back pain over the age of 40 schedule an appointment to at least rule out more serious causes which include spinal cancer, compression fracture and infection.

The Chiropractic Approach to Back Pain in the Elderly

The chiropractic approach to treating back pain follows a "holistic" type course. The chiropractor is concerned with the patient's personal health goals. This plays an important role in designing an effective treatment plan which results in the wanted outcome. While evaluating the patients health disorder, the cause as well as all contributing factors which lead to the development of the condition will be sought. Once determined, this information will be combined with the health goals of the individual in order to design the safest and most successful treatment plan. There will also be a careful evaluation to rule out more serious causes of back pain in the aging; cancer, compression fracture, infection, etc.

The treatments utilized by chiropractors do not include drugs or surgery. Instead, safe and natural noninvasive methods of healing are utilized. These include spinal adjustive techniques, physical therapies, soft tissue therapies, exercise and stretching programs, diet and nutritional counseling, and lifestyle modifications. As stated above, these therapies are directed towards the root cause of the health condition. The result is safe, fast, effective long-term relief as well as the overall optimization of health and wellness. Treatments which focus solely on symptomatic relief are short lived, ineffective, and lead to patient frustration and dissatisfaction.

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The Medical Approach to Back Pain in the Elderly

While our wish here is not to "bad mouth" medical doctors, it is a well known fact that the majority of primary care physicians simply do not understand back pain and lack not only the knowledge and experience, but lack confidence in treating back pain.

According to a recent study titled Practitioner Self-confidence and Patient Outcomes in Acute Low Back Pain, chiropractors had significantly stronger self-confidence scores than physicians when it came to treating back pain.

1. Arch Fam Med. 1998;7:223-228

The majority of medical doctors prescribe (1) prolonged rest, (2) avoidance of exercise, and (3) prescription medications like non-steroidal anti-inflammatories (NSAIDs) such as aspirin and Ibuprofen to mask pain and decrease inflammation. The problem with this approach is that although the pain has been artificially lessened with medications, the cause of the pain has not yet been addressed - kind of like cutting the wire to a flashing "low oil" light on your car dash; rather than adding oil to the engine.

i. numerous studies show that bed rest is detrimental rather than beneficial; patients can lose their capacity at a rate of 3-7% daily in total rest but can only improve at a rate of 1% per day,

ii. early motion and mechanical loading stimulate properly aligned, newly formed collagen fibers, promoting synovial fluid diffusion in joints and enhanced local blood flow,

iii. the use of NSAIDs and analgesics do not focus on increasing function or inhibiting progression of the disease, rather, it simply masks the symptoms of pain; moreover, a recent study has found that many NSAIDs (aspirin, ibuprofen, fenoprofen, sodium salicylate, sodium tometin) actually inhibit the repair processes involved with the articular cartilage of joints... rapid deterioration of joints after long-term NSAID use has been termed "Analgesic Arthropathy" and is essentially deterioration of a joint induced by the use of NSAIDs.

1. Nelson, DC. Top Clin Chiro 1994;1(4):20-29

2. Gottlieb MS, DC. JMPT 1997; 20(6):400-414

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Head and Neck Pain

While not as prevalent as back pain, neck and head pain still affect a large percentage of the aging population. And similar to the back, tissues of the cervical spine undergo degenerative changes which accumulate over time eventually giving rise to headaches, neck pain and stiffness, as well as dizziness and balance problems.

The Chiropractic Approach to Neck and Head Pain in the Elderly

The chiropractic approach to treating neck and head pain follows a "holistic" type course. The chiropractor is concerned with the patient's personal health goals. This plays an important role in designing an effective treatment plan which results in the wanted outcome. While evaluating the patients health disorder, the cause as well as all contributing factors which lead to the development of the condition will be sought. Once determined, this information will be combined with the health goals of the individual in order to design the safest and most successful treatment plan. There will also be a careful evaluation to rule out more serious causes of neck and head pain in the aging; tumors, temporal arteritis, infection, etc.

The treatments utilized by chiropractors do not include drugs or surgery. Instead, safe and natural noninvasive methods of healing are utilized. These include spinal adjustive techniques, physical therapies, soft tissue therapies, exercise and stretching programs, diet and nutritional counseling, and lifestyle modifications. As stated above, these therapies are directed towards the root cause of the health condition. The result is safe, fast, effective long-term relief as well as the overall optimization of health and wellness. Treatments which focus solely on symptomatic relief are short lived, ineffective, and lead to patient frustration and dissatisfaction.

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The Medical Approach to Neck and Head Pain in the Elderly

While our wish here is not to bad mouth medical doctors, it is a well known fact that the many primary care physicians simply do not understand back pain and lack not only the knowledge and experience, but lack confidence in treating back pain.

According to a recent study titled Practitioner Self-confidence and Patient Outcomes in Acute Low Back Pain, chiropractors had significantly stronger self-confidence scores than physicians when it came to treating back pain.

1. Arch Fam Med. 1998;7:223-228

The majority of medical doctors prescribe (1) prolonged rest, (2) avoidance of exercise, and (3) prescription medications like non-steroidal anti-inflammatories (NSAIDs) such as aspirin and Ibuprofen to mask pain and decrease inflammation. The problem with this approach is that although the pain has been artificially lessened with medications, the cause of the pain has not yet been addressed - kind of like cutting the wire to a flashing "low oil" light on your car dash; rather than adding oil to the engine.

i. numerous studies show that bed rest is detrimental rather than beneficial; patients can lose their capacity at a rate of 3-7% daily in total rest but can only improve at a rate of 1% per day,

ii. early motion and mechanical loading stimulate properly aligned, newly formed collagen fibers, promoting synovial fluid diffusion in joints and enhanced local blood flow,

iii. the use of NSAIDs and analgesics do not focus on increasing function or inhibiting progression of the disease, rather, it simply masks the symptoms of pain; moreover, a recent study has found that many NSAIDs (aspirin, ibuprofen, fenoprofen, sodium salicylate, sodium tometin) actually inhibit the repair processes involved with the articular cartilage of joints... rapid deterioration of joints after long-term NSAID use has been termed "Analgesic Arthropathy" and is essentially deterioration of a joint induced by the use of NSAIDs.

1. Nelson, DC. Top Clin Chiro 1994;1(4):20-29

2. Gottlieb MS, DC. JMPT 1997; 20(6):400-414

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Posture

Proper posture simply refers to maintaining the body in a position which protects against excessive stresses which cause injury, while requiring a minimal amount of muscular effort to maintain. In other words, a comfortable position which will not irritate your spinal tissues.

Posture plays a significant role in the development of chronic conditions such as chronic back and neck pain. Poor posture is responsible for overstretching ligaments and other supportive spinal structures as well as exhausting spinal musculature, all of which quickly leads to the development of chronic spinal pain.

Learning and practicing proper postural habits will help reduce the likelihood of acquiring back and neck injuries, reduce spinal degeneration, and help keep your spine and body happy and healthy.

Proper Seated Posture

Prolonged sitting is a frequent cause of back and neck pain. And while extended periods of sitting are best avoided, for many, it's a fact of life.

When sitting, it's important to keep the back straight, knees bent, and head centered over the shoulders. Slouching forward may be comfortable and allow the spinal muscles to relax but gradually overstretches spinal ligaments, leading to back and neck pain among other problems. We always encourage patients to maintain a "neutral spine" position at all time is ideal.

Seat Backrest - The proper chair has a backrest which slightly inclines backwards. This has the effect of relaxing the spinal musculature and decreasing spinal discal pressure.

Armrests - Armrests provide support for the arms which helps to reduce the work load and stress on the trapezius and shoulder muscles. The armrest height should allow the forearms to comfortably rest while being low enough to go underneath tables or desks in the work area.

Lumbar Support - Having a lumbar support either built into the chair or inserting a portable lumbar support helps to maintain your natural lower back curve. These small supports are quite handy, effective and relatively inexpensive.

Seat Bottom Angle - The seat angle relative to the floor is more of a personal preference than an exact science, as long as a neutral spine can be maintained in comfort. In general, the more the seat bottom tilts forward the more extension of your lower back will occur to keep you in a neutral position.

Seat Height - The height of the seat should be so that it allows you to sit all the way back in the seat while your feet are still able to reach the floor. If they can't and you're stuck with the chair, use a footrest to remedy the problem.

In addition to the suggestions provided above, it's important to:

  • be aware of your posture throughout the day and be sure to maintain a neutral spine -no slouching
  • take mini breaks on a regular basis when in a prolonged position and remember to stretch
  • have the right equipment and tools for working in a prolonged position, use ergonomically designed furniture and keep a lumbar support in your car for "chair crises"

Proper Standing Posture

Although standing is something we do every day most of us have never really given "the art of proper standing" a second thought. Many people are actually unaware that their standing habits can contribute to their back and neck problems.

If you're one of those people, the following "general standing guidelines" should help you out.

General Rules for Standing:

  • maintain a straight spine rather than slouching to the side
  • avoid slouching forward or hyperextending
  • keep the chin up with the head centered over the shoulders
  • viewed from the side, your ear, shoulder, hip, knee and ankle should be in a straight line
  • keep the feet slightly less than shoulder width apart
  • keep the knees slightly bent
  • wear comfortable shoes and leave the heels at home
  • avoid standing still for long periods of time, rather, sit down or move around

Proper Lying Posture

Approximately 1/3 of our life is spent lying in bed, on the couch, and on the floor. Like other positions, there is a right way and a wrong way to lie. For individuals suffering from pain, modifications may be necessary to obtain a "pain-free" position or a position which does not aggravate the pain.

  • Lying On Your Stomach
  • Lying On Your Back
  • Lying On Your Side
  • Choosing A Pillow

Lying On Your Stomach

Extended periods of "stomach lying" should be avoided. This is because excessive stress is placed on the joints of the low back and because excessive rotation must take place in the neck. Neck pain, back pain, headaches, dizziness, as well as arm paresthesias are commonly experienced when in this position for an extended period of time. If you must lie in this position to relieve pain or for some other reason, keep one leg bent with the same side arm raised with approximately 90 degrees of flexion at the shoulder and elbow joints.

Lying On Your Back

Most people find lying on their back to be a relatively comfortable position. For individuals suffering from back problems, placing a folded pillow underneath the knees will help reduce tension in the lower back and make this position more tolerable. Some individuals may also find placing a small pillow or towel under their lower back to be helpful. This will help to maintain the natural curve of the lumbar spine.

Lying On Your Side

Lying on your side is a favored position by many individuals. It may also be a comfortable position that provides relief for individuals with back problems. It's important while in this position to have adequate support for the head and neck. A pillow which fills the gap between the head/neck and the bed should be used to keep the head and neck in line with the rest of the spine. Additionally, placing a pillow between the knees will help reduce lumbar and pelvic torsion. Women with larger hip and small waists will find a small pillow under the waist will prevent lateral bending of the spine while lying on the side.

Choosing a Pillow

Choosing a pillow which supports the cervical spine is extremely important, especially for those with neck or upper back problems as well as those with a history of headaches. There are a number of cervical pillows on the market, however, many of the inexpensive pillows (those under $20) are poorly designed with rigid foam which does not conform to the natural contours of the head and neck. Look for a cervical pillow which will contour to the shape and size of your head and neck while still providing support. Don't be scared to spend a little extra on a high quality pillow - it's well worth the money, and besides, it's something you'll use every day.

Pregnancy

Pregnancy is a unique time in a woman's life filled with new experiences, heightened excitement, mixing emotions, and significant physical changes. It's also a time filled with many unanswered questions.

The following links provide much of the basic and more complex, yet essential information that can assist the mother-to-be in her quest for a smooth uncomplicated pregnancy and a healthy baby.

Chiropractic Care

Regular chiropractic care is an integral part of the prenatal and postpartum care during pregnancy. It helps keep mom feeling good and assists her in coping with the physical stresses of an ever changing body.

Neuromuscular and Biochemical Changes During Pregnancy

During pregnancy, most women experience a number of neuromuscular and biochemical problems which respond favorably to gentle, safe, noninvasive chiropractic care. These include:

  • release of the hormone relaxin causes muscle and ligament relaxation
    • allows joints to more easily misalign
  • increased weight gain
    • increased demand and fatigue on spinal and pelvic muscles
    • increased stress on spinal and pelvic ligaments
    • increase in lumbar and thoracic spinal curves which further increase the above
    • increased joint stress and thus occurrence of vertebral and sacroiliac joint misalignments
  • change in weight distribution
    • increased demand and fatigue on spinal and pelvic muscles
    • increased stress on spinal and pelvic ligaments
    • increase in lumbar and thoracic spinal curves which further increase the above
    • increased joint stress and thus occurrence of vertebral and sacroiliac joint misalignments

The above changes primarily affect the pelvic and spinal ligaments, muscles, joints and other supportive soft tissues. These changes cause sprain/strains of pelvic and spinal structures, as well as alteration of the normal spinal curvatures and spinal biomechanics. The result is an increased stress on the body leading to pain and discomfort.

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Chiropractic Treatment of the Neuromuscular and Biochemical Problems

Doctors of chiropractic can alleviate the uncomfortable symptoms arising from the muscular, ligamentous, and biomechanical stresses encountered during pregnancy. We accomplish this through the use of a number of highly specialized procedures and techniques:

  • Gentle Spinal Adjustive Procedures - specifically designed for use in the pregnant female
    • assist in maintaining a spine free from vertebral misalignments and fixations - optimizing spinal biomechanics
    • keep pelvis and spine in correct position/posture
    • assist in pain relief by (1) reflexively reducing pain levels, and (2) reducing spinal and pelvic stresses which produce soft tissue pain
    • keep tissues and biomechanics functioning optimally to minimize complications during birth
  • Therapeutic Exercises and Stretches - safe for use during pregnancy
    • keep spinal musculature strong, balanced, and pain-free
    • enable spinal muscles to maintain the spine and body in a neutral, correct posture
    • keep mom active and mobile
  • Soft Tissue Work - massage, trigger point work, soft tissue mobilization, etc.
    • keep muscles relaxed and flexible
    • reduces bouts of muscle aches and pains
    • reduces spinal stress
  • Dietary and Nutritional Counseling - unique to the pregnant mother
    • prevent neural tube and other birth defects
    • increase the chances for a healthy baby
    • assist the mother in maintaining optimal energy levels
    • keep mother happy and healthy during stressful periods
  • General Pregnancy Information - general info on pregnancy
    • answer mother's questions
    • improve mother's health
    • optimize birthing process
    • enhance baby's health
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Frequently Asked Questions

Is Chiropractic Care Safe During Pregnancy?

Chiropractic care during pregnancy is safe for both mother and fetus. Spinal adjustments are especially gentle during pregnancy as far less force is required to correct subluxations. This is due to the increase in hormones causing significant muscle and ligamentous relaxation. Special "adjustive" positions are also used to provide comfort and safety for both mom and fetus.

How Often Should I Receive Chiropractic Care During My Pregnancy?

The frequency of care varies for a number of different reasons. Typically, regular care during a non-complicated pregnancy will range from once per week to once per month.

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Chiropractic and Pregnancy Scientific Studies

Low Back Pain During Pregnancy

In this study, researchers identified the sacroiliac joints of the pelvis (frequently "adjusted" by chiropractors) as being responsible for the majority of low back pain cases in pregnancy. This is due to the significant number of hormonal and biomechanical changes occurring in the pelvis during pregnancy. Researchers found 7/10 women were helped by spinal manipulation in this study.

1. Bery G, Hammar M, Moller-Nielsen J et al. Obstet and Gynecol, 72:71-75, 1988.

Textbook on Chiropractic & Pregnancy

According to Dr. Fallon, author and internationally recognized "chiropractic pediatrician", statistics from her office "have demonstrated that chiropractic adjustments effectively reduce the average amount of time spent in labor." Her data shows a nearly 25% reduction in the average labor times in those receiving chiropractic care versus the generally accepted average labor time - in women who had given birth in the past, there was a 33% reduction in average labor time.

1. Fallon J. International Chiropractic Association. 1994 - Arlington, Virginia.

Italian Study on Chiropractic & Pregnancy

Postpartum pain was relieved in 90 of 120 patients who received chiropractic adjustments.

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Back Pain

Chiropractic Treatments

Common Causes of Back Pain During Pregnancy

Back pain is the most common soft tissue complaint pregnant women generally encounter. There are a number of reasons for this, including:

  • increased ligament laxity due to the release of the hormone relaxin
  • increase in weight gain and forward weight bearing
  • poor body mechanics and postural habits
  • ribcage enlargement increasing rib subluxations
  • nerve and vascular impingement from mechanical pressure

The above factors increase the frequency of vertebral subluxations, muscular spasms, soft tissue pain and altered spinal biomechanics - all of which respond exceptionally well to regular chiropractic care.

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Chiropractic Treatments

Spinal Adjustments

Spinal adjustments are safe, natural treatments chiropractors use to successfully manage soft tissue abnormalities in pregnancy. The adjustments are used to treat muscular, ligamentous, joint and neurological problems of the neck, back, pelvis and extremities. They help alleviate pain originating from the spinal and pelvic regions, reduce muscle spasm and tightness, correct biomechanical stresses, and keep the nervous system free from irritation and impingement. Chiropractic spinal adjustments are a safe and successful adjunct to any prenatal care program.

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Soft Tissue Work

Muscles frequently become fatigued, irritated, spasmed, and achy during pregnancy for the reasons previously mentioned. Chiropractic doctors utilize various soft tissue techniques such as trigger point work, soft tissue mobilization and massage to keep muscles relaxed, healthy, and functioning optimally.

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Stretches and Exercises

Therapeutic stretches and exercises are an excellent way to keep the pregnant body flexible, strong and mobile. Chiropractic doctors utilize these therapies to assist the muscles in coping with the increased demands caused by the sudden weight gain and change in weight distribution - which fatigues and irritates unconditioned muscles. Keeping the pregnant body strong and flexible increases comfort and improves the likelihood of having a successful pregnancy.

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Proper Body Mechanics and Postural Practices

Sudden weight gain and altered weight distribution also lead to a number of improper postural and biomechanical habits. Improper postural and mechanical habits further increase spinal and pelvic stress which increase tissue irritation and produce frequent bouts of pain and discomfort. Chiropractors focus on teaching proper postural habits and body mechanics to minimize stress on the body, minimize the risk of injury and keep mom functioning optimally and without discomfort throughout her pregnancy. To see the proper standing posture, click here or continue to scroll down.

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Special Orthopedic Supports

Certain orthopedic supports and other products may be beneficial during pregnancy. This includes orthotics for the feet and certain orthopedic belts specifically designed for pregnancy (i.e. maternity belts, trochanter belts, etc.).

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Proper Posture During Pregnancy

Proper PostureImproper Posture
keep the head and chin up and the ears centered over the shoulders head and chin are lowered and the ears are not centered over the shoulders
keep shoulders slightly up and back shoulders are allowed to roll forward and down
focus on keeping the abdominal muscles toned to keep back slightly flattened-avoid hyperextending relaxed and weak abdominal muscles allow the pelvis to tilt forward
keeping the knees slightly bent reduces tension in the lower back knees locked in full extension increases the tension in the lower back
widen stance and keep weight on center of each foot do not place weight on inner aspects of the feet
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Prenatal Care

Chiropractic adjustments quicken recovery time and assist the body in normalizing overall pelvic and spinal biomechanics. Prenatal care during pregnancy assists mom in having a successful pregnancy and birth. It keeps mom and baby healthy and provides mom with needed physical and emotional support.

The Birthing Plan

Developing a birth plan plays an important role during the prenatal period. It is a written plan which outlines the wishes and wants of the mother in relation to procedures to be followed and actions to take during the prenatal period, during the birth and postpartum. The more detailed and specific the birth plan is, the more likely a successful outcome will be achieved. The following list includes many of the points which should be addressed and determined early on in pregnancy:

  • Choice of caregiver
    • obstetrician
    • certified nurse-midwife
    • lay midwife
  • Other Practitioners
    • chiropractor
    • pediatrician
    • massage therapist
    • acupuncturist
  • Birth Venue
    • hospital birthing room/chair delivery room
    • home
    • birthing center
  • Prenatal care
    • frequency of visits (primary care giver & chiro care)
    • what do you do at visits
  • Prenatal testing
    • ultrasound frequency - abdominal vs. transvaginal (should always be performed by an ultrasonographer)
    • amniocentesis
    • CV sampling
    • alpha-fetoprotein tests - to identify neural tube defects
    • non-stress test
    • other blood tests
  • Levels of activity during the pregnancy
    • working outside the home
    • working in the home
    • other children
    • exercise
  • What is your view on:
    • anesthesia during birth
    • what is your C-section rate
    • how do you feel about vaginal birth after cesarean
    • how do you feel about childbirth classes
    • how do you feel about nursing
    • how do you feel about testing in women over 30
  • Labor
    • how long to stay home before attending birth venue?
    • how long can I labor before intervention?
    • when would Pitocin be used?
    • level of monitoring during labor
    • IV
    • what positions can I assume?
    • how mobile can I be?
    • can I eat?
    • under what circumstances would a C-section be performed?
    • would you deliver a breech vaginal?
  • Medications during labor
    • epidural
    • anesthesia
    • IV drugs
  • Birth
    • can siblings be present?
    • can my husband/labor support person be with me the whole time?
    • how long can I push?
    • what signals will you have to do a C-section?
    • can I hold the baby directly after the birth before weighing etc.?
    • will you be there the entire time?
    • how often do you do an episiotomy?
  • Postpartum
    • can the baby room-in?
    • who can visit the baby?
    • what will the baby eat immediately after birth?
    • can I begin to nurse immediately?
    • frequency of visits?
    • which pediatrician will see the baby?
    • when can we go home after the birth?
    • given a C-section, how long will I be in the hospital?
    • should something be wrong with the baby, what type of services does the hospital offer?

1. Fallon J. TextBook on Chiropractic & Pregnancy. International Chiropractic Association. 1994 - Arlington, Virginia.

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Regular Chiropractic Adjustments

Regular chiropractic adjustments play an integral role in the prenatal and postpartum periods. The adjustments help counter the effects of increased weight gain, altered weight distribution, and excessive ligament laxity. This keeps the spinal and pelvic regions healthy, biomechanically sound, and minimizes soft tissue irritation and discomfort.

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Proper Diet and Nutrition

Maintaining a complete nutritious diet accompanied with supplementation is critical for mom's health and the health of the developing fetus. Making appropriate nutritional choices during pregnancy can be confusing but your chiropractic doctor can help guide you. Also, additional supplementation of prenatal vitamins and minerals is crucial; such as folic acid to prevent neural tube defects in your child.

Pregnancy requires an additional 300 calories per day in order to maintain metabolic homeostasis. Thus, those exercising should pay close attention to ensure adequate nutritional intake.

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Exercise / Physical Activity Program

Except in special cases, mild to moderate physical activity and exercise during pregnancy is not only safe, but has been shown to be beneficial.

Kegel Exercises

Kegel exercises are extremely important for the pregnant woman. They function to improve and maintain pelvic floor muscular tone which is vital during pregnancy and delivery. These exercises are best initiated early in pregnancy and continued throughout the term of the pregnancy. This ensures that during the delivery process the pelvic musculature is able to withstand the changes taking place during labor. They're also important in decreasing the likelihood of tearing during delivery as well as the later development of hemorrhoids.

These exercises are performed by squeezing the muscles of the pelvic floor. This is done by contracting and holding the same muscles used to start and stop urination in midstream.

Exercise In Pregnancy Is Safe (For Mother and Fetus)

A recent study published in the American Journal of Obstetrics and Gynecology finds that women who exercised prior to their pregnancy can continue to do so without negatively affecting the fetus' growth or the pregnancy itself. According to the researchers, "Our results indicate that healthy and well-conditioned women may take part in exercise during pregnancy without compromising fetal growth and development as judged by birth weight or complicating the course of pregnancy or labor." Forty-two women participated in either a medium or high intensity exercise program throughout their pregnancy, including 6 weeks postpartum. The women exercised 6 times per week, participating in strength, interval and endurance training. All 42 women had been physically active prior to the pregnancy.

Overall, researchers discovered no differences between the high and medium intensity exercise groups in terms of labor, fetal birth weight, or the health of the infant immediately after birth. The researchers did note that women who exercised more gained more weight during pregnancy and went into labor earlier if they had a girl.

1. American Journal of Obstetrics and Gynecology 1998;178:280-286.

Exercise may protect against miscarriage

A study from the journal Epidemiology indicates that women who continue to exercise regularly during their pregnancy have a 40% lower risk of having a miscarriage of a chromosomally normal fetus compared with those who do not exercise. In the study, researchers interviewed 346 women who had suffered a miscarriage, asking them about exercise and other habits during their pregnancy. From these interviews, researchers were able to determine that exercise, such as swimming, jogging and aerobics, reduced the risk of miscarriage of a chromosomally normal fetus, but other physical activities such as housework, childcare or employment did not have this protective effect.

According to researchers, "The protective effect of exercise, but not of other forms of activity, may arise from the sustained aerobic nature of exercise; exertion during employment, housework and childcare is often sporadic." Of the women interviewed, approximately 25% claimed to have exercised during their pregnancy.

1. Epidemiology 1999;10:6-7, 73-75.

Athletes Can Work Out During Pregnancy

According to a case report in The Lancet, a 33 year old distance runner continued to exercise intensely throughout her pregnancy and gave birth to healthy twins, without complications. Throughout the woman's pregnancy, she ran an average of 66 miles per week with a heart rate of 130-140 beats per minute up until 3 days prior to giving birth. The researchers did warn that women who were inactive prior to their pregnancy would have to be more cautious.

1. The Lancet 1998;351:1182

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Soft Tissue Work

Soft tissue work includes massage, trigger point work, soft tissue mobilization, and other soft tissue procedures. These techniques assist in keeping muscles and other tissues relaxed and flexible while reducing bouts of muscle aches and pains.

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Stages of Fetal Development

Conception

  • Formation of a viable zygote by the union of the male sperm and the female ovum; fertilization.
  • Normal hormonal balance, normal cycle, healthy pregnancy.
  • Normal gametes.
  • Healthy fallopian tubes - normal conduction of ovum, no ectopic pregnancy.
  • Healthy, normally positioned uterus, normal implantation.
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Embryonic Development

4-8 weeks of embryo development.

1.5 Weeks

Completely developed embryo.

2nd Week

Primitive streak.

3rd Week

Central nervous system begins to develop.
Heart development initiated - beating begins.

4th Week

Complete mass (baby and chorion, etc.) - about 1" long and the size of a pigeon's egg.
Embryo inside is about 3/8" and weighs less than 1 gram.
Outpouching from anterior brain - early eyes - limb buds of arms and legs.

5th Week

Nose and lips formation begins.
Brain is developed into 5 components and lumen of spinal cord is continuous with brain vesicles allowing free cerebral spinal fluid flow.

8th Week

Major organs begin development.
Now about size of hen's egg.
Embryo is 1" long and about 4 grams.
Hands and feet are seen.
Baby is extremely reactive to its environment.
Male sex hormone (testosterone) produced by testes
Masculine development in males - no change in females.

12th Week

Embryo is about the size of a goose egg.
Placenta is well established and weighs more than the baby.
Baby is approximately 3 1/2" long and weighs about 60 grams (2 oz.). Fingers and toes can be seen.
This is the end of the embryonic stage.

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Fetal Development

14-16th Weeks

Brain developed to the point that baby can suck, swallow and make irregular breathing movements.

16th Week

6", 6 oz. (180 grams)
Complete closure of nasal septum and palate.
Fetal heart beat heard with amplification.
Fetal movement is recognized.
Sex is distinguishable now.
Meconium formation in intestines.

20th Week

8", 10 oz. (300 grams).
Lanugo - fine hair covering over entire body, probably for protection of skin.
Vernix Caseosa - secreted by fetus, made of sebaceous material, and other materials and is probably protective.
Has some antimicrobial substances.
Fetal heart beat heard: 120-160 beats per minute.

24th Week

12", 1 1/2 lbs. (720 grams).
Baby is maturing, not considered viable (until 28 week).

28th Week

Baby can survive outside uterus if lungs capable of breathing.
10-20% survival if born at this time.
14", 2 1/2 lbs.
Viable (legally).
Fetus in breech position until 32nd week.

32nd Week

Maturing. 50% survival if born at this time.
Should turn to head down position.
16", 3 1/2 lbs. (1680 grams).
Skin is red and wrinkly.
The downy type hair is less plentiful and has more vernix.

30-34th Week

Baby is the same size as placenta.

36th Week

94% survival rate if born at this age.
18", 5 1/2 lbs.
Has some subcutaneous fat.
The baby stores things during this last trimester.
Mother should watch her weight at this time.
Fingernails are now at the tips of the fingers.

40th Week

Full term. 20", 7 lbs. (3360 grams).
Length is better indication of maturity of fetus.
Very little lanugo, lots of vernix.

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Complications of Pregnancy

Complications During Pregnancy

Bell's Palsy

This condition involves a sudden onset of painless loss of facial muscle function. Lowering the eyebrows, closing the eye or pursing the lips is not possible. Patients may also experience a loss of taste in the anterior 2/3rd's of the tongue as well as pain posterior to the ear. While this condition has currently no known cause, many believe that vertebral subluxations are at least partly responsible.

Bell's palsy is 3 times more common in the pregnant women. Hormonal changes increasing water retention, grimacing during labor and delivery, as well as ligamentous laxity are primarily responsible. In the typical presentation, the woman awakes with a painless inability to operate the facial muscles on one side of the face. This typically occurs during the 3rd trimester. The condition tends to improve over the course of many weeks to months, depending on its severity. Many studies have shown favorable results with chiropractic care.

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Brachial Neuralgia

A large collection of nerves, the brachial plexus, from the cervical spine descend into each arm to provide sensory and motor innervation. Again, due to increases in hormonal factors, parts of the nerve plexus may become impinged or irritated. This results in radiating arm pain and may also be associated with neck pain or stiffness. Restoring cervical biomechanics and eliminating cervical subluxations is performed by the chiropractor to eliminate cervical stress and radicular symptoms.

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Breast Cancer

Breast cancer is occurring earlier and earlier in women. Breast cancer occurs in approximately 1 out of every 3,000 pregnancies. It's important to have a breast examination prior to pregnancy or early on in the pregnancy to check for its presence and establish a baseline if present.

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Carpal Tunnel Syndrome

Carpal tunnel syndrome, commonly associated with repetitive wrist movements, is also increased during pregnancy. This is because of hormonal changes which increases water retention, leading to increased pressure on the median nerve as it passes through the 'carpal tunnel' in the wrist, hence the name. Symptoms include numbness and tingling of the hand and fingers as well as achiness in the forearm and neck. Chiropractic adjustments applied to the cervical and wrist regions can help eliminate inflammation and quicken resolution. Additionally, vitamin B6 supplements have been shown to assist in eliminating the symptoms of carpal tunnel syndrome.

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Coccydynia

This condition simply refers to a painful coccyx. The coccyx bone is located on the end of your sacrum or tailbone and can become irritated and painful in pregnancy. This is especially evident in the final trimester due to the position of the baby and the lack of room for the baby to maneuver. Manual adjustment of the coccyx is often required and can be safely and successfully performed by the chiropractor.

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Ectopic Pregnancy

An ectopic pregnancy occurs when implantation and subsequent development of a fertilized ovum is outside the uterus. This most commonly occurs in a fallopian tube. As the embryo develops the fallopian tube is unable to expand like the uterus and can eventually rupture. Symptoms include cramp-like or stabbing pain in the lower abdomen. In 75% of the women vaginal bleeding will occur. This is a serious condition as acute internal hemorrhaging may occur leading to possible death.

Certain factors can increase the likelihood of ectopic pregnancies including:

  • prior IUD use
  • prior pelvic or tubal infection (certain STD's)
  • tubal abnormalities

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Headaches

Most headaches experienced during pregnancy are muscle tension headaches. These headaches are soft tissue and biomechanical in nature and respond excellent to chiropractic care. Fortunately for migraine headache sufferers, migraines are rare during pregnancy as hormones released counteract the processes involved that normally cause migraines.

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Intercostal Neuralgia

Hormonal changes during pregnancy lead to the relaxation of ligaments and joint capsule which include the joints of the ribs. Additionally, increased weight gain increases the pressure on the rib cage. These two factors lead to increased rib subluxations and increased in intercostal nerve irritation. Chiropractors adjust the rib heads to alleviate nerve irritation and restore normal positioning of the rib heads.

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Meralgia Paresthetica

This condition is a result of pressure on the lateral femoral cutaneous nerve which provides sensation to the skin of the upper lateral thigh. Increased abdominal weight and pressure as well as an increased lumbar curvature tend to place additional pressure in the area of the nerve which leads to pain, numbness and tingling in the area of the lateral upper thigh. Chiropractors commonly treat this condition successfully.

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Sciatic Neuralgia

This common condition is a result of increased pressure on the large collection of nerves in the lower back. Symptoms include back pain with symptoms of pain, numbness and/or tingling radiating down the buttock and leg(s). There are also other causes of this condition which include sacroiliac joint dysfunction, lumbar disc syndrome, lumbar facet joint irritation, and vertebral subluxations. Chiropractic care is especially effective in treating sciatic neuralgia as the treatment directly addresses the cause.

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Teratology of Drugs and other Substances

It's vital that all women who believe they may be pregnant or who are pregnant be 100% sure not to consume any drugs which may lead to birth defects or complications. It is estimated that 2-3% of all birth defects are drug-induced. One problem is damage to the embryo can occur early on prior to the woman knowing she is even pregnant. Vital systems such as the heart and nervous system develop in the embryo weeks after conception and are extremely susceptible to toxins such as drugs and alcohol.

Some common substances and drugs that can produce adverse effects on the growing embryo/fetus include:

  • Artificial Sweetener - Aspartame
  • Caffeine
  • Aspirin
  • Smoking
  • Antihistamines
  • Antibiotics
  • Recreational Drugs (marijuana, cocaine, etc.)
  • Antidepressant Drugs
  • Antiepileptic Drugs
  • Acne Drugs - Accutane
  • Cardiovascular Drugs

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Toxemia of Pregnancy - Eclampsia

This fatal condition can develop in the 2nd half of pregnancy and has no known etiology, although some believe it results from poor nutrition. In the early stages (pre-eclampsia) signs include high blood pressure (hypertension), protein in the urine (proteinuria), and excessive edema (not always present). If eclampsia develops, the following may develop:

  • epilepsy
  • subarachnoid/cerebral hemorrhage
  • preexisting brain tumors may fulminate
  • uremia
  • liver failure
  • placental necrosis
  • glomerular (kidney) and tubal necrosis

Complications During Birthing Process

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Insufficient Power

Sufficient power and coordinated contractions are essential for a smooth uncomplicated labor. When the power of the contractions are weak or the pattern of contractions disorganized, the mother is more likely to become exhausted. This can cause fetal distress resulting in fetal harm and/or c-section. The following are causes of insufficient power or improper contractions:

  • disordered uterine action
  • colicky uterus
  • constriction ring - Bandl's ring
  • rigid cervix
  • edematous cervix
  • annular detachment

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Passage Obstruction

Passage way obstructions (pelvic, uterine, cervix, etc.) can complicate the birthing process. These include:

  • tumors
  • cysts
  • fractures
  • subluxations
  • flat male-like pelvis (android)
  • physiological changes (degenerative joint disease, tuberculosis, rickets, osteomalacia)

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Baby Malpositions

Malpositioning of the fetus can lead to abnormal birth presentations. Some of the more common malpositioned birth presentations include:

Upside Down Presentation - This presentation occurs in approximately 13% of births and involves a presentation where the baby presents in an "upside down" or "sunny side up" position. If the baby does not turn to the proper position or turns late, the newborn will generally develop "cone head". This position also produces what is known as "back labor". This can be significantly reduced in women who receive regular chiropractic care during their pregnancy.

Breech Presentation - In a breech presentation, the feet or buttock present first as opposed to the head. This presentation occurs in about 1 out of every 40 births. Possible complications can be serious and include:

  • intracranial bleeding
  • neck dislocation
  • shoulder dislocation
  • hip dislocation
  • clavicle fracture
  • internal organ disruption
  • genital edema
  • premature placental rupture
  • prolapsed cord
  • uterine rupture

Face Presentation - Face presentation occurs approximately every 3,000 births. In this presentation, the baby presents face first with the neck in extension. Causes include a lax uterus, flat pelvis, multiple fetus, anencephaly, or neck spasms of the fetus. This is stressful on the cervical spine and usually results in a cervical subluxation in the newborn. Chiropractic care by a chiropractor trained in adjusting newborns is crucial for the continued proper growth of the spine.

Shoulder Presentation - The shoulder presentation occurs in every 200-300 births and involves a "shoulder first" delivery. The causes include:

  • twin birth
  • hydramnios - excess of amniotic fluid
  • placenta praevia - part of the uterus presents before the fetus due to placental malposition
  • multiparity - a women who has had 3 or more children
  • sub-septate uterus
  • unusual fetal shape
  • undue mobility of the pelvis

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Forceps Delivery

In the event there is fetal or mother distress, or the labor is not going as planned, forceps assistance may be used. As forceps can cause a number of problems, forceps should only be used in absolutely necessary situations. The following injuries can result from improper/inappropriate forceps use:

  • skull fractures
  • birth marks
  • doctor-induced torticollis
  • brachial plexus damage

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Cesarean Section

Although C-sections were becoming very popular a short while back, experts now recommend avoiding this procedure unless the mother or fetus are in extreme distress. This is due to the invasiveness of the procedure and unnecessary stresses placed on the baby. The indications for cesareans are:

  1. placenta praevia - part of the uterus presents before the fetus due to placental malposition
  2. fetal distress
  3. maternal distress
  4. failure for labor to progress

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The Birthing Process

The time leading up to the normal birthing process is generally 266 days (38 weeks) - from conception to birth. However, only about 5% of births occur on the actual due date.

The 4 Stages of Labor:

Stage 1: Labor Onset to Full Cervix Dilation

Stage 1 consists of regular uterine contractions with cervix dilation. Full cervix dilation occurs at approximately 4 inches. The length of this stage varies from mother to mother. It depends on many factors including but not limited to previous pregnancies, the health and condition of the mother and fetus, patience of the doctor (or midwife) and willingness to induce labor, medications used at this stage, hospital versus home birth, etc.

Stage 2: Full Cervix Dilation to Delivery of Baby

Stage 2 generally takes from 15 to 50 minutes. During this time, uterine contractions strengthen and become more frequent. During this stage mother will feel the need to bear down and push. The baby goes through a series of passive movements - especially the head, which undergoes flexion, internal rotation, extension, external rotation, and crowning (the first sign of the baby's head).

Stage 3: Delivery of Baby to Expulsion of Placenta

This stage consists of the period immediately following birth to the expulsion of the placenta - generally taking 5 to 10 minutes. Should the placenta not easily come out, tugging or pulling should not be performed. Gentle uterine massage may be utilized to assist in the release. The placenta should always be examined to be sure no parts remain within the uterus. This can become detrimental to the mother causing hemorrhage and/or death.

Stage 4: Expulsion of Placenta to Afterbirth Recovery

During this stage, mother is monitored to be sure no uterine bleeding or other complications occur.

Postpartum

Chiropractic Care for Mother

After giving birth the woman once again undergoes many changes. Hormonal levels normalize, tissues shrink, and bones and joints shift. Throughout the pregnancy and birthing process, the woman's body has undergone many stressful events and some type of recovery/rehabilitation to reach pre-pregnancy state should be sought. Failure to restore normal biomechanics and tissue health can result in future problems in health and with future pregnancies. Chiropractic adjustments quicken recovery time and assist the body in normalizing overall pelvic and spinal biomechanics.

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Chiropractic Care for Baby

Birth is generally a traumatic event for the baby. During the process, the body is "squeezed" through a relatively small opening compared to the size of the baby. This can result in serious injury which is not readily apparent, especially to the untrained eye. Chiropractic doctors can assess the spine for injuries which frequently occur during the birthing process. Immediate correction of vertebral subluxations and other abnormalities are necessary to prevent developmental problems for the child later in life.

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Exercise/Weight Loss Program

A common complaint after birth is the excessive weight gained by the mother during pregnancy. While some women do not find it difficult to shed the extra pounds gained during pregnancy, this is generally not the case for most women. Beginning a weight loss and/or fitness program not only improves the mothers health and fitness levels, but also helps mothers deal with the increased energy and psychological demands of raising a family. Many chiropractors find weight loss and health programs an integral part of the treatment program.

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Baby's Nutritional Requirements

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Breast Feeding vs. Formula

It's important for the new mother to understand the significance breast milk has on their baby's health. A great number of studies have consistently shown babies fed breast milk (compared to formula) are significantly healthier with a much lower incidence of sickness from various infections and diseases.

Breast Feeding Reduces Infant Illnesses

A recent study has shown that breast feeding significantly reduces the occurrence of common infant illnesses such as respiratory tract infections, pneumonia, ear infections, and gastrointestinal disorders. In the 2 year study of 977 babies, a community program was implemented which urged women to breastfeed their infants rather than use baby formula. The program resulted in a significant increase in breastfed babies - 54.6%, up from 16.4%. During this time, the number of babies who developed pneumonia in the first year of life declined by 33% and the cases of gastroenteritis decreased by 15%.

According to researchers, their results suggest that "breast milk itself or the process of breast feeding provides protection against infant illnesses." The American Academy of Pediatrics recommends that mothers breastfeed their babies for at least one year, "and longer if mutually desired by the mother and child."

1. Pediatrics 1998;101:837-844.

Breast milk is better for premature infants

Experts believe breast milk contains a number of immune-boosting compounds which "jump-start" the infant's immune system and assist the infant in fighting off infections. In this study, researchers found that preterm infants fed breast milk developed significantly fewer infections. 212 preterm, very low birth weight infants (under 3 pounds) were fed either breast milk or formula. After adjusting for all other factors, researchers determined that infants fed breast milk decreased their odds of infection by 57% - a dramatic decrease. Also, many immune system agents normally found in breast milk are in higher concentrations in the breast milk of mothers who deliver prematurely compared with mothers who delivery at term.

The American Academy of Pediatrics has long advocated the use of breast milk as the primary food source of newborn, full-term infants. In 1997, this advisory was extended to cover premature infants.

1. Pediatrics Electronic Pages 1998;102:e38.

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Iron

According to the American Academy of Pediatrics, women should breast feed until at least 1 year of age and should not feed infants under 1 year cow's milk. Doing this can lead to a deficiency of iron. However, most baby formulas now contain added iron to prevent this from occurring.

Vitamin A

Vitamin A (retinol) is available in liquid form and is also added to most baby formulas. Occasional supplementation in infants and children is recommended if deficiency is suspected. Research has shown a single dose of 100,000 IU (International Units) in children under 12 months of age and 200,000 IU in children over 12 months of age can reduce the risk of death from measles and, according to a study on Brazilian children, can help treat severe diarrhea.

  1. Butler JC, Havens PL, Sowell AL, et.al. Measles severity and serum retinol (vitamin A) concentration among children in the United States. Pediatrics 1993;91:1176-1181.
  2. 2
  3. Barreto ML, Santos LM, Assis AM, et. al. Effect of vitamin A supplementation on diarrhea and acute lower-respiratory tract infections in young children in Brazil. Lancet 1994;322(Jul 23):228-231.

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Vitamin B's

Vitamin B is passed to the fetus and to the baby (via breast milk) by the mother. Thus, if the mother is deficient so to can the baby become deficient. In the case of mothers with vitamin B deficiencies (more common in vegetarians and vegans), supplementation may be necessary for mother and child.

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Vitamin D

Vitamin D is another vitamin in which there may be a deficiency. Generally, a deficiency is most common when the mother is a vegetarian and/or lacks adequate sun exposure. In both cases, supplementation of the mother and infant is recommended. Also, mothers who breastfeed may spend 15 minutes in the sunlight daily to increase their vitamin D levels.

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Vitamin K

In some infants and neonates, including those with certain malabsorption disorders, vitamin K deficiency may occur. This can lead to unexpected hemorrhagic disease (bleeding). Often, babies are given intramuscular vitamin K shots at birth to prevent this condition.

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Zinc

Zinc deficiencies can occur in infants whose mothers are deficient in zinc or if there exists a problem with zinc uptake from the mammary glands in the mother's breasts. Zinc deficiencies are also common in premature infants and children with malabsorption syndromes. Zinc deficiencies are generally not found in infants who breastfeed, assuming the mother is not deficient. Signs of deficiency include:

  • skin lesions (appear as diaper rash or candida)
  • diarrhea
  • growth failure
  • alopecia (baldness)
  • irritability
  • anorexia

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