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Good Head Posture Will Help

October 11, 2010 By 1 Comment
What is “Good Head Posture?”

Have you ever noticed how many people have terrible posture? One of the most common faulty postures is called “forward head carriage” or “anterior based occiput.” Other terms are “hump back” or slouching. There are several reasons for this common postural fault. One is the weight of the head is, on average, approximately 10-13 pounds and if it’s positioned too far forwards, the muscles in the upper back and neck tighten up much more than normal, fatigue and become painful. Also, the muscles that attach to the skull have different degrees of strength. They also attach and pull at different angles, contributing to the common forward head carriage posture. The muscles of the chest are much stronger than those in the mid and upper back and tend to pull our shoulders forward. The following pictures offer a good view of both a faulty posture as well as a “good” posture. Notice the forward shift in the line in the pictures of poor posture and backwards shift in the good posture pictures.
As you can see, the weight of the head is back over the shoulders and the shoulder posture is appropriately positioned back in the image titled “Good Head Posture.”
Forward Head Carriage 

Good Head Posture
         




                  



          

          

 
 




Forward shoulders



Good Shoulders Posture
It is important to understand correcting Forward Head Carriage takes time – in fact, it takes a minimum of 3 month before this becomes an automatic new “habit.” Of course, it could take longer or, completely fail IF you are not VERY conscientious about CONSTANTLY reminding yourself to position your posture as shown above in the “Good Head Posture” image (above). An exercise based on this posture correction technique is performed by retracting your chin / head as far back as you can and holding that position for 5-10 seconds. Doing this multiple times a day, between the time you maintain a partial chin tuck (“Good Head Posture”) position will further facilitate the posture retraining process.

Dr. Cilea is president of Advanced Wellness, an integrated practice that offers chiropractic care, physical therapy, pain management, acupuncture and massage therapy. To find out if you are a candidate for their customized treatment approach call 732-719-8148 or visit www.advanced-wellness.net.

Filed Under: acupuncture, chiropractic care, Dr. Joseph Cilea, Good Head Posture, massage therapy, pain management, physical therapy

What is Vestibular Rehab?

February 23, 2010 By Leave a Comment

By Mary Ann Gargano

When people think of physical therapy, most will think the usual: rehabilitation after shoulder or knee surgery, treatment for neck or low back pain, etc.  The general idea with physical therapy is to get the patient back to normal function.  However, most will not realize that Physical Therapists treat a vast patient population, including those with traumatic head injury, stroke, open heart surgery, various orthopedic disorders, and even Vestibular dysfunction.

Vertigo, (a sense of spinning/movement within a still environment), is characterized as a Vestibular disorder.  Our Vestibular System connects the workings of our inner ear and a specific part of our brain and helps us maintain our balance.  Vertigo is a very common complaint and can be the result of many different diagnoses.  A visit to a medical doctor is in order when someone is experiencing feelings of dizziness, or balance issues. Once a doctor determines whether the diagnosis is a Central Nervous System Disorder vs. a Peripheral Vestibular Disorder, he or she will usually prescribe medication and/or Physical Therapy. 

The most common Peripheral Vestibular Disorder, Benign Paroxysmal Positional Vertigo (BPPV), is a type of vertigo that is characterized by spells of vertigo that are of short duration (30-60 seconds), positionally induced (rolling, lying, getting out of bed, lying in a reclined chair, etc.), and commonly occur spontaneously.

The most common form of BPPV is Canalithiasis.  This is a condition where the canaliths (tiny particles of calcium carbonate) become dislodged from a part of the inner ear, and collect within the semi-circular canals, triggering false signals to the brain that your head is still moving even after it stops, causing dizziness and other symptoms. 

The type of therapy used for Canalithiasis is called CRP (Canalith Repositioning Procedure).  CRP was first described in 1992 by John M. Epley MD, and is referred to as the Epley Maneuver.  This therapy involves taking the patient through a series of head position changes that move the canaliths from the canal to the utricle.  The canaliths may then re-adhere to a special membrane, or possibly dissolve or break up, or move some place where they can’t cause symptoms.  The positions involve specifically patterned head and trunk movements and are performed while the doctor or therapist closely watches the patient for eye movements with each position change.  Once the canaliths are repositioned, the patient is offered special precautions in order to ensure that these particles remain in their new position.

The approximate cure rate for CRP is 80%.  The occurrence rate is low.  Usually one treatment is all that is necessary, but occasionally, additional treatments may be needed. Often times, symptoms of vertigo clear up on their own, and intervention is not necessary.

It is always recommended that the patient has had a recent physical examination, and up- to-date blood work, to help rule out other medical issues that may be contributing to their symptoms.

Our team of professionals, here at Advanced Wellness, is available to help with any questions or concerns you may have about your health.  If you are having problems with vertigo, please call us at 732-431-2155, to schedule an appointment for an evaluation.

Filed Under: Dr. Joseph Cilea, physical therapy, vertigo, Vestibular Rehab

Health Update: Low Back Pain

February 6, 2010 By 1 Comment

What Do Consumers Say Works Best?
            
              We know that many people, in fact about 80%, hurt their back at some point in life.  In a recent survey by Consumer Reports (CR) (see the May 2009 issue), over 14,000 subscribers had low back pain (LBP) but no surgery to treat it in 2008.  More than half reported severe daily activity limitations for at least one week and 88% reported their LBP recurred throughout the year.

              Many indicated their sleep, sex life, and weight management all suffered as a result of LBP.  What is important about these findings is that once you have LBP, you’re probably going to have repeat episodes.  It’s the chronic, recurrent nature of LBP that makes it one of the most costly conditions to the injured employee, the employers, fellow workers, insurance companies, and the health care system in general.  Of interest, most of the 14,000 LBP sufferers indicated they had tried 5 or 6 different treatment approaches.  When rating the degree of helpfulness of each type of care and, their overall satisfaction with the various health-care professionals, the hands-on therapies were the top rated, with chiropractic leading the list at 59%.  Physical therapists (PT) were next at 55% though later in the article a “very helpful” rating for PT was reported at 46% vs. massage therapy at 48%.  Acupuncture was listed at third with 53%, specialty physicians at 44% and primary care physicians were rated the lowest at 34%.  Medications by prescription “helped a lot” in 44% and about 22% were helped by over the counter medication.  It is ironic that other reports have indicated that only about 15% of people with LBP go to chiropractors when research, consumer satisfaction as indicated here, and all of the international guidelines have recommended that chiropractic be considered as one of the first approaches in the management of non-surgical LBP.  What is the hesitation?

              Other interesting points in the article include that most of the LBP sufferers that elected not to seek treatment (about 35%) did so because of cost concerns or the belief that professional care would not help. Both research and the majority of the 14,000 who tried chiropractic said it helped and a LBP case was reviewed emphasizing this point. The case example emphasized the value of periodic chiropractic treatment for a worker in a heavy physically demanding job and the benefits he received from a treatment every few weeks, indicating this approach, “…is able to keep his back pain to a minimum.”  Another important point was that 44% of the 14,000 consumers reported exercise was helpful, and this represented the top placed self-help measure.  Moreover, 58% indicated they wished they had included more exercises to strengthen their back in the past year.  Chiropractic management of back pain and other musculoskeletal conditions includes exercise training during the care rendered for LBP.

              The article concludes with caution about back surgery, and references a separate CR survey completed in 2006.  They reported 60% satisfaction in about 1000 LBP consumers that had surgery in the prior 5 years compared to hip or knee replacement satisfaction at 82%. Additionally, more than 50% reported at least one problem during recovery, 16% had no improvement at all, while 8% were worse. The recommendation of obtaining at least 2 opinions was suggested prior to under going surgery, preferably one from a non-surgeon.

              Therefore, if you, a loved one, or a friend have not yet utilized chiropractic for LBP management, the time is now as all the evidence points to chiropractic as yielding the highest level of satisfaction and activity restoration for LBP sufferers.  This recommendation may be one of the most important acts of kindness that one can give to another person.

Filed Under: Dr. Joseph Cilea, low back pain, lower back pain, pain management, pain relief, physical therapy

Dr. Cilea’s Health Update: Carpal Tunnel

February 6, 2010 By Leave a Comment

Carpal Tunnel Syndrome (CTS)– A New Treatment Approach



Carpal Tunnel Syndrome or CTS, is the most common of the peripheral nerve conditions where the median nerve is compressed or pinched at the wrist.  The resulting symptoms of numbness/pain in the wrist, index, third, and forth fingers, multiple sleep interruptions, frequent shaking and flicking of the hand/fingers, difficulty in gripping or pinching such as buttoning a shirt, threading a needle, lifting a coffee cup, frequent dropping of objects, the inability to perform work duties – especially fast, repetitive work tasks can have a devastating effect on a person’s quality of life.

While treatments traditionally have involved activity modification, night splints, anti-inflammatory medication, and in advanced/severe cases surgery, a recent study comparing different vitamin approaches reports promising results with the use of alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA).  This combination was described as a logical early stage treatment aimed at “neuroprotection” or, to limit and correct nerve damage caused by CTS.  The doses utilized for 90 days in 112 subjects with moderately severe CTS were 600 mg/day of ALA and 360 mg/day of GLA.  This combination was compared against a commonly recommended multiple vitamin B complex that included 150 mg of B6, 100 mg of B1, and 500 mcg of Vit B12 per day for the same 90 day period.  Questionnaires regarding CTS symptoms and function and electromyography (EMG) were utilized to track the outcomes in the study.  The ALA/GLA treated group was statistically significantly improved when compared to the other B-complex vitamin approach.  This included significant improvements in both symptom scores and functional impairment compared to only a slight improvement in the vitamin B group.  Similarly, EMG was significantly improved in the ALA/GLA and unchanged in the vitamin B group.
             
Because there are many contributing causes of CTS, a multi-dimensional treatment plan will usually yield the best long-term results.  Because repetitive motion / cumulative trauma are often associated with the onset and perpetuation of CTS signs and symptoms, ergonomic issues must be addressed.  This includes perhaps a period of time when slower “light duty” work is necessary and consideration for workstation modifications, when feasible.  Because most people do not ‘run to the doctor’ with the early signs of CTS, over time, many CTS patients develop abnormal movement patterns by minimizing hand/wrist motions. Instead, they start to shrug the shoulder and lean the body to one side.  Hence, management addressing neighboring joint problems at the elbow, shoulder, and neck is needed.  A condition called “double-crush” where the nerve is pinched in more than only at the wrist but also at the elbow, shoulder, and/or neck results in a significantly worse CTS presentation.  These patients require treatment at all areas involved, not just at the wrist if long-term, satisfying results are to be obtained. 

Metabolic conditions including diabetes mellitus, hypothyroid, obesity, pregnancy, the use of birth control pills, and others also contribute or, can even by themselves cause CTS.  Chiropractic has traditionally viewed the body as a whole, treating the person from the ground upwards paying attention to posture, leg length, pelvic tilt, shoulder and head tilt.  The use of manipulation of not only the wrist and hand, but also the elbow, shoulder, neck and back has yielded the best results rather than focusing only on the hand/wrist.  The traditional use of night splints, work station/ergonomic modifications, as well as diet and exercise are also commonly addressed by chiropractors when managing CTS patients.  We take pride in providing quality, evidence-based care and appreciate the opportunity to do so when patients choose our clinic for their care and we realize there are many healthcare options available. The first step is to get an accurate diagnosis utilizing appropriate diagnostic testing.


Dr. Cilea is president of Advanced Wellness, an integrated practice that offers chiropractic care, physical therapy, pain management, acupuncture and massage therapy.  To find out if you are a candidate for their customized treatment approach call 732-719-8148 or visit www.advanced-wellness.net.


Filed Under: Dr. Joseph Cilea, joint pain, pain management, pain relief, physical therapy

What is Kinesio Tape?

January 8, 2010 By 1 Comment

By Dr. Jeff Gontarski
“Few who watched the 2008 Beijing Olympics will forget the Gold Medal beach volleyball performance of Kerri Walsh and Misty May-Treanor. The black Kinesio tape atop Walsh’s 6-foot, 3-inch frame, in stark contrast to her white bathing suit, also sparked a good deal of speculation.”
“Internet message boards made wild guesses. Was it a political statement or a sponsor’s logo? Perhaps a memorial to a deceased relative? Countless therapists knew the answer, but viewers were mystified. According to several reports, Walsh’s therapists used the tape to stabilize the superstar’s surgically repaired shoulder and boost blood circulation.” A quote from the article, “Kinesio Tape Comes of Age.” by Greg Thompson.
At Advanced Wellness of Marlboro, Kinesiotaping techniques are used for multiple ailments such as low back pain, plantar fascitis, knee alignment, pain issues and numerous others. “ Taping techniques are quick, easy, comfortable and allow the patient to get back to there activities of daily living faster” say Dr. Jeff Gontarski PT, CEAS, physical therapist at Advanced Wellness. “Our taping methods also help patients with posture and everyone is amazed with the results.”
The specialized tape works in different ways depending on its’ intended use. For patients with pain and inflammation, tape is applied to relax the skin and underlying tissues to allow for increased blood flow. Patients with instability problems can easily have their problems corrected by aligning the joint properly and securing with kinesiotape. “ The tape is a specialized tool and should be applied by a trained professional according to your problem” says Dr. Jeff.
If you have any questions about Kinesiotape and are wondering if it could help your problem, please contact one of our clinicians at Advanced Wellness.

Filed Under: health, pain management, physical therapy