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Dr. Johanna

Tinnitus, Teeth Grinding, and Jaw Pain

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Tinnitus, Teeth Grinding, and Jaw Pain
Getting in the way of sleep, focus and energy?

Over the years, we’ve met lots of patients who’ve experienced the terrible trio of tinnitus (ringing in the ears), teeth grinding, and jaw or head pain. As they know too well, these are usually chronic and debilitating conditions. Most of them didn’t know that we could help them until they asked.

Muscle tensions in these patients get “stuck” because the brain is reinforcing a signal to contract, contract, contract, contract. The pattern that we want is contract, relax, contract, relax, correlating with use and rest. For example, we need our jaw muscles to contract when we’re chewing or speaking, and to relax when we’re not.

The intervention that has worked for so many people entails a complete neuromusculoskeletal approach. Put simply, we use exercises to help regulate your nervous system, hands-on myofascial release to relax muscle spasms, and chiropractic adjustments or mobilizations to regain joint ranges of motion in your neck, head and jaw.

If you’re afflicted by any part of this terrible trio, then I imagine you’re waiting for the day when your concentration, focus, ease of sleep, and energy return to normal! Let’s give you a little more detail on how our approach results in alleviation of headaches, jaw and neck pain, ear ringing, and even reduction of teeth grinding.

Neurologic Approach

Factors like stress, anxiety, sleeplessness, and generally being overworked all contribute to a sympathetic nervous system dominance. The fight-flight mode becomes too pervasive and overrides our body’s ability to move back into the normal state of a parasympathetic (relaxed) nervous system. Our doctors train our patients in a number of appropriate exercises that incorporate eye movements, balance, and breathing techniques.

Muscular Approach

In order to break the cycle of muscle spasm, your body needs to receive the appropriate therapeutic contact. AMR (a technique called Advanced Muscle Reconditioning) works extremely well for these patients. It’s a hands-on therapy technique that relaxes the muscle trigger points that are commonly found around your head, neck and jaw. Sometimes, thickened adhesions build up in the muscles which renders them both tight and weak. For this problem, we often use a light scraping technique with Graston instruments.

Skeletal or Joint Approach

Chiropractic adjustments, or slower mobilizations, are usually the final step in a typical treatment session. In order to improve and render pain-free neck and jaw ranges of motion, our docs use their hands to apply the right amount of torque into a neck and/or head joint. Decades of academic research supports the observation that patients who receive chiropractic adjustments experience a calming input to their nervous systems and a relaxation of guarding muscle spasms around those joints.

Just as the debilitating aspects of these conditions arose gradually over time, the healing is also expected to take time to resolve completely. As doctors, we evaluate and offer a treatment plan that we believe, based on clinical experience, will resolve your problem as swiftly as possible. Patients respond at a rate that is dependent upon many health factors. Whereas some patients experience dramatic shifts early on in their care, others may shift more slowly over the course of treatment.

If I can answer any further questions about this topic, please don’t hesitate to reach me, Dr. Johanna Lelke, at DrJohanna@onsightchiro.com.

Achieve Balance

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Your Vestibular System

Did you know we spend 80% of our time walking on one leg and practically all of our time running on just one support. This is why it’s very important to develop a good balance system to keep all of our joints in alignment during these task, whether you are a runner or a fighting athlete. Before I give you some exercises here is a little something about the system that keeps us balanced: the vestibular system. Arguably the first nervous system to develop in the evolutionary process, it served the purpose of keeping us oriented in space as cute little jellyfish. The vestibular system takes input from three separate senses. The eyes, joints and inner ear. With that in mind, we want to strengthen and challenge the inner ear by removing the other two senses.

IF YOU FEEL WOBBLY PLEASE STAND CLOSE TO A WALL DURING THESE TO HAVE SOMETHING TO GRAB ON TO

Exercise 1: Single Leg Balance. Simply stand on one leg by bending the knee of the other leg backwards. That alone should be enough to make some of us wobble and if it does, you have to seriously consider doing these balancing exercises or at least getting tested for gluten sensitivity.

Exercise 2: Same as exercise 1, but this time close your eyes. This takes out our most dominant balance system, the eyes. We tend to overly rely on eyes to keep us balanced, but true balance should come from the inside.

Exercise 3: Finally do the same thing as in exercise 2, only on a soft uneven surface. I recommend an Airex pad for best results, but a pillow will do just as well. This takes out the steady input from your ankle joint and makes the exercise progressively harder. If you can hold for 30 seconds in this position your vestibular system is in great shape!

This article was written by Dr. Nick Predtechensky. He may be reached via email at DrNick@onsightchiro.com.

Knee Pain Solutions for Runners

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Having to Limit your Runs due to Knee Pain?

I may have the solution to your problem, but it will take a little work.

If you have been having pain on the outside of the knee or close to the knee cap after long runs, then chances are your muscles (gluteus max, mid, min and the TFL) are not doing the best job of stabilizing your hips. Same thing goes to all you lifters out there, if your hips are not stable, it’s the knee and ankle that end up paying the price.

Here is a quick and dirty rehab program:

  1. Hip Abductions: Start by lying down on your side and bending your bottom leg for stability. Make sure your hips are perpendicular to the floor and your pelvis is in neutral. While keeping your spine and leg straight start lifting the top leg to about 45 deg. You should feel a burn on the outside of your butt. Progress to an elastic band and then to standing.
  2. Hip Hikes: Find something to hold on to like a wall and stand next to it. If you have a platform use it like in the picture, but these work just as well on a flat surface. Stand on one leg and bring your opposite hip up to the ceiling. You should feel the burn in the exact same spot on the standing leg. Train until you can do 50 on each side, at that point you should be stable enough for even the most gruesome runs.
    Notes: It takes a while to build up the endurance in your glut muscles. The hip abduction must be in proper form to reap the benefits, which means the pelvis remains immobile during the exercise. Once you can do 30 good ones standing with an elastic band on both sides, then progress to the hip hikes. Don’t exercise this muscle every day and give it 24-48 hours rest for best progress.

    Your glutes make bodybuilders jealous, but you are still having knee pain? There is a number of other factors that could be contributing, such as ankle stability. Why not come into the clinic and we would be more than happy to figure out how to help you.

    Dr. Nick Predtechensky is the author of this blog. He may be reached at DrNick@onsightchiro.com.

Challenge It with a Resistance Band

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Resistance bands can be used to make exercises harder AND easier!

Something that we utilize heavily in our practice are resistance bands, like Therabands, because they are incredible versatile, yet don’t take up much space at all. As some of you know, my favorite is the looped band as it can be used for all of the exercises below without you having to go out and buy multiple bands. They also come in various thicknesses and can range from low resistance to high 20 lbs resistance. Here are my favorite ways to use them:

  1. Breathing

This one absolutely blew my mind when I did it for the first time. Lie on your back, hips bent at 90 and loop the band above your knees and gently push out against the resistance. Now take a deep belly breath. Feel that!? That incredible sensation of fullness of breath comes from proper activation of your core muscles. Every breath should feel this good.

  1. Making an exercise easier

Struggling with your basic core exercises? No worries, just grab a band let the tension help you complete the movement. You can do that with various core exercises or my personal favorite is taking a heavier band, wrapping over a pullup and under your feet and behold, that pull-up that you could never achieve can now be practiced in perfect form.

  1. Challenge Yourself

Finally, the part all you athletes out there love the most. Want to get more out of your hip abduction exercises, but not quite ready to move up to the hip hikes (more about that in the next post). Just take a elastic band, loop it around your thighs and see how many you can do now. Ready for more? Move the elastic band down to your ankles, provided you don’t have knee problems, and get more resistance out of the same exact band!

Hope you find these useful and go on amazon right now to get a band you’ll never get tired of using. The trick, after all, is to get creative!

Dr. Nick Predtechensky is the author of this post. He may be reached at DrNick@OnsightChiro.com.

Get Fired Up!

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Warm-ups in Detail

Here you are, about to start run, the weather is great, you got your favorite sneakers on or about to start a Pilates class and sweat enough to save California from any upcoming drought. Well hold up champ, before you jump into it you just might want to do a proper warm up first. We here at Onsight came up with 3 easy tips to make sure you are getting as much from your workout as possible without ending up face first on the pavement with a sprained ankle.

First off, start slow and gradually build up tempo. Imagine yourself as a powerful, unstoppable freight train that needs to build up momentum. This one goes out to all of you morning runners out there, there is no shame is starting just a bit slower than your normal pace, trust me.

Second do dynamic stretches whenever you can. This means instead of touching your toes you do leg swings. Start gentle and gradually work your way up like a pendulum. You can also swing your leg side to side, just make sure you are holding onto something. These are an especially better alternative you are going to do unpredictable movements, as in soccer, volleyball or fighting.

Third, do a little core before your main workout, even if it involves core down the line. Nothing serious, just a few seconds in plank and maybe Russian twists. Forget crunches, and if you want to know why, check out my earlier post on core exercises. This one is my favorite as I noticed in my workouts (even running!) that a little core can go a long way for better performance and muscle engagement.

Now go out and get sweaty! Did I miss any of your favorite warmups, let me know at drnick@onsightchiro.com

This article was written by Dr. Nick Predtechensky.

No More Crunches

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First of all, stop doing crunches.

This may make some people mad, but 90% of us don’t need to round our upper body into further flexion. I mean sitting hunched over is already what we do all day, don’t make it worse! A good core means you have a stable torso that stays stable during movement of the limbs and here is the single best exercise to begin developing just that:

Dead Bug Exercises

Lie on your back and press your lower back into the floor. This is the most important part: that back should be as flat as a pancake! Now bring both hands out in front of you and bring your hips to 90°  and bend your knees at 90°  (Figure 1). Now move one arm back behind your head and the opposite leg straightens until the heel just barely touches the floor (Figure 2). It looks like a bug after you sprayed them with a generous amount of insect repellant.

figure 1figure 2

Want to make it more challenging? Grab a swiss ball and now the stationary hand and knee are squeezing toward each other, squishing the swiss ball in between and really activating those abdominals.  (Figure 3).

Repeat these 10 times for 3 sets or until you feel that you can’t keep your back flat.

figure 3

Dr. Nick Predtechensky is the author of this post. He may be reached at DrNick@OnsightChiro.com.

Massage and your Lymphatic System, huh?!

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As if you need another reason to get a massage.

The lymphatic system is made up of small glands that spread throughout your entire body containing lymph fluid. This precious fluid contains B-cells and T-cells which create antibodies, destroy microscopic pathogens, and remove cellular waste. There is a higher concentration of these glands, also called lymph nodes, in the groin, neck, and armpits. The lymph system is similar in function to your circulatory system. Your heart pumps blood through your arteries, helping to circulate your blood. However, your lymph system has no pump to help it move along. That’s why you need exercise, dry brushing and massage to help the lymph to circulate!

Massage can increase lymphatic drainage by more than 50% of what it would normally do with just your daily movement. White blood cells increase with massage which strengthens the immune system. Keep your immune system strong and your lymph fluid moving (especially during the “cold season”) with a therapeutic massage!

Amanda Upchurch, Certified Massage Therapist, is the author of this post. She can be reached at Amanda@OnsightChiro.com.

Here’s a Few Tips on Getting Better Sleep!

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Sleep quality matters.

Nothing beats starting the day full of fresh energy and a good night’s sleep is the only way to do so. This is why we at Onsight put together three of our top tips backed up by medicine to help you slumber:

1)      Spend energy to gain energy

Did you know that 30 min of light to moderate cardio during the day improves sleep quality just as well as an over the counter melatonin supplement? But there is no better way to reset your bioclock than to do 3-5 min of intense exercise as soon as you wake up. Cranking out pushups just after getting out of bed may seem like a challenge, but you may be surprised how effortless your mornings may become.

2)      Manage your lights

Our sleep wake cycle is in part controlled by the hormone cortisol and the most reliable way to control the cortisol cycle comes from our age old friend – the Sun. Well at least it used to be the Sun until humans came up with artificial light, but don’t let Edison spoil your day. But this isn’t just about going to bed when it gets dark! The first thing I would do is download f.lux for your computer if you love to browse the web before going to bed and if that doesn’t improve your sleep than removing all the LED and other lights from where we sleep. F.lux will take out the blue hue from your screen, stopping the light from fooling your brain that its still daytime.

3) Eat well

For me personally, this has been the biggest one of them all. We all know that high carb meals are not great for us (especially if we are watching our weight) but high carb foods are absolutely devastating for keeping our blood sugar in check and can undermine our nightly sleep. So keep your last meal low carb and avoid any sugars and that alone may solve your insomnia. More importantly if you find yourself waking up in the middle of the night, try eating a tablespoon of peanut butter (no sugar of course) or coconut oil just before going to bed. It will help stabilize your sugar and stop you from getting up.

Still not satisfied with your sleep? There are a lot of factors that influence sleep and lifestyle choices that change your cortisol cycle and sometimes it takes a professional to navigate all the factors. Talk to us and we promise to help.

Dr. Nick Predtechensky is the author of this post. He may be reached at DrNick@OnsightChiro.com.

Hang Away the Pain

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Shoulder pain is a buzzkill.

Shoulder impingement, frozen shoulder and rotator-cuff tears are common reasons for a painful shoulder. Onsight Chiropractic is here to introduce a simple but effective method to add to your daily routine and get your shoulder functioning back to 100%.

The Method

The method is quite simple. Just hang. The goal is to hang from a bar for two minutes each day. Sometimes this number needs to be increased, but 2 minutes of body-weight hanging is enough to make physiological changes and see whether this method will help with your current issue. Some of you may be thinking that there is no way you can hang from a bar for 2 minutes straight. That’s okay! Splitting the time up into 10 to 30 second reps is okay as long as you hit that 2 minute goal. If 10 seconds is too difficult then start with putting one or two legs on a stool or other type of support as shown in the picture.  This will help take some of the weight off of your shoulders and let you work up to hanging from full bodyweight. Sometimes your local gym will have a pull-up machine that allows you to adjust the amount of assisted weight. In addition, you want to make sure that your hands are in the pull-up position (palms facing forward) and not the chin-up position (palms facing backwards).

This method can be easily added to your prescribed rehab routine of mobility and strengthening exercises. I prefer to do this as a warmup before an upper body workout, especially on “push days.”  Simply perform the hanging regiment before the strength or rehabilitative training. It will warm up the tissues and open up the joint space so you can use you can exercise without pain.

At first this may be painful on your shoulder joint, capsule and rotator cuff muscles. The force of gravity on these structures are stretching the tissues into a more favorable position for shoulder mobility. Similar to the feeling of braces in your mouth, the stretching may cause some discomfort. The more you challenge the  tissues the more your body will adapt to the discomfort.

***Disclaimer***

The hanging exercise is not recommended for persons with unstable or dislocating shoulders, for those in precarious physical health or with severe osteoporosis. If you have shoulder pain that goes unexplained for several weeks, you should obtain a proper diagnosis from your chiropractor.

-Dr. Edward Espinoza is the author of this post. He may be reached at DrEspinoza@OnsightChiro.com.

Importance of a Lumbar Roll

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A Work-Life Tip from Dr. Espinoza

95% of low back pain is biomechanical in nature. That means there are things we can do to reduce the amount aggravating positions in your low back. We have all heard to sit up straight and not to slouch when you sit. Easier said than done when you are working against gravity!  One of the simplest ways to encourage proper behavior is to use a lumbar roll when sitting, especially when sitting on a large soft couch. Placement of the roll or pillow is key to the success of this tip. Many times people place the roll too high for the pillow to do its job. We want to place the pillow in the lower half of the curve where the lumbar spine meets the pelvis or “belt line” for most people.  This can generally be easy to find as it is typically where the pain originates from. In addition, you do not need a fancy roll to get relief. Many times a throw pillow or rolled up towel will provide enough support to get the job done. Lastly, make sure you are also sitting back as far as possible so that you are on your hamstrings or ”sit bones” as opposed to your tailbone being curled under your body. Keeping the correct curve in your back is a great way to reduce low back pain and using a support pillow helps make this easy!

Dr. Espinoza, or Eddie as he prefers, can be reached at DrEspinoza@OnsightChiro.com