 Pain in pregnancy is very common: - 50-85% of pregnant women have low back pain - 20% of pregnant women have pelvic girdle pain This pain can be felt in the w hole region of the hips, buttocks, and run down the legs into the feet.  WHY? There are several reasons back pain and dysfunction is so common during pregnancy. 1. Biomechanical Changes: aka body changes. Normal weight gain is between 20-40lbs during pregnancy combined with a shift in centre of gravity that puts extra strain on the low back and pelvis. As your baby grows, so does your belly and the curve in your low back which alters your posture as your body compensates for these changes. Along with the growing belly is a stretching of your abdominal or core muscles which changes the stress placed on the low back. 2. Hormonal and Circulatory Changes: aka adapting for baby. Relaxin is one of the many hormones that change during pregnancy and is responsible for allowing your joints and muscles to relax to allow for the passage of baby through the pelvis. This can contribute to the discomfort of the low back muscles, spine and pelvis. There is also an increase in blood volume as much as 50% which can cause inflammation and water retention (swelling or edema). What is Chiropractic Care for Pregnancy? Low back, pelvis and hip pain are most often caused by neuromusculoskeletal dysfunction which chiropractors are expertise at treating. Chiropractors provide pain relief during pregnancy without the use of medication and provide holistic advise to maintain health before, during and after pregnancy. This includes safe and effective care tailored to each individual pregnant woman, education and advice on diet and exercise. We look at as sleep position, posture and movements to be mindful of during pregnancy and while caring for an infant. Our office has specialty pregnancy pillows which allows for pregnant bellies to safely and comfortably lie on during assessments and care. Is chiropractic care safe during pregnancy? Yes! It is safe for all three trimesters and a benefit for the fourth trimester as well. Care will not harm the fetus in anyway and has been shown to improve overall function, quality of life, and is associated with easier, safer birth with less pain medication and less intervention. (See pictogram at the end for more details). Chiropractic care studies have shown that 75% of pregnant patients who receive care during their pregnancy experience pain relief AND on average have shorter labour times!  The late Dr. Jeanne Ohm who taught the Webster Technique to many chiropractors who share the same passion for caring for pregnant patients and families. What is Webster Technique? The Webster Technique is a chiropractic analysis and adjustment of the pelvis and surrounding soft tissue that is safe to use during pregnancy. The main purpose of the Webster Technique is to reduce the pelvic (sacral and sacroiliac joint) dysfunction discussed above leading to improved biomechanical function of the sacrum and pelvis. Pelvic biomechanics may play a role in the positioning of the infant in utero. With misalignments, the body compensates creating tightening and torsion of the round ligaments that attach from the pelvic bone to the uterus as well as surrounding muscles and ligaments. This may lead to constraint within the uterus that prevents baby from assuming the best possible position of birth. This technique uses pregnancy pillows which allow pregnant patients to safely and comfortably lie face down during the analysis and adjustments. The Webster Technique also uses soft tissue therapy and joint work in the back, pelvis, and abdomen to allow for proper alignment and function of the spine and pelvis as well as surrounding tissues. Treatment is gentle but has impactful results including decreased pain and improved biomechanical function of the lower chain. Is This Treatment Right for You? Knowing there is safe and effective treatment for pain and discomfort of the low back and pelvis during pregnancy is a great first step. Please reach out to any Webster Certified Chiropractor or your healthcare provider to see if you could benefit from care. For more information, visit the International Chiropractic Pediatric Association (ICPA) website.  Disclaimer: The advice provided in this article is for information purposes only. It is meant to augment and not replace consultation with a licensed healthcare provider. Consultation with a Chiropractor or other primary care provider is recommended for anyone suffering from a health problem. References 1. Aldabe D, Ribeiro DC, Milosavljevic S, Dawn Bussey M. Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review. Eur Spine J 2012;21(9):1769-76. Epub 2012 Feb 4. 2. Stuber KJ, Wynd S, Weis CA. Adverse events from spinal manipulation in the pregnant and postpartum periods: a critical review of the literature. Chiropr Man Therap 2012;20:8. 3. Canadian Chiropractic Association. https://www.chiropractic.ca/blog/chiropractic-treatment-for-pregnancy-pain/. 2020 May 22. 4. Borggren, C.L. Pregnancy and Chiropractic: A Narrative Review of the Literature. Journal of Chiropractic Medicine. 2007; 6: 70-74. 5. International Chiropractic Pediatric Association. A Webster Technique: A Sought Out Technique for Pregnant Women. ICPA Family Wellness First. 2014. 6. Pistolese, R.A. The Webster Technique: A Chiropractic Technique with Obstetric Implications. Journal of Manipulative and Physiological Therapeutics. 2002; 25(6): 1-9. 7. Ohm, J. The Webster Technique: Definition, Application and Implications. Journal of Pediatric, Maternal and Family Health. 2012: 49-53. 8. Sabino, J. Pregnancy and Low Back Pain. Current Review in Musculoskeletal Medicine. 2008; 1: 137-141.
0 Comments
 "Why does a baby need chiropractic care?" This is something many people will ask. The reasons are the same as for an adult, stress on the neuromusculoskeletal system (it just shows up differently in their bodies than in an adult). The birth process, even one without any interventions, can produce stress on an infant's developing spine, especially the neck and pelvis. These irritations or stress can cause many health complaints. This includes what is known as torticollis (head turning preference) which can more easily be identified as one side breastfeeding preferences. If this condition persists and little one will only lie facing one direction, it can lead to plagiocephaly otherwise known as flat head syndrome (more on that in another blog). Another cause of head turning preference is caused by one of the muscles in the neck called the sternocleidomastoid muscle (SCM) for short may become hypertonic or tight, causing neck to be tilted and rotated to the opposite side and making other movements difficult. Dysfunction of the TMJ or jaw can also lead to latching issues if baby is unable to fully engage the mouth in the sucking action or even able to fully open their jaw.  "You adjust babies!?" Chiropractic care for infants is a gentle technique that is very different from an adult adjustment. If you think of the structure of an infant spine versus an adult spine, they are very different and care is modified for these differences. Chiropractors are trained during their 4-year curriculum about pre-and ante-natal care. This includes topics such as embryology, genetics, congenital and developmental defects, maturation of the skeletal system and more. There are also 50+ hours education on of paediatric diagnosis and management of antenatal care. During the 1-year internship, students care for patients of all ages with the close supervision of an experienced chiropractor.  "What is chiropractic care for babies?" Chiropractic care includes the assessment, diagnoses, and management of neuromusculoskeletal issues babies are facing. At your little one's appointment, there will be a review of their health history including the birth history and pregnancy history. A physical exam will also be performed to determine where the dysfunction is and any treatment necessary. After sharing the findings and reviewing informed consent for care with the parents, care options will be presented. The management of any issues may include safe and gentle modified pediatric-specific adjustments, soft tissue therapy, gentle mobilizations, exercise, postural corrections and lifestyle counselling for the parents to help their little one maintain a properly functioning nervous system.  "What health complaints are commonly seen?" Chiropractic care for babies commonly sees complaints of nursing difficulty, poor latching, muscle imbalances, head rotation preference, plagiocephaly, and general spinal health checks. It is important to know that your child's spine and nervous system grow more than 300% in the first three years and many developmental milestones are being met which create movement and neurological patterns within their brain and body. Each milestone grows upon the previous one. For example the ability to hold their head up creates the curve within their neck and builds strength and neuro-communication to the brain. As children grow and explore their world, many experience injuries such as bumps, falls, and bruises. These are important times to have your child checked by a chiropractor. For more information, check out the International Chiropractic Pediatric Association website here. Disclaimer
The advice provided in this article is for information purposes only. It is meant to augment and not replace consultation with a licensed healthcare provider. Consultation with a Chiropractor or other primary care provider is recommended for anyone suffering from a health problem. References
 Soft Tissue Therapy Soft tissue includes muscles, ligaments (attachment of bone to bone), and tendons (attachment of muscle to bone). Sometimes these soft tissues can show tension due to compensation of poor posture, physical injury, strain or sprain from a specific acute or repetitive activity. Tension can be related to pain production, discomfort, movement disorders and create trigger points. Trigger points can refer pain and create dysfunction and is more commonly known as a kink or knot. Soft tissue therapy involves pressing and kneading of the soft-tissue structures with the hand or instrument. The goal of this therapy is to decrease pain and spasms, correct abnormal posture, improve circulation and reduce inflammation and prevent injury. Blood flow increases at local soft tissue therapy which contributes to clearing damaged cells, supplying tissues with oxygen and nutrients which leads to tissue healing. Soft tissue therapy can reduce stiffness and dysfunction and promote increased range of motion. It has been found to improve short term trigger point pain. References
1. Piper S, Shearer HM, Côté P, et al. The effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury management (OPTIMa) collaboration. Man Ther. 2016; 21:18-34. 2. Montañez-Aguilera FJ, Valtueña-Gimeno N, Pecos-Martín D, Arnau-Masanet R, Barrios-Pitarque C, Bosch-Morell F. Changes in a patient with neck pain after application of ischemic compression as a trigger point therapy. J Back Musculoskelet Rehabil. 2010; 23(2): 101-4. 3. McMurray J, Landis S, Lininger K, Baker RT, Nasypany A, Seegmiller J. A comparison and review of indirect myofascial release therapy, instrument-assisted soft tissue mobilization, and active release techniques to inform clinical decision making. Int J Athl Ther Train. 2015; 20(5): 29-34. 4. Vernon H, Schneider M. Chiropractic management of myofascial trigger points and myofascial pain syndrome: a systematic review of the literature. J Manipulative Physiol Ther. 2009; 32(1):14-24.  Education Education is an important part of a person feeling empowered and equipped to make choices regarding their health. This includes information about what issue is bothering them, advice for prevention, knowing why they are experiencing pain and what to expect with care. This is a part of every patient experience whether the patient is a newborn or experiencing chronic pain. Not only does education empower patients to help themselves, it also reduces emotional distress regarding their health as well as decreases need for additional health care visits. Education involves postural advice, movement advice, and strengthening advice as well as learning about the body-brain connection and how we experience pain. Separating pain from tissue injury can be beneficial for people with chronic conditions.  Part of education is related to overall wellness. Proper nutrition, exercise, sleep, and hydration are important things to learn and your chiropractor can help you. There is a lot of information available in the world but having it be tailored to you and your needs will allow you to achieve your health and wellness goals. And if there is someone that would be better apt at providing guidance to you, a referral to another healthcare professional will be provided. References:
1. Emilio J. Puentedura PT, DPT, PhD & Timothy Flynn PT, PhD (2016) Combining manual therapy with pain neuroscience education in the treatment of chronic low back pain: A narrative review of the literature, 2. Traeger A.C., Hubscher M., Henschke N., Moseley G.L., Lee H., McAuley J.H. Effect of primary care-based education on reassurance in patients with acute low back pain: systematic review and meta-analysis. JAMA Intern Med. 2015;175(5):733–743.  Kids and teens can experience back pain like adults do. This may include musculoskeletal pain, injuries to back, neck, knees, shoulders, overuse of muscles or repetitive movement injuries. Most of these injuries are preventable including falls, sports, day-to-day life, and improper backpack wearing. Chiropractic care can help treat the injury but also help prevent reoccurrence and future injuries.  Reasons Why Kids and Teens Seek Chiropractic Care: - Scoliosis - Headaches - Back pain - Knee pain - Growing pains - Sports injuries - Concussions - Neck pain - Injuries from falls - Wellness checks Many kids and teens that suffer from pain can experience more lost school time and lost school sport time. Chiropractic care is not only effective at relieving these symptoms but also determining the root cause and reducing the frequency of the pain.  The assessment and technique for kids and teens are similar to that of adults but gentler and adjusted to body and age of patient as well as development. Studies have shown that manual care is safe for both adults and children. Care many include gentle mobilizations, adjustments modified for body size and development, soft tissue therapy, exercise, postural correction, and lifestyle counselling. Postural correction and lifestyle counselling may be related to technology use and ensuring the body is in an ergonomically correct posture for especially when in prolonged positions (studying, playing video games, on tablets/phones). To see if chiropractic care would benefit your child, please contact a chiropractor in your area to learn more. References
1. Hayes NM, Bezilla TA. Incidence of iatrogenesis associated with osteopathic manipulative treatment of pediatric patients. J AM Osteopath Assoc. 2006;106:606–608. 2. Vohra S, Johnston BC, Cramer K, Humphreys K. Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics. 2007;119:275–283. 3. Miller JE, Benfield K. Adverse effects of spinal manipulative therapy in children younger than 3 years: a retrospective study in a chiropractic teaching clinic. Jour Manip Physiol Ther. 2008; 31(6):419–422. 4. Doyle MF. Is chiropractic paediatric care safe? A best evidence topic. Clinical Chiropractic. 2011;14(3):97–105. 5. Moore, Michael J., Gregory L. White, and Donna L. Moore. "Association of relative backpack weight with reported pain, pain sites, medical utilization, and lost school time in children and adolescents." Journal of School Health 77.5 (2007): 232-239.  Rehabilitation is part of every care plan. This is to make sure that once the pain, injury, or condition starts to ease, some of the disturbances behind this injury such as muscle imbalance, weakness, functional limitations, repetitive stress, can be corrected as well. This will help prevent future injuries by strengthening and balancing the body. Goals with rehab can include increased strength, flexibility, endurance, postural correction, balance, proprioception, range of motion and maintenance of proper motion of the spine and rest of the skeletal system. At home rehabilitation has been found to reduce pain, improve function, and improved outcomes. Rehabilitation is designed around you as a person and your history which is unique for every person. Compliance is required to allow for a faster recovery and prevention of aggravation. Having guidance from a professional at regular follow up appointments as well as modifying exercises as needed plays a role in improvement.  This is especially important during and post pregnancy. Not only does your body go through large biomechanical shifts in posture and gait, but also hormonal changes as well. This will change the activation of various muscles including gluteal muscles and abdominal muscles. Making sure your muscles and spine can handle these changes is important in order to have a pain free pregnancy and postnatal period. Once baby arrives there are different stressors on your body including posture for feeding, rocking, and carrying little one. These can create strains and pains, which is the last thing you need while enjoying the new addition to your family. To see if chiropractic care including rehabilitation is right for you, check with your local prenatal and pregnancy focused chiropractor. References
1. van Middelkoop M, Rubinstein SM, Kuijpers T, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J 2011;20: 19–39. 2. Hayden JA, van Tulder MW, Tomlison G. Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med 2005;142:765–75. 3. World Health Organization. Adherence to long-term therapies evidence for action: evidence for action. WHO library 2003, Switzerland. In: Karnad P, McLean S, eds. Physiotherapists’ perceptions of patient adherence to home exercises in chronic musculoskeletal rehabilitation. Int J Physiother Rehabil 2011;1:14–29. 4. Kale, Ashwini A., and Nawaj M. Pathan. "Effect of Core Stabilisation Exercises in Postnatal Women with Lumbo-Pelvic Instability." Indian Journal of Physiotherapy & Occupational Therapy 13.2 (2019).  Instrument Adjusting Instrument adjusting often uses an activator adjusting instrument. It can be used in management of osteoporotic bone fragility, for children, for patients fearful of manual adjusting that result in joint cavitation (aka “cracking”), for extremity adjusting, and for those who prefer not to be touched physically. There has been some evidence that shows benefits for patients with spinal pain and trigger points similar to a manual adjustment of trigger point soft tissue therapy. There have been reports of clinically meaningful improvements in patients with acute and chronic low back or SIJ pain, acute and subacute neck pain, TMJ disorders and trigger points in the trapezius muscles.  Thompson Technique Thompson technique (aka table assisted drop piece technique) uses a special table that “drops” during an adjustment. This allows for a lighter adjustment for the patient while using gravity to assist the spinal joints and other joints to restore motion. This technique also helps protect the patient from being over-adjusted. It is great for those who are nervous about manual adjusting, great for kids who require lighter adjustments, and for anyone! Diversified Manual Therapy This is the most common type of chiropractic care provided. It is a skilled movement of the hands to cause movement of the joints to help improve tissue stretch, increased range of motion, encourage relaxation, decrease pain, and reduce soft tissue swelling, inflammation or restriction. This movement of the joints may improve range of motion at the adjusted segment, decrease local inflammatory factors, and facilitate muscular control. Something that is associated with this type of adjustment is known as a cavitation. Cavitation is the scientific name for the popping/cracking nose that is heard when many people move their joints or with some manual adjustments. The joints that make this noise are called synovial joints which hold lubricating fluid called synovia as well as dissolved gases such as CO2, oxygen and nitrogen. When these joints move the capsule containing these things stretch or compress and gases are rapidly released from the solution of synovia and form bubbles. This creates that popping or cracking noise (not bones cracking).  Webster’s Technique The Webster Technique is a chiropractic technique used mostly for prenatal care. It involves the analysis and adjustment of the pelvis and surrounding soft tissue that are effected by the biomechanical, structural and hormonal changes that occur during pregnancy. The main purpose of the Webster Technique is to reduce the pelvic (sacral and sacroiliac joint) dysfunction leading to improved biomechanical function of the sacrum and pelvis. Pelvic biomechanics may play a role in the positioning of the infant in utero. With misalignments, the body compensates by creating tightening and torsion of the round ligaments that attach from the pelvic bone to the uterus. This may lead to constraint within the uterus that prevents baby from assuming the best possible position of birth. The Webster technique uses pregnancy pillows which allow pregnant patients to safely and comfortably lie face down during the analysis and adjustments. The Webster Technique also uses soft tissue therapy and joint work in the back, pelvis, and abdomen to allow for proper alignment and function of the spine and pelvis as well as surrounding tissues. Treatment is gentle but has impactful results including decreased pain and improved biomechanical function of the lower chain. References
Suvorova, Y. S., & Conger, R. (2017). MECHANISMS INVOLVED IN THE SOUNDS PRODUCED BY MANIPULATION IN SYNOVIAL JOINTS: POSSIBLE ROLE OF PH CHANGES IN LESSENING PAIN LEVELS. Chiropractic Journal of Australia, 45(3). American Physical Therapy Association 2014 Guide to Physical Therapist Practice 3.0. Alexandria, VA, American Physical Therapy Association Teodorczyk-Injeyan JA, Injeyan HS, Ruegg R 2006 Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. Journal of Manipulative and Physiological Therapeutics 29: 14–21. Cooperstein R, Gleberzon BJ. Technique systems in chiropractic. St. Louis: Churchill Livingstone; 2004, p243-4. Huggins T, Boras AL, Gleberzon BJ, Popescu M, Bahry LA. Clinical effectiveness of the activator adjusting instrument in the management of musculoskeletal disorders: a systematic review of the literature. J Can Chiropr Assoc. 2012;56(1):49-57. Pistolese, R.A. The Webster Technique: A Chiropractic Technique with Obstetric Implications. Journal of Manipulative and Physiological Therapeutics. 2002; 25(6): 1-9. Ohm, J. The Webster Technique: Definition, Application and Implications. Journal of Pediatric, Maternal and Family Health. 2012: 49-53.  What is Acupuncture? This is a technique where sterile needles are inserted into specific pressure points for the purpose of neuromodulation (or regulation of the nervous system). Chiropractors who use acupuncture have taken an additional 200 hours of formal training before being permitted to perform acupuncture. What does Acupuncture do? It is used to encourage natural healing, muscle relaxation, decrease pain and improve function in affected areas of the body. It has been proven to be helpful in many conditions including joint pain, back pain, migraines, and headaches. This can be a great additional modality that can be used to treat your musculoskeletal related pain.  Neck Pain Acupuncture has been shown to reduce pain in cases of chronic neck pain. Those who received chiropractic care with other modalities including acupuncture have moderately better pain reduction, greater patient satisfaction, and improved function, range of motion and strength. Headaches The treatment of acute or chronic tension0type headaches through acupuncture has been found to be effective. With acupuncture, there is evidence of reducing the frequency of migraine-type headaches when combined with symptomatic treatment. Low Back Pain Acupuncture has been found to be useful for relief of chronic low back pain and improved function versus conventional therapies alone and than no treatment or short term "sham" treatment.  Does Acupuncture Hurt? Despite what many people think, it is a gentle, painless treatment option and is safe during pregnancy. There are few side effects which may include skin irritation or bruising. For more information, please reach out to an acupuncture trained chiropractor or any other healthcare provider. Disclaimer
The advice provided in this article is for information purposes only. It is meant to augment and not replace consultation with a licensed healthcare provider. Consultation with a Chiropractor or other primary care provider is recommended for anyone suffering from a health problem. References
 I spent the day at Pickering High School in Ajax teaching students about the path to become a chiropractor and what being a chiropractor is all about. It was very inspiring to meet so many bright young minds that were interested in a career in the health field. The future looks bright and I can't wait to see what is in store for our youth.
|
Dr. TessaPassionate about educating and helping families on their pursuit of health and happiness. Archives
July 2022
Categories |
RSS Feed
