Weekly News & Insights

Tissue injury to the body is a common issue we see in our patients. It can be from a sports injury, such as improper lifting of weights, or one that occurs through repetitive stresses, such as sitting in an awkward position with poor spinal posture while performing work duties or by improperly going through a sports training.

In any case, injured tissues undergo physical and chemical changes that can cause inflammation, pain and diminished function for the sufferer, all in a short period of time, and can last indefinitely if not properly treated. Spinal manipulation, or chiropractic adjustment, of the affected joint and tissues, begins the process of restoring mobility, thereby alleviating pain and muscle tightness. This process permits tissues to heal naturally.

Evaluating the Patient

I find the most effective method to begin a treatment protocol is to evaluate patients through clinical examination, laboratory testing, diagnostic imaging, and other diagnostic interventions to determine whether chiropractic treatment is right for the patient’s condition. Sometimes, I refer patients to the appropriate health care provider when I determine that chiropractic care is not suitable for their condition. Other times, the condition warrants co-management in conjunction with other members of our health care team and we manage all necessary services within our clinic.

The primary focus of my chiropractic treatment, and any other procedures that we perform in our clinic, is to use the right approach to alleviate the health issue. That’s it!

Getting healthier is definitely about lifestyle improvement and the chiropractic adjustment is a powerful tool, but just one of many. The practice of chiropractic manipulative therapy is the most powerful tool that can be applied to physical conditions and does a lot of great things. However, it is not the end all/be all of healthcare. It has to be incorporated and used appropriately when needed, the same way nutrition, rehabilitation and anything else must be used to help a patient improve their health and well- being.

by Dr. Thomas M. Mitchell, D.C., CCSP | Owner, Clinic Director Chicago Institute for Health and Wellness Copyright ©

1. If you get injured, STOP PLAYING IMMEDIATELY! This is an extremely simple concept that those who get injured can put into action immediately and easily. “Suck it up” and “Walk it off” are not good strategies for caring for an injury.

2: The acronym RICE will help you remember what to do and in what order: RICE stands for: Rest it, Ice it, Compress it, and Elevate it. This is the gold standard in the athletic training world. Just to be clear: the ‘I’ in RICE stands for ICE, NOT heating pads and hot tubs. I would also like to add the letter “S” for the word “Support” to this acronym, as in the various support devices that help to stabilize the area. But, I believe the acronym RICES seems a bit strange and not as catchy for anyone to remember.

3: Seek out a health care professional or injury specialist. In this day and age it may be as simple as walking to the sideline. Many teams now have athletic trainers and coaches on staff that can handle the evaluation and, on occasion, care for some injuries. Side note: Athletic trainers do not receive the respect that they deserve. They are the top of the food chain when it comes to the evaluation of acute injuries, and they are often placed in difficult situations. They sometimes make life-altering judgment calls in a matter of seconds, and they, for the most part, do one heck of a great job. It is easy to criticize when you see an injury the next day in the comfort of a clinic, and the treatment plan and/or diagnosis might change, but that takes nothing away from what the trainer did for urgent care. I have tremendous respect for what they do!

4: Let your body heal! Jump back into the game too early because you feel “OK” and you will quickly learn what a second or secondary injury feels like. A complete healing cycle must occur for the injury to heal properly. This process can be accelerated but only through the help of a professional who treats injuries.

5: DO WHAT YOU ARE TOLD! I do not go to my tax accountant to receive tax advice and then flush that advice down the toilet and do whatever I want. In sports, this behavior can get you seriously injured. If you have recommendations from a professional, listen and implement the advice, including:

• Take the necessary time off to heal
• Follow the treatment protocol diligently
• Follow the rehabilitation plan to get yourself back to being able to perform

It’s sad to say but injuries do happen. Acute injuries can become chronic, and chronic injuries are the most prevalent cause of diminished sports performance. Decreased performance leads to the demise of the athlete. general, take responsibility for your health and seek help when necessary. Then you get to talk about what you are able to do now instead of what you “used to be able to do”.

by Dr. Thomas M. Mitchell, D.C., CCSP | Owner, Clinic Director Chicago Institute for Health and Wellness Copyright ©

If you are a newbie, planning to use sports to build stamina, or participating in a rigorous exercise program to build up your body strength, no matter what your age, here is some information you need to know. These are basic preventive measures to help you avoid injuries through warm ups, routine fitness check-ups and stamina-building exercises.

To begin with you need:

1. A Routine Physical Fitness Test.

Before beginning any new program, you should always consult your functional sports medicine doctor first and foremost. Usually, the human body tends to react negatively to any new activity, and when the activity is forced, it creates a stress on the body and sometimes results in injury. In talking with your doctor, you can go into your own personal health history to hopefully reduce the risk of injury. Depending on your age and physical condition, a stress test may be required. Have a “True” athletic physical assessment to assess any risk of potential injury. This is required because you must modify your sports exercise and body building programs according to your current health condition. Your doctor will advise you on how to set your limits and suggest not only the right exercise for you, but also tell you the stress level that your body can endure under your particular fitness regimen.

2. Increase your physical activity in phases.

After you’ve been cleared by your doctor, this is the second most important concept to understand. All too often many beginning athletes, with lots of enthusiasm, overexert themselves with vigorous exercising and develop fatigue from over exertion that they aren’t yet ready for. You wouldn’t ask a small child to carry something too heavy for them, would you? Then why push yourself into physical activity you’re not yet ready for? Participation in sports is not a one-day camp event nor is it the buzzer round of a quiz competition. You’re not going to walk on to a field or into a gym the first day and work like a pro. You must build to that strength level. When people participate in this mad rush and over-enthusiastic approach they often seriously hurt themselves. The wise approach is to start with warm-ups and stretches, as mentioned earlier, and start with moderate exercises for 20 minutes at the beginning, then work out three times a week and gradually build the tempo based on this initial, slow momentum.

3. Never work out on an empty stomach.

It’s a really bad practice to exercise or participate in vigorous sports immediately after having a heavy or moderately heavy meal. Just as they told you not to go swimming after eating when you were a child, similarly no sports or exercises should be undertaken on an empty stomach. You must eat at least two hours before playing the sport or working out. This will help you maintain the adequate energy levels that are required to exercise and avoid fatigue during the workout and during sports performance.

4. Drink Water Before You Exercise.

Dehydration is a great killer of personal enthusiasm and performance. Therefore, keep your body well hydrated. Drink at least 16 oz. of purified water two hours before you start your workout or your game, and drink water during your exercise or sports and performance to replenish the fluids lost during the exertion.

5. Listen to Your Body as It Speaks to You.

If you experience any weakness, sharp pain or light-headedness while exercising or playing, do not ignore these symptoms. Pay proper attention to them. These signals are your body’s way of telling you that something is going wrong and you should take action immediately. If you ignore these warnings, that’s a sure way to develop severe and chronic problems and injuries. When you do not feel well, you should rest until your body recovers. If the body sends these signals repeatedly, get to your doctor right away.

6. Rest and Recover.

It is important to rest. Sleep is one of the best ways to recover your body’s energy level, but sleep alone might not be enough for some people with less stamina. If they work out too much for too long, it can lead to overtraining syndrome and possibly harm the body, by reducing the body’s immunity, instead of benefiting it.

7. Cross Train with Neuro-stabilization.

Human beings have a creative mindset. If they are asked to do the same work every day, they ultimately get bored. Similarly, people who perform the same exercises every day are prone to develop ‘workout boredom’. The best remedy for this is cross-training. It provides a complete workout for your body without overstressing certain muscle groups.

8. Wear the right gear for the specific sport.

You don’t wear workout sweats while going to a black-tie party, do you? No way! People would think you were nuts if you did! In the same way, wearing the proper sports gear and footwear is essential to prevent injuries as well as wearing the appropriate safety equipment, as advised by your coach or trainer. The proper gear is designed to protect from you from accidental injuries.

by Dr. Thomas M. Mitchell, D.C., CCSP | Owner, Clinic Director Chicago Institute for Health and Wellness Copyright © 2013

The first thing that you must understand is that there is a significant difference between an injury and physical soreness. As soreness is common, usually something you will feel directly after exercising, being in a game, or some other strenuous activity, you must become aware of what soreness feels like. It’s very different from an injury.

Injuries, on the other hand, are usually felt during an event and can hinder you from doing whatever you are doing, even after the event. If you are injured, when you try to resume normal workouts or game play, the damaged tissue continues to stress during any activity and you typically feel it at that time. The muscle or tissue becomes inflamed and that is something that you will notice as swelling in that part of your body. You will probably feel tenderness or a feeling of warmth to the touch.

You’re not expected to be an expert

Obviously, you’re not expected to be an expert on injury, but to know the difference between being sore and getting injured is something you must be able to determine. If you determine that you are injured, you must go to an expert for help. In the meantime, be extremely cautious! If you can’t recognize the difference between soreness and injury get yourself to an expert quickly to determine if you are sore or injured.

Please hear me clearly

I’m not saying that all nicks and dings that can occur whenever you are practicing or playing any particular sport need “medical” attention. But, injuries that go untreated can become lifelong issues. Rather than take chances with a lingering pain or discomfort from an injury, go see an expert.

by Dr. Thomas M. Mitchell, D.C., CCSP | Owner, Clinic Director Chicago Institute for Health and Wellness Copyright © 2013

From my viewpoint as a Chiropractic Physician who sees injuries daily, I think that statement is extraordinarily accurate. Wouldn’t you rather know how to prevent an injury than to deal with one after the fact, when you are in pain and suffering?

Whatever your answer is, do not worry. This book will take care of both situations. Here we’ll consider it all; from food to form and function. We’ll help you in every way, to put it all together for both the athletically inclined and for those who just want to get healthier.

Let’s analyze what’s required to prevent injuries in different situations.

The risk of injury will be significantly reduced by completing an effective warm up consisting of exercises that increase your heart rate and get your pulse up, followed by sport-specific, dynamic stretches (stretches while moving).

To further reduce the risk of injury:

• Eat correctly for your body and your sport!
• Apply Neuro-Stabilization Training.
• Receive proper coaching.
• Take at least 1 day off per week from your particular sport activity to permit the body to recover from the stresses.
• Use the right gear. You need to wear proper protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. This is basic, and younger athletes shouldn’t believe that protective gear protects them from performing dangerous or unwise activities. Nothing protects us from our own stupidity when we show off to others
• Build your muscles. Performing conditioning exercises before games and during practice strengthens your muscles that get stressed during the game.
• Improve your overall flexibility. Stretches before and after games or practices tend to benefit your body by increasing flexibility.
• Use proper playing technique. This must be reinforced during the playing season and coaches must enforce this for player longevity.
• Take breaks. Your body needs rest periods during practice and during games. These will reduce injuries and prevent heat illnesses.
• Follow safety rules. Certain sports have ‘rules’ for safety including no headfirst sliding (softball and baseball), spearing (football), and body checking (ice hockey).
• Avoid injuries from heat by drinking plenty of fluids before, during and after exercise or games.
• Decrease or stop practices or competitions during high heat/ humidity periods.
• Wear light clothing during brutally hot weather.
• And, above all, stop the activity if there is pain.

Prevention is something that all athletes can grasp. No one wants to get hurt: of course not. But no one can guarantee that reading this book will ever stop you from getting hurt. What will happen (hopefully) is that you will learn how to take care of yourself if you do get hurt and maybe how to make sure it doesn’t ever happen again. No matter what sport, activity or walk of life you work in, I think we can all agree on preparedness and care as beneficial toward prevention.

by Dr. Thomas M. Mitchell, D.C., CCSP | Owner, Clinic Director Chicago Institute for Health and Wellness Copyright © 2013

INJURY PREVENTION: Don't neglect your nutrition

In general, food is often neglected or overlooked when, in fact, it should be the cornerstone of your routine. As an athlete, your body requires certain nutrients so that it can be prepared to perform at its best. That being said, don’t ever go out and grab the first diet/nutrition plan you see.

Everybody is different and so are athletes. What works for one may not work for another. I believe that having a customized nutritional program is your best bet to ensure that it’s tailored to your specific needs and your particular sport involvement.

Often poor nutrition is the cause of injury, and this type of injury doesn’t go away all by itself. These are the injuries that linger and you may never feel the same again if you don’t take proper action. Injury can also lead to chronic inflammation, which results in further injuries that your body can’t repair properly.

Its far more critical than you know

In short - make sure that you eat the right foods. It’s far more critical than you know. If you don’t have the right nutrients to perform your energy levels will be low, and you may sustain an injury. If you don’t have the proper nutrition, it will be more difficult for you to recover after exercise or injury. If you get hurt and your nutrition doesn’t feed your cellular structure, the tissue can’t be repaired and that may lead to a whole slew of other problems. If the tissue doesn’t heal properly, it can’t perform at its optimum, and optimum performance is what you strive for in your sports involvement.

Then, when you try to push yourself through your routine exercises, like you always would, you might end up hurting yourself. Damaged tissue is an injury. When it comes to food, getting what you need, and getting it at the right time, in the right form, can help you avoid injury. If you do get hurt, the right food can help in the reparation of damaged tissues.

by Dr. Thomas M. Mitchell, D.C., CCSP | Owner, Clinic Director Chicago Institute for Health and Wellness Copyright © 2013

SIGNS AND SYMPTOMS

The Mayo Clinic staff (2016) states, the signs and symptoms of a concussion can be subtle and may not be immediately apparent. Symptoms can last for days, weeks, or even longer.

One very serious concern that people often miss about concussions is that the onset of symptoms may be delayed by hours or days after the initial injury.

People may experience the following symptoms with a delayed onset (Mayo Clinic, 2016):

• Concentration and memory complaints
• Irritability and other personality changes
• Sensitivity to light and noise
• Sleep disturbances
• Psychological adjustment issues and depression
• Taste and smell disorders

CHILDREN AND CONCUSSIONS

More research has been done on children and concussions since concussions with children are commonplace. As I have stated earlier, they should be treated within the appropriate time frames. It is sometimes difficult to diagnose a young child with a concussion, but you can look for these symptoms:

• Listlessness, tiring easily
• Irritability, crankiness
• Change in eating or sleeping patterns
• Lack of interest in favorite toys
• Loss of balance, unsteady walking

The American Academy of Pediatrics (2016) recommends that you call your child’s doctor for advice if your child receives anything more than a light bump on the head. If your child remains alert, moves normally, and responds to you, the injury is probably minimal and usually doesn’t need further testing. In this case, if your child wants to nap, it’s OK to let them sleep.

If worrisome signs develop later, seek emergency care. I would take this one step further because even a mild concussion should be evaluated for further treatment. Injuries in young athletes can be cumulative if not treated promptly, or if they return to play too early.

The Mayo Clinic (2016) recommends, and I agree, seeking immediate medical attention if you or someone you are caring for has a head injury and begins experiencing the following symptoms:

• Vomiting
• Headache that worsens over time
• Changes in his or her behavior, including irritability or fussiness
• Changes in physical coordination, including stumbling or clumsiness
• Confusion or disorientation
• Slurred speech or other changes in speech
• Vision or eye disturbances, including pupils that are bigger than normal (dilated pupils) or pupils of varying sizes
• Changes in breathing pattern
• Lasting or recurrent dizziness
• Blood or fluid discharge from the nose or ears
• Large head bumps or bruises on areas other than the forehead, especially in infants under 12 months of age

In any case, the concussion needs more than just a brief evaluation; the patient should be treated for the whole brain and not just for cognitive function. If other areas are damaged they must get the help, and the rest they need.

Reference: http://www.mayoclinic.org/diseases-conditions/concussion/basics/symptoms/con-20019272 (2016).

Recent evidence indicates that repeated concussions cause cumulative brain damage, and the damage shows up as chronic neuropsychological deficits which tend to result in social dysfunction, lost productivity time, and excessive healthcare costs (B W Benson et al. British Journal of Sports Medicine 2002).

Even though there has been a lot of hype in recent news, concussions are still vastly underestimated in the sports world. I personally feel that there needs to be an environment created where the patient/athlete is treated properly, not just sent home to rest with sunglasses, pain killers, and an ice bag on their head. Proper follow up is imperative.

Considering the growing incidents of concussions resulting from sports, it appears that there aren’t sufficient healthcare practitioners who treat concussions for neuro-functional control. Very few practitioners are doing anything to stimulate the areas of the brain that have been concussed for the injured person’s brain to recover more quickly with reduced long-term adverse, or life-threatening effects.

Treating concussions is a specialty in the field of sports medicine and it is one of the specialties at our clinic as well. Our approach is an integrative one, with physicians who initially treat the injury and later provide the aftercare needed for thorough healing. In my opinion, this is the best approach for treatment of concussions.

Recently, sports-related concussions have become a hot topic, because there is a lot of media exposure regarding pro athletes who have suffered from repeated concussions and exhibit the many debilitating effects of long-term damage that can happen with repeated concussions. To date, medical science does not comprehend the full impact and long-term effects of having multiple concussions.

In my clinic, I am regularly treating an increasing number of high school athletes with concussions.

According to researchers (They, et al. “Heads Up”: Concussions I High School Sports - a review, Clinical Medicine, and Research, 2004) high school athletes are more susceptible to concussions, and they take longer to heal. High school athletes seem to recover about one week slower than their college-age counterparts. These younger athletes are also about three times more likely to have a second concussion in the same season as the first one. We call this “Second Impact Syndrome” and it can be caused by trauma, as well as the chemical after-effects of the first concussion, as I mentioned earlier.

My strongest belief is that it is vital that athletes are properly evaluated immediately after the concussion, just as they would be for any other injury that requires emergency care. The fact is if you don’t get proper treatment, and you’re in a position for multiple concussions to happen, real damage can occur. The “gold standard” out there now is repeated evaluation, without any real care for the injured individuals. The lack of complete treatment options for concussions is sad and I believe more development in thorough and proper treatment is necessary to prevent further or permanent brain injury in these cases.

Warm-up is extremely crucial. A dynamic, generalized warm up is non-sport/ activity specific. These basic exercises that loosen up the entire body, increase overall blood circulation and lymphatic drainage and increase respiration. Examples of such exercises, include but are not limited to:

• High Knee Walking
• Leg Swings Squats: Lateral and Vertical
• Lunges
• Chin Tucks with Scapular Tightening
• Calf Raises and Toe Raises
• Wall Angels

STRETCHING

Don’t cut corners. Be sure to stretch. The purpose of stretching is to literally lengthen the muscle. Chronically shortened muscles don’t have the same amount of contractile force and don’t perform as well as muscles that are lengthened and provide full range of motion to joints. Stretching is performed after the muscles have been significantly warmed-up. Stretching should be a combination of static and dynamic activities.

Stretching in general helps to minimize injury, increases joint range of motion, creates flexibility in the muscles and increases muscular performance. Remember that your body has to be properly hydrated (at least 2 liters of purified water a day) to be flexible.

SPORTS/ACTIVITY SPECIFIC WARM-UP

Don’t jump from stretching to sprinting. Warm-up in the activity you are about to perform and take the time to do it properly and thoroughly. This allows your nervous system to adjust the muscles’ firing patterns for the activity. This also allows your body to increase blood flow to the area in demand.

Cold muscles don’t perform well and must be warmed up with increased blood circulation. With increased blood flow, comes the necessary nutrients and oxygen needed for performance. Cold muscles are less pliable and at high risk of injury. To maximize prevention and performance, warm up your muscles!