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By Dr. Mark Bodnar, B.Sc., D.C., FCCRS

How did this happen? At times you expect it. After hours of stacking firewood, shovelling the driveway or trying to lift something too heavy you're not surprised to feel painfully stiff and sore. The injury makes sense to you, and while the pain can be severe you're pretty sure you know why it happened.  Better yet, you think that by knowing what caused the injury you'll be able to avoid it in the future. If you just pay someone else to shovel the driveway or stay away from lifting furniture, you can avoid the next episode. But, at other times the pain comes without warning and without provocation. Everything seems to be going smoothly when, for no good reason, something goes horribly wrong.  Maybe you sneeze, or you bend over to pick up a sock and suddenly feel severe pain.

How did this happen and how can you avoid the pain if it comes on randomly? These are questions I hear frequently, and unfortunately many reading this article can relate all too well.  Well, there might actually be some logic underlying these painful episodes, and understanding why they happen is your best chance at avoiding them in the future.

There are several different factors that play a roll, but the three primary factors in this equation are strength, endurance and coordination so lets take a look at each one.

Strength: Lack of strength and excess strain, such as simply lifting something too heavy, is an obvious way to pull a muscle or rupture a disc. Surprisingly, however, simple overload is the least common cause of injury.

Endurance:  Endurance, or lack thereof, might be the most common cause of back injuries  Lifting 50 small boxes can do just as much damage as one big box because fatigue can make you sloppy.  As you get more and more tired your technique starts to suffer, you start bending awkwardly and that is when the injury happens.

Coordination: Poor coordination or proprioception is another significant injury trigger and often the cause of those unexpected episodes. Proprioception is the ability to know where your body is without looking – its what allows you to touch your finger to your nose with your eyes closed.  Imagine driving your car, with good control you stay in the middle of your lane and watch for traffic. However with poor control you might end up swerving to the edge of the ditch at one point, then almost into the guardrail the next.  It's obvious which one is more likely to end up in a crash if a car pulls out unexpectedly. Your back can suffer exactly the same way.  With good coordination you hold the joint safely as you bend to get that shoe from the back of the closet, but with poor proprioception you might think that you are bending in a safe way, but actually you have put your back in a risky position, one were the slightest nudge or slip can push you over the edge.

The last part of the puzzle is simply luck, or in scientific terms probability.  To go back to our car accident analogy – you might drive to work every day for 10 years without ever having a problem, but then one day someone runs a light and hits your car.  You ask “Why me? What did I do?” In reality you did nothing wrong at all, but probability tells us that everything comes with a risk and sometimes accidents just happen.  Your body is much the same. We regularly do things that might be risky, most of the time getting away with it, but eventually we get caught.

When you add all the factors together you can sum up your overall risk of injury, however none of the factors are black/white options.  As you fatigue the risk of injury goes up, if you are strong the heavy box is relatively easy to lift, with better coordination you are less likely to get hurt.  Add in probability and even the simplest activity could result in an injury if its just not your day!

The good news is that with the right exercises each factor in the equation can be improved.  We can build core strength and endurance and improve coordination with proprioceptive training to make sure you're as ready as you can be when life just happens.

Bedford Chiropractic, based in Bedford, Nova Scotia, offers full-service consultations, diagnosis and treatment plans for a variety of workplace, repetitive strain and other injuries. We treat pain to the head, neck, jaw, arm, shoulders, upper body, chest, lower back, legs and feet.  Contact us today at 902-835-6865. We serve patients in the Halifax Regional Municipality, including Halifax, Dartmouth, Bedford, Sackville and surrounding areas.

Jaw ProblemsHaving pain in the jaw makes eating, one of life's most routine but enjoyable experiences, a lot less pleasant.

Jaw problems typically originate either in the joint or in the muscles. Joint problems, technically called Temporal Mandibular joint Dysfunction (TMD), or muscle problems can stem from an injury, poor tooth and bite alignment or even chronic stress/tension.

• Symptoms can include headaches, jaw pain and difficulty chewing.
• Pain can be on both sides or just one.
• Treatment may also require dental management to address bite alignment.
• Jaw problems can be managed with mobilization, soft tissue therapy, or massage therapy.

Treatment
Treatment must always start with an appropriate diagnosis.

HeadachesTreatment should focus on the underlying cause of the pain, both the tissue causing the pain as well as the factors triggering the problem.  A combination of treatments, such as, massage, soft tissue treatments (Graston), manipulation/mobilization and/or home stretching exercises can be effective ways to reduce the tissue irritation.

We identify any aggravating factors and help you manage any issues through a program of self-care and prevention.

For a clinical assessment of your jaw pain, the triggers and best treatment options, please contact Bedford Chiropractic for an appointment.

See also:

Headaches
Neck Pain
WhiplashNeck Pain

HeadachesA vital connection between our head the rest of our body, the neck protects nerves that channel information from our brain to the rest of our body. Discomfort and pain in the neck makes working, recreation and getting a good night sleep a problem.

There are several tissues in the neck that can cause pain. Muscles, nerves, joints and discs are the most common.

Joint “sprain”

Between each vertebrae there are small joints that help guide motion. Excess stress/strain on these small joints can result in a joint “sprain” or irritation.

• pain can be sharp or dull, localized or referred
• often restricts range of motion (sometimes in very specific movements)
• frequently described as a “kink” or “pinch”
• very common injury

HeadachesMuscle or myofascial irritation

The head and neck are supported by an intricate web of muscles that provide mobility, stability and feedback on positioning. Prolonged periods or excess strain can injure the muscle fibres and lead to pain, tension or discomfort.

• can range from stiffness to severe pain. Either aching or sharp pain
• can restrict mobility
• very common, often happens in concert with joint injury

Disc injury

Often a problem in the lower back, the neck can also have disc issues. Ranging from a minor sprain to a severe herniation.

• can “pinch” or compress a nerve causing arm symptoms including numbness, pain or weaknesses into the arm or shoulder
• will often restrict neck mobility

HeadachesNerve “pinch”

Often pain referring down the arm is blamed on a “pinched nerve”. Nerves can be “pinched” in the neck from a disc injury, with osteoarthritis and degenerative changes or from an injury.

• typical nerve pain is severe and sharp/stabbing
• can cause numbness, total loss of feeling or weaknesses
• true nerve compression is not very common. More often pain referral stems from muscle, joint and disc problems – even if the nerve is not being directly affected

Depending on the specific area and tissue in the neck that is injured pain can radiate into the upper back, the arms, the chest or up into the head.

Treatment
Treatment must always start with an appropriate diagnosis.

HeadachesTreatment should focus on the underlying cause of the pain, both the tissue causing the pain as well as the factors triggering the problem.  A combination of treatments, such as, massage, soft tissue treatments (Graston), manipulation/mobilization and/or home stretching exercises can be effective ways to reduce the tissue irritation.

We can identify aggravating factors and help you manage any issues through a program of self-care and prevention.

For a clinical assessment of your neck pain, the triggers and best treatment options, please contact Bedford Chiropractic for an appointment.