Caution: Do not attempt to perform this stretch without consulting with your chiropractor or physician – if you have a serious injury this activity may cause further injury.

Where is it? : Your adductor muscles are located on the inner portion of your thighs that assist in pulling your legs in and across your body.  The adductor group is made up of four muscles: pectineus, adductor brevis, adductor longus, and adductor magnus.  All of these muscles attach the pelvic bone to the femur and allow for adduction, or the returning of a body part towards you body’s center line from the side, which is the opposite of abduction, or the movement of a limb away from your body’s center line to the side.

Why should I do it? :  If the adductor muscles become too tight they can pull the pelvic bone out of place, causing anything from low back pain to sciatica; there is also the risk of the muscles around the knee becoming affected by bone and muscle imbalance, causing painful movement in the knees.  Stretching these muscles can relieve some nerve impingement, pain, numbness and tingling, and even muscle fatigue.

How do I do it? :  There are several different ways to stretch the adductor muscles, each type of stretch depending on how flexible you are.

The easiest way to stretch the adductor muscle group is to sit on the floor facing a wall or couch.  Place the instep of each foot against the wall or couch and, while keeping your legs straight, slowly move your body forward while widening the gap between your feet.  If you are using a couch you may use the cushions to pull yourself forward.  Keep widening your stance until you feel a stretch along the inside of your thighs that feels uncomfortable without being painful.  Hold for at least 30 seconds.

The second type of stretch you can perform is commonly referred to as frog splits.  Placing your knees and hands on the ground in a crawling type position, slowly move your knees directly apart from each other to the side.  Keep the bottom half of your legs bent so they are parallel to each other.  Hold for at least 30 seconds.

The third type of stretch you can perform is the splits.  Place your feet in a triangular stance, then slide both feet directly away from each other until you feel a stretch along the inner part of your thighs.  For this particular type of stretch you need to make sure your feet are both pointing forward, as tilting them up on the heel will cause some stretching of the hamstrings rather than concentrating on the adductors.  It is also important to note that this stretch can be stressful on the shoulders from the strain of holding the positing against gravity, as well as difficult on the knees.  It is important to consult with your doctor before trying this stretch, as it can be detrimental for some.

Helpful hints :  Because there are three levels to this type of stretch it is important to start at the most basic level first to prevent injury.  While there is little chance of you hurting your legs during the couch or wall stretch, there is a much greater chance of hurting your back or knees during the other two stretches.  I therefore recommend beginning with the simplest step and working your way up, no matter how experienced you are at stretching.  I also recommend consulting a doctor specifically about performing this stretch to prevent said injuries.

With a new year upon us once again it is time to make New Year’s Resolutions – the bane of every January, thanks to the difficulty we all have in keeping said resolutions.  Since most resolutions come with the idea of health reform in mind I’d like to offer a few suggestions on how to plan, execute, and achieve your personal goals for 2012.

We should look at what types of goals can be relevant to you and your personal health.  Everyone needs to attack health at a different angle, but there are some general categories that apply to most of us.  First, there is the idea of weight loss.  While losing weight is an admirable goal it is not always the best indicator of health, since muscle mass weighs more than body fat.  That being said, weight loss is still a good goal to have if your body needs it.  Other good goals include losing body fat percentage, losing inches in the waist or hips, gaining flexibility, gaining strength, eating healthier, and reducing pain.  Of course, the best way to identify which goal is best for you is to contact your Chiropractor or health care professional.  Your doctor can help you identify the best way to improve your personal health based on a simple exam and some body tests.

Now, once you have determined the nature of your personal health goal the next step is making that goal something attainable for you.  A good goal can be achieved by applying the SMART goal system to your broad health ideals.  SMART stands for: Specific, Measurable, Attainable, Relevant, and Timely.  Each of these terms accounts for a factor in making a real goal for your personal health.  Here’s a breakdown example, using flexibility as the general goal:

Specific:  Make your goal have very specific result so that you can see your progress – if a goal is to vague it can be too difficult to achieve.  Instead of using “more flexibility” as a goal, make the goal “gaining flexibility in my hamstrings”.

Measurable:  If a goal has a start and finish line that can be tracked it is something that can be achieved.  For example, if you consult with your Chiropractor you can find the current degrees of flexibility you have in your hamstrings and make a goal based on that.  If your current flexibility is at, say, 45 degrees, then a good goal would be “gaining 45 degrees flexibility in my hamstrings for a total of 90 degrees”.  This goal can be easily measured as you make progress during regular checkups, and can also be something you yourself can track.

Attainable:  It’s important to be realistic when setting a goal for yourself, even if it’s not the total desired effect.  If you set a goal for yourself that is too difficult to achieve it will not be enjoyable working towards it and may derail your efforts.  If hamstring flexibility is the goal then setting a finish line within realistic limits will be easier to attain and therefore more satisfying.  For example, your long term goal for hamstring flexibility may be to touch your face to your knees, but setting the current goal at gaining 45 degrees is a more attainable goal to set for the start.

Relevant:  Setting a goal that is relevant to your life is incredibly important; without the relevancy there will be no urge for you to attain that goal!  Talking to your health care professional is one of the best tools you can employ to discover which health goals are relevant to you.  For example, if your Chiropractor suggests gaining muscle strength in your core will greatly improve your back health you would want to set your goals relating to core strength.  Hamstring flexibility is an important part of overall body health but may not be the best goal for you.  Make sure your goals are relevant to your body, rather than following the general health information available to the public!

Timely:  Putting a time limit on your goal means that you will both be able to measure your progress and you will have a reason to push yourself to reach that goal.  If your goal has no time limit your progress may meander without any solid movement forward, since you have all the time in the world to get to the finish line.  In the example of gaining flexibility, a timely goal would be “gaining 45 degrees flexibility in my hamstrings for a total of 90 degrees by July 1st, 2012”.  Setting a six month goal gives you time to work on the goal without losing focus or putting too much pressure on yourself.

Of course, the specifics, relevancy, and time constraints you set on your goal all depend on your health, personality, and lifestyle.  The goals that may work for you may be too difficult or too easy for someone else, and vice versa.  The most important thing is to set a goal for yourself – after all, with a goal you can make progress and feel good about the results!

Caution: Do not attempt to perform this stretch without consulting with your chiropractor or physician – if you have a serious injury this activity may cause further injury.

Where is it? :  Your hamstrings are actually a group of muscles that occupy the back part of the thigh, which are responsible for lifting the lower half of the leg up towards the body (flexion), as well as allowing for some rotation of the lower leg and moving the leg back (extension) .  The muscles are individually know as the semitendonosis, the semimembranosis, and the biceps femoris.  These three muscles attach at the top to the pelvic bone and at the bottom to the tibia (semitendonosis, semimembranosis) and the fibula (biceps femoris), which are the two structural bones in the lower leg.

Why should I do it? :  Since the hamstrings attach to the pelvis any muscle rigidity can cause numerous painful conditions, including Sciatica.  Stretching these muscles can relieve lower back pain, some types of knee pain, leg pain, numbness and tingling in the legs, and some leg muscle fatigue.

How do I do it? :  For this exercise you will need an object that you can grasp in both hands with a weight range of 3 to 10 lbs (anything will do – I use my son’s toy fire truck).  Stand with your feet pointing straight forward shoulder width apart.  Bend your knees just enough so they are not locked (this will assure the only muscles being stretched are the hamstrings instead of the calves) and keep your back straight.  Hold your weighted object in both hands against the  front of your body, allowing your arms to relax as much as possible.  Allow your body to slowly bend at the waist, using the weighted object to pull you down, until you have reached a point where you feel a pulling sensation in the back of your legs.  Make sure your back stays straight as you move, as bowing your back can cause muscle strains.  Count to ten while in this position, making sure to ease up if pain occurs.  After counting rise slowly into the original standing position, making sure to keep your back straight.  Repeat this process for a set of 10, doing at least 3 sets in a day.

Helpful Hints :  This stretch is designed for beginners in mind, especially those who do not have a great range of motion in their legs.  As you progress in this stretch you may increase the count from 10 to 15, as well as adding extra sets in a day.  This stretch is designed to be safe and slow, so progress may not show right away, but it should minimize the opportunities for pain.  When beginning stretching there will be discomfort, which can be misconstrued as pain; however, if you experience discomfort that does not diminish when you stand straight you may be pushing your stretch too far, and you should ease up on the distance you bend.

If you do sports, physical activities, or just plain walk around you should know what knee pain feels like.  Everyone has had at least a twinge of knee pain, be it from a sports injury or walking into the coffee table, and everyone knows how much it can hurt.  Since the knee is such an important joint (after all, if your knees don’t work it makes walking a much more daunting task) it is essential to keep its health up to scratch.  I have, therefore, compiled a few “Knee Health Rules” for all to share.

Knee Health Rule #1 – STRETCH

Stretching after a mild warmup can not only make muscles feel more pliable and limber, but it can also prevent injuries when performing more serious tasks or exercises.  However, when it comes to the knees (or for that matter, any joint) it’s important not to over stretch.  You should stretch for 30 to 60 seconds holding a pose (don’t bounce!!) only to the point of mild discomfort without pain.  Stretch each muscle group in turn – the quadriceps, the hamstrings, the calves, the abductors and adductors, the gluteus muscles, and the hip flexors.  If you don’t know how to stretch these muscle groups stay tuned for a step-by-step guide on how to stretch each of these muscle groups!

Knee Health Rule #2 – WATCH OUT!

Being aware of your body’s positioning is a GREAT way to make sure you don’t get injured, especially with your knees.  Since the average person is not aware of all parts of their body at once this is a much more difficult task than it sounds.  However, it is important to pay attention to having proper posture and positioning at all times.  For example, while performing any sport or activity it is best to have your feet pointed in the same direction as your knee before putting any type of weight or stress load on the rest of your body.  Make sure that if you need to turn quickly in one direction or another than your turn your hip joints or your feet on the ground rather than rotating at the knee joint.  Most of all, make sure you are aware of any person or object coming at your knees to prevent hyperextension (bending backwards) or side to side movement that may create a tear.

Knee Health Rule #3 – VITAMINS

The knee joints have within them a fluid-filled sac called the synovial membrane.  This membrane acts as a cushion between your bones, much as bubble wrap does between breakable items in a box.  To keep this cushion healthy it needs a few vital nutrients, all of which are easily attainable at any health food store.  The first two are glucosamine and chondrointin, which are usually sold together.  These supplements are known to prevent arthritis, as well as promote joint health.  The second vitamin is Omega-3 fatty acid, which can be found in flax seed and fish oil (yes, I know fish oil is disgusting, but if you live in San Diego county I urge you to come to our office in La Jolla to try the supplement we have.  It tastes like lemon meringue pie with no hint of fish!).  This oil helps to lubricate the joint as well as providing a natural anti-inflammatory to reduce any potential scar tissue buildup in the knee joint.

Knee Health Rule #4 – EXERCISE

It’s common knowledge at this point that you need exercise to stay healthy, and joint health is included.  Regular, well rounded aerobic exercise can keep the muscles surrounding and contributing to the knee joint can be kept strong and free of spasms.  Weight bearing exercise is also beneficial to the knee joint, as this type of movement encourages the production of synovial fluid (the lubricant inside the synovial membrane).  Common sense must prevail, however – if an exercise, such as running, is hurting your knee rather than promoting its health then switching to a lighter, lower weight bearing exercise is recommended (such as swimming or using an elliptical machine).

Knee Health Rule #5 – LISTEN TO YOUR BODY

Taking each of the former rules into consideration, this is the most important.  If you feel that your knee is getting uncomfortable with something you are doing get it checked out by a Chiropractor or Physical Therapist right away.  If there are issues leading to knee discomfort there are many ways alternative health practitioners can fix it, but only before it becomes a serious problem.  If you push your body to the point where you get a tear or rupture the prognosis is far more dire, the recovery time greater, and the pain worse.  The complexity of the knee  may take you to an Orthopedic Surgeon if you don’t listen to your body and correct your knee now.

While these rules do not apply to every case they can help those of you within the normal range of knee conditions to stay healthy and pain free.  Taking on all of these different rules can be daunting at first, but try implementing one per month to give yourself time to get used to each in turn.  Once you get used to caring for the health of your knees you should be able to live a long and happy life with your knees in good form – after all, the rules above can be applied to your whole body!

I can understand why numbness doesn’t cause alarm in most people – after all, it only takes sitting in the wrong position for a few minutes for a hand or foot to fall asleep.  However, experiencing numbness and tingling in the limbs can lead to a much more serious situation.  I’m not speaking about permanent nerve damage (although that can be an issue for some) since any long term numbness will usually cause some distress and a subsequent doctor’s visit.  A greater issue is the secondary injury that can arise from the lack of feeling or use of a limb.  Case in point:  I have a patient (called “Alice” here, for privacy reasons) who has chronic inflammation in her pelvis, low back, and shoulders, resulting in frequent periodic numbness and tingling in both her arms and legs.  Since these episodes are frequent Alice treats numbness as an annoyance rather than treatment-worthy issue and does not usually come in for a treatment, opting instead to allow the numbness to recede on its own.  During a recent bout of numbness Alice, who exercises regularly, sprained her Achilles tendon and partially dislocated her Calcaneus (heel bone).  The reason for this serious injury is that the lack of feeling in her feet made for poor proprioception (the ability to sense the position of and strength being used by a body part), allowing her ankle to roll several times during exercise without her even feeling it.  She had no idea her ankle had rolled, or even that it was injured, until the next day when the numbness receded enough to allow her to feel the significant pain of the injury.  Alice has since admitted that this is not the first time this has happened; she has rolled her ankles in the past for the same reason, as well as receiving many cuts on her fingers during food preparation due to lack of feeling in her hands.

I bring up Alice in the hope that her situation will allow others to avoid her uncomfortable situation (at the current moment in time Alice has not been able to exercise for almost a month while her ankle heals) by seeking treatment for what may seem a minor annoyance.  Having numbness, tingling, or even aching pain in the arms or legs can be the sign of an impinged nerve near the spine or another joint.  If a nerve is pinched for an extended amount of time it will cease to send signals down its core; much the same as pinching a running hose will make the flow of water stop.  Nerve bundles are set up in a way that the nerves responsible for  feeling are wrapped protectively around the nerves responsible for moving which, in an evolutionary sense, is a plus for survival; after all, if faced with a dangerous situation the nerves used to move your muscles are more likely to keep you alive than those used to feel the world around you.  However, since none of us is in imminent danger of being eaten by a Saber-toothed Cat, this doesn’t mean a great deal to modern humans, and means that a pinched nerve provides the disservice of movement and weight bearing without proper positioning.

In the end, even though I am in the Chiropractic field I do understand that the average person cannot take endless breaks from life to visit the doctor’s office, and therefore give this advise:  pay attention to your body.  If you have any numbness or tingling in your limbs be very wary of exercise, especially those which are weight bearing or require shifting body weight or directions frequently.  If in doubt, swim.  If numbness or tingling lasts for more than 24 hours seeing a Chiropractor would be a wise idea, but not required.  If numbness or tingling has occurred within a week of a traumatic incident (such as a fall, sports injury, auto accident, etc) please see your Chiropractor right away, as it may be a sign of a more serious condition.

Our bodies induce a formidable amount of force through the Achilles each time we stand up, not to mention run, walk or jump. Tiny rips and tears can occur every day and heal themselves at night when we sleep. When the Achilles experiences repeated and harsher stresses, the tears can lead to tendonitis. Because relatively small blood supple, healing can take longer. Overuse, imbalance and poorly fitting shoes are huge offenders. Minor rips, tears, and tendonitis can certainly occur from imbalances in the foot or sports activity. However, this tendon is more at risk for injury caused by long-term overuse.

Achilles Tendonitis
Avid runners and athletes frequently experience inflammation or Achilles tendonitis. It is important to protect the feet during any activity. An injury to the Achilles tendon will surely inhibit activities as simple as walking. Proper healing is also critical to prevent chronic pain from injury. Tendonitis can be fought with plenty of rest and ice.

Pronation
Excessive pronation of the feet can have a considerable effect on the Achilles tendon. Pronation creates imbalances that off-center the foot and ankle, which can lead to injury. Injury caused by pronation can affect men and women of all ages. The tendon becomes weakened or stretched beyond its normal limits and can be timely to restore back to health.

Recovery
Given the location of the Achilles tendon, and the critical role it plays each day, it is important to recover this part of the body effectively. Rest and ice should be incorporated even for the most severe cases. Ice will help reduce inflammation and rest will take stress off of the injured tendon and help restore its natural range of motion.

In addition to rest and ice, proper recovery and prevention can be supported by proper footwear, and stretching. Proper stretching is beneficial for restoring the natural range of motion in the feet. A chiropractor’s knowledge of the body’s functionality is an excellent approach for recovery. Footwear that offers a solid medial arch and extra support for the foot and ankle will help prevent injury. It will also support an injured ankle from further injury.

Contact Dr. Goldstein for a consultation at 858-558-3111 or go to newlajolladc.wpengine.com for more information.