Deep Tissue Laser Therapy for Shoulder Injuries with Dr. Harold Meinzer

Mark: Hi, it’s Mark Bossert, producer of the Evolution Wellness video series with Doctor Harold Meinzer of Langley, Vancouver and Aldergrove. And of course today we’re talking about shoulder injuries. Do you see a lot of shoulder injuries in the clinics?

Harold: Yeah, shoulder injuries are really common in the clinic and they’re notoriously a really difficult joint or also conditions to treat. The shoulder joint has a lot of moving parts, a lot of muscle and we have so much mobility with it, but then it can leave us vulnerable to have all sorts of injuries. So within the clinic I like to, you know, always do an assessment, a history exam, an assessment on the joint, what’s working, what’s not working, what’s dysfunctional. And then usually trying to employ some sort of soft tissue treatment. But we’re here to talk a little bit more in depth about laser and how the laser can help these types of conditions.

Mark: So having had numerous different shoulder injuries myself, how does the laser actually help with the healing inside the joint?

Harold: Well, usually what my protocol entails is that when we start treating a shoulder, and if we are having a shoulder injury, whether it’s the AC joint or even some soft tissue problems within the upper trapezius muscle or other rotator cuff muscles, is that I usually always start where the nerve roots exit. So the nerve roots are what’s controlling that entire shoulder and arm. So usually I like to start with the soft tissue and over top of those nerve roots and then proceed along that pathway of the nerve in and around that shoulder joint. And so the laser is going to help in a couple of key ways. We’re going to use it and as it’s being applied to the shoulder joint, it’s going to help with reduction in shoulder pain. So pain by, with every patient that’s a thing that you want to get away from as soon as possible.

And so the laser is going to reduce pain by releasing endorphins and enkephalins in that area. And those are sort of pain blocking molecules that we naturally produce. So it’s not anything new into the joint, we’re just stimulating the body in that way. And then as that laser is working, we’re increasing blood flow to that area. We need blood flow for healing. We want all those material, the building materials for repair and healing if the joint’s injured, but we also want to pull out and get rid of inflammation. And so that’s the lymphatics. So we want to open up the lymphatic channels and we increase the blood flow to that area. And those two things work as a really nice and strong anti inflammatory. Again, natural with no side effects to that area. So I think those are two key things and we’ll talk about another in a second. But if you’ve got a question, but it’s really important to to reduce the inflammation. Once inflammation is reduced, then range of motion will start to increase. And obviously we want that pain level to diminish right away.

Mark: So what’s a typical treatment series for a shoulder problem?

Harold: Typically for most conditions, I like to give the modality at least six treatments. So I could do a series of six treatments and we do them pretty sequential. So I don’t want a lot of time between them. And we do it every other day. And so that really keeps energy into that system. So the laser itself is stimulatory, so we can stimulate the body and that can run. In the literature they say for up to 24 hours. Everybody’s a little different. So some people have changed pretty quick within an hour or two or immediately. And some people have it after 10 or 12 hours, they’ll have bigger changes. So, but we want to keep those treatments close together. So I say the minimum, we want to give the therapy a chance of six treatments, and then after the six we’ll be re-evaluating and see, okay, where are we at? Are we at 50% improvement? 70? 20? Do we need to add or change anything within our protocols?

Mark: And is it mostly the, when a patient’s experiencing this, is it mostly first there’s a reduction in pain and then the range of movement comes back? Is that, typically …

Harold: Yeah, a lot of times those will happen the quickest. So the inflammation diminishes and they kind of self fulfill as well. So the range of motion increases, there’s less inflammation. Because there’s less inflammation, there’ll be less pain as well. And then when you add the endorphins and enkephalins in there, that even can drop it further. And the third thing that we haven’t touched on too is that as that laser goes into the tissue, it really is a stimulatory effect into the cell. So it gives that cell more energy so that we can have greater turnover within the cell for that healing. So then we can have longstanding changes versus just sort of symptomatic changes. Because we want repair of that tissue.

Mark: So are you seeing a lot of, like, this seems very obvious, any sports that use shoulders a lot? Like paddling or volleyball or football.

Harold: Yeah, like all those sports. And then you think of people, the weekend warriors that sit at their desk all day and don’t do much and then they go play softball on the weekend, you know, swinging motions, you know, and then traumatic injury, right? Sliding into the base or falling out of the tree or whatever that you’re doing and trying to clean your gutters. And you fall and the crazy thing is that you’ll, I’ll even see something like sleep injuries when we think that we should be at rest and should have no injuries and someone sleeps on their shoulder funny and kind of kinks themselves, get up after eight hours of sleep and you just can’t move your shoulder. So we get the gamut of sports to trauma to a sleep injury.

Mark: And I imagine that because it’s effective, there’s a lot of pro sports teams, baseball, football, basketball that are using this?

Harold: Absolutely. All the pro sports teams are using it. And there’s a probably a couple of videos you can find. Toronto Blue Jays or one of the users of it as well as you know, Seattle Seahawks and other elite athletes. But it works for us mortals as well. The elite athletes obviously are great. They’re in top physical form, but they want the fastest therapy to get them back on the field. And this therapy is fast. It’s not invasive, it’s all natural. It doesn’t affect any kind of drug testing or anything like that. So it can get them back on that field as fast as possible. We really don’t have any other modality that can stimulate the body and the body’s natural healing mechanism to speed up what it would do other than laser. Nothing else will do that. No ultrasound or TENS or any other unit will do that. So it’s really unique in that it really stimulates right at the cellular level turnover, which is I think one of the coolest things.

Mark: And protocol for how soon after injury this can be applied?

Harold: Yeah. So immediately after, in the acute stage, that’s where we want to get at. The sooner the better because then we can stimulate that blood flow and then the repair system. So your body doesn’t have as big of a chance to inflame. It’s going to inflame, but then we can modulate it. So the faster you can get repair into that joint, the more organized it’ll be and the better that tissue will heal and the better outcomes you’ll have.

Mark: So there you go. If you’re looking for treatment for your shoulder problems in Vancouver, North Langley or Aldergrove, you can give Doctor Harold a call to book. They’re busy. You have to book ahead. Give him a call at (604) 881-2404 to find out where he is this week and book an appointment. Thanks a lot, Doctor.

Harold: Yep, thanks. Look forward to seeing all these shoulder injuries this week. Thanks.

Five Ways to Reduce Low Back Pain While Cycling

Cycling competitively, to work or just for the enjoyment of it is an excellent way to keep in shape and enjoy the outdoors, but it’s no fun at all if your back hurts. Back pain or discomfort while riding a bicycle can result from various factors, such as poor riding posture, a poorly fit bicycle, the wrong-sized bicycle or even from a pre-existing injury. Like any other physical activity, cycling requires some conditioning and adaptation, and if you’re just starting out in this sport, you may want to seek out more information before strapping on your helmet.

Importantly, if you experience recurrent or prolonged back pain while cycling or even afterwards, make sure to seek prompt assessment and treatment. There are also some simple adjustments you can make to keep riding easy, prevent injury or prevent an existing injury from progressing to a more serious problem. Often, simple fixes like adjusting your seat or correcting your posture could help. Read on for helpful tips!

1. Take it easy

Whether you are training for a race or simply working towards your personal best, be careful not to overdo it. On long rides, make sure to take breaks as needed, hydrate and do some stretches or move about. Check out our Resources section for excellent stretches for athletes.

2. The right fit for your needs

Touring, road racing or all-terrain – there is a bike for every rider. Make sure you have the bike that suits your needs. What terrain will you be riding on? How long will your trips be? Are you looking for comfort or speed? When you buy a new bike, or take yours for maintenance, ask to have your bike properly fitted for your individual frame.

3. Posture

While riding, keep a neutral spine by bending at the hips and avoiding the “hunch” in your mid-back. If possible, avoid excessive movement from your upper body and use your back as a fulcrum instead.

4. Core Strength

Having well-conditioned abdominal and back muscles will help to support your upper body while riding and minimize excessive swaying. Your chiropractor can help to guide you and recommend exercises that are targeted to your core, as well as exercises to enhance your overall conditioning.

5. Adjust your bike to your frame

Minor adjustments can make a huge difference. Different styles of bikes require different riding postures, however, this infographic provides a quick reference for general adjustments that can help ensure a relaxed, comfortable posture while riding your bicycle.

bike posture infographic

 
This blog was written, and shared with permission, by Canadian Chiropractic Association.

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Keeping It Green: 8 Benefits to Getting Fresh Air While You Exercise

Getting any type of exercise is good for your body, but did you know there are specific benefits to taking your workout outside? Not only is it a great way to boost your activity in the Spring, it’ll also help boost your mood.

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Here are a few of the main benefits to getting exercise in a natural environment:

  1. You can move faster. When you’re walking or running outside, you can better control your pace. Often, you end up moving a little faster than you would indoors on a treadmill.
  2. It’s easier. When the effort of exercise participants was studied comparing indoor to outdoor walking, participants not only moved faster, they reported the exercise also felt easier to complete.
  3. It’ll alter your perception. Since your perception of effort is lower when you’re in a green environment, it gives you the opportunity to push harder without your perception changing. When an activity is perceived as easier, it’s also perceived to be more enjoyable.
  4. You’ll increase your enjoyment. When you’re exercising outside you’re often engaging with other people. This has been shown to increase enjoyment of the activity and how often you participate, since you have social motivation behind you.
  5. You’ll feel revitalized. Studies have shown that doing physical activities in a natural or green environment can help improve feelings of revitalization. You also feel more positively engaged.
  6. You can improve your self-esteem. Exercising in green environments have also been linked to improved self-esteem and reducing negative moods such as tension, anger, and depression.
  7. It’s better for your physical health. Studies have shown that outdoor environments, particularly green spaces, support better physical health both subjectively and objectively. That means that your sense of well-being, heart health, immune system, and recovery time are all positively affected by your green environment.
  8. It’s also better for your mental health. Work out outside to improve your general mental health, psychological well-being, anxiety, stress, or depression. Both your well-being and perceived well-being benefit from taking-in natural spaces.

To help get you going, here are a few green activities you can try:

  • Plant trees
  • Go hiking
  • Canoe or kayak
  • Explore natural parks (or take advantage of the free 2017 Parks Canada Discovery Pass)
  • Go for a bike ride
  • Play tennis
  • Sign up for an outdoor fitness class or boot camp
  • Join a recreational sports leagues for soccer, ultimate Frisbee, or flag football

This blog was written, and shared with permission, by Canadian Chiropractic Association.

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5 Stretches and Exercises for Better Posture

 

How many hours a day do you spend looking at a screen with your head tilted forward? Think about it. Chances are if you own a cell phone, tablet, laptop or desktop computer, you’ve spent hours viewing these devices. Other instances where you might tilt your head forward include watching television, driving and even reading a book. This constant state of having your head tilted forward causes postural alterations, often leading to faulty movement patterns, which increases the stress placed on the neck, shoulders, as well as the head.

Upper cross syndrome is described as a muscle imbalance pattern located at the head and shoulder region. It is most often found in individuals who work at a desk or who sit for the majority of the day and continuously exhibit poor posture. The term ‘upper cross’ can be broken down into two components. ‘Upper’ simply refers to the head and neck region, as there is a lower cross syndrome for the low back and pelvic regions as well. ‘Cross’ refers to the distribution of tight or overactive muscles, which crosses with weak or underactive muscles. Primarily, tightness of the upper back muscles crosses with the tightness of chest muscles, while weakness of the neck muscles in front crosses with the weak muscles of the mid back. Common signs and symptoms of upper cross syndrome include forward head posture, rounding of the shoulders, hunched upper back, headaches, as well as pain in the shoulders, upper back and neck.

The good news is that work station adjustments and appropriate exercises and stretches often improve posture and muscular coordination.

Below are some of the following stretches and exercises that you can do to help improve your posture:

Stretches:

Trapezius Stretch

  • In a sitting position, slowly and with ease, draw your right ear towards your right shoulder. You may place your right hand over your head and let it rest on your left cheekbone for slightly more pressure. Hold for 20-30 seconds. Repeat on other side. Perform 3-4x throughout the day.

Levator Scapulae Stretch

  • Similar to the trapezius stretch, the above stretch can be modified by gently pulling your head and directing your nose to your underarm region. Hold for 20-30 seconds. Repeat on other side. Perform 3-4x throughout the day.

Chest Stretch (Brugger’s Position of Relief)

  • Sitting on the edge of a chair with legs slightly wider than shoulder width apart, have your palms face upwards and lift the chest up. Hold for 20-30 seconds. Perform 3-4x throughout the day.

Strengthening Exercises:

Chin Tucks

  • While seated, look forward and bring your head backwards, as if you were making a double chin. Make sure not to tilt your head down. Hold this for 8 seconds. Repeat 5 times and that’s one set. Perform 3-4 sets throughout the day.

Shoulder Blade Squeeze

  • Sitting comfortably on a chair with arms relaxed by your side, squeeze shoulder blades together without raising them. Hold for 8 seconds before releasing. Repeat 5 times and that’s one set. Perform 3-4 sets throughout the day.

This blog was written, and shared with permission, by Canadian Chiropractic Association.

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7 Backsaving Tips when Gardening this Season

Warmer temperatures and sunny days have finally arrived and so have the first flowers of spring! This might entice you to do a bit of gardening. Understandably, most gardeners are anxious to plunge their hands into the dirt and get growing. Gardening can be an extremely rewarding pastime, but it can also come with an increased risk of aches and pains if you’re not careful. We’ve put together a few tips to help you maximize your joy of gardening while minimizing the risk of pain.

  1. WARM UP

After waiting all winter, it may be tempting to jump right into the spring garden cleanup. Do your future self a favour and pause to warm up your muscles before you start the work. Like any other physical activity, gardening requires preparing your body for the new movements. In fact, over the winter months, you may have become deconditioned and will require some time before you can invest yourself into a regular gardening routine. Straighten Up Canada only takes 3 minutes and helps to improve your posture and keeps you moving.

  1. TAKE BREAKS

When you’re in the zone, one can lose track of time. Hungry to see results, you might just plow through the work without paying attention to your body’s cues. However, it’s wise to pace yourself instead of powering through to get the job done. Set a timer and take a break every 15-20 minutes to stand up, stretch and walk around a bit rather than staying in the same position for extended periods of time.

  1. DRINK WATER

Hydration is always important, but especially when you are physically active under the sun. Carry a bottle of water along with your garden tools. When you take your break every 15-20 minutes, have a drink of water, too.

  1. BREATHE 

While you’re stretching and hydrating, take in some deep, oxygenating breaths to nourish your hard-working muscles and help to improve circulation. Keep your shoulders and chest relaxed. When breathing deeply, you should see your abdomen extend out and then in calmly.

  1. LISTEN TO YOUR BODY

It’s easy to get caught up in the sheer joy of getting your hands dirty. Gardening can be very meditative, in fact. However, be careful not to get so lost in the task that you ignore those niggling aches and pains until it’s too late. Pay attention to the messages your body is sending you. If you feel a twinge, take a break or change positions.

  1. BE MINDFUL OF LARGE LOADS

Bags of mulch and soil or heavy potted plants come with the territory. Instead of lugging a whole bag of soil from one end of the garden to the other, consider using a wheeled cart. Divide large loads into smaller batches that are easier to handle. If you must lift something heavy, consider asking for help, or check out these pointers on how to lift properly without injuring your back.

  1. VARY YOUR TASKS

Rather than concentrating on one area or job at a time, vary your tasks to ensure that you aren’t holding the same position for extended periods.

Gardening can be a lot of work, but it’s also a great source of pleasure and beauty, all the more so when you feel in top physical condition! We’ll have more tips next week, but in the meantime, take a look at the Resources section of our website to learn more about how to Plant and Rake Without the Ache and other useful tips to stay healthy doing the activities you love.

This blog was written, and shared with permission, by Canadian Chiropractic Association.

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Laser Therapy…Just The Beginning

For most people, laser therapy means…well…nothing. Eye surgery and hair removal may come to one’s mind but that is not the type of laser that we practice at our centres. What we are referring to, are lasers that are used on a therapeutic level, to aid the bodies normal healing response. This technology has been jumping forward over the past few years and a whole new class of lasers have emerged which will soon be at the forefront of the therapeutic world.

Let’s start with what ‘LASER‘ stands for. ‘Light Amplification of Stimulated Emissions of Radiation’. Make sense? Probably not. The basics of lasers are that they produce wavelengths of light and emit them. They start off with weak light and gradually add more and more energy until the wavelengths are concentrated. A true laser will produce exact wavelengths of light that all travel in one direction and are coherent (instep with one another). As opposed to a flashlight, where the light is incoherent and the wavelengths are out of step with one another, the coherency of lasers is what makes the laser light such a concentrated emission of energy. Lasers can be focused onto a small spot from a much farther distance, as could a flashlight which would spread out the wavelengths it emits. This makes lasers great for being able to narrow in on specific areas we would like to treat.

So what is it good for?

Science has determined that the mitochondria of our cells respond to certain wavelengths of light within the red and infrared category (600-1000nm). As you may recall from grade 12 cell biology, the mitochondria is the energy producing engine of the cell. Every cell has many mitochondria and nerve tissue has the most. We tend to deplete the numbers of mitochondria per cell as we age, hence part of the reason we heal slower as we get older.

Light energy from the laser is converted to chemical energy in the mitochondria, as the laser stimulates it. If a cell is injured, in theory, any cell (muscle, nerve, bone), should be able to heal quicker if it is activated and stimulated with therapeutic laser light from class 3 & 4 lasers. Now you get it!

Now what is Laser Class?

Therapeutic lasers have classes and are typically found in Class 3b & Class 4. The difference in class has to do with the power. Class 4 lasers have a higher power than Class 3. The more powerful the laser, the quicker the tissue can be saturated with light energy. However, it does not necessarily mean that the light penetrates deeper. The depth of penetration is more complex and has a lot to do with the actual wavelength of the light.

How deep does the laser light penetrate?

Most would agree that a true laser light, can penetrate approximately 2-3 inches. This is typically enough for really most problems.

Risks?

Luckily, therapeutic lasers pose very little risk. Eyes are the most obvious and goggles are typically worn during treatment. Some patients experience warmth, a dull ache and nerve numbness and tingling when treating an injured nerve. Most feel very little while being treated and rarely have an increased soreness in the area treated. Overall, laser therapy is very straightforward and can be used for so many conditions. Our focus is on the neuro-musculo-skeletal system both from a pain management perspective, as well as from a healing/resolution standpoint.

Key conditions laser therapy may help:

1. Tendonitis ie. tennis elbow, achilles tendons

2. Knee Injuries ie. meniscus tear, ligament sprains/tears, arthritis

3. Whiplash

4. Plantar Fasciitis

5. Low Back ie. strains/sprains, disc injury, degeneration, sciatica

6. Neuralgias

Now that you understand Laser Therapy, we would love to show you how it may be helpful for you and your condition.

Traction? Inversion? Decompression?

I am often asked by patients about options for chronic lower back pain. Options outside of the more traditional approaches of Chiropractic, Physiotherapy, Acupuncture and Rehabilitation. Occasionally, patients with severe chronic lower back pain may not respond to the above therapies. They do not have the ‘Quick Fix’ lower back symptoms. So what else is there?  

Over the years, I have always recommended home traction or Inversion tables. Now that we have the new clinic with an extra treatment room, we have invested in a state of the art DOC Decompression table for these very difficult cases. For the average patient, with lower back pain derived from severe joint arthritis and compressed discs, this is a great way to go. Gentle traction to start, and only for a minute or two. Then we slowly increase the angle of the table, in order to create a bit more separation of the joints and discs.

So what does this really do?

By stretching the spine, we are creating something called a negative pressure, which can retract or reposition herniated or bulging discs back into place. As the spine stretches, the discs separate, which allow nutrients and oxygen to be pulled into the area. If you were to imagine having 2 magnets stuck together, as you slowly pull them apart, you create this pressure, and pull in whatever is around the area into the space. In the case of your spine, you are pulling in oxygen, nutrients and fluid from the surrounding tissues. The discs now have a chance to expel previously trapped waste and allow the natural healing process to begin.

How does the DOC table do this?

The DOC table remains essentially horizontal, while applying computer generated patterns of traction. The table has the potential to tip, tilt and pivot in all directions, in order to find the perfect place to position the patient in order to relieve their compression.

How often should I do traction or decompression?Untitled-2

We recommend daily at home, or 4-6 days in the clinic. As opposed to the home version where you are using your inverted body weight, in the clinic we will be adding weight and amount of time of traction as you go through a 3-4 week treatment cycle. Yes, it can be time consuming but yes, it may also save you from having back surgery.

When not to do traction of any kind?

1. After an acute injury where the low back has been severely sprained and strained. You need to let the ligaments heal and not pull or traction on them.

2. Severe osteoporosis of the spine may be a limiting factor due to the possibility of creating a spinal fracture.

3. Severe nerve compression has occurred where the caudal equina nerves to bowel and bladder have been compressed and it is now a surgical condition.

Please call us today for a consultation.

Dr. Fred Meinzer, BSc DC

Owner/Chiropractor

Apprehensive about Chiropractic?

After 23 years of practicing chiropractic, in Vancouver and Langley, I am still regularly told that “my wife/husband should really come and see you but they are too scared to come in.” Naturally, I ask why? Consistently the same answer bubbles up, they are afraid of having their neck ‘twisted’ or ‘cracked’. To that I happily answer, “we do not need to twist or crack the neck in order to treat the neck.”  Yes, it is possible to treat one’s neck with other methods, such as the use of myofascial work and chiropractic Impulse instrument adjustments.

Myofascial? Impulse Instruments? 

Well…in English…myofascial work is the releasing of muscle and it’s surrounding sheath, the fascia, with one’s finger/hand pressure. This may be enough to free a stuck or misaligned joint.

The Impulse instrument is a pressure gauged adjusting instrument, that is using quick bursts of very mild pressure, in order to mechanically vibrate and impulse the joint back into alignment. Basically it’s nudging the joints along, back into where they need to be. There is no cracking or quick twisting actions involved. Have a look at how it works below…Skip ahead to 0:19 to see its effects on the spine.

Still scared? We didn’t think so.

At Evolution, we’ve taken the fear out of chiropractic treatments by offering options. Our centres use myofascial work and Impulse adjusting instruments so that you don’t have to be afraid anymore. As far as the Impulse instrument, if you have never been adjusted with one, we would be happy to demonstrate it for you. The last thing we want is for you to be afraid of coming to see us. We always have options if you’re not comfortable with something. Remember we’re here to help YOU!

Dr. Fred Meinzer, BSc DC

Owner/Chiropractor

 

Once I start chiropractic care…….

Once I start chiropractic care….should I continue care….will my back be weak now…. most would agree that a well-aligned spine is stronger and more resilient.  Most back problems develop because spinal vertebrae become misaligned and stuck in an improper position, which puts pressure on spinal nerves causing pain with associated stiffness and tension in the surrounding musculature.

Chiropractic treatments realign those vertebrae, restore proper motion to the spine, decreasing nerve pressure and easing muscle spasms. Once you are out of pain and back to all your normal activities, we suggest a few follow up appointments to make sure proper motion and alignment is maintained so that the problem does not reoccur. 

Many of our patients decide to continue care with regular check-ups, maintaining their body much like they do their car with regular scheduled oil changes.  This keeps patients pain free and functioning at their best. Regular care is much more common once patients are in their 40’s and recognize the need for maintenance as they feel the wear and tear of life. Ultimately, it is up to each individual patient to decide what level of care they desire and how long they continue according to their own health philosophy.  We are here to help guide each patient back to health whether it is a brief treatment plan for a minor issue or a long term regular maintenance plan for an old car accident. At Evolution Physical Med Centres we pride ourselves in no pressure treatment plans.

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