Free GuideFor Self Managing Your Aches & Pains During the COVID-19 Crisis
To All of Our PatientsTo All of Our PatientsTHIS GUIDE IS FOR YOU, YOUR FAMILY AND FRIENDSTHIS GUIDE IS FOR YOU, YOUR FAMILY AND FRIENDS
SO YOU MAY CONTINUE TO MAINTAIN YOUR HEALTHSO YOU MAY CONTINUE TO MAINTAIN YOUR HEALTH
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To Our Valued Patients,
As you are by now aware, Absolute Chiropractic has suspended all non-essential (non-emergency) care during this COVID-19 crisis until further notice. However, we understand that aches and pains will still occur during this crisis, and maintaining spinal health is still a priority for us all.
Therefore, we’ve created this guide to help you maintain your physical health during your time away from our clinic. The activities in this booklet provide you self care strategies that can help alleviate your aches and pains during this social distancing period until we are once again able to resume healthy chiropractic care. Your health and wellness is always our priority, both in the clinic and during isolation. We hope you find our guide helpful during this time away.
From our chiropractic family to yours, we wish you all continued health and wellness during this difficult time. If you require more assistance than is provided in this booklet, please reach out to us over email and we will do our best to assist you further. Stay safe!
Our sincerest regards,Dr. Barry Young Dr. Jennifer Kragten RoDr. Dan Srouji
Absolute Chiropractic and Wellness1508 Upper James Street Hamilton, ONL9B 1K3
For YouWe’re Here For You
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Contact 16
15Sciatica
12, 13, 14 Lower Back Pain
10 & 11Upper Back Pain
8 & 9Shoulder Pain
4 & 5Headaches
Content
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This guide highlights some of the most common musculoskeletal issues people experience. Select from the list below what you are currently experiencing to learn how to help yourself alleviate your discomfort.
Note Well: Any sharp symptoms of an acute or sudden nature that are not easily recreated via movement or touching the area, in addition to symptoms including sudden shortness of breath, dizziness, nausea, or general feelings of being unwell should be further assessed for more serious, non-muscle/joint related causes.Please note, the following activities are not intended to treat any specific condition or to imply diagnosis. This guide is intended to be used for educational purposes only. Always ensure any activity is safe for you before beginning.
Neck Pain 6 & 7
For You
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Headaches
Diagonal Neck Stretch (Smell the Armpit Stretch)
-performed seated or standing -to stretch the right side of the neck as shown, grasp the right side of your head with your LEFT hand
-tuck your neck diagonally towards your LEFT armpit -provide gentle pressure using your LEFT hand
-hold this position for 10-15 seconds, repeat 3-5x (flip direc-tions for opposite side)-bonus: use the resting arm to grasp the bottom of a chair or tuck it behind your back to exaggerate the stretch-repeat several times daily
There are a few common types of headaches people experience. Some of the under-lying factors for headaches include dehydration, stress, and low glucose that can compound physical issues related to the muscles and joints. Stretching the muscles and moving the joints of the neck are oftentimes ways to help alleviate headaches. In these next pages you’ll find 4 strategies to help alleviate headaches. **Discontinue activity if any excess pain or unusual symptoms arise (See note on Page 7).
Upper Neck Muscle Release
-performed against a wall or lying flat on the floor-utilize a tennis ball or similar density object
-position the ball at the base of the skull as shown by the yellow circles-gently apply pressure onto the ball, while turning the neck left and right
-hold each neck position for 10-15 seconds, repeat 3-5x-tip: place the ball in a long tube sock for the standing variation to prevent dropping it
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Neck Range of Motion Activity
-perform this maneuver seated-begin with a neutral neck (not overly flexed or extended)
-fold towel diagonally, and wrap around neck-grasp each towel ‘tail’ with the opposite hand (left tail with right hand and vice versa).-starting with the head turned to the RIGHT, raise your right hand (holding left towel tail) and cross the towel over your left cheek bone
-gently, but firmly pull with your right hand, slowly increasing how far your neck is turned -hold for 10-15 seconds, return to starting position, repeat 3-5x -repeat the procedure in the opposite direction for left side rotation
Deep Neck Flexor Stretch/Stabilization
-can be performed 1. lying on your back or 2. seated/stand-ing, with or without a towel underneath your head
1-starting in a neutral neck position, pull your chin down-wards by pushing the back of your head into the towel. **Goal is to give yourself a ‘double chin’, and to not bend your neck.
2-standing against a wall, maintain a neutral neck position and ensure your head is contacting the wall throughout the maneuver-pull your chin in towards the wall, while your head gently glides upwards - again, try not to bend your neck
-hold for 10-15 seconds, return to starting position, repeat
Headaches
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3 Keys to Relieving Neck Pain:
Neck PainAcute Neck Pain:
Neck pain can take several forms and presentations, however, the most common types are related to acute joint and muscle dysfunctions caused by poor movements, overuse, or simply bad luck. A “pinched nerve” or “kinked neck” sensation can usually be relieved with prompt care that involves maintaining your full/normal range of motion through the pain, which requires moving the muscles and joints. **It is important to note that neck pain following a trauma or accident should be assessed and cleared for activity.
ICE IT!
• When you have a kink in your neck, moving left and right, or any direction can be extremely painful and you may feel like you are locked up.
• It is important though to keep moving, and to continue educating your body that it needs to function into that painful range.
• • To do so: slowly and gently, but with intent, turn your neck as far as you can
towards the painful side and hold it there. Then gradually with your hand apply some pressure to help it turn a little bit more. Repeat this several times until you reach a new range of motion that was previously unattainable during this painful episode. (SEE RIGHT, AND PAGE 5 FOR NECK RANGE TOWEL ACTIVITY)
STRETCH IT!
A stiff neck can negatively compound how you’re feeling by making all of your movements that much more noticeable. Stretching the neck muscles as shown on Pages 4 & 5 will help alleviate that tension associated with acute neck pain or an ongoing neck issue. Add in this extra stretch to the ones found
on the previous pages to target a major contributor to neck discomfort. Refer to Page 11 for Self Release of the Lower Neck Muscles.
Whether you love it or hate it, icing can provide relief to an acutely inflamed area of the body. Gel packs work well, alternating on and off at 15 minutes for 3-5 cycles.
MOVE IT!
REFER TO PAGES 4 & 5 FOR THE NECK PAIN ACTIVITIES SHARED WITH HEADACHES
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Note WellNote Well: Neck pain and headaches are common everyday experiences for many Canadians, and especially prevalent during times of increased workload or stress. That being said, it is important to accurately screen yourselves and/or seek medical attention as available for unusual symptoms you may be feeling.
These include sudden/acute: double vision, dizziness (vertigo, lightheadedness unrelated to hunger), sudden loss of strength in any part of your body, difficulty speaking or articulating (including slow and nonsensical speech), difficulty swal-lowing, sudden change in your ability to walk or move, nausea (again, unrelated to hunger), and numbness (face, limbs).
Sudden, extreme headaches (worst of your life) should not be taken lightly; self assessing for any of these other symptoms would be prudent. Once again, this is not an exhaustive list nor is it meant to be diagnostic; however, considering the state of our health care system currently, this information can help guide you to-wards self relief or further medical care as necessary.
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Shoulder pain is usually the result of chronic movement dysfunctions and/or acute overuse scenarios. The following activities aim to address common sources of shoulder pain, including tight tissues and poorly functioning shoulder structures. Refer to Page 10 for activities that help loosen the upper back, which is important to shoulder function.
‘Sleeping’ Shoulder Stretch -perform by lying on the ground or a bed off to an angle on your side, with the affected arm on the bottom (**You should be rolled backwards slightly, pinning your shoulder blade beneath you)-your affected arm should be bent 90° at the elbow and your forearm should be pointed upwards towards the sky (as shown)
-next, use your unaffected arm to gently draw your affected forearm towards the bed or ground - DO NOT STRETCH INTO EXCESSIVE PAIN-hold for 10-15 seconds, return to the starting position and repeat 5x
-bonus: as you progress and can eventually reach the flat surface with your forearm, you can add resistance to the top of your forearm using your free hand and reverse this activity, pushing your affected arm upwards to the starting position
Shoulder Pain
‘Reach Up the Back’ Stretch
-aim your hand (on the affected side) towards your opposite back pocket-with your other hand, hold your affected arm (palm out-ward) behind your back by the wrist
-gently pull your arm up to stretch your shoulder-hold for 10-15 seconds, then return to the starting position - repeat 3-5x
-bonus: to further increase the stretch, grasp a towel in the affected arm behind the back and wrap it over your opposite shoulder, using that hand (on the unaffected side) to gently pull the towel down in front of you to increase the stretch felt in the affected arm positioned behind you
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Shoulder Pain
Shoulder Side Wall-Push: This simple activation maneuver helps the shoulder use the muscles being tar-geted. This activity has you contracting your muscles without actually moving your arm.
-standing with your affected shoulder next to a wall, place the back side of your forearm and wrist flat against the wall-your upper arm should be against your body, with your elbow bent 90 degrees (your hand straight ahead)
-keeping your elbow locked at your side, push your wrist and forearm gently against the wall with about 30% to 50% of your strength - don’t let your body move away as you push-hold for 10-15 seconds, relax and reset -repeat 3 sets of 8-10 repetitions
Shoulder Self ReleaseSelf release of the shoulder is a good way of releasing tissue tension to help reduce pain and discom-fort. However, it can temporarily increase pain symptoms, so stretching and icing are recommended with it. More on self release can be found on Page 11.
You can use a lacrosse ball or similar type rubber/medium firm ball to complete the activity.
-begin by lying on the floor or standing against a wall (on your affected shoulder), arms at your sides -position the ball (between you and the wall/floor) on your shoulder as indicated by the yellow spot in the diagrams (if standing, place the ball in a long tube sock or pantyhose to keep from dropping)
-gradually add just enough body weight onto the ball to feel the pressure (do not roll on the ball or press too deeply - simply allow the ball to melt into your shoulder)
-slowly punch your arm straight forward (if lying down) / raise your arm straight up above your head (if standing), maintaining pressure on the ball for 3-5 seconds, return to starting position, repeat 10-15x
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Acute upper back pain is usually the result of poor movement, overuse, and dysfunctional underlying physical structures finally ‘giving way’ (straw breaking the camel’s back). It’s important to distinguish between a muscle and joint issue and something more serious.
Again, any sharp symptoms of an acute or sudden nature that are not easily recreated via movement or touching the area, in addition to symptoms including shortness of breath, dizziness, nausea, or general feelings of being unwell should be further assessed for more serious, non-muscle/joint related causes.
You can address most upper back pain with 3 useful steps: mobility, release, icing.
Upper Back Pain
Upper Back Mobility (Foam Rolling)If you’re experiencing general upper back stiffness, this in conjunction with the following stretches and release can help alleviate it. For specific/focal pain in the upper back - read on!
-position yourself seated in front of a foam roller with knees bent, feet flat on the floor-place your hands around your head to provide neck support, then lean back until your upper-back touches the foam roller
-keeping your hips on the ground, relax backward over the foam roller as if trying to touch the ground with your head-hold for 15-30 seconds, then slowly return to the start position-reposition the foam roller a little lower and repeat the maneuver, making contact with the mid back this time
-you can move up and down your back with this method, but making sure to reset in between positions
Thread the Needle StretchIf you’re experiencing an acute bout of upper back pain that takes your breath away, and/or has very localized pain the size of a toonie, then try this stretch in conjunction with the mobility activity above, and the self release on the next page.
-begin on your hands and knees, arms straight-then tuck your arm on the affected side under your chest and try to touch your opposite side rib cage
-now lean your body downward, placing your body weight on the tucked arm underneath (this arm should be flat on the ground)
-you should feel your body ‘twisted’ in that direction and your shoulder blade on the tucked arm/affected side should feel stretched open-hold for 15-30 seconds, repeat 2-3x per side making sure to reset in between positions (complete this activity on both sides)MOBILITY, RELEASE, ICE
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Self Myofascial Release - Upper Back (SMR)
Myofascial release is a process that attempts to release tension that develops in the fascia. Fascia is the tissue that surrounds all muscles, bones, nerves, and organs in the body, and essentially connects the body from head to toe. Trauma, inflammation, chronic disuse/abuse, and joint instability are common sources of increased fascial tension. With increased tension, the normal and/or optimal mechanics of the body are hindered and can result in pain, further mobility issues, and kinetic chain dysfunction - both locally and in distant regions of the body.
Fascial release is a documented way of releasing fascial tension to decrease the effects above. It is not for the faint of heart, as it can temporarily increase pain symptoms, however, when done properly it can be a tremendous aid in decreasing discomfort. The following version of SMR utilizes a lacrosse ball or similar type medium/hard rubber to complete the activity.
Targeted Anatomy: 1-Rhomboid Major/Minor | 2-Trapezius | 3-Latissimus Dorsi | 4-Infraspinatus
• If you’ re experiencing acute or chronic upper back or neck pain, focus your efforts on areas 1 & 2 on the diagram• If you’re experiencing acute pain at a specific spot in the upper back, along the region highlighted by the blue
line, focus the rubber ball in that area (you may need to start with a softer ball at first)• As shown on Page 9, shoulder issues can benefit from focusing on area 4• General stiffness and discomfort can be addressed with focusing on 1-4 as well as any other area tension is felt
HOW TO RELEASETHE KEY: SLOW & WITH INTENT
→ ‘Melting’ is the term used to describe how the rubber ball is implemented at each release location→ rolling on the rubber ball is not advised, especially near the spinal column - simply position it & MELT→ moving your arm across your chest, above your head, and behind your back is acceptable during self release and can be extra beneficial → soreness afterwards is normal, but pain during release should be tolerable; no more than 5/10 → each release is held for 10-30 seconds based on your tension, pain threshold, and mobility → each release target can be repeated 2-3x
Self Release Guide
MOBILITY, RELEASE, ICE
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of adults experience back pain in their lifetime
Low back pain (LBP) is one of the most common issues Canadians seek chiropractic care for, as it affects upwards of 80% of the population at some point. Back pain will still occur during the COVID-19 crisis, however, unfortunately easy access to the experts best suited to care and treat back pain is lim-ited during this time.
Therefore it is imperative you focus on these three principles for back pain: 1. Movement is your friend, move often and as much as you can when experiencing a bout of LBP. 2. The overwhelming majority of back pain is not serious and will subside with good care and treat-ment - unfortunately during this time, you will be responsible for a lot of that self directed care. 3. When recovering, don’t be so focused on how painful it still is, but focus on how much more capable you are each day.
Pain is a poor indicator of progress: no pain doesn’t mean it has resolved, and pain doesn’t mean it is not improving. But in general, as you improve function, your pain will gradually decrease as well - the goal is to heal the tissues appropriately for the long term, not simply getting out of pain for tomorrow.
Note Well: If you are experiencing sudden low back pain, it is essential you keep track of the following: numbness tingling or weakness in the area between your legs (including groin, buttocks, genitals, and inner thighs) and/or in your lower limb(s), emerging bowel or bladder incontinence or retention (you go accidentally/can’t go) in addition to severe sharp pain in the leg(s) and/or lower back. If you are experi-encing any combination of the above symptoms, seek immediate medical assistance.
Low Back Pain~80% Rubin (2007)
If You’re Experiencing Low Back Pain...• for the first time, that occurred recently (acute) and is not due to a trauma or accident• that has been going on for several months or more (chronic) and is a normal part of your
day to day life• or that comes and goes every so often and is currently flared up (recurrent)
...then the following activities on the next pages may offer some relief of your symptoms
Rubin, Devon I. “Epidemiology and Risk Factors for Spine Pain.” Neurologic Clinics, vol. 25, no. 2, 2007, pp. 353–371., doi:10.1016/j.ncl.2007.01.004.
Low Back Pain
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Modified Cat-Camel (Cat-Cow)
-begin in position 1, with head slightly tilted up, low back gently arched - (pretend you are trying to “touch your tail-bone to your skull”) - hold 5 seconds
-transition into position 2 by slightly dipping your head, round-ing your back and ‘hollowing your stomach as you flex your core’ (imagine someone is pulling you straight up by a string through your back like a puppet, feel the stretch in the low back) - hold 5 seconds
-enter position 3 by sinking your rear into your heels, with arms stretched out forward - hold 5 seconds
-then finish with the most important part by reaching your arms side to side for 5-10 seconds each, feeling a stretch on each side of your low back (red arrow)-repeat all steps from the beginning, 3-5x
Figure 4 Stretch
-begin on your back with knees bent, feet flat on the floor-cross the leg on the affected side over the opposite knee-grab the uncrossed leg and pull it towards your chest (you can use a wrapped towel to assist if needed)-feel the stretch in the low back and gluteal muscles - hold 10-15 seconds, repeat 3-5x each side
-seated variation: sit upright with good posture, then cross the leg on the affected side over the opposite knee-push down on the bent knee while leaning your entire torso forward (from the waist, do not bend your low back forward) to feel the stretch in your low back/gluteal area - hold 10-15 seconds, repeat 3-5x each side (this is a useful variation that can be done anywhere)
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Low Back Pain Cont’dSelf Myofascial Release - Low Back (SMR)
Myofascial release is a process that attempts to release tension that develops in the fascia. Fascia is the tissue that surrounds all muscles, bones, nerves, and organs in the body, and essentially connects the body from head to toe. Trauma, inflammation, chronic disuse/abuse, and joint instability are common sources of increased fascial tension. With increased tension, the normal and/or optimal mechanics of the body are hindered and can result in pain, further mobility issues, and kinetic chain dysfunction - both locally and in distant regions of the body.
Fascial release is a documented way of releasing fascial tension to decrease the effects above. It is not for the faint of heart, as it can temporarily increase pain symptoms, however, when done properly it can be a tremendous aid in decreasing discomfort. The following version of SMR utilizes a lacrosse ball or similar type medium/hard rubber to complete the activity.
Targeted Anatomy: Quadratus Lumborum (QL) | Gluteal Complex | Erector Spinae
HOW TO RELEASETHE KEY: SLOW & WITH INTENT
→Select the yellow spots that best reflect your discomfort →‘Melting’ is the term used to describe how the rubber ball is implemented at each release location→ rolling on the rubber ball is not advised, especially near the spinal column - simply position it & MELT→ crossing your leg can enhance the release at the low back and glutes → soreness afterwards is normal, but pain during release should be tolerable; no more than 5/10 → each release is held for 10-30 seconds based on your tension, pain threshold, and mobility → each release target can be repeated 2-3x as tolerated
The yellow spots on the diagram (LEFT) indicate the areas to place the ball for self release, based on your pain and symptoms. Each spot can be per-formed on the opposite side as well.
Erectors
QL
Glutes
QL | Erector Release Position
Glute | QL Release Position
Glute Release Side Position
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Low Back Pain Cont’d Sciatica (With or Without Low Back Pain)Before continuing, please refer to the Note Well section on page 12.
If you have sharp, shooting, burning pain or tingling sensations down your leg, you’re likely experiencing sciatica, which is a symptom or a group of symptoms of a larger underlying issue.
Three of the major causes of acute sciatica (burning, numbness, weakness, pain down the leg) include bulging and/or herniated discs in the lumbar spine, acute inflammation in spinal joints, and piriformis muscle dysfunction. However, diagnosing the cause of your sciatica requires a thorough assessment and exam, which during this crisis may be difficult or impossible.
That said, alleviating sciatica pain and discomfort is possible using the self release noted in the previous page, as well as the following two activities.
Nerve Flossing
This exercise is intended to be relatively painless while the gliding activity is performed, which helps reduce inflammation and adhesion of the nerve.
Not feeling the ‘benefit’ immediately is normal and expected.
-begin seated on an elevated platform, with your head down and toes of the affected leg tucked below the sitting surface (toes down/nose down)
-in one coordinated movement, straighten your knee of the affected leg as much as is tolerable while extending your head backwards and opening up with a ‘proud’ chest (toes and nose to the sky) (toes can be pointed straight up or angled forward like the image above)
-hold this position briefly - it should not be unbearably
Piriformis Ball Release
-use a tennis ball or similar soft object for this activity, which can be done on the floor or seated
-follow the same instructions as shown on Page 14 for the glute release, however, the ball placement will be slightly lower by about 5 cm on the affected side
-this activity can also be done seated, similar to the seated Figure 4 shown on Page 13, only this time with a ball placed under the glute on the affected side
All images included in this guide are the respective property of their owners, used for non profit education to help those helping us.
Contact UsIf you require specific assistance or have questions regarding any of the content or activities in this guide, do not hesitate to contact us.
Email:[email protected]@canadianchiro.ca
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