I will be attending the ICAC convention for chiropractors from tomorrow evening through Sunday (23-25 March 2018). I’m very excited. As chiropractors, we have to complete 24 hours of continuing education every year. This is a rather stringent requirement, but I think it reflects that our profession is vigilant in preparing doctors for the present as well as the future. It is a “no chiropractor left behind” model of education. When I was studying at the University of Virginia, students were not referred to as freshmen, sophomores, juniors, or seniors. Rather, we called ourselves first-years, second-years, third-years, and fourth-years, respectively. This is in honor of Thomas Jefferson‘s concept of education, that learning never stops, but is instead marked by the length of time we devote to it. I think Mr. Jefferson would have approved of California’s continuing education requirements for chiropractors. So, cheers to my second year of seminars. Have a good weekend!
Category: Chiropractic
Guided imagery
The third technique highlighted in this article is guided imagery, a specific form of meditation. So, in order to explain the former, I’ll first expound on the latter.
Meditation is the practice of concentration. It is an ancient technique that was associated with spirituality and religion, but in the modern context, does not have to be either spiritual or religious. But, why concentrate? Why focus on just one thing, concrete or abstract? It appears that by focusing intensely on one idea, the clutter of the mind stills. In stillness, there is clarity, and through the clarity, one can find relaxation.
There are two broad categories of meditation: concentration meditation and mindfulness meditation. Concentrative meditation is meditating on the breath, on an image, or on a sound. Indeed, if you’ve been following only with this series, you’ve already done concentrative meditation when we discussed breathing. The point of focus is slightly more concrete than that of mindfulness meditation. In mindfulness meditation, one experiences the environment without attachment, judgment, or application of conscious thought. It is the experience of one’s surroundings as a witness, rather than as a participant. For now, we will focus on concentrative meditation and explore mindfulness in a later post.
In order to start meditation, it is helpful to follow these steps:
- Find a quiet place.
- Maintain a comfortable but proper posture. This is especially important when using meditation to reduce pain. However, it is not recommended to lie down, as sleep comes quite easily in this position during meditation. If you have trouble finding a posture that you can maintain for ten minutes, ask me at your next appointment.
- Choose something to focus on. Be creative.
- Be passive. Perhaps this is the most counterintuitive step. How can one possibly be passive when concentrating fiercely? What this means is to not judge yourself harshly when you find that focusing on one thing is difficult. Your thoughts will certainly drift. Rather than feeling frustrated, recognize that you’ve thought of something else, and think, “Oh. That’s interesting,” and then return to your subject of focus.
I think guided imagery is a fantastic introduction to meditation. Rather than self-driven meditation, guided imagery involves someone telling you what to visualize. You create the images in your mind, based on what you hear. You can attend an in-person class or listen to a recording. Here is an example.
How did that go? Let me know in the comments, and feel free to share other resources. I’ve found that because guided imagery involves listening to someone’s voice, people may prefer certain inflections over others. Listen to recordings that work best for you.
In honor of daylight saving time
I’m going to take a pause from our regularly scheduled programming to offer some insights about sleep, with help from my friends at Tuck.
Around this time of year, every year, I hear people noting how much the one hour difference negatively affects their sleep. It made me think of all the others things that make sleep difficult. I’d like to direct you to three articles that are insightful and comprehensive.
- Does pain affect sleep?
- Is a soft pillow causing your neck pain?
- How to pick the best mattress for back pain.
I hope you enjoyed these resources. And if you do suffer from neck or back pain related to sleep, pillows, and/or mattresses, let me know at your next visit or make an appointment.
Progressive muscle relaxation
The next item in this article is “eliciting the relaxation response.” Let’s start at the basics, with progressive muscle relaxation.
There are two steps to progressive muscle relaxation: tension, followed by relaxation of the tension muscles. You will focus on one muscle group at a time, on just one side of the body. Let’s say you’re starting with your right hand. As you inhale, squeeze your right hand as hard as you can for five seconds (be careful not to hurt yourself when tensing muscle groups). In these five seconds, focus on what the tension feels like. Then, exhale and quickly release your fist. Let all the tension dissolve from the right hand for five seconds. These five seconds are the most important part of this exercise. Focus on what relaxation feels like. Contrast that with tension. You will repeat this sequence until you have tensed and relaxed all the muscles groups on both sides of your body. You can use this video to guide you.
The point of progressive muscle relaxation is to make us aware of the feeling of tension. I so often see people walk into the office with their shoulders drawn up to their ears. They are no longer aware that those muscles are tense! It will take more than one session, but by consistently doing this exercise, you will relearn what tension actually feels like and become more aware of when you are tense throughout the day.
Breathing
As promised, this is the first post of a series, exploring the points introduced in this article.
We’re going to give some thought to breathing, which is so instinctual, that we don’t think about it. However, breathing is not only a necessity; it can help us relax and manage pain.
Here’s what happens when we breathe:
- Muscles contract
- Diaphragm expands
- Low pressure is in the lungs, high pressure is outside
- Air goes into the lungs through the mouth/nose and then through the trachea
- Air passes into the bronchi
- Air passes through the bronchioles
- Air passes to the alveoli and gas exchange occurs
- Muscles relax
- Diaphragm contracts
- Pressure increases in the lungs
- Air is breathed out
- Repeat
We take this system very much for granted, but if it were to fail, we would give anything to breathe again. Indeed, most people would lose consciousness after not being able to breathe for two minutes; brain death usually occurs four or five minutes after cessation of this process.
It’s no surprise that breathing is essential to life. But is that its only purpose, to sustain our existence? No. Breathing consciously is a powerful tool for relaxation, and through relaxation, pain management. Breathing therapy has been used successfully in managing chronic low back pain. So, how do we breathe consciously? Try this (an oldie, but a goodie).
How’d that go? Let me know in the comments!
The mind and the body
I’d like to share this great article from Harvard, that speaks on the effect that the mind can have on the perception of pain. It states, very importantly, that the brain can continue to perceive pain without noxious stimuli; this is called central sensitization, in which the mind is so wired and so used to the perception of pain that it will create the sensation of pain without any external influence.
In chiropractic philosophy, it is said that three things cause subluxation: psychological stress, mechanical stress, and chemical stress. In other words, stress, physical trauma, and toxins will individually and synchronously cause misalignment of the joints of the body. Indeed, the mind can work against us, but what is learned can be unlearned.
In the coming weeks, I will discuss the six techniques overviewed in this article in detail. (I’ve got to put that sport psychology degree to use.)
Posture
Posture fascinates me. As a child and through most of adulthood, I had terrible posture. My parents would constantly tell me stand up straight. While I also wanted to stand straight, it was just so difficult to do so. However, my parents would also remark that when I played the piano or the violin, I would stand so tall.
These days, I still don’t think I have great posture, but, just as when I was younger, I know that in certain situations, my posture is excellent. I now know how to achieve good posture, how to stand tall consciously, if not constantly. We learned much about posture in chiropractic school, but this article takes away the medical terminology and tells you what good posture looks like (tl;dr note the bullet points at the end). Using these points, simulate the posture in your body, hold, then relax. That’s how you teach yourself over time what posture feels like, so you can return to that state again and again, and maybe even make it your new normal.
P.S. A posture examination is part of every chiropractic examination that I do. Have you had your posture examined?
Veterans and chiropractic
Take a look at this abstract of a recent research paper. It finds favorable outcomes for female VA veterans utilizing chiropractic care to manage lower back pain. Very exciting!
Closures (2018)
The clinic will be closed on the following dates:
- 15 January 2018 in observance of the birthday of Martin Luther King, Jr.
- 19 February 2018 in observance of the birthday of Washington.
- 30 March 2018, to prepare for Passover.
- 4 April 2018, because I have lots of baking to do for a Seder.
- 28 May 2018 in observance of Memorial Day.
- 4 July 2018 in observance of Independence Day.
- 5 and 6 July, because I have a conference.
- 22 August, because I will be meeting with a colleague.
- 10 and 11 September 2018 in observance of Rosh Hashanah.
- 19 September 2018 in observance of Yom Kippur.
- 23 October through 8 November 2018.
- 12 November 2018 in observance of Veterans Day.
- 4 through 21 December 2018.
- The third Thursday of the month. (Please note that I will be out of town on 20 December 2018, but I will see RARCC clients on 27 December 2018.)
The clinic will be open by appointment only on 22 and 23 November 2018, 25 December 2018, and 1 January 2019.
Have a good one!
Justice League
Warning. Spoilers ahead!
But truly, it’s just a teeny, tiny spoiler, completely irrelevant to the plot.
Has anyone seen Justice League? I recently did, and I thought it was fantastic. There was a particular moment that made me incredibly proud to be a chiropractor.
Last warning. Spoilers ahead!
Here goes. Wonder Woman gives Batman a shoulder adjustment.
She, and chiropractic, got so much cool points from this. Not that either were lacking in coolness. But more coolness is better. I’m always on the lookout for portrayals of chiropractic in modern media. Alan Harper from Two and a Half Men comes to mind. Misty Copeland sees a chiropractor in the documentary, A Ballerina’s Tale. Have you seen any references to chiropractic recently on the small screen or big screen?