Dr. Richard Schwartz /215-283-2844/ Ambler Chiropractic / Can Poor Posture Predict Mortality?

Dr. Richard Schwartz / 215-283-2844/ Ambler Chiropractic

Can poor posture

predict mortality?

Maybe so according to a recent study and that ain’t all! Turns out that posture (in this case thoracic HYPER kyphosis) is getting some attention in the literature and appears related to a wide range of ailments, of which increased risk of death is only one. Only problem is that chiropractors aren’t doing the research. OH NOOO!!!

Because while half of our profession has relegated spinal structure to the dustbin of chiropractic history in pursuit of more “sophisticated” theories, our MD and PT colleagues are more than happy to lay the scientific ground work relating spinal structure to a wide range of ailments. End Of Rant…promise.

First off…thanks to Dr. Roger Coleman at ScienceInBrief.com for making me aware of this research. For those of you who aren’t familiar with the ScienceInBrief.com
project, we review scientific articles on a wide range of subject which are of interest to chiropractors. Unlike this newsletter, very little of what we do at SIB is directly related to posture based chiropractic. But occasionally, I run across articles which are relevant for readers here at Postural Rehab. Here’s a recap of the article along with some thoughts on managing thoracic HYPERkyphosis.

Hyperkyphotic Posture Predicts Mortality in Older

Community-Dwelling Men and Women: a prospective study 1

The Facts:

a. The authors studied the association between thoracic hyperkyphosis and mortality in over 1300 individuals with a mean age of 73.

b. If the individual laid on their back and was unable to rest the head on the table without putting the neck into hyperextension they were considered to have thoracic hyperkyphosis.

c. Patients were followed for an average of 4.2 years.

d. Those “with hyperkyphotic posture had greater mortality rates. Increased severity of “kyphotic posture” appeared to be associated with a higher risk of mortality.

Discussion: Obviously, the inability to bring the head back to neutral resting position COULD be also caused by factors other than thoracic hyperkyphosis, but what’s important here is that POSTURE appears to be associated with early mortality. Interestingly, thoracic kyphosis was found to be twice as common in men (44%) as women(22%) in this study, which seems to be at odds with conventional thought that thoracic hyperkyphosis is commonly caused by osteoporosis, a condition much more common in women.

The “NORMAL” Thoracic Kyphosis

Obviously, a radiographic evaluation of the T spine gives us a much more accurate idea of the sagittal curvature.

Harrison defined the thoracic kyphosis as ELLIPTICAL in shape, having a Jackson’s (Cobb) angle of 44.2 degrees from T1-T-12. Realizing the difficulty of visualizing both T1 and T12 on the radiograph, Harrison recalculated the model to reflect a thoracic kyphosis of 33.3 degrees between T 3 and T10. 2

Vaz et al, define the average thoracic kyphosis as 47 degrees in healthy young adults. 3

Boseker et al, defined a range of “normalcy” between 20-50 degrees in healthy children. 4

So you can see that opinions vary as to what is actually normal. I encourage interested readers to come to do some reading and establish in their mind what they consider to be the appropriate upper limits of thoracic kyphosis. Personally, I generally tend to view curves in excess of 40 degrees (as measured from T3-T10) as suspect. That’s just my opinion based on my reading of the literature, but 40 degrees is an upper limit you will find frequently cited. Regardless of which value you consider appropriate, it is important to have some sort of firm upper limit, above which you will start considering clinical intervention.

Clinical Management:

A number of tools have been looked at for treating thoracic hyperkyphosis but definitive research is still sorely lacking. Some options you may want to consider are exercise, bracing, and spinal remodeling. Here are two simple, inexpensive tools I have found to be helpful.



Thoracic Rolls

One method of actively addressing the thoracic kyphosis is to simply place the patient over a large foam roll ( our Multipurpose Rolls in the 10-13″ range work well for this), have them raise their hips up, and then “roll” themselves up and down over the roll by alternately flexing and extending the knees. This does two things. First, it introduces a fulcrum effect into the mid T spine to help reduce the kyphosis. Secondly the rolling motion helps mobilize the spine and costovertebral articulations to promote a reduction of kyphosis.

Thoracic Arch

Another method is to simply allow the patient to passively rest over a foam roll or fulcrum for 20-30 minutes. This time frame allows for stretching of the paraspinal tissues to occur and for the spine to “remodel” into a reduced kyphosis. I use our Thoracic Archfor this purpose and we now have lots of doctors using these arches on a regular basis to remodel the T spine.

I generally start with the patient over the arch with the fulcrum at the apex of the kyphosis as shown above. Once they can comfortably relax for the full 20-30 minutes without any problems or soreness, I place a 1″ spacer beneath the arch to raise it up and increase the leverage effect into the mid thoracics. Occasionally, I may end up placing an additional spacer or two as needed to effectively introduce extension into the thoracics.

References:

1.Kado DM, Huang MH, Karlamangla AS, Barett-Connor E, Greeendale GA. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. JAGS 2004;52:1662-7

2. Harrison DE, Janik TJ, Harrison DD, Cailliet R, Harmon SF. Can the thoracic kyphosis be modeled with a simple geometric shape? The results of circular and elliptical modeling in 80 asymptomatic patients. J. Spiinal Disord Tech. 2002 Jun;15(3):213-20.

3. Vaz G, Roussouly P, Berthonnaud E, Dimnet J. Sagittal morphology and equilibrium of pelvis and spine.Eur Spine J. 2002 Feb;11(1):80-7.

4. Boseker EH, Moe JH, Winter RB, Koop SE. Determination of “normal” thoracic kyphosis: a roentgenographic study of 121 “normal” children. J Pediatr Orthop. 2000 Nov-Dec;20(6):796-8.

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Chiropractic Care in Ambler, PA

What to Do If Injured, Chiropractic Care in Ambler, PA
215-283-2844

Automobile Accidents, Chiropractic Care in Ambler, PA

Understanding what to do when an accident happens, and what types of injuries can occur may save you time, money, and long-term medical care. A prompt physical examination is the best advice. A thorough examination by a chiropractic physician is a wise precaution to determine the presence or absence of “hidden” injuries. Confer immediately with your doctor of chiropractic who will determine the extent of any injuries.

Serious and costly injuries do not always result in immediate pain or bloodshed. Aside from the more dramatic wounds which require surgery or hospitalization, other serious and costly injuries may result from auto accidents. Doctors of Chiropractic are particularly well-qualified to detect and treat a wide variety of injuries of the spine, nerves, and other related structures.

 

Common Injuries:

Low-Velocity Injuries (under 10 mph), usually result from the rapid movement of the body during the accident. This movement may result in muscle strain, seat belt bruises or Traumatic Brain Injury (TBI). Other symptoms may be delayed, but pain and stiffness may occur within 12-36 hours after impact.

High-Velocity Injuries (over 10 mph), usually result from a second impact, the body hitting objects inside the vehicle such as the dashboard, steering wheel, or window. Common injuries of this kind include shoulder, head or knee hematomas, wrist fractures, neck sprains, concussions, and a variety of contusions.

Traumatic Cervical Syndrome, more commonly known as whiplash, occurs when the neck is forced through a rapid series of movements faster than the bones, muscles and ligaments can accommodate. Some symptoms include swelling, tenderness, weakness or pain in the neck and shoulder; sore throat and/or loss of voice, trouble swallowing; jaw problems; vomiting; flashing lights in the visual field; headache; light-headedness or dizziness; painful tingling sensations; visual disturbances or blurred vision; and ringing in the ears. In some cases pain may not present itself for 12-36 hours after impact. 

Dr. Richard Schwartz DC talks about Trigger Point Massage

Trigger Point Massage

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Whiplash from a Car Accident What can a Chiropractor do?

Whiplash How Did This Happen

By: Dr. Richard Schwartz

The accident injury doctor

You’re in your car, relaxed, waiting and suddenly you hear the screeching of tires. In that split second and before you can brace yourself, you feel the car lunge forward. You’ve been rear-ended. What happens in this brief moment can surprise you and what you do about it in the next few hours, days, and weeks can and will affect your future health. Chiropractic can help stop the harmful effects of car accidents that happen in Ambler, Pa , Horsham, Pa , Glenside, Pa In fact Dr. Schwartz helps all types of injuries from auto, work injuries to sport injuries even herniated disc. Please read on to see how you can be affected by a car accident

Upon impact, your body pushes deeply into the seat. Your head, momentarily isolated by your neck, delays its reaction while your body quickly reaches the limits of the seat. Then, your body instantly changes directions, moving forward to the limits of your seat belt. Now, your head starts moving backward in the opposite direction. Unrestrained by a seat belt your head is jerked back and forward beyond its normal limits. Your head is always going opposite of your body. What happens when you hold a piece of paper and move your hands in opposite directions, it tears. This is exactly how we can tear the ligaments and muscles of the neck. Everything is happening in slow motion, yet you are unable to prevent your head from whipping back and forth.

How can we minimize our injuries in a rear-end collision, we must be restrained by a seat belt this obviously prevents severe injuries and excessive forward motion of your body. The second crucial factor is the position of the headrest. It has to be no more than 1 inch away from the back of your head and the height has to extend above the top of your head. With the proper positioning the headrest can prevent excessive backward motion. If the position is incorrect the headrest actually adds to the problem by creating a fulcrum, which allows your head extend over the top and increases the stretching of ligaments and muscle tissue in the front of your neck.

Don’t minimize your own injuries because your car has sustained little or no damage in Horsham, Pa . It has been proven that a 5 mph impact can result in soft tissue injury. Signs and symptoms from a whiplash type injury can be many and vary in severity. The most common symptom is neck pain, which may take a few hours to begin due to the adrenaline rush. Headaches are the second most common symptom, 85% of all headaches are tension headaches, and we know after the above description of an accident we would have tension. Do not let these signs and symptoms go for a long period of time, because pain is an indication that something is wrong and just blocking the pain will not fix the problem. A thorough evaluation would be required to identify the problem and to determine the treatment you need. You have to restore proper motion with in the neck, in order to allow the muscles and ligaments of your neck to repair and heal. Don’t wait or think, my accident wasn’t that bad, seek proper care. Chiropractic can help. Dr. Schwartz a local chiropractor in Horsham, Pa is a specialist in accident and injury rehabilitation.

Find out more about whiplash click here

Car Accident and Work Injury Massage Horsham, PA

Car Accident and Work Injury Chiropractic Treatment For Horsham, Pa

Specializing in physical rehabilitation, we are committed to helping our patients restore their normal lives after a car accident or work-related injury. Using the latest knowledge and technology in chiropractic care, we apply a multidisciplinary approach to diagnosing and treating your condition.

If you’ve ever been involved in a car accident or work-related injury, it often isn’t until days – or even weeks – later those physical problems arise, stemming from the accident.

When your livelihood, and more importantly, your health are at risk, you want to be sure your care is entrusted to experienced and qualified medical professionals. At Burch Chiropractic Center, we specialize in and frequently treat a wide variety of chiropractic conditions, including:

  • Back pain
  • Headaches
  • Neck pain
  • Muscle spasms
  • Stiffness
  • Insomnia
  • Located at 701 Limekiln Pike, Ambler, Pa

Your health should be your top priority after a car accident or work-related injury. To schedule a free exam, call or contact us online today!

215-283-2844