How to prevent injury when shoveling snow.

FACT!- Snow shoveling injuries are the leading cause of back and neck pain during the winter months.

Improper technique can be anything from bending at the waist instead of the knees, to throwing snow rather than pushing it. The average weight of one shovelful of snow is 3 to 5 kilograms, and if your technique is off it can result in serious aches and pains.

What to do when shoveling:

• Dress in several layers so you can remove a layer as you get warm.
• Drink plenty of water. Dehydration is just as big an issue in cold winter months as it is in the summer.
• Wear proper footwear to minimize the risk of slip and falls.
• Pick the right shovel, when standing with arms at your side the handle of the shovel should reach your elbow. Use a lightweight, non-stick, push style shovel. If you spray the blade with a silicone-based lubricant, the snow will not stick to the shovel, and will slide off more easily.
• Warm up for 10-15min to get your joints moving and blood circulating. A quick walk around the block or marching in place are both good options.
• Push the snow to one side and avoid throwing it.
• Bend your knees, use your legs and arm muscles to do the pushing and lifting while keeping your back straight.
• Take a break! Make it a habit to rest for 2 min after 15min of work.

GUIDELINES FOR SHOVELING:

Keep feet wide apart.  Place front foot close to shovel. Put weight on front foot.  Use leg to push shovel. Shift weight to rear foot.   Keep load close to body. Turn feet in direction of throw.

How to avoid colds and the flu?

1. Wash your hands frequently and scrub for 30 seconds.
2. Cough into your sleeve.
3. Include oregano and garlic in your diet.
4. Eat fibre and take pro-biotics: they keep your intestines healthy which are a main area for immune function.
5. Eat oranges.
6. Zinc lozenges are a quick boost to immune function.
7. Take vitamin D everyday.
8. Sleep for 7-9 hours every night.
9. Drink 8 glasses of water everyday.
10. Visit your chiropractor, adjustments have shown to boost immune function.

What is Medical Acupuncture?

Acupuncture is a system of diagnosis and treatment. The diagnosis is based on a comprehensive Chinese theory of energy balance. The treatment involves insertion of small solid needles into precise anatomical sites in the body to produce therapeutic effects. The target structures are based on the examination findings and the aim is to stimulate a healing response directly at the tissue level. Electric stimulation may be added to the needles to amplify the healing effect for a stronger acupuncture healing response.

What can be treated by Medical Acupuncture?

Acupuncture is recognized by the World Health Organization and is effective in treating a number of disorders including but not limited to:

• Shoulder pain
• Neck and back pain
• Knee pain
• Tennis and golfer’s elbow
• Osteoarthritis
• Muscular imbalances
• Repetitive stress injuries
• Sports injuries.
• Headaches
• Insomnia
• Fatigue
• Anxiety
• Sciatica
• Numbness and tingling

Thoracic outlet syndrome is often attributed to extensive overhead activities, like cleaning or painting, or prolonged forward-reaching activities, such as typing, assembly work, working a cash register or carrying heavy loads over one’s shoulder. Symptoms include pain and weakness in the arms, clumsiness when performing tasks with the fingers or hands, stiff and/or painful neck muscles, pain in the chest near the arm pit, or a “pins and needles” feelings in the arms or hands.

Treatment includes mobilizing the neck muscles and engaging in treatments designated to keep them from entering spasm to relieve pain and arrest the condition before it becomes worse. Preventive care includes stretching and strengthening exercises to relieve pressure and increase range of motion.

When the rotator cuff is damaged, a variety of issues arise:

- Pain and spasm limit the range of motion of the shoulder.

- The muscles do not make the small adjustments within the joint to allow the humeral head to move smoothly.

- Fluid accumulation within the joint due to inflammation limits movement.

- Arthritis and calcium deposits that form over time limit range of motion

What are the best treatments for shoulder pain?
The treatment of shoulder pain depends entirely on the cause of the problem. Therefore, it is important for the chiropractor to accurately diagnose the problem before any treatment can start.

Carpal tunnel syndrome is pressure on the median nerve — the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.
The median nerve provides feeling and movement to the “thumb side” of the hand (the palm, thumb, index finger, middle finger, and thumb side of the ring finger).
The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow, so any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome.

Who gets carpal tunnel?

Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel. Other causes include:
• Sewing
• Driving
• Assembly line work
• Painting
• Writing
• Use of tools (especially hand tools or tools that vibrate)
• Sports such as racquetball or handball
• Playing some musical instruments

Symptoms:
• Numbness or tingling in the thumb and next two or three fingers of one or both hands
• Numbness or tingling of the palm of the hand
• Pain extending to the elbow
• Pain in wrist or hand in one or both hands
• Problems with fine finger movements (coordination) in one or both hands
• Wasting away of the muscle under the thumb (in advanced or long-term cases)
• Weak grip or difficulty carrying bags (a common complaint)
• Weakness in one or both hands

Treatment:
Success in treating CTS involves releasing pressure off the median nerve where it begins at the top of the spine as well as along the arm, forearm and wrist.  Rehabilitation will include soft tissue therapy (trigger point release) to the affected muscles, customized stretching and strengthening exercises, and  proper ergonomic practices to prevent recurrence.  Applying cold therapies to relieve swelling daily for 15min can ease symptoms.  Providing the proper arm support during the day, and bracing at night to keep the wrist in a neutral position contributes to healing.

Contact Dr. Tahir for help with Carpal Tunnel Syndrome. Call today: (416) 598-4999

While it’s important to maximize health with regular spinal alignment or “maintenance care”, a big component is to improve your overall fitness.

Being physically active helps you feel good and helps you get more enjoyment out of life. Physical activity is one of the most important things you can do to enjoy a longer, healthier life.’

The benefits you reap from exercise are numerous! Here is a short list:

1. Keeps your bones strong and reduces your risk of osteoporosis
2. Improves mood
3. Prolongs life
4. Strengthens heart and blood vessels
5. Promotes sustainable weight loss
6. Achieves metabolic balance

How much exercise do you need? Lets take a look at the formula:

There are 3 components to fitness

1. Aerobic (cardiovascular)
2. Strength
3. Flexibility

Adults 18 to 64 years of age require:
150 minutes of moderate intensity aerobic activity every week
60 minutes per week of flexibility
2 days per week of muscle-strengthening activities that work all major muscle groups
(legs, hips, back, abdomen, chest, shoulders and arms)

15 MINUTE RULE

150 minutes each week sounds like a lot of time, but you don’t have to do it all at once. Not only is it best to spread your activity out during the week, but you can break it up into smaller chunks of time during the day. As long as you’re doing your activity at a moderate or vigorous effort for at least 15 minutes at a time.

Its easy to get started! Here is a plan that you can implement today!

As you become accustomed to your exercise routine you can modify the types of
activities that you do. Choose activities that you enjoy. Here is a short list:
1. Riding a bike
2. Jogging/running
3. Hockey
4. Tennis
5. Fitness class (boot camp/pilates)

Questions? chiro@rubinatahir.com

What is Medical Acupuncture?
What can be treated by Medical Acupuncture?
Does Acupuncture hurt?
How deep do the Acupuncture needles go in?
How long are the Acupuncture needles left in place?
Are the Acupuncture needles clean?
How many Acupuncture treatments does it take to get better?
How long does each Acupuncture treatment take?
Do insurance plans cover Acupuncture?

What is Medical Acupuncture?
Acupuncture is a system of diagnosis and treatment. The diagnosis is based on a comprehensive Chinese theory of energy balance. The treatment involves insertion of small solid needles into precise anatomical sites in the body to produce therapeutic effects. The target structures are based on the examination findings and the aim is to stimulate a healing response directly at the tissue level. Electric stimulation may be added to the needles to amplify the healing effect for a stronger acupuncture healing response.

What can be treated by Medical Acupuncture?
Acupuncture is recognized by the World Health Organization and is effective in treating a number of disorders including but not limited to:

• Shoulder pain
• Neck and back pain
• Knee pain
• Tennis and golfer’s elbow
• Osteoarthritis
• Muscular imbalances
• Repetitive stress injuries
• Sports injuries.
• Headaches
• Insomnia
• Fatigue
• Anxiety
• Sciatica
• Numbness and tingling

On November 35, 1997, an independent panel of experts at the U.S. National Institute of Health (NIH) Consensus Development Conference stated that “Promising results have emerged showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain.”

“There are other situations, such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program.”

The conclusion of the NIH Consensus Statement was, “There is sufficient evidence of acupuncture’s value to expand its use into conventional medicine and to encourage further studies of its physiology and clinical value.”

Does Acupuncture hurt?
No, Acupuncture does not hurt. It is normal when a patient sometimes feels heaviness, aching or tingling around the site of the needle insertion. The Acupuncture needles used are very fine and thin, and are unlikely to cause any discomfort. In general, most patients describe acupuncture as very relaxing.

How deep do the Acupuncture needles go in?
Typically, the acupuncture needles are inserted to a depth of ¼ to 1 inch. Depth depends on the size of the person and the target structure and location.

How long are the Acupuncture needles left in place?
Once the needles are inserted, they are left in place for 15 minutes, depending on the patient’s condition. During this time, the patient should remain still, relaxed and in a comfortable position.

Are the Acupuncture needles clean?
Sterilized, single use, stainless steel Acupuncture needles are used. Once the needles are removed from their sealed packaging they are only used once and then disposed of.

How many Acupuncture treatments does it take to get better?
This depends on the condition being treated. If the condition is fairly new and uncomplicated, a patient may only need up to five acupuncture treatments. However, if it is a more serious condition the patient may require anywhere from five to 15 Acupuncture treatments.

Some chronic conditions may require more sessions of Acupuncture.

How long does each Acupuncture treatment take?
The first visit will include a full assessment where the patient is asked a number of questions about his or her health. A focused regional physical exam follows. Following this, the first treatment is performed. This process takes about one hour, and around 30 minutes for subsequent treatments.

Do insurance plans cover Acupuncture?
Yes. The majority of Canadian workers have partial or full coverage for Acupuncture services in their workplace health care plans. OHIP does not cover these services. The Acupuncture patient is provided with a detailed itemized receipt listing the services provided, the credentials of the treating Acupuncture Provider, as well as payment details for reimbursement.

More and more third party Insurance companies and Worker Safety Insurance boards are recognizing the effectiveness of acupuncture, enabling patient treatments to be billable under most health and wellness plans.

According to health Canada:  In 1990, almost one in five workers missed over one week of work as a result of sickness, injury, or disability.  One-third of these employees, or 6% of all workers, missed in excess of five weeks away from work. In addition to the reduced quality of life experienced by these employees, absenteeism impacts the productivity of Canadian business and, by extension, Canada’s Gross Domestic Product. Indeed, employers view higher productivity and lower absenteeism as two of the key benefits of health promotion programs at work.

How can you get started?
It can be as simple as a workplace health talk.  These seminars are done over a one hour lunch break.  They are interactive, informative and provide easy solutions that employees can implement immediately. Some topics Dr. Tahir has covered include, but are not limited to:

1. Heart smart
2. Healthy eating “bite sized”
3. How to cut out stress
4. Sleep:  How to get it!
5. Osteoporosis:  what does your bone bank look like?
6. Detox
7. Easy Exercise

Dr. Tahir also works with company wellness committees to customize long term wellness initiatives.  Get your company motivated!

Interested in a pedometer challenge? Contact us today.

Companies we have worked with:

• TIC travel insurance
• Essence of Health
• Adair Morse, LLP
• Lerners, LLP
• College of Physicians and Surgeons
• Industrial Alliance
• Sunlife Financial
• McMillan, LLP
• Canadian Breast Cancer Society
• Eat Right Ontario
• BBC Canada
• Canada Life

Custom made foot orthotics are medical appliances that are placed into the shoe to correct an abnormal or irregular walking pattern. They perform functions that make standing, walking, and running more comfortable and efficient, by gently restoring the normal balance and alignment of your feet and therefore the rest of your body.

Orthotics are prescribed by Dr. Tahir following a complete biomechanical assessment and gait analysis of your feet. They are custom made at a laboratory based on the prescribed recommendations to align the structures of the feet in their most functionally efficient position. The orthotics are designed to stabilize the feet and to prevent them from moving into unbalanced position while walking or running.

Foot orthotics are known to solve many biomechanically related issues, not only for obvious foot problems including excessive pronation and plantar fasciitis but also for ankle, knee, hip, and spinal pain and other health issues such as diabetes and arthritis. This is achieved by preventing misalignment of the foot, which can significantly alter the way in which the bones move within their joints.

Foot orthotics take various forms and are constructed of various materials for different functions. All are concerned with improving foot function and minimizing stress forces that could ultimately cause deformity and pain in your feet and the rest of your body.

Chiropractic?

Chiropractors are “primary contact” health care providers, which means you do not have to be referred to one by a physician or anyone else.

What conditions do chiropractors treat?

Chiropractors are experts trained in the neuromusculoskeletal system. They diagnose and treat disorders of the spine and other body joints by adjusting the spinal column or through other corrective manipulation. Chiropractors provide conservative management of neuromusculoskeletal disorders including, but not limited to, back, neck and head pain (over 90 percent of conditions treated). They also advise patients on corrective exercises, lifestyle and nutrition.

What happens during a treatment?

During your first visit, the chiropractor will want to know about your health history as well as your current complaint. Your home and work life as well as your level of physical activity may also affect your health, so don’t be surprised to be asked questions about these.

Although chiropractors use their hands for most treatments, they also use other methods such as heat, light, specialized adjusting instruments, ultrasound, electrotherapy, personalized exercise programs, muscle-testing and balancing. Your chiropractor can also give you information and guidance on how you can stay healthy through proper nutrition, exercise and lifestyle changes.

What kind of education and training do chiropractors have?

Chiropractors are educated as primary contact health care practitioners, with an emphasis on neuromusculoskeletal diagnosis and treatment. Preparation for the practice of chiropractic is concentrated on three areas: basic training in the biological and health sciences, specialized training in the chiropractic discipline, and extensive clinical training. Becoming a chiropractor in Canada requires a minimum of 7 years of post-secondary education including no less than 4 years of full-time classroom and clinical instruction at an institution approved by the Council on Chiropractic Education Canada.

What is a subluxation?

“Subluxation” is a term used to describe a problem with a spinal joint. The World Health Organization defines a “subluxation” as a functional problem related to a joint and the structures associated with the joint such as the muscles, tendons and nerves. Dysfunction can present itself in various ways such as pain, inflammation and restricted movement of the joint. Some types of dysfunction, such as sprain, will not appear on an x-ray. Chiropractors are trained to identify dysfunction that does not appear on imaging through the use of manual examination and non-imaging diagnostic tests.

What is the “vertebral subluxation complex”?

VSC is a term used to describe the kinds of issues that may be associated with a joint that is not functioning properly. For example, there may be loss of motion. changes in the muscles that attach to the spine, irritation or injury to the nerves that radiate out from the vertebrae, degeneration of the disks or inflammation of tissues in the spinal region. Chiropractors are well trained to identify the components – or complex – of problems that may accompany a joint problem.

Some of the indicators include tenderness,  soreness and stiffness, spasm, tightness or weakness, headaches, and reduced mobility. Pain may or may not be felt. Chiropractors typically use a combination of imaging such as x-ray, manual examination, patient history, and non-imaging physical tests to determine what is taking place physiologically.

What results can I expect from treatment?

That depends on your condition. The length of time you have had the problem, your age and the degree of your disability all affect the length of your treatment. Your chiropractic doctor should tell you the extent of treatment recommended, and how long you can expect it to last.

One of the main reasons people choose chiropractic is that they often get quick results. Individual cases vary and chronic conditions obviously need more treatment, but Workers’ Compensation Board studies show that people with low back pain get back to work much faster with chiropractic care.

You might also consider the benefits of regular chiropractic adjustments even when you feel healthy. Sometimes you won’t know you have a disorder of the neuromusculoskeletal system until it becomes acute and painful. So, just as you see your dentist to have your teeth checked and your optometrist for eye exams, regular visits to your chiropractor can catch related health conditions early, often preventing them from developing into major problems. Remember, your spine is every bit as susceptible to wear and tear as your teeth and your eyes so you should look after it.

How is chiropractic adjustment performed?

Chiropractic adjustment or manipulation is a manual procedure that utilizes the highly refined skills developed during four intensive years of chiropractic education. The chiropractor typically uses his/her hands to manipulate the joints of the body, particularly the spine, in order to reduce pain, and restore or enhance joint function. Chiropractic manipulation is a highly controlled procedure that rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient.

How many people see chiropractors?

Statistics Canada data found that over 11 percent (3 million) Canadians consulted a chiropractor in 1996. The figures today are closer to 15 percent, or over 4 million Canadians annually.

Is chiropractic covered by government health plans?

Chiropractic care is covered extensively by third party payers. These include the federal public service, worker’s compensation boards, the automobile insurance industry, private health care insurers, large employers, the RCMP, and Veteran’s Affairs Canada.

Is chiropractic manipulation a safe procedure?

Chiropractic adjustment or manipulation is a drug-free, non-invasive approach to common musculoskeletal conditions such as headache, and neck and back pain. As such, it is a low risk therapy. Complications arising from adjustment are rare.

Is chiropractic evidence-based?

Chiropractic is a healing discipline firmly grounded in science. Few other health care interventions have been assessed as extensively as chiropractic manipulation, both in terms of safety and effectiveness. There have been at least six formal government studies into chiropractic worldwide over the last 25 years and all have concluded that contemporary chiropractic care is safe, effective, cost-effective and have recommended public funding for chiropractic services. In addition, there have been countless scientific clinical studies assessing the appropriateness, effectiveness, and/or cost-effectiveness of spinal manipulation or chiropractic manipulation, most notably for low back pain. The Canadian Institutes for Health Research (CIHI) now offers research grants in partnership with the Canadian Chiropractic Association to chiropractors and other scientists for high quality, chiropractic research.

Is chiropractic regulated in Canada?

Like medicine and dentistry, chiropractic is a self-regulating profession, and each provincial chiropractic regulatory body has the authority to grant a license to practice chiropractic. There are Chiropractic Acts in all 10 provinces and the Yukon Territory which establish a self-regulatory process which includes extensive testing for licensure. In all provinces, licensure requirements include university studies followed by graduation from an accredited chiropractic institution, and passing national and provincial board examinations.

Is chiropractic treatment appropriate for children?

Yes, children may benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from activities of daily living as well as from participating in sports. Injuries such as these may cause many symptoms including back and neck pain, stiffness, soreness or discomfort. Chiropractic care is always adapted to the individual patient. It is a highly skilled treatment, and in the case of children, very gentle.

While there is some clinical evidence that musculoskeletal treatment of infants may have positive effects, well-controlled studies are required to verify the benefits that are seen in clinical practice.

Is every patient’s treatment the same?

The treatment a patient receives is related to the specific condition diagnosed by the chiropractor, and will vary from person to person depending on each persons unique situation.

Is chiropractic treatment ongoing?

The hands-on nature of chiropractic treatment is essentially what sends patients back to the chiropractor a number of times. To be treated by a chiropractor a patient needs to be in his or her office.

A chiropractor may provide acute, preventative and/or maintenance care thus making a certain number of visits necessary. The average number of annual visits per patient is eight.

Can chiropractic treatment cure colds, earaches and other ailments?

Chiropractic care cannot “cure” these conditions, but there is some evidence to indicate that adjustment may have a beneficial effect on a variety of conditions. Adjustment may alleviate some of the secondary, or referred pain, arising from the response of the musculoskeletal structures to the primary cause. For example, research conducted in Denmark resulted in chiropractic treatment being recommended for the relief of infantile colic. Similarly, a recent U.S. study concluded that the application of manipulative techniques in children with recurring ear infections can prevent or decrease surgical intervention or antibiotic overuse.

Can chiropractic treatment provide a preventative function?

Clinical experience suggests that individuals with chronic conditions such as degenerative joint disease (osteoarthritis) or recurrent neck pain, back pain or headaches may experience less frequent and less severe symptoms when under regular chiropractic care. This also applies to individuals in highly stressful situations and those who experience repetitive physical and postural strain from their daily activities.

What is the difference between physicians and chiropractors?

That’s like asking the difference between a physician and a dentist: they are different professions within the health care spectrum. Both chiropractors and physicians are legally entitled to use the title “doctor”. As the appellation MD means “Doctor of Medicine”, so DC means “Doctor of Chiropractic”.

The role of chiropractic is complementary to other areas of primary health care. Chiropractic is not, for example, a replacement for medical care, but may offer an alternative to medication and surgery in appropriate circumstances.

Do chiropractors refer patients to medical doctors when necessary?

Yes, like medical doctors, chiropractors refer patients to other health professionals when they feel it is appropriate. Chiropractors are well trained to recognize risk factors as well as individual disease patterns and will not hesitate to make a referral when it is in the best interest of the patient’s health.

Does chiropractic treatment require a referral from an MD?

No. A patient does not have to be referred. Chiropractors are legislated as primary contact health care professionals in every province in Canada. This means that patients can consult them directly.

Do chiropractors take a medical history?

Like MD’s, the chiropractor will take a detailed health history during the first visit, prior to initial treatment. This will include details on lifestyle and risk factors to give the chiropractor a full picture of the patient’s health in order to determine the best treatment. As well, a detailed health history is important to rule out any contraindications to treatment and to fully investigate risk factors before a diagnosis and treatment recommendation can be reached.

Does chiropractic treatment require x-rays?

X-rays can play an important role in diagnosis and are taken when a need has been determined after taking a patient case history and conducting a physical examination. Chiropractors receive 360 hours of education in radiology covering a full range of topics from protection to X-ray interpretation and diagnosis. Governments in every province have recognized the training and competence of chiropractors to take and interpret X-rays and have granted them this right.

Why is there a popping sound when a joint is adjusted?

Adjustment of a joint may result in release of a gas bubble between the joints that makes a popping sound – it’s exactly the same as when you “crack” your knuckles. It is not painful. It is caused by the change of pressure within the joint resulting in gas bubbles being released.

For more information please contact the Canadian Chiropractic Association