Why I am an enabler....the reason we rehab.

Wait, an enabler? A doctor? (We'll get to that in a minute..)

First of all, here at Maximum Performance - we do sports chiropractic, rehabilitation, athletic performance, and treat each of our patients as if their athletic/physical needs are as important as a professional athlete's.  Because - they are!  When physical dysfunction and pain gets in the way of doing the things we need to do and love to do, it interferes with our lives.  That can be debilitating, frustrating, and exhausting.  To not function means that we are less than living, and fighting physical and health battles can be overwhelming as we try to operate as humans in today's world.  As someone famous once said, "Ain't nobody got time for that!"

Enter MPC.  We are here to get people back to their optimal function.  We do help get people out of pain, but it doesn't stop there.  Pain is an indicator.  It is the "check engine light" for the body.  Our patients hear us say, "Pain is the last thing to show, and the first to go."  Meaning: the painful tissue is usually not the cause of the problem, and just because it's gone, doesn't mean it won't come back.  When we evaluate an injury, we look to the cause of the dysfunction.  If we look to relieve the pain, the issue may return.  When we look to correct the cause, that will prevent the issue from returning.  How do we correct the cause?  As one of our honored mentors and a leader in the rehabilitative field, Dr. Craig Liebenson will say, "There are many roads to Rome."  The leader in spinal biomechanics research, Professor Stu McGill will famously answer, "It depends."  Our answer is a combination, "It depends on what will work best for our patient."

We combine therapy options like soft tissue management, chiropractic adjustments, and rehabilitative exercises.  Each patient brings in not only different biomechanics and injury mechanisms, but different goals.  Each patient that comes into our office is asked the same question: "What are your goals of treatment?"  Because if I have a parent who's number one goal is to be able to lift their 20lb child without pain, will working with 5lb weights or therabands help them?  Not enough.  We need to train that patient how to manage weight and their movement in real-life situations that are specific to them.  This is why we rehab.

Ok, so let's look into the word rehabilitate.  It comes from the Latin: re + habilitare.

Re = again.

Habilitare = to enable, make suitable.

So, yes - I am an enabler.  I enable movement all day.  But I am not the first to do so.  Let's not forget the "re-" aspect.  To rehabilitate is to enable or to make suitable "again."  It was suitable before.  This is a common missing link.  We tend to forget that throughout development, movement patterns are earned and learned and that we were born with all the mobility we needed and as a toddler and child, we earned our stability.  Motor patterns are the key here.  These are brain-body connections that allows us to move without thinking of each participating nerve, muscle, and joint.  With an injury, either chronic or acute, we MUST retrain the motor pattern, otherwise, we'll either see a recurring injury, or a transfer of the problem to another part of the body. (ex. an ankle issue becomes a knee issue, etc.)

Why rehabilitate the motor pattern? Well, if we look at an injury in a reductionist way - we see parts and a sum of the parts.  With this train of thought, a sprain of the ankle can easily be fixed by allowing the ligaments and muscles of an injury to heal (6-8 weeks or longer depending on severity) and then re-entering activity.  So, why do we see so many chronic ankle sprains if this is true?  Because when it comes to human locomotion, we can not view each part separately and expect the whole to work.  It is because each part does not own its mechanism.  All parts are connected and controlled by our central nervous system - so we must take a holistic view when it comes to evaluating movement.  This is what allows us to connect cause and symptom and create an opportunity for our patients to re-learn and rehabilitate their motor patterns. 

At MPC we strive to enable and empower our patients to take control of their movement and physical health, so that when they move, they feel good, and they feel "able." Otherwise stated: we rehabilitate.  Whether it's getting back on the field, or keeping the ability to play with the grandkids, getting people to be able to do the movements and activities they love do to as long as they'd like to do them is our top priority.

If you have any questions or want to know more about how we rehab, never hestitate to ask!  Email me at: drma@maxperformchiro.com and make sure to "Like" us on Facebook and Follow us on Twitter and Instagram (@maxperformchiro) to keep in the know about movement!

On Inflammation with Dr. Harrington

Thank you to Organic Radiance Skincare for interviewing me on Inflammation.  Chronic inflammation, not acute, is something that we should be concerned about, and something we can make small changes in our lives to try to avoid.  What changes you may ask?  Check out the interview to find out!


Here's what Candice at Organic Radiance had to say about it: (original blog post here)

"This interview will give you an understanding of what chronic inflammation is, why we need to be concerned with it, and what we can do about it.

 We talk about chronic inflammation with Dr. MaryAnne Harrington, one of the doctors at Maximum Performance Chiropractic in Costa Mesa, CA. MaryAnne specializes in the treatment and rehabilitation of injuries using conservative and natural therapies. She holds a number of certifications, including Active Release Technique (A.R.T.) nutritional counseling, work ergonomics and wellness, as well as being a yoga instructor.

The interview is in written format, and you can download the pdf version for free here:
Dr. Harrington's Inflammation Interview"

Want a sneak peek?

"We need inflammation. However, what we don’t want is chronic inflammation.  Chronic inflammation is something that lasts for several months or even years.  It can come from many different sources, like failure to get rid of what was causing the inflammation in the first place or a chronic irritant of low intensity.  Chronic inflammation can also come from an autoimmune response due to a self antigen, meaning that the immune system is reacting to something that is in the body that it things is a foreign object. So that is the type of inflammation that we want to be mindful with."
 

For more details on inflammation or for any questions you may have - feel free to contact me via email at drma@maxperformchiro.com.  

While you are at it - give us a "Like" on our Facebook Page! 

Breathing = Inhale and Exhale… Simple as that?

           Breathing is a thoughtless basic movement in our daily lives that is engrained into our nervous system from birth.  Unfortunately breathing is one of the most common (if not THE most common) dysfunctional movement patterns in todays society.  Our obsession with having a midsection that looks slim (sucking in) combined with poor posture and daily stress is the perfect storm for interrupting proper diaphragmatic breathing mechanics. 
 

It’s just breathing…  Why should it matter how I breathe?  Well poor breathing habits can cause a whole slew of musculoskeletal problems from neck pain, TMJ dysfunction, shoulder pain, and low back pain just to name a few.  Not to mention the stress placed on the body to “fight” for air.  Have you found yourself randomly taking in deep breathes throughout the day?  Guess what, you probably do not breathe properly. 

Correct breathing should demonstrate the use of the diaphragm and show the entire midsection (the entire belly, lateral obliques, and even the posterior obliques) expanding in a 360 deg fashion with very minimal, if any movement of the chest and shoulders.  Ask someone to take a deep breath and usually you will see the shoulders shrug and the entire chest expand upon inhalation.  Most often the belly will expand secondary to the chest being filled up and sometimes the belly will be drawn in closer to the spine on inhalation.  This drawing in on inhalation is the most dysfunctional breathing pattern and shows that they primarily use the secondary muscles of respiration upon inhalation. 

Next time you’re at the gym, watch someone who is doing a high intensity exercise and observe their breathing pattern when they are finished.  It will most likely be all chest with the shoulders shrugging.  Now if you take that same person and teach them the correct way to breathe, they will recover their “wind” much faster than the gasping struggle they are used to. 

Curious if you breathe correctly?  Here are a few quick evaluations to see if you are.

1.     Lay down flat on your back with your legs straight and your shirt pull up exposing your entire abdomen.  If your ribs are “sticking out” that’s a telltale sign that you do not use your diaphragm properly during respiration.

2.     In the same resting position as above, have a friend record you breathing at your regular rate and then taking full deep breathes in and out.  This will show you if you are using your diaphragm (belly first) or the secondary muscles of respiration (chest first) for breathing.

3.     Sit upright with your hips and knees at 90 deg and your shirt pulled up exposing the entire abdomen and back.  Have a friend record your breathing from this position from the front and then from the side.  Again look for the dysfunctional movements mentioned earlier.

A quick way to become more aware of breathing with your diaphragm is to lay on your back with your feet flat and close to your glutes.  Place one hand on your chest and the other hand on your belly.  Now when you breathe in, try not to move the hand on the chest and only move the hand on the belly.  Seems simple right… Try it.

The clinical breathing assessment and corrections I use in the office is a lot more in-depth and complicated (and effective), but this is a simple start to become aware of your poor breathing habits.  If you have any questions please feel free to email me at drd@maxperformchiro.com or contact us via our website: www.maxperformchiro.com.  Also, head over to our Facebook Page and give us a "Like!" Thank you!

We were made to move...what happened?

We were made to move.  We were made to crawl, climb, jump, sprint, throw, swing, and punch.  We were made to push, pull, squat, hip hinge, and more.  We were born with all of the mobility one could have, but we had to EARN every ounce of stability we obtained. 

What happened?  Our movement patterns are "hard wired" into our nervous system, but we lose them somewhere along the line.  If I ask an 80 year old female to perform a full squat for me, I literally get laughed at and have "Are you serious?" following.  If I go to a 3rd world county and ask the same aged female to squat, I'd get a 3 on Gray Cook's FMS Squat Test.  Why? What happened?

Chairs, computers, cell phones, iPads, iPods, TV's, etc. have taken us from a society of movement to a society of slouchers and chest breathers.  We literally suffer from movement pattern atrophy.  We have lost our ability to squat and hip hinge so we suffer from low back injuries.  We sit for hours on end and our thoracic spine becomes over kyphotic and lacks CRITICAL movement and we have compensatory movement in the neck and lower back.  This leads to disc herniations and degeneration in both the neck and the lower back.  Poor thoracic spine mobility also leads to shoulder pathology.  And if you have surgery (neck, low back, shoulder, elbow, hip, knee, etc.) and you do not address joint restrictions/ joint stability problems away form the surgery site and faulty movement patterns, it is only a matter of time before it happens again.  I know, I've had 3 low back surgeries. 

So what do we do?  How do we keep ourselves away from the issues that comes with our "sedenterism"?

You have to take action BEFORE you are in pain!  Pain is the last to show and the first to go.  What I mean is that the dysfunction was there before the pain started and most often once the pain is gone the person still has dysfunctional mechanics somewhere in the locomotor system that if not addressed will cause pain again, maybe not at the original pain site, but somewhere else up or down the kinetic chain.  All too often patients discontinue care because they are out of pain and are "fixed".  They are stuck in the medical model of pain management and the western lifestyle that wants results fast and cheap. 

In order to take action on our poor movement habits we have to wake up and realize that the answer is not to sit in a chair and drive to work, sit in a chair at work, sit in a chair and drive to the gym, and when we get to the gym sit in another chair to "workout".  We need to quit facilitating poor posture (chest flys, bicep curls, leg extensions, leg press, sit-ups, etc) and break the unnecessary tone we create throughout the day by doing exercises that are advantageous to the movements that we were born with.  Don't get sucked into todays norm... Don't get sucked into todays society of slouchers!

The 12 Days of Rehab: Day 10 - The Y Wall

12 Days of Rehab: Day 3 - The Plus from Quadruped

5 Basic Nutrition Tips for the Athlete

Dr. MaryAnne’s

Top 5 Basic Nutrition Tips for the Athlete

1. Excessive carbohydrate loading can lead to extra fat.

Carb-loading.  Fuel.  Electrolytes. These are commonly heard terms among the athletic community, and have to do with carbohydrates.  A carbohydrate is broken down into the simplest form of sugar for energy.  The muscles of the body rely on those sugars for energy during activity.  Glycogen is the first, quicker source of energy for the muscles, followed by fat.  When the body can't use sugar immediately, glycogen stores are filled first before fat, which is more of a long-term storage option.  So, what about when you aren’t active? If not currently active, when simple sugar is ingested, it has a greater potential to be stored as fat.

WHAT DO YOU NEED?  Complex carbohydrates.  Carbohydrates that come from natural sources such as fruits, vegetables and some kinds of unrefined grains offer fiber, which slows down the breakdown of the carbs and allows the body to more efficiently use it for energy.

ADVICE:  Carb-load before, not after!   Make sure to eat some sort of complex carbohydrate about 60-90 minutes before activity to help boost that energy your muscles need.  Need quick energy right before?  Simple sugars such as those found in some fruits and naturally sweetened sports drinks. (And as soon as you find one of those, let me know!)  After? See number 3.

2.  Fats can be good for you! You just need the right kind. (Omega 3s!)

Fats have been portrayed as “bad for overall health” for a long time.  Unfortunately, there are a few fats that are essential to the proper functioning of the circulatory system and general health that have been thrown by the wayside along with the bad.  Females also need a healthy and sufficient fat intake to maintain hormonal balance.

WHAT DO YOU NEED?  Omega 3 Fatty Acids.

ADVICE:  Supplement your diet with fish oils, snack on nuts between meals, and use almond milk as a substitute for regular milk.  Remember that there is always a possibility of too much of a good thing, so moderation is important in all food groups, but particularly fats.

3.  Protein is the most important nutrient for athletes, and chances are, you aren’t getting enough!

When we strengthen a muscle, it is first broken down, and then rebuilt stronger than before.  This process requires all the building blocks necessary to make a muscle.  Mainly? Protein.  An athlete or someone that trains needs more protein than someone the same age and size who is not active on a daily basis.  That post-workout hunger that is often felt is commonly treated with a large dose of carbohydrates (pasta, grains, etc.).  That leads to the protein needs of an athlete to not be met.

WHAT DO YOU NEED?  Lean protein, and often.  This includes turkey, chicken, and fish.  Red meat is also a great source of protein, but dependent on quality and cut may carry large amounts of saturated fats.  Having a variety of protein sources is key.

ADVICE:  If there is a large amount of time between the end of a workout and your next meal, eat a protein rich snack, such as almond butter or a protein shake.

4.  Hydrate, Hydrate, Hydrate!

Our body is mainly composed of water, and when an active body continually needs to replenish itself, adequate water intake plays a large role.  The ability of the body to function is highly dependent on water intake, and young athletes are commonly dehydrated.  Not only do they not take in enough water to function daily, but being active leads to loss of fluids in the form of perspiration, which can lead to further dehydration.

WHAT DO YOU NEED? Drink half your body weight in ounces per day, and extra for any activity.

ADVICE:  Buy a reusable water bottle (BPA free!) that carries at least 750mL of water.  Carry it with you during the day so you are reminded to hydrate and refill it often.

5.  Make sure you are getting your vitamins and minerals!

As your body develops throughout exercise, you need the proper building blocks so that your body replenishes itself properly.  Commonly deficient vitamins and minerals (especially for young female athletes) include (but aren’t limited to): calcium, B vitamins, Vitamin D, and iron.  Making sure that your diet includes ways to get those vitamins is extremely important as you develop and train.

WHAT DO YOU NEED? Balanced nutritional habits that include all vitamins and minerals.

ADVICE:  Take a multivitamin along with your meals each day.  This will help ensure that adequate nutritional building blocks are supporting your health.

           

These are just a few things to keep in mind as you work towards your body’s highest potential.  If you ever have any questions about what type of nutritional adaptations you need to make, never hesitate to ask!  You can email me, find us on Facebook, or check the blog.  Let’s improve your performance!