VSI Blog

BREAKFAST 101: THE MEAL YOU DON’T WANT TO MISS

I’m sure you’ve heard it a hundred times over; breakfast is the most important meal of the day. Though we have all heard it, not all of us realize why it is so important.

Here’s why!
Skipping breakfast for the sake of time or to consume fewer calories may cause you more harm than good. Studies have shown that skipping meals can lead to the development of obesity and make weight control more difficult to achieve. By passing up breakfast, you are at risk of consuming more food at your next meal or binging on snacks that are high in calories, resulting in increased potential for weight gain and accumulated body fat. You wouldn’t expect your car to run without gasoline would you? Your body is your vehicle and cannot run without “fuel.” In addition, your body has gone several hours without food {while you were asleep} and within 30 minutes of waking your body is ready to burn more calories!

5 Tips for a Better Morning Routine:

1. Break your meals into smaller, more frequent occurrences as opposed to fewer, larger meals for the best calorie consumption and metabolism optimization
2. Eat breakfast before you have you have your coffee {to avoid a spike in blood glucose levels}
3. Avoid high fat and sugary breakfast foods
4. Not all cereals were created equal! Popular cereals are known to have over five grams of sugar per serving, be sure to read nutritional information before purchasing your breakfast cereal
5. Don’t think you have time? You can easily have a nutritious breakfast in less than five minutes

Important Breakfast Nutrients:

• Focus on consuming fiber and a source of protein:
• Protein: low-fat dairy, low-fat meats, nuts or nut butters
  • Eggs have a hefty dose of saturated fat but are a good source of protein; if you’re short on time boil them for the week so you can grab and go, or consider purchasing an egg poacher {takes less than a minute!}
  • Fiber: fruits, vegetables and whole grains

Keep it Simple with these Breakfast Pairing Options:

• Egg white spinach and mushroom omelet with low-fat cheese & a piece of whole grain toast
• Whole gain cereal with low-fat milk or almond milk; add a side of berries or a banana
• Hard-boiled egg & a piece of whole grain toast with almond butter {or natural peanut butter, popular brands tend to have a lot of added sugar, read your labels carefully}

 

What’s your healthy on-the-go breakfast?

Tony Harris, NASM, CPT

Head Personal Trainer at Virginia Therapy & Fitness Center

 

WHAT IS ATHLETIC TRAINING?

What is Athletic Training? Written by Jason Arnett, MS, ATC, PES

When we meet new people, at some point, the topic of occupation always comes up. When I say that I’m an Athletic Trainer, I get asked, “What exactly is that?” My quick reply, “you know when you’re watching a football game and someone gets hurt? The first person to run onto the field to tend to the injured athlete is the Athletic Trainer.” It’s my job to evaluate the athlete and determine the appropriate course of treatment. Do I need to stabilize the cervical spine and contact EMS? Can I safely remove the athlete from the field and perform a more thorough examination? Do I tape the injured area and return the athlete safely to competition or do I need to refer the athlete to a physician for further diagnostics?  Now this doesn’t fully explain what an Athletic Trainer is. So, the National Athletic Trainer’s Association (NATA) defines my profession as:

“…health care professionals who collaborate with physicians to optimize patient and client activity and participation in athletics, work and life. The practice of athletic training encompasses the prevention, examination and diagnosis, treatment, and rehabilitation of emergent, acute, subacute, and chronic musculoskeletal conditions and certain medical conditions in order to minimize subsequent impairments, functional limitations, disability, and societal limitations.”

In the traditional sense, Certified Athletic Trainers (ATC) have worked with sports teams (professional, collegiate, high school levels) to help keep the athletes on the field.  However, as the profession has grown, more employers are seeing of the benefits of employing ATC’s. As a result, you will see ATC’s employed in:

• Professional and Collegiate Sports
• Secondary and Intermediate Schools
• Sports Medicine Clinics
• Hospital ER and Rehabilitation Clinics
• Occupational Settings
• Fitness Centers
• Physician Offices

To learn more about the profession of Athletic Training, please visit www.NATA.org

Athletic Training quick reference guide: http://www.nata.org/sites/default/files/Profiles-of-Athletic-Trainers.pdf

Did you know that VTFC employs three Certified Athletic Trainers? To learn more about VTFC’s Certified Athletic Trainers, click here

ASK THE EXPERT: CARPAL TUNNEL SYNDROME VS CERVICAL RADICULOPATHY

 

I was recently asked “how to recognize the difference between a cervical spine issue versus carpal tunnel syndrome with accompanied numbness.” As a spinal neurosurgeon, I frequently encounter a patient who has symptoms in his or her upper extremity (arm) that seemed to either extend from the shoulder down toward the fingers or extends from the fingers back up toward the shoulder.  In medicine, we use the term “differential diagnosis” to describe the possibilities which may exist to explain the symptoms.

Degeneration of the discs in the cervical spine or bone spurs associated with arthritis, can cause compression of the nerves which exit the neck and travel down the arm.  The nerve endings will have a specific distribution to the skin and musculature, which may result in pain, numbness, or weakness when those nerves are compressed. Usually, a careful physical examination will identify the source of the symptoms. For example, if neck extension (leaning backward) causes worsening of the arm pain, there is usually compression of the cervical nerve root in the spine. Similarly, if tucking the chin and tilting the head toward the shoulder opposite the pain gives some relief of symptoms, this is often associated with compression of the nerve in the foramen (spinal nerve opening).

Carpal tunnel syndrome, on the other hand, is compression of the median nerve through an area of ligaments at the wrist.  When the median nerve is compressed, many times patients will complain of pain, numbness, and weakness affecting the thumb, index, and middle finger. Carpal tunnel syndrome is often activity-dependent, meaning that when the hands are used more frequently such as typing or grasping a screwdriver, the symptoms can be exacerbated.  Many patients will complain of numbness when they sleep, often from curling the wrist and hand under a pillow.

The difference between cervical radiculopathy and carpal tunnel syndrome is often made clinically by using not only a careful neurologic examination but also by provocative tests, which can often cause irritation of a cervical nerve root in the neck or by tapping the overlying carpal tunnel itself, causing reproduction of symptoms into the hand.  If a careful physical examination cannot disclose the cause of the symptoms, whether it be the neck or the carpal tunnel, then many times an EMG (electromyogram) test may be utilized.  The EMG test is utilized to determine the contribution of nerves to the symptoms.  The nerve endings may be compressed in the neck or may be compressed as they cross either the elbow or the wrist.

In any case, the differential diagnosis of cervical radiculopathy versus carpal tunnel syndrome can often be difficult for both the provider and the patient.  Usually a combination of clinical acumen, electromyographic testing, and physical therapy is helpful in defining the problem in most cases.

What spine related question do you have for our next edition of “Ask The Expert”?

 

OVERCOME MINDLESS EATING WITH THE SECRET TO IMPROVE WILLPOWER

Virginia Spine Institute welcomes, guest blogger , Ryan Lonnett, a Certified Health Counselor and the founder of Empowered Wellness. Leveraging his culinary and nutritional training along with professional coaching education and experience, he delivers custom programs and group classes that provide a unique combination of nutritional information and practical kitchen skills for achieving wellness goals in ways that are fun, easy, and efficient without denial or excessive discipline.

 

OVERCOME MINDLESS EATING WITH THE SECRET TO IMPROVE WILLPOWER

A topic that I like to focus on is “Mindless Eating”. People mindlessly eat more than they think, much more.  I like to offer strategies that encourage participants to make a few easy and hardly recognizable adjustments that lead to mindlessly eating less of the not so good foods and even mindlessly eating more of the good foods!  The best diet is the one that you don’t know that you’re on, right?

Four Foods That Easily Cause “Mindless Eating”:
1. During a Super Bowl study, researchers learned that guests who served themselves from gallon sized bowls took 53% more Chex Mix than those that served themselves from ½ gallon bowls.

 

 

2. In a movie study, researchers gave half of the people a ½ lb. bag of M&Ms and the other half got a 1 lb. bag.  Those given the ½ lb. bag ate an average of 71 M&Ms and the others ate an average of 137, almost twice as many and 264 more calories.

 

3. In the same theater, researchers gave half of the random people were given big buckets of popcorn and the rest received medium buckets.  The big bucket holders ate an average of 173 calories more, which was 53% more.  In another study, TV viewers were given a large bowl of popcorn and dish of baby carrots.  For each ½ hour of TV watched, they consumed 28% more popcorn but the good news is that they also consumed 11% more carrots.

 

 

4. Serve yourself before you start snacking.  Most people can’t stop eating a sleeve of Thin Mints if it is sitting in front of them but they can minimize the damage in a distracting situation if they dish out a ration before they start.  Not a fan of Thin Mints? Try one scoop of ice cream in a small bowl with a small spoon.  If you need more, get more but more often than not, you’ll find getting extra more of a hassle than a habit.

 

 

In addition to mindless eating, willpower is another downfall that many struggle with when it comes to trying to eat healthier. I’m frequently asked how to help people to improve their willpower.  As a closer, I will let you in on the secret:

If your strategies are centered on deprivation and you put yourself in positions where will power is needed over and over again, you will win some battles but most likely lose the war.   We have plenty of best practices to share for winning more battles but in order to sustain long-term success; the key is to re-engineer your environment so that the need to summon willpower is mitigated.

Interested in learning more about nutrition? Stay tuned to hear more from Ryan Lonnett, RIGHT HERE at Virginia Spine Institute and Virginia Therapy & Fitness Center. In the meantime, if you have questions, we would like to hear from you, email us at: contact@spinemd.com

ASK THE EXPERT: HOW DOES A LOW BACK MUSCLE STRAIN OCCUR AND HOW IS IT TREATED?

 

How does a low back muscle strain occur and how is it treated?

When force exceeds a muscle’s threshold for strength production, injury can occur. Regarding the lumbar spine musculature, lifting from a position of flexion and rotation is the most common mechanism of injury, often creating forces greater than eight times a person’s body weight. The pathogenesis of overloaded muscles can lead to involuntary shortening, loss of oxygen supply, loss of nutrient supply, and trigger point formations. When muscle is strained from severe trauma, overuse, or mechanical overload, there is a disruption of the muscle’s basic elements myosin and actin. In a normal muscle, these two proteins slide on each other as the muscle contracts. When injured, these proteins remain stuck on one another and often lead to trigger points or shortened muscle fibers. Treatment for muscle strain begins with control of swelling, pain, and edema. The first three days of treatment following injury should consist of ice, compression, and avoidance of activities that may create more injuries. Day three up until six weeks, should consist of gentle range of motion, soft tissue mobilization via dry needling or cross friction massage, and strengthening within the patient’s tolerance.

How long do muscle strains usually take to heal?

Grade I muscle strains mean that only 25% of the muscle fibers were injured. These types of strains present with pain when stretched, but no strength loss during resisted testing. The strains heal between three days and two weeks. Grade II tears infer that 50% of the muscle fibers are involved and normally take four to six weeks to fully heal. Grade II tears are diagnosed by pain upon stretch and pain and weakness against resistance. Grade III muscle tears usually require surgical intervention and may require from 12 weeks to one year of rehabilitation to fully heal. These tears are diagnosed when 75% to 100% of the muscle fibers are injured, there is a complete loss of strength when manually tested, and the response to stretch or contraction is painless since the muscle’s nerve supply was also disrupted during the injury.

What are myofascial trigger points and how are they treated?

Myofascial trigger points are defined as taut, hyper-irritable bands within a skeletal muscle that are painful with palpation. Myofascial trigger points often refer pain to other regions surrounding the tissue. They also may twitch or involuntarily contract when palpated. Research has identified an increased metabolic demand within tissues containing trigger points. In my opinion the most effective method of treating myofascial trigger points is through dry needling. Dry needling releases shortened muscles, produces local inflammation necessary for healing, and removes chemical elements responsible for pain production.

 

Richard Banton, PT, DPT, OCS, CMPT, ATC serves as a a co-clinic director at Virginia Therapy and Fitness Center. To read his complete bio, click here.

 

 

 

SEVEN TIPS ON REDUCING LOWER BACK PAIN CAUSED BY PREGNANCY

 

Pregnant women frequently experience low back pain, especially after the second trimester. As your baby grows, low back pain becomes more pronounced. Between 50 to 70% of all pregnant woman will report having low back pain.

Lower Back Pain From Pregnancy Can Be Caused By The Following:

Hormonal changes: During pregnancy, certain hormones allow the muscles in the pelvis to relax in preparation for birth. The same hormones can promote loosening of the ligaments in the spine leading to back pain.

Weight gain: On average, most women will gain between 20-30 pounds, during pregnancy. The spine has to suddenly support much of the weight, which can be painful much of the time.

Posture: After the second part of the second trimester, women will typically begin to adjust their posture since the expanding uterus will shift of the center of gravity. This change can also lead to pain in the lower part of the back.

 

Seven Tips on How to Reduce the Likelihood of Low Back Pain During Pregnancy:

1. Avoid bending over, but rather try to squat to pick up an object during lifting.
2. Regular exercise is always important. Your physician can recommend the right exercises. If low back pain continues, adding a physical therapist to your regimen may be very useful.
3. Aquatic exercises can be very helpful during pregnancy without putting too much strain on the body.
4. Always try to use comfortable shoes with good support.
5. Always pay attention to your posture. Try not to slouch, as this can apply more pressure to your spine. When sitting, you may find that placing a small pillow behind your back, can be helpful. If you still find yourself slouching, you may want to raise your feet, until you find that your low back is as straight as possible with the least amount of pressure.
6. You are encouraged not to sleep on your back during pregnancy, but rather sleep on your side. Often times it is helpful to place a pillow between the knees.
7. Wear pants with a support waistband. These can be found in most maternity stores

It is essential to consult your obstetrician regarding any health issues you are experiencing during pregnancy or treatment options prior to initiating them.

• Most low back pain during pregnancy will resolve after you give birth.
• It is important NOT to use hot tubs during pregnancy.
• If low back pain radiates into the lower extremities or you experience any weakness, you should contact your health care provider immediately.

 

TRUE STORY: MR. BAKER SPENT 15 YEARS IN PAIN; NOW HE’S BACK TO HIS LIVELIHOOD

True Story:

As the owner of Baker Farms in Mt. Jackson, Virginia, my lifelong profession is one that is physically demanding.  I have been pursuing my passion for farming for over 35 years; but not without pain. Over the past 15 years, I’ve learned to live with low back pain until finally one day the pain literally drove me to the floor. My lifestyle was literally taken away from me. I couldn’t stand up and was walking hunched over. I didn’t know where to turn. I tried several other modalities including chiropractic but just couldn’t seem to permanently silence the pain. This pain continued to weigh on me not just physically but also emotionally.

I was scared to death. This all felt like a bad dream. That was until I found Dr. Good and the team at the Virginia Spine Institute. Something I kept putting off for 15 years finally came to a head and I was forced to seek treatment. After my initial consultation, Dr. Good assured me that although this was a very complex case as long as I followed his directions he would get me back to my life. And sure enough after a Transforaminal Lumbar Interbody Fusion (TLIF), to repair my lumbar annular tear, herniated disc, and spondylolisthesis , this top notch team had me on the road to recovery.

The personal touches by Dr. Good and his team made me feel like I was a real person. Now I am back to my life and livelihood 100% after back pain took my life away for so long.

 

LUMBAR ARTIFICIAL DISC REPLACEMENT: CASE STUDY

 

Everyone will have some back pain at some point in their lives; after all it is the second most common reason for medical visits.  Most adults will have brief episodes that resolve with a little rest and exercise.  The vast majority of patients that have ongoing pain will have improvement without surgery.  Often physical therapy, medications, and, at times, selective injections can help manage the pain. However, a small group of patients will continue to have significant pain that limit their lives. Having failed non-operative, conservative treatment, their only option is operative treatment. For a select group, an artificial disc will be a desirable option for their treatment.

Who Is Considered a Good Candidate For Disc Replacement:

• Lower back pain thought to be caused by one or two intervertebral discs in the lumbar spine
• No significant facet joint disease or bony compression
• Within healthy weight range
• No previous major surgery in the lumbar spine
• No abnormality of the spine

Case Study:

Prior to her surgery, my patient had severe lower back pain and could not work or do most of the things she wanted to do.  She could not sit for more than 15 to 20 minutes. Her x-rays did not reveal any severe arthritis or any deformities. It turns out she had one bad disc in her lower back in the lumbar region of the spine. After surgery, even in the recovery room, she could tell a big difference.  Her severe back pain was gone.  She reported some soreness from surgery, but that was about it.  Just three weeks post-operation, she was feeling much better.  She was up walking and getting ready to return to work. She was actually smiling, she felt so good. She started physical therapy to regain some strength she lost over the last few months when she was hurting so much that she could not get up and move. For this patient, an artificial lumbar disc replacement was the best treatment option for her; she was able to get her life back.

 

In the right patient, an artificial disc replacement is a great treatment option; the device is modular, so the surgeon can tailor the device to the patient’s distinctive anatomic requirements.  It is very important to meet the appropriate criteria in order to have the best results.  Not everyone is a candidate for the artificial disc.  But, for the right patient, it could be the best treatment of their life.

 

TRUE STORY: SHELDON OVERCAME LOWER BACK PAIN AND IS TRAINING AGAIN!

 

True Story: I was an extremely healthy 33 year old.  I was just a week away from competing in my second half Ironman and was at peak fitness.  In the past three years I had finished my first marathon, first Half Ironman and completed multiple sprint and Olympic Distance triathlons. Life was very good. Then out of nowhere, someone ran a red light at 45mph and hit my car directly on the driver’s side.  I had numerous injuries to my neck, left shoulder, knee and back.  Over the next four months, I went to physical therapy twice a week and things were slowly getting better and I was regaining strength, however my back was just not getting any better, if anything it was getting worse. I had severe pain in my lower back, numbness in both feet and a dropped right foot that was only getting worse.

Treatment: Anterior L4-L5-S1 fusion in fall 2010.  Within a week of returning home from the hospital, I was out walking a mile a day with almost no pain and certainly no numbness.

Today:  Before surgery, I struggled to walk more than 300 yards without severe pain and numbness in both feet.  I recently began training again and I am for the most part pain free.  I am up to 1 hour on the bike, 1/2 mile swimming and about 45 minutes on the elliptical. Again, a huge success!

The fact that I live relatively pain free and that I am back exercising and hoping to return to triathlons is the greatest gift that a doctor can give. I have my life back!

 

Are you a Spinal Champion? A Spinal Champion is someone has overcome back or neck pain, either through surgical or non-surgical interventions. We encourage you to share your story with us if you have successfully gotten back to the life you love. One single story can inspire, teach and provide hope for millions of men and women. Click here to find out how to submit your story, today!

 

DON’T LET THE SUPER BOWL OVERSHADOW GROUNDHOG DAY!

Groundhog Day February 2, 2013

One of the many benefits to living in the Washington, DC metropolitan is the opportunity to experience all four seasons. If you are not a big fan of the frigid February temperatures then the suspense of the Groundhog’s unveiling of the weather prediction may excite you. Every year in the weather capital of the world, Punxsutawney, Pennsylvania, this renowned fuzzy creature discloses our weather fate; will it be six more weeks of winter or an early spring.

The history of Groundhog Day in Punxsutawney dates back to 1886 with record crowds up to 50,000 people. Did you know the average lifespan of a groundhog is only about six to eight years?

Here’s the breakdown on what this all means:

• If the Groundhog emerges from its burrow and fails to see its shadow, it will leave the burrow, signifying that winter will soon end.
• If the groundhog sees its shadow, the groundhog will supposedly retreat into its burrow, and winter will continue for six more weeks.

Last year Punxsutawney Phil saw his shadow and predicted six more weeks of winter. What do you think will happen tomorrow?

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