Patient Education
Dr. McIntosh is a contributing writer for Kansas City Sports & Fitness Magazine and sheKC.You can also find her on Hot Talk 1510,Saturdays at 8 am. Check out her articles and radio clips below!
Stress Fractures
As any athlete knows, participating in excessively physical activities means risking injury to your body. Stress fractures are among the 5 most common injuries in athletes, but it is one of the most preventable. They are most commonly found in the weight bearing bones of the lower leg and foot. A stress fracture is caused by overuse of the bone. When the muscle has fatigued due to repetitive motion, the bone begins to absorb the shock of the activity, thus causing a tiny crack in the bone.People of all ages, male or female, involved in high-impact sports are at risk for stress fractures. However, women tend to suffer from stress fractures nearly four times more often than men due to what is known as the “female athlete triad”. The triad consists of amenorrhea (a disrupted menstrual cycle), osteoporosis, and eating disorders. All of which can result in decreased bone density.Athletes often do not like to sit out due to injury, especially when it interferes with training for a particular event. Often, they will ignore the pain and press on through it and continue on their routine. However, ignoring a stress fracture can result in far more serious injury to the bone. Stress fractures need time and rest to heal. If the athlete were to put stress on the fracture too soon, a complete break can occur. Generally, cessation of the stress causing activity is enough to allow the bone to heal. Occasionally a fracture is bad enough to require casting or bracing. Healing of the fracture can take six to eight weeks. Prevention is paramount to avoiding the long recovery time.Several simple things can be done to prevent stress fractures:

  • Include foods enriched with vitamin D and calcium in your diet. Adding those supplements to your diet is also extremely helpful.
  • Use only proper exercise equipment and wear good tennis shoes. Using worn down equipment and old tennis shoes can cause undue stress on your body and less protection.
  • Cross training helps to balance out the training also. Adding strength training to a running regimen is extremely beneficial.
  • Increase your training gradually. Any significant changes in intensity of training can cause damage to your muscles and eventually your bones. Increase training by only 10-15 percent per week.
  • When you feel pain, stop exercising!

Stress fractures are likely to reoccur if changes are not made to the work out and prevention steps implemented. Stress fracture pain is localized to one specific area and is very painful. If you feel pain while exercising, stop and rest. If the pain continues, have your injury checked by a doctor before resuming activity to prevent a more serious problem. You will be much happier if you only have to sit out for 6 weeks with a fracture instead of 6 months from a fully broken bone!

Dr. McIntosh is a board certified Chiropractor, licensed in both Kansas and Missouri. In addition to being licensed to provide general chiropractic care, she is also a Certified Chiropractic Sports Physician, working with athletes from multiple disciplines on specific sports-related problems and a Certified Acupuncturist. She can be found on the internet at KansasCityChiropractic.com.

Rhabdomyolysis
Most athletes want that ripped, muscular look. What physical price would you pay for it? The very popular power work out regimens promise dramatic results. However, those high-intensity programs are coming under fire for having serious consequences, including being under review in all branches of the military. In a regular muscle building work out, the muscle gets tiny tears to give it room to grow. Once you are resting these muscles, the body naturally utilizes proteins and nutrients from food to repair the muscle tears and by the next day, the athlete is ready to work out again. Unfortunately, the goals in these power work outs push the body to consistently, and brutally exceed its ability. This strenuous work-out can cause a condition known as Rhabdomyolysis which is a break down in the muscle and kills the muscle fibers. Once these fibers are dead, they secrete a protein called myoglobin, potassium and creatine kinase into the blood stream. The myoglobin is then carried out through urine as waste. If left untreated, the myoglobin builds up in the kidneys causing renal failure. The potassium and calcium in the blood stream can interrupt the proper transmission of the heartbeat causing irregular heartbeat and muscle spasms.Unfortunately for the person wanting to quickly “get ripped” after not working out regularly at all or the physically fit athlete who works out regularly but wants to kick it up quickly, the results can be devastatingly the same. The muscle can break down just as quickly in either physical condition that the person began with. It can be sudden or it can happen over a length of time. Pushing the physical limits gradually and over time is completely different than these high-intensity programs.The symptoms of Rhabdomyolysis vary and can be as simple as muscle aches and pains, stiffness or muscle weakness or the athlete can be overcome by a sudden severe burning sensation. The urine can be a darker, cola color from the myoglobin as well. There could be no physical symptoms at all. Rhabdomyolysis can be confirmed through complete blood count tests and detection of the enzymes in the blood. Signs that are conducive to symptoms of kidney failure such as swelling of the feet or hands, shortness of breath and lethargy should be paid attention to. Acute renal failure occurs in 30-40% of Rhabdomyolysis cases.Treatment of Rhabdomyolysis can include aggressively pushing fluids through the kidney by intravenous measures to flush out the myoglobin. A physician may prescribe diuretics to aid in the flushing the kidneys.

Getting that ripped look can happen safely and have the same satisfaction when done while keeping health in mind. An athlete can prevent Rhabdomyolysis by:

  • Increase the work out gradually
  • Be sure to hydrate before, during and after any work outs
  • Limit alcohol use
  • Avoid becoming overheated while exercising

Rhabdomyolysis has potential to be a fatal condition and should be taken seriously. If treated within a timely manner, most patients recover in a matter of weeks or months, with few complications. Severe and long lasting results can occur if not treated swiftly. When beginning a new exercise routine, be sure to use caution and common sense. Never increase intensity by more than 10-15% per week and listen to body signals that warn of injury.

Dr. McIntosh is a board certified Chiropractor, licensed in both Kansas and Missouri. In addition to being licensed to provide general chiropractic care, she is also a Certified Chiropractic Sports Physician, working with athletes from multiple disciplines on specific sports-related problems and a Certified Acupuncturist. She can be found on the internet at KansasCityChiropractic.com.

 

Planning Your Physically Fit New Year
The New Year always brings new resolutions and goals. The majority of the time, these resolutions include new fitness goals. When most of us look to improve our bodies, we tend to focus on a single problem area. Unfortunately this approach is rarely successful, which means we give it up quickly. Once you have decided you want to make a change, you need to define your goals. Set realistic, smaller goals and gradually work from there. Everyone wants instant gratification, and this can help fulfill that desire, while the ultimate goal is being worked toward. That five hundred crunch workout might build your abs, but no one is going to see them if you have some extra weight to drop as well.It is very important to avoid one of the biggest mistakes made by people heading to the gym for the first time in many years: do not attempt to do the workout you did in high school. Your body is different now. It has different abilities and requires you to adjust to the body you have today, not the one from 10 or 20 years ago. The amount of weight you can bench press is not the most important thing anymore. What matters is how much you can bench, squat, or lift repetitiously. When you use too much weight too fast you risk injury. Focus on lower weights and higher reps for better overall fitness and stamina. For example, squats are a great exercise to work the glutes, but only if performed properly and not overdone. A mistake we have been taught is how you do your squats. Previously, you would do a squat and go below the 90 degree plane of thighs to the floor. When you are eighteen, your knees can probably withstand this abuse, but when you are 35 or 40, you are risking a severe knee injury. If you need a more challenging glute work out, lunges with weights is a better option. Lunges will work the glutes with greater benefit than squats, with less risk, and with an increased cardio benefit.A frequently asked question is: What is the best exercise to start with? The exercise that has the highest level of consistency for the longest period of time with the lowest risk of injury is walking. Walking 10,000 steps a day is an activity which will ease you along the exercise continuum from sedentary through metabolic fitness, increasing cardiovascular endurance, muscular endurance, and improving body composition. The next step is to start working in resistance training with stretching to improve muscular strength, fat-free mass and physical function. To avoid injury don’t increase workload by more than 10% per week for either weight or time.Once you get started, remember to keep at it! After your ultimate goal is attained, maintenance can be successful by keeping active and scheduling at least two work outs a week. This ability to maintain a certain level allows us to vary our workouts, and integrate rest periods of several weeks in length. Variation and extended rest periods will help prevent injury and ensure that your program does not become boring. Just remember to keep moving! If you stop altogether you will lose roughly 50% of your gains in as little as 4-8 weeks.

The first step to getting fit is to start being active and stick with it. Get out and walk, join a game of basketball, or try the free training session for beginners. When you are having an off day, or getting bored with a particular activity, try something new; even if you don’t think it is as rigorous as your normal work out plan. Staying active is better than just sitting on the couch!

Pain Free Fun in the Sun
After long winter months of reduced activity, most of us can’t wait to spend time outdoors. For some, it’s a chance to return the yard and garden. For others, summertime sports are the lure. Yet for many others, back pain puts a damper on summer fun. In fact, an astounding 60 percent to 85 percent of the population will suffer from low-back pain (LBP) at some point with approximately 10 percent of those cases becoming chronic. There are many risk factors for LBP, from genetic predisposition to environmental influence. But back pain doesn’t have to ruin your summer plans. Whether you’re a weekend warrior or a gardening guru, here is the latest research to uncover the following unbeatable tips for thwarting back pain this summer.Optimal posture is perhaps the most important factor for avoiding back injuries. Studies show that correct posture has a direct effect on preventing many types of back pain. Chiropractors analyze by examining stance and the alignment of the knees, hips, shoulders and pelvis. One condition chiropractors look for is vertebral subluxations, or misalignment of the spinal bones (vertebrae). This irregularity generates back pain because it alters nervous system function and irritates spinal musculature.Physical exercise is key to preventing all types of back pain. This holds true even for people who have previously endured episodes of spinal injury or discomfort, because regular exercise is known to prevent relapses. Most types of commonly performed exercise are adequate for maintaining back strength and improving conditioning. But a 2008 study from Germany tested exercise programs that involve movements opposite to the positions the spine is in most often. The study found that these “countering” exercises are especially effective at preventing pain and overuse injuries. This same research team proved that inactivity causes back muscles to atrophy, or weaken – so staying active is crucial.Especially important for developing a strong back is “core” stability. The core area includes muscle groups, such as the abdominals and the back supporting paraspinals, that hold the spine erect. These core muscles work together to provide both strength and injury prevention. Core strengthening is recommended to stabilize the spine and prevent injury from summertime activities that stress the spine, such as swatting a baseball or pushing a lawn mower.

Take a look at these special tips for individual sports:

Golfers – Golfers are prone to back injury because of the stress placed on the spine during the club swing. A good swing often pulls to the lumbar area of the back, especially during the follow-through. Sports injury experts urge golfers to focus on strengthening the abdominal muscles, along with the multifidi, which are the long muscles on either side of the spine. Reinforcement in this area increases flexibility and provides preventive benefits.

Most golfers carry their own bags, usually on only one shoulder. This can trigger back pain, Using a hand-pull cart, or adding a special strap, available at most pro shops, balances the bag’s weight and spreads the load across the entire back, while still allowing golfers to enjoy the cardiovascular benefits of walking the course.

Tennis – Researchers report that the simple biomechanics of the game of tennis can set a player up for lumbar neuro-muscular imbalance. To prevent damage from over-working the same parts of the back, a tennis-specific exercise routine will relieve stressed areas. Other research looked at the patterns of muscle activation triggered in a game of tennis, especially during the serve. These studies confirm that strengthening the abdominal and lower back muscles protects against injury and still allows a powerful serves.

Boating – while power-boating may not require much physical exercise, other types of watercraft can provide a genuine workout. Paddling sports such as kayaking and canoeing build strong backs in short order and help increase endurance levels. Rowing a boat is usually just a means to an end. But for more competitive types, rowing and sculling in specially designed shell-type boats work all the back and abdominal muscles efficiently. Your back also gets a workout if sailing’s your passion. There are myriad opportunities for back injury when sailing, as the crew scrambles from one awkward position to another in order to keep up with changing wind and water conditions. British researchers noticed that sailors fare better when they avoid pulling ropes by hand and use a windlass instead. This special winch is hand-operated and can hoist and adjust, or “trim” heavy sails without causing back strain.

By all means, get out and enjoy summer, whether it’s playing sports and swimming at the beach, or cutting grass and pulling weeds. Taking just a few simple precautions can help keep back pain at bay all summer long.

Dr. McIntosh is a board certified Chiropractor, licensed in both Kansas and Missouri. In addition to being licensed to provide general chiropractic care, Dr. McIntosh is a Certified Chiropractic Sports Physician, working with athletes from multiple disciplines on specific sports-related problems.

Your Athletic Immune System
While exercise has long been advised as a good deterrent of cold and influenza viruses, too much exercise in the winter can actually work against an athlete. The very people one would think have less of a risk at being ill are actually more susceptible to upper respiratory infections, colds, influenza, and other viruses. All athletes, including endurance athletes, should reduce the volume and intensity during the winter months to let the body become stronger and ready to peak when needed. During strenuous exercises, the body uses up its fuel, which are carbohydrates, causing the immune system to become vulnerable for some time during the exercise and several hours of recovery time after the exercising is completed. Another side effect of strenuous exercise is large amounts of oxygen is processed, in what is called oxidation. Oxidation uses up antioxidants in the system, allowing molecules known as free radicals to cause damage to healthy cells and keeps the immune system busy fighting them. This leaves a wide window of opportunity for the virus to take hold. Knowing how to keep the immune system boosted is the key to winning the battle against the viral bugs.How do athletes go about protecting themselves against these infections in the winter? Exercise and diet is still the best defense against illness but needs to be done sensibly. Resistance training is a good winter-time activity. Aerobic exercises are also good choices, such as jogging, brisk walking and cycling. Whichever type of exercise you choose, keep the work outs moderate. During a moderate workout, the immune system gets a boost and the increase in immune cells allowing them to move quickly through the body looking for infections to attack.Winter is the ideal time to increase the consumption of fruits and vegetables to fuel up the nutrients in the body that help fight those infections and keep the immune system at its premium. Broccoli is one example of a fantastic vegetable to increase in consumption as it provides a high amount of carotenoids. These carotenoids break down in the body and form vitamin A. Vitamin A helps with the very basis of your immune system. Cauliflower, bok choy and brussel sprouts all provide a source of Vitamin A to increase the immune system’s ability to fight infection. The orange colored vegetables, such as carrots, sweet potatoes, and squash boost your system with Vitamin C. Vitamin C increases production of white blood cells, which in turn increases antibodies and helps the immune system fight infections. Vitamin E is important as it is where your antioxidants come from. Sunflower seeds, almonds and spinach are all good sources for Vitamin E. It is also important to ensure that you are consuming enough carbohydrates in your diet, particularly before and after working out as it works as fuel for the body. Carbohydrates break down into glucose which stores in your muscles and liver and is readily available for the body to use as the energy it needs to sustain a workout. Any extra glucose is stored as fat and is used by the body in long work outs.How do you know you are getting enough of the right nutrients? Be sure to keep a balanced diet of all of the recommended daily nutrients the body needs. Keep the processed, greasy foods at a minimum, as they tend to make the body sluggish which causes the immune system to run sluggish. They also provide very little nutritional value to your diet. Even though you may already try to follow a healthy diet, certain conditions, age, genetics and prescription medications can cause nutrition depletions. Vitamin supplements are also an option to providing your body with the nutrients it needs. Before taking vitamin supplements, consider nutrient testing to learn which nutrients your body needs as you really can take too much unnecessarily causing unwanted side effects. Nutrient testing can assess your wellness and identify any potential health risks. A Comprehensive Nutritional Panel can identify any functional cellular deficiencies telling you if you are consuming enough vitamins, which ones you may need to increase and if your body is utilizing them appropriately. As healthy as you strive to be, the majority of people are deficient in their nutrients. Kansas City Chiropractic does the micronutrient testing and can help guide you through a healthy winter this year. Give them a call today to schedule your appointment.

Dr. McIntosh is a board certified Chiropractor, licensed in both Kansas and Missouri. In addition to being licensed to provide general chiropractic care, she is also a Certified Chiropractic Sports Physician, working with athletes from multiple disciplines on specific sports-related problems and a Certified Acupuncturist. She can be found on the internet at KansasCityChiropractic.com.

Heart Health
February is Healthy Heart month. Heart disease is the leading cause of death in the United States. Many believe heart disease to be a “man’s” disease, but it is equally prevalent in women. There are ways to lower the risk of developing heart disease. One method is to eat dark chocolate. It’s true! Eating dark chocolate in moderation helps with mild high blood pressure. Dark chocolate acts as an antioxidant which helps fight free radicals. Free radicals are the destructive molecules that can cause heart disease and other serious illnesses. The plant flavonoids from cocoa help prevent cholesterol from building up in the blood vessels. Cocoa also contains a chemical called epicatechin that improves the blood flow through the vessels. Epicatechin keeps your blood flowing well through your body and keeps your heart strong.This is not to say you should run out and consume large amounts of chocolate. Milk chocolate has lots of sugars and additives and does not contain the same benefits as dark chocolate. Also, dark chocolate that has caramel or marshmallow inside is not helpful either. These contain too many calories and fats which are not good for you. A small amount of dark chocolate a few times a week balanced with a healthy diet will reap the best benefits.How about a glass of wine? Drinking red wine also can help with heart disease prevention. Red wine contains antioxidants, which increase the levels of the “good” cholesterol needed to prevent heart disease. Red wine contains polyphenols that help protect the lining in the blood vessels in your heart. Any alcohol, including red wine, should be used in moderation. Drinking too much wine can actually have the opposite effect on your heart. Over use of alcohol can cause high blood pressure, heart failure and increases your calorie intake. This can lead to obesity and diabetes among other diseases.Maintaining a good balance of healthy diet and exercise is your best line of defense when it comes to heart disease. Eat lean meats and avoid foods high in cholesterol or high in salt. Select low fat dairy products and cut back on foods with added sugars.

Exercise is very important in defeating heart disease and obesity. Exercise helps dilate the blood vessels and allows blood to flow through more smoothly. Walking is one of the best exercises for your heart. If it has been a while since you exercised, start slowly and work up to a brisk walk. Aerobic exercises are another great way to keep the heart healthy. According to the National Cholesterol Education Program, measuring the lipoprotein subgroups is the only way to accurately assess cardiovascular risk. Kansas City Chiropractic offers this screening and other micronutrient testing which allows you to be aware of your nutritional health. Call and set up an appointment today and get started on being responsible about your healthy heart!

Dr. McIntosh is a board certified Chiropractor, licensed in both Kansas and Missouri. In addition to being licensed to provide general chiropractic care, she is also a Certified Chiropractic Sports Physician, working with athletes from multiple disciplines on specific sports-related problems and a Certified Acupuncturist. She can be found on the internet at KansasCityChiropractic.com.

Get some Shut-Eye!
Working twenty-four hours a day may be the way to succeed in business, but it is not the way to living a long healthy life. Adequate rest is vital to peak performance. Studies have long supported this theory, and given us an in-depth look at exactly what lack of sleep can do to your ability to perform. We can all identify common symptoms related to lack of sleep: depression, weight gain, low sex drive, irritability, diminished brain and immune function, and impaired muscle and aerobic performance. However, a closer look into our bodies also reveals interferences with glucose metabolism and decrease in testosterone.Test results indicate that after being deprived of sleep, men’s body’s metabolized glucose less efficiently, which means lower energy stores in muscles. Lower energy stores mean less strength and increased muscle fatigue. Lower levels of testosterone were also observed, which can add to the overall level of fatigue and reduced muscle performance.Long Term Physical Effect of Sleep DeprivationMost of us do not push sleep deprivation to the point of exhaustion, where we would expect to suffer from symptoms more severe than fatigue. However, in relying on a system of banking sleep to make up for frequent short nights; we can be creating a long term pattern of sleep deprivation, which can lead to serious health issues.

Consistent interferences in glucose metabolism caused by sleep deprivation can lead to and increase the severity of, diabetes. Adverse effects on metabolism can lead to obesity, and obesity-related problems such as heart disease, diabetes, and sleep apnea.

The studies on this subject emphasize the importance of getting a full night’s sleep every night. Eight hours is recommended for ultimate health and well being.

A Few Suggestions for Getting More Sleep

  • Allow enough time to sleep, usually about eight hours
  • Sleep in the same room and bed every night, or at least try to follow a similar routine each evening to help insure a full and restful night’s sleep
  • Keep the bedroom free of noise and disruptions likes phones and TV
  • Turn your clock so you can’t see it. Watching the clock can keep you awake.
  • Don’t eat, drink alcohol or smoke for two or three hours before you go to bed.
  • Avoid a high-fat diet and caffeine.
  • Get some exercise earlier in the day
  • If you wake up during the night, avoid bright lights. Have a low wattage light in the bedroom and bathroom, so that if you need to turn the light on it will not shock your senses.
  • If you find it difficult to fall asleep, or sleep through the night, try a visit to your chiropractor. An adjustment at the end of a stressful day can release anti-stress hormones that help you relax and get to sleep. Your chiropractor can also suggest dietary supplements like melatonin to help regulate your sleep patterns.
    A good night’s sleep tonight will help your health throughout your day and in every way.

Dr. McIntosh is a board certified Chiropractor, licensed in both Kansas and Missouri. In addition to being licensed to provide general chiropractic care, she is also a Certified Chiropractic Sports Physician, working with athletes from multiple disciplines on specific sports-related problems and a Certified Acupuncturist. She can be found on the internet at KansasCityChiropractic.com.

Do You Need to See Your Physician Before Starting an Exercise Program?
By: Dr. Lynn McIntoshWe’ve all seen the warnings: Check with your doctor before beginning an exercise program. It’s on all of the exercise equipment and in all the articles you read about exercise. But is this really necessary? In most cases, beginning a moderate exercise plan without seeing your physician is quite acceptable. If you are a healthy adult, starting a new exercise program is going to be just fine. You do need to use good judgment to determine if you can jump into a program or need to schedule an appointment for testing before hand.Think about these factors to determine if you should make an appointment:

  1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
  2. Do you feel pain in your chest when you do physical activity?
  3. In the past month, have you had chest pain when you were not doing physical activity?
  4. Do you lose your balance because of dizziness or do you ever lose consciousness?
  5. Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity?
  6. Is your doctor currently prescribing drugs for your blood pressure or heart condition?
  7. Do you know of any other reason why you should not do physical activity?If you answered YES to any of these questions, then you should consult your physician before beginning an exercise program.

The Surgeon General’s Report on Physical Activity and Health states that 25% of adults are not active at all. If you haven’t been active at all for a prolonged period of time, now is a good time to start a new exercise program for yourself. Physical activity does not need to be overly strenuous to be beneficial. A good guideline to follow when beginning an exercise program is the ability to elevate your heart rate and break a sweat while carrying on a conversation, even though it’s a bit challenging. If it’s challenging, but not difficult, and you aren’t gasping for air between words, this would be an appropriate level of moderate exercise. As you become more accustomed to the exercise, you can slowly increase the intensity. You are more likely to continue an exercise that you enjoy and are comfortable doing.

If you experience any of the following conditions after starting your work out, slow down the intensity of your exercise:

  • Have pain or pressure in the left or middle part of your chest, or in the left side of your neck, left shoulder or left arm
  • Feel dizzy or sick
  • Break out in a cold sweat
  • Have muscle cramps
  • Feel sharp pain in your joints, feet, ankles, or bones
  • Notice that your heart starts racing or beating irregularlyIn cases of severe pain, stop immediately and seek help and follow up with your physician.

Dr. McIntosh is a board certified Chiropractor, licensed in both Kansas and Missouri. In addition to being licensed to provide general chiropractic care, Dr. McIntosh is a Certified Chiropractic Sports Physician, working with athletes from multiple disciplines on specific sports-related problems.

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