Why You Should Lighten Your Purse and Lose Your Wallet

The days of big fat leather wallets loaded with long roles of plastic sheathed photos of friends, family, and girlfriends are over, thanks to modern day technology.

Large wallets were so 1987!

The new wallet is the “money clip” one simple tip I always give men with low back pain, neck pain, hip/hamstring/knee problems, is to check their wallet for unneeded items and then shift the wallet to the front of their pants or carry it in a jacket pocket.

It’s amazing how simply sitting on a large wadded up leather wallet all day long can throw a body out of whack.

Now let’s get one thing perfectly straight….I am in no way as a doctor endorsing fanny packs *shudder* unless they are those Kevlar kind from REI that kind of look cool.

Part of being healthy and feeling good is checking in on the ergonomics of our posture, and physical structure from time to time. Read more

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Disease as Our Teacher

By Dr. Nicole Sundene

Happy Teacher Appreciation Week Everyone!

Who is Your Teacher?

Did you know that even adults have teachers?

We may not knowingly be matriculated into the curriculum, but LIFE is teaching us so many things.

In my opinion, disease is an amazing teacher.

Whether chronic or acute, disease is the only way the body can send us messages.

My friend with diabetes refers to her diabetes as her “teacher.”

Anyone with diabetes who is reading this can commiserate at what a challenging life lesson having this disease can be.

Pain is also one of the most common signals that the body sends to us when it wants to teach us a lesson, but we often miss the other hidden messages, the otherwise less pronounced teachers,  those substitute teachers….you know? The ones that NO ONE wants to pay attention to,  and they are known as SYMPTOMS.

Symptoms are a lot like substitute teachers because no one wants to listen to them.  They are going buh-bye in a day or two. Yippee! We can do whatever we want….

But we can’t.  What we need to do is listen to that inner wisdom of the body…pay attention to those symptoms.

Wow….symptoms are our teachers too! How amazing is that to think about? The body is trying to tell you something when you are spending hours on the toilet with The Swine Flu (or nature’s Spring Cleaning as I like to call it.) We know that this virus causing gastroenteritis is upsetting the digestive system, and the body is smartly shooting it out of us as quickly as possible (no puns intended…I promise with all due respect.)

Same thing happens when we get a bad cough, or when we have to sneeze…..and maybe boring yawns even have something to teach us.

Speaking of yawns, bear with me here for a second while we transport back in to time….

Picture it– Issaquah High School 1993:

When I was in high school, my best friend and I had this substitute teacher who eventually became our full time teacher.  He was fresh meat out of grad school, and not much older than we were. Smelling his fear, everyone in the class acted like the typical high school students that knew more than everyone else in the world (let me tell you when I was 18, I was the smartest I will ever be in my entire lifetime. The more I learn, the more I realize how little I will ever know.)

It seemed that everyone in the class had fun taking turns making his day a nightmare.  We were a bunch of arrogant Honor Society Students.  We were used to receiving “A’s” for thinking out of the box and leaving a tiny dot on a science test that asked us to draw a scientific model of a geographical system, and the teacher gave credit.

We had been tested, we had applied to schools, we already knew where we were going for college, many had full ride scholarships, we had it made….

In all nerdy honesty, I was just taking the Advanced Physics as an elective because I almost failed small engines, and in the 17 years that Mr. Endicott taught his curriculum, he never had a group of students not have their lawn mower run.  He even took it apart and put it back together again, and it still didn’t work.

He never had a group of students like us, who thought we were taking the class for an easy “A,” kind of like the “nerd” in “Breakfast Club” who wanted to kill himself with a flare gun because he couldn’t get his elephant lamp to work. Anyway, I got a C in the small engines class, the worst score I had ever received, and never had to work harder to almost not fail.  My BF and I would stay up late with flashcards talking about “tulip valves” and memorizing auto parts. To each his own genius right?

I digress….

In advanced physics class we refused to listen, we had already had six months of physics and thought we knew more than the teacher. We caused trouble just to cause trouble. We made our poor teacher work a million times harder than necessary. We chatted loudly amongst ourselves while he was forced to just yell louder and louder over us to gain our attention. In guilty hindsight, I’m quite certain we must have driven him to drink. I think he may have even given up teaching.

One morale of this blabbering story is that: He kept yelling louder and louder….and we didn’t listen. Hmmm…sound familiar? Pain and other disease symptoms can keep yelling louder and louder too….when we aren’t listening.

I think many of us that now work with super scary teenagers wish that we could flash back in time and apologize to or thank a particular teacher who worked really hard to make us better.

Teachers are some of the most under-appreciated professionals in the working world in comparison to what they are asked to do, and how much they are asked to give.

As a doctor, I have grown to accept that disease is one of our best under-recognized teachers.

Why else does the public speaker develop laryngitis when he does, or the athlete sprain their ankle? Why do most people have heart attacks at 8am on Monday mornings? Why does the skin problem finally show up on your face where your own vanity is forced to recognize it? Why do we get sick when we get sick? Why do we get sick with the things that we get sick with?

Why does our body choose the particular messages in the form of disease that it chooses to communicate with us?  Why aren’t we listening to the inner wisdom, or in Naturopathic Medicine we call it, “The Vis Medicatrix Naturae” or “The Healing Power of Nature.”

We recognize that although their is no cure for the common cold, for instance, the body manages to still recover.

The problem with symptom suppression is that we are ignoring the body’s inner wisdom. Obviously there are times when we have to ignore this “inner wisdom” and intervene to do what is safest, such as in the case of a high fevers! But let’s stop and think about what the purpose of a low grade fever is before we choose to immediately suppress it with acetaminophen.

When the immune system first interacts with a virus or bacterial particle, a message is sent to the brain to increase our thermostat. When the body has a higher temperature, it makes oxygen more available to white blood cells that kill the very bugs that are making us sick.  This is the immune system equivalent to the President giving a report that then gets distributed and the captain of the ship then says, “Computer–activate our shields.”

Sorry once a Trekkie always a Trekkie.

When we ignore our teachers, and assume we are better than our teachers, we are not quite present for life’s lessons. We miss the growth opportunity in the challenge. When we don’t listen to the messages sent by disease, disease just shouts back louder at us. What is that cold really telling you? Why did you have a heart attack? What is your chronic heart burn telling you?  Why does your back really hurt so bad?  Why do you do more nurturing for other people than you do for yourself?  Why aren’t you taking care of yourself?  Why aren’t you listening to your teachers?

Today is the day to start thinking about these things.

And, if you happen to be the 6th period Advanced Physics teacher at Issaquah High School in 1993, I would like to offer my sincerest apology!

God bless all of our teachers!

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Back Pain: Try a Half Bath

By Dr. Nicole Sundene

If you have chronic neck or back pain, you might want to try a half bath next time instead of a full one. Now, many with big Jacuzzi bath tubs may not need this tip, but if you have a standard little bath tub you may want to try this out.

As a med student I was always hunched over a book, which resulted in chronic neck and upper back tension. If you fill the bath tub up so that you can lie with your legs up and your neck and back in the water you may be able to decrease spasming muscles and prevent the tightness from progressing in to a full blown event that leaves you laid up in bed in pain for days on end.

This tip is also great to do right before you go in for a massage, chiro adjustment, physical therapy, acupuncture, or other body work. The looser you are before your appointment, the easier it will be for your practitioner.

Tight muscles can make chiropractic adjustments very difficult. If you always suffer from chronic back and neck pain, be sure to check your office desk ergonomics in addition to being fully worked up by your physician and the proper experts.

If you suffer from high blood pressure, heart problems, or other chronic health conditions, please contact your doctor before implementing any hydrotherapy techniques, and ask someone to assist you whenever you are not feeling well.

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Computer Desk Ergonomics

Using your computer improperly and having an unbalanced desk set-up can lead to chronic musculoskeletal complaints such as wrist pain, neck and shoulder tension, and even low back pain. Simple shifts in your desk arrangements can make a big difference in alleviating chronic aches and pains.

Quick Tips for Computer and Desk Set-Up and Use:

A normal desk height is 28-30” above the floor. This is comfortable for writing on paper, but it is too high for keyboard and mouse work. You may need to raise your chair slightly to get the optimal height. Make sure to use a foot rest to maintain proper seating posture. Another option is to consider using a height adjustable keyboard/mouse tray system beneath the work system.

Adjust chair so thighs are roughly parallel with the floor. Your knees should be at an open angle (90° or slightly greater). Your feet should be flat on the floor or on a foot rest. Sit back in your chair or use a cushion for lower back support. The seat should not apply pressure to the back of your knees and there should be about an inch on both sides of your legs. Do not use the armrests while typing, only between typing sessions.

An adjustable chair is a good investment to prevent long-term problems.
If your chair is too low, use a cushion to boost you up. If your chair is too high, consider using a footrest to bring your thighs parallel with the ground (you could use a telephone book!) If your seat is too deep (creating pressure on the backs of your knees), use a pillow, rolled towel, or backrest to support your lower back.

Center your monitor directly in front of you. Sit arms length away when you’re sitting back in your chair. Position the top of your screen level with your eyes (unless your screen is 20” or larger then position the top of the monitor 3” above eye level). Tilt your monitor slightly upward. Reduce glare and balance the brightness of the monitor with its surroundings.

Consider using an adjustable keyboard/mouse tray. Your keyboard should be just above the level of your lap which is lower than most people place their keyboard. This lets your arms tilt downward, leaving your elbows at a comfortable, open angle (>90°). Adjust your chair upwards to get this effect if you do not have a separate tray. Use a slight negative tilt with your keyboard (tilt back edge of keyboard slightly down) versus an upward tilt. If there are “legs” attached to the underside of the keyboard, do not extend them. Keep your wrists neutral, your shoulders relaxed, and your elbows at your side.

Place your mouse close to your keyboard and within easy reach to avoid constantly outstretching your arm which leads to neck and shoulder pain. Use of a touchpad or scroll wheel reduces the distance and amount your shoulder has to travel. Mice come in different sizes. Make sure it fits comfortably in your hand. Use your elbow, not your wrist to move the mouse. Flicking of the wrist leads to increased intracarpal pressure leading to wrist/finger pain. Use keyboard short-cuts when possible.

Do not lay documents flat on your desk while you are working on them Use a screen-mounted or free-standing document holder to keep them at the level of your screen. Make sure you have enough light to see your documents to avoid unnecessary strain.

Below is a list of common musculoskeletal complaints and associated ergonomic problems and solutions:

Neck and Shoulder Pain

• Problem: You’re cradling the telephone between your head and your shoulder.
• Solution: Keep your head straight and shoulders relaxed while using the phone. Consider using a hands-free headset.  
• Problem: The documents you’re working from are too low and too far to the side.
• Solution: Position the documents at the same level as your monitor. Consider using a document holder that attaches to your computer or sits beside it.
• Problem: Your monitor is not the right height.
• Solution: Make sure your monitor is directly in front of you and in line with your chair.
• Problem: Your chair is too far away from your keyboard or desk, or the back of your chair is tilted too far back.
• Solution: See suggestions in above section to learn how to set-up your chair and keyboard properly.
• Problem: You wear bifocals and tilt your head back to see the computer screen.
• Solution: Consider positioning your monitor slightly below eye level. Sit back in your chair and avoid hunching.
• Problem: You’re leaning forward to see the screen.
• Solution: Be conscious about sitting in upright posture against the back of your chair.

Shoulder Pain

• Problem: Your keyboard is too low or too far away. This causes you to raise or lower your shoulders to accommodate.
• Solution: Keep your elbows close to your sides as your type and arrange your keyboard at proper level. See proper keyboard set-up in above section.
• Problem: Your mouse is too high, to the side, or too far away.
• Solution: Position your mouse close to and approximately at the same height as your keyboard. Consider using a touchpad or trackball to minimize distance your shoulder has to travel.

Wrist and Forearm Pain

• Problem: Your wrists aren’t in a neutral position.
• Solution: Keep your wrists straight in line with your arms. People with broad chests may prefer a split design keyboard as their elbows are already pushed outward.

 

• Problem: Your keyboard feet are extended, giving your keyboard an upward tilt.
• Solution: Your keyboard should have a neutral or slightly downward tilt.
• Problem: The edge of your desk or hard wrist rest is putting unwanted pressure on the palm side of your wrist.
• Solution: Consider using a soft wrist rest and check the height of your keyboard.
• Problem: You’re typing too hard or for too long.
• Solution: Use minimal force when typing. Make sure to take frequent short breaks (30 seconds) and consider performing quick stretches.

Low Back Pain

• Problem: Your chair isn’t offering proper lumbar support.
• Solution: If your chair is adjustable, make sure it’s properly adjusted to fit your body. If it’s not adjustable, considering purchasing a lumbar support or using a pillow or rolled towel to support your lower back.
• Problem: You’re not maintaining good posture.
• Solution: Your chair may be too high or too low. Your feet should not be dangling; they should either reach the floor or a footrest.
• Problem: You’ve been sitting too long without a break.
• Solution: Make sure to get up every few hours. Consider stretching to relax muscles and improve circulation.
• Problem: You’re leaning forward to view your screen.
• Solution: Be conscious about sitting in upright posture against the back of your chair if necessary.

Hip and Leg Pain

• Problem: Your legs are cramped under your desk.
• Solution: Clear the space under your desk so that your legs can move freely.
• Problem: The padding on your seat is too firm.
• Solution: Make sure your seat is padded. The angle between your chair back and seat may be too tight. Adjusting the backrest backwards slightly or the seat downward may help.
• Problem: You’ve been sitting too long without a break.
• Solution: Your legs need occasional movement to keep blood flowing and to avoid stiffness.

Knee Pain

• Problem: Your chair is too low or too high. Dangling feet may cause knee pain.
• Solution: Raise or lower your chair as necessary.
• Problem: Your seat is too deep which can cause pressure on the back of your knees.
• Solution: Tilting the seatback slightly forward or using a back pillow may help. Some adjustable chairs now have sliding seats that adjust for depth. 

- Dr. Nicole Sundene, Naturopathic Physician

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The work place stretching routine

Sitting at a desk all day long creates a hunched over posture, which typically results in upper back and neck pain. The reason for this is that the muscles on the back side of the neck and upper back become chronically stretched throughout the day. A muscle can only stretch for so long before it will begin to spasm. By stretching out the muscles on the front side of the body such as the neck and pecs you can give the tight muscles on the backside a break.

A simple routine involves doing several sets of neck rolls twice daily, along with a few breaks a day to do “doorway stretches” . You can do a simple doorway stretch by standing slightly in front of a doorway with both hands placed slightly above shoulder height on the trim of the door. Now lunge forward until you feel a nice stretch in your pecs and the front crease of your armpits. Take some deep breaths and hold for at least 10 seconds. Keep in mind it takes at least 10 seconds for a muscle to relax. Taking a few moments throughout your work day to take care of yourself will not only help you feel better but should also enhance your overall productivity.

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