Low-Impact #AerobicExercise

From Spine-Health: Read More on their sitedreamstime_xl_52110136

“Along with specific back exercises, aerobic exercise that increases the heart rate for a sustained period is very beneficial for helping back problems. Aerobic exercise increases the flow of blood and nutrients to back structures which supports healing, and can decrease the stiffness in the back and joints that lead to back pain. While many patients with back pain are able to participate in vigorous exercise like running or step aerobics, others find it easier to engage in low-impact exercise, which does not jar the spine.”

Athletes and Heel Pain

How to evaluate and treat heel and foot pain.

Since I have become a chiropractor One of the things I love is treating complicated situations that are not the typical chiropractic case. I also love treating the spine and it is the bread and butter of the chiropractic industry, but some times you just need a change and challenge to keep life interesting.

One of theses areas is the treatment of heel or foot pain, in many cases this may be diagnosed as Planter fasciitis. A study was performed by Daniels and Morrell on plantar fasciitis and they found it “improved after a course of a multimodal treatment approach using chiropractic manipulation and soft tissue therapy in addition to exercise and stretching therapies.”(Daniels CJ, Morrell AP. Chiropractic management of pediatric plantar fasciitis: a case report.J Chiropr Med, 2012 Mar;11(1):58-63)

Many of my patients come in complaining of foot pain and this may also have an affect on there back and neck pain. In my 10 years of practice I have treated many athletes for back, shoulder, wrist, elbow, hip and Knee pain but as well as these complaints 10-15 percent also have heel and foot pain complaints at one time or another.

II have found that in some cases the foot pain may resolver with a few adjustments but in many cases this requires a multi modality approach. This approach often includes chiropractic adjustments of the foot and ankle joints, facial release techniques such as trigger-point, cold laser, and stretching as well as strengthening exercises. As a last resort special shoe inserts night be needed but not until the foot is aligned more normally. At this point

Anatomy of the Heel

The prominence at the posterior end of the foot is the heel and is crested by a projection from the calcaneus or heel bone. Other articulating bones of the ankle are the mortise (tibia and talus). When weight is applied to the foot the forces are distributed along the five toes or metatarsals. The lateral support stretches over the cuboid bone in the front to the heel and the medial support moves over the three cuneiform bones and the navicular to the heel. These bones form the three functional arches of the foot which are the medial longitudinal, lateral longitudinal, transverse arches. It is these arches that distribute compressive forces across an uneven terrain across the foot. Often when patients have foot pain they go to the drug store and buy arch supports but many of these supports only account for the main arch in the foot and as we know see there are three arches that need to be supported as well as the navicular bone and this is why in my office when arch supports are needed we recommend custom made orthodic supports. They are more expensive but worth the cost they many last up to 5 years if treated properly. Orthodics often help with the biomechanics of the foot. The heel is the actual point of contact during the heel-strike portion of the gait cycle. It is also an important point on which weight must be equally balanced from the forefoot and heel. When walking there needs to be a 50/50 weight distribution at the forefoot and hindfoot. Without this 50/50 distribution the gait and the standing positions are unhealthy.

When the foot is healthy the arches are working well together during gait and the heel strikes the ground in a slightly supinated position and during the gait cycle it moves into a slightly pronated position. Stand up and walk a few paces do you notice how it feels. A healthy gait is present in only only in about 10 percent of patients that I see. More often I see patient who are over pronating. This excessive pronation results in flattening of the arches and collapsing of the foot, this causes the heel to strike the ground in an over supinated position altered the heel-strike pattern and creating stress in the heel, but also altered biomechanical patterns of the foot. In the end this can lead to pain in the foot and heel. Excessive supination occurs much less frequently, most statistics suggest less than 5 percent, so its effects on the heel are not as profound.

Common Conditions

First there is the condition of Achilles tendinitis. This is due to excessive pronation of the feet and affects the tendon of the triceps surae. The collapse of the foot creates tension in the Achilles tendon, causing it to bow inward and this bowing is happening every time the foot over pronates creating microtrauma and stress to the Achilles tendon. If the Patient supinates, the bowing of the Achilles tendons is outward and creates similare strain and stress on the bones and soft tissue. Over time the body calcifies these tendons to support the joints that are unstable and spurs can develop on the posterior, superior portion of the calcaneus bone. Tight muscles and trigger-points may also form in the gastrocnemius and soleus muscles of the foot and lower leg. Achilles tendonitis is often debilitating due to the the pain and this continues to alter gait and mobility patterns to the point that it prohibits walking for any amount of time without pain. According to Papa “A combination of conservative rehabilitation strategies may be used by chiropractors to treat midportion Achilles tendinopathy and allow an individual to return to pain-free activities of daily living (ADLs) in a timely manner.” (Papa JA. Conservative management of Achilles tendinopathy: a case report.J Can Chiropr Assoc, 2012 Sep;56(3):216-24.)

Another common condition of the foot and heel is plantar fasciitis. A healthy plantar fascia ligament exhibits elastic properties but over time,the three arches of the foot tend to collapse. Over time this leads to excessive pronation and stresses the plantar fascia chronically. This causes the ligament to stay overstretched and it loose its elasticity and becomes longer due to the plastic deformation. Supination creates a thinner, tighter foot due to the tendency of the foot to roll outward creating a high instep with collapsed transverse and lateral arches in these patients. In either case, we can note biomechanical instability and irritation to the plantar fascia from its origin at the calcaneal tubercle across to the insertion on the metatarsal heads. In these patients symptoms begin as a dull ache in the underside of the heel that is more of an annoyance. Patients can still perform normal activities and sports, but over time the pain becomes more intense and sharp, these patients have to curtail or eventually stop their activities. In the later phases, pain can move off the heel and into the middle of the fascia, or at the insertion on the metatarsal heads.

We have all known some one with a sprained ankle. Ankle sprains range from the very mild kind to the severe, grades 1 through 3. The milder types are suggested when a patient complains of “turning the ankle.” This is like when someone missteps off a curb or a step. The opposite extreme is when ligaments and tendons are torn due to a traumatic injury. Either way, biomechanics, particularly of the calcaneus and talus, are compromised. The most common type an inversion ankle sprain, the calcaneus bone moves medial while the talus tends to move lateral. There is also an eversion sprain, where the talus bone moves medial while the calcaneus tends to move lateral. Recall that the bony anatomy allows inversion ankle sprains to occur much more frequently. In either case, the movement of the bones inhibits normal mobility. Since most people do not see a chiropractor after a sprained ankle, the bones stay out of alignment, leading to a slow rate of healing, chronic degree of tenderness and decreased function, and a tendency to repeatedly sprain the ankle in the future. Thus, it is imperative that chiropractors intervene and break this cycle. A 2004 study suggested “high velocity, low amplitude chiropractic manipulative therapy to the spine, pelvis, and extremities, particularly at the ankle, should be considered when managing young recreational athletes with functional chronic, recurrent, ankle inversion sprains.” (Gillman SF. The impact of chiropractic manipulative therapy on chronic recurrent lateral ankle sprain syndrome in two young athletes. J Chiropr Med, 2004 Autumn;3(4):153-9.)

Heel Spurs are a painful and common problem of the heel. As previously discussed, a heel spur forms at the posterior, superior calcaneus bone courtesy of Achilles tendinitis. The most common place we see a spur is on the underside of the foot at the calcaneal tubercle where the plantar fascia originates. The worse the chronic pull on the bone, the worse the spur. Spurs form when the body tries to stabilize an unstable joint. According to Wolf’s Law the Body will remove calcium from places where it is not needed and deposit it in areas were force and instability requirer it. We can’t take the spur away, of course, but we can help it from getting worse and if the joint stabilizes the body may even re-absorb some of the calcium reducing the size of the spur. Depending on how quickly you seek treatment for one or more of the above ailments, the faster they heal. If a patient is acute enough and there is sharp pain and inflammation, modalities like cold laser, ultrasound, ice, etc., are indicated. You can also provide light, soft-tissue therapy at this stage, making sure you apply the appropriate amount of pressure.

Chiropractic treatment for foot and ankle injuries!

Adjusting the bones of the feet to restore healthy biomechanics is extremely important. Adjusting the calcaneus, talus, navicular and cuboid bones is particularly helpful. If you don’t get in there and move those bones, they will not heal very well and will be prone to future injuries.

Another helpful tool is stabilizing orthotics. These are flexible, have all three arches and are custom molded and help to support the patient’s feet as well as the rest of their body. A 2002 study suggests the effectiveness of applying orthotics and ankle braces during the acute and subacute phases of ankle rehabilitation. (Mattacola CG, Dwyer MK. Rehabilitation of the ankle after acute sprain or chronic instability. J Athl Train, 2002 Dec;37(4):413-429.) The use of orthotics, when necessary, has been a part of chiropractic practice as well as my practice. They help to maintain proper biomechanics and structural integrate as well as helping hold the adjustments longer.

Ankle stretches and stabilization exercises also can be provided, and they are helpful as well as easy. A passive exercise (Doctor performs) would be to have the patient cross the affected ankle over the opposite leg and passively dorsiflex, plantarflex, invert and evert the foot. Another exercise is to have the patient stand on the edge of a step or a door frame and stretch the calf muscles, each repetition should be held for 30 seconds. Stabilization exercises should be performed with elastic tubing. The patient performs the following active movements of the foot and ankle dorsiflexion, plantarflexion, eversion and inversion. Elastic tubing is easy and convenient, and you can change the resistance quickly.

It is common for patients to walk into our office complaining of ankle and foot pain. At our office we take a few moments to listen, look and feel so we can help them in a manner that isn’t complicated or time consuming. Since the ankle is such an important stability structure for the entire body, our patients benefit tremendously from our expertise and care of their ankle and their entire body.

By: Dr. Paul R. Mahler

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Methods that Will Turn Your Pre-Shot Routine into Your AdvantageUse the Golf Pre-Shot Routine to Set You Up to Be Successful

The few seconds concerning when you tee up the ball, or approach the golf ball in the fairway, and in fact hit it may determine how successful the golf shot will be. Will that be a period when those mental demons creep in, making you lose focus? By utilizing your pre-shot routine that is tailored to you, there’ll simply be time to focus on the job at hand. So why does every superior golfer have an effective pre-shot routine, even when it comes down to How to Putt? Because it works!

Basically, your pre-shot agenda is really a progression of checkpoints, thoughts, movements, and attention to details prior to striking a golf shot. It should be unique to every golfer, and it is best if it fits the player’s character. In other words, when a golfer throughout his every day routine moves through life in warp-speed, he wouldn’t use a unhurried, methodical routine. Similarly, if you are a more measured person, that slower schedule may fit your needs better.

So what would your pre-shot routine appear to be? Since I can simply stress its importance and what components go into it, I cannot state what is best for you. So I will describe what I do before each golf shot, and perhaps you’ll draw a few ideas.

1. Before I choose a golf club, I stand behind the golf ball and create in my mind the shot. This does not mean merely distance. I factor in wind direction and intensity, the way the golf ball is carrying that day, how I’ve been striking the ball, and I leave a margin for error away from problem places.

2. Select a golf club. Even if I had previously pre-decided my golf club prior to visualizing my golf shot, I at all times bring one or two, and occasionally three, additional clubs with me. Should I change my mind following deciding the proper shot, attempting to hit that golf shot with a club I am uncomfortable with will almost certainly wind up poorly. That is the most important explanation why I always opt to walk the golf course when doable; all of your tools will always be there with you.

3. Decide your target. I do this from behind the golf ball, after which I line up a spot about five feet on line and before the golf ball. That is where I will set my stance and my clubface to. I’ve found in the course of my experience that this gives me a greater consistent set-up to my target area.

4. Before I set my feet, I locate the golf club on the exact location I would like it to hit the ball. I know that when anything mechanical goes amiss with my swing, a great deal may be corrected with a suitable ball strike. Next I set my left foot to the ball, after that my back foot.

5. Subsequently after one final glance toward the target area, to prompt the swing (I think this is very important) I to some extent push the hands forward previous to drawing the club in the backswing. This “activate mechanism” gives a uniform starting point to start the golf swing.

As I said earlier, your pre-shot routine is individual, so you must determine what is the best fit for you personally. But it ought to be part of every golfer’s Short Golf Game and his long game, and to be your most consistent, you must address this crucial piece of the game.

I am not a good golfer but am always looking for golf tips. I posted this in-case it can help you your comments are welcome.

This Article was provided by an author from Seolink but has been red and approved by Dr. Paul Mahler of Mahler Family Chiropractic CenterKingston, PA for  posting on our blog.

Sharks in the Great Barrier Reef

Guest Post: How to avoid shark attacks in the Whitsunday Islands among the types of different sharks seen at the waters around Airlie Beach is the shovel nose shark named for the natural shovel shape of its upper body. But there are many other recorded sightings of the bull nose to tiger and a number of reef sharks. It is possible the great white shark, the most dangerous shark to humans, may pass by in the deeper waters past the continental shelf, but is more often seen from the Sunshine coast and further south as it prefers the colder waters.

Varieties of Sharks in the waters around Airlie Beach

So, how many different species of sharks swim in the Whitsuday Islands? The quantities are unclear, although there are obviously more than a dozen from the bottom feeding cat shark to the larger and more dangerous tiger shark. The following list names some of the more commonly seen sharks varieties living in the area:

  • White Tip Reef Shark
  • Grey Reef Shark
  • Oceanic Silver-tip shark
  • Hammerhead Shark
  • Shovel Nosed Shark
  • Bull Shark
  • Cat Shark
  • Tiger Shark
  • Reef Sharks

The white tip reef shark; with its slender body and short, wide head, only measures in at an average of 5 feet 2 inches. It swims close to the floor of the ocean in clear waters, making the Great Barrier Reef an ideal environment for the Reef Shark. The shark is well known for its nightly hunt after sleeping in caves during the day. It would be a rare experience for the white tip reef shark to instigate an assault on man. The only natural difference on the Black Tip Reef Shark is the black tip of the fin as compared to the white tip. The black tip reef sharks stays in shallow waters and is considerably smaller than the white tip. Sharks in the waters around Airlie Beach Dangerous to Humans All sharks are obvious predators staying beneath the surface hunting for the next prey but there are not many dangerous species. There are a few that, because of their size, power and massive jaws that a diver needs to be aware of such as the tiger, bull, bronze whaler, mako and hammerhead sharks. Attacks on us are very rare in the waters around Airlie Beach. It is said the tiger shark is the most dangerous but it is a night feeder and heads to deeper waters during the day.

There are places along the coast providing dive tours for anyone that would like to see the waters around Airlie Beach. Some tours are especially aimed at spotting one of the sharks of the Great Barrier Reef. At the Whitsuday Islands going with an skilled tour operator reduces the risks of being in the water and increases the chances of seeing some magnificient tropical fish, live coral and sharks.

The Dangerous Creatures series and this article about sharks of the Great Barrier Reef Series has been put together by Toscana Village Resort, Airlie Beach Accommodation.

This information was provided by seolinkvine.com and the copyright is owned by the original owner.

Every now and then I see interests me other then health information. I was a Marine Biology major in undergrad and a dive instructor in an earlier part of my life and love everything water and marine related just thought this post was cool.  At Mahler Family Chiropractic Center we love to bring you useful information. This post has been approved by Dr. Mahler.

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Consider these Three Factors when Learning How to Correctly Hit a Golf Ball

Beginning learning the basics of the game can be overwhelming, but I will offer some swing tips for the beginner golfer, and focus on three areas.  Nearly all manuals will go into golf grip ideas, golf driving tips, and other facets of the game that are farther down the to-do list. The golfing recommendations I would like to go into here include the set-up, proper balance, and golf ball concentration. These three elements will determine the quality in the golf swing, and once they are put into routine, golf driving and grip tips will fall into place.

To simplify, so as to hit a golf ball consistently imparting as little side spin as achievable, we will study the following golfing guidelines:

1. The set-up. As opposed to setting up to your ball with the idea of generating as much club speed as possible (you are not there thus far), think about being in a position to strike the ball evenly, without a slicing, or glancing blow. If you were to look down on the golf ball, and the contact spot would be twelve o’clock on the ball, ideally you would like to strike the ball at roughly seven o’clock and would exit the golf ball at about one o’clock. If done having a golf club head that’s square to the ball (not opened or closed), you should be in a position to launch the golf ball with a minor counter clockwise spin, or hook spin. With the new golfer, that gives you the most distance.

2. Balance. The next of our golf suggestions could possibly be the most important to the swing for starting-out golfers, as it is not possible for any golfer at whichever level to be consistent without keeping correct sense of balance. But instead of getting into a long discussion on things that go into sense of balance, let us keep it simple. Consider keeping the spine vertical and upright during the golf swing. Maintaining a vertical spine will allow an unrestricted rotation with least resistance, making for less moving parts. It will also keep the head still, allowing you to better focus on the golf ball during the golf swing. A vertical spine with some bend in the hips and knees will permit you to become more balanced, providing you with a more consistent golf swing.

3. Ball concentration. There is a huge distinction between seeing the golf ball in the course of the swing and having a total, laser-like focus on your ball. It is one thing not talked about for the reason that everyone assumes that you routinely keep the “eye on the ball”. However that is not sufficient. I read once where a pro golfer would juggle two golf balls in one hand in order to make him better concentrate on the golf ball. Whatever teaching support you use that can assist you with the ball concentration is excellent, but this last of our golfing advice is one which is critical for consistent ball striking for new golfers.  Practice this with the Pitching Wedge around the practice green, and you will find your ball focus improved.

Obviously these only scratch the surface, but at this point your golf education should be kept simple, lacking getting too technical. But I congratulate you on trying to improve yourself in the sport, and hope these golf suggestions have gotten you started with the right foot.  Finally, do you think you’re a Last Minute Golfer?  If you would like an easy way to reserve your tee times, even at the last minute, check out our website.  You will find some great deals, too.

This information was provided by seolinkvine.com and the copyright is owned by the original owner.

Every now and then I see a good tip that is not directly related to my practice of chiropractic but would lick to make it available to you that is the care with this post. For all of you golfers out there I hope you find this helpful and informative. At Mahler Family Chiropractic Center we love to bring you useful information. This post has been approved by Dr. Mahler.

How to avoid low back injuries when golfing.

© Karlien Du plessis | Dreamstime Stock Photos

The golf swing places a large amount of stress on the low-back, and over time the lower back becomes fatigued. This will results in a decrease in performance and possible injury.

So how do you prevent such an injury from occurring? Golfers can takes steps to prevent low back injuries. One of these steps is the implementation of a fitness program targeted at improving your golf game. Included in this routine will be exercises targeted at improving lower back flexibility such as the one above and strengthening the lower back to avoid injury and pain. This part of the program contains a series of golf-specific flexibility exercises geared to maintaining the range of motion within the lower back. One exercise to increase flexibility in the lower back is descried here. It is a simple exercise for the low back to improve flexibility and rotation during the back-swing, and it also helps keep the musculature of the lower back flexible.

Here’s how to perform the exercise. First begin the exercise by lying on your side with the left hip in contact with the floor, then bend both knees approximately 90 degrees, resting the right knee on top of the left. The second step is to extend both arms straight out from the shoulders, resting the left arm on the floor, and hands clasped together and slowly raising your right arm off the left. Finlay continue to raise and rotate the right arm until it is resting on the floor opposite your left arm and hold this position for 20-30 seconds, and repeat the exercise sequence by switching sides. This should be performed 2-4 times on each side. Remember, to go slow with a new exercise and, check with your physician before starting any new physical training program.

Keep in mind not all lower back injuries can be prevented, but with the implementation of a lower back flexibility and strengthening program, the possibility of one occurring to you can be greatly reduced.

Most acute low back injuries that occur during a game of golf will get better over a couple of days. The most common injuries from golf include, muscle strains which typically occurs with rough or forceful golf swings or a sudden shift during the downswing, muscle and tendon sprains which generally occurs due to excessive use, accidents or swing abnormalities while playing golf, and disc injuries which can occur from swinging abnormalities. It is important to not that disc injuries may be present but symptoms may not occur without the incorrect golf swing (see preventing golf injuries).

For relief of the miner low back pain and to promote healing from golf-related injuries and low back pain, it is generally advisable to rest for a day or two, and apply ice. It is advisable not to further stress inflamed muscles by continuing to play golf through an episode of low back pain. If you take time off the injury will often heal quicker allowing you to get back to golf sooner. It is important to continuing stretching and exercise programs between golf sessions. A low-impact aerobic exercise program, such as walking for 30 to 40 minutes every other day can be helpful and after the low back pain has stopped, slowly return to playing golf and apply the prevention tips to help avoid injuries.

It is well known one of the most common injuries in golf is the lower back. Research indicates more than half of all golfers will incur a lower back injury at some time during their playing careers. Professional golfers spend great deal of time and energy preventing low back injuries. So prevention in this case is the best medicine. If you do injure your low back and the pain continues for more than a few day to a week, a specific problem may be the cause of the back pain and a chiropractic professional should be consulted. Chiropractic are uniquely train in neuromuscular injuries and can often help get you back on the links sooner, you might even shave a stroke or two off your game.

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By: Paul R. Mahler DC
may be reproduced in whole only

Invaluable Golf Instruction Suggestions for Novices Trying to Learn the Game

Whilst it is straightforward to seek golf instruction strategies for inexperienced players on-line, most articles or blog posts and e books ignore several areas that are essential for inexperienced players. The following are some of the “not so well known” golfing tips for newbies.

First of all, it is important for you to select the correct golf equipment. Young people and juniors need to have golf equipment that are catered suitably with regards to their height. A large amount of junior golfers start off by practice using their parents’ clubs, yet this is not the optimum method to learn the skill-sets younger golfers need, and might even lead to negative golf swing patterns. Go and visit additional resources on golf swing basics here…

Yet another ignored golf recommendation for inexperienced players is to recognize and observe the common regulations as well as your behavior in the course. As an example, a great deal of newcomers do not know the correct method to enter and exit the sand trap. They might not have any idea the reason why that rake is perched there, or that if they ground their club, they are really violating a rule. This is where more knowledgeable players can help. As you engage a round with a beginning golfer, reveal whatever you can with regards to the protocols and conventional course manners.

The majority of newcomers will strive to train themselves the principles of the golf swing action. This is usually a drawn out, disheartening process. Perhaps the best golf instruction suggestions for beginners is to try to complete a tutorial or perhaps 2 through someone that has knowledge of the aspects of the great swing. The course guru will help the gamer get set up correctly, describe the entire golf swing process, as well as analyze the golf swing immediately. Check out good strategies on golf lessons for beginners here…

Of special significance to inexperienced players will be the takeaway. A number of newbies will most likely whip the club back in their hands. The correct takeaway for any golfing swing is extremely important to your remaining swing. All beginners should really see that they don’t have to draw the golf club back speedily to manufacture a solid golf shot.

Upper body rotation is an additional difficult area for many new players. A right manner to move the golf club back is to allow the the shoulders to immediately turn as you are maintaining a square golf club face, accompanied by the body. Towards the top of your back-swing, the sides begin the process involving the downswing, and not making use of the arms. Consider more strategies on golf instruction tips here…

Most of all, probably the most vital golfing strategies of novices will be to train. This is the game which calls for hands-on workout, not just with the driver but also with each and every clubs, along with the golf putter. You’ll never master the golf swing action if you don’t commit the time and effort to learn every different club and have an understanding of how it reacts to your swing.

This article was provided by seolinkvine.com and the copyright belongs to the original author not our site.

For more information see our blog on Golf and injury prevention. Mahler Family Chiropractic Center serving the greater Wilkes Barre and Kingston area for over 10 years.

Quick Tip Ice or Heat

Should I pick ice or heat? Ice is almost always safe, where heat can cause more damage to the area of injury. If you have an ice allergy or major vascular problem you should consult your physician first. Heat on the other hand is a great pain reliever but it increases inflammation. In conditions such as back injuries, sprains or strains and sports related injuries more inflammation equals more tissue damage and a longer period to heal.
So if you have low back pain or neck pain you should initially use ice until consulting with a physician. To use ice apply for 15 to 20 min. then leave off for at least an hour. If you use anything other than water ice put a towel or tee shirt between you and the gel pack. The gel pack is the temperature of the freezer and can give you ice burn otherwise.
It is important to remember that the acute phays can last several weeks due to re injury and does not necessarily fit the ice for three days while acute then use heat.

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By: Paul R. Mahler DC
may be reproduced in whole only

Shoulder Exercises

Six great exercises to rehabilitate, strengthen, and prevent injury of the shoulders.

1: Scapular Retraction: For this exercise, you will need elastic exercise material, such as Thera-band.

  • Put the band around a solid object, at about waist level. Each hand should hold an end of the band.
  • With your elbows at your sides and bent to 90 degrees, pull the band back to move your shoulder blades toward each other. It should feel like you are trying to hold a pencil between your shoulder blades.
  • Return to the starting position.
  • Repeat 8 to 12 times. and up to 3 sets

As you improve and If you have good range of motion in your shoulders, try this exercise with your arms lifted out to the sides, with your elbows at a 90-degree angle. Raise the elastic band up to about shoulder level. Pull the band back to move your shoulder blades toward each other. Return to the starting position

2: Shoulder External Rotation

  • Attach elastic to secure object at waist level.
  • Place a rolled up towel between elbow and body.
  • Grasp elastic in hand, elbow bent to 90 degrees.
  • Rotate arm outward and return.
  • Slowly return to start position and repeat.
  • Do 8-12 reps and up to 3 sets. Do both shoulders see guidelines below.

3: Shoulder Internal Rotation

  • Secure elastic at waist level.
  • Place a rolled up towel between elbow and body.
  • Sit or stand with involved side to elastic,
  • Grasp elastic and pull hand inward, across body, as shown.
  • Slowly return to start position and repeat.
  • Do 8-12 reps and up to 3 sets. Do both shoulders see guidelines below.

4: Shoulder Flexion

  • Stand on elastic.
  • Begin with arm at side, elbow straight, thumb up.
  • Grasp elastic.
  • Raise arm in front over head, keeping elbow straight.
  • Slowly return to starting position.
  • Do 8-12 reps and up to 3 sets. Do both shoulders see guidelines below.

5: Shoulder Extension

  • Secure elastic at waist level as shown.
  • Grasp elastic and pull arm backwards keeping elbow straight.
  • Slowly return to start position.
  • Do 8-12 reps and up to 3 sets. Do both shoulders see guidelines below.

6: Stability Ball Push Up Technique

  • In the first week place the stability ball on a wall about the level of your chest with feet out from the wall.
  • As you improve work you way to the floor this is harder than it sounds be careful.
  • Lay with your chest on the stability ball
  • Place your hands at the sides of your chest.
  • Place your toes on the floor, legs straight.
  • Push your body up until your arms are almost straight (do not lock your elbows).
  • Hold and balance for two seconds.
  • Slowly return to the starting position and repeat.
  • Do 8-12 reps and up to 3 sets.

It is important to remember that for is the most important thing wen performing these exercises not the amount of weight or repetitions, so start slow and work into the shoulder exercise over several weeks. It is also important to work both shoulders evenly don’t neglect the good shoulder but keep it light with the good shoulder until the injured one caches up. It is important to maintain balance at all time you don’t want to injury the good shoulder so if you can only do 8 reps on the injured side do 8 with the good side.

Start with exercise 1,2, and 3 on week one, In week 2 to 4 add exercises 4 and 5. and after 1 to 2 months add exercise 6. The rate at which you add these exercises depends on how you feel don’t over do it but keep moving forward. This is a routine that should be performed 2-4 times a week for the rest of your life. It will help you avoid future injuries as well and can be used to prevent rotator cuff injuries. The bad shoulder will catch up don’t worry and good luck.

By: Paul R. Mahler Jr. DC
Mahler Family Chiropractic Center
1144 wyoming Ave.
Kingston, PA. 18704
May be reproduced in whole only.
We can treat shoulder injuries including rotator cuff.

Exercise Mistakes: how to exercise

Exercise mistakes are common, correct them before you injure yourself!

Sixty percent of people who initiate an exercise program wind up injuring themselves in the first month, and if you are hurt you will never reach your fitness goals. Most people who start an exercise program either want to burn fat or build lean muscle mass. So how do we work smarter and safer to achieve our fitness goals.

First and foremost is proper form, if your form is not correct, you need to reduce the amount of weight you are using and/or slow down. Proper form is too important to ignore, weather it is a workout for the shoulder or exercises for the back . If you can not maintain proper form then you are trying to do too much and it will result in not achieving your goals. Correct form is key when doing any exercise. If you want to get the most out of your workouts, you have to use correct form. There is a right way to exercise and a wrong way to exercise, and this applies to each and every exercise you perform. Lack of proper form is the number-one cause of injuries. Most of the time, when a person tries mimic someone in the gym, the person they are looking too as a model saw someone else do the exercise and they are doing it wrong as well.

Next lets review sets and repetition. If you are trying to gain muscle or get stronger,you want to do low reps and higher sets. You put on a heavier weight and do 6-8 reps per set, with proper form, for 4-5 sets. On the other hand, if you are just trying to build endurance and lean out, then you should typically do 15-20 reps per set for 2-3 sets. If your goals are some were in-between then these two can be blended to archive your own personal goals.

Exercise Mistakes:

Lat pulldown, pulling bar behind neck can cause serious injury to the shoulder. The correct way is pulling bar down in front of you while squeezing your back muscles.

Push-ups, you should never have a dip or arch in your back or lock your arms. The correct way is Arms should be underneath you and not locked, back parallel to the floor, and engage your core muscles the entire time.

Walking lunges, when performing a lunge, do not extend the front knee past the front foot this will cause injury at some point. The correct way is when you are in a split stance, go straight down and do not let your front knee go past your foot.

Leg press, your knees should not be by your ears; that is not a position your knees are used to being in, especially under heavy weight. The correct way is to keep 80 percent of the weight in your heels; press out and go a little past 90 degrees.

Abs crunches, pulling the head up as you’re doing a crunch. The correct way is relax your head and bring your shoulders off the ground, engaging your abs and rotating your hips to the ground.

Squats, knees coming forward over your toes is not correct. The correct way to perform this exercise is as if you were sitting back on a chair and putting 80 percent of your weight on your heels. Then lean slightly forward so you won’t fall back.

Chest press, lifting the weight using your back (high arch). The correct way is keep your back flat and relax your shoulders while lifting the weight.

Cardio is something that lots of people do wrong. You should not do an hour of straight cardio unless you compete in endurance events such as marathons. I recommend high-intensity training short sets repeated often. An example of this would be a 30-second sprint or quick walk followed by a 60-second jog, then another 30-second sprint, repeat that cycle about 10-12 times. This form of interval training will get improved results in less time.

Frequency can be another problem the body needs to rest and rebuild it is better to train 2 to 3 days with a day or two in between for the body to recover. This will help you avoid repetitive injuries and alow for balance in your life.

Movements to Avoid When Exercising:

1. Using jerking motions, especially when lifting. Speed is fine when done appropriately, but you should always have fluid motion and proper form when performing any and all exercises; otherwise you could strain or even tear something.

2. Using body parts not required for the exercise. Have you ever seen people doing biceps curls and rounding their shoulders or arching their backs? Those are just two of the big no-no’s that can lead to injury.

3. Locking out your knees or elbows. Never lock your joints when working out; keep them slightly bent so the weight will not be transferred to the joints.

4. Arching your back. Picture someone on the barbel bench press, lifting a weight that is actually too heavy for them. Chances are that eventually, they will start arching their back. Sooner than later, that back is going to give out and they won’t be able to exercise for days, weeks or even longer.

Lets start out those new Year exercise programs right and have a long healthy year.

By: Paul R. Mahler Jr. DC
Mahler Family Chiropractic Center
1144 wyoming Ave.
Kingston, PA. 18704
May be reproduced in whole only.
We can treat sports injuries including shoulder pain, rotator cuff, ankle pain, foot pain, knee pain, and much more.

Understanding Golf Injuries and How to Prevent Them

Golf is a sport that is prone to injury. No mater how long you have been involved in the sport the more likely it is that you will injure yourself. It is most likely reason for injuring your self  is inappropriately swing the golf club. Professional golfers commonly injure the wrist, followed by the back, hand, shoulder, and knee. Amateur golfers most commonly injuries the lower back, followed by the elbow, wrist, shoulder, and knee. It is obvious that you can be injured even in non-contact sports such as golf, swimming, and track. If you under stand the golf swing you can avoid or correct these injuries but if they are persistent some sort of physical medicine may help.

Let’s analyze the golf swing. There are three phases to the golf swing, and each can cause injury if executed incorrectly. There are also specific exercises you can perform to help reduce your risk of hurting yourself during that particular swing phase.

Phase 1: Take-Away. The take-away consists of the back swing. Thumb and wrist injuries are most common during this phase particularly on the lead hand. Here is an effective workout for the muscles of the wrist, hand and forearm. To begin, stand with your feet shoulder-width apart holding a 5-pound dumbbell in your right hand. Keeping your arm to your side and using only your wrist, raise the dumbbell as high as you can and lower it as far as you can. Do two sets of 25 reps. Next, do another two sets of 25 reps, but while moving your wrist from side to side as far as you can. Repeat this entire workout with the dumbbell in your left hand. An advanced workout for your wrists would be to take a barbell/dumbbells with a weight you can handle, anywhere from 10-45 pounds, and do three exercises (known as a “tri-set”) back to back to back without rest. Start with your feet shoulder width apart and grab the weight with your hands facing down, shoulder-width apart, held which each thumb. Reverse curl the weight up toward your body, flexing the forearm as you finish the movement at the top. Do 10 reps. Next, hold the weight behind you, palms facing up and even with your gluteus maximus (your buttocks). The back of your hand should be touching the top of your buttocks. Raise the weight as high as you can without moving your arms; use your wrist only for 10 reps. Finally, sit down on the bench and rest your forearms on your thighs. Do not allow your wrists to rest on your knees. Hold the weight with your palms up and move only your wrist vertically for 10 reps. Do not rest and perform another tri-set, but this time do 12 reps, and then finish the last set with 15 reps. Another option is to pyramid: increase the amount of weight while decreasing the number of repetitions. For example: 10 pounds for 15 reps, 12 pounds for 12 reps, and 15 pounds for 10 reps. There is an inverse relationship at play here: As you add more weight, you do less reps.

Phase 2: Impact. The next phase of the swing consists of the downswing and impact with the ball. The most common injuries during this phase knee particularly the back of the knee and compression forces acting on both wrists. Also, the lead elbow and hand/wrist are often hurt during impact. In terms of exercises that can help prevent these injuries, leg extensions/leg curls and abduction/adduction exercises. Many fitness clubs have equipment for these types of exercises. These exercises along with regular stretching and massage, are extremely effective for the legs. Triceps push-downs using a reverse grip with the hands up is an excellent exercise for the triceps and will help to prevent injury to the elbows. High-intensity training (one set to muscle exhaustion for each exercise, using slow, deliberate movements) works well and is a safe method of training for all the exercises above. For the legs, do 15-20 reps; for the triceps/elbows, do 8-12 reps.

Phase 3: Follow-Through. This is the phase after impact where the golfer finishes his swing. From a chiropractic stand point this can be the most damaging phase for your spine because it involves abnormal torque on the low back. This phase requires training the oblique muscles. Using a trunk rotation machine, at your local gym, twist slowly in a circular fashion for 20-25 reps, and also use lower back extension machine for 15-20 reps. Keep the weight light and the reps high for this exercises and make sure to do them slowly and eliminate momentum. Strengthen the core muscles with these exercises will help prevent back injuries. This means that a routine of exercises for the back will help your game and while you are at it don’t forget back stretching as well.

Stretching and massage can also help prevent injury but always warm up before stretching to bring blood area. You should warm up before a round of golf, take a brisk walk or get a quick massage that includes techniques and stretches to increase range of motion. The right way to stretch is important. Begin with three sets of 10-15 deep knee bends and then walk a quarter of a mile. Next, perform a series of stretches. Reciprocal inhibition stretches, performed by stretching to a level at which your body innately says stop, is effective for increasing range of motion without over-stretching and injuring yourself. When you reach the point at which your body says stop, contract the opposite muscle and hold the contraction for several seconds; then release. There should be an increase in of range of motion Now hold the new position for at least 30 seconds, then move on to your next stretch.

Some good stretches are toe-touch stretches and side stretches. When doing the toe-touch stretch, you must keep a flat back. Do not round your back. When you drop down into the stretch, contract your gluteus maximus and hold the contraction for 6-7 seconds, then breathe and release and you will find yourself falling deeper into the stretch. You must remember not to hold your breath even during an Isometric contraction and always feel your breath releasing in and out of your nose. You should also breathe deeply through your diaphragm. The toe-touch stretch will increase flexibility in the hamstrings. Place one arm over you head and bend to the side to do the side stretch. Do this stretch in increments as follows. Go as far as possible without pulling the muscle, then contract the gluteus maximus muscle for several seconds; then release and drop into the stretch, holding for 30 seconds. Repeat 2-3 times on each side.

Cooling down after playing is imperative to do some simple breathing and stretching exercises after golfing. Lie flat on your back and tuck your knees to your chest and breathe; hold for 30 seconds. Extend your arm in the supine position [palm up], grab your finger tips and pull your hand down; again, hold for 30 seconds. Next, extend your arm in the prone position (palm down) and grab your fingertips and pull toward you from the bottom position. Hold for 30 seconds. These simple exercises are essential to injury prevention following each round of golf, practice session, etc.

Injuries can happen at any time in any sport, but following these suggestions can certainly help you avoid severe and permanent injuries whenever you’re golfing.

Why are so many golfers are injured every year? 27 million injuries annually, according to some estimates. The average golfer has no warm-up or stretching protocols for golf then they are swinging the club with violent, intermittent effort. This is a recipe for injury and in addition the average golfer uses the “grip it and rip it” golf swings. On top of this many golfers have varied amounts of pre-existing postural dysfunction and poor flexibility. When you add it all up, this is a recipe for injury. Many of these golfers are suffering from repetitive strain injuries due to lack of flexibility, postural instability and poor swing mechanics.

Isn’t it time to repair your golf swing. Contact Mahler family Chiropractic Center and we will help get your golf game back into the swing of things.

By: Paul R. Mahler Jr. DC
Mahler Family Chiropractic Center
1144 wyoming Ave.
Kingston, PA. 18704
May be reproduced in whole only.
We can treat golf injuries and pain  including neck pain, back pain, rotator cuff, foot pain, carpal tunnel, and much more.

Injuries and Sports

Other Posts: Golf; Shoulder Streching; Swimming; Exercises

What to do when you have a sports injuryChiropractic plays a larger role in the health and performance of many athletes. Today, coaches and colleges as well as a number of Olympians include chiropractic care as part of their training regiment. Chiropractors are considered part of the team. Chiropractic care is over 100 years and plays an important part in swimming and other sports.

All athletes, at one point or another, have suffered some kind of an injury, ranging from  a muscle pull, a sprain/strain injury, a repetitive stress injury or a major trauma. Sports and injury go hand in hand! So what can be done to treat sports injuries and what is the most appropriate type of care for treating these types of injuries? Most people who suffer sports related injuries try an over the counter medication (such as Tylenol, Motrin or Aleve). when that doesn’t work then they’ll go to their family doctor for something stronger. Unfortunately drugs only temporarily mask the symptoms, they do not cure sports related injuries. Instead consider a physical medicine approach, such as chiropractic care, to treating sports injuries. Physical medicine includes chiropractic adjustments coupled with a rehabilitation program (physical therapy) which is designed to improve functional range of motion, stabilize and strengthen the supportive soft tissues, foster balance and coordination and of course to get you out of pain as quickly as possible. Many professional athletes and 85% of all Olympic athletes rely on chiropractic care to enhance performance and to help them heal from injuries. The world’s best athletes, such as Tiger Woods, Emmitt Smith, Joe Montana, (decathlon gold medal winner) Dan O’Brien, Evander Holyfield, Lance Armstrong, etc.., have all used chiropractic care and it works for them.

A chiropractor can treat knee injuries, pack, injuries, rotator cuff injury, ankle injuries, and much more. Isn’t it time you consider chiropractic care, it will work for you too!

By: Paul R. Mahler Jr. DC
Mahler Family Chiropractic Center
1144 wyoming Ave.
Kingston, PA. 18704
May be reproduced in whole only.
We can treat sports injuries and pain  including neck pain, back pain, rotator cuff, foot pain, carpal tunnel, and much more.

Shoulder Stretching Routine

Avoiding a rotator cuff injury

Front of the Shoulder Stretch: Pector Elongator

Shoulder stretching

Shoulder stretching

Maintaining open, fluid movement in the front of the shoulder during swimming will decrease compression in the joint. With biking and running, the shoulder tends to rotate inward and lift up toward the ear.

This same movement in swimming will add to tension and compression in the neck and shoulder. The pector elongator is a great stretch to use before or after a workout.

  1. Stand with your right hip about two or three feet away from a wall.
  2. Place your right hand on the wall at shoulder level, behind the torso. Keep your elbow loosely bent.
  3. Now rotate your elbow forward and maintain this forward rotation throughout the stretch.
  4. Twist your upper torso to the left, while retaining elbow rotation, to create a stretch in the front of the right shoulder.
  5. Hold the stretch for five to 12 breaths.
  6. Switch arms and repeat.

Variations can be created by moving your hand up and down the wall or by stepping farther away from the wall. Pector elongator is intense, so go easy. When you start to feel the stretch, stop and inhale deeply into the area being stretched.

Also, using a doorway will give you a perfect stretch at home or at the office. The hard part of this stretch is continuing to maintain a forward rotation of the elbow.

Deltoid/Rotator Cuff Stretch

Every shoulder problem seems to have rotator cuff involvement. These muscles are unique because they function as a ligament at the joint, and a muscle in locomotion. Located above the rotators are the deltoids, which can be stretched along with the rotators.

When an athlete has any type of shoulder problem, this is the first stretch I introduce. It’s ideal because it takes care of the muscle, the joint capsule and the range of motion.

  1. Stand facing the wall, approximately a foot away.
  2. Draw your right arm across your body.
  3. Place the back of your right hand on the wall at shoulder level.
  4. Move your left shoulder toward your right hand as far as you can, then lean the right shoulder toward the wall.
  5. To create a slightly different stretch, place the front of your hand on the wall.
  6. Hold the stretch for five to 12 breaths.
  7. Switch arms and repeat.

There’s room to be creative with this stretch. You can walk the hips away from the wall or experiment with your hand in different locations. To intensify the stretch, use the floor instead of the wall. The key is to move the shoulder that’s not being stretched down, and slowly lean the involved shoulder into the wall, floor or couch. (see step 4).

Side of the Torso Stretch: Lateral Bend

The side (lateral) muscles of the torso have a great deal of strength, power, endurance and elasticity. This natural elasticity adds power without increased mass. This stretch will allow you to be more effective in the reaching part of your swim stroke and have more power on the recovery part.

  1. Stand with your feet hip-distance apart, knees slightly bent.
  2. Expand your chest, lift your ribs and raise both hands over your head.
  3. On exhale, pull your abdomen back and lean to the right.
  4. Hold this position and inhale into the ribs.
  5. As you exhale, pull abdomen back and lean to the left, hold, inhale into the ribs.
  6. Repeat this side-to-side motion to the right and left four to six times.

Move from one side to the other on an exhale, allowing for a deep inhale into the ribs. This will increase both extension and strength. Keep the chest slightly in front of the hips and rotate the top of the pelvic girdle back—this will elongate the lower-back muscles and stretch the lats.

Lateral bend is a great stretch to use after a hard workout because of its effect on the lower back.

To concentrate the effects of flexibility training, your breath should be long and smooth, and your mind should be focused on the area you want to effect. Easy, extended breathing like this will improve both performance and recovery. Race and train forever.

A proper stretching routine will help avoid pain in the shoulder and rotator cuff injuries.

By: Paul R. Mahler Jr. DC
Mahler Family Chiropractic Center
1144 wyoming Ave.
Kingston, PA. 18704
May be reproduced in whole only.
We can treat rotator cuff injuries and pain.

Treating chronic pain, what is it and what can I do?

chronic painWhat is chronic Pain? It is pain that has persisted for more than six months although in some definitions it is considered chronic if it is over three months. To confuse maters more you could have acute exacerbation’s of a chronic pain condition that seem short lived but the chronic condition is an underling-factor in the acute condition. what are some of the common cause of chronic pain? Chronic pain can be caused by problems or irritations of the nervous system, injuries or degeneration of the joints, muscle injuries.

erve problems can be one of the causes of chronic pain. Interference with the nerve occurs when the nerves is  pinched, choked, stretched or chaffed. This can cause pain, numbness, tingling and other abnormal sensations. These types of nerve problems are correctable by a Doctor of Chiropractic . A Chiropractor can reduce or eliminate the pain by re-aligning the spine. Alignment is achieved through the use of safe, gentle and very specific adjustment to the spine and extremities.   These adjustments take the pressure off the nerves, allowing them to calm down and feel better.

oint problems are another factor in chronic pain or chronic pain syndrome. Healthy joint motion  should be fluid, free and smooth against each other. This motion is like ice gliding on ice.  Dysfunctional joints move like rusty old hinges and needs a shot of WD-40 oil, or the chiropractic adjustment.  When this happens, it sets the stage for arthritis, degenerative joint disease and chronic pain. It must be remember that for joints movement is health. Chiropractors are experts in joint movement and how it affects both nerves and muscles as well as the organ systems nearby.

uscles are under constant stress. Muscle attracted to injured nerves or joints are beyond stressed. If a muscle is injured due to the structures around it or direct trauma this will cause pain. This will cause the muscle to go into spasm, or worse develop trigger points. Trigger points are extremely painful spasms that can cause referred pain to travel up into your head, into your arm or down your leg often referred to as sciatica or carpal tunnel. These are some of the conditions that chiropractors are skilled at treating.

We fix these problems through a combination of acupressure therapy, stretches, laser and specific exercises.   If you’re suffering with muscle spasms, Mahler Family Chiropractic Center is your first stop on your road to recovery. Our unique approach to chiropractic care and unique methods restore joint motion, enhance flexibility, improve balance, and restore coordination. We also strengthen and stabilise the spine  as well as correct postural and structural distortions. Our clinical focus is to get you out of pain and  keep you out of pain by finding and correcting the root causes of the pain syndromes.

I welcome you to call us today to schedule a complimentary, no-obligation consultation. Is it not time to find out how our unique approach can get you out of pain, give you more energy, improve your posture, restore your flexibility, and improve your quality of life. If you have been suffering with chronic pain, call us to schedule a free, no-obligation consultation.   We can get together and discuss your case.   We look forward to hearing from you soon.  Please also feel free to visit us at our facility in Kingston, PA.

Paul R. Mahler Jr. DC
Mahler Family Chiropractic Center
1144 wyoming Ave.
Kingston, PA. 18704
May be reproduced in whole only.
We can treat inflammation and in many cases cure inflammation including neck pain, back pain, rotator cuff, foot pain, carpal tunnel, and much more.

The Physiology of Pain


The physiology of pain can often be complicated. The bottom line is that pain is chiropractors can help with fibromyalgiaall in your head and is also based on your life experiences. Pain is also the bodies last warning system that something is wrong and often comes after months or even years of dysfunction.

So what is pain? Pain is the brains interpretation of the nerve signals being sent from the injured region of the body. There are several factors on how pain is perceived by an individual. One of the most important factors is life experience what is the worst pain ever to a child will often not phase an adult who has lived through several traumatic events. Second is the emotional state of the patient. Yes I did say the emotional state, people who are depressed or have other normal physiological factors may ether magnify painful symptoms or ignore them all together. Finally the quality of the signal is an important factor if the signal for pain that the brain must interpret is reduced or amplified by forces on the nerves themselves (chiropractic subluxations being one type), it is like using a dimmer switch on a light and the intensity of the pain may change. This is often seen when there is disc involvement or in sciatica.

As well as these three main factors on the quality of pain there are several factor that effect the location of the sensation of pain. Again location can be effected by interference with the nerve and how it transmits the signal. If there is pain in the right leg it may not be the right leg at all. In some instances pressure may be placed on the nerve as it exits the spine or even in the spine, but since the brain thinks this nerve ends at the foot it thinks you have foot pain. This is the same mechanism that causes phantom leg syndrome in amputees.

To further complicate the situation there are disease that excite the nervous system and produce the symptoms of pain in areas that may have no injury at all. Some of these conditions are fibromyalgia and RSD. Finely there is the double crush syndrome. This is often seen in Carpal Tunnel Syndrome (CTS), and is when pressure is put on the nerve in two or more locations. In the case of CTS this is often the neck and wrist with some shoulder involvement. What happens is when the wrist puts pressure on the nerve there may be no symptoms but when the neck and wrist or shoulder and wrist or all three act up the hands go numb or become very painful to the point of being debilitating.

All of these factors make managing pain difficult in some case. If your pain doesn’t resolve in a reasonable amount of time you may have one or more of these factors. In these case it takes a professional with many years of experience to help track down the cause and place you on the road to recovery.

At Mahler Family Chiropractic Center we have over 10 years of experience helping people with these problems.

By: Paul R. Mahler Jr. DC


This article may be reproduced in its entirety only.

We treat pain and  in some cases it can be cured neck pain, back pain, shoulder pain, rotator cuff pain, and more.