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Freiberg’s Disease

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Freiberg’s Disease (FD) is not a usual term that we hear on a regular basis! 

 

FD is a relatively rare condition that predominantly affects the second and third metatarsal bones (i.e. foot bones). While FD is nonspecific to a particular age group, it is primarily diagnosed in those from adolescence to the 20’s. 

 

For those suffering from FD, the head of the affected metatarsal essentially dies. As such, FD generally presents as pain, tenderness, swelling, reduced range of motion and stiffness of the forefoot. Over time, these symptoms can lead to the development of a limp. Furthermore, the symptoms tend to present while weight bearing, such as when walking. The exact cause of FD and the death of the affected metatarsal is not totally understood, however, what is known is that genetic and environmental or lifestyle factors may play a role. Also, acute or repetitive insults to the forefoot area and vascular (i.e. blood supply) compromise to a metatarsal bone are theorized as contributing factors in the development of FD.

 

Diagnosis of FD is usually made via special imaging such as x-ray, MRI, bone scan and/or CT scan. Blood tests may also be ordered by your healthcare team in order to rule out other similar diseases. Typically, FD can be managed conservatively by a Chiropractor or Physiotherapist to control pain, restore range of motion and provide applicable and safe rehabilitation.

 

If you think you may be suffering from Freiberg’s Disease, contact our office today to book your initial assessment!



Author:  Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.

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The Right Office Chair

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Tips on How to Choose An Appropriate Office Chair

 

When shopping for the best ergonomic office chair, finding a chair that fits your unique needs should be the top priority. Not every chair labeled “ergonomic” has all of the adjustment features necessary to truly be considered ergonomic. Here are the top 5 features you need to consider to make the best selection possible:

 

  1. Seat pan comfort and shape-

When you sit on the chair, the seat pan should be at least 1 inch wider than your hips and thighs on either side. Also, the seat pan should not be too long for your legs otherwise it will either catch you behind the knees or it will prevent you from leaning fully back against the lumbar support. Most ergonomic chairs possess a seat pan with a waterfall front that prevents the seat from catching you behind the knees. The seat pan should also be contoured to allow even weight distribution and finally, it should be comfortable to sit on.

 

  1. Think adjustable-

Always ensure that your chair is pneumatically adjustable so that you can adjust the seat pan height while you are sitting on the chair. You should be able to adjust the height of the seat pan so that the front of your knees are level or slightly below level while your feet are firmly on the ground. In most cases, there should be no need for you to use a footrest. The mechanism to adjust the seat height should be easy to reach and operate when you are seated.

 

  1. Lumbar support is key-

Many chairs have cushioned lumbar supports that can be adjusted up and down and forwards and backward in order to best fit your shape. If the chair will be used by multiple users then this level of adjustment may be required. However, if you are the primary user of the chair then a fixed lumbar support may be acceptable if it feels comfortable.

 

  1. Don’t forget about the hips-

A chair that doesn’t provide enough hip room can make you sit too far forward on the seat pan. This will not provide enough thigh support while you are sitting on the chair.

 

  1. Have a long-term strategy-

Think about how the chair will feel after 60 or 120 minutes. Low-density foam seat pans can become permanently deformed after long term use which can affect cushioned support leading to discomfort, imbalance, and hip and back fatigue.

 

And one bonus tip!

 

  1. Chair covers 101-

On the market, there is a variety of upholstery materials available, each of which has benefits and concerns. Vinyl and vinyl-like coverings are easy to clean and spill resistant, but they don’t breathe. As such, if the chair begins to heat up under the thighs, uncomfortable amounts of moisture can accumulate. Cloth upholstery on the other hand is the most common covering, but it is less resistant to spills and more difficult to clean. A cloth-covered seat pan can also become warm and moisture-laden. Also, over time, cloth-covered foam seat pans can become a significant source of dust mite allergen. When selecting your chair covering, think about cleaning and maintenance in order for you to plan and decide appropriately.



Author:  Dr. Marco De Ciantis, D.C.

 

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Freiberg’s Disease

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Freiberg’s Disease (FD) is not a usual term that we hear on a regular basis! 

 

FD is a relatively rare condition that predominantly affects the second and third metatarsal bones (i.e. foot bones). While FD is nonspecific to a particular age group, it is primarily diagnosed in those from adolescence to the 20’s. 

 

For those suffering from FD, the head of the affected metatarsal essentially dies. As such, FD generally presents as pain, tenderness, swelling, reduced range of motion and stiffness of the forefoot. Over time, these symptoms can lead to the development of a limp. Furthermore, the symptoms tend to present while weight bearing, such as when walking. The exact cause of FD and the death of the affected metatarsal is not totally understood, however, what is known is that genetic and environmental or lifestyle factors may play a role. Also, acute or repetitive insults to the forefoot area and vascular (i.e. blood supply) compromise to a metatarsal bone are theorized as contributing factors in the development of FD.

 

Diagnosis of FD is usually made via special imaging such as x-ray, MRI, bone scan and/or CT scan. Blood tests may also be ordered by your healthcare team in order to rule out other similar diseases. Typically, FD can be managed conservatively by a Chiropractor or Physiotherapist to control pain, restore range of motion and provide applicable and safe rehabilitation.

 

If you think you may be suffering from Freiberg’s Disease, contact our office today to book your initial assessment!



Author:  Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.

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Text Neck

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Text Neck and How to Avoid It

 

Our modern digital age has gifted us with many conveniences. Smartphones, tablets, and e-readers make it possible for us to communicate or be entertained with the push of a button. While technology can improve our quality of life, it comes with a price; being huddled over our devices for long periods of time can do more harm than good.

 

Using certain devices for extended periods of time can easily lead to neck strain, headaches, as well as pain in your shoulders, arms and hands. If you’ve used a smartphone or tablet for an extensive amount of time, you’ve probably experienced the strain it puts on your upper body. These conditions even have their own name, “Text Neck”.

 

Four Strategies to Help You Avoid “Text Neck” Strain:

 

  1. Take frequent breaks:

Take frequent breaks and look up from your device. This will give your neck some relief from the pressure of looking down.

 

  1. Sit up straight:

It’s important to sit up straight while texting. This way, you can maintain good posture, relieving your back and shoulders from the strain of being hunched over.

 

  1. Hold the phone a little higher:

Holding the phone closer to eye level helps maintain a healthy posture and puts less strain on your neck. Consider using a stand for devices, even periodically, to change the way that you hold and look at your device.

 

  1. Stretch:

Be sure to stretch often between long periods of extended use of devices. Put your hands at your sides and rotate your shoulders to relieve tension. You can also tuck your chin down to your neck and then lookup. This action helps relieve some of the tension built up in your neck due to the forward-down position we often adopt when looking at our devices.



Author:  Dr. Marco De Ciantis, D.C.

 

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Dupuytren’s Contracture

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Dupuytren’s Contracture (D.C.) is a relatively common condition affecting the hand.  You may have seen a friend or relative suffering from D.C. and had been unaware.

 

D.C. is a condition that affects the fascia of the palm of the hand. “Fascia” is a fibrous connective tissue that wraps around bodily material such as muscle. In patients suffering from D.C., the fascia of the palm progressively, slowly thickens and tightens. The reason why this occurs is not well understood but what is known is that genetics and injury may play a role. The progressive thickening and tightening of fascia can create distinctive nodules (i.e. small lumps) of thickened tissue. The nodules can initially be painful but then become less so over time. With progressive nodule formation, a distinctive pitting appearance on the palm of the hand may occur. “Pitting” (i.e. deep indentation at the nodules) occurs as the fascia underlying the skin begins to pull on the skin overlaying it. As D.C. worsens, the fascia can begin to form thick cords (progressive thickening and then contraction of nodules) that begin to tether fingers and pull them into a distinctive bent position. As such, the sufferer may not be able to fully extend and subsequently use fingers that are affected. Attempting to move the tethered fingers may cause the sufferer pain. Since D.C. can occur slowly over many years, in some patients, it does not influence daily life. In fact, D.C. may occur so slowly that the patient never requires an intervention and the condition only presents as small inconsequential nodules. However, in other cases, the bent finger position can affect daily life significantly and requires a therapeutic intervention. 

 

Depending on how aggressive the condition is in a patient, surgical or pharmacological interventions may be recommended. Conservative approaches for treatment can also be utilized such as those provided by a Chiropractor or Physiotherapist. 

 

If you think you may be suffering from Dupuytren’s Contracture, contact our office to book your assessment today!



Author:  Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.

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Daily Routine

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Whether we’re in a pandemic or not, we live in a world where we’re constantly in a hurry, juggling multiple tasks and carrying our belongings with us everywhere.  Believe it or not, this can have serious consequences on your back health.  Here are some common activities that negatively impact the back health of Canadians:

Scenario

Commuting: just like sitting at your desk, hunching over your steering wheel can cause your muscles to tighten, curving your back.  Over time this can result in long-term lower back problems.  This is important for the 15.4 million Canadians who commute!

How to fix it: be sure to sit at a 90-degree angle and don’t fully extend your legs.  Move your seat up to allow yourself to sit up straight.  Adjust your lumbar (i.e. “low back”) support to fit your back, and if it’s not enough support, try rolling up a towel to help decrease stress on your lower back.

 

Scenario

Work-life: did you know sitting puts 40% more pressure on your spine than standing?  It’s important to remember your posture especially when you’ve had a long day at your desk.

How to fix it: practice ‘active sitting’ with your feet flat on the floor in front of you with your back straight, your shoulders squared and chin parallel with the floor.  Ensure your workspace is set up to enable frequent breaks  from sitting, getting up at least once each hour can help keep you moving.  Consider a sit/stand workstation to allow varied working positions.

 

Scenario

Carrying your belongings: when you’re carrying a heavy purse or laptop bag, your shoulders become out of line. This can cause your muscles to ache and can put uneven pressure on your spine.

How to fix it: reduce the number of items you carry with you.  Also, consider using a backpack to help distribute the weight of your load evenly across your body.  This will help avoid the stress of isolated muscles overcompensating for unevenly distributed weight.

 

Scenario

Improper lifting: you’re not alone if you have strained your back while lifting heavy boxes. Improperly lifting heavy items can put undue pressure on your spine and even cause spinal disc injury.

How to fix it: picture yourself doing the lift before engaging to ensure you’re keeping the object in front of you, your back is straight and you’re lifting with your knees/hips rather than your back.



Author:  Dr. Marco De Ciantis, D.C.

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Osteoporosis and Exercise

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How Exercise Can Help With Osteoporosis

 

Aging, obesity and chronic health conditions, among other factors, can lead to limited mobility and strength. These issues can in turn contribute to spinal, muscle and joint problems. Starting at approximately 30 years of age, our bones decline in density. If bone mass gets dangerously low, it’s called “Osteoporosis”. Physical exercise, particularly if it’s weight-bearing, can help you better manage Osteoporosis, including its side effects. “The higher you get your bone mass up before 30, the lower the risk of getting Osteoporosis later,” says Dr. Kenneth Stelsoe, a Chiropractor and owner of Enhanced Wellness Studio in Waterloo, Ontario. According to Report on Ageing and Health 2015, a spine, muscle and joint report prepared for the World

Health Organization (WHO), Osteoporosis, Osteoarthritis and Sarcopenia (i.e. muscle loss) affect millions. In Canada, Osteoporosis affects 2 million Canadians but many only get diagnosed after they fracture a bone.

 

A Mix of Issues:

For most people, spine, muscle and joint prob­lems start with mild symptoms, such as joint pain, stiffness and swelling. Discomfort can prompt you to limit activity, leading to weaker muscles. As you progressively lose range of motion, things start to increasingly hurt. “An inactive lifestyle can contribute to many chronic conditions, including Osteoporosis, among others,” says Dr. Amy Brown, a Chiropractor at Coronation Chiropractic & Massage Therapy in Cambridge, Ontario. Inactivity can also lead to balance issues, which puts you at risk of falling. Also, individuals who suffer from

multiple conditions must often juggle a wide range of medications and all their potential side effects. These conditions can lead to very serious outcomes, such as falls that shorten your lifespan. However, it doesn’t have to be this way.

 

Gamechanger-The Right Exercise to Manage Osteoporosis and Osteoarthritis:

Being physically active can turn things around for those with conditions such as Osteoporosis and Osteoarthritis. That’s the power of exercise. Exercise impacts health, but it must be the right exercise. Controlled movements that build strength and range of motion are ideal. A combination of activities, such as swimming, cardio gym machines and low- impact aerobics, can be effective. However, weight-bearing exercise works best to help you manage Osteoporosis.

 

For those whose range of motion is limited, yoga and Pilates can be helpful, along with further support from Chiropractic care, Registered Massage Therapy and Physiotherapy.

The right activity for the right person can make a big difference. Dr. John Antoniou, an orthopaedic surgeon and former president of the Canadian Orthopaedic Association, says: “You won’t reverse the damage that’s occurred, but it’ll maintain the function that’s still there.” Exercise can help you manage Osteoporosis to slow the rate of bone loss that comes with this age-related bone disease. It can also reverse some age-related muscle mass loss. With less pain, stronger muscles and better balance, you’ll find you can do much more.

 

How Can a Chiropractor and Your Care Team Help?

A Chiropractor can prescribe a therapeutic exercise program to help increase your strength and range of motion. This program can include stretching, strengthening, postural awareness, balance training and neuromuscular exercise. However, exercise as therapy to help manage Osteoporosis can be challenging because your instinct is to stop moving once you have mild pain. An integrated approach between a medical doctor who is supporting patients with chronic health conditions and a Chiropractor assisting in managing the muscle, spine and joint components can help

you become more active. “The mentality is sometimes it hurts, so I won’t do it,” says Dr. Ed Ziesmann, vice-president of education programs and services for the Arthritis Society. You need to push through discomfort but stop when you feel true pain. Guidance from healthcare profession­als on “hurt versus harm” can make sure exercise is healing, not hurting. Meanwhile, for the many people who don’t enjoy traditional exercise, such as going to the gym, Ziesmann ad­vises focusing on doing everyday life activities. These activities can include walking, gardening and playing golf.

Currently, only 1 in 5 Canadian seniors get the recommended 150 minutes of activity per week. With help from healthcare professionals, like a Chiropractor and your integrated care team, you can break this pattern to better manage age-related conditions like Osteoporosis.



Author:  Dr. Marco De Ciantis, D.C.

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Snapping Hip Syndrome

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“Snapping Hip Syndrome” is a term that most athletes and avid sport enthusiasts have heard, but what does it mean?

 

Snapping Hip Syndrome occurs when tight muscles and/or tendons located in the area of the hip roll over a bony prominence as you move your leg. As a result, a sufferer can feel a “snapping” sensation in the area of the hip and possibly hear an audible “pop” sound. Typically, Snapping Hip Syndrome is painless and not damaging to the involved tissue but it can be annoying. However, if left untreated, over time in some cases, bursitis can develop in the area of the hip as a result of Snapping Hip Syndrome. 

 

As mentioned above, Snapping Hip Syndrome is most commonly associated with tight muscles and tendons located in the area of the hip. As such, those who play sports or perform activities with repeated hip flexion are vulnerable to its development. The good news is that Snapping Hip Syndrome can often be treated conservatively by a Chiropractor, Physiotherapist, Registered Massage Therapist and Fascial Stretch Therapist, all of whom are available at our clinics. All of these healthcare professionals can assess and treat the tight muscles and/or ligaments involved and can all also provide stretches and exercises to remedy the situation.

 

If you think you may be suffering from Snapping Hip Syndrome, contact our head office today at 416-385-0110 or book your appointment on-line!



Author:  Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.

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Daily Routine

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The Pains in Our Daily Routines

 

We live in a world where we’re constantly in a hurry, juggling multiple tasks and carrying our belongings with us everywhere. This can have serious consequences on your back health. In fact, back pain sends more patients to doctors than any condition other than the common cold. Here are some common activities that negatively impact the back health of Canadian’s.

 

Scenarios

 

Commuting: just like sitting at your desk, hunching over your steering wheel can cause your muscles to tighten, curving your back. Over time this can result in long term lower back problems. This is important for the 15.4 million Canadians who commute daily!

How to fix it: be sure to sit at a 90 degree angle and don’t fully extend your legs. Move your seat up to allow yourself to sit up straight. Adjust your lumbar support to fit your back and, if it’s not supportive enough, try rolling up a towel to help decrease stress on your lower back.

 

Work-life: did you know sitting puts 40% more pressure on your spine than standing? It’s important to remember your posture especially when you’ve had a long day at your desk.

How to fix it: practice ‘active sitting’ with your feet flat on the floor in front of you with your back straight, your shoulders squared and chin parallel with the floor. Ensure your workspace is set up to enable frequent breaks from sitting, getting up at least once each hour can help keep you moving. Consider a sit/stand workstation to allow varied working positions.

 

Carrying your belongings: when you’re carrying a heavy purse or laptop bag, your shoulders become out of line. This can cause your muscles to ache and can put uneven pressure on your spine.

How to fix it: reduce the number of items you carry with you. Also, consider using a backpack to help distribute the weight of your load evenly across your body. This will help avoid the stress of isolated muscles overcompensating for unevenly distributed weight.

 

Improper lifting: you’re not alone if you have strained your back while lifting heavy boxes. Lifting heavy items improperly can put undue pressure on your spine and even cause spinal disc injury.

 

How to fix it: picture yourself doing the lift before engaging to ensure you’re keeping the object in front of you, your back is straight and you’re lifting with your knees/hips rather than your back.

 

If you do experience pain, consult a healthcare professional to assess your specific needs and identify a course of action that’s right for you. Canada’s Chiropractors are committed to helping you be more physically active. A Chiropractor can evaluate your strength and flexibility and screen for anything that may limit your physical activity. Ask your Chiropractor for an evaluation today!



Author:  Dr. Marco De Ciantis, D.C.

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Pandemic Fitness

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Finding time for Fitness during a Pandemic

 

How do you find time for fitness when so many things are competing for your attention? It’s a

common problem. The good news is that as little as 15 minutes a day can start a fitness habit

and deliver health benefits! A study conducted over a span of 12 years has demonstrated that as little as 15 minutes of moderate intensity exercise a day can increase life expectancy. Every additional 15 minutes of exercise performed daily can further improve the health outlook of the participants in this study.

 

Try these tips to fit 15 minutes of exercise into your day:

 

Pick a time of day that works for you and stick with that time for fitness.

Perhaps it is first thing in the morning, during a break at work or in the evening after dinner. Think of it as a part of your regular daily routine. Treat fitness like showering in the morning or

brushing your teeth before bedtime.

 

Do something you enjoy!

People tend to make time for things they like. A brisk walk outside, a video exergame, a dance

workout to your favourite music, a simple stretch-and-strengthen routine you can do with one

eye on your favourite TV program – they all qualify.

 

Expensive gyms need not apply!

Some great no cost activities include cardio, strength exercises and flexibility stretches. It’s

important to vary these activities.

 

Why cardio, strength and flexibility activities?

Cardio activities are good for your heart, lungs and circulatory system. And moving your body

feels great. To get started, walking is the simplest cardio activity you can do. Strength exercises, such as biceps curls and pelvic lifts, focus on your muscles. Muscles help support all the joints in your body and your movement. Flexibility stretches are all about keeping you limber for bending, reaching and turning with ease. Most people don’t stretch their muscles enough and wonder why they feel stiff and sore.

 

Remember the benefits.

We make time for things we know will reward us. The rewards of physical activity are numerous.

Regular exercise can reduce stress, improve our energy level, improve your strength and

flexibility. Also, regular exercise can simply make you feel good about doing something for

Yourself.

 

Fifteen minutes a day can be the beginning of a habit that can grow and help you achieve your

fitness goals. You’ll feel good about fitting it in and that’s an important factor in your overall

health. Keeping active will help improve your physical health, increase energy and put a smile on your face. And once 15-minute activities become a habit – and they will in almost no time – you may want to schedule even more move-your-body time into your day. Check out the Activity Guide website at www.publichealth.gc.ca/paguide.



Author:  Dr. Marco De Ciantis, D.C.

 

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