Terry's Blog

October 2, 2014

Low Back and Hip Pain: Your Gluteus Maximus

Dr. Terry L. Wiley, D.C., C.M.E.                                

Your low back is usually one of the leading areas of pain at some point in your life. This is an area that can be supported and the muscles toned up to help you prevent back pain. The importance of the butt muscles (the GLUTEUS MAXIMUS, or GM) can’t be overstated. It’s a key muscle. This muscle will protect your low back, your knees and the hip. There is also a link between the Iliotibial Band and the GM. The famous researcher, Stuart McGill, has coined the phrase “gluteal amnesia” to describe this inhibition.       

When your gluteus maximus muscles are weak, you will use the hamstring muscles more for hip extension. This causes increased force on the hip. Weakness of muscles can then inhibit the GM and this can increase the likelihood of injury and impede athletic performance.

Most of your bodily exercises are performed weight-bearing in a closed kinetic chain.  For patients that have a greater degree of infirmity, they may use the clam exercise. It is preferred not to isolate muscles from their functional patterns.

Squatting is something we do hundreds of times per day.  When we raise from chairs, car seats or the commode, we are performing the squat. One of the factors that prevents geriatric patients from independent living is the inability to rise from a seated position. Some patients may progress to weighted squats in order to remedy this, but they must be monitored to use good form with body weight squats prior to adding resistance.

Here are some steps to doing the exercise:

  • Stand with the feet wider than shoulder-width apart and the toes pointed outward. This has been called an athletic stance. The feet should grip the ground with an external rotation force (although they should not move).

  • Stiffen the core muscles by bracing your abdominals, neither pulling them in or pushing them out. 

  • While maintaining a lumbar lordosis, descend with the buttocks moving down and backward. The motion should occur through the hip in a hip hinge. The shins should remain perpendicular or nearly perpendicular to the floor.

  • Descend until the femurs are parallel to the floor or until you can no longer maintain your lumbar lordosis. (Not everyone will be able to perform deep squats.)

  • The torso can move forward as long as the lumbar lordosis is intact. The arms may be extended forward to act as a balancing cantilever while performing body-weight squats.

Progression: Once the body-weight squat has been mastered, resistance may be added. Instead of beginning with a barbell, begin with the resistance of exercise tubing. Place the tubing at or above the knee and perform a squat while maintaining pressure against the resistance of the band. Once this is mastered, weighted squats with exercise bands may be added.  

I have exercise tubing and elastic webbing that sells for about 1 dollar a foot and patients can pick it up very inexpensively. Just stop by and buy five or six feet of the tubing or webbing.

Monster or Sumo Walks: Place an exercise band around the knees, ankles or fore feet. Next, separate the legs until the band is taut and the legs are at least 14 inches apart. While maintaining constant tension on the band, descend into a quarter-squat. Walk forward to perform monster walks or sideways to perform sumo walks. Do not let the exercise band lose tension while performing either exercise.

Hip Thrusters with Exercise: This exercise is performed from supine position with the legs bent. Place an elastic exercise band just above the knees. Spread the thighs until tension is felt and the GM is engaged; then rise up to a bridge position. A weighted bar may be placed across the pelvis to increase resistance.

Lunges or Lunge Walks: Lunges should be performed with the same principles used for squatting. Maintain the lumbar lordosis, keep the tibia parallel to the ground, and stiffen the core.  While watching yourself in the mirror, step forward with one leg. Keep upright with your shoulders back and your chest out. Descend until your femur is parallel to the ground. Your foot should remain flat on the ground, while the posterior foot may bend so that only the ball of the foot is in contact with the ground. 

Clams: Clams are not our preferred gluteal exercise due to their isolation of the external rotators of the hip. However, there are patients who are unable to perform the compound exercises we have previously proposed. In such cases, clams are performed with a resistance band placed just above the knees with the patient in side-lying position. The knees are bent and feet are together. The patient then opens the knees like a clam opening its shell to approximately 50 degrees. Perform repetitions on each side.   

There are dozens of exercises to help the gluteus maximus that range from using machines or equipment, to exercises without equipment and other ways to turn on the muscles.

The body has a nervous system, and poor diets that contain too much refined carbohydrates will turn off switches that can turn off the GM.   Many patients need to have their spine adjusted in order to turn the nerve energy back on in order to make the GM become full strength again.

If you come into my office, we can do a nutritional exam to determine if you have any nutritional stress on your body. We also coach you on diet and lifestyle changes to make the mechanical-musculoskeletal system return to normal.

When you make the decision to bring your body back to normal, call me and get yourself scheduled for a history and examination. Once you know where the stress is at and where it is coming from, the treatment plan becomes obvious.

Grateful acknowledgement is made to Dr. William E. Morgan, DC, and Amin Javid, DC, for the information from their article in Dynamic Chiropractic.

September 29, 2014

Young People Need Chiropractic Now More Than Ever

Dr. Terry L. Wiley, D.C., C.M.E.

According to a recent study published in BMC Musculoskeletal,1 “It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18.”

The study notes that by age 11, “The lifetime prevalence of spinal pain was 86%.” The authors also found that “the two-year incidence of spinal pain varied between 40% and 60% across the physical locations.  Progression of pain from one to more locations and from infrequent to more frequent was common over the two-year period.”

I can’t help but think of children that have fallen from swings or down stairs, or that have been bucked from their horse, rolled an ATV, or been tackled head to head by a 150 pound athlete. The ways that young people can back injuries is endless. 

Children need to be checked by a chiropractor and have their spines re-adjusted. I look at the national athletes that I worked on in my practice, and I have helped them with just the demands of training.  They are lifting, running, jumping, throwing and straining their bodies to the full limits to develop their full potential. This is why they came in for care. Chiropractic adjustments can help with the demands on the body and help keep them performing at their best.

Having been a parent of teenagers, I am familiar with the risks inherent in “coming of age,” and I’m sure you are, too. Many studies have shown that teens are particularly susceptible to abusing alcohol and drugs:

  • At least half of all high-school students consume alcohol.2
  • Approximately 4,500 underage drinkers die each year,3 with many thousands visiting emergency rooms for alcohol-related illnesses and injuries.4
  • More than 2.1 million teens abuse prescription drugs annually, with Vicodin and OxyContin the most commonly abused.5
  • Twelve percent of teenage boys and 8 percent of teenage girls report using non-medical analgesics at least once in the past 12 months.6

I have had the opportunity to accompany two friends of mine to the ER.  One had broken her humorous bone (upper arm) the other had been butted by a bull and had broken four bones in his lower back.  Both had the pain onset building up in the area of injury.  The laws of physiology show that the body will begin to make inflammation as a normal next step toward healing. Both of these people chose to have some pain medication.  One was very conservative and the other was given more. 

My point is there is a time and place to help someone with pain and the medications are a tool to help manage pain.   The education and mindset of the individual is key in how you will accept and authorize the medication.  Individuals disciplined with diet, rest, exercise and the care of the spine and nervous system will refuse medication whenever possible and will only take the minimum amount when they feel the need.

People that have never been shown and had explained the Beauty and Power of Nature will have no idea that the body does heal itself. The truth is that the body does repair and pain is “your friend.” Don’t disagree with it.  It will pass and you will heal.  Often the first aid of R.I.C.E. (Rest, Ice, Compression and Elevation) is the most important thing you can do for a new sprain.

Headaches are often a sign that you are dehydrated and need a glass of water.   Contact Assists and Locational Assists7 are excellent for illness and injuries.  I can’t count how many times that I have done an assist on some individual that had an old injury or a fresh injury and seen that they were able to cope and tolerate the pain, or that the pain vanished. Their bodies healed faster and they were able to get on with life much faster. 

As adults, we have a responsibility to become educated and to set an example for our children and teach them what to do when they are injured. Currently in the Valley, here where I live, residents are abusing 2 times the number of opioids as compared to the rest of the state of Colorado. 

According to the last study referenced above, “Male athletes use alcohol, marijuana, and prescription pain relievers more frequently than non-competitors,” and “Female athletes use substances more frequently than non-competitors.” 6  

By taking minerals, Cal-Mag, taking a baking soda bath, consuming Protease enzymes, and hydrating the body you can help your body to heal and recover.  These alternative methods are safe and effective.  These are not taught on highway billboards and TV commercials. Drug companies advertise on every possible medium there is, and it is not the only way to live life.   We must think and take responsibility for how we want our bodies cared for.

It should be noted that the drugs most used by teens are not the typical street drugs you might imagine.  These days, they are taking drugs like methadone, opium, morphine and codeine, under the brand names of Demerol, Vicodin, Oxycontin and Percocet.

Things have changed greatly. In my day, most of the athletes knew what beer or whiskey tasted like, but most had never taken and drugs or medications; now the reverse is true, and most athletes have been prescribed a medication or taken street substance.

Better chemistry has not brought our nation better health.  We sit low on the charts of other industrial nations, our World Health Score is about 37th from the top.

I will talk to you about how your body functions.  You will understand basic physiology and you will learn about safe foods, a better diet, rest and exercise programs that care for the human frame and nervous system. Chiropractic and nutrition are safe and effective.  We are the doctors of the future.

 

1. Aatun E, Hartvigsen J, Wedderkipp N, Hesbaek L. Spinal pain in adolescents:  prevalence, incidence and course: a school-based two-year prospective cohort study in 1,300 Danes aged 11-13.  BMC Musculoskel Disord, 2014 May 29; 15:187.

2. Siegel MB, Naimi TS, Cremeens JL, Nelson DE. Alcoholic beverage preferences and associated drinking patterns and risk behaviors among high school youth.  Am J Prevent Med, 2011;40:419-426.

3. Roeber J, Green DL, Meurer KM, et al. Types of alcoholic beverages usually consumed by students in 9th-12th grades-four states, 2005 Morb Mort weekly rep, 2007;56:737-740.

4. Li G, Keyl PM, Rothman R, et al.  Epidemiology of alcohol-related emergency department visits.  Academ Emerg Med,, 1998;5:788-795.

5. Ellickson PL, Tucker JS, Klein DJ, Saner H. Antecedents and outcomes of marijuana use initiation during adolescence.  Preventive Med,  2004;39:976-984.

6. Denham BE. High school sports participation and substance use: differences by sport, race, and gender. J Child & Adolesc Substance Abuse, 2014; 23: 145-154.

7. Hubbard, L. Ron, Assists for Illness and Injury, Volunteer Minister’s Handbook, volunteerminister.com, Chapter Assists for Illness and Injury. 

September 24, 2014

Another Typical Drug Company Lawsuit

Dr. Terry L. Wiley, D.C., C.M.E.

This lawsuit is about opioids and about the damage they cause in our community. Take a moment and think about how many zeroes are in $1,000.

In $1,000, we have one, two, three. Three is correct.  If I were to take $10,000 dollars and walk down Main Street and hand out ten $1,000 bills to ten people and asked them each to go to City Market and buy a watermelon, I bet City Market would sell ten watermelons.  

How many zeroes are in a million?  One, two, three, four, five, six.  Six is correct.  If I handed out 999,000 $1,000 bills in town and asked each person to go and purchase a watermelon from City Market, I bet they would sell out of watermelons very fast.

Now for the magnitude of what is actually going on with drug manufacturers, how many zeroes are there in one billion?  One, two, three, four, five, six, seven, eight, nine.  Nine is correct.  If I took 999,999,000 $1,000 bills and handed them out in town, well, you get the picture.  This is just a fraction of what the drug companies have done to make opioids accepted, marketable, and sold to the public.

This shows a lack of ethics.

A definition of the word “ethics” would go like this:  “Ethics consists of rationality toward the highest level of survival for the individual, the future race, the group and for mankind.”  The whole subject of ethics is one that has become almost lost in society in its current state.

Our nation is heavily involved in drug use, both legal and illegal.  Last year, and continuing today, our valley had high level of use of prescription drugs.  Law enforcement officials have stated that the level of prescription drug use in the San Luis Valley was twice that of the state level.

This spring at the Summer Fest on the Rio I was speaking with an EMT driver, and he stated that he made fifty calls that week to homes where someone overdosed on drugs.  Social services is going into homes and gathering children and placing them into foster care because of the parents’ drug problems.

I'm looking at an article that shows how drug companies want to monopolize pain relief by expanding the opioid market.  It is a Tale of Gross Deception.   It is becoming very common to see drug companies negotiate “false claims” settlements for millions and billions of dollars.  

Wikipedia lists that the top twenty legal settlements were worth more than $17 billion in criminal and civil penalties between 2001-2012.  Add in the Johnson & Johnson settlement from last year and the number is closer to $20 billion or about $1.5 billion a year.

Looking at these violations and the insidious nature of the drug company marketing tactics, one wonders if these penalties are accepted by the pharmaceutical industry as a cost of doing business.  With annual sales well over $330 billion and estimated marketing budgets of $72 billion, a few billion in annual fines is not likely to make much of an impact, regardless of their PR rhetoric when “agreeing” to pay the fines.

A difference maker is on the dockets of the California courts.   A new lawsuit brought forth by Orange County and Santa Clara County is directed at nine manufacturers of opioids. These are drugs that have been over-marketed to the point that “in 2009, there were more than twice as many deaths from prescription opioid overdoses (15,597) than from cocaine (4,350) and heroin (3,278) put together.”

One of the attributes that makes this lawsuit so interesting is the detail regarding the well-crafted facade allegedly designed by the defendants.  According to the lawsuit, this two-decade facade effectively “(1) misrepresented the efficacy of opioids, (2) trivialized or obscured their serious risks and adverse outcomes, and (3) overstated their superiority, compared with other treatments.”

Their goal, according to the suit, was simple: to expand the market for opioids from their FDA- approved use (for cancer and other end-of-life pain) to chronic pain patients, a much larger market consisting of more than 100 million Americans.

Their deceptive messages tainted virtually every source doctors could rely on for information and prevented them from making informed treatment decisions.  Directly and through public relations firms, drug companies have hired advocacy groups and professional societies they financed and influenced, defendants have funded, drafted, edited, approved, published, and distributed websites, books, patient education brochures, videos, and other materials that carry their misrepresentations to targeted groups of doctors (such as family doctors), and patients - particularly veterans and the elderly.

Expanding the opioid market required them to work through professional organizations, authors, spokespersons, key opinion leaders (KOL's), patient advocacy groups and various PR firms in their effort to paint the picture that opioids were safer, more effective and not likely to be addictive.  Apparently, those tactics were extremely effective.  The U.S. opioid market now exceeds $10 billion annually.

In 2000 the shift of the paradigm on opioids began with the Joint Commission on Accreditation of Healthcare Organizations in conjunction with the University of Wisconsin Pain and Studies Group, declared that pain was the “5th Vital Sign” and required all healthcare  practitioners to make pain assessment and management a priority in daily practice. Both the American Pain Society and the American Academy of Pain Management guidelines promoted opioids as “safe and effective” for treating chronic pain, despite acknowledging limited evidence and concluding that the risk of addiction is manageable for patients with and without a past abuse history.  These guidelines have been a particularly effective channel of deception and have influenced not only treating physicians, but the body of scientific evidence on opioids.

The list is extensive of where the money was spent (invested) to get the agreement they wanted.  The American Geriatric Society, which produced the guidelines and education materials focused on elderly patients. Five of ten of the experts on the panel had close financial ties with the defendants, receiving grants and investing in the defendants’ stock.

In spite of a complete lack of scientific basis, in 2011 Purdue made statements “that multiple clinical studies” have shown that opioids were effective in improving daily function, psychological health, and health-related quality of life for chronic pain patients.  The U.S. Federation of State Medical Boards itself received support during the time they published the opioids guidelines. Other groups such as the Pain Care Forum, American Academy of Pain Management, Doctors and Nurses in the Field, American Society of Pain Educators, Patient Advocacy Groups, American Chronic Pain Association, and Northern California Pain Initiative and other like-minded organizations, almost all received substantial funding.

Important elements of this case are only now coming to light, such as paying third parties for access to the FDA and a voice in formulating standards for the clinical trials.  Deceptive marketing occurred at medical education conferences.   Key Opinion Leaders (KOLs) received money, prestige, recognition, research funding, and avenues to publish, which positioned them in more of a position to influence the medical community.

In 2010, 254 million prescriptions for opioids were filled in the U.S. – enough to medicate every adult in America around the clock for a month.  Twenty percent of all doctors' visits result in prescription of an opioid (nearly double the rate in 2000).  Opioids - once a niche drug - are now the most prescribed class of drugs - more than blood pressure, cholesterol, or anxiety drugs.

Their corrupt money touched literature, websites, community groups, and programs related to chronic non-cancer pain from illnesses such as low back pain, shingles, migraines, osteoarthritis, phantom limb pain, fibromyalgia and multiple sclerosis.  They marketed directly to patients to ask their doctors for the drugs and educated the doctors to allay their well-founded concerns that opioids were dangerous or addictive.  They targeted the vulnerable, but usually well-insured groups of patients, such as veterans and the elderly.  

What action can you take in this story?  You could say, “Well, those doctors...” or “Those drug manufacturers...”, or “I just didn't know.”   The fact is that their ethics are gone.  They do not care for your survival, but they do care for your money.  

Let's take it one step closer to a solution.  You, and only you, know what is right.  When you hear a drug advertisement or ask for a prescription and you take a dangerous drug, you know what it is.  You instinctively know right and wrong.  You must stand up for yourself.

This is just one type of drug with creates many billions of dollars in profit.  Other drugs with equally nefarious outcomes are killing 55,000 people annually and damaging millions of lives. News of these drugs has already hit the media and has been forgotten.  What is one of these drugs?  Prozac.

Antidepressant cocktails are causing more deaths by suicide than all of active duty combat deaths together. The death toll does not include dependent spouses and their children that seek help and are medicated that then commit suicide.

You can control your unethical actions. For example, when you do something which is unethical (meaning that it harms your survival and the survival of others) you instinctively try to right the wrong.  Usually you just end up caving yourself in.  (“Caving in” means mental and/or physical collapse to the extent that the individual cannot function causatively.)

For example, you might ask for a medication and it doesn't work.  You know it was wrong and you ask your doctor for more in an effort to do yourself in and wind up caving yourself in. You might even justify it and say, “Look what the doctor did to me.”

Someone drinks a beer.  He feels good, but knows inside that it is a false sense of good.  He drinks more and keeps doing himself in. He looks around to see if anyone is noticing his stupidity and keeps drinking.   Finally he passes out, throws up, or wrecks the car or worse yet, kills someone else with his drunk driving. This is harming others’ survival.  

Are there solutions?  Alternative health care provides safe, natural solutions to getting well.  Chiropractic, naturopathy, massage, acupuncture, exercise, nutrition, enzymes, vitamins, minerals, water, and simple rest are all great solutions, and the list goes on.  These methods of true health care could not lobby to be funded fully (if at all) under the Affordable Care Act.  The Affordable Care Act (also known as “Obamacare”) was lobbied for at the tune of $16 million a day by the drug companies, surgeons, mental health industry and the insurance companies to bring you more of the same.

We know that more drugs and surgery are not the right answer, yet that is what is covered by Medicare, Medicaid, CHP, the Veteran's Administration and most insurance companies operating under the Affordable Care Act.  They don't provide full coverage for what works.  Take a slow, long look at what you are getting when you pay for insurance.  Read through the coverage you have.

This article is about enacting justice on drug manufacturers.  Ethics is not justice.  Justice comes after an individual fails to put ethics in on himself.

For true health care, which is ethical health care, call me.  If you would like to look at habits and ethics as they apply to you, give me a call.  Almost all conditions can be handled without drugs and surgery.  

Stand tall and smell the fresh air. Stand tall and see the light. Stand tall and be free. Stand tall and think for yourself. You are deciding to make a change in your life. You are deciding to do one positive thing for yourself. You are drawing a line in the sand. You are deciding to start now to change your own habits, your own dietary choices, how you care for your body and what you want the outcome to be.  You have the power, and you have the ability to decide to start NOW!


Also, I have a special Drug Free World Video that I'd love to show you.  Call me for a free showing time at 589-5163.

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