The shorter your sleep, the shorter your life: the new sleep science

By | Uncategorized

This article is very interesting but long.  I’ve highlighted a synopsis of the article in the red text, so just read that if you want the short abbreviation.

This is an article from www.theguardian.com by Matthew Walker on his new book, Why We Sleep: The New Science of Sleep and Dreams, Published by Allen Lane

 

Leading neuroscientist Matthew Walker on why sleep deprivation is increasing our risk of cancer, heart attack and Alzheimer’s – and what you can do about it

Matthew Walker has learned to dread the question “What do you do?” At parties, it signals the end of his evening; thereafter, his new acquaintance will inevitably cling to him like ivy. On an aeroplane, it usually means that while everyone else watches movies or reads a thriller, he will find himself running an hours-long salon for the benefit of passengers and crew alike. “I’ve begun to lie,” he says. “Seriously. I just tell people I’m a dolphin trainer. It’s better for everyone.”

Walker is a sleep scientist. To be specific, he is the director of the Center for Human Sleep Science at the University of California, Berkeley, a research institute whose goal – possibly unachievable – is to understand everything about sleep’s impact on us, from birth to death, in sickness and health. No wonder, then, that people long for his counsel. As the line between work and leisure grows ever more blurred, rare is the person who doesn’t worry about their sleep. But even as we contemplate the shadows beneath our eyes, most of us don’t know the half of it – and perhaps this is the real reason he has stopped telling strangers how he makes his living. When Walker talks about sleep he can’t, in all conscience, limit himself to whispering comforting nothings about camomile tea and warm baths. It’s his conviction that we are in the midst of a “catastrophic sleep-loss epidemic”, the consequences of which are far graver than any of us could imagine. This situation, he believes, is only likely to change if government gets involved.

Why, exactly, are we so sleep-deprived? What has happened over the course of the last 75 years? In 1942, less than 8% of the population was trying to survive on six hours or less sleep a night; in 2017, almost one in two people is. The reasons are seemingly obvious. “First, we electrified the night,” Walker says. “Light is a profound degrader of our sleep. Second, there is the issue of work: not only the porous borders between when you start and finish, but longer commuter times, too. No one wants to give up time with their family or entertainment, so they give up sleep instead. And anxiety plays a part. We’re a lonelier, more depressed society. Alcohol and caffeine are more widely available. All these are the enemies of sleep.”

But Walker believes, too, that in the developed world sleep is strongly associated with weakness, even shame. “We have stigmatised sleep with the label of laziness. We want to seem busy, and one way we express that is by proclaiming how little sleep we’re getting. It’s a badge of honour. When I give lectures, people will wait behind until there is no one around and then tell me quietly: ‘I seem to be one of those people who need eight or nine hours’ sleep.’ It’s embarrassing to say it in public. They would rather wait 45 minutes for the confessional. They’re convinced that they’re abnormal, and why wouldn’t they be? We chastise people for sleeping what are, after all, only sufficient amounts. We think of them as slothful. No one would look at an infant baby asleep, and say ‘What a lazy baby!’ We know sleeping is non-negotiable for a baby. But that notion is quickly abandoned [as we grow up]. Humans are the only species that deliberately deprive themselves of sleep for no apparent reason.” In case you’re wondering, the number of people who can survive on five hours of sleep or less without any impairment, expressed as a percent of the population and rounded to a whole number, is zero.

The world of sleep science is still relatively small. But it is growing exponentially, thanks both to demand (the multifarious and growing pressures caused by the epidemic) and to new technology (such as electrical and magnetic brain stimulators), which enables researchers to have what Walker describes as “VIP access” to the sleeping brain. Walker, who is 44 antd was born in Liverpool, has been in the field for more than 20 years, having published his first research paper at the age of just 21. “I would love to tell you that I was fascinated by conscious states from childhood,” he says. “But in truth, it was accidental.” He started out studying for a medical degree in Nottingham. But having discovered that doctoring wasn’t for him – he was more enthralled by questions than by answers – he switched to neuroscience, and after graduation, began a PhD in neurophysiology supported by the Medical Research Council. It was while working on this that he stumbled into the realm of sleep.

“I was looking at the brainwave patterns of people with different forms of dementia, but I was failing miserably at finding any difference between them,” he recalls now. One night, however, he read a scientific paper that changed everything. It described which parts of the brain were being attacked by these different types of dementia: “Some were attacking parts of the brain that had to do with controlled sleep, while other types left those sleep centres unaffected. I realised my mistake. I had been measuring the brainwave activity of my patients while they were awake, when I should have been doing so while they were asleep.” Over the next six months, Walker taught himself how to set up a sleep laboratory and, sure enough, the recordings he made in it subsequently spoke loudly of a clear difference between patients. Sleep, it seemed, could be a new early diagnostic litmus test for different subtypes of dementia.

After this, sleep became his obsession. “Only then did I ask: what is this thing called sleep, and what does it do? I was always curious, annoyingly so, but when I started to read about sleep, I would look up and hours would have gone by. No one could answer the simple question: why do we sleep? That seemed to me to be the greatest scientific mystery. I was going to attack it, and I was going to do that in two years. But I was naive. I didn’t realise that some of the greatest scientific minds had been trying to do the same thing for their entire careers. That was two decades ago, and I’m still cracking away.” After gaining his doctorate, he moved to the US. Formerly a professor of psychiatry at Harvard Medical School, he is now professor of neuroscience and psychology at the University of California.

Does his obsession extend to the bedroom? Does he take his own advice when it comes to sleep? “Yes. I give myself a non-negotiable eight-hour sleep opportunity every night, and I keep very regular hours: if there is one thing I tell people, it’s to go to bed and to wake up at the same time every day, no matter what. I take my sleep incredibly seriously because I have seen the evidence. Once you know that after just one night of only four or five hours’ sleep, your natural killer cells – the ones that attack the cancer cells that appear in your body every day – drop by 70%, or that a lack of sleep is linked to cancer of the bowel, prostate and breast, or even just that the World Health Organisation has classed any form of night-time shift work as a probable carcinogen, how could you do anything else?”

There is, however, a sting in the tale. Should his eyelids fail to close, Walker admits that he can be a touch “Woody Allen-neurotic”. When, for instance, he came to London over the summer, he found himself jet-lagged and wide awake in his hotel room at two o’clock in the morning. His problem then, as always in these situations, was that he knew too much. His brain began to race. “I thought: my orexin isn’t being turned off, the sensory gate of my thalamus is wedged open, my dorsolateral prefrontal cortex won’t shut down, and my melatonin surge won’t happen for another seven hours.” What did he do? In the end, it seems, even world experts in sleep act just like the rest of us when struck by the curse of insomnia. He turned on a light and read for a while.

Will Why We Sleep have the impact its author hopes? I’m not sure: the science bits, it must be said, require some concentration. But what I can tell you is that it had a powerful effect on me. After reading it, I was absolutely determined to go to bed earlier – a regime to which I am sticking determinedly. In a way, I was prepared for this. I first encountered Walker some months ago, when he spoke at an event at Somerset House in London, and he struck me then as both passionate and convincing (our later interview takes place via Skype from the basement of his “sleep centre”, a spot which, with its bedrooms off a long corridor, apparently resembles the ward of a private hospital). But in another way, it was unexpected. I am mostly immune to health advice. Inside my head, there is always a voice that says “just enjoy life while it lasts”.

The evidence Walker presents, however, is enough to send anyone early to bed. It’s no kind of choice at all. Without sleep, there is low energy and disease. With sleep, there is vitality and health. More than 20 large scale epidemiological studies all report the same clear relationship: the shorter your sleep, the shorter your life. To take just one example, adults aged 45 years or older who sleep less than six hours a night are 200% more likely to have a heart attack or stroke in their lifetime, as compared with those sleeping seven or eight hours a night (part of the reason for this has to do with blood pressure: even just one night of modest sleep reduction will speed the rate of a person’s heart, hour upon hour, and significantly increase their blood pressure).

A lack of sleep also appears to hijack the body’s effective control of blood sugar, the cells of the sleep-deprived appearing, in experiments, to become less responsive to insulin, and thus to cause a prediabetic state of hyperglycaemia. When your sleep becomes short, moreover, you are susceptible to weight gain. Among the reasons for this are the fact that inadequate sleep decreases levels of the satiety-signalling hormone, leptin, and increases levels of the hunger-signalling hormone, ghrelin. “I’m not going to say that the obesity crisis is caused by the sleep-loss epidemic alone,” says Walker. “It’s not. However, processed food and sedentary lifestyles do not adequately explain its rise. Something is missing. It’s now clear that sleep is that third ingredient.” Tiredness, of course, also affects motivation.

Sleep has a powerful effect on the immune system, which is why, when we have flu, our first instinct is to go to bed: our body is trying to sleep itself well. Reduce sleep even for a single night, and your resilience is drastically reduced. If you are tired, you are more likely to catch a cold. The well-rested also respond better to the flu vaccine. As Walker has already said, more gravely, studies show that short sleep can affect our cancer-fighting immune cells. A number of epidemiological studies have reported that night-time shift work and the disruption to circadian sleep and rhythms that it causes increase the odds of developing cancers including breast, prostate, endometrium and colon.

Getting too little sleep across the adult lifespan will significantly raise your risk of developing Alzheimer’s disease. The reasons for this are difficult to summarise, but in essence it has to do with the amyloid deposits (a toxin protein) that accumulate in the brains of those suffering from the disease, killing the surrounding cells. During deep sleep, such deposits are effectively cleaned from the brain. What occurs in an Alzheimer’s patient is a kind of vicious circle. Without sufficient sleep, these plaques build up, especially in the brain’s deep-sleep-generating regions, attacking and degrading them. The loss of deep sleep caused by this assault therefore lessens our ability to remove them from the brain at night. More amyloid, less deep sleep; less deep sleep, more amyloid, and so on. (In his book, Walker notes “unscientifically” that he has always found it curious that Margaret Thatcher and Ronald Reagan, both of whom were vocal about how little sleep they needed, both went on to develop the disease; it is, moreover, a myth that older adults need less sleep.) Away from dementia, sleep aids our ability to make new memories, and restores our capacity for learning.

And then there is sleep’s effect on mental health. When your mother told you that everything would look better in the morning, she was wise. Walker’s book includes a long section on dreams (which, says Walker, contrary to Dr Freud, cannot be analysed). Here he details the various ways in which the dream state connects to creativity. He also suggests that dreaming is a soothing balm. If we sleep to remember (see above), then we also sleep to forget. Deep sleep – the part when we begin to dream – is a therapeutic state during which we cast off the emotional charge of our experiences, making them easier to bear. Sleep, or a lack of it, also affects our mood more generally. Brain scans carried out by Walker revealed a 60% amplification in the reactivity of the amygdala – a key spot for triggering anger and rage – in those who were sleep-deprived. In children, sleeplessness has been linked to aggression and bullying; in adolescents, to suicidal thoughts. Insufficient sleep is also associated with relapse in addiction disorders. A prevailing view in psychiatry is that mental disorders cause sleep disruption. But Walker believes it is, in fact, a two-way street. Regulated sleep can improve the health of, for instance, those with bipolar disorder.

I’ve mentioned deep sleep in this (too brief) summary several times. What is it, exactly? We sleep in 90-minute cycles, and it’s only towards the end of each one of these that we go into deep sleep. Each cycle comprises two kinds of sleep. First, there is NREM sleep (non-rapid eye movement sleep); this is then followed by REM (rapid eye movement) sleep. When Walker talks about these cycles, which still have their mysteries, his voice changes. He sounds bewitched, almost dazed.

During NREM sleep, your brain goes into this incredible synchronised pattern of rhythmic chanting,” he says. “There’s a remarkable unity across the surface of the brain, like a deep, slow mantra. Researchers were once fooled that this state was similar to a coma. But nothing could be further from the truth. Vast amounts of memory processing is going on. To produce these brainwaves, hundreds of thousands of cells all sing together, and then go silent, and on and on. Meanwhile, your body settles into this lovely low state of energy, the best blood-pressure medicine you could ever hope for. REM sleep, on the other hand, is sometimes known as paradoxical sleep, because the brain patterns are identical to when you’re awake. It’s an incredibly active brain state. Your heart and nervous system go through spurts of activity: we’re still not exactly sure why.”

Does the 90-minute cycle mean that so-called power naps are worthless? “They can take the edge off basic sleepiness. But you need 90 minutes to get to deep sleep, and one cycle isn’t enough to do all the work. You need four or five cycles to get all the benefit.” Is it possible to have too much sleep? This is unclear. “There is no good evidence at the moment. But I do think 14 hours is too much. Too much water can kill you, and too much food, and I think ultimately the same will prove to be true for sleep.” How is it possible to tell if a person is sleep-deprived? Walker thinks we should trust our instincts. Those who would sleep on if their alarm clock was turned off are simply not getting enough. Ditto those who need caffeine in the afternoon to stay awake. “I see it all the time,” he says. “I get on a flight at 10am when people should be at peak alert, and I look around, and half of the plane has immediately fallen asleep.”

So what can the individual do? First, they should avoid pulling “all-nighters”, at their desks or on the dancefloor. After being awake for 19 hours, you’re as cognitively impaired as someone who is drunk. Second, they should start thinking about sleep as a kind of work, like going to the gym (with the key difference that it is both free and, if you’re me, enjoyable). “People use alarms to wake up,” Walker says. “So why don’t we have a bedtime alarm to tell us we’ve got half an hour, that we should start cycling down?” We should start thinking of midnight more in terms of its original meaning: as the middle of the night. Schools should consider later starts for students; such delajjys correlate with improved IQs. Companies should think about rewarding sleep. Productivity will rise, and motivation, creativity and even levels of honesty will be improved. Sleep can be measured using tracking devices, and some far-sighted companies in the US already give employees time off if they clock enough of it. Sleeping pills, by the way, are to be avoided. Among other things, they can have a deleterious effect on memory.

Those who are focused on so-called “clean” sleep are determined to outlaw mobiles and computers from the bedroom – and quite right, too, given the effect of LED-emitting devices on melatonin, the sleep-inducing hormone. Ultimately, though, Walker believes that technology will be sleep’s saviour. “There is going to be a revolution in the quantified self in industrial nations,” he says. “We will know everything about our bodies from one day to the next in high fidelity. That will be a seismic shift, and we will then start to develop methods by which we can amplify different components of human sleep, and do that from the bedside. Sleep will come to be seen as a preventive medicine.”

What questions does Walker still most want to answer? For a while, he is quiet. “It’s so difficult,” he says, with a sigh. “There are so many. I would still like to know where we go, psychologically and physiologically, when we dream. Dreaming is the second state of human consciousness, and we have only scratched the surface so far. But I would also like to find out when sleep emerged. I like to posit a ridiculous theory, which is: perhaps sleep did not evolve. Perhaps it was the thing from which wakefulness emerged.” He laughs. “If I could have some kind of medical Tardis and go back in time to look at that, well, I would sleep better at night.”

 

Sleep in numbers:

■ Two-thirds of adults in developed nations fail to obtain the nightly eight hours of sleep recommended by the World Health Organisation.

■ An adult sleeping only 6.75 hours a night would be predicted to live only to their early 60s without medical intervention.

■ A 2013 study reported that men who slept too little had a sperm count 29% lower than those who regularly get a full and restful night’s sleep.

■ If you drive a car when you have had less than five hours’ sleep, you are 4.3 times more likely to be involved in a crash. If you drive having had four hours, you are 11.5 times more likely to be involved in an accident.

■ A hot bath aids sleep not because it makes you warm, but because your dilated blood vessels radiate inner heat, and your core body temperature drops. To successfully initiate sleep, your core temperature needs to drop about 1C.

■ The time taken to reach physical exhaustion by athletes who obtain anything less than eight hours of sleep, and especially less than six hours, drops by 10-30%.

■ There are now more than 100 diagnosed sleep disorders, of which insomnia is the most common.

■ Morning types, who prefer to awake at or around dawn, make up about 40% of the population. Evening types, who prefer to go to bed late and wake up late, account for about 30%. The remaining 30% lie somewhere in between.

A Differrent Way For Core Stability

By | Exercise

Personally written by Dr. Milan Lassiter, Laser Sport & Spine, 1303 W. Main St, Richmond, VA 23220. He can be reached by calling (804) 254-5765.

ATM2 logo

 

 

 

The idea of core stabilization is different than that of core strength. Often (especially with athletes) we have sufficient strength. After an injury, however, core stabilizer muscles can fail to fire appropriately, causing atrophy and, ultimately, failure to regain their function to stabilize the spine. Muscles will fire with different patterns depending on if there’s pain or not. These abnormal nervous system patterns can’t be corrected with core strengthening exercises.

Core stabilizer muscles are very deep and wrap very closely around the spine. When the spine is injured, there’s a loss of stability. The larger muscles that are not designed to stabilize the spine get recruited. This is a guarding, defensive mechanism to prevent instability (everything tightens up).

Traditional core strengthening exercises contradict the basic principles of motor learning and motor training. Following are three of the basic principles for re-training motor/movement patterns:

•  Similarity and specificity principles – You have to practice the same movement in the same position that you’re having a problem. If your restriction is that you can’t bend forward, doing a crunch or plank does not put you in a similar position as that movement restriction (floor exercises are not in the same position as being upright and weight bearing).

•  Internal vs. external principle – In real life, we think of what goal we want to accomplish (external), not what muscles we need to internally use to accomplish that goal. For example, you don’t think about what muscles you need to use in order to bend forward to wash your face, you just think of the end goal (which is to wash your face). In other words, when you have a pain pattern when bending forward, you don’t need to strengthen the muscles that bend you forward. You have to change the way the nervous system is automatically firing the different muscles involved with bending you forward.

•  Economy of motion – The brain is always trying to optimize motor patterns to avoid pain and to sequence the least amount of muscle movements. The ATM2 uses a belting system to reposition and compress the spine into a stable position. This allows an optimized, pain-free sequence of movements to be learned. When you’re in pain and you’re using regular floor exercises, you’re just re-affirming a dysfunctional movement pattern (one that’s already painful).

How do we change how people move? Instead of looking at pain and movement problems as being caused by local injury and dysfunction of an area, another important aspect is to look at how the body has “learned” how to move. These abnormal patterns are deeply ingrained habits that the body has adopted over time as a preferred movement strategy. Deficits in strength and mobility still need to be addressed (ie: through exercise and chiropractic adjustments), but they can’t be expected to correct the abnormally learned movement pattern. The body has to be re-taught how to coordinate movement with more appropriate patterns.

Traditional core stabilization exercises are performed on the ground (ie: a crunch or a plank). Muscles are activated differently in a standing, weight-bearing position than they are when you’re doing floor exercises. This is why the ATM2 puts the patient into an upright, weight-bearing posture.

With Active Therapeutic Movement, we’re also looking to treat a specific movement impairment (the specific movement that causes pain and limited range of motion). Core stabilization is movement specific. For example, a patient may be able to bend backwards and sideways just fine, but there’s a lot of pain and limitation when bending forward. With the ATM2, we’re working on a specific movement impairment. We need to restore that specific, painful movement impairment, but we need to eliminate the pain first.

The active therapeutic movement concept has 4 Phases:ATM extension

1)  Exam What movement is painful and impaired?

2)  Set-up Stabilize the restricted movement to make it pain-free by using belts to compress and re-position the area.

3)  Intervention Isometric exercises, in a specific direction, are performed to make the nervous system memorize the pain-free movement pattern. This is where the nervous system says “aha, this is the position in which I can fire my muscles correctly and not have pain…so I’ll remember it.”

4)  Re-exam Re-test the movement impairment; There should be 50-100% reduction in pain and improvement in movement.

The ATM2 gives you the capability to alter the way the brain activates the muscles, teaching the brain a different and non-painful way to execute a movement. As a person does the ATM2 exercises, now their central nervous system is training and learning a new firing pattern per their condition. The ATM2 changes the way the nervous system acts to fire muscles. You can’t change this firing pattern by doing floor exercises or by thinking about it; It has to happen automatically by the brain. The ATM2 does not use exercises to strengthen an area, it uses exercises to change the way your nervous system is activating a movement to occur.

The Functional Movement Screen

By | General Health Topics
Personally written by Dr. Milan Lassiter, 1303 W. Main St, Richmond, VA 23220.  Contact us at (804) 254-5765 for your FMS assessment.FMS-Pictures

The FMS (Functional Movement Screen) is a series of 7 screening assessments. It’s efficient and powerful enough that it has been used for years as part of the physical assessment at the NFL scouting combine in order to screen potential players.

The FMS can detect limitations in our ability to perform basic movements, reveal imbalances from side to side, and identify risk for future injury. It is also used to identify areas that can be improved upon for better performance. The test is made up of 7 different movement patterns:  (1) Squatting (2) Stepping (3) Lunging (4) Reaching (5) Leg Raising (6) Push Ups (7) Rotating. Each of these patterns have specific criteria that has to be met and a score is given accordingly. It’s basically a series of tests that you pass or fail.

In real life we move in patterns.  In other words, we don’t just bend the knee…instead we bend the knee while also bending at the hips and ankle, simultaneously moving our torso, balancing with our arms, and shifting our weight with subtle movements made all the way from our neck to our toes. The FMS is a screen for movement patterns, not individual joints or areas.  Instead of assessing parts, the FMS assesses patterns, which is actually the way the body moves in real life.  The FMS leads us to the weakest link in the chain within these patterns.

The FMS is a rating and ranking system, sort of like getting a grade in school (an A or an F). However, with the FMS test, the grade is from a 3 to a 0.  Getting a 3 or 2 is a pass, while a 1 or a 0 is a fail.

3 = Optimal (perfect execution of a movement pattern)

2 = Acceptable (some compensation is occurring)

1 = dysfunctional (unable to perform the movement, which will lead to the clinical assessment called the SFMA)

0 = Pain (a movement pattern produces pain, which will also lead to the SFMA)

When pain is discovered upon an FMS test, it should be assessed by a clinician who can perform something called an SFMA (Selective Functional Movement Assessment).  I will write about this in another blog at a later time, but suffice to say that it’s an amazing tool and, in my opinion, you should look for physical therapists, chiropractors, or even MD’s, who can perform an SFMA if you are injured or have pain upon movement. I am in the process of being certified and will be ready to do the SFMA soon.

There is a standardized screening system for the risk of cardiovascular and heart disease (ie: checking for high blood pressure, cholesterol, and triglycerides and screening for whether or not they smoke, what they eat, whether they exercise or are overweight, etc). It doesn’t matter where you go, these same parameters are going to be screened.  However, we don’t have anything like this standardized screening assessment for exercise, athletic performance, pain upon movement, or musculoskeletal problems. The FMS is a standardized test that is used to quickly assess the way that we move.

When an assessment is performed to screen for cardiovascular disease, a person can have no symptoms or complaints, yet still find out they have high cholesterol or high blood pressure. This puts them at high risk for a potential heart attack or stroke. By intervening and making changes, that person can be saved from something serious or even deadly.

Similarly, the FMS is a risk assessment tool that uses either specific intervention exercises or therapies to save a person from future injury, pain, impaired movement, and performance deterioration. If the assessment comes up decent, but not perfect, it can also be used to enhance the way someone moves…in other words moving them from mediocre, to good, to great. That can only be beneficial for anyone, whether you’re a carpenter who has to do heavy manual labor or a recreational, but competitive tri-athlete.

This is how the pros are being assessed these days.

In our office, you don’t need to be a pro-athlete to be treated like one!

Radial Pulse Therapy: A Deep Tissue Technology Worth Checking Out

By | Uncategorized
Personally written by Dr. Milan Lassiter, Chiropractor, 1303 W. Main St., Richmond, VA, Tel #: (804) 254-5765
ripples-in-water

Radial Pulse Therapy has also been dubbed ShockWave Therapy, but it’s a mis-nomer because there is no “shock” involved.  It uses an instrument to create pulsing waves, similar to throwing a rock into a pond and creating ripples in the water. Think of Radial Pulse Therapy as creating those same type of ripples in the soft tissues (muscle, fascia, tendons, ligaments, bursae, connective tissue), penetrating deeply down and spreading out as they go deeper. These “ripples” are actually rhythmic waves that are delivered into scar tissue and adhesive tissue, breaking it up over a 5-10 minute treatment. The German Radial Pulse unit that we use has a “soft” option, which makes it very effective while being very comfortable.

I particularly like shockwave therapy for chronic soft tissue conditions. Treating soft tissue conditions in the acute phase is much easier than treating those conditions once they have become chronic. The challenge with treating long-standing problems is that scar tissue and adhesions, once in the chronic stage, are either becoming permanent or are permanent. This makes most traditional treatment methods less effective and may be the reason why you’ve tried many different therapies, but nothing has worked.

The initial minute of treatment stimulates chemicals that release natural pain-killers in the body.  The reaction from the treatment is usually that the skin will turn red and feel warm, often with mild post-treatment soreness for a day or two.  This type of therapy is so deep that it can only be used once every 4 or 5 days.

Our other soft tissue treatments, such as Active Release Technique (ART) and Graston Technique, are state-of-the-art soft tissue therapies. However, with tough, chronic cases, ART and Graston are even more effective if the problem area has been pre-treated with the deeper, more high intensity mechanical energy from the shockwave therapy. No one else in Richmond has this cutting-edge therapy.

I first became aware of this therapy from my friend of mine in NJ who is one of the chiropractors for the NY Jets. He works very similarly to me, using a lot of manual therapies such as Active Release Technique, Graston Technique, and chiropractic adjustments. He has been using shockwave therapy for over 10 years and has a huge sports practice, working with high level runners, tri-athletes, and other athletes in all types of sports. When he first started working with the NY Jets, he was taking his shockwave unit back and forth to their training camp. After a year of using it with the Jets, their training staff found shockwave therapy to be so effective that they went out and bought a few Radial Pulse Therapy units for treating their athletes.

If you have had other “deep tissue” treatments without getting results (or aren’t getting good enough results) and are looking for someone to help you when no one else has been able to, give us a call at (804) 254-5765.

Myofascial Therapy In Our Office…A Massage or Something Different?

By | Active Release Technique (ART), Chiropractic, Graston Technique
Personally written by Dr. Milan Lassiter, Chiropractor, 1303 W. Main St., Richmond, VA, Tel #: (804) 254-5765

 

fascia_1244463_whiteI am not a massage therapist, although I greatly respect and appreciate the work that massage therapists do. I am a chiropractor in Richmond, VA, who has been in practice for about 15 years. In chiropractic college, we learned a lot about the spine and adjusting the spine in order to correct spinal mis-aligment, improve spinal movement dysfunction, and increase nervous system function.

 

As soon as I was licensed and started working on patients, I couldn’t help but notice an inordinate amount of soft tissue problems. I was always doing pressure point therapy and cross friction massage on the soft tissue disorders that I’d notice. In 2008, I started to study Active Release Technique (ART), a patented myofascial technique that is widely used with athletes (it’s really appropriate for anyone with tight, tense, or dysfunctional soft-tissue movement). Most of the professionals who do Active Release Technique are chiropractors or physical therapists, and I noticed that many of them also did another myofascial technique called Graston Technique. I preceded to study that technique too, and, between the two myofascial techniques, it totally changed the way that I practice. By the way, the word myofascial stands for muslces (myo) and fascia (a connective tissue that is replete throughout the body and is very important in producing movement).

 

Most of the dysfunctional movement problems in the body fall under one of 2 categories: (1) Joint mobility dysfunction or (2) Tissue extensibility dysfunction. The chiropractic adjustments that we perform in our office corrects joint mobility problems. The myofascial work that we do, and that massage therapists perform, corrects the tissue extensibility problems. Tissue extensibility dysfunction basically means soft tissues (muscle, fascia, ligaments, tendons, etc.) that can’t or aren’t able to move properly. They’re stuck, restricted, contracted, and just plain lacking the proper ability to move the way that they should.

 

I love the way that massage therapists work the soft tissue system from head to toe, but I’ll leave that to them…they’re the professionals that you should go to for that because they do that better than anyone. The soft tissue work that I do, ART and Graston Technique, is much more regional. I identify specific soft tissues that are dysfunctional and I work to correct that.  Examples would be an ITB syndrome, patello-femoral syndrome, achilles tendonosis (tendonitis), or rotator cuff syndrome that is hindering someone from running or from moving their shoulder properly.

 

In our Richmond office, I address joint mobility dysfunction by chiropractic adjustments, spinal decompression therapy, and Laser therapy. I address tissue extensibility dysfunction by various myofascial techniques, including ART, Graston Technique, Dry needling, and Laser therapy. When patients come to our office, they get one or both…they get adjusted and/or they get myofascial therapy (ART and/or Graston), depending on what’s indicated. Most people get both…they get adjusted and then they get some soft tissue myofascial therapy. To me, the two systems work symbiotically and one doesn’t work without the other, so it’s natural to make sure both the spine/joints are working properly while at the same time making sure the soft tissue system is doing the same.

 

The Balancing Act

By | Exercise
Personally written by Milan Lassiter, DC, 1303 W. Main St, Richmond, VA, Tel #: (804) 254-5765

 

In it’s simplest sense, I break down exercise into 4 parts:

 

–  Resistance training (weights, bands, kettle bells, etc)

 

–  Cardiovascular training (aerobic exercise)

 

–  Stretching (lengthening muscles and tendons)

 

–  Balance training

 

Many people who exercise do 1 or 2 of the above; most people do not do all 4.  The most common one that is overlooked is balance training. Your sense of balance can be improved when it is trained, just like you’ll get stronger by lifting weights or become more limber by stretching.

 

Clinically, a good deal of your sense of balance comes from something called proprioception. Proprioception is your sense of knowing where your body is with relation to the space around you. This is an abstract concept to grasp because much of proprioception occurs subconciously. Think of your ability to close your eyes, put your arm out in-front of you, and then touch tour finger to your nose. You know how to do that because of proprioception.

 

Your sense of proprioception is often impaired when you’ve had a muscle sprain or strain, arthritic joint, or have damaged an area of your body on the job, in an accident, during sport,  or in some other way. Over the years, you may notice increased stiffness, chronic inflammation, continual pain, and the diminished capacity to use an area of your body. This will commonly lead to reduced proprioception, sometimes recognized as poor balance.

 

Proprioceptive exercises teach your body how to control the position and stability of a deconditioned or injured area of your body. A simple example that I teach in the office is standing on one foot and being able to hold that position for 1 minute.  Think it’s easy?  Try it. If it is easy, try closing your eyes and balancing on one foot (working up to 1 minute). This helps to retrain your balance and proprioceptive abilities from a conscious state to a subconscious state. A fast, subconscious, and properly firing proprioceptive system is important for your daily activities and is especially essential relative to sport activities.

 

Balance and proprioception are critical to retrain after any injury, but it’s also smart to train them during your daily workouts. Below are a few ways to exercise your sense of balance during your normal workouts. Shown here are delt flies, but you can use the same concept to do bicep curls, tricep kickbacks, over-head presses, etc.

 

Instead of doing deltoid flies while standing on the floor, try doing them with both feet on a BOSU Ball or other balance board

Instead of doing delt flies while standing on the floor, try doing them with both feet on a BOSU Ball or other balance board

 

To make it even harder, do delt flies while balancing on only one foot.

To make it even harder, do delt flies with only one foot on the floor (or even harder, with one foot on a balance device).

Class IV LASER…Healing Your Injuries At The Speed Of Light!

By | LASER therapy
 Personally written by Milan Lassiter, DC, 1303 W. Main St, Richmond, VA, Tel #: (804) 254-5765

 

I’ve written this detail of LASER therapy to expand upon what I’ve written on our webpage.  If you are not interested in the technicalities of LASER and why it works, this is long and it will bore you to death! You can click here to get back to the Class IV LASER therapy page on our website, which describes LASER in a much more simple fashion.

 

LASER technology has been widely used in Europe since the 1970’s and after clearance by the FDA in 2002, is now being used more and more in the USA. LASER therapy is the use of specific wavelengths of light to create therapeutic benefits. These different wavelengths promote the healing of skin, bone, cartilage, muscle, fascia, nerve and tendons.  There are 2 basic categories of LASER:  (1) Surgical LASER that cuts tissues and (2) Therapeutic LASER that heals tissues.

The trend in the research points to higher-powered LASER’s with deeper penetration, which is why our office has invested in the highest powered, deepest penetrating LASER that is on the market.

One of the unique characteristics of Class IV LASER therapy is that it promotes and accelerates the healing process (not just treating symptoms), thereby restoring and repairing the normal function of injured areas…FAST! Many offices actually use Class III LASER, which often are around 15 mW (milli Watts). Our Class IV LASER is literally one thousand times stronger, using 15,000 mW (milli Watts).

There are a few things that make true LASER light different than ordinary light.

 

• True LASER uses monochromatic (one) wavelength of “color,” whereas ordinary light comprises all the different colors in the spectrum. Think of one specific paint-chip color on a paint wheel, rather than all the different hues, shades and color tones available of all the different colors.  With LASER therapy, only very specific wavelength “colors” have therapeutic properties. In actuality, the therapeutic wavelengths used with LASER therapy are not really “colors” because they’re invisible to the human eye, but I’m just trying to convey a complex concept by making it more understandable.

 

• True LASER has coherent (in-phase) waves, whereas ordinary light is incoherent. Coherency with light would be analogous to hundreds of professional singers all singing the same note, perfectly in-tune, with perfect pitch…sounding beautiful! Incoherent light, such as light from a light bulb, would be like a bunch of tone-deaf amateurs, all singing out-of-tune and sounding dissonant. This means they’re all out-of-phase, which, of course, sounds awful! For light to be therapeutic and healing, it has to be in-phase, which is like “beautiful,” perfectly “in-tune” light.

 

• True LASER is directional, whereas ordinary light is non-directional. Think of the difference between the two as shining both a LASER pointer and a light bulb in a dark room. The LASER pointer will shoot a very pin-point, straight beam of light (usually red). The light bulb will disperse and scatter light all over the place and light up the entire room. In order for LASER therapy to have healing effects, it has to be directional light with very pin-point and straight penetration. This way it reaches the target tissues without being absorbed prior to getting there. Non-directional light scatters all over the place, thus getting absorbed quickly.

 

I referred to “true LASER” because many so-called LASER units that are used in offices actually use LED lights. LED is NOT coherent or directional light (remember the bullet points above), even though being coherent and directional are 2 of the 3 major reasons why LASER therapy has any healing properties in the first place. LED units are significantly less expensive to produce, leading to the reason so many offices that advertise LASER therapy are in-fact using LED treatments. True LASER is extremely expensive, which is why so many offices opt for the cheaper technology. Our office (Laser Sport & Spine Rehab) has invested in the latest, most cutting-edge, true LASER equipment that is currently available.

LASER therapy has a significant effect on damaged tissues, while normal tissues are not affected. Without getting too technical, the chromophores (light receptors) on compromised tissues respond to a LASER treatment, whereas chromophores on healthy tissues do not. Since only chromophore receptors on injured tissues absorb LASER energy, only the chemical reactions in those tissues get affected. This is the same way many medications work, by affecting receptors on cells, thus influencing what the body is doing. An example would be a blood pressure medication attaching to a receptor on a blood vessel, so the vessel can relax and open, thereby lowering blood pressure. The big difference between Class IV LASER therapy and medication is that LASER therapy does not have any dangerous side effects. LASER therapy simply stimulates the natural healing process in the body to happen a lot faster and a lot more often. It’s all natural and organic.

2 factors that are absolutely essential for LASER treatments to be therapeutically healing are:  (1) the energy must penetrate deep enough to reach the target tissue and (2) there has to be enough energy to stimulate the therapeutic healing effect.

With LASER therapy, the ability to penetrate to the damaged area is crucial. This depends upon:

 

WAVELENGTH    The wavelength of light determines its effects on tissues, meaning it’s delivered to specific tissues in specific ways to stimulate specific healing purposes. Research shows that specific wavelengths of light will speed up many stages of healing, particularly the use of the wavelengths from 600-1,000 nm. Our K-LASER uses 4 of the most efficient wavelengths: 660 nm, 800 nm, 905 nm, and 970 nm, which are the optimal wavelengths for healing. Most LASER’s on the market use 1 or 2 wavelengths. Our K-LASER is the first LASER on the market that uses 4 wavelengths.

 

OUTPUT POWER    Many LASER’s that are used in offices are around 4-15 mW (milli Watts), whereas the LASER that we use is 15,000 mW. That’s over 1,000 times stronger! That’s an even bigger difference than lighting a room with a 4 Watt night-light versus a 100 Watt bulb. I think you get the idea…the 100 Watt bulb is a lot brighter and a lot more powerful than a 4 Watt night-light. With LASER therapy, this high power is necessary, otherwise most of the energy is absorbed before reaching the damaged tissues. Our K-LASER is amongst the highest-powered therapeutic Class IV LASER’s available on the market.

 

ABILITY TO PULSE     Many LASER’s can only deliver continuous light, which means the LASER is always “on.”  Our LASER can pulse and even super-pulse the light. This is like a strobe-light effect, only our K-LASER is so sophisticated, it can pulse anywhere between 1 to 20,000 times per second!  Only the most sophisticated and expensive LASER’s can pulse with that intensity. Pulsing works by delivering the light energy to deeper tissues by sort-of “punching” its way down farther until it reaches the damaged tissues.

 

I hope this educational background helps for those of you who are technically inquisitive. As I always say in the office though, the proof is in the pudding. In other words, come in, try it, and you be the judge…Class IV LASER therapy really is that cool!

Class IV LASER therapy offers powerful therapeutic benefits, all of which occur simultaneously, including:

  • Dramatic pain relief
  • Dramatic acceleration of healing to repair injured areas faster
  • Increased circulation, bringing more oxygen and nutrition to an area
  • Increased cellular reactions (*see paragraph above regarding chromophores)
  • Decreased scar formation and stiffness
  • Non-addictive with no side-effects

Call us today at (804) 254-5765 to see if Class IV LASER therapy can get you back to what you love to do, FASTER!

CPM Therapy Has Withstood The Test-Of-Time For Decades

By | General Health Topics
Personally written by Milan Lassiter, DC, 1303 W. Main St, Richmond, VA, Tel #: (804) 254-5765

 

Continuous passive motion (CPM) is a rehabilitation therapy that’s been around for more than 30 years because it works. The REPEX table in our office is a CPM machine for the low back. It can help when a person has “arthritis,” degenerated/herniated discs in the low back, or just plain stiffness and lack of movement in the low back. It features precise, touch-screen controlled repetitive movements, where exact angles, depth of back and forth movements, speed of treatment, and the total number of repetitions can be controlled.

I was introduced to CPM therapy about 15 years ago without even knowing about it. I was a new chiropractor, just out of school, and I was working for someone. As I remember it, I had an incident of low back pain that was so acute, my boss couldn’t adjust or manipulate my spine. The muscles around the area were locked very tightly. He put me on my back, pulled my knees to my chest, put one hand under my low back and lifted it, and then rocked me back and forth while lifting my low back up and down. After doing that for a while, my muscles were much more relaxed and I felt better with less pain. That is an example of a simple type of CPM. Our REPEX table can do that movement, but do it many more repetitions and also specifically relegate it to the maximum amount of motion that a person’s spine can handle at that given moment in time. It’s all very controllable via a computer interface where you can increase or decrease the range of motion depending on what the person can tolerate.

Passive range of motion moves an area gradually and slowly, without the use of the patient’s muscles. CPM produces a stressless motion by controlling motion in the affected area and moving it passively, without causing additional strain or inflammation.  A common way to produce CPM is to have a machine do all the work and force the area to move within that persons limitations. During rehabilitation, these joints may be too sore or weak to bend on their own. CPM machines are commonly used in the knee, ankle, elbow, or shoulders. Our office has the only machine that specifically produces continuous passive motion in full range of motion (flexion and extension) for the lumbar spine.

 

CPM has been clinically proven to:

Reduce pain and swelling

Prevent joint stiffness

Promote blood and oxygen to a damaged area

Increase range of motion

Prevent scar tissue formation and muscle contractures

Activate muscles so they don’t weaken

 

How does the REPEX treatment work?

The REPEX machine was developed by Robin McKenzie, one of the forefront specialists on spinal conditions in the world. He even has an entire institute named after him, which trains physical therapists and rehab specialists. The exclusive, trade-marked design of the REPEX table was developed by him to address low back disorders using his McKenzie Technique.

Because of pain, fatigue, and other limitations, patients are sometimes unable (or very limited) to repeat exercises to maximum benefit. The REPEX table automatically and passively exercises a patient’s lower back to its full available range of motion (the table does all the work for you until you’re able to do it on your own). The REPEX table can exercise a patients low back with a greater number of repetitions than what is possible using exercises that someone could perform on their own.

 

Do You Neglect This One Simple Health Habit? Beware!

By | General Health Topics
Personally written by Milan Lassiter, DC, 1303 W. Main St, Richmond, VA (804) 254-5765

 

I had a patient who came in last Friday and told me a crazy story about her husband who had a seizure that was so bad, he actually bit his tongue half way off. Right before he had the seizure, he called his wife (my patient) and she detected that something wasn’t right, so she called his father and told him to get over there ASAP. Long story short, if his father hadn’t gone, she said that her husband very well may be dead.

 

You won’t believe why he had the seizure…from dehydration! She said that he doesn’t drink water…ever. The seizure was so bad that he actually caused a few compression fractures to his spine. She also said that their place looked like a murder scene because there was blood all over the place from the tongue.

 

Drinking water is one of the most powerful health improvements that most people can make. Water makes up more than 70% of the body’s tissues and plays key roles in nearly every body function. Drinking water is one of the most important health habits that you can establish and if you don’t get enough, you’ll suffer with bad health consequences.

 

The basic rules are:

 

• Most of what you drink should be water.

• If you drink alcohol, space out drinks by drinking water in-between drinks and drink water before going to bed.

• Avoid drinking tap water because of chemicals.

• Brita filtered water will cost maybe $0.20 per gallon and is well worth the investment.  Filtered tap water is great because there are a lot of minerals in there, but you can still filter out bad things like lead, chlorine, flouride, arsenic, etc.  (One of the problems with bottled water is that minerals have been taken out)

• Don’t buy the one-gallon jugs of water from the grocery store that are in the cloudy or bumpy plastic containers because of PVC plastic, which will transfer chemicals  into the water.

• Never drink water bottles that have been out in the sun, especially bottles that have been left in the car for the same reason.

 

Also important is to avoid ALL sodas and juices.  That includes diet and “zero calorie” sodas, orange juice, and sports and energy drinks.  Coffee and most sodas are loaded with caffeine, which is a diuretic that will dehydrate you even more. Add in all the sugar or high-fructose corn syrup and you have a recipe for worse health and the number one source of calories for all the overweight people in our nation (almost 70% are overweight).

 

You can use 2 things to determine when to drink water:  thirst and color of your urine.  When thirsty, drink filtered water, not Gatorade, lemonade, or iced tea. If it’s hot or dry outside, or if you exercise a lot, you’ll need more water.  As for the color of your urine, it should be a very light pale yellow. A deep, dark yellow means you’re dehydrated, even if you’re not thirsty.

 

As far as sports drinks go, your most healthy choices for replacing electrolytes are (1) fresh coconut water or (2) simply adding a pinch of natural, unprocessed salt to a glass of water and stirring it very fast to create a vortex (like a tornado).  I like sea salt or Himalayan salt as natural salt options. Sodium is the most important electrolyte that you need to replenish after exercise, so I like adding salt to filtered water, but I know that many people won’t be able to handle the taste.

Kinesio Tape…how does that stuff work?

By | Kinesio Taping
Personally written by Milan Lassiter, DC, located at 1303 W. Main St, Richmond, VA, Phone:  (804) 254-5765

 

You may have seen the colorful tape on an athlete in the Olympics or while watching sports on Saturday afternoon. Kinesio Tape can be used to alleviate pain from both chronic or acute injuries.  It’s a cotton therapeutic tape that has no medicine in it, manufactured with a thickness and weight that’s very close to that of skin; that way the brain can be familiar with how it feels, creating the perception that it’s not even there. Kinesio Tape is a stretchable product (it stretches and recoils like a rubber band).

By far, the most common question that I hear regarding Kinesio Tape is: “how does that stuff work?” So here is my synopsis of the basics of how the tape works:

The skin is the body’s largest sensory organ and it’s very flexible, allowing for a good deal of motion. Try pinching and pulling up on the skin on your forearm and you’ll notice how elastic and stretchable the skin is.

A major part of how Kinesio Tape works is by way of sensors that are on and under the skin (sensory receptors). These sensors send information to the sensory part of your brain. Sensory means that it’s picking up (sensing) signals about your environment or your body (ie: the pain that’s caused from a torn muscle).

Depending on if you’re viewing this blog on a computer, tablet, or cell phone, you’ll see a picture of the brain either above or to the right:

 

•  The sensory part of your brain is the light blue area in the illustration 

•  The motor part of your brain is the red area in the illustration 

 

The sensory and motor parts of the brain are directly next to each other; they’re inter-linked and constantly in communication with each other. The motor part is the area of your brain where your body’s muscles are controlled from. There’s a constant feedback loop that’s always happening between the sensory and motor system.

Sensory information causes the brain to send out certain signals to the rest of the body about how to react to particular stimuli. The relationship between the sensory and motor parts of the brain can be illustrated by the example of putting your finger over a candle flame: The sensory receptors on the skin would pick up the burning sensation, transmitting that sensation to the sensory part of the brain. Communication between the sensory and the motor part of the brain would activate motor signals and, without even thinking about it, you’d jerk your hand away from the flame. Through different application methods, Kinesio Tape can affect these sensors that are on and under the skin.  Through manipulation of these sensors, Kinesio Tape can influence and change the healing process.

Another big part of how Kinesio Tape works is via what’s called “convolutions.” This basically means that ripples are created in the tape (and hence to the attached skin), which lowers pressure in the area and causes a decompression of the lymph channels. This allows more space beneath the skin, causing less compression to the sensory nerve receptors under the skin and substantially decreasing information that is sent to the brain regarding how painful and irritated the injured area is.  Kinesio Tape alters the information that these receptors send to the brain and causes a less reactive response in the body, allowing the body to work in a more normal manner and removing some of the roadblocks that normally slows down the healing process.

Although it’s somewhat technical, there are 2 basic application directions for the treatment of muscles:  (1) Origin to Insertion and (2) Insertion to Origin (See examples below):

 

The Insertion to Origin method is used to relax a muscle and relieve some of the tension off of it (inhibiting it). Think of this method as allowing the muscle to “slack” a little bit, thereby allowing less activity or recruitment of the muscle.

Origin to Insertion is used for increasing activation of a muscle (facilitating it). This method is used for a chronically weak muscle and to re-educate a muscle (remind the muscle of what movement it’s supposed to perform). Think of this method as adding a slight assistance to re-train and remind the motor part of the brain what that particular muscle is supposed to do.