Ask the Chiropractor: Part 1
Q: What can I expect during an appointment?
A: During your first appointment, it is a chance for you to tell your story. Usually, we begin with a focused history about your current concerns or aches and pains, and then proceed to a general health history, where we begin to put the big picture together. From there, we move into a physical and orthopaedic examination. Using range of motion, palpation, and specific orthopaedic testing, we dig deeper, looking for the root cause of your problem. Once all testing is finished, we go over the findings, and how this relates to you. I then suggest various forms of treatment based off the guidelines (research) and patient preferences and we come up with the best plan that works for your goals and values. Finally, we finish the appointment with your first treatment! This can include anything and everything from adjustments, joint mobilization, soft tissue therapy, muscle release, rehabilitation exercise (Pilates, FRC, PBT), laser therapy, medical acupuncture, electrical stimulation, taping, and custom orthotics. From there, follow-up appointments are usually shorter, and more focussed on the treatment (including active care). You are always in control of what your treatment looks like, and how we spend our time together during follow up appointments!
Q: Tips for using a foam roller effectively? Are foam rollers a good tool?
A: Rolling out can mobilize your soft tissues, leading to some lengthening (typically more short term). If we look at the Meta-Analysis from 2019, “pre-rolling resulted in a small improvement in sprint performance and flexibility, whereas the effect on jump performance and strength performance was negligible” (1). The same study also looked at post-rolling and found that it “slightly attenuated post-exercise induced decreases in sprint and strength performance” (1). It also reduced muscle-pain perception, but had trivial changes on jump performance. Taking that research into consideration, I would say roll out pre or post-performance if you are looking to mobilize your tissue and potentially feel less pain after dancing. I may also swap out the foam roller for the Lacrosse ball. Although a foam roller does provide a broad contact surface, making rolling a bit more comfortable, I find dancers rolling out their iliotibial band most frequently. Rolling out your tight IT band does not address the root cause of your tightness, and often garners minimal results. Your IT band is STRONG! The chances of you getting tissue change simply from rolling your IT band are negligible. Instead, I suggest using a ball to pin the muscle you are trying to stretch and then, following anatomy, actively lengthening that pinned muscle. This approach will get better results and is more inline with what I’ve seen with dancers in my clinical experience. If you need help executing a pin and stretch like this, consult your local Chiropractor!
Q: What is happening when hips tighten from sitting too much and what can be done to counteract this?
A: When we are sitting and experiencing hip stiffness when we get up to move, this could be happening for a few reasons. One reason can be a phenomenon known as gelling. This occurs when a joint has some arthritis (inflammation) and most frequently comes on when trying to move after a long period of rest (ie. sleeping or sitting for long periods). The other main cause of hip stiffness from sitting could be from the hip flexors. When we sit with our hips flexed at 90 degrees, our flexors are in a shortened position while their antagonistic musculature is in a stretched position. When we stand up after sitting for prolonged periods, we feel those changes in tissue length. To counter both of these, I suggest you get up from your sitting position for 10 minutes every hour you are sitting to move, stretch, and improve circulation. Nothing like a mid-day battement en clôche to keep your hips happy and healthy!
Reference List:
Wiewelhove T, Döweling A, Schneider C, Hottenrott L, Meyer T, Kellmann M, Pfeiffer M, Ferrauti A. A meta-analysis of the effects of foam rolling on performance and recovery. Frontiers in physiology. 2019 Apr 9;10:376.
