Five million dollar randomized controlled trial sponsored by Thrasher Research Fund and NIH
Scientists around the world presented their work at the recent Vitamin D conference in Brugge, Belgium. Many, but not all, of the scientists opined that we have to wait for randomized controlled trials (RCT) before recommending Vitamin D. In a future newsletter, I will review many of these presentations.
However, one was extraordinary. Professor Bruce Hollis presented findings from his and Carol Wagner’s five million dollar Thrasher Research Fund and NIH sponsored randomized controlled trials of about 500 pregnant women. Bruce and Carol’s discoveries are vital for every pregnant woman. Their studies had three arms: 400, 2,000, and 4,000 IU/day.
1. 4,000 IU/day during pregnancy was safe (not a single adverse event) but only resulted in a mean Vitamin D blood level of 27 ng/ml in the newborn infants, indicating to me that 4,000 IU per day during pregnancy is not enough.
2. During pregnancy, 25(OH)D (Vitamin D) levels had a direct influence on activated Vitamin D levels in the mother’s blood, with a minimum Vitamin D level of 40 ng/ml needed for mothers to obtain maximum activated vitamin D levels. (As most pregnant women have Vitamin D levels less than 40 ng/ml, this implies most pregnant women suffer from chronic substrate starvation and cannot make as much activated Vitamin D as their placenta wants to make.)
3. Complications of pregnancy, such as preterm labor, preterm birth, and infection were lowest in women taking 4,000 IU/day, Women taking 2,000 IU per day had more infections than women taking 4,000 IU/day. Women taking 400 IU/day, as exists in prenatal vitamins, had double the pregnancy complications of the women taking 4,000 IU/day.
What does this huge randomized controlled trial mean?
We have long known that blood levels of activated Vitamin D usually rise during very early pregnancy, and some of it crosses the placenta to bathe the fetus, especially the developing fetal brain, in activated vitamin D, before the fetus can make its own. However, we have never known why some pregnant women have much higher activated Vitamin D levels than other women. Now we know; many, in fact most, pregnant women just don’t have enough substrate, the 25(OH)D building block, to make all the activated Vitamin D that their placenta wants to make.
Of course fetal tissues, at some time in their development, acquire the ability to make and regulate their own activated Vitamin D. However, mom’s activated Vitamin D goes up very quickly after conception and supplies it to baby, during that critical window when fetal development is occurring but the baby has yet to acquire the metabolic machinery needed to make its own activated Vitamin D.
The other possibility, that this is too much activated Vitamin D for pregnancy, cannot stand careful scrutiny. First, the amount of activated vitamin D made during pregnancy does not rise after the mother’s 25(OH)D reaches a mean of 40 ng/ml, so the metabolism is controlled. Second, levels above 40 ng/ml are natural, routinely obtained by mothers only a few short decades ago, such as President Barack Obama’s mom probably did, before the sun scare. (President Obama was born in Hawaii in late August before the sun-scare to a mother with little melanin in her skin) Third, higher blood levels of Vitamin D during pregnancy reduce risk of infection and other pregnancy complications, the opposite may be expected if 25(OH)D levels above 40 ng/ml constituted harm.
It is heartening to see the Thrasher Research Fund and NIH support such a large randomized controlled trial. In fact the Thrasher Research Fund has already funded a three year follow up and the NIH request for a follow up grant is pending. Nevertheless, a large number of medical scientists keep saying, “We need even more science before recommending Vitamin D.” What are they really saying?
First they said we need randomized controlled trials (RCT) before we do anything. Well here is a big one. Then they say, as they did in Brugge, “We don’t believe this RCT, we need more money for more RCTs.” If you think about it, they are saying pregnant women should remain Vitamin D deficient until scientists get all the money for all the RCTs they want, which may take another ten years. How many children will be forever damaged in that ten years?
Amazing study just presented at American Heart Association meeting
Dr. Tami Bair and Dr. Heidi May, of the Intermountain Medical Center in Utah, report yet another study showing that your risk of heart attack, stroke, congestive heart failure and death are dramatically increased by Vitamin D deficiency. In a presentation at the American heart Association meeting, they found that people with low levels (< 15 ng/ml) had a 45% increased risk for cardiovascular disease, 78% greater risk of stroke and double the risk for congestive heart failure, not to mention a 77% increased risk of death, compared to people with Vitamin D levels > 30 ng/ml. All that disease and death occurred in only 13 months of follow up for the 27,000 people in the study.
New York Times: Vitamin D Shows Heart Benefits in Study
So how many Americans died this last year from Vitamin D deficiency? Ten thousand? A hundred thousand? More? How many will die next year? Someone is responsible. Medical scientists who want more money before recommending that Vitamin D deficiency be treated have to assume responsibility. I am all for more studies but we have to act now, like we did with cigarettes. Remember, no human randomized controlled trials exist showing cigarettes are dangerous, so we have much more and better science than we did when we warned about smoking. If we fail to act on the dangers of Vitamin D deficiency, someone will end up with blood on their hands.
The Great Disappearing Act
We are currently witnessing one of the great mysteries of the natural world. The H1N1 outbreak is rapidly disappearing, despite a wealth of potential victims without antibodies to the virus, and yes, in spite of plummeting Vitamin D levels. In several weeks, the CDC will announce that perhaps one-third of Americans were infected in the last nine months and now have Swine flu antibodies, leaving the majority of the population still susceptible.
But this H1N1 virus is rapidly refusing the invitation to infect the two-third of Americans who are mostly immunological virgins and will soon recede until the next widespread outbreak, which may come this spring or next fall and winter. When H1N1 returns again, I predict it will cause more illness and death than it did this fall despite the fact it will attack a population with more H1N1 specific antibodies. Measles, another virus thought to transmit via respiratory secretions, would never forego the opportunity to infect so many virgins.
Influenzologists have no idea why this Disappearing Act happens. Dr. Edgar Hope-Simpson believed the reason lay in the mode of transmission; the current outbreak is ending despite a wealth of potential victims because the people transmitting the flu are suddenly no longer contagious. I recommend Hope-Simpson’s book:
The Transmission of Epidemic Influenza (The Language of Science).
I also believe that only a small population was transmitting, not all those infected. If these good transmitters – and not all the sick – usually spread the virus, and their transmission period is limited, the epidemic would end shortly after the good transmitters lose their infectivity. Why they lose their infectivity is yet another mystery, but a mystery that fits the epidemiology of influenza.
Cannell JJ, Zasloff M, Garland CF, Scragg R, Giovannucci E. On the epidemiology of influenza. Virol J. 2008 Feb 25;5:29. Review.
Another incredible Disappearing Act, one that usually follows the introduction of a pandemic virus, is the rapid and usually complete replacement of seasonal flu with the pandemic one. It is as if the pandemic virus murders the seasonal flu. We will have to wait to see if that happens worldwide with this pandemic, but in the USA it has already happened. Last week the CDC reported that more than 99% of all influenza viruses identified in the USA were Swine flu. Only 1 of 1,874 influenza A viruses identified last week was seasonal flu. Where did the seasonal flu virus go?
John Cannell, MD
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Thursday, December 3, 2009
Monday, October 12, 2009
More good news about Vit D supplementation
Older adults with insufficient levels of vitamin D die from heart disease and all-cause death at greater rates than those with adequate levels of the vitamin, according to a recent study.
Also according to a new study, many pregnant women who are supplementing with vitamin D are still presenting as vitamin D deficient. This suggests that current recommendations for D supplementation may be still too low. Vitamin D insufficiency during pregnancy is associated with childhood rickets and longer-term problems including schizophrenia and type 1 diabetes.
And finally, patients on atorvastatin, a drug used to lower cholesterol, who were simultaneously supplemented with vitamin D, demonstrated lower blood serum levels of the drug and its metabolites and yet LDL and total cholesterol levels were also decreased.
Sources:
1. Prospective Study of Serum 25-Hydroxyvitamin D Level, Cardiovascular Disease Mortality, and All-Cause Mortality in Older U.S. Adults
2. Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study
3. Statins and Vitamin D–Conflict or Concord? Prospective Study of Serum 25-Hydroxyvitamin D Level, Cardiovascular Disease Mortality, and All-Cause Mortality in Older U.S. Adults
Also according to a new study, many pregnant women who are supplementing with vitamin D are still presenting as vitamin D deficient. This suggests that current recommendations for D supplementation may be still too low. Vitamin D insufficiency during pregnancy is associated with childhood rickets and longer-term problems including schizophrenia and type 1 diabetes.
And finally, patients on atorvastatin, a drug used to lower cholesterol, who were simultaneously supplemented with vitamin D, demonstrated lower blood serum levels of the drug and its metabolites and yet LDL and total cholesterol levels were also decreased.
Sources:
1. Prospective Study of Serum 25-Hydroxyvitamin D Level, Cardiovascular Disease Mortality, and All-Cause Mortality in Older U.S. Adults
2. Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study
3. Statins and Vitamin D–Conflict or Concord? Prospective Study of Serum 25-Hydroxyvitamin D Level, Cardiovascular Disease Mortality, and All-Cause Mortality in Older U.S. Adults
Tuesday, September 29, 2009
Chronic Pain and the often overlooked glut muscles
Chronic Pain and the Often Overlooked Glut Muscles
Most people look at the abdominal wall when they have chronic low back or pelvic problems. They do endless amounts of crunches and Pilates type movements to strengthen their core. While this does build strength, it doesn’t address an often overlooked group of muscles which includes the external rotators of the hip and the gluteus muscles. For ease, I’ll call them the butt muscles.
When the butt muscles are weak (inhibited) they can cause multiple problems for the musculoskeletal system. Let’s look at the gluteus maximus as an example. This muscle attaches to the outside of your upper leg to a thick band called the iliotibial band. Its other attachment is at the top of your pelvis and to the small pie shaped bone at the base of your spine that forms the foundation of your spine, called the sacrum. It crosses the sacroiliac joint and the hip joint. It’s nearly always involved in sacroiliac pain, lumbar spine pain and hip pain.
You can notice the gluteus maximus muscle working when you walk with a long stride. If you place your hands over the lower portion of your buttocks and walk with a short stride, you will feel very little muscle contraction. Now lengthen your stride and you will feel the muscle contract when you toe off and when your heel strikes the ground. This is actually a good way to keep the muscle strong. Walking in heels prevents long strides and contributes to inhibited butt muscles.
Getting out of a chair or car and climbing stairs are other common uses of the butt muscles. When they are weak, you have to lean forward to shift your weight more over your knees in order to get up.
Why is the strength in these muscles important?
When these muscles are weak there will be a slow lengthening of the sacroiliac ligaments which causes pain and pelvic imbalances that become chronic. If this occurs, there will usually be muscle tightness running up your back even up to the neck muscles.
What are the symptoms of weakness of the butt muscles?
1. Chronic pelvic problems
2. Chronic knee pain
3. Stiffness to the lower back
4. Restriction in neck rotation
5. Difficulty sitting for long periods of time
6. Difficulty getting out of a car or up from a low chair
What can you do about this?
First you have to have your pelvis, hip, foot and thoracic spine tested for any structural imbalance. Then the muscle needs to be tested for its proper function and corrected if it cannot contract properly. Once the muscle is able to function properly, simply walking with long strides may be enough to keep the muscle contracting properly. If this is not enough, then specific exercises can be prescribed to help allow for proper biomechanics of the butt muscles. Unfortunately, all of the machines at the gym don’t take into account the way the butt muscles actually function when walking and they often work the hamstring and low back muscles more than the buttock muscles which leads to further imbalance.
If you have chronic problems or know someone with this type of problem, please talk to me about it. Often treating this group of muscles helps with many problems at once, from the foot to the neck.
As always, your referral is my greatest compliment.
Kevin Colling, D.C. 503-808-9145
¬¬
Most people look at the abdominal wall when they have chronic low back or pelvic problems. They do endless amounts of crunches and Pilates type movements to strengthen their core. While this does build strength, it doesn’t address an often overlooked group of muscles which includes the external rotators of the hip and the gluteus muscles. For ease, I’ll call them the butt muscles.
When the butt muscles are weak (inhibited) they can cause multiple problems for the musculoskeletal system. Let’s look at the gluteus maximus as an example. This muscle attaches to the outside of your upper leg to a thick band called the iliotibial band. Its other attachment is at the top of your pelvis and to the small pie shaped bone at the base of your spine that forms the foundation of your spine, called the sacrum. It crosses the sacroiliac joint and the hip joint. It’s nearly always involved in sacroiliac pain, lumbar spine pain and hip pain.
You can notice the gluteus maximus muscle working when you walk with a long stride. If you place your hands over the lower portion of your buttocks and walk with a short stride, you will feel very little muscle contraction. Now lengthen your stride and you will feel the muscle contract when you toe off and when your heel strikes the ground. This is actually a good way to keep the muscle strong. Walking in heels prevents long strides and contributes to inhibited butt muscles.
Getting out of a chair or car and climbing stairs are other common uses of the butt muscles. When they are weak, you have to lean forward to shift your weight more over your knees in order to get up.
Why is the strength in these muscles important?
When these muscles are weak there will be a slow lengthening of the sacroiliac ligaments which causes pain and pelvic imbalances that become chronic. If this occurs, there will usually be muscle tightness running up your back even up to the neck muscles.
What are the symptoms of weakness of the butt muscles?
1. Chronic pelvic problems
2. Chronic knee pain
3. Stiffness to the lower back
4. Restriction in neck rotation
5. Difficulty sitting for long periods of time
6. Difficulty getting out of a car or up from a low chair
What can you do about this?
First you have to have your pelvis, hip, foot and thoracic spine tested for any structural imbalance. Then the muscle needs to be tested for its proper function and corrected if it cannot contract properly. Once the muscle is able to function properly, simply walking with long strides may be enough to keep the muscle contracting properly. If this is not enough, then specific exercises can be prescribed to help allow for proper biomechanics of the butt muscles. Unfortunately, all of the machines at the gym don’t take into account the way the butt muscles actually function when walking and they often work the hamstring and low back muscles more than the buttock muscles which leads to further imbalance.
If you have chronic problems or know someone with this type of problem, please talk to me about it. Often treating this group of muscles helps with many problems at once, from the foot to the neck.
As always, your referral is my greatest compliment.
Kevin Colling, D.C. 503-808-9145
¬¬
Friday, August 21, 2009
Hips- The Powerhouse to the Entire Body
HIPS
The Powerhouse to the Entire Body
The hips provide power to the entire body. When they are working correctly they are your best friend, but when they are inhibited they quickly become your worst enemy. The hips affect joints as far away as the elbow and the ankle. An improperly functioning hip can easily contribute to low back pain (disc bulges/herniations), knee injuries (ACL, tendonitis), shoulder injuries (impingement, rotator cuff) and elbow injuries (tennis and golfer’s elbow).
The hip joint is a tremendously mobile yet stable joint. It connects the femur (thigh bone) to the pelvis via a deep cup called the acetabulum. It has 17 of the thickest, strongest muscles attached to it and these muscles are held together by fascia which functionally links the hips to pretty much the entire rest of the body. The secret behind the power of the hip is its ability to load and unload in all three planes of motion. This allows the hip to control motion of the kinetic chain. Let’s use the knee as an example of how the hip has an effect down the kinetic chain. Most traditional rehabilitation stresses the quadriceps and the hamstrings, but these muscles really only control knee motion when the knee is flexed close to 90degrees. This excludes them from being the primary stabilizer during everyday activities like walking. The hip muscles, on the other hand, are well designed to control the three dimensional motion of the knee because they are oriented to slow down the motion of internal rotation, adduction and flexion of the knee. This takes tension off the ligaments of the knee (especially the ACL).
Now let’s look at an example of how the hip has effects up the kinetic chain. The hip helps protect the rotator cuff of the shoulder and the ligaments of the elbow. In this case it’s the muscles in the front of the hip that do the work. Namely, the iliopsoas, abdominals and adductors… When I see tennis players with elbow pain in my office, I always examine their hips. This is because they play a significant roll in stabilizing the body for movement. To see how the hips influence the shoulder stand up and take a long step forward with your left leg and then raise your right arm out to the side to shoulder height. Did you feel tension at your hip? This means that the muscles of the front of the hip are loaded and ready to contract. Now sit down and lift your right arm up. Did you feel the same tension? Probably not, because the flexed position of the hip inhibits its ability to contract and properly stabilize the body.
As you can see proper hip function is essential to injury prevention and optimal performance. It is important to keep the hips strong in order to stabilize the rest of the body. But be careful! Not all training exercises are the same. Most of the traditional exercises used to build abdominal and gluteal strength actually inhibit the ability of the hip muscles to contract at the right time. And activities like prolonged sitting actually promote faulty capsular patterns of the hip. Your training program should be unique to your needs and functional goals and should promote both mobility and stability. Whether you are an active or inactive person your hips are a key piece of a pain-free life.
Dr. Colling has extensive training an experience dealing with hip biomechanics. If you would like an evaluation, have an injury or would like advice on how to properly train your hips for optimal performance, please call 503-808-9145.
The Powerhouse to the Entire Body
The hips provide power to the entire body. When they are working correctly they are your best friend, but when they are inhibited they quickly become your worst enemy. The hips affect joints as far away as the elbow and the ankle. An improperly functioning hip can easily contribute to low back pain (disc bulges/herniations), knee injuries (ACL, tendonitis), shoulder injuries (impingement, rotator cuff) and elbow injuries (tennis and golfer’s elbow).
The hip joint is a tremendously mobile yet stable joint. It connects the femur (thigh bone) to the pelvis via a deep cup called the acetabulum. It has 17 of the thickest, strongest muscles attached to it and these muscles are held together by fascia which functionally links the hips to pretty much the entire rest of the body. The secret behind the power of the hip is its ability to load and unload in all three planes of motion. This allows the hip to control motion of the kinetic chain. Let’s use the knee as an example of how the hip has an effect down the kinetic chain. Most traditional rehabilitation stresses the quadriceps and the hamstrings, but these muscles really only control knee motion when the knee is flexed close to 90degrees. This excludes them from being the primary stabilizer during everyday activities like walking. The hip muscles, on the other hand, are well designed to control the three dimensional motion of the knee because they are oriented to slow down the motion of internal rotation, adduction and flexion of the knee. This takes tension off the ligaments of the knee (especially the ACL).
Now let’s look at an example of how the hip has effects up the kinetic chain. The hip helps protect the rotator cuff of the shoulder and the ligaments of the elbow. In this case it’s the muscles in the front of the hip that do the work. Namely, the iliopsoas, abdominals and adductors… When I see tennis players with elbow pain in my office, I always examine their hips. This is because they play a significant roll in stabilizing the body for movement. To see how the hips influence the shoulder stand up and take a long step forward with your left leg and then raise your right arm out to the side to shoulder height. Did you feel tension at your hip? This means that the muscles of the front of the hip are loaded and ready to contract. Now sit down and lift your right arm up. Did you feel the same tension? Probably not, because the flexed position of the hip inhibits its ability to contract and properly stabilize the body.
As you can see proper hip function is essential to injury prevention and optimal performance. It is important to keep the hips strong in order to stabilize the rest of the body. But be careful! Not all training exercises are the same. Most of the traditional exercises used to build abdominal and gluteal strength actually inhibit the ability of the hip muscles to contract at the right time. And activities like prolonged sitting actually promote faulty capsular patterns of the hip. Your training program should be unique to your needs and functional goals and should promote both mobility and stability. Whether you are an active or inactive person your hips are a key piece of a pain-free life.
Dr. Colling has extensive training an experience dealing with hip biomechanics. If you would like an evaluation, have an injury or would like advice on how to properly train your hips for optimal performance, please call 503-808-9145.
Wednesday, August 19, 2009
Chiropractic costeffective and safe
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Media Contacts:
Caitlin Lukacs: (703) 812-0218 | clukacs@acatoday.org
FOR IMMEDIATE RELEASE: August 12, 2009
New Pilot on Quality Shows Cost-Effectiveness of Chiropractic Care for Musculoskeletal Disorders
A new pilot program shows that conservative heath care, including chiropractic, may reduce overall health care costs in patients with musculoskeletal disorders, such as back and neck pain. The pilot, conducted by Wellmark Blue Cross and Blue Shield to measure quality of patient care for its members in Iowa and South Dakota, also shows promising outcomes for the patients choosing chiropractic and other conservative care.
“The cost-effectiveness and safety of chiropractic has been documented in several studies. ACA is pleased that insurance companies are starting to recognize the value that doctors of chiropractic and other conservative providers can offer to their members,” said ACA President Glenn Manceaux, DC. “Especially during the health care reform debate, it’s important that chiropractic and other conservative care methods are taken into serious consideration as a cost-effective alternative to the utilization of expensive surgery and hospital-based care,” he added.
Wellmark conducted the Physical Medicine Pilot on Quality in 2008 for Iowa and South Dakota physical medicine providers. A total of 238 chiropractors, physical therapists and occupational therapists provided care to 5,500 members with musculoskeletal disorders. According to Wellmark, data from participating clinicians show that 89 percent of the patients treated in the pilot reported a greater than 30-percent improvement in 30 days.
The pilot compared data for Wellmark members who received care from doctors of chiropractic or physical therapists with a member population with similar demographics who did not receive such services. The comparison showed that those who received chiropractic care or physical therapy were less likely to have surgery and experienced lower total health care costs, according to Wellmark.
Chiropractic is widely recognized as one of the safest non-invasive therapies available for the treatment of back pain, neck pain, headaches and other neuromusculoskeletal complaints. A significant amount of evidence shows that chiropractic care for certain conditions can be more effective and less costly than traditional medical care. Recent research includes:
* A study published in the October 2005 issue of the Journal of Manipulative and Physiological Therapeutics (JMPT) found that chiropractic and medical care have comparable costs for treating chronic low-back pain, with chiropractic care producing significantly better outcomes.
* A March 2004 study in JMPT found that chiropractic care is more effective than medical care at treating chronic low-back pain in patients’ first year of symptoms.
* A study published in a 2003 edition of the medical journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than do a variety of medications.
The American Chiropractic Association is the nation’s leading chiropractic organization representing more than 15,000 doctors of chiropractic and their patients. To find a chiropractor near you, visit www.acatoday.org.
Chiropractic Symposium and Expo '09
1701 Clarendon Blvd. Arlington, VA 22209 | 703 276 8800 | Copyright © 2009 ACA
Media Contacts:
Caitlin Lukacs: (703) 812-0218 | clukacs@acatoday.org
FOR IMMEDIATE RELEASE: August 12, 2009
New Pilot on Quality Shows Cost-Effectiveness of Chiropractic Care for Musculoskeletal Disorders
A new pilot program shows that conservative heath care, including chiropractic, may reduce overall health care costs in patients with musculoskeletal disorders, such as back and neck pain. The pilot, conducted by Wellmark Blue Cross and Blue Shield to measure quality of patient care for its members in Iowa and South Dakota, also shows promising outcomes for the patients choosing chiropractic and other conservative care.
“The cost-effectiveness and safety of chiropractic has been documented in several studies. ACA is pleased that insurance companies are starting to recognize the value that doctors of chiropractic and other conservative providers can offer to their members,” said ACA President Glenn Manceaux, DC. “Especially during the health care reform debate, it’s important that chiropractic and other conservative care methods are taken into serious consideration as a cost-effective alternative to the utilization of expensive surgery and hospital-based care,” he added.
Wellmark conducted the Physical Medicine Pilot on Quality in 2008 for Iowa and South Dakota physical medicine providers. A total of 238 chiropractors, physical therapists and occupational therapists provided care to 5,500 members with musculoskeletal disorders. According to Wellmark, data from participating clinicians show that 89 percent of the patients treated in the pilot reported a greater than 30-percent improvement in 30 days.
The pilot compared data for Wellmark members who received care from doctors of chiropractic or physical therapists with a member population with similar demographics who did not receive such services. The comparison showed that those who received chiropractic care or physical therapy were less likely to have surgery and experienced lower total health care costs, according to Wellmark.
Chiropractic is widely recognized as one of the safest non-invasive therapies available for the treatment of back pain, neck pain, headaches and other neuromusculoskeletal complaints. A significant amount of evidence shows that chiropractic care for certain conditions can be more effective and less costly than traditional medical care. Recent research includes:
* A study published in the October 2005 issue of the Journal of Manipulative and Physiological Therapeutics (JMPT) found that chiropractic and medical care have comparable costs for treating chronic low-back pain, with chiropractic care producing significantly better outcomes.
* A March 2004 study in JMPT found that chiropractic care is more effective than medical care at treating chronic low-back pain in patients’ first year of symptoms.
* A study published in a 2003 edition of the medical journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than do a variety of medications.
The American Chiropractic Association is the nation’s leading chiropractic organization representing more than 15,000 doctors of chiropractic and their patients. To find a chiropractor near you, visit www.acatoday.org.
Chiropractic Symposium and Expo '09
1701 Clarendon Blvd. Arlington, VA 22209 | 703 276 8800 | Copyright © 2009 ACA
Monday, July 20, 2009
Auto accident safety
I normally talk about functional biomechanics in my posts, but since the summer months entice us into road trips, I wanted to take this opportunity to briefly speak about motor vehicle accidents, how to keep you and your child as safe as you can and how to prevent chronic injury.
Motor vehicle collisions are a major cause of injuries in the United States. They are the leading cause of preventable death in children and they are a leading cause of chronic pain, decreased range of motion and degenerative joint disease (osteoarthritis). What can we do to be safe? Well, there are a number of things we can do to prevent accidents and to minimize an accident’s effect on our body. I’ll mention some of the important ones here:
1. Wear a seatbelt. It’s best worn over your pelvic bones and across your shoulder/chest away from your neck. Seatbelts decrease the risk of injury by 42% without an airbag. (Airbags by themselves are only 12% effective)
2. Child restraints- Use a child seat that has a high rating for safety. Follow instructions for rear facing, forward facing and weight limits and where the straps should lie on the child. Infants and toddlers can easily fly out of the seat if the straps are not on correctly.
3. Booster seats- the only booster seat that improves safety is the high back booster seat. It decreases injury by 70%. Just a booster without the high back is no more effective than a seatbelt alone.
4. Airbags are effective, especially side impact airbags. It’s unfortunate that side airbags are optional, but you should get them if at all possible. Never place your hands or feet on the airbag. Place hands low on the steering wheel. Airbags can cause multiple fractures.
5. Head restraint- Adjust the head restraint to ensure it actually prevents your neck from bending backwards. Many head restraints are positioned too low.
6. ABS- automatic braking systems allow you to steer while you are braking. Look to where you want the car to go not for what you want to miss.
7. Electronic stability control- is an excellent safety option, so buy it if you can. It helps stabilize the car in case of skidding or hydroplaning.
8. SUV’s- because they are a larger vehicle they can provide an advantage over smaller cars, but they are much more likely to be involved in a roll over crash that results in death. SUV’s are less maneuverable so they are in crashes more often. SUV’s are designed to be driven slowly.
9. If you know you are going to be in rear ended by another car, it is best to shrug your shoulders, brake hard, and look at the top of the windshield.
10. Do not drive while text messaging or utilizing a cell phone. Avoid all other distractions.
Hopefully some of these tidbits have been helpful to improve your safety on the road. However, if you are in an accident, it is extremely important to seek care as soon as possible. When a problem is caught early it is much easier to resolve than a problem that has been left untreated for a long period of time. Even low impact, seemingly minor accidents can cause injuries. Research shows that 9% of Americans have chronic neck pain because of an automobile accident. Chronically tight muscles and restricted joints lead to decreased range of motion, painful movement and osteoarthritis. Our joints are designed to move. They have limited vascularity so they depend on motion to bring in nutrients and take away waste products. If a joint doesn’t move properly, it will begin to break down. This leads to arthritis and bone spurs. Seeking high quality care that addresses these issues is critical to full recovery.
I have much more valuable information about auto accident recovery, so if you would like a consultation please feel free to contact me. 503-808-9145.
Motor vehicle collisions are a major cause of injuries in the United States. They are the leading cause of preventable death in children and they are a leading cause of chronic pain, decreased range of motion and degenerative joint disease (osteoarthritis). What can we do to be safe? Well, there are a number of things we can do to prevent accidents and to minimize an accident’s effect on our body. I’ll mention some of the important ones here:
1. Wear a seatbelt. It’s best worn over your pelvic bones and across your shoulder/chest away from your neck. Seatbelts decrease the risk of injury by 42% without an airbag. (Airbags by themselves are only 12% effective)
2. Child restraints- Use a child seat that has a high rating for safety. Follow instructions for rear facing, forward facing and weight limits and where the straps should lie on the child. Infants and toddlers can easily fly out of the seat if the straps are not on correctly.
3. Booster seats- the only booster seat that improves safety is the high back booster seat. It decreases injury by 70%. Just a booster without the high back is no more effective than a seatbelt alone.
4. Airbags are effective, especially side impact airbags. It’s unfortunate that side airbags are optional, but you should get them if at all possible. Never place your hands or feet on the airbag. Place hands low on the steering wheel. Airbags can cause multiple fractures.
5. Head restraint- Adjust the head restraint to ensure it actually prevents your neck from bending backwards. Many head restraints are positioned too low.
6. ABS- automatic braking systems allow you to steer while you are braking. Look to where you want the car to go not for what you want to miss.
7. Electronic stability control- is an excellent safety option, so buy it if you can. It helps stabilize the car in case of skidding or hydroplaning.
8. SUV’s- because they are a larger vehicle they can provide an advantage over smaller cars, but they are much more likely to be involved in a roll over crash that results in death. SUV’s are less maneuverable so they are in crashes more often. SUV’s are designed to be driven slowly.
9. If you know you are going to be in rear ended by another car, it is best to shrug your shoulders, brake hard, and look at the top of the windshield.
10. Do not drive while text messaging or utilizing a cell phone. Avoid all other distractions.
Hopefully some of these tidbits have been helpful to improve your safety on the road. However, if you are in an accident, it is extremely important to seek care as soon as possible. When a problem is caught early it is much easier to resolve than a problem that has been left untreated for a long period of time. Even low impact, seemingly minor accidents can cause injuries. Research shows that 9% of Americans have chronic neck pain because of an automobile accident. Chronically tight muscles and restricted joints lead to decreased range of motion, painful movement and osteoarthritis. Our joints are designed to move. They have limited vascularity so they depend on motion to bring in nutrients and take away waste products. If a joint doesn’t move properly, it will begin to break down. This leads to arthritis and bone spurs. Seeking high quality care that addresses these issues is critical to full recovery.
I have much more valuable information about auto accident recovery, so if you would like a consultation please feel free to contact me. 503-808-9145.
Milk Myth
This is an article from Dr. Mercola that hits a few key points about milk and calcium:
A recent study claims that young adults are not drinking enough milk -- at least according to press reports on the matter. But according to the study’s lead author Nicole Larson, the focus on the study was on calcium.
The words "milk" and "calcium" are often used interchangeably in the popular press. But while milk is a calcium source, no standard other than that of the National Dairy Council considers it the best calcium source.
The suggestion that you need to drink three glasses of the secretion of a cow's mammary glands in order to be healthy is a bit outrageous and doesn't fit the human evolutionary profile. In fact, most humans around the world cannot easily digest cow milk.
Yogurt has more calcium than milk and is easier to digest. Collards and other greens also have about as much or more calcium than milk by the cup. Greens, unlike milk, have the added benefit of vitamin K, also necessary for strong bones. Sesame is also very high in calcium.
When you measure calcium by cup of food product, milk is high on the list. When you view it by calorie, though, milk is at the bottom. A hundred calories of turnip greens have over three times as much calcium as 100 calories of whole milk.
A recent study claims that young adults are not drinking enough milk -- at least according to press reports on the matter. But according to the study’s lead author Nicole Larson, the focus on the study was on calcium.
The words "milk" and "calcium" are often used interchangeably in the popular press. But while milk is a calcium source, no standard other than that of the National Dairy Council considers it the best calcium source.
The suggestion that you need to drink three glasses of the secretion of a cow's mammary glands in order to be healthy is a bit outrageous and doesn't fit the human evolutionary profile. In fact, most humans around the world cannot easily digest cow milk.
Yogurt has more calcium than milk and is easier to digest. Collards and other greens also have about as much or more calcium than milk by the cup. Greens, unlike milk, have the added benefit of vitamin K, also necessary for strong bones. Sesame is also very high in calcium.
When you measure calcium by cup of food product, milk is high on the list. When you view it by calorie, though, milk is at the bottom. A hundred calories of turnip greens have over three times as much calcium as 100 calories of whole milk.
Sunday, June 28, 2009
Low Back Pain - Treatment considerations
The Low Back
The low back (lumbar spine) is perhaps the most dysfunctional and weakest musculoskeletal link in the body. It is one of the leading reasons for visits to the emergency room. And anyone who has had a bout of back pain will tell you it affects everything they do throughout the day. It is active in nearly every functional activity of the body and its proper function is integral to most of our movements in every day life.
Interestingly, the low back is rarely the first to move. If you take a swing in golf, first your arms move, then your upper back, and then your low back moves then hips. If you step forward and bend down to pick something up, first your foot moves then your leg and hip then your sacroiliac joint and then your low back moves. This is a very important point, because the low back relies on proper communication from the rest of the body in order to function properly. Thus, any therapy for low back pain should integrate the rest of the body and promote proper communication between the low back and the upper and lower body.
What does communication to the low back mean? It means the ability to transfer triplane (sagittal, frontal and transverse) motion into triplane stability. The low back is designed to move really well in the front to back motions (sagittal plane); it has some movement in the side to side (frontal plane motion) and very little motion in rotation (transverse plane). The limitation in rotation allows the lumbar spine to be stable enough to transfer rotational motion between the upper and lower body. As a practitioner I consider how the body functions in its transformational zones between two stages of motion. The load and the unload. Loading is the preparation for a movement. The unload is performance of a specific movement. Let’s look at an example.
I recently treated a person who was training for her first marathon that was to take place in 3 weeks. She had been having right low back pain for the last 2 months of her training and had just recently started to get right knee pain and swelling. She was unable to run or even go from sitting to standing without pain.
I started her evaluation by observing her walk. I immediately noticed that she walked on the outside of her right foot, her right foot turned out more than the left and her heel came off the ground early. My next step was to get more specific and see how her right foot moved in all three planes of motion and when she was doing a balance reach exercise she lacked balance in the frontal and transverse planes. In response to this unbalance she said, “I do remember spraining my ankle about a year ago”. Next I assessed her hip function on the TrueStretch which allowed for a stable environment to look at triplane motion. It quickly became evident that she lacked sagittal, and more importantly, transverse plane motion of her right hip. “Yeah, but what does this have to do with my back”, she asked me. Next I set out to re-gain motion in her right ankle and hip by facilitating these motions in a pain-free range of motion and then I followed up with triplane functional lunges to activate some sleeping muscles. Within one and a half weeks, this patient was back to pain-free running.
Although the patient’s original complaint was right low back pain and knee pain, I believe the true cause of pain and dysfunction was rooted in the foot/ankle and hip. Since the low back only has a nominal amount of rotation to begin with, there is not much it can do to compensate for lack of motion in other parts of the body. Therefore those restricted parts of the body must be evaluated and treated in order to have a truly successful and lasting resolution of back pain.
The low back (lumbar spine) is perhaps the most dysfunctional and weakest musculoskeletal link in the body. It is one of the leading reasons for visits to the emergency room. And anyone who has had a bout of back pain will tell you it affects everything they do throughout the day. It is active in nearly every functional activity of the body and its proper function is integral to most of our movements in every day life.
Interestingly, the low back is rarely the first to move. If you take a swing in golf, first your arms move, then your upper back, and then your low back moves then hips. If you step forward and bend down to pick something up, first your foot moves then your leg and hip then your sacroiliac joint and then your low back moves. This is a very important point, because the low back relies on proper communication from the rest of the body in order to function properly. Thus, any therapy for low back pain should integrate the rest of the body and promote proper communication between the low back and the upper and lower body.
What does communication to the low back mean? It means the ability to transfer triplane (sagittal, frontal and transverse) motion into triplane stability. The low back is designed to move really well in the front to back motions (sagittal plane); it has some movement in the side to side (frontal plane motion) and very little motion in rotation (transverse plane). The limitation in rotation allows the lumbar spine to be stable enough to transfer rotational motion between the upper and lower body. As a practitioner I consider how the body functions in its transformational zones between two stages of motion. The load and the unload. Loading is the preparation for a movement. The unload is performance of a specific movement. Let’s look at an example.
I recently treated a person who was training for her first marathon that was to take place in 3 weeks. She had been having right low back pain for the last 2 months of her training and had just recently started to get right knee pain and swelling. She was unable to run or even go from sitting to standing without pain.
I started her evaluation by observing her walk. I immediately noticed that she walked on the outside of her right foot, her right foot turned out more than the left and her heel came off the ground early. My next step was to get more specific and see how her right foot moved in all three planes of motion and when she was doing a balance reach exercise she lacked balance in the frontal and transverse planes. In response to this unbalance she said, “I do remember spraining my ankle about a year ago”. Next I assessed her hip function on the TrueStretch which allowed for a stable environment to look at triplane motion. It quickly became evident that she lacked sagittal, and more importantly, transverse plane motion of her right hip. “Yeah, but what does this have to do with my back”, she asked me. Next I set out to re-gain motion in her right ankle and hip by facilitating these motions in a pain-free range of motion and then I followed up with triplane functional lunges to activate some sleeping muscles. Within one and a half weeks, this patient was back to pain-free running.
Although the patient’s original complaint was right low back pain and knee pain, I believe the true cause of pain and dysfunction was rooted in the foot/ankle and hip. Since the low back only has a nominal amount of rotation to begin with, there is not much it can do to compensate for lack of motion in other parts of the body. Therefore those restricted parts of the body must be evaluated and treated in order to have a truly successful and lasting resolution of back pain.
Wednesday, May 20, 2009
Knee pain
When I think about injuries that happen to the knee it reminds me of a quote that most of us used in our childhood. “It’s not my fault, they made me do it” Although injuries to the ACL, MCL, collateral ligaments and patellar tendon are well known, it is not as well known why they occur. Yes, it’s easy to deduce that when a 280lbs linebacker lands on the back of your knee and you hear a pop that that is what tore your ACL, but most ACL injuries and other knee injuries are not the result of one specific trauma. The knee is stuck between the foot and the hip and it can only react to what happens above it and below it. The motion of the foot dictates the motion of the tibia and fibula (the lower bones of the knee) and the hip joint motion dictates the motion at the femur (the upper bone of the knee).
Most knee injuries are the result of repetitive micro-trauma’s usually involving foot and hip joint dysfunction. As I described in the last newsletter, the heel must properly dorsiflex, and move down and in (pronate) to allow the tibia to rotate medially. If this motion does not happen properly then the muscles up the kinetic chain are not stimulated to contract and without muscular support, the ligaments of the knee must take on more of the load. Over time this can lead to a tear. Similarly, the hip joint motion must be within normal limits to have proper knee function. When the foot strikes the ground the hip should flex, internally rotate and adduct. This motion lengthens the powerful muscles of the buttock stimulating them to contract in order to stabilize the knee and then bring the tibia out of internal rotation and into external rotation. Like problems with the foot, problems with hip can cause the ligaments and tendons of the knee to take on extra loads which can cause tears.
The good thing about knee injuries is that if you can identify the area of greatest restriction or greatest mobility you can address the true cause of the pain. Dr. Colling has a series of functional diagnostic tests and treatments which are specifically designed to identify the body’s true area of weakness. He can provide effective treatment and exercise protocol’s to help prevent knee pain and to help recover from major knee injuries. It is interesting to note that, often knee pain issues can be treated successfully without treating the knee itself. So in many cases of knee pain, “it is not the knee’s fault, something else did make it hurt.”
Most knee injuries are the result of repetitive micro-trauma’s usually involving foot and hip joint dysfunction. As I described in the last newsletter, the heel must properly dorsiflex, and move down and in (pronate) to allow the tibia to rotate medially. If this motion does not happen properly then the muscles up the kinetic chain are not stimulated to contract and without muscular support, the ligaments of the knee must take on more of the load. Over time this can lead to a tear. Similarly, the hip joint motion must be within normal limits to have proper knee function. When the foot strikes the ground the hip should flex, internally rotate and adduct. This motion lengthens the powerful muscles of the buttock stimulating them to contract in order to stabilize the knee and then bring the tibia out of internal rotation and into external rotation. Like problems with the foot, problems with hip can cause the ligaments and tendons of the knee to take on extra loads which can cause tears.
The good thing about knee injuries is that if you can identify the area of greatest restriction or greatest mobility you can address the true cause of the pain. Dr. Colling has a series of functional diagnostic tests and treatments which are specifically designed to identify the body’s true area of weakness. He can provide effective treatment and exercise protocol’s to help prevent knee pain and to help recover from major knee injuries. It is interesting to note that, often knee pain issues can be treated successfully without treating the knee itself. So in many cases of knee pain, “it is not the knee’s fault, something else did make it hurt.”
Monday, April 27, 2009
Preventing injuries by improving foot function
As spring is becoming more evident, many of us are starting to venture outside more often. If you plan to start a new workout program or simply move your current workout from the treadmill to the trails you should be aware of proper foot mechanics.Outdoor surfaces can be uneven, too hard, too soft, too bumpy and unpredictable.Your foot needs to be able to adapt to all of these changes.
As your heel strikes the ground it needs to move down and in (pronate) to unlock the foot joints and make the foot a flexible adaptor so it can react to uneven surfaces.When the heel is about to come off the ground the joints of the foot should lock so your foot has something rigid to propel off of. If these things don’t happen you could be setting yourself up for an injury.When the foot pronates too much or for too long it puts more stress on the fascia of the bottom of the foot which can lead to plantar fascitis, tendonitis, bunions, and other foot pain and tingling symptoms.If the foot does not pronate enough it won’t absorb shock like it should which could lead to metatarsalgia and stress fractures of the foot and leg.
In addition, the motion of the heel bone allows the lower leg to internally rotate which allows the upper leg to internally rotate and allows for several other reactions up the chain. This internal rotation of the leg "turns on" or stimulates the powerful butt muscles to contract which in turn slows down the internal rotation and eventually moves the leg into external rotation for proper lift "off".
This is a very important concept that must be addressed with all foot/leg/ and spine injuries. If it is not addressed many injuries will heal improperly or you will be set up for the same injuries over and over again.
So as you are outside enjoying a spring workout and enjoying the spring foliage pay special attention to your feet and thank them for working properly.If you feel that your feet need some help, remember that I am here for you.
Kevin Colling, DC
As your heel strikes the ground it needs to move down and in (pronate) to unlock the foot joints and make the foot a flexible adaptor so it can react to uneven surfaces.When the heel is about to come off the ground the joints of the foot should lock so your foot has something rigid to propel off of. If these things don’t happen you could be setting yourself up for an injury.When the foot pronates too much or for too long it puts more stress on the fascia of the bottom of the foot which can lead to plantar fascitis, tendonitis, bunions, and other foot pain and tingling symptoms.If the foot does not pronate enough it won’t absorb shock like it should which could lead to metatarsalgia and stress fractures of the foot and leg.
In addition, the motion of the heel bone allows the lower leg to internally rotate which allows the upper leg to internally rotate and allows for several other reactions up the chain. This internal rotation of the leg "turns on" or stimulates the powerful butt muscles to contract which in turn slows down the internal rotation and eventually moves the leg into external rotation for proper lift "off".
This is a very important concept that must be addressed with all foot/leg/ and spine injuries. If it is not addressed many injuries will heal improperly or you will be set up for the same injuries over and over again.
So as you are outside enjoying a spring workout and enjoying the spring foliage pay special attention to your feet and thank them for working properly.If you feel that your feet need some help, remember that I am here for you.
Kevin Colling, DC
Friday, April 17, 2009
Body Mind Spirit Expo
Dr. Colling will be hosting a booth with the Vital Health and Wellness crew at the Body Mind Spirit Expo this weekend. Please stop by to say hi and chat about functional biomechanics.
Where: Oregon convention center 777 NE MLK Blvd Hall A
When: Sat 10-7, Sun 11-6
Thanks,
Kevin Colling, D.C.
Where: Oregon convention center 777 NE MLK Blvd Hall A
When: Sat 10-7, Sun 11-6
Thanks,
Kevin Colling, D.C.
Monday, March 16, 2009
How to prevent Bunions
There are many factors that can lead to the formation of a bunion. I believe the most significant is Wolf's law which says that bone will grow where ever the most force is applied. In this case an abnormal amount of force is applied to the big toe joint causing the body to react by laying down more bone.
The abnormal force is typically created when the gastroc/soleus (calf muscles) are so tight that the person can't properly bend their ankle (dorsiflex). To make up for the lack of dorsiflexion the body turns the toe out as the foot is planted, which moves the forces of walking over the inside of the big toe rather than spreading the forces out over the rest of the foot.
Proper stretching of the calves and hip in all three planes of motion can help prevent toeing out during walking and thus can help prevent the formation of bunions.
Another simple way to help prevent bunions is to avoid wearing heeled shoes. The higher the heel the worse it is for your feet. High heel shoes place your foot in an unnatural plantar flexed position and places abnormally high stresses on the inside of the big toe.
Dr. Colling can assess the factors described above in addition to many more factors that lead to bunions. Many times bunion pain and progression of bunions can be averted with proper evaluation and treatment.
Cheers!
Kevin Colling, DC
The abnormal force is typically created when the gastroc/soleus (calf muscles) are so tight that the person can't properly bend their ankle (dorsiflex). To make up for the lack of dorsiflexion the body turns the toe out as the foot is planted, which moves the forces of walking over the inside of the big toe rather than spreading the forces out over the rest of the foot.
Proper stretching of the calves and hip in all three planes of motion can help prevent toeing out during walking and thus can help prevent the formation of bunions.
Another simple way to help prevent bunions is to avoid wearing heeled shoes. The higher the heel the worse it is for your feet. High heel shoes place your foot in an unnatural plantar flexed position and places abnormally high stresses on the inside of the big toe.
Dr. Colling can assess the factors described above in addition to many more factors that lead to bunions. Many times bunion pain and progression of bunions can be averted with proper evaluation and treatment.
Cheers!
Kevin Colling, DC
Wednesday, February 11, 2009
Evolution of Darwin's theory
The evolution of Darwin's theory
AFP / Getty Images
Charles Darwin
200 years after his birth, scientists are analyzing DNA in an effort to keep pace with increasingly rapid changes among humans and solve the mysteries behind blue eyes and our other differences.
Blue eyes are typically associated with beauty, or perhaps Frank Sinatra. But to University of Wisconsin anthropologist John Hawks, they represent an evolutionary mystery.
For nearly all of human history, everyone in the world had brown eyes. Then, between 6,000 and 10,000 years ago, the first blue-eyed baby was born somewhere near the Black Sea.
For nearly all of human history, everyone in the world had brown eyes. Then, between 6,000 and 10,000 years ago, the first blue-eyed baby was born somewhere near the Black Sea.
For some reason, that baby's descendants gained a 5% evolutionary advantage over their brown-eyed competitors, and today the number of people with blue eyes tops half a billion.
"What does it mean?" asked Hawks, who studies the forces that have shaped the human species for the last 6 million years.
Nobody knows. It is one of the questions about evolution that persist 200 years after the birth of Charles Darwin, whose birthday will be celebrated worldwide Thursday.
Darwin amassed a lifetime of observations on plants and animals to famously conclude that all life on Earth evolved from simple organisms through a painstakingly slow process of tiny random changes and a continuous contest for survival of the fittest."What does it mean?" asked Hawks, who studies the forces that have shaped the human species for the last 6 million years.
Nobody knows. It is one of the questions about evolution that persist 200 years after the birth of Charles Darwin, whose birthday will be celebrated worldwide Thursday.
Though Darwin published his masterwork, "On the Origin of Species," 150 years ago and died in 1882, studies on evolution continue apace. Much of that effort focuses on the species Darwin considered the pinnacle of the evolutionary process: Homo sapiens.
Until recently, conventional wisdom held that human beings had mastered their environment so thoroughly that the imperative to evolve in many ways diminished about 10,000 years ago, when agriculture gave rise to more-stable societies.
"People thought that with technology and culture, there'd be no reason for physical things to make any difference," said Milford Wolpoff, a paleoanthropologist at the University of Michigan. "If you can ride a horse, it doesn't matter if you can run fast."
That turned out to be wrong. As it happens, the pace of evolution has been speeding up -- not slowing down -- in the 40,000 years since our ancestors fanned out from Ethiopia to populate the globe.
And in the 5,000 to 10,000 years since agriculture triggered the growth of large societies, the pace has accelerated to 100 times historical levels.
"When there's more people, there are more mutations," Wolpoff said. "And when there are more mutations, there's more selection."
Hawks and other scientists quantified this in late 2007 by comparing more than 3 million genetic variants in the DNA of 269 people of African, European, Asian and Native American descent. They created sophisticated computer models to scour the genome for telltale patterns signaling recent adoption of favorable genes.
Their methods rely on the fact that new mutations are not inherited alone, but are passed along in large DNA chunks. Over time, random changes make those chunks smaller. By comparing the length of those chunks in different people, scientists can estimate how long the beneficial mutation has been spreading through the gene pool.
The analysis turned up about 1,800 genes -- 7% of the genome -- that have been widely adopted in the last 40,000 years. Researchers using more conservative methods estimate the number at 300 to 500.
The function of most genes is unknown. The scientists identified 17 genes for the hair cells involved in hearing, which may have been favored by natural selection because they help people identify voices or speak tonal languages such as Mandarin.
And they found a number of genes involved in brain development, including a version of a dopamine receptor gene called DRD4 that is sweeping through the European population. Some think it is a novelty-seeking variant, others that it affects libido. What they do know is that having two copies increases the odds of having attention-deficit hyperactivity disorder.
Among the genes whose purpose is understood, the biggest category is devoted to fighting infectious diseases. For instance, the researchers found more than a dozen new genetic variants involved in fighting malaria to be spreading rapidly among Africans.
Scientists had previously identified several mutations that offered protection against the disease. Most were shared by people of African descent, because the scourge is most widespread on that continent. But malaria afflicts people throughout the tropics and subtropics, and additional mutations to combat the disease arose in Thailand and New Guinea, Hawks said.
One of the newly discovered mutations helps defend against a form of the disease in which malaria parasites congregate in blood cells in the placenta, causing a high rate of miscarriage.Diet is another big force behind recent human evolution. As humans made the transition from being hunter-gatherers to farmers, their bodies had to adapt to new kinds of foods.
The best-known example involves the gene that regulates a person's ability to make an enzyme required to digest lactose, the sugar in milk. Historically, the LCT gene shut down in early childhood as babies were weaned off breast milk. But after cows, sheep and goats were domesticated, people with a mutation that allowed them to drink milk as adults had a nutritional advantage that made it easier for them to propagate their genes.
Foot Function
The heel is the key that turns on the machine. At heel strike the calcaneous (heel bone) must dorsiflex, evert and externally rotate in order to allow the rest of the leg and body to properly react. The motion of the heel bone allows the lower leg to internally rotate then the upper leg to internally rotate and allows for several other reactions up the chain. This internal rotation of the leg "turns on" or stimulates the powerful butt muscles to contract which in turn slows down the internal rotation and eventually moves the leg into external rotation for proper lift "off"
This is a very important concept that must be addressed with all foot/leg/ and spine injuries. If it is not addressed many injuries will heal improperly or the person will be set up for the same injuries over and over again.
It's know coincidence that the term "Achilles Heel" is so well known. Proper heel function is essential for proper walking and running biomechanics.
Kevin Colling, DC
This is a very important concept that must be addressed with all foot/leg/ and spine injuries. If it is not addressed many injuries will heal improperly or the person will be set up for the same injuries over and over again.
It's know coincidence that the term "Achilles Heel" is so well known. Proper heel function is essential for proper walking and running biomechanics.
Kevin Colling, DC
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