The Dangers of Flip-Flops, and How to Avoid Them!

Now that we have passed July the 4th, it's officially summer in Portland! That means we can look forward to more days of sun than rain for a while, and after this year's winter, I think we all deserve some warmer temperatures. The first thing that most people do in these summer months is change their wardrobe to cooler attire, which often means a change of shoes. Time to put away the snow shoes and break out the flip-flops, right? As much as I also enjoy a nice pair of "flops," there are some risk factors to these shoes that you should know about in order to prevent injuries that could sideline your summer plans. Here are a few of the more common flip-flop related injuries that I see in the summer, and this year is no exception. We are going to start at the rear of the foot and move forward and upward. Let's get started!

Heel Injuries

The Problem: Let's face it: flip-flops are lots of fun, but they really don't give a lot of cushioning support to your heels. With heavy walking on hard surfaces such as pavement, that's a lot of heel strikes on to the ground without much to lessen the blow. In some cases, the sole of the flip-flop is so thin that you may as well be barefoot for all the support it's giving you. The biggest risk factor here is irritation of the heel bone (calcaneus) and a risk for a stress fracture of the bone. Stress fractures happen as a result of constant, repetitive stress to a bone that begins to break down the outer layers of bone, eventually forming a small, incomplete fracture line to develop. This can be very painful, and usually gets worse with weight-bearing activity like walking. Treatment usually involves time off your feet and possibly a walking boot, both of which are sure ways to kill your summer fun.

The Solution: Try to wear flip-flops that have a decent amount of rubber in their soles. Inexpensive shoes are often lacking in their level of material, so drop a little extra dough at the shoe store and get a pair that are thick in the heel area. Also, if you know you're headed out for a long hike, wear your normal athletic shoes and save the flip-flops for chilling out afterwards at the pool.

Mid-foot Stress Fractures

The Problem: We already addressed stress fractures in the heel, but this can also happen in the mid-foot in the metatarsal bones. You have five of these bones, and they make up the bulk of the foot from ankle to toes. These bones are long and slender, and don't do well with repeated impact--if you want proof, ask any ballet dancer and they will tell you. The problem with flip-flops is again the issue of sole thickness. Too thin of a sole, and your foot is basically hitting the ground every time you take a step. Eventually, you could develop a stress fracture in this area of the foot. Like heel fractures, treatment usually involves time off your feet and possibly a walking boot. Bye, bye summer.

The Solution: Again, try to find some flip-flops that give good support through the entire sole of the foot. A little extra padding there will go a long way in keeping you moving.

Plantar Fasciitis

The Problem: Across the bottom of your foot runs a thick band of connective tissue called the plantar fascia. It connects your heel to your toes, and helps provide support to your arch. This tissue can be supported by strengthening the muscles of the foot (that's another blog for another day soon) and also by wearing shoes with good arch supports. But many flip-flops have very little contour to their soles, allowing the arch to collapse and the plantar fascia to become stretched and inflamed. Pain under and slightly in front of the heel with weight bearing, especially early in the morning, that slightly decreases over the day but never resolves is the hallmark of this condition called plantar fasciitis. Once this condition comes on, treatment is sometimes complicated and lengthy and will require time off your feet and correct shoes.
The Solution: More and more flip-flop manufacturers are starting to put arch support features in their shoes. Look for those types of flip-flops to help your arches stay up and healthy. You can also do exercises to strengthen your foot muscles, but we will get to that another day.

Hammer-Time!

The Problem: Flip-flops use a simple toggle to keep your foot in the shoe. That requires you to use your toes to grip that toggle with every step which doesn't happen when you wear closed-toe shoes. That repeated gripping can lead to inflammation of the tendons in the toes (usually the second, third, and fourth) that causes the toe to become permanently flexed and pointed downward. This condition is called hammer toe, and can be very painful.
The Solution: The obvious answer is to not wear flip-flops, but come on...it's summer! This condition is not frequently caused by flip-flops but is something you should be aware of if you develop early signs of toe flexion. Choosing open shoes that use straps across the top of the foot rather than a toggle between the first and second toes is also a smart option. If you feel that you're developing this problem, change shoes and/or seek treatment immediately.

The Infection Section

The Problem: Feet are dirty. Don't be offended, but yours are probably no exception. Think about all the stuff you walk across in a day that contacts your shoes. With flip-flops, there is no barrier between your skin and those foreign substances. Bacteria, viruses, fungi--these can all now get direct access to your feet and take advantage of any small open wounds or scratches you may have that allow a point of entry into your body.
The Solution: Washing your feet regularly is always important to prevent this kind of problem from getting a foothold (Sorry; I had to use that pun at some point). Inspect your feet daily as well and address any wounds, scratches, or cuts that you find. Keeping your feet protected and clean will help keep you healthy this summer.

Finally, Shin Splints and Knee Pain

The Problem: Flip-flops can cause problems beyond the foot as well. The overuse of the muscles of the shin to control the foot position in a shoe that offers no structure or support can cause shin splints due to fatigue and inflammation that lead to pain. The lack of arch support also causes the feet to roll in when walking (pronation) which changes the angle of the knee. If your femur (leg bone) and your tibia (shin bone) don't align normally to make the knee joint stable, you risk irritation and injury to the knee. Excessive pronation can also lead to an inner ankle sprain.
The Solution: There are many ways to address these issues. First, always look for the supportive style of flip-flop to give your arches some help. Second, you can be proactive and use a foam roller to reduce the tightness in your shin muscles and your IT bands in order to lessen some of the strain these two muscles can put across the knee.

Dangerous But Not Deadly

Now don't get me wrong: I love flip-flops just as much as the next guy, and I'll never give up my red, white, and blue set for the 4th of July. But I have seen every one of these injuries limp into my clinic at least once during the summer over the years and the common thread has been flip-flops. They're a summer tradition, but there are some risks and warning signs that you should know. But with a smart shoe choice and a little preventative care, you should be ready to rock the summer with your toes in the sun.


If you have any questions or need treatment, you know where to find us. Have a great summer, and be well!


Seth Alley, DC, CCSP
Doctor of Chiropractic
Certified Chiropractic Sports Physician

    

New Year + Small Changes = New Life

So here we are at the start of the second week of 2016! It's a new year now and if you're like most people, you made your New Year's resolutions thinking, "It's time I made some changes around here and got back in shape!" But how are you doing so far in fulfilling those resolutions?

Starting off a new year with plans to improve your health is a common practice; but sadly, a lot of those resolutions are eventually sacrificed as the year progresses. Why? Because a lot of people start off the new year by making HUGE resolutions that are not realistic and often prove daunting once undertaken. Don't believe me? Look at the statistics: The International Health, Racquet & Sports Club Association estimates that 12% of new gym memberships start in January, but 80% of those new members have quit by mid-February. Instead of making sweeping changes that won't last, I suggest some simple small changes you can make every day so that your new year's resolution for health isn't a casualty.

Baby Steps, Baby Steps

Telling yourself that you're going to lose 100 pounds, get six-pack abs, and lower your cholesterol thirty points by March is insane. And when you don't hit those goals, it's depressing. Instead of setting lofty goals that will plague you in the middle of the night and make you obsessed during the day, be realistic. Instead of shooting to lose 30 pounds, aim to lose 5 pounds in a month from now. That's a goal that can be achieved with diet and exercise. If you lose more, congratulations! If you lose less, at least you aren't far from your target and you will stay motivated to keep losing. Take baby steps to get to your goal instead of a massive leap that may actually be dangerous and require unhealthy diet or exercise practices. At a rate of 5 pounds per month, you should be swimsuit-ready by June!

Warm Up, Don't Jump Up

So many people decide that starting in the new year, they are going to jump out of bed and hit the ground running in the morning! Don't. Seriously, don't. Here's why: blood is thixotropic. Don't know that word? Don't feel bad; aside from being a killer point victory on Scrabble, it's not commonly used. It means that a liquid, when left idle, will thicken and congeal until it's stirred and caused to become less viscous. Why does that matter? At night, our heart rate slows so blood moves less rapidly, allowing it to thicken a little. When you jump out of bed and start working out, you're asking your heart to pump a material that is thick and sluggish instead of fluid. This means your heart has to work harder, and your blood pressure will increase due to resistance in the arteries. All of that science means that you increase your risk for heart attack. If you're a morning exercise person, great! Stick with it! But get up and have at least one glass of water and get moving your muscles a little so that the blood will become less thick and easier for your heart to pump before you hit that treadmill.

There Is Strength In Numbers!

That old adage applies to military strategy as well as exercise success. Working out alone can be easier and more convenient if you're at home. But if you're the kind of person that craves socialization (and you know who you are), then get out to the gym and find a class you like. Or call up some neighbors and make a running group! Or cajole your workmates into taking yoga at lunch! For a lot of people, excessing in a group setting lessens anxiety about working out, increases a little friendly competition to push your boundaries, and psychologically obligates you to stick to the routine and keep working out. By not disappointing your workout buddies, you will stick to your goals and satisfy yourself as well.

You Are What You Eat

Now that we are past the days of cookies, snacks, and cocktails, we can get back to a quality diet. That means drop those carbs you don't need, switch to lean meats, increase your fruit and vegetable intake, and have more water than coffee or alcohol during the day. But you can do this in small ways: reduce portion sizes, change your cooking oils to olive oil and not butter, try carrot slices instead of potato chips. Here's a game for you to play: Try to drink at least half of your body weight in ounces during the day. If you succeed, reward yourself with a hot bath or a trip to the bookstore that day. These little changes can go a long way! 

Skip the Detox for Now

A lot of health practitioners will tell you that now is the time to do a cleanse. I disagree, and here is why: It's cold outside. "Duh, it's winter!" you think, and you're right. But detoxification requires a lot of energy on the part of your body to remove toxins from the liver and fat cells. That's energy your body also needs to stay warm this time of year, as well as get you moving on the treadmill or lifting those weights or punching that bag. Whatever you're doing to work out, if you're also trying to detox then you're asking your body to do double-duty and you will be exhausted and grumpy. That means you may end up reducing your immune system's performance and leaving yourself open for sickness, which is the last thing you want. I recommend that you focus on your exercise right now, get yourself into a solid routine, and wait for the spring to detox. By then, you should have access to more fresh vegetables and fruits that will aid in a juice detox or a food-based detox.

Avoid the Scale and the Mirror

Yes, that's what I wrote: avoid them both. A lot of people start an exercise routine and expect magical weight loss overnight. "I did thirty crunches, why don't I look like Brad Pitt?" Weight loss takes time, just like weight gain. The road to better health is not an express lane; it's more of a gradual climb up a mountain to an amazing viewpoint. Looking at the scale or examining yourself in the mirror too early or too frequently can be abusive to your psyche. If the numbers aren't budging or you don't look like Eva Longoria, you may lose inspiration and give up. Don't do that to yourself. Instead, go by how your clothes fit. With diligent persistence in your diet and exercise, you should notice a difference within thirty days or less. Also, unless your scale shows fat percentage and weight, then you're just looking at a total. Which means you could be losing fat and gaining muscle, but your total weight is staying the same. That could frustrate and deter you because you'll think, "All this sweat, and I'm not losing weight!" If the number goes down, you could be losing both fat and muscle, or one and not the other. If the number goes up, you could be adding one or the other. That's why I suggest avoiding the scale for a month and going by how you feel instead. If you have to check that scale, then perhaps now is the year to invest in a better scale that will allow you to know how your numbers (and your body) are shifting.

Be Kind to Yourself

Finally, be kind to yourself. Rome wasn't built in a day. Aim for small goals that are realistic and can be achieved in reasonable time. It will save you frustration and help keep you on track to better health and better future. Remember: It's the steady rain that fills the lake!


As with any change in your diet and exercise, if you have concerns about your health then you should consult your physician before going forward. A physical examination may be necessary before undertaking vigorous exercise, and exercise modification may be needed based upon your injury history or medical conditions. If you need further information or are in need of a physical exam to establish baseline health factors, please contact your physician. The treatment team at Sylvan Chiropractic Clinic and Wellness Center is also always available to assist you in achieving your exercise, diet, health, or weight loss goals in order to maximize your body's potential for performance and longevity. Happy 2016!

doTerra Holiday Joy Essential Oil

Just Released For a Limited Time!
doTerra Holiday Joy Essential Oil

doTerra only offers this essential oil for two months out of the year and this blend is made in limited supply! If you are interested in this perfect holiday aroma to diffuse in your home this season, please order today!

It is the perfect blend of: Siberian Fir, Wild Orange, Clove, Cinnamon Bark, Cassia, Douglas Fir, Nutmeg and Vanilla.

Price ~ $33.00 ~

Remember, this is a limited-time blend and when it's gone ... it's gone. Order yours today! To order:  Please call the office at 503.297.4447 or email billing@sylvanchiropractic.com

Get a Head Start on your Shopping!

The holidays are just around the corner so why not get a head start on your shopping!

doTerra Whisper Blend for Women is the perfect stocking stuffer for the women in your life.

Each essential oil in the blend provides an inviting aroma of its own, but when combined, these oils offer a distinct scent that intrigues the mind and senses to both the wearer and those passing by. Regarded as the most precious flowers in the perfume and aromatherapy industries, Jasmine and Ylang Ylang's euphoric aromas combine with the warm and spicy scents of Patchouli, Vanilla, Cinnamon, and Cocoa to make this blend unmatched in complexity and aromatic influence.

Primary Benefits

• Combines with each individual's chemistry to create a beautiful, unique, and personal fragrance ... it smells different on everyone!
• Provides a warming, musky aroma that entices the senses and intrigues the mind.
• Calms the skin and emotions.

Uses:

• Apply to wrists, back of neck, and pulse points for a distinct and individual fragrance.
• Use three to four drops in the diffuser of your choice.
• Diffuse or add to clay pendants for a unique aromatic experience.
• Dispense one to two drops in the palm of the hand and rub on clothing, scarves, and coats to experience its calming and blissful scent throughout the day.

Ask for it the next time you are at the clinic!

Price: ~ $32.00 ~

Healthy Onion Soup Recipe

This a is a simple onion soup recipe that helps boost the immune system on these wet days and opens up those sinuses. Dr. Alley has been using this family recipe for years, helping everyone from college roommates to current patients stay healthy in the depths of a wet fall and snowy winter. No cheese and bread in this one; just a bowl of health!

 

Ingredients:
~  3 - 4 medium yellow onions, diced
~  6 cups of water
~  1 - 2 tablespoons of chili powder, depending on tolerance
~  Grated ginger can be substituted for chili powder if you prefer
~  A pinch of salt and pepper, to taste

Instructions:
Dice the onions and add to the water, along with the chili powder.
Boil together for 30 - 45 minutes until the onions are soft.
Try NOT to inhale over the pot; the chili powder can be strong!

Dish up a bowl, and enjoy!

Beating the Stress of Tax Season

If you are like most Americans, you probably have only one thing on your mind these days: income taxes. The college basketball brackets have been destroyed by upset wins, spring break has ended for your children, and the weather just hasn't been good enough lately to get out and do some yard work in preparation for sunny days to come. All of this leaves you without distraction, and perhaps your mind frequently drifts towards the upcoming April 15th deadline.

For those lucky few of you out there that have already filed your returns, the middle of April will just be a nice time for you to start planning your summer vacation. But many people are still running around their offices or homes, looking for those missing receipts and wondering how their perfect filing systems didn't quite work out again this year. Trying to balance this added stress with your existing work and home schedules can sometimes prove to be overwhelming, leaving you exhausted at the end of the day. Not only will this added stress effect your mood and energy levels, but it can also lead to more long-lasting negative effects such as increased blood pressure, diminished immune system function, and loss of quality sleep at night.

Here are five simple suggestions for handling this stressful time of year. While these are suggestions that are also ideal for maintaining good health all year, they play an especially important role right now to help you combat the sudden increase in stress that you may be experiencing.

• Exercise: Granted, your free time these days may already be taken up with number-crunching and talking to your accountant. But you don't necessarily have to make it to the gym for an hour to get a little beneficial exercise in your day. Take a walk around your office at lunch, climb the stairs in your building for fifteen minutes, or replace a less-active part of your day (watching television, reading the newspaper, having that cocktail after work) with something that makes you break a sweat. The positive neurological and physiological effects of exercise can help dampen your stress and will help you bring down your blood pressure. 
• Diet: Make sure that you are eating sensibly, with decent portion sizes that place an emphasis on vegetables and lean proteins. And skip the sugar-enriched snacks in favor or fruits or granola that will give you better, more long-lasting energy to use while you plow through your 1099's and W-2's. Also, make sure you are getting plenty of water throughout the day, and try to avoid stimulants like coffee in favor of anti-oxidant beverages like green tea. As tempting as a cocktail may be after hours of deciphering Uncle Sam's paperwork, don't forget that alcohol is technically a depresant and a diuretic--two things that really won't help you stay in tip-top, productive shape. Make sure that you are taking at least a decent multi-vitamin supplement to restore any nutrients that you may be depleting at an accelerated rate due to stress such as Vitamin C.
•  Rest: While you may find it difficult to sleep with figures dancing in your head, regular sleep will restore your body's energy, allow for repair of damaged neurons, and give your immune system a chance to recharge. Sleep deprivation has numerous side effects, none of which will help you conquer the tax monster this season. Most people perform their best with eight to ten hours of sleep at night. If you find yourself having trouble falling asleep, try some calming chamomile tea before bed. Also, I suggest that you refrain from watching television programming that enhances your anxiety (violent dramas or late-night news) and may leave your mind over-stimulated or depressed and therefore unable to fall into the deep sleep cycle necessary for your body's repair and regeneration.
• Verbalize your stress: While it isn't always easy to talk about what's bothering you with your loved ones, try to find a verbal outlet for your stress at this time of the year. Your accountant may be in the same boat as you as far as stress these days, but perhaps a close friend, spouse, or family member could provide a kind ear and a reassuring embrace to bolster your spirits and offer advice. The more you try to contain the stresses in your life, the more acute they become. Everyone gets anxious about taxes this time of year, and I am sure you can find a sympathetic listener among your peers that may even be in need of a little venting as well. 
• Take a time-out: Much like exercise, regular maintenance care of your body during a stressful time can do wonders to relieve your tension, lift your spirits, and restore your positivity. Take time for yourself and see your chiropractor for regular spinal adjustments to support the immune system and relieve stress. See your massage therapist to address any muscle tension you may be feeling. Or you could visit your favorite aesthetician for a relaxing facial. These little gifts to yourself will give you a needed break from your calculator and pen, and help get you through this tax season in good health.

As always, thank you for reading and please feel free to pass this information on to your friends and family if you feel they would benefit. If our clinic can be of service to you in order to help relieve your stress or address any other health concerns, please contact our office at your convenience to schedule an appointment or consultation.

Getting you back on track!
Dr. Seth Alley, DC

The Risks of Vitamin D Deficiency

I am sure that each of you is asking the same question that I have on my mind as I look out the windows of my clinic at the rain: Where is our spring?! It seems like this rain has moved in as a permanent resident, and won't be letting up for some time. In most areas of the country, people are already pulling out swim suits and digging in their bathroom closets for last year's sun screen. But for us, it's still raincoats and umbrellas for another month. Obviously, direct sunlight is in scarce supply here in the Pacific Northwest, and that presents a problem from a physiological standpoint. Aside from being almost impossible to get that natural sun-kissed glow to our skins, we also face a higher-than-normal rate of Vitamin D deficiency.

Vitamin D and your health:

Vitamin D3 (cholecalciferol) There has been a lot of information in the news lately regarding research into Vitamin D and its beneficial effects on the body. Everyone knows that Vitamin D is a key factor in allowing your body to bind calcium into a useful form for bone creation. But you may not realize the other benefits of Vitamin D and the health risks associated with being deficient in this powerful vitamin. Your body uses a few different forms of Vitamin D, but current research indicates that the most important form is Vitamin D3, also known as cholecalciferol. Your body's skin naturally produces this form of the vitamin through exposure to sunlight. However, studies show that only 40% of US adults are receiving adequate sunlight exposure on a daily basis to produce acceptable levels of Vitamin D. In other words, 60% of the adult population in this country is deficient in their Vitamin D levels! You're probably wondering, "Well, why do I care?" That's a good question, since Vitamin D deficiency is not something you would probably notice on a daily basis. However, aside from promoting good bone density, Vitamin D protects your body from numerous other health risks. Here are just a few:  Prevention and treatment of osteoporosis Has been shown to combat depression and Seasonal Affective Disorder (SAD)—two very common conditions in the Northwest in the fall and winter months  Helps prevent and treat certain autoimmune diseases such as rheumatoid arthritis and diabetes type I Bolsters the immune system (something we all need now with the threat of swine flu!), and helps prevent infectious diseases such as tuberculosis Vitamin D deficiency has been linked to autism and multiple sclerosis (MS) The last point in that list is of specific interest to us here in the Northwest, and since March is national multiple sclerosis month. You may not know it, but the Pacific Northwest has the highest level of multiple sclerosis in the country. One theory behind this statistic is the lack of sun exposure for many months in the fall and winter leads to greatly diminished levels of Vitamin D in the body on a yearly basis. Numerous studies have shown that low levels of Vitamin D are associated with a higher risk of MS, and that MS sufferers generally exhibit low levels of Vitamin D. For that reason, it is believed that countries in equatorial regions have a lower level of MS due to the amount of sun exposure creating high levels of Vitamin D—especially early in life.

Increasing your Vitamin D intake with supplements:

Vitamin D is found naturally in oily fish, eggs, and butter, but most patients would rather avoid those foods for reasons of taste and cholesterol content. Your best option to effectively increase your vitamin D intake is through a daily supplement. Experts from universities, research institutes and university hospitals around the world assessed evidence from research and concluded that the public health is best served by a recommendation of higher daily intakes of Vitamin D. Changes such as increased food fortification or increasing the amount of Vitamin D in vitamin supplement products could bring about rapid and important reductions in the morbidity associated with low Vitamin D status, according to the experts. A recent review of the science resulted in the recommendation that the tolerable upper intake level for oral Vitamin D3 should be increased five-fold, from the current tolerable upper intake level in Europe and the U.S. of 2,000 International Units, equivalent to 50 micrograms per day, to 10,000 International Units (250 micrograms) per day. (The American Journal of Clinical Nutrition; March 2007, volume 85, number 3, pages 649-650) If you feel that you may be suffering from a Vitamin D deficiency, our clinic offers an inexpensive means of testing to determine your current level in order to plan an appropriate rate of supplementation. Currently, most Vitamin D supplements available to the public through health stores offer between 1,000 and 2,000 IU's per pill, which means you could end up taking at least five pills a day! There are supplements available that offer a higher dosage per pill, as well as liquid forms of Vitamin D which may be easier for children. If you are interested in beginning supplementation with these types of high-dosage supplements, please contact your doctor or our clinic for evaluation and recommendations. We offer supplements from Thorne, Pharmax, and Standard Process that deliver higher IU's per dosage. Thank you for reading, and please feel free to pass this information on to your friends and family if you feel they would benefit. If you would like to learn more about Vitamin D or have any other health-related questions, please contact our office at your convenience to schedule an appointment or consultation. Getting you back on track! Dr. Seth Alley, DC