Sleep is essential for every living being. Resting during the night is imperative to help the body recover from the day’s activities. On average, humans sleep 6-8 hours everyday- spending approximately 2,820 hours a year sleeping in a bed!

Most neck and back pain caused by poor sleeping habits is the result of an improper sleeping position, type of bed or pillow used. There are various sleeping positions that can provide better overall alignment for your spine which decreases the chances of waking up to pain in the morning.

A general rule to follow is you want your spine in a neutral position. To achieve this, the best position for sleeping is on your back. Sleeping on your back allows your head, neck and spine to maintain a neutral position. While sleeping on your back, you should place a pillow under your knees or a rolled towel under the small curvature of your lower back to maintain the spine’s general curve.

Sleeping on your side is another good sleep position, which complements the natural curvature of the spine while keeping the spine elongated. As it turns out, sleeping on your side is the most popular sleeping position. According to a nationwide survey of more than 2,000 people by Tempur-pedic, 57% of people start in this position. While sleeping in the side position, it is ideal to keep your knees slightly bent and a pillow between your legs. This position will reduce stress on the hips. In addition, if you have shoulder pain, be sure to avoid sleep on the side with the painful shoulder, as this this will aggravate the injured area. Keeping your arms in front of you and not under your head or pillow will prevent your hands from going numb from nerve irritation and reduce the stress on your neck and shoulder.

Laying on your stomach is the worst sleeping position for your back and neck. Sleeping on your stomach creates the most strain and pressure against curvature of your neck and lower back. As it flattens the natural curve of the spine, lower back pain can result.

Ideally, you want to find a sleeping position where your joints are not being excessively compressed or muscles are placed in an abnormally shortened or stretched position. Consistently compressing the body on one side over time can create a postural imbalance and result in soreness or pain in an area.

It is important to choose a mattress that is most suited for your body. Ideally, you should purchase a new mattress every seven to ten years. Choosing to sleep on a mattress that is comfortable for you with the least amount of pressure or compression can allow you to fall asleep faster, stay asleep, and get an overall restful nights sleep.

According to the Department of Motor Vehicles, approximately 10.8 million car accidents occur each year. Getting into a car accident can be physically and mentally stressful for the body.  An accident does not only affect your neck and lower back, it also results in whiplash, headaches, shoulder, jaw pain and post concussion symptoms. It’s very important to understand how your body can be affected after a motor vehicle accident and the steps you can take to make sure you can be as healthy as you can be after the accident.

One of the most common symptoms associated with whiplash is neck pain.

The forceful impact of a car accident can cause tearing or stretching of the soft tissues which hold the spine together. This form of ‘shear’ force can cause an unnatural movement of the spine and may result in damage to the ligaments in the neck. Recent studies from the American Journal of Physical Medicine and Rehabilitation have also shown that force resulting from motor vehicle accidents is also applied significantly to the lumbar (lower back) region. It is also common for health care practitioners to see reports of whiplash patients experiencing TMJ pain.

Often times, symptoms do not present immediately after the collision and can be delayed for weeks or even months. Because of this, it is very important to consult a medical professional on your condition following a motor vehicle accident. Chiropractic care is one of the few modalities used to help fix motor-vehicle accident induced injuries, such as whiplash.

One of San Francisco’s premier personal injury attorneys, Al Stoll, witnesses dozens of victims of motor vehicle accident trauma each day with lingering symptoms. “The biggest problem I see post MVA clients is letting the pain lead to guarding, deconditioning, and loss of strength, which all lead to more pain and further disability,” Al says. “In my experience, seeing a chiropractor as soon as possible post accident allows an injured person to resume their normal and pain free routine faster and also helps prevent the body entering a commonly seen downward spiral towards chronic pain.”

Studies have shown that exercises and various stretches of the neck can be used as an adjunct with chiropractic care to effectively reduce subjective pain and disability, while strengthening surrounding muscles.

We are extremely excited to welcome the addition of new chiropractor, Dr. Anthony Gustin onto the SF Custom Chiropractic team! Dr. Gustin is a graduate from the University of Western States in Portland Oregon and will be working along side Dr. Jacobs to help treat patients with chiropractic care. In addition to his Doctorate of Chiropractic degree, Dr. Gustin has also received a Masters of Science in Exercise and Sports Science. Dr. Gustin’s M.S degree is a great addition to help patients quickly return to a pain free lifestyle following sports injuries through an individualized exercise and rehabilitation program as well as state-of-the-art functional movement analysis, taping techniques, and nutritional consultations.

To know more about Dr. Anthony Gustin, here is a brief Q&A.

Fast Growing San Francisco Chiropractic Clinic Welcomes Addition of New Chiropractor Dr. Anthony Gustin

Where did you grow up?
I grew up in the midwest in cold, snowy rural Minnesota. I then headed next door for the University of Wisconsin for my undergraduate work in Human Biology.

What drew you to chiropractic care?
After a football injury in high school I was left with no choice but surgery. This was until I discovered chiropractic and the world of conservative care. It was my first experience of dealing with health care that addressed the “why” and root of the problem and how to safely, non invasively, and cost-effectively manage various types of injuries instead of the quick fix. Needless to say, I was immediately hooked and knew I wanted to have the same impact on others.

Do you have any tips for workers to help prevent back pain?
The best thing to prevent back pain is to consult with a trained professional regarding their current ergonomic set up and to see where they need to make improvements in their work environment and current posture.

How do you manage stress?
There’s nothing better at managing stress for me than working up a sweat. Exercise doesn’t only make you look and feel more physically fit, it also helps release the “feel good” neurotransmitters in your brain that help fight chronic fatigue, depression and stress.

What activities do you enjoy doing for fun?
Living in the Pacific Northwest for almost four years left me with quite the addiction for the outdoors. Whether that involves mountain biking, hiking, camping, surfing or snowboarding, I’m glad to know that the Bay Area features some of the best of everything.

What is your favorite book?
School unfortunately left me in the habit of being a nerd. I’m continuously restocking my bookshelves with the newest literature on treatment techniques, nutrition, exercise and functional movements/training.

What do you like about the Bay Area so far?
The weather here has been absolutely phenomenal since I’ve been here. There is never a lack of excitement in the Bay Area and it has more to offer than anywhere else I’ve ever been. I could not be more excited to start exploring in my new home! Additionally, the people are extremely kind and welcoming, quickly helping me feel at home.

What are you most excited about working here at SF Custom Chiropractic?

The most exciting part about SF Custom Chiropractic is all of the involvement in the wonderful community of San Francisco. Working alongside Dr. Adam Jacobs provides me with the opportunity to learn from one of the best providers in health care in the Bay Area.

The Functional Movement Screen test is one of the many services we provide for patients to attain their optimum function. This October is dedicated to National Chiropractic Health Month. The American  Chiropractic Association has deemed the theme, ‘Find Your Game’.  ’Finding your Game’ means to achieve optimum function at any level of fitness, age or weight. Check out our recent press release on: National Chiropractic Health Month and ways to achieve optimum function.

1)   Forward Neck Flexion:
Stand or sit with your shoulders directly over your hips. Reach with both arms and clasp your hands behind  your neck.
Relax muscles of your neck and allow your arms to pull your head down toward the chest.
Hold this stretch for 15 seconds and relax

2)   Ear to Shoulder stretch
Sit or chair on the chair with a good erect posture.
Tilt your head as you bring the right ear towards the right shoulder
Raise your right arm to hold and assist the stretch.
Hold the stretch for 15 seconds and relax.
** If you would like an additional stretch, place the opposite hand behind you to help stretch out the trapezius muscle**
Repeat with the left side.

3)   Chin to Chest Stretch
Sit or stand with good posture
Turn head so chin is halfway towards the right shoulder
Slowly curl the head forward to bring the chin to the right chest
Place the right hand on top of the head, assist stretch and hold
Hold the stretch for 15 seconds and relax
Repeat on left side
This stretch will help stretch out your levator scapulae, which is a muscle in your neck that is often tense.

4)   Neck Extension:
Sit or stand with good posture
Slowly let your head tip backwards and let gravity assist the stretch and hold for 15 seconds
Return to starting position

3)      Exercise: Stress can build up in your body overtime. One effective way to get stress out of the body is with exercise. Exercise can help release endorphins, which are neurotransmitters that can help boost your mood. With daily movement and physical activity, you may find that this focus on a single task can help you remain calm and give you a sense of command over your body and your life.

4)      Get a chiropractic adjustment and  a massage: For those who are under chronic stress, receiving a deep tissue massage can help relieve tension in your muscles by breaking down adhesions and restoring movement. . Whether you receive an hour and a half massage or a quick rub down on your shoulders and back, it’s highly beneficial to reduce your cortisol levels.  While getting your body realigned can take pressure off your nervous system making you better able to deal with life’s stressors

5)      Get adequate sleep and a healthy diet: As simple as it may sound, getting a minimum of 6-8 hours a day and having a healthy diet of fruits and vegetables can significantly improve your lifestyle and your mood. When eating lunch, it’s important to be able to eat lunch without being in a hurry. Instead of shoving food into your mouth, be sure to take the time to enjoy your lunch and relax while spending time with friends and family.

By following these simple tips, you will notice a difference in your life, especially at your workplace.

One of the best ways to prevent low back pain or a disc herniation is to help stabilize the muscle core. Often times, low back pain is experienced because the muscles in the back are over compensating for the abdominal muscles. Strengthening the abdominals and obliques can help stabilize the core which will support the low back.

Here are some exercises for you to help strengthen the core. If you happen to experience any form of pain from any of these exercises, stop and be sure to consult a medical professional.

1)      Plank:

The plank is a great exercise to help build endurance in both the abs and the back ,as well as building strength for pushups.
a.       Lie face down on the mat resting on the forearms, palms flat on the floor
b.      Push off the floor, raising up onto toes and resting on the elbows
c.       Keep your back flat in a straight line from head to heels. If you experience shaking or moving, be sure to stop and relax before repeating the plank form.
d.      Tilt your pelvis and contract your abdominals to prevent your rear end from sticking up or sagging in the middle
e.      Hold for 30 seconds to a minute.

2)   Side Plank

a.       Lay on one side on the mat.

b.      Place forearm on mat under the shoulder perpendicular to the body.

c.       Place the upper leg directly on top of the lower leg and straighten the knees and hips.

d.      Raise the body upwards by straightening out the waist so the body is ridged.

e.      Hold the position for 30 seconds and repeat on the opposite side.

f.        If you like to be challenged, you can make dips with the arm or the pelvis while in the side plank position to help strengthen the oblique.

3)   Bird Dog:

a.       Keel on the floor with hands firmly placed about shoulder width apart

b.      First practice lifting one hand and the opposite knee off the floor while balancing on the other hand and knee.

c.       When ready, extend both the arm and opposite leg out to the front and the rear.

d.      After extension, go back to go into a table top position on all fours, take one arm and touch to the knee and go forward and extend and back. Do 10 reps of those. Holding in the nice position.  Repeat with the opposite side.

4)   Superman:

a.       Lay flat on your stomach with arms straight out in front of you and your legs straight out behind you. Keep your arms and legs shoulder-width apart.

b.      Lift your legs and arms simultaneously for at least 6 inches off the ground. Keep each movement slow and controlled to prevent pulling muscles

c.       For Lay down on your stomach and do a superman. Come up and raise both your arms and legs. Do 10 reps and you can make cross motions with the opposite leg

Running plays a large role in many people’s lives, especially in San Francisco. With many races that take place in the Bay area, I feel it is important to give advice about running injuries. Whether you plan to compete in a 5k, 10 K, half or full marathon, you can benefit from knowing when to recognize soreness from injury.
As the number of participants in competitive and recreational running increases, so does the number of running-associated injuries. A majority of novice runners are, in general, ill-prepared to begin a sound training program and often overestimate their capabilities. Consequently, up to 60 percent of runners will experience an injury that will ultimately limit their activity. While some of these injuries are due to actual trauma, a vast majority fall into the category of “overuse syndromes.” These injuries are recurrent and can be frustrating for the athlete, which can overwhelming and cause the individual to abandon running or exercise altogether.
Overuse or misuse injuries tend to be gradual in onset, developing over a period of weeks or months. These injuries are the result of excessive and/or repetitive motion. Ultimately, the athlete suffers a microtrauma injury, where the body is unable to keep up with the repair and re-strengthening demands. As a result, the tissue begins to fail and becomes symptomatic. If the injury is not particularly painful, or if the symptoms are reduced by taking medication, the athlete usually continues to run. Eventually, this cycle ends with injuries, such as a stress fractures or ligament tears. The causes of these types of injuries can be categorized into “extrinsic” and “intrinsic” factors.
Injuries that are external to the runner are often the easiest to modify, and should be treated immediately.
Extrinsic sources include:

• The training program (mileage per week)
• Number of speed or hill workouts
• Recent increase in mileage, and amount of rest time
• Equipment (design and running shoe materials)
• Running surfaces (asphalt, artificial track, or trails).
• It is important to note that exposure to a high training load (duration, frequency, or distance) increases the risk of injury. Therefore, modification of the athletes’ training schedule (less mileage on more forgiving surfaces) can significantly reduce this risk.

For San Franciscans, hills tend to be the biggest issue.  Running up and down hills can put extra stress into the knees or athletes, which can lead to biomechanical stress and ultimately, injury.

Intrinsic factors associated with overuse injuries relate primarily to muscle imbalances or structural problems. Therefore, a well executed examination is necessary to investigate underlying biomechanical, misalignments and dysfunction in the body. Once these factors have been identified, a proper treatment program should sufficiently address these issues. Often times, a patient will have a condition that is easy to diagnose, however, re-injury or delayed recovery can occur due to these factors.

Overuse injuries in runners are a good example of problems may arise from the environment (extrinsic factors) or the individual’s biomechanics (intrinsic factors). Proper treatment and rehabilitation can help address structural stress and strain. For long term improvement, it is important for the athlete to incorporate a training program that is tailored to their individual strengths and weaknesses. A comprehensive multi-model approach to the treatment of running injuries is the best hope for many years of recreational or competitive enjoyment. As a general rule, if you experience any form of pain in the body, you should go seek a sports health care professional for proper evaluation and treatment.

Here is a list of upcoming races in San Francisco and throughout the Bay Area:
July 14: The Color Run (5k)
July 15: Miles for Migraine (5k,10k)- In Mountain View
July 15: Crissy Field (5k)
July 21: Urban Dare -(10k, 5 miles)- San Jose
July 28: Bad Bass Half Marathon (5k, 10k included)-Castro Valley
July 29: The San Francisco Marathon (5k, 10k, half and full)
July 29: Munchkin Kids Run (Kids race)
August 8: Survival Dash (5k)
September 16: The Lake Merced Half Marathon
September 16: The San Francisco Giant Race (5k)
October 14: Nike Women’s Marathon and Half Marathon

If you are training for one of these races and are experiencing pain, SF Custom Chiropractic would be happy to evaluate your condition and help you reach the finish line. Call 415 788-8700 for an appointment.

Knots and adhesions develop in three ways:

1) Acute injury or trauma.

2) Overuse or repetitive motion injury. i.e. typing or mousing at the desk

3) Constant Pressure / Tension for extended periods of time.  i.e. poor posture

Normally, muscles are able to function best when they are well nourished and have proper blood circulation.  As we get stressed or overworked, certain muscle fibers cluster together and form a knot. While these knots are initially harmless, they can eventually become painful. This pain is referred to as a myofascial trigger point. It often takes up to 3 months before a knot actually develops.  Fortunately, there are ways to get rid of these knots and prevent them from coming back.

1) Massage: One of the most common ways to relieve aches from knots is to massage the knot out with your hands or to use a foam roller. A foam roller is a long, firm cylinder that can be used to massage the knots with the pressure of your own body weight. Using the foam roller is an inexpensive yet highly effective method to reduce the tension in your body.

2) Active Release Technique: Like massage, ART breaks up knots and adhesions.  It is done with direct tension and very specific movements.

3) Technica Gavilan: This is a soft tissue technique that utilizes instruments to increase the rate of blood flow to and from damaged connective tissues and muscle fibers to aid in restoration.

4) Proper Nutrition: Low potassium levels contribute to the formation of muscle knots or tension. Because bananas have a high source of potassium, including them in your diet will be an excellent way to prevent muscle cramps or adhesions. Other potassium rich foods include: avocados, dried apricots, pistachios and fish.

5) Heat: Applying heat to the affected muscle can help loosen and release the knot.

6) Exercise and stretching: Stretching is an excellent way to relieve muscle tension. It’s a good habit to stretch every day, especially before and after a workout.

It is inevitable that you will experience periodic muscle knots. Through adequate treatment, proper diet, and exercise, you can help get rid of the knots naturally.  If you have knots in your muscles from stress, work, poor posture or from working out, make an appointment
with local message therapist or chiropractor who specializes in sport injuries or is certified in ART, Graston, Technica Galvan.

In good health,

Dr. Jacobs

One of my New Years’ resolutions is to start this blog.  This being my first post, I will give some advice on how to keep your resolution.
Many of us make a resolution more out of custom rather than actually planning. This is why the success rate of New Years’ resolutions tends to be low.
So how do you keep your resolution?  Here are some tips to increase your odds at maintaining your goals.

1. Write it down. Record your progress each day. I believe writing down your goals in life is a key component of success.  Set goals weekly and work towards these goals every day.

2. Take pride in your resolution. Pick something that is really important to you.

3. Make promises you can keep.  Start small.  If you want to lose weight and you eat fast food daily, cut back by only eating fast food twice a week and pack a healthy lunch for the other days.  Instead of eating ice cream late at night, substitute it with a bowl of cereal.

4. Change your habits. Habits can be difficult to break. Replace negative behaviors with more positive behaviors..  If you want to quit smoking but realize that it helps you relieve stress, find something else to help you relax.  Yoga, or any form of exercise, can help you feel re-energized and more at ease.

5. Break down your goals into tactical planning.  i.e:  plan out your meals for the week; write down your workout routines; budget and keep track of daily spending. If your New Years’ resolution is to get in shape, I can help. As a sports chiropractor in the heart of San Francisco’s Financial District, I have formed many relationships with gyms, boot camps, and personal trainers.  If you can’t afford to have a personal trainer or join a gym, there are many easy at home exercises that can lead you on the right track to health.

If you are in pain or have an injury, you can’t get back into shape and fully exercise. Before you get back in the gym for your daily workout, be sure to see your local chiropractor or doctor and get your health cleared so you can make 2012 the year you achieve your goals and resolutions.  At SF Custom Chiropractic, we are offering half off the Initial Exam and treatment for new patients who want to make better health part of their resolution for 2012.

In good health,

Dr. J