What does a Chiropractor do … on a Sunday?

What does a chiropractor do?

That’s a question I often get asked – even people who’ve been through a course of treatment only get a snapshot of a typical clinical day as it relates to their presenting condition … and life as a chiropractor can involve so much more than just turning up and treating patients.

I decided to keep a journal of different days of the week for three months – and then pick one entry for each day of the week at random.

Here’s what I got up to.

A day of rest it isn’t.

As anyone with an eight-year-old will know, Sunday usually begins several hours before dawn as they wake up a good two hours earlier than on weekdays and sneak in to make sure you’re enjoying your lie in.

There is then the after breakfast (bacon, sausage and black pudding butties  – #5stepping is about moderation in all things including moderation) dash to some remote corner of Somerset to collect whichever teenager needs extracting from sleeping over after a play/match/concert/party in time for coffee at Granny and Grandad’s.

Another question I often get asked is what it’s like to work alongside your mother.  The answer is I don’t know – we’re now only in the same clinic at the same time once a week, and she spends her time in her treatment room from 9 till 7, whilst I’m in mine for the same period: if we need a meeting, we have to schedule it … or we get a chance to chat over coffee in between grandchildren and crosswords on a Sunday morning.

Sunday afternoon is dilemma time: family first as it’s our only day together – but there’s also gardening (once a whole family activity but no more) and those little bits of work that you didn’t get done during the week and which you feel guilty for doing and guilty for not having done.

Today though there’s a major – and highly complex – medicolegal report that’s needed by tomorrow and at the 6,200 words I managed to write between 142 patients last week, I’m only halfway finished. These days I have every speed device known to mankind [try TextExpander if you need to type long, technical phrases on a regular basis] and can manage 1,000 words an hour unless I’m on a particularly difficult area … which means I can finish the report and still find time for Harry Potter, help with homework, diary planning for the coming week, five emails from patients and the last ten minutes of Downton Abbey.

At least on Monday, you can guarantee that the eight-year-old will need waking up after the alarm goes off at 6!

Plantar Fasciitis may be a common cause of foot pan … but it’s not the ‘sole’ cause.

Plantar Fasciitis may be a common cause of foot pan … but it’s not the ‘sole’ cause.

When it comes to feet there is a medical truism: we all take them completely for granted – until they start to go wrong!

Complaints about foot and ankle pain are a daily presentation to any chiropractic clinic; particularly so at Yeovil Chiropractic Clinic, where we normally have a podiatrist (foot specialist) working alongside us (get well soon, Robin!). 

Although the complaint itself may appear simple, the underlying causes can often be complex – did you know that a quarter of all the bones in your body are in your foot?To make matters worse, foot problems aren’t just caused by feet.  They can also be the result of knee, hip and low back dysfunction and it’s important that any treatment takes this holistic approach.

 Of the dozens of possible diagnoses, which can include congenital variants, neuromas, stress fractures, arthropathies, sprains, strains, bursitis, tendinopthies and fat pad pathologies we, in this country, appear to have a fixation with one condition – plantar fasciitis (pronounced ‘fash-ee-eye-tis’).

Of course plenty of people do present with plantar fasciitis – it’s a common condition in middle and old age.  It’s caused by inflammation in the soft tissues that make up the arch of the foot – so if your pain isn’t in that area, it isn’t plantar fasciitis.  The onset is usually quite sudden and associated with an obvious cause (change in footwear, walking barefoot, trekking across cobbled streets) and treatment should comprise two elements: symptom relief and determining the reason for the dysfunction and not just the cause of the onset – are the bones of the foot aligned properly? Are the muscles working properly? Is there damage to the ligaments? Are the legs functioning in a balanced and symmetrical manner? Are the nerves that control the feet working as they ought?

The symptoms are usually easy to control: medical treatment usually involves drugs to control the inflammation and advice about footwear (Crocks are our top tip) but if you want the treatment to be as effective as possible and minimise the chances of it coming back you need to ask the basic question: ‘why have I got this problem?’

…and if you feet aren’t giving you any grief, perhaps you should ask yourself ‘what can I do to keep it that way?’ – like many musculoskeletal conditions, the signs are normally there for the expert eye to detect before things actually start hurting: so are you taking your feet for granted?

Arthritis – Should I learn to live with it?

 Arthritis is another of those words that mean different things to different people. To most, it means your joints have got a bit of wear and tear in them; to a specialist such as a rheumatologist or chiropractor, arthritis refers to a very specific group of much rarer inflammatory diseases of which rheumatoid arthritis and anklylosing spondylitis are probably the best known. Wear and tear – often referred to as ‘osteoarthritis’ – is a completely different disease process, which is why specialists prefer the term ‘degenerative joint disease’, or DJD for short.

So do you have DJD?  If you’re over 50, then the answer is almost certainly “yes” – most commonly, it affects the joints that we use the most (thumbs, toes, backs and necks) or the ones that bear the most weight (hips and knees), particularly if you’re carrying extra poundage!  So if you’ve got some swelling or stiffness in those joints, can you do anything about it?

The Key Ingredients to a Healthy & Successful Diet: Shopping Like Gran Did

You are what you eat as the old adage runs – and all the evidence suggests that the huge increase in the average weight of the UK's population is due to precisely that… we are, fuelled by convenience, increasingly champing our way through the heavily promoted products of the ‘food industry’ which are all too often laced with the addictive sweetening agents and fats that are not only guaranteed to make you put on weight, but to make sure that you  to keep coming back for more.

More than half of us are unhealthily overweight – still slightly behind the Americans, but only just – and it’s not just adults: the rise in morbid obesity in children is particularly scary as fat children are actually developing more fat cells rather than doing what adults do, which is simply overfilling the ones they already have. This makes it incredibly difficult for them to lose weight without existing in a state of semi-starvation … for life.

Part of #5stepping is to make sure you don’t eat the wrong food … and then to kick on and make sure your diet is laced with the ‘superfoods’ that can add to your health: it doesn’t mean you can’t ever eat a Big Mac again but, in the same way that cutting out some of the caffeine and alcohol helps reduce toxins and empty calories, putting in place good food habits can benefit you and all those around you – and those habits begin on the high street or more probably the out of town hypermarket because, the way we shop has changed beyond all recognition.  In a single generation, supermarkets have replaced individual high street shops; you can now buy what used to be seasonal fruit and vegetables twelve months a year; and exotic, occasional treats have become weekly staples.

My Shoulder is Frozen!

Have you ever had a shoulder joint that’s painful and restricted?  The chances are you probably thought it was a ‘frozen shoulder’ – and the chances are you were probably wrong!

As with some of the previous terms we’ve discussed, such as sciatica and migraines, the problem lies in part with the difference between what you might mean by ‘frozen shoulder’ (it hurts and I can’t move it properly) and what a musculoskeletal specialist means by ‘frozen shoulder’ (very specifically, adhesive capsulitis) … and differentiating between the two is very important as they can have very different treatments and outcomes.

The shoulder is the most complicated joint in the body – in fact, it’s not one joint at all, it’s three joints plus the articulation between the shoulder blade and the top seven ribs.  If it’s going to work properly, there are over 100 joints, muscles, ligaments and bursae that have to we working normally and integrate smoothly.  Fortunately, of all the things that can go wrong, frozen shoulder (or adhesive capsulitis as we should call it from now on) is one of the less common.

Early to Bed…

So far, #5stepping shouldn’t have proved to onerous – drink more water, walk a little more; drink less caffeine and alcohol, sit a little less … but then that’s the whole point of #5stepping: it isn’t meant to be hard, it’s all about those little incremental changes that stack up to make a big difference.

The third step you can take to make your life healthier is even easier … it involves doing absolutely nothing, and doing it for at least seven-and-a-half hours a day!

That’s the minimum amount of sleep the average person needs to stay healthy yet more than half of us aren’t getting more than around six hours per night – and not enough zeds doesn’t just make you feel a bit slower, it could kill you!

LIES, DAMN LIES & STATISTICS

The County Council have gone on the defensive, explaining to the Western Gazette why paralysing the town is in our best interests and how we should be grateful to them for all that they are doing … but let's pretend that we're savvy eight-year-olds and see whether we have the intelligence to read between the lines of spin.

I am, by the way, writing this whilst waiting for my first patient of Friday afternoon to arrive – predictably, the combination of POETS afternoon, school pickups and the genius decision to combine closing Hendford Hill and Brunswick Street with resurfacing work to the A30 (White Post area, start of the week) and A37 (Red House area, right now) means that the town has reached meltdown and is gridlocked.

So here are the roadworks in number form, best Daily Mail style courtesy of the Western Gazette. In nice simple soundbites because we're obviously stupid enough to have elected these people so we don't want any joined-up thinking.

14 – The work's cost in millions of £££s. £3M is being spent on the Eastern Corridor as we speak, with £11M invested in the Western Corridor from January 2016. The work involves improving roundabouts and junctions and providing better facilities for cyclists and pedestrians.

Name me one "improvement" that has actually helped Yeovil's traffic. Every "improvement" I can think of has cost millions, caused weeks or, more usually, months of disruption and made no difference. Add this money to the £3.5M wasted on moving the Reckleford bottleneck 70 yards further up the road and you can't help but think of whether £17.5M couldn't have built some if not all of a proper bypass.

16 – The roadworks are expected to make journey times from Horsey roundabout to Lyde Road 16 per cent faster than if they weren't implemented.

Sounds great doesn't it. How much do you want to bet that: a) This is a guess; b) That it turns out to be wildly over-optimistic; c) that "journey times" includes cyclists and pedestrians at whom all the "improvements" seemed to be aimed despite the fact they can usually travel faster that traffic. There is also the phraseology to consider ……"than if they weren't implemented" – ie, Yeovil is going to gridlock when they build thousands of extra houses that nobody wants but maybe it won't gridlock quite as much if we do this and at least you won't be able to say we didn't do anything. Or maybe they're just getting us used to sitting in unmoving traffic as preparation.

  

Build a bypass guys and then feed your new unwanted and unnecessary estates off the bypass.

20 – There will be at least 20 hectares of employment land to be developed in Yeovil – 4.4 at Lufton and 16 at Bunford Park.

So much for the Green Belt.

Who do they think will want to come to a town with such rubbish transport infrastructure? There is an increasingly strong argument for moving at least one of our clinics out of town (the one that relies on cars to transport patients rather than the faster moving pedestrians).

23 – The roadworks are expected to make journey times from West Coker Road to Thorne Lane 23 per cent faster than if they weren't implemented.

Bearing in mind the decision to feed the access for the 1,000+ cars from the completely unnecessary and universally disliked East Coker development onto the A37 just south of the Hospice, and that much of this traffic will either be going down West Coker Road or Hendford Hill, is there anyone out there that actually believes that transit times will be faster. No? Good, because that isn't what this says.  They will, of course, be slower because of all the extra cars, just maybe not quite as slow as they might have been. Or Not.

123 – the amount in millions of £££s that road users are expected to save over 60 years through reduced delays, vehicle operating costs and collisions on the Western Corridor.

Talk about plucking figures out of thin air.

…But, if they really believe that, just think of how many times over a bypass would pay for itself – you know, one of the traditional ones that goes around the town, taking away all the through traffic.

2,247 – The total number of houses planned to be built in Yeovil. The Brimsmore development involves 830 homes, Lufton 710 and Lyde Road 700. Upgrading Yeovil's roads is a legal requirement for future housing and development.

And here we finally cut to the chase … it's nothing to do with improving Yeovil's traffic flow, it's a requirement to be seen to be doing something to tick the boxes to allow the extra houses to be built.

So here are a few of stats of my own: 

0 – The number of patients to whom I have spoken who want Yeovil turned into city. All those extra patients may be good news for patient numbers (assuming the disruption doesn't bankrupt us) but I came to work in Yeovil because I wanted a market town with a strong sense of community. Who asked the residents whether they wanted all this development?

0 – The number of patients who think the "improvements" will actually improve anything.

6 – The millions of hairs Yeovil's traffic planners have caused me to pull from my head.

352 – The number of patients who were affected by the traffic last week.

The people I feel really sorry for (apart from the traders who can only sit and count the cost of their potential customers avoiding Yeovil like the plague) is those well-meaning souls charged with reinvigorating the High Street. What is the point when nobody wants to come as it isn't a shopping destination and you have to pay a fortune to park when you get there; and how will it ever become a shopping destination when you CAN'T get there.

Cut the Rates – Fire the Planners – Build a Bypass.