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Low back pain or lumbago affects over 3 million people per year, peak age is 19 years old to 80+.  Typically low back pain is caused by injury to a muscle (strain), or ligament (sprain).  Common causes include improper lifting, poor posture (repetitive strain), lack of regular exercise, arthritis, fracture, injured spinal disc.

If you experience low back pain over a two week period, experience leg weakness, numbness, tingling in the legs, feet or hamstrings see your primary care doctor or chiropractor immediately.

Preventing Low Back Pain

Maintain a healthy diet and weight

  1. Try cooking your own meals, eating smaller portions, eat early (not eating after 6:30pm so you have a minimum of 12 hours before your first meal of the day),

           Drink more water.

        Avoid prolonged inactivity

           Take three to four micro-breaks when sitting (30-40 second stretches for the hips, low  back, possibly look at a sit-stand desk or desk top at work,


  1.        Warm up and stretch before physical activity

such as walking, hiking, gardening.  Think dynamic stretching such as partial lunges,  squat-rises, runners stretch, hamstring stretch,  gluteal stretches.


  1.       Wear comfortable low heel shoes
  2.       Sleep on mattress that is a medium firmness

This will minimize improper curve in the spine while sleeping.  Use a pillow between the knees,


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  1.  Lift with your knees and do not twist the spine when lifting 

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5 Exercises for lower back pain and strength


Sources of lower back pain

Lower back pain affects almost 100 million Americans adults each year (2011).  Lower back pain can be caused by any of the structures that make up your lower back.   Typical sources of lower back pain could include the muscles, ligaments, the facet joints or the spine, or the large nerve roots that originate from each spinal segment.   This could be from an acute injury like a sprain / strain, from degeneration or arthritis, or another pathological cause.

 Causes of low back pain

Typically younger adults between 30-60 years old are more likely to experience back pain from damage to the spinal disc or a sprain / stain or other soft tissue strain. Older adults over 60 years of age are likely to experience low back pain from degenerative changes such as osteoarthritis or spinal stenosis or even a compression fracture of the vertebrae.

Exercises for the lower back

Below are 5 exercises, generally for beginners who are not suffering from an acute injury or an active spinal disc with radiating pain into a leg. If you are experiencing low back pain with leg symptoms, active sciatic symptoms, fever, chills, difficulty in urination, or bowel movement then YOU REQUIRE IMMEDIATE MEDICAL CARE to further investigate you lower back pain.

THESE EXERCISES are for lower back pain maintenance and to strengthen the supporting ligaments and muscles of your low back (multifidi muscles, rotatory ligaments, quadratus muscles, abdominals), not to eliminate acute lower back pain. The muscle and support ligaments typically weaken leading to instability and weakness. When this progresses it leads to injury, inflammation and eventually development of degenerative changes to the joints of your lower back.  Movement, chiropractic treatment and natural anti-inflammatory relief  such as Turmeric can help keep your back strong, mobile and generally pain free.

ONE: Lie face-down on a Swiss Ball with your feet straight behind you and your arms fully extended in front of you, palms pressed against the floor. This is your starting.

TWO: Extend your back and raise your arms so they form a straight line with your torso. Hold, then return to the starting position.

ONE: Get on your hands and knees, using a mat if necessary for comfort. Make sure your back is flat and tighten your abs.

TWO: Reach one arm forward while simultaneously extending your opposite leg straight back. Hold the position and then return to starting position to switch sides.

ONE: Lie back on a Swiss ball with knees bent at a 90-degree angle and feet on the floor about shoulder-width apart. Interlace your fingers behind your head. The ball should be under your hips and lower back. This is your starting position.

TWO: Crunch your torso toward your knees, raising your chest upward. Stop when the middle of your back loses contact with the ball. Pause, then return to starting position.

ONE: Begin in high lunge with your right foot forward. TWO: Take your hands together in a prayer at the center of your chest. Take a deep inhale, using your thumbs to slightly lift your chest. THREE: Use your exhale to engage your navel to your spine and twist your torso to the right. FOUR: Hook your left elbow outside of your right thigh. Breathe here for at least three deep breaths, then repeat on the other side.

Plank 1



Lie on the floor with elbows directly beneath your shoulders and legs fully extended. Raise your torso into the air until it makes a straight line from your shoulders to your ankles. Tighten your stomach, squeeze your butt and hold this position for the desired amount of time.

Perform each exercise 5 times per week to keep your lower back strong.  Ad pelvic stretches to increase flexibility, have good ergonomics when sitting, to keep a healthy back.

Your Walnut Creek Chiropractor.


These exercises are not meant to diagnose or treat or substitute for the recommendations of your care provider.

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When to Get a Joint Replacement

What Happens To a Joint

Joint replacement surgery, weather for a knee, a hip or shoulder can improve mobility and quality of life but should be evaluated carefully before having the procedure.  Your joints can become damaged by injury, illness, osteoarthritis, rheumatoid arthritis, or even food poisoning (  These conditions cause inflammation, stiffness, reduced function which compromises blood flow to the joint.  This additive process causes joint damage, cartilage erosion.

A New Joint

A new joint or prosthesis is usually a combination of plastics and metal which replace the moving part of the joint, preserving the surrounding muscles and ligaments.  Replacement joints are usually reserved for people 60 and over.  In younger patients if performed may need to be performed again in 15-20 years.

Knee and hip replacements are becoming more common due to the aging population.   Currently about 1 million joint replacements are done each year.

Do I need a Joint Replacement

This decision is between your doctors findings from examination, x-rays orthoscopic examination and how it is effecting your quality of life.   Your doctor may try treating you with medications for joint pain (Turmeric for joint pain), prescribe daily therapy you do at home, ad aqua aerobics classes, chiropractic care.  These measures will not cure your joint problem but can improve your health and reduce pain.  One thing to consider is how it effects your mobility and health in general.  Here is an example of a questionnaire  If you answer yes to 4 or more questions  consult your primary care doctor for possible joint replacement or further evaluation.  Basically if you experience constant daily joint pain and swelling, taking multiple medications for pain and inflammation, are gaining weight because you cannot walk, interrupts sleep.  Then it may be time to consider a joint replacement.

The surgery itself can take a few hours.  Post-surgery rehab takes about 6 months but usually you are walking with assistance the very next day (


7 Quick Tips About Back Pain


As the saying goes, “If you have spine you have at one time or another felt back pain.”  Most people feel back pain due to inactivity or lack of proper back movement throughout the day.  Over time this lack of motion can create tension, tight muscles, shortening of spinal ligaments, muscle weakness.  So how does one keep the back healthy for a lifetime?


Ergonomics is usually associated with your work desk.  But lets think of ergonomics in any situation where you perform a sustained task.  Sleep, driving, a pillow, your shoes, positions you relax in.


Your sleep surface should support your hips and shoulders giving you a neural posture on your side and on your back.  There are many different mattresses, some without a box spring support (sleep comfort and tempurpedic).  Look for a mattress at a store that assesses you, gives you choices and a 30 day return policy.

Your pillow should support your neck, not lift your head.  A side sleeper needs a slightly thicker pillow due to a bigger distance between the neck and shoulder.  I recommend a water filled pillow for most sleeping situations because you can adjust this pillows height and firmness.


Your company should offer you an ergonomic assessment to assess your desk-chair, keyboard-mouse, monitor arrangement.  You want a basic arrangement where your chair can get close to your desk so your arms are bent and relaxed.  A keyboard tray is a must as this assists in keeping the arms/shoulder relaxed and back upright in the chair. The monitor is set to eye level and centered, if you use duel monitors then you may want a “standing” Desktop as an option.


Your shoes are your foundation and support your feet and three different arches, contribute to you standing posture such as neutral pelvis and body lean.  If you are wearing out the inside edge of your shoes you are tilting in or pronating your foot/feet (up to 80% of the population).  This can contribute to knee pain, ITB band pain, hip pain, plantar pain, low back pain.  If you are wearing the outer edges of your shoes then you are tilting outwards or supinating your feet.  This can give you low back pain, ITB Band pain, shin pain, sacroiliac joint pain.  Have your feet assessed by a chiropractor for proper shoe support or even active orthotics.  I use Comfort Fit orthotics when necessary because they are reasonably priced, last 2-3 years, and are inexpensive to refurbish.


When driving your arms and legs should be bent to relax your shoulders and keep your back in the seat.  A lumbar support should be used to keep you pelvis neutral.  If you are sitting in your care seat and you feel as if your bellybutton is being pulled in then you need more anterior pelvic tilt.  Increase your lumbar support.

How you relax

Your posture when you relax can contribute to your back pain,  If you sit all day, sit when you commute, then sit when you come home, you poor spine has basically not moved all day.  This leads to back deconditioning, shortened spinal ligaments, compressed spinal discs.  When you relax on a couch you are probably still tilting the pelvis backwards and rounding the spine.  When you sit all day you are constantly flexing the spine, the hips and the knees.  You are not using 1/2 of your body!


When you come home in the evening you need to spend some time stretching and moving.  The health of your spinal joints, hips, and knees is dependent on movement for circulation and lubrication.  The old saying goes “if you don’t use it you lose it” holds true here.  During the work day follow a simple rule: 3-4 micro-breaks a day.  A micro-break is a series a few simple stretches performed for 30-60 seconds, that’s it.  OSHA recommends micro-breaks to elevate strain and stress placed on joints, muscle, ligaments when they don’t move for sustained periods.


Here is an example of 8 simple stretches for your low back and hips.  These could be performed 5 days per week for benefit and consistency.  Remember these stretches are not a diagnosis or a cure for your individual low back pain.  If you have not stretched on a regular basis, have current spinal disc problems these  PLEASE consult your primary care doctor FIRST!  Before you perform these stretches.

Kneeling Hip Flexor Stretch : Step 1

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Legs Up Wall Pose : Step 4

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Seated Spinal Twist Pose : Step 3

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Supine Spinal Twist Pose : Step 4

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Eye of the Needle Pose : Step 3

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Opposite Arm and Leg Balance : Step 2

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Baby Cobra Pose : Step 3

Bent-leg Calf Stretch : Step 1

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REMEMBER: If you have a specific low back condition such as spinal stenosis, disc herniation, severe arthritis THEN CONSULT your primary healthcare provider BEFORE starting these exercises.

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Simple Tips To Roll Away Muscle Tension

Foam RollerAfter a long day at work spent sitting or standing can create tight and congested muscles.  Long term tightness can lead to discomfort, pain, bio mechanical limitations.  In less than 10 minutes you can release this tightness and discomfort in the back, legs, hips, knees and shoulders.

How The  Foam Roller Works

Basically when you roll the body part in question, you are stretching the connective tissue / fascia releasing adhesions.  You are lengthening muscles and increasing circulation to those muscles.

Precautions For Using The Foam Roller  

If you have never used the foam roller, are on blood thinner medication, find it hard to get up from the floor then check with your primary care doctor, your chiropractor or personal trainer before using this piece of equipment.

massage stickAlternative To The Foam Roller

An alternative to the foam roller is the massage stick.  The massage stick is used standing up and is best for the legs, thighs, , feet, forearms.  When using the massage stick try rolling an area for 30 to 90 seconds using alternating light and moderate pressure.   Conditions such as plantar fascitis, carpal tunnel, tennis elbow, shin splints, ITB Band Syndrome, knee pain.

Tips For Using The Foam Roller

  • Place the tissue for rolling on the roller, control pressure by partially lifting off the roller the entire time you roll the muscles.
  • Never roll over boney parts, only roll the soft tissue.
  • Start by rolling and area for 30-45 seconds, then move on to another body part.
  • After rolling for a 5 minute session, rest a day in between sessions.  After one week try to increase rolling time to 8-10 minutes.  Build up to 10-15 minute sessions 3-4 days per week.
  • If you feel bruising, pain, more stiffness then STOP! You may be using too much pressure or putting too much strain on the underlying tissue.  Check with your primary care doctor or chiropractor first, before continuing.

Conditions Helped By Foam Rolling

ITB Band Syndrome, shin Splints, Sciatica, and low back pain have all benefited from foam rolling.  If you have low back pain, leg pain, shoulder pain please check with your primary care doctor or chiropractor before starting a routine.  Routines usually start on the side legs first, working towards the back of the legs to the front, then to the low back / mid back.


I recommend foam roller stretching to all my patients, whether an athlete, golfer, office worker, cycler of all ages.  Before starting this exercise please check with your doctor first.

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Why We Love Good Sleep (And You Should , Too!)

Who doesn’t like a good night’s sleep. You wake up energized, refreshed, feeling great both mentally and

Human brain model, studio shot

Human brain model, studio shot

physically. Ready for the day.


Poor sleep not only hurts the body but negatively effects the brain as well. Almost 60% of adults report sleep problems, from un-restful sleep, stress, to sleep apnea. Only 37% of ADULTS GET THE RECOMMENDED hours of sleep every night. Almost half of sleep problems are stress related.


The diagram below simulates how your brain regulates our circadian rhythm or master clock and the impact.

Eyes >>> light passes through >>> stimulates the suprachiasmatic nucleus regulating circadian rhythm >> and inhibits melatonin and stabilizes all night until interrupted by morning light. >> Morning light enters the eyes and resets with increase in cortisol from the adrenal gland. This cycle keeps you biological clock synced.


The first Stage and second Stage happen when you fall asleep or in a light sleep phase. This cycle takes 90 minutes on average. Stage three and stage four you enter a deep, restful sleep. Here your respiration lowers and your heart rate lowers. Stage five is when your brain is active, when you dream. This Entire Stage ! Through 5 take 90 minutes then is repeated.sleep

Deep and restful sleep has a major physiologic effect. Here (REM Sleep) your body experiences increased blood flow to the muscle, tissue grown and repair happen, immune system repair takes place, hormones are released and regulated such as Leptin, growth hormone, ghrelin (for appetite regulation), UV damage to skin is repaired. This REM Cycle improved memory, consolidates long term memory, motor skills. During REM sleep your brain cells actually shrink. It is believed this allows the brains cerebrospinal fluid to flush out the small crevices and wash away toxins and waste products. Products such as proteins that can build up and are responsible for neurological disorders.

I always think of the 5 stages to the sleep cycle like the Borg Regeneration Cycle in the Star Trek TV show. Kind of a geeky analogy but this cycle for us Physical beings it is essential for proper healing and health.


Most adults need seven to nine hours each night. After 18 years of age can become more individualized. A New born needs up to 20 hours a day while a 10 year old need about 10 hours a day.


Ø Don’t eat dinner after 630pm. This can lead to digestive problems and interferes with the five stages to sleep cycle.
Ø Put technology away a few hours before bed. Let your brain tune down free of all stimuli.
Ø Turn off all the lights, cellphone screens, TV, clock lights (should be RED light), remember that excess light interferes with the 5 stages of sleep. During REM your eyes flutter and expose the eyes to light.
Ø Go to sleep at the same time every night, this sets a pattern for your body and creates more restful and rejuvenated sleep.
Ø Make sure the bed and pillow support restful, comfortable sleep. If you keep waking because the mattress and pillow are nor supportive and comfortable then you interfere with the sleep cycles, shortening them or never Entering REM sleep.

If you snore or your partner keeps nudging you because you do, and feel un-restful sleep then mention this to your primary care at your next physical and have a checkup for possible sleep apnea. Try not to take sleep medications long term as they can lead to disruption of diurnal cortisol levels. We advocate lifestyle changes first to correcting poor sleep.


Natural Arthritis Pain Relief without The Associated Risks of NSAIDS

What if you could take a natural supplement for arthritis with virtually no side effects, have the same of better relief than some prescription medications, and have other promising health benefits?

A recent study in San Diego presented at The World Congress on osteoarthritis demonstrated a combination of Curcumin and Boswellia extracts relieved knee pain better than Celecoxib (generic brand name Celebrex®).  Turmeric is a member of the Ginger family and contains Curcumin; the principal curcuminoid found in turmeric, is generally considered its most active constituent.  When combined with Boswellia extract the two products complemented well. 1,2,3

Subjects in the study were classified with moderate osteoarthritis and joint swelling between the ages of 18 to 65 of both sexes.  One group was given Celecoxib, 100 mg, two times daily for 12 weeks, the other group was given 500 mg Curcumin and Boswellia two times daily for 12 weeks.  At the end of the study 93% of the group treated with the herbal combination reported improvement or elimination of pain vs. 79 percent of the drug group and there were no serious adverse effects.  Blood and Liver function was monitored throughout the study.  Also 93% of the subjects taking the curcumin-boswellia supplement could walk more than 1,000 meters, versus 86% in the Celecoxib group.  The herbal group also experienced improved joint movement with less crepitus.

Other comparative studies have demonstrated similar results and other health benefits such as cancer prevention and  for co-treatment in Cystic Fibrosis, and other inflammatory diseases.  It is believed curcumin regulated Cytokine reactions involved in immune and inflammatory responses. 2

Osteoarthritis is the most common arthritis in people over 55 years of age.  It is estimated that 27 million Americans have osteoarthritis.  To relieve osteoarthritic pain most people turn to Non Steroidal anti-inflammatory drugs (NSAID’s) such as Ibuprofen, Naproxen or Celebrex.  NSAID’s relieve pain but when taken long term, are associated with gastrointestinal, kidney and heart risks and other possible damage.  So the Curcumin / Boswellia extract combination could offer a safer alternative to NSAID’s.

Caution should be used if you are pregnant or lactating.  You should always check with your doctor before starting a new therapy and to verify possible drug interactions.   I recommend a similar standardized Turmeric and Boswellia supplement for my patients that fit the definition of moderate osteoarthritis and other inflammatory diseases.


Curtis Haake D.C.

Health Coach





2 (2005: Jane Higdon, Ph.D. Linus Pauling Institute Oregon State

3 Clinical Evaluation of an Herbal Formulation in the Management of Knee Osteoarthritis. Poster presentation at the Osteoarthritis Research Symposium International (OARSI) Annual World Congress on Osteoarthritis, September 15-18, 2011. San Diego, CA. B. Antony, R. Kizhakkedath, M. Benny, B. Kuruvilla. University)




This information is not intended as medical advice for individual problems. Liability for individual actions or omissions based upon the contents of this site is expressly disclaimed.