Date: August 26, 2014 | Time: 10:44am | Posted By: drmroski


Bad Form

I have been seeing a lot of people at the gym lately who need some help. Lifting too much weight which in turn causes a breakdown in proper form, increasing the chance of injury and decreasing the benefits of the intended exercise. I saw one guy doing bicep curls who kept his elbows flexed 90 degrees the whole time while rapidly moving his shoulders up and down with a total movement of about 2 inches. This is really doing nothing to build the muscles that he is trying to work on. Don't get me wrong - I think it is great that he is getting out there, but he should really go on Youtube or another website and do a search for proper workout techniques. Most gyms have some kind of trainer on staff that can help also. Remember, getting the most from weight lifting requires proper form, controlled movements and the right amount of weight. Lifting weights that are too heavy for you is a set-up for injury. If you can't maintain proper form while lifting, the weights are too heavy for you.
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Date: May 29, 2014 | Time: 10:32am | Posted By: drmroski

Lift Correctly or Don't Lift!

mower lift

I have had a couple of patients in the last few months who have seriously injured their lower back by lifting their lawnmower, so I just wanted to post something to address improper lifting. Lifting a bulky item can really cause some problems. Even an item that really is not that heavy can overload the back if it is lifted improperly. Big boxes, mowers, and large pieces of furniture should not be lifted by one person. Their large size causes you to lift with your arms extended far forward and create a fulcrum effect which multiplies the forces on the lower back. If the item is so large that it can not be lifted properly by yourself, then get some help! The few moments that it takes to ask someone for assistance is well worth the time you will lose while you are injured.
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Date: February 25, 2014 | Time: 7:44am | Posted By: drmroski

computer back and neck

Bad Computer!!

Poor posture at the computer can cause pain. It is common for people to spend hours upon hours at work staring at a monitor and clicking their mouse. These same workers go home and continue this same activity while playing games, checking social media, or just browsing the internet. Repetitive stress like this can really take a toll on your back and neck. Laptops and handheld devices compound the problem because they encourage a forward flexed neck position at almost every spare moment of the day. Here are some tips to help avoid computer neck/back:
  • Make sure your monitor and workstation are set up correctly for your task. The most effective way to determine correct monitor height is to sit correctly in your chair or where ever you view your monitor. Next, close your eyes and position your body and head in a neutral and comfortable position - your spine should be straight and head centered over your shoulders. Then, open your eyes and note at which point your eyes are initially focused on. This area should correlate to the center of your monitors screen or the part of the screen you view most frequently.

  • Be aware of your posture throughout the day and be sure to maintain a neutral spine -no slouching!
  • Take mini breaks on a regular basis when in a prolonged position and remember to stretch.
  • Have the right equipment and tools for working in a prolonged position, use ergonomically designed furniture or use an added lumbar support if needed.

  • For more tips on workstation ergonomics click here
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    Date: February 7, 2014 | Time: 7:16am | Posted By: drmroski

    painful situp

    Lower Back Pain & Three Exercises You Should Avoid

    I just read an interesting article about the 3 exercises people with lower back pain should not do. Here they are:

    1. Elliptical Machines
    2. Crunches & Sit-Ups
    3. Leg Presses

    The first one surprised me a little. I assumed that because elliptical machines were low impact that it would be a good cardio exercise for people with lower back pain. It turns out that the motion created when walking on these types of machine causes the spine and pelvis to twist more than they should, causing sacroiliac and lower back pain. Situps/crunches and leg presses cause repetitive flexion of the lower spine, which can aggravate some common conditions that cause chronic lower back pain.

    It is important that patients with chronic lower back pain regain core stability prior to attempting to strengthen the muscles that support the lower back. For more information visit our website.
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    Spinal Decompression

    Date: November 19, 2013 | Time: 7:27am | Posted By: drmroski

    Spinal Decompression

    Spinal Decompression Therapy is a proven, non-surgical method of treatment to relieve persistent aches and pains stemming from disc problems such as disc bulge and disc herniation. Unlike the traditional traction of the past, spinal decompression can be directed at specific levels in the neck or back. Because it is level-specific, more spinal decompression is achieved using less force overall. This makes the treatment very comfortable. In fact, many of our patients become so relaxed during their treatment that they doze off.

    Mandeville Chiropractor disc bulge and disc herniation treatmentIt works by creating a negative pressure inside the disc, causing the bulging disc material to be retracted away from irritated nerve tissues. At the same time, the disc is rehydrated and healed by the nutients that are drawn inside during the process. We have been using this non-surgical treatment method in our chiropractic practice with great success in Mandeville since 2005.
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    Head Forward Effects

    Date: October 28, 2013 | Time: 4:29pm | Posted By: drmroski


    Head Forward & Health Down

    The head-forward posture is something that the majority of my neck pain patients deal with. With the modern workplace becoming more and more computer dependent, neck pain due to poor posture is on the rise. Patients need to be educated on proper workplace ergonomics and how to promote proper neck and head posture throughout their work day. Here is a simple demonstration on how a head forward posture can effect you: Stand upright and stick your head and neck out forward as far as you can. Next try to raise your arms above your head while your neck and head are still forward. It becomes really difficult to use your arms properly in this position. Now try the same thing with your head in a neutral position and you will see how much easier it is to raise your arms. Next, while putting yourself in a head-forward posture try to take a deep breath. It becomes very difficult to breathe properly. Lung capacity is decreased by 30% in this position. Now try the same thing with the head and neck in a neutral position. Some literature has even attributed digestive system dysfunction, sluggishness, and constipation to the head-forward posture. As you can see, correcting the head forward posture can have profound effects on health. For more information on office ergonomics check out our website here.
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    When Do I Need An Adjustment ???

    Date: October 11, 2013 | Time: 1:00pm | Posted By: drmroski

    A lot of patients who's initial complaints have resolved with our care ask me how often they should come back for care in the future. The answer is that it depends. I know that sounds like a pretty ambiguous answer, but let me explain. All of my patients become educated about their specific problem throughout the course of their care. They learn techniques to help them do their part in the healing process. Home care techniques, specific stretches, and exercises that will help prevent future episodes. Unfortunately, life happens between visits. Mothers pick up their children, carpenters grab a board to quickly, and office workers sit for too long in bad positions. All of my patients use what I call the "chiropractic rule of thumb". In general, if a patient does something that causes pain, then they should use all of the home care techniques that they have learned to get their symptoms under control. If, after three days of consistently using proper home care they are no better, then they need to get in the office ASAP. Studies have shown that an episode left untreated for a week with no improvement take twice as many visits to resolve. Some patients with chronic conditions have found it to be beneficial to get treatment on a more regular basis. I do not recommend once a month for everyone in my practice. Some patients need more care, some less often. Each patient's problem is unique. Over time, patients determine how often they need care based on when their symptoms resurface. Whatever the case, it is a fact that chiropractic care makes you more healthy overall. Patients who utilize chiropractic care take less drugs, have less outpatient procedures, spend less money for healthcare, and are more satisfied with their care. <view entire article>

    Chiropractic and Vertigo

    Date: October 9, 2013 | Time: 9:43am | Posted By: drmroski

    Can Chiropractic Help Vertigo???

    A quick post concerning BPV: I occasionally have patients come in that complain of vertigo that is worsened by certain body positions. This is a condition known as benign positional vertigo, or BPV. It is an inner ear disorder that is caused by clogging of one of the semicircular canals with otoliths (small crystals in the inner ear) that have been dislodged. Many of these patients have been the medical route and have been given antivert aka Meclizine. Because the problem has a physical cause (a clog in the canal) this medication quite often offers little relief. There is a procedure that I perform called canalith re-positioning that is 86% effective for curing the problem. This procedure addresses the physical problem that is the cause of the symptoms. An examination by good chiropractor can confirm if the vertigo is BPV related. The three main causes of vertigo include inner ear problems, neck dysfunction, and TMJ (jaw) disorders. In the absence of any cranial nerve involvement or other neurological deficit, then a short-term plan of conservative care is indicated. chiropractors can address all three of these problems, giving the patient the best chance of success. In my office, I identify the causes through examination and treat whatever seems to be contributing to the problem, whether it is one or more. Should conservative treatment fail, then a MRI should be ordered to rule out any more serious causes such as tumor, infection, etc. Can chiropractic help vertigo?? The answer is yes (usually). For more information about chiropractic you can visit our website
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    Date: August 19, 2013 | Time: 1:57pm | Posted By: drmroski

    Can Chiropractic Care Help Headaches?

    I have had many chiropractic patients in the Mandeville and Covington areas who have come to me for relief of their headaches, so I get this question a lot. The answer I usually give is that it depends, but the chances are good that chiropractic care can help. The most common cause of chronic, recurring headaches is upper neck dysfunction. These types of headaches are known as cervicogenic headaches, meaning that the headaches source originates in the neck. It has been estimated that 80% of chronic headaches fall into this category, so you can see how chiropractic care would be a really good choice for treatment. Other types of headaches also respond chiropractic, which addresses the structure an function of the cervical spine. This is because the cervicogenic headache can trigger other types of headaches such as migraines or tension headaches. Self treating with over the counter medications has been shown to actually increase the frequency and duration of headaches long-term. Isn't it ironic that the very medication that people take for their headaches actually makes their problem worse in the long run? A Duke University study in 2001 concluded "Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic control...a course of manipulation treatments resulted in sustained improvement in headache frequency and severity." What this means is that chiropractic care results in long term improvement with less headaches and less severe headaches. If you are suffering from chronic headaches then this is some really good news! If you are a patient who has recurrent headaches and the medications do not offer any long-term relief, then you should see a good chiropractor in your area.

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    Home Care for Low Back Pain

    Date: May 31, 2013 | Time: 3:23pm | Posted By: drmroski

    Patients ask me all the time what they can do at home to manage their low back pain. This is a very important question. Patients get relief when they come to the office for treatment, but can cause their pain to resurface or worsen by doing the wrong things at home in an attempt to self-treat. One of the most common mistakes is using a heating pad on an already inflamed lower back. The signs of inflammation are pain, heat, redness, and swelling. That's right - pain is a sign that you have inflammation! Putting heat on an area that is already inflamed will make the inflammation worse and your pain worse. I'm not saying that heat should never be used, but in this case, where you are having acute lower back pain, heat is not indicated. Ice should be used instead of heat if you are experiencing lower back pain that has recently started. 20 minutes on and then 40 minutes off is the proper duration. This can be repeated every hour. If you are diabetic or have sensory impairment, then you should consult your doctor before attempting this. Another common mistake is to stretch too vigorously in an attempt to loosen tight muscles. Stretching should always be done according to the patient's tolerance. If it causes pain to stretch, then you are stretching too far. No pain, no gain does not apply here! A little soreness is expected during a stretch, but not pain. There is a difference. Another mistake is to bounce or repeatedly jerk on a muscle while stretching. A muscle reacts to a sudden stretch by suddenly contracting. By stretching, you are trying to relax the muscles, not trying to make them contract. for this reason, you should perform steady stretches for at least 10 seconds according to your tolerance. These two tips for caring for your lower back pain, using ice properly and stretching properly at home, can really help you get better faster and can help you manage your pain between visits. For more information about chiropractic care and our office visit
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    I Believe in Chiropractic

    Date: January 21, 2013 | Time: 11:00am | Posted By: drmroski

    It never ceases to amaze me when I hear a patient say that they know someone who says that they "don't believe in chiropractic". I understand that people might not understand what it is and how it works, but that doesn't stop these same people from believing in other things that have a whole lot less research and evidence supporting its existence. I guess those people are not saying that they do not believe it exists, they just don't believe that it works. Quite often, the very people that say such things end up trying chiropractic care because they see first-hand the results that their friends are getting. Results that are natural, with no risky surgery or drugs. I recently had the pleasure of treating someone who tried the medical treatment approach for his back pain and sciatic pain. He had drugs, injections, and 50 visits to a PT clinic with no results. His next stop was going to be surgery, but he decided to try chiropractic as a last resort. After just a few visits here his pain is already reduced by 50%. I can tell you that this man, who was quite skeptical when he came in for his first visit, now believes in chiropractic. Maybe he should have tried chiropractic first instead of last. Quoting research statistics does little to sway the opinion of a skeptic, but results speak for themselves. Days like today make me thank God that he lead me to this profession. <view entire article>

    Treatment for Sciatic Pain

    Date: November 19, 2012 | Time: 9:55am | Posted By: drmroski

    I recently came across an article about the use of epidural steroid injections for sciatic pain. The study analyzed the results from two dozen clinical trials on thousands of patients. The study concluded that "epidural injections (into the spine) of corticosteroids had no long- or short-term effect on sciatica back pain, and such a small short-term effect on leg pain it would make no difference to the patient." A link to this article can be found here.
    To be honest, I have mixed feelings about this one. I have been using pain management doctors for many years to help my patients who can not seem to get their inflammation under control. Like any procedure, the effectiveness is dependent on many different factors. Better candidates experience better results. I understand that the injection itself does nothing to correct the physical problem that is the cause of the sciatic pain. Instead, the steroid simply extinguishes the inflammation temporarily. This explains why there seems to be some good short-term relief but no real gains in the long run. For this reason, in my practice, I tend to utilize epidural injections for that short-term pain reduction so that I can get some work done in an effort to make some structural changes that will treat the cause of the irritation to the sciatic nerve, rather than just treating the outcome. This can be achieved through spinal manipulation, spinal decompression, physical therapy modalities, and rehabilitation. I have had really great results co-managing patients this way. The pain management doctor helps the patient with their pain in the short-term while I offer non-surgical treatment that addresses the cause of the patient's sciatic pain.
    I hope that other physicians who read the article continue to educate themselves on the treatments available for their patients who suffer with sciatic pain. I sincerely believe that all treatment options should be utilized before surgery is considered. Given the high success rate of spinal decompression and chiropractic care for patients with back pain and sciatic pain, I think that these treatment methods should always be considered before more invasive procedures are carried out.

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    Common Sense Treatment Progression

    Date: October 29, 2012 | Time: 2:30pm | Posted By: drmroski

    I am seeing a disturbing pattern starting to emerge in regard to the treatment that a typical lower back pain patient goes through prior to seeing a surgeon. The norm now goes something like this: The patient goes to his primary care doctor with lower back pain. His doctor prescribes some medications and orders a MRI. Sometimes a the patient is referred for some PT, which usually consists of some stretching, massage, and maybe some ball or balance exercises. If there is any sign of a disc bulge on the MRI, then the patient is referred to pain management for a series of epidural injections. The next step, should the injections fail to give the patient relief, is referral to a neurosurgeon.
    When I think about the logical sequence of treatment, it should progress from the least invasive, least expensive care to the most invasive, most expensive care without skipping any steps in between. Lower back surgery is statistically the least effective and the most expensive care for lower back pain and should be the last resort unless certain red-flag signs are present. It is generally accepted that the rate of success is about 50%, and a recent study indicates that only 1 in 100 back surgeries are medically necessary. Injections are not very cost effective either, somewhere around $1500 per injection with most cases requiring a series of three for a total of around $4500. Injections like these should be used in conjunction with some form of physical treatment because they do not actually fix anything. The steroids used simply turn off the inflammatory process temporarily. Don't get me wrong, I have nothing against medical doctors who perform these procedures - I refer many cases to pain management and to neurosurgery every year and they do a fantastic job. The patients that I refer, will however, never look back and say that they should have tried something else prior to surgery.
    At Northshore Chiropractic, we offer non-surgical treatment for patients suffering from lower back pain and other musculoskeletal conditions. We take a logical approach that is problem focused and does not skip any of the steps that can potentially save a patient from going through a surgery before it is absolutely needed. We are happy to co-manage our patients with their medical doctor in order to achieve the best results utilizing the least invasive procedures. One of the procedures we use is spinal decompression therapy. It is a non-surgical treatment for bulging and herniated discs that has been shown to be up to 86% effective. This, coupled with its relatively low cost when compared to injections or surgery, make it a logical step that should be added before these other more invasive and expensive procedures are utilized. <view entire article>

    Functional Rehab for Low Back Pain

    Date: October 22, 2012 | Time: 4:51pm | Posted By: drmroski

    There is a problem in traditional rehabilitation for lower back pain. I see patients every day who, despite the fact that they have had extensive treatment and rehabilitation, still exhibit instability in functional positions. They almost always describe to me exercises that they were taught that include ball exercises, abdomen strengthening, and the like. Lumbar core stabilization is, unfortunately, not equal to abdomen strength. It is all about coordination and co-contraction of the abdominal muscles and the main lumbar stabilizing muscles that include the multifidus, quadratus lumborum, and pelvic floor muscles.

    Strength does not equal stability. I have seen some really big and strong athletes who are completely unstable in positions needed for normal daily activities. Think about some activities that require stability and balance, like riding a bike. Do you have to be strong to do that? No! Four year old children can learn to ride a bike pretty easily. They just have to develop the coordination needed to perform that action first.

    One thing that I have noticed is that patients have been given a lot of abdominal strength exercises and lumbar strength exercises, but nothing that facilitates the co-contraction patterns that are needed to truly be stable in functional positions such as sitting and standing. This is the missing element in a great deal of lumbar rehab protocols. I see no point in performing strength exercises for lower back pain until unstable muscle patterns are corrected. Otherwise you would just be reinforcing these unstable patterns, making it more difficult later on to address.

    In my practice, I see many patients who have had disc problems for extended periods of time who have had multiple episodes. I utilize chiropractic care, spinal decompression , and functional rehabilitation designed to address the instability patterns that develop in response to pain. Strengthening comes after instability is addressed. The great thing about this approach is that stability exercises are less strenuous and can be started earlier in care when they can not tolerate strength exercises. This approach is "phase of care friendly" for that reason and the progression from stability to strength becomes a logical process that progresses as the patient's pain level decreases. This helps to prevent future episodes from happening over and over due to bad muscle patterns that, if left untreated, continue to cause pain and interfere with normal function.
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    Structure and Function

    Date: October 19, 2012 | Time: 4:14pm | Posted By: drmroski

    What is chiropractic and what to doctors of chiropractic do? That is a really good question. Chiropractors believe that the structure of your body greatly effects how it functions. Not just how you move around or how fast you can run and those types of things but how you function overall. We are talking joints, muscles, nerves, ligaments, organs, and everything else. Your brain controls every cell and organ in your body. Its nerve signals are sent downward from the brain to the spinal cord and then out to the nerve roots which eventually branch out to innervate everything. The spinal cord is housed within the bones of your neck and back called the spine and the nerve roots exit from the spine through little holes called IVF's. When the structure of your spine is altered, bad things start to happen. First of all, because the structure is altered, joints start to have dysfunction. They don't move correctly and become restricted. This in itself is enough to cause cellular breakage, inflammation, and pain. A recent study showed that joint restriction and immobilization caused joint surfaces to start degenerating within just 72 hours! Altering structure causes stresses to be taken up unevenly. Bones form according to the stresses placed on them and uneven stress leads to uneven bone growth. Whenever I see a bone spur on a X-ray I know right away that there is a structural problem. I always think of the car alignment analogy here - If the alignment on your car went out one day you might not really even notice anything at first. Drive another couple of thousand miles with a bad alignment and I can guarantee that you will start noticing that things are not right. What might start as just an irritating wobble at first could end up becoming a big problem later when you start to mess up tie rods, ball joint, and other expensive parts. Your spine structure is like this. Bad alignment left untreated will eventually lead to much worse problems later on such as arthritis, disc problems, nerve problems, joint problems...the list goes on and on. Structure effects function. It is as simple as that. Chiropractors are the very best healthcare professionals that address the structure of your body without invasive procedures or drugs. <view entire article>