What's with "Cracking Backs"? Understanding the Popping Noise you Hear at your Chiropractor

You’re nervously walking into your first visit to a Chiropractic office with stories from your friend who referred you to the doctor who "cracks your bones" ominously swirling around in your head. "Yeah, the ones in your back, your neck and even in your arms and legs", but “don’t worry” they said, “it feels great and my pain is gone”. Yeah, right! How could someone cracking my bones feel "great"? Fair enough, that sounds pretty terrifying to me and I’m a chiropractor… but don’t worry! This is a very common misconception and you’re not the only one who assumes this myth to be true.

Allow me to set your mind at ease and tell you that we do NOT crack bones; to be honest, we do very little to bones at all. A chiropractic adjustment, manipulation, back crack, or whatever you want to call it is intended to affect your bodies joints. Now, as a great teacher of mine once said, "I don’t mean to insult your intelligence" - a joint is a fluid-filled, pressurized, connective tissue capsule that connects bones together and allows for movement in different directions. There are different types of joints with different structures and functions – some of which have more movement than others, and some that are more likely to become restricted and pain producing. Again, we do NOT crack bones, we help to create space and movement within a joint.

Again, we do NOT crack bones, we help to create space and movement within a joint.

Now that we've gotten that out of the way, why do your joints make that cracking sound when they are adjusted? Well to use the proper term, we call that noise a ‘cavitation’. A cavitation is the formation of an air bubble inside of a liquid which undergoes the phenomena of ’tribonucleation’, this is a known natural process where distraction forces on a joint result in a small separation due to viscous attraction by the synovial fluid within the joint capsule. The fluid cavity is then formed, and a cavitation may be heard when sufficient force rapidly separates the liquid. The cavity only disappears when the action is completed.

Well that’s a little bit confusing, now isn’t it? Let’s break it down.

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When a Chiropractor administers an adjustment, they’re applying a controlled, high velocity (read: quick) low amplitude (shallow) force to the desired joint. This force is sufficient to gap the joint, which creates enough space within the joint capsule to form the bubble that creates the cracking sound you may hear.

Wait! Bubbles? Yes, just bubbles. Not so bad, right?

What does the joint gapping and adjusting do? How does it get me out of pain? How does it allow me to move my neck, back, arms, and legs more freely? And where did my headache go? Those are all great questions, and ones I look forward to answering another day!

I hope this helps you better understand what is truly happening when your Chiropractor adjusts you!

Summary:

  • Chiropractors do NOT “crack” bones
  • Chiropractors DO gap joints to improve movement and decrease pain
  • The cracking noise is called a cavitation and is caused by a gas bubble forming within the joint
  • Bubbles are not scary:)

Bulletproof Coffee: Upgrade your morning and boost your energy throughout the day

You may or may not have heard of bulletproof coffee, but this yummy morning brew is going to amp up your mornings and the rest of the day! So many people these days are in a huge rush in the morning and simply grab a coffee, a muffin (or other carbohydrate dense breakfast food) and head out the door. In my experience, this usually causes fogginess, fatigue and hunger mere hours later. Sound familiar?

Bullet or Bulletproof coffee is a delicious, creamy and easy recipe to add some healthy fats to your morning brew. Adding healthy fats, such as MCT oil and grass-fed butter dense with omega 3 and 6, to your coffee slows down the absorption of caffeine. Medium chain triglycerides (MCT) are isolated from coconut oil, for their ability to bypass metabolism in the liver and provide the body and the brain with sustained energy. Blending in these fats and some other powerful, natural add-ins essentially turns your drab morning joe into a breakfast of champions. No need for any more muffins, and it will keep you full until lunch! It is important to note that Bulletproof coffee is not the appropriate choice for everyone, but can be a healthful breakfast substitute for many.

The individual ingredients in bulletproof coffee are nothing too special on their own, but all together... Look out! You’re in for a treat! Aside from the joy of your morning coffee ritual, you’ll also have these amazing benefits:

1. Less desire for multiple coffees throughout the day

Possibly one of my favourite benefits of bulletproof coffee, is that having one cup in the morning is going to stop you from reaching for that second, third or even fourth cup in the afternoon. This is a nice change for both your liver and your wallet. Black coffee has some proven health benefits, but these only holds up if consumed in moderation, meaning less than three cups (250mL) of coffee per day. The reason for this reduced craving for that afternoon joe is multi-factorial, but largely due to the ability of fats and coffee to balance blood sugar levels. The addition of fats to caffeine slows its absorption and prolongs coffee’s energy enhancing and blood sugar balancing properties throughout the day. More specifically, one component in coffee (chlorogenic acid) causes glucose to be absorbed further along in the intestine, therefore prolonging satiation and reducing blood sugar spikes. Moderate black coffee consumption has been linked to enhanced metabolic profiles by improving insulin sensitivity, which in turn can even lower the risk of Type II Diabetes. We know that carbohydrates and proteins (like the ones in your breakfast muffin) can be converted to sugar, and therefore cause blood sugar levels to rise, but the fats in bulletproof coffee aren’t going to promote blood sugar spikes at all. Without a blood glucose spike in the morning, you won’t get a blood glucose drop in the afternoon.

Having fewer blood glucose highs and lows creates a sustainable balance that will have you saying goodbye to that 2-3pm slump!

2. More efficient fat metabolism throughout the day (which can lead to weight loss for some)

Ok wait… so adding fat to coffee, can improve my fat metabolism? You bet!

Adding fats to coffee is going to massively increase the caloric profile of your morning brew. Giving your body ample calories in the morning is important so that it doesn't get tricked into entering starvation mode, which is prompted by caloric restriction. Calorie restriction promotes fat storage and decreased metabolism, which in turn causes you to gain back all the weight that you would have lost restricting your calories. Instead, having a calorie dense, fat-filled breakfast is going to kick start your metabolism for the day ahead of you!

Coffee itself is known to improve the satiety hormone profile, via ghrelin and serotonin, while specific phenols in coffee also increase fat utilization and promote fat excretion. Butter that comes from grass-fed cows contains a much higher content of healthy essential fatty acids (omega 3 and omega 6) when compared to regular run-of-the-mill butter, and these EFAs are going to promote production of an optimal hormone profile. Having healthy hormones is key for efficient fat metabolism (see benefit #4).

Medium chain triglyceride (MCT) oil is specific type of fat that is more easily digested than other fats and sugars. While being easy to digest, MCT oil helps you feel full longer by producing ketones that will suppress the hunger hormone grehlin, and increase the satiety signal via CCK. Ketones also fuel your brain and promote thermogenesis, which helps speed up your metabolic rate.

3. Improved cognitive function and energy (no more 3pm fatigue and brain fog)

We all know that the caffeine in coffee gives most people an energy boost, can stimulate digestion, and promotes regular bowel function. MCT oil helps stimulate digestion in a similar way, therefore it is important to start with only about 1tsp per day, and increase slowly from there. Regular bowel function is key to removing toxins, and an overburden of toxins and inefficient digestion can make us foggy and fatigued throughout the day, which will reduce our energy and cognitive function.

There has been a lot of mixed research on the benefits and harms of coffee. However, recently black coffee in moderation has been shown to reduce rates of neurological disorders such as Parkinson disease, age-related cognitive decline, and even Alzheimer’s disease. Potentially due to the large antioxidant profile of coffee which can be protective against oxidative damage in the brain. Similarly, MCT oil is known to help optimize brain function and cognition by being metabolized into ketones quickly, and providing the neurons in your brain with fast, available energy.

4. Increased production of healthy hormones

I’ve already mentioned a lot about hormones, particularly the ones that send signals of whether you’re hungry or full: ghrelin, CCK, and serotonin. However, it is important to note that the building blocks of ALL hormones in the human body is through saturated fat and cholesterol – no fat equals no hormones. The fats from both MCT oil and grass-fed butter are going to promote production of our hormones including steroid and sex hormones, including testosterone. Testosterone is known to promote fat loss, lean muscle mass development and improved energy!

INGREDIENTS

  • 1 cup of organic coffee (Not a fan of coffee? Try experimenting with bulletproof matcha, or chai tea!)
  • 1 tsp MCT Oil High in C8
  • 1 Tbsp organic grass-fed unsalted butter (or ghee if you’re dairy sensitive or lactose intolerant)
  • ¼ tsp organic vanilla

INSTRUCTIONS

Put all ingredients in a blender or food processor. Mix on high speed for about 20 seconds until frothy. Enjoy immediately!

Test out these optional add-ins:

  • 2-3 drops of stevia extract to help sweeten the mix
  • 1-2 tsp Chaga mushroom powder as a coffee substitute or for its adaptogenic and immune boosting function.
  • 1-2 tbsp Collagen Hydrolysate to hydrate connective tissue and joints.
  • 1/2 tsp Cinnamon to additionally balance blood sugars and add a warming flavor.

Note: Information can be empowering, but we all have unique health profiles and needs. Health-related information contained in this post is intended to be general in nature and should not be used as a substitute for a visit with a Naturopathic Doctor.


REFERENCES

Pourshahidi, L. K., Navarini, L., Petracco, M. & Strain, J.J. (2016), A Comprehensive Overview of the Risks and Benefits of Coffee Consumption. Comprehensive reviews in food science and food safety, 15: 671–684. doi:10.1111/1541-4337.12206

Cunnane, S. C., Courchesne-Loyer, A., St-Pierre, V., Vandenberghe, C., Pierotti, T., Fortier, M., . . . Castellano, C. (2016). Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimers disease. Annals of the New York Academy of Sciences,1367(1), 12-20. doi:10.1111/nyas.12999

Baseline Testing - is it worth it?

As a parent, coach or athlete have you been thinking about baseline testing?

 You might want to reconsider.

Just this month, the national injury prevention organization Parachute Canada released a Statement on Concussion Baseline Testing in Canada that makes pivotal statements on the use of baseline testing for Canadian Athletes.  Parachute is a highly respected group that makes recommendations that influence practice across the whole country.  

The key messages from the statement were:

  1. Baseline testing is not recommended for youth sports in general.
  2. Baseline testing is not required to provide good quality care after a concussion.
  3. Rather than using resources to pay for an organize baseline testing, sports organizations should develop guidelines to recognize concussions and when to remove athletes from play.
  4. Return to play should be guided by a licensed medical provider and based on a comprehensive assessment, not any one test.
  5. In adults, baseline testing should only be done if there are qualified healthcare practitioners available to administer testing and follow up after injury.

There are plenty of reasons why these things are being suggested.  For one, evidence has not shown that baseline tests are always reliable and useful.  Quality care and decision making can still be provided based on tests done after injury - just like with most other health conditions or injuries.  A truly comprehensive baseline assessment is difficult and expensive to administer and takes a lot of time - so it is rarely ever done.  Most of the time baseline tests are of a single type (like the ImPACT test) and only assess a small number of issues.  Concussion is a complex injury that has a wide variety of potential symptoms and issues, so unless we test absolutely everything we will be missing key information.

Quality care and decision making can still be provided based on tests done after injury - just like with most other health conditions or injuries.

Parachute recommends that time and money be better spent on developing better policies and procedures for how concussion is recognized and dealt with on the field.  We don’t need expensive, time consuming tests to decide when to pull athletes out of play.  We just need to better recognize the situations where concussions can occur, assume and injury has happened and pull players out of the game or practice quickly.

Through the last few years, baseline testing has been aggressively marketed to sports teams all over North America.  While the intentions are overall good (baseline testing seems logical and helpful) the research just hasn’t panned out to say that it’s a necessity or that it significantly helps us make better decisions for children and youth especially.  There can be a conflict of interest when these baseline test platforms become multi million dollar businesses rather than clinically oriented assessments.

 

Side notes:

If your team or sports organization wants to put together better policies around concussion management, reach out to us.  We’re keen on consulting with groups to best manage concussion in the community.  If you are still interested in exploring baseline assessment even in light of these recommendations, you can seek out free services from the University of Victoria’s Brain Lab.

What's The Best Thing We Can Do For Our Health?

As a society, we are obsessed with things we can do to look younger, live longer, avoid disease and feel good. We spend billions on medications, special foods, creams and a whole slew of other things. So, what really works? What is the best thing we can we do to live longer, healthy lives and avoid disease? Although some pills, supplements and foods may contribute to longevity and health, the answer is a simple intervention that everyone can do and often costs nothing: exercise!

We all know that exercise makes us look better but its benefits are far more widespread. A recent systematic review published in the British Medical Journal found that active individuals experienced significantly less serious disease with heart attacks, strokes and diabetes all being reduced by as much as 25%. Other studies have found significant reductions in various forms of cancer, depression, Alzheimer’s, dementia, anxiety and osteoarthritis for those who exercise regularly.

While some of these studies suggest a more intense exercise program can lead to greater health benefits, many studies found substantial health benefits with simple exercise programs at lower intensities such as walking 15 minutes, five times a week. What this means is that you don’t have to do a triathlon or live at the gym to get benefit from exercise – low levels of exercise also help benefit our health.

....many studies found substantial health benefits with simple exercise programs at lower intensities such as walking 15 minutes, five times a week

As if these benefits are not enough to convince you to exercise, people who are active also live longer. In fact, one large trial published in the Lancet followed almost half a million people and found that those who regularly exercised at a low intensity for only 90 minutes a week lived an average of 3 years longer than inactive individuals. Those people who were classified as being very active found further health benefits, with the most active group living about 4.5 years longer than the inactive group. There is even more to the benefits of exercise on longevity. Not only did these people live longer but they also lived more of their life without disability. We all show some decline with age but those who exercised regularly tended to have a better quality of life for a much longer period of time.

So, there are lots of benefits to regularly exercising but only 20% of the population gets the recommended weekly amount of exercise – 2.5 hours of moderate cardiovascular exercise and two strength training sessions per week. Why is this? Well, it has been said that if exercise came in a pill form, everyone would be on it and herein lies the problem. Exercise does require more motivation, time and commitment than taking a pill. Here are a few tips and pieces of information to make you successful at starting up an exercise program:

  • Choose an activity you like. Your much more likely to stick with an exercise program if you are having fun.

  • Try a group activity where you are accountable for showing up. You’ll benefit from the socialization and be more likely to attend when others are expecting you to be there.

  • Know that it is common to get some aches and pains when you first start an exercise program. This does not mean you should stop! We can help and a visit to your physiotherapist can get you back on track quickly!

Often exercise programs are preceded by a disclaimer that you “Should contact your doctor before starting any new exercise program” but after reading this blog I hope you think that you should contact your doctor if you don’t plan on starting an exercise program!