Flip flops!

Flip flops!

Now that we are well and truly into the summer season I thought I would use this blog post to look at the impact of flip-flops on your lower back and pelvis. Although for the brave flip-flops are a mainstay for some people throughout the year many of us only put them on during the summer months.

Now, not focusing on the types of problems they specifically cause with feet like hammer toe, bunions not to mention fungal infections – although that may be enough to put most people off wearing them. Instead I’m focusing on how they can change the way you walk and thereby how it loads the spine.

The key changes are altered gait due to:
-It being a supeflat shoe
-It has minimal cushioning for heel strike

When you wear a flat type of footwear the main change usually occurs in the arch of the foot, really it depends on the biomechanics of your foot, so if you have a high or low arch it may affect you more. It also usually affects you more if you have flat feet or have been told that you over-pronate.

Heel strike is when our heel makes contact with the ground, this means it goes very quickly from zero force to almost all of the force being carried by the heel before the midfoot and then the toes come into contact with the ground to dissapate the forces and prepare to spring off for the next step. When we walk with shoes on we actually take longer strides as the shoes provide cushioning, when we are barefoot we take shorter strides as it results in less force going through the heel. So flip flops encourage us to walk with longer strides when really we should be taking shorter ones due to the reduced cushioning.

Sometimes you see people who are walking in flip flops and there is a distinctive slapping sound as they are (sometimes not conciously) avoiding the heel strike and allowing the midfoot and forefoot to take more of the strain. Whereas when people run barefoot they commonly avoid a heel strike, when we walk, even barefoot we should have a heel strike. This and the other changes in gait can have a big impact on the way the forces are transferred up the legs and into the pelvis and spine. This results in compensations and eventually secondary conditions such as pain/discomfort or isolated cases of hip pain or low back pain.

Where does Chiropractic Works come in to this I hear you say? Well I can’t stop you from wearing flip flops (as much as I may recommend it to some people) but I can do is assess the spine to see if it is having any detrimental impact on you and then what is the best plan of action to correct these shifts in the spine.

Focus On: Headaches

Focus On: Headaches

There are a number of causes for headaches, of which I will be focusing on the one most commonly seen in the clinic, cervicogenic headaches. Cervicogenic headache literally means that the headache itself is as a result of a problem in the neck.

So what is causing the headache?

Usually to be classified as a cervicogenic headache the spinal dysfunction has to be within the upper three vertebrae in the neck whereby these have been shown to have the highest correlation of dysfunction, with onward pain referral into the head.

What does it feel like?

Really this varies from person to person, generally it begins as a tightness/pressure at the top of the neck which then extends into the back of the head (the occiput) and then sometimes extends to the top of the head and can go into the eyebrow/back of the eye region. Interestingly some people don’t even feel the neck pain or discomfort!

What causes the joint dysfunction in the first place?

First of all there are a number of potential causes. I find there is a high correlation with cervicogenic headaches and anterior head syndrome (AHS), this is a postural/structural condition that puts increased strain onto the joints and muscles of the neck and upper back. If a person also has degenerative changes within the spine, which can be seen on an x ray or MRI scan, along with AHS then this usually indicates that the condition has been present for quite a while.

What causes AHS?

Unfortunately it’s the usual suspects:

-previous neck trauma (e.g whiplash)

-inappropriate desk set up

-poor sleeping positions

-sedentary lifestyle

-prolonged use of computers, tablets

Can anything be done for cervicogenic headaches?

The evidence is good supporting chiropractic care for cervicogenic headaches. At Chiropractic Works I focus on working to correct the structure which in turn helps to improve the function of the spine decreasing joint dysfunction, muscle tightness and ultimately the headache.



1. Haas M., et al. , Dose response for chiropractic care of chronic cervicogenic headache and associated neck pain: a randomized pilot study. J Manipulative Physiol Ther, 2004. 27(9): p. 547–53 [PubMed]

2.Haas M., et al. , Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. Spine J, 2010. 10(2): p. 117–28 [PMC free article] [PubMed]

3. Jull G., et al. , A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine (Phila Pa 1976), 2002. 27(17): p. 1835–43; discussion 1843. [PubMed]

Warm Up Vs. Stretching

In this post I’ll be looking at why we stretch, what we are trying to achieve and if we are going about it the right way.

I’m sure it won’t be a surprise to you that there is more than one way to stretch, however you may be surprised to find out that generally it is classified into seven, yes, seven, different ways to stretch (for the list and explanation check it out here). I’ll be focusing on the most commonly discussed and used which are static/passive and active/dynamic stretching.

Static/Passive Stretching

Static stretching is the most common type of stretching people do, you stretch to a position and hold it. With passive stretching you are using another body part or a piece of equipment to stretch (theraband) whereas static doesn’t.

Active/Dynamic Stretching

Active stretching is where we use the strength of other muscles to facilitate the stretch, many of the moves seen in yoga are active stretches. Dynamic stretching uses gradual and controlled increases in movement and in speed to stretch, for example arm swinging.

Why do we stretch?

The primary aim of stretching is to increase the functional range of motion. This is the useful movement that we have in a joint. A lot of people also do stretches before exercise. There has been a growing body of research that shows this may be detrimental to us if performed before exercise. It has shown to result in:

– A possible increased risk of injury.

– Less stability whilst performing exercises.

– A decrease in muscle strength/output.

The last two points about stability and decrease in muscle strength are really important and interesting to me. Those that have been to see me will know that my favourite words are structure and co-ordination.

Exercise and balance go hand and hand, one without the other makes it extremely hard to perform well. When you add muscles that are unable to work to their maximum potential it is easy to see how it can result in accumulative strain and eventually secondary conditions (muscle spasm/tears, neck pain etc.).

So before exercise we should be aiming to warm up: increase the heart output and almost pre warn the muscles that they are going to be called into action. If you are going out for a cycle don’t burst straight into your full stride or save that hill for later – not always easy in Sheffield. Walk for a few minutes before running and throw in a few lunges or hip rotations. After exercise is the time that we should be doing static stretching (or indeed PNF which I’ll cover another time).

Have fun!

Chiropractic Works focuses on improving and maintaining the proper structure of your spine, ask for a complimentary consultation to find out how we can help you.

Snow Advice

We all love a snowy postcard scene, but our thoughts towards it are less favourable when we have to go out in it. Here’s some advice for walking on snow/ice.

  • Choose a good pair of winter boots, a worthwhile investment. Look for warmth, stability, insulation, waterproof and a non-slip tread sole made of natural rubber.

  • Get a grip, ice grippers can be great on hard packed snow and ice. They can however be treacherous on stone, tile and ceramic surfaces. Make sure you get a pair that are easy to remove (even with gloves on).

  • Extra support, a pair of ski poles, a cane or walking sticks can help with balance. Ensure they are the correct height for you.

  • If you struggle with mobility at the best of times consider using a walker.

  • Wear bright colours – visibility can be reduced in a snow shower.

  • Dress in layers and don’t forget your hat, scarf and gloves.

If you are walking on ice:

  • Slow down, think about the next step but don’t tense up.

  • Bend your knees, helping to stabilise the body and allowing it to react if it is a bit slippier than expected.

  • Keep a wide base of support, make sure you have one foot planted before you transfer onto the other one.

  • If you feel you have to drag your feet or shuffle, just remember to keep your base of support approximately one foot wide.

Finally, think whether it is better to venture out now or delay it for a couple of hours if conditions are likely to get better.

How adaptable are you?

Adaptability is “the ability to change your ideas or behaviour so that they are suitable for different conditions, a new environment, etc, in order to deal with the new situation successfully”. – Collins English Dictionary

In real life a great example of this is when your hands get wrinkled in the bath, this is your body adapting to the conditions to actually improve your grip when your hands are wet and reduce your chances of falling. Or in the case of the lovely picture above, the chameleon adapts to it’s surrounding by using colour to blend in – not that we do that!

Our bodies are constantly adapting to the environment and also the demands we put on it, that’s why we gradually find exercise easier and why repetitive strains take time to build up (although this is a failure to adapt).

To me as a Chiropractor this is really important for our patients as one of our primary focuses is function, how that function has altered and how we can alter it to improve and restore function. This ties in with adaptability as the greater the adaptability the more resilience our bodies have and the greater our bodies can cope with the strains that we put through it.

One research paper that focuses on improved function is a study that looked at improved muscle strength after an adjustment, even when there was a muscle imbalance. This highlights the impact that Chiropractic has, not just on pain but on the function on the nervous system and the body as a whole.

When a patient attends our clinic with symptoms (secondary conditions) it is usually due to a failure to adapt to those strains that are being placed on it, this has resulted in altered function (neuro-segmental dysfunction). By working with the individual to remove this altered function we are effectively aiming to allow their body to restore and gain a greater degree of adaptability.

When we have more adaptability we are more likely to work to our full potential and be more resilient.

If you have any questions or comments don’t hesitate to get in touch.