What is One of the Most Popular Reasons for Repetitive Strain Injury?

159627312_2670919bWritten by Dr. Marcus Wong

Ten years ago, if someone asked a practitioner this question, the answer would simply be ‘from the work place’.  Ergonomic problems in the work force have caused many injuries, resulting in millions of dollars spent in health care each year in North America.  There are usually two main kinds of injuries that occurs to a patient.  The first and most obvious is ‘direct trauma’. This is when the patient falls or injures themselves in sports and activities. The second type is less recognized, but most common. The ‘repetitive strain’ injury occurs most often when an action at work or from a hobby consists of the same repetitive moments and/or posture.  This repetitive motion will result in misalignment in the spine and cause muscle imbalance.  From this, symptoms arise and patients feel discomfort.

Ironically, what causes this popular type of injury today isn’t just from the work force alone, but also from the same technology that makes our lives more enjoyable, convenient and overall ‘better’.  Several new studies show that the #1 cause of repetitive strain injury is from overuse of electronic handheld devices such as mobile phones, tablets, and handheld gaming devices.  The average adult uses these devices for 5-6 hours per day. This problem affects both adults and children as parents frequently allow their young children to use these handheld devices. Soon enough, their children will suffer from the same physiological strain just like their parents and this problem will affect many generations.

young_boy_textingLet’s talk a little bit about what is happening to our body when we are using these handheld devices for long periods of time.  On average, our head  weighs about ten pounds. As we look down on our mobile phones or tablets, our head is pushed forward, adding extra pressure and weight.  This extra weight is mainly supported by your cervical spine or the neck.  The extended time will cause the joints to compress and become misaligned, in turn causing the supporting muscles to go into spasms.  This is when the patient feels stiffness and pain.  These symptoms can radiate to the shoulders and mid-back.  In some severe cases, headaches will result from this sustained posture.  These may be simple acute symptoms, but long-term damage may result in chronic cervical spinal misalignment and muscle strain, disc herniations and pinched nerves. Over time, it can even flatten or reverse the natural curve of your neck.  Due to prolong strain on your neck, this will eventually lead to issues in mid and lower back.  Symptoms of the lower back is the same as the neck.

Since these electronic devices have been integrated into our daily lives already, there are some steps to take that can help and/or prevent repetitive strain injuries to our neck.  A simple rule of thumb as with any postural issue is to take micro breaks in between long sessions of using these devices.  Regular stretches and postural exercises should be done as well.  Please refer to the exercise portion of our website for more information and instruction on proper stretching and postural techniques.

As with work force injuries, using electronic devices have been so embedded and implemented into our lifestyle that it is inevitable that majority of us will suffer from these symptoms.  For acute and/or chronic symptoms, chiropractic adjustments along with massage therapy and/or acupuncture has been effectively shown to manage repetitive strain injuries.

If you have any questions please contact Dr. Marcus Wong at drwong@truehealthstudio.com

Chiropractic Best Option for Sacroiliac Joint Pain

99367830-300x225Dysfunction in the sacroiliac joint (SIJ), located in the pelvis, is thought to be a possible cause of sciatica, resulting in back pain that radiates down the leg and below the knee.

Scientists have questioned what the best treatment option is for patients with SIJ-related leg pain. In a recent study, researchers compared three treatment options: physical therapy, chiropractic manual therapy, and intra-articular injections of corticosteroids. Patients included 51 adults with leg pain associated with the sacroiliac joint. Researchers analyzed the effectiveness of each method after 6 weeks of selected treatments, and again after 12 weeks. The results for each patient was categorized as either a success or failure, based on relief or worsening of symptoms and average pain scores.

The study’s findings revealed that manual therapy is the superior choice for treating leg pain associated with the SIJ. The success rate for chiropractic manual therapy was 72%, compared to just 20% for physiotherapy and 50% for corticosteroid injections. Researchers also found that neither physical therapy nor injections resulted in significant pain relief, whereas manual therapy resulted in a significant improvement on pain scores.

Due to the success rate and pain reduction of manual therapy, the study authors concluded that chiropractic should be the first treatment of choice in patients with SIJ-related leg pain. They hoped that their findings would be confirmed by further research with a larger sample size.

Additional research has highlighted the efficacy of chiropractic for sciatica, even after surgery has failed.

If you have any more questions about sacroiliac joint injuries/prevention or treatment options please email Dr. Marcus Wong at drwong@truehealthstudio.com



Chiropractic Beats Epidural Injections for Disc Herniations


Chiropractic adjustments were just as effective as epidural injections for patients with back pain in a new study — without the risks and at lower cost.

The findings show that chiropractic can significantly reduce pain in patients with lumbar disc herniation, and is less expensive than medical treatment.

Lumbar epidural injections are frequently used for back pain and sciatica in patients with lumbar disc herniation, failed back surgery syndrome, and spinal stenosis. During the procedure, a physician injects a high dose of pain medication, and sometimes steroids, into the area of the lumbar spine around the damaged nerve. This temporarily reduces inflammation and pain.

Although the injections are widely used, controversy lingers due to the lack of a studies with placebo controls, and questions about the effects of steroids versus anesthetic alone. Side effects of steroids include a weakening of muscles and spinal bones around the affected nerve and a disruption of the body’s natural hormone balance. It’s also unclear whether epidural injections are more effective than other conservative treatments for lumbar disc herniation.

While a number of studies have established the efficacy of chiropractic for low-back pain, fewer have tested its comparative effectiveness with other treatments for lumbar disc herniation.

In a new study from the Journal of Manual and Physiological Therapeutics, researchers from Switzerland compared the effects of chiropractic spinal manipulative therapy (SMT) and epidural nerve root injections (NRI). The study included 102 with symptomatic, MRI-confirmed lumbar disc herniation who were treated with either SMT or NRI.

After one month of treatment, both groups experienced significant improvements. Of the patients under chiropractic care, 76.5% said they were “much better” or  “better” compared to 62.7% of NRI patients. Sixty percent of chiropractic patients had a significant reduction in pain compared to 53% of NRI patients. These slight differences were not statistically significant.

While none of the chiropractic patients received surgery, three of the NRI patients eventually opted for an operation.

Since the treatments were considered equally effective, the cost analysis became even more important for comparing both treatments, the researchers pointed out.  On average, one month of chiropractic adjustments was less expensive than NRI ($558 vs. $729). Their analysis included only the “minimum cost” of NRIs, and did not take into account other costs that are frequently tacked on like additional consultations with clinicians, multiple injections, or possible surgery. Additionally, treatment cost for chiropractic patients may have been slightly higher than normal since they were required to receive an MRI to be in the study. Many chiropractic patients do not receive MRI because imaging guidelines do not recommend MRIs for patients with lumbar disc herniation in most cases. In contrast, MRIs are typically performed before injections or other more invasive procedures.

Although randomized trials are needed to confirm these results, the authors concluded that, “There were no significant differences in outcomes between the more universally accepted treatment procedure of NRI compared to SMT.”

This study suggest that patients can experience substantial relief from chiropractic care without worrying about the side effects of steroids or drugs. It may even save them money, since researchsuggests that chiropractic patients have lower annual medical costs compared to patients under traditional care.

If you have any more questions about disc herniation injuries/prevention or treatment options please email Dr. Marcus Wong at drwong@truehealthstudio.com


Chiropractic is Recommended from Medical Journal

Journal of the American Medical Association recommends Chiropractic


Perhaps a turning point has been reached. The Journal of the American Medical Association (JAMA) has recommended that patients who seek back pain treatment should consider chiropractic care before taking invasive measures such as electing for surgery. The surgical option should only be considered if conservative therapies fail. According to the JAMA, conservative alternatives like Chiropractic care should be the first “line of defense” because they are safer and more efficient in relieving pain.



Back pain can be anything from dull or sharp pain in your back or tingling or numbness that runs down your leg. These symptoms may indicate a pinched nerve which occurs when the disc bulges out and puts extra pressure on the nerve that is exiting between the spinal bones.

Chiropractic care can show you how to properly maintain back health and prevent the possibility of future spinal pain. Surgery should always be a last resort because there is a higher chance of failure. If you have or have had back pain or any other spinal conditions, please follow the advice of the JAMA and consider seeing a chiropractor.

– source

Golf Season is Here !!!

Written by Dr. Marcus Wong

The sun is finally out and it looks like its here to stay!!!  Many people start to dust off their golf bags if they haven’t done so already.  Some even started hitting balls at the driving range already couple months ago in the rain and cold breezy weather of Vancouver.  But after a long period of sitting on the couch and the holiday festivities of Christmas and then the Winter Olympics, and the ending playoff run of the Vancouver Canucks, many of us are left out of shape and not quite fit for a nice long season of golfing.  After all low back pain and elbow injuries are the most common conditions suffered by golfers.




Every time you take a swing the spinal rotation of the golf swing can reach up to 160 km/h, which can leave a lot of stress on your body.  Here are some tips to follow to prevent such injuries to your body:

  • Strength training of your core muscles are very to important prevent injuries.  The muscles stabilizes your spine and body through each swing, and acts as shock absorbers to prevent sprains and strains.  Core muscle flexibility and strength also increase proper oxygen flow in the body.
  • Warm-up and cool-down both before and after your game or session for a 20 minutes, which include gentle stretching and range of motion exercises, as well as a brisk walk or gentle jog to loosen the muscles and joints.  Muscles which should be stretched include your low back, hamstrings, quadriceps, calf muscles, etc.
  • Stay hydrated by drinking plenty of fluids before, during and after your game.  Remember that once you are thirsty, you are already starting to dehydrate.  Dehydration affects your energy level and your physical functioning and performance.  When your body and energy level decrease, this is when your body is most prone to injuries.
  • Use a wheeled golf cart for carrying heavy clubs. If you must carry your golf bag, buy the ones that have two shoulders straps.  This will spread the weight across a greater area on your back, so there isn’t one side of your back that is stressed throughout the day.  If there is only one strap, alternate sides frequently.  If you find that your bag is getting too heavy, put it down and take a break.  Taking breaks frequently is important, its your body telling you to stop and rest. Further stress will once again make your body prone to injuries
  • When wheeling your golf cart, push rather than pull.
  • Golf requires long periods of standing.  Frequently alternate your weight from one foot to the other or rest one of them on your golf bag or cart.  Taking breaks and sitting down if you get dehydrated or really tired.  Gentle stretching of your hamstrings, quadriceps, and calf muscles throughout the game.
  • Make sure you have the proper shoes for your type of feet.  Golf shoes with short cleats are the best.  Some times you may need orthodic insoles custom made for your feet.
  • Use the right technique for your physical capacity and limits. Adopting a golf swing based on your physical and biomechanical capacity is important.  Amateurs are usually better off adopting a classic golf swing, which enables the hips to turn nearly as much as the shoulders to minimize spinal twisting.  If in doubt, consult a golf pro.
  • Sleep well the night before the game, and have an overall healthy diet.  Eat before games and after games to replenish your body.  Playing hungry in any sport is not optimal for the body as your body tires quickly and your body will be prone to further injuries.

Preventing Shoulder Injuries

Shoulder injuries in golfers are common due to the repetitive nature of the swing.  This is a type of repetitive strain injury.  Therefore, a proper swing is very important as you don’t want to repetitively add stress and strain to your shoulders.   To reduce shoulder pain, try these two tips.

  • Shorten the back swing slightly. Instead of ending the club head at the 3 o’clock position, stop at the 1o’clock position.
  • Strengthen your shoulder, scapular, chest , and back muscles. Your chest and back muscles are large and generate the power in the swing.

Preventing Elbow, Wrist and Hand Injuries

  • Select larger and softer club grips and use a neutral grip.
  • Select irons with large heads and graphite shafts to lessen vibration.
  • Select the correct club length.
  • Strengthen your forearm muscles.

Chiropractors can help prevent backpack problems by showing you golf exercises and stretches. Should you suffer an injury from golf, a chiropractor can also provide treatment for your low back pain or shoulder/elbow injuries.




Enjoy yourself this golf season, remember to prepare yourself and prevent injuries before they occur is most important!!!!

If you have any more questions about golf injuries/prevention or treatment options please email Dr. Marcus Wong at drwong@truehealthstudio.com

Gardening is a Great Exercise !!

Written by Dr. Marcus Wong

 Have a look around you, the trees are turning green, the flowers are blossoming, and people everywhere are mowing their fresh green lawns. As the summer approaches, many people are bring out their tools from the shed and getting ready to “jazz” up their garden for the nice summer weather.  Gardening is a great exercise alternative, and you can enjoy the sunshine as well.




Every spring and summer, many individuals take part in raking, lifting, digging, kneeling and planting activities that lead to aches and pains in their neck, low back, and other extremities issues. Improper gardening techniques can cause repetitive strain injuries, lead to degenerative joint and disc problems, cause sprain and strain injuries to muscles throughout the body and wear and tear to joints and muscles.  Here are some following tips to follow for a safe and enjoyable gardening season.

  • Always stretch and warm up before starting any activities.  Gardening seems like a stress free activity, but it can lead to strenuous strain to the body resulting in injuries and aches and pains.  Take the time to prepare your body for activity by stretching your low back, shoulders, arms and legs.  Always warm-up and cool down your muscles. Take a short walk around the neighbourhood.
  • Always use good proper lifting technique.  Keep the load close to your body with your back straight.  Bend your knees while picking up and putting down the load. Avoid flexion of the trunk and twisting, as this puts lots of strain in your vertebral disc, and can result in injury.  Ask someone for help with heavy, awkward loads.


gardening-1 (1)

  • Alternate your tasks. Take turns between heavy chores such as digging and less physically demanding tasks such as planting.
  • Stand with one leg forward and one leg back when you rake. Raking can put significant strain on your back and arms. So take extra care with this activity.
  • Change hands often: Changing hands frequently when you rake, hoe or dig prevents muscle strain on one side of the body.
  • Kneel onto grass or soft surface to plant and weed. Don’t kneel on hard surfaces or cement as this can put stress on your knee joints.  Use kneepads or a kneeling mat to minimize the amount of stress.  Constant bending can put strain on your back, neck and leg muscles and joints.
  • Change positions frequently. Make a point of changing position every 10 to 15 minutes. Move from kneeling to standing, from digging to planting.
  • Make sure that tools are a comfortable weight and size for you.  There are many ergonomically designed tools which are lightweight with long, padded handles and spring-action mechanisms that can reduce strain and effort.Get-up, move around, alternate tasks, repeat your stretch routine or sit back, relax and have a cool drink.
  • Get-up, move around, alternate tasks, repeat your stretch routine or sit back, relax and have a cool drink.  Try not to overexert yourself; and take three brief breaks at least once every hour. The work can also be spread over several days! Give yourself a breather. Your back will thank you!




If you do get injured or have aches and pains stop the gardening immediately.  Trying to push yourself or thinking the pain will go away on its own is not a good thing.  Rest and ice the area for the first 48 hours.  Use ice for 15 minutes intervals with a 60 minute break between each session as needed.  If the problem persists for over 5 days, seek treatment/help from a chiropractor.  Chiropractors play an important role in providing preventative education and early detection of spinal problems, as well as expert care for back, muscle and joint pain and injury.

If you have any more questions about gardening injuries/prevention or treatment options please email Dr. Marcus Wong at drwong@truehealthstudio.com

Summer Time – Air Traveling Tips.

Written by Dr. Marcus Wong

As the summer is officially here, and school is almost done for the year.  Many families and people are planning their long awaited trips around the world.  This usually means numerous hours stuck and cramped into the airplane for many hours.




Comfort is not usually the first word that comes to mind when someone mentions flying.  Sitting cramped in a small space for a long plane ride could lead to neck and low back pain, swollen ankles/feet, leg cramps or in some rare, but more severe cases blood clots or thrombosis.

When preparing for your flight here are some tips to follow:

  • When booking your flight try to reserve a spot on the aisle or the window seat, as these seats provide more leg room than the center seat.
  • Avoid excessively heavy luggage.  If you need to use heavy luggage get assistance or use the airport trolleys.  Remember proper lifting techniques at all times.
  • Keep your hand carry light and comfortable.  Avoid single strap bags, and use a back pack instead to distribute the weight to both shoulders

While on the air plane here are some tips to follow:

  • Keep the space under the seat in front of you empty for more leg room and comfort.
  • If you are prone to cramping or have predisposing thrombosis condition wear special leggings or stockings, which are made for promoting blood circulation.  These leggings/stockings can be easily purchase from many local pharmacies.
  • Moving around is good for your circulation and helps to prevent swollen feet and ankles.  Wear loose clothing and walk about the cabin periodically every 60 to 90 minutes.  Wear shoes you can slip off easily.  Every so often, draw circles with your toes and contract your calves to help prevent blood from pooling in your legs. Tapping your feet can also help increase circulation and reduce the chance of muscle cramping.   Frequently perform seated leg stretches to promote muscle and blood movement in the body.  This will decrease chance of cramps and blood clots.
  • For a quick and easy stretch, stand up and raise your arms above your head.  If your neck muscles get sore from sitting, rotate your shoulders back and forth, bend your neck by bringing your ear to your shoulder and by bringing your chin to your chest.
  • When sitting for a prolonged period of time, position your lower back against the back of the chair to obtain the greatest amount of support for your spine.  A rolled sweater can also be used for added support. Use the footrests on your seat.  Most importantly, try not to stay in one position for a long period of time. Accept whatever pillows and blankets are available and use them to change the pressure distribution of your body weight on the seat when sitting for a prolonged time.
  • Keep hydrated as the humidity in the plane can be below 20%.  When your body is dehydrated this can lead to problems such as muscle soreness or cramping.  Avoid caffeine and alcoholic drinks as these will dehydrate your body faster.  Drink lots of fluids such as water and juices.


Plan ahead, educate yourself and your family about proper airplane tips and safety, and have a wonderful summer holidays !!!

If you have any more questions about traveling exercises and safety email Dr. Marcus Wong at drwong@truehealthstudio.com