Pickleball has been growing in popularity as a fun sport to play at most ages and fitness levels. It’s a great way to be active and enjoy time with others. Though pickleball tends to be relatively low impact in nature, injuries can occur, and we have seen an increasing number of these injuries in our clinic.

To minimize your risk of injury with pickleball (and improve your performance), consider the following tips:

• Warm up and cool down: Proper stretching or easy movements before and after playing helps prepare your muscles and prevent soreness. Make sure to include gentle stretches for the back, arms, and legs.
• Use proper technique & posture: Correct form is crucial for avoiding strain and overuse injuries with any sport. Avoid a slouched position that places more stress on your body.
• Wear appropriate footwear: Good shoes provide support and reduce the risk leg injuries with pickleball.
• Listen to your body: If you experience pain, rest and avoid overexertion.
• Stay hydrated: Drinking plenty of water prevents dehydration and fatigue that interfere with performance and increase your risk of injury.

Follow these tips and you can enjoy the benefits of pickleball while staying safe on the court. If you feel a little more soreness than usual, try applying ice or compression. For pains that don’t resolve within a couple days, schedule an evaluation. When injuries do occur, drug-free care like chiropractic can help you bounce back faster so you don't miss the fun!

Aches and pains cause millions of Americans to take non-steroidal anti-inflammatory medications (NSAIDs) like Ibuprofen, Motrin, Aleve, Advil, Bayer, and Aspirin, but research links these common pain relievers to higher risks than once believed. Fortunately, there are alternatives that can reduce inflammation without the risk of side effects.

Inflammation & Arthritis Pain

Inflammation occurs when there is damage to tissues of the body. Common signs of inflammation include pain, swelling, redness, and warmth over the area of injury. While inflammation is a natural response to injury, it can become severe or chronic, contributing to significant pain and disability. Inflammation is a large component of the pain experienced by those with osteoarthritis, which affects over 30 million American adults. Controlling inflammation can help these patients control pain and stay more active.

NSAID medications are commonly used for inflammation and arthritis, but they can be hard on the digestive system, sometimes damaging organs and causing stomach upset and bleeding. The body's processing of these drugs can lead to liver or kidney damage for some patients. Others can experience increased risk of heart attack or stroke. Anti-inflammatory medications can reduce pain by blocking inflammation in the body, but this benefit may not be worth the risk for some patients.

Natural Strategies to Reduce Inflammation

Anti-inflammatory medication is not the only way to reduced inflammation. Healthy habits can help reduce inflammation in the body, and may be even more effective than medication for some patients without the risk of side effects. Try improving these habits to reduce your inflammatory aches and pains:

• Avoid inflammatory processed foods and eat more whole foods
• Drink plenty of water
• Keep up with active exercise to your tolerance
• Counteract stress with stress-relieving habits
• Ensure adequate sleep each night (6 hour absolute minimum)
• Improve your posture to reduce physical stress on your joints and soft tissues

Extra Support to Reduce Inflammation

These health habits can reduce inflammatory aches and pains in most patients, but some may need a little more help. A variety of food and herbs are anti-inflammatory and can help even more. One of our favorite supplements to support a healthy inflammatory response (especially for those patients we see with arthritis pains) is Boswellia Complex by Mediherb. This herbal supplement includes boswellia, ginger, turmeric, and celery seed, four naturally anti-inflammatory herbs. This combination inhibits inflammatory leukotrienes without interfering with other processes of the body so we don't have to worry about the risks associated with NSAIDs.

One tip when taking boswellia to help inflammatory levels, is to take it with a meal when eating healthy fats or oils. This helps improve the effectiveness. Start improving your habits today, and try Boswellia Complex if you need more anti-inflammatory support.

Researchers looking for methods to better evaluate treatment options for health conditions have developed the "Benefit-Harm Scale," and a recent study used this scale on back pain treatments to highlight which options provide the most benefit and least harm.

Some health conditions have multiple treatment options that could be utilized to benefit a patient, but it's important to balance not just benefit, but also harm. A treatment that can be helpful but has high risk of harm is unlikely to be the best choice. That's why the Benefit-Harm Scale was developed as an easy way to assess the potential benefit and risk of a treatment, and compare it to other options.

A recent study published in The Spine Journal, reviewed research for common back treatments, including chiropractic spinal manipulation, acupuncture, medication, injections, and surgery. The graphic below illustrates the benefit and harm of these treatment options for chronic low back pain.

Evidence Lacking for Many Back Pain Treatments

The most surprising result may be the lack of evidence to appropriately evaluate many of the treatments. The researchers found a lack of quality evidence supporting medications, injections, and surgery, and were therefore unable to evaluate the benefit of these options. Evidence evaluating harm was also lacking with most of the medications studied, while serious harms have been identified for opioids and surgery.

In contrast, both spinal manipulation and acupuncture have quality evidence of benefit and low harm risk. The study authors concluded that more research is needed to further evaluate the various treatment options, but based on available evidence "acupuncture and spinal manipulation provide safer benefits than pharmacological or invasive interventions" for chronic low back pain.

We've been lucky so far...but it's just a matter of time before the snow blows in and these snow shoveling tips can help you avoid injury. We frequently see snow shoveling injuries this time of year, but most can be avoided by keeping in mind a few simple tips:

Warm up first - shoveling can be a major workout so prepare for it like one. Start with gentle movements and stretching to warm up your muscles for a few minutes.

Minimize lifting & throwing - heavy lifting and twisting the body is the perfect recipe for injury. Push the snow out of the way as much as possible. If lifting is needed, keep if light and use those knees.

Often & easy wins - try to make frequent lighter cleaning passes rather than waiting for the snow to stack a foot deep.

Take a break when it's too much - there's no medal for finishing this marathon without stopping. Do some now, rest, and come back later.

Avoid ice skating - wear boots or shoes with a good grip. Frozen ground or ice does not cushion a fall very well, and you need stable footing to shovel snow.

Consider your equipment - maybe it's time for a snow blower, or maybe you just want a more ergonomic shovel.

Now you can make the winter season a healthy one. Try these tips next time you're shoveling snow, or give us a call when you didn't: (330) 492-1010.

HealthDay News reports that the number of newborns treated for drug withdrawal in the United States has nearly quadrupled since 2004 - another sad result of the prescription opioid epidemic.

30% of mothers used prescription narcotic painkillers while pregnant

Recent studies have found the use of prescription narcotic (opioid) painkillers during pregnancy to be surprisingly common, noting "Nearly 30 percent of the Tennessee mothers-to-be in the Pediatrics study used at least one of these drugs while pregnant, and the associated risks [of newborn drug withdrawal] went up if they also smoked or took antidepressants."

Opioid painkillers include the drugs hydrocodone (Vicodin), oxycodone (Oxycontin), codeine and morphine. They were often used in women who had reported headaches, migraines or other musculoskeletal problems, as well as depression or anxiety.

Along with drug withdrawal, the researchers noted that infants of mothers on prescription painkillers were "twice as likely as other newborns to be born at a low birth weight. They were also far more likely to have respiratory conditions, feeding difficulties and seizures."

First an adult opioid epidemic, now drug withdrawal in newborns

The opioid drug epidemic started a few years ago when experts recommended doctors treat their patients' pains more seriously. However, instead of encouraging patients to try effective conservative treatment like chiropractic or physical therapy, doctors dramatically increased their prescriptions of addictive opioid drugs. States including Ohio are now fighting to fix this drug epidemic; and now we know it's causing harm to more than just those taking the drugs.

Pregnant mothers should minimize the medications they take to reduce the risk of health problems in their infants. Chiropractic treatment is proven to be an effective treatment for pregnant mothers with musculoskeletal pains and is a great way to avoid medications. Chiropractic care not only reduces the risk of injury to infants by avoiding medications, it can also provide further benefits by making labor and delivery easier.

A recent analysis of Optum insurance data concluded, "spinal manipulation is the single service that -- if not included during management of a non-surgical spinal episode -- will lead to higher total episode costs. Optum data, which covered a two-year span, projected a total savings of $1.3 billion had its reported 14.7 million non-surgical spinal episodes begun with chiropractic care."

“Chiropractic care advances the opportunity for optimal outcomes across care delivery, quality and cost”

The data from patients covered under Optum insurance plans showed that when spinal manipulation is performed "within the first 10 days of a spinal episode, results include:

• Reduced overall episode costs
• Lower frequency of imaging, injections, prescription medications and surgery"

“Musculoskeletal conditions rank amongst the costliest in health care and are a top concern for all stakeholders – patients and payers, alike,” states Gerard Clum, DC, spokesperson, F4CP. “Doctors of Chiropractic (DC) provide evidence-based, cost-effective care, which includes spinal manual care appropriate for the management of these conditions and other health concerns.”

Imagine the billions saved if all insurers, Medicare, Medicaid, Military, Veterans Administration and other health care systems recommended trying chiropractic treatment first for spinal problems (not to mention extremity problems); and more importantly the reduced suffering.

The medical community has not always acknowledged the benefits of chiropractic treatment, but that is gradually improving. Medical institutions and organizations are increasingly recognizing the value of chiropractic. Some medical treatment guidelines even recommend trying conservative chiropractic treatment before trying more invasive medical treatments.

An online article published by Harvard's Medical School describes chiropractic treatment and its benefits:

"Most research on chiropractic has focused on spinal manipulation for back pain. Chiropractic treatment for many other problems—including other musculoskeletal pain, headaches, asthma, carpal tunnel syndrome, and fibromyalgia—has also been studied. A recent review concluded that chiropractic spinal manipulation may be helpful for back pain, migraine, neck pain, and whiplash."

It's good to see more positive information about conservative treatment like chiropractic that has been shown to be safe, effective, and low cost. More patients should experience the benefits of chiropractic treatment first, before trying more invasive medical care.

While Celebrex is commonly prescribed as a medication for knee pain related to arthritis, Medpage Today reports on a recent study that has found Glucosamine Chondroitin supplements to be just as effective for treating osteoarthritis of the knee:

"In a clinical trial known as MOVES that included 606 patients with moderate-to-severe pain, 6 months of treatment with the dietary supplements was associated with a 50.1% decrease in pain...compared with a 50.2% decrease among patients given celecoxib, according to Marc C. Hochberg, MD, of the University of Maryland School of Medicine in Baltimore, and colleagues."

Prior studies comparing Glucosamine Chondroitin to Celebrex had similarly found that the supplements were as effective as the medication, especially for patients with moderate-to-severe pain. Researchers also found that Glucosamine Chondroitin can reduce narrowing of the knee joint which occurs over time with arthritis (leading to bone on bone).

This is especially good news since Celebrex has been associated with cardiovascular, gastrointestinal, and kidney problems. Based on the research, Glucosamine Chondroitin provides a safer alternative for knee pain related to arthritis, but should be taken daily for at least 6 months (or longer to reduce narrowing of joint space).

Researchers looking to study the risk of injury following chiropractic treatment found a surprise.

Researchers analyzed Medicare data of patients aged 66-99 who were treated for neuromusculoskeletal complaints by their primary medical physician or chiropractic physician. They specifically looked for risk of traumatic injury to the head, neck, or trunk following an office visit for chiropractic spinal manipulation.

The risk of injury after chiropractic treatment was significantly lower than risk of injury after a medical visit. Data showed only 4 injury incidents per 10,000 chiropractic visits, as compared to 15.3 incidents per 10,000 primary care medical visits.

Risk of Traumatic Injury 76% Lower One Week Following Chiropractic Treatment

Researchers concluded that among Medicare beneficiaries aged 66-99 with an office visit for a neuromusculoskeletal problem, risk of injury within 7 days was 76% lower among subjects with a chiropractic office visit as compared to those who saw a primary care physician.

The safety of chiropractic treatment has been well documented for years. Chiropractic adjusting has also been shown to help improve balance and reduce falls in the elderly, which may play an important role in the reduction of injury following treatment.

Medpage Today reported on a recent study linking knee surgery to increased rates of arthritis. Individuals with knee pain who had undergone knee surgery were significantly more likely to experience loss of cartilage, developing arthritis of the knee.

Radiologists examined imaging of patients with knee pain for signs of arthritis. All of the knees showing signs of arthritis were those that had undergone surgery, while none of the 354 patients who avoided surgery developed arthritis.

They reported, "Individuals with knee pain who undergo surgery to repair meniscus cartilage tears often develop osteoarthritis in that knee within a year of the operation..."

"...the type of surgery was not apparent from the records accessed for the study but [researchers] believed that most of the procedures were performed through arthroscopic rather than open surgery."

With current research on arthroscopic knee surgery finding no significant improvement compared to sham (fake) surgery, this study provides more reason to try conservative treatment first and only choose surgery with caution.

Acetaminophen, sold as Tylenol and other brands, is commonly recommended for back pain, but until now only minimal medical research had been performed to see if it actually helps. Even back pain treatment guidelines recommend acetaminophen as a first-line treatment without any direct evidence of benefit.

To the surprise of many, a study recently found no benefit to using acetaminophen for back pain. Researchers studied over 1600 patients with back pain. The patients were given acetaminophen or placebo pills. The scientists found no significant difference between the groups in recovery time, pain, disability, function, symptom changes, sleep or quality of life.

With increasing awareness of the significant risks of taking acetaminophen (causing over 50,000 liver injuries in Americans each year), this study gives further support to the recommendation of minimizing use as much as possible.

Medical treatment guidelines offer a better treatment choice for back pain: chiropractic manipulation. Research has found chiropractic treatment to be one of the only options that reduces back pain, improves function, and has minimal risks. Before reaching for that bottle of Tylenol for your back pain, think twice.

As part of National Chiropractic Health Month, we take a look at one the biggest issues affecting patient's ability to heal from injuries - delaying treatment.

The National Institute of Health notes pain affects more Americans than diabetes, heart disease and cancer combined.

Why do so many Americans experience chronic pain?

It's common to wait after an injury to see if it will go away on its own, but waiting too long only makes it harder to bounce back. Research confirms that waiting more than 7 days to treat an injury increases your risk of chronic problems.

But why? It's all about how the body heals from an injury:

Initially, inflammation increases at the site of an injury. This means swelling, redness, warmth, and PAIN. Inflammation increases over 1-3 days, which explains why pain may not be immediate but can build after a day or two. Frequently, the pain and inflammation will start to reduced after a few days - this is where you can get in trouble...

Within a week of injury, the body starts repairing soft tissues with fibriotic scar tissue. Picture normal muscles and soft tissues as nicely organized fibers lined up next to each other. Now picture scar tissue as a tangled nest of fibers trying to patch up a hole. Pain may be fairly well controlled at this point, but as scar tissue builds, increased stiffness and joint restrictions can develop. If scar tissue develops enough to restrict a full range of motion in a joint, it's only a matter of time before pain and inflammation return -- because the joint can't function correctly.

Moral: Don't delay treatment more than one week or the risk of chronic problems increases

Chiropractic treatment is key to not only reducing pain and inflammation, but also improving scar tissue function so your joints are moving correctly again. The key is healthy movement. Chiropractic adjustments help the scar tissue align and reorganize to be more similar to your body's normal healthy soft tissues. This reorganization process can take months, but chiropractic care tends to accelerate  this natural response.

Don't rely on pain as your only indicator of health. If you pay attention to how well your body is moving and functioning, you may be able to avoid the pain in the first place.

As part of National Chiropractic Health Month, we take a look at recent news and research that has highlighted the growing epidemic of prescription drug problems:

CNN's story, "Let’s End the Prescription Drug Death Epidemic," reported on the increasing injury and death from prescription medication as Americans consume 80% of the world's pain medication for less than 5% of the world's population.

Harvard research published in the Journal of the American Medical Association highlighted increasing medical mismanagement of back pain as doctors continue to increase narcotic pain prescriptions and ignore medical guidelines that recommend safer, more effective options like chiropractic treatment.

A national report on prescription drug abuse ranked Ohio as 12th Highest Drug Overdose Mortality Rate in the US, with most deaths coming from prescription medications.

"Fifty Americans die a day from prescription drug overdoses, and more than 6 million suffer from prescription drug abuse disorders. This is a very real epidemic - and warrants a strong public health response," said Andrea Gielen, ScD, Director of the Johns Hopkins Center for Injury Research and Policy.

What's Going On?

October is National Chiropractic Health Month. Discover how to improve your health with chiropractic care.

Joints are critical to all movement and allow us to carry out normal activities of daily living. Some 150 million to 200 million cases of back pain send people to the doctor every year—and many of those are related to joint injuries. The bones that make up the joint allow movement, but it is the muscles that pull the bones that produce the movement.

Use it or Lose it

The movements that you perform on a daily basis are critical to long-term joint health, as are proper nutrition, a healthy exercise regimen, and a healthy lifestyle. Moving a joint through its full range of motion serves several important purposes. Joints are not supplied directly with blood as are other organs within the body, but instead are nourished with synovial fluid that is forced into the joint cartilage through pressure resulting from body movement. So the saying, “Use it or lose it” applies to joint function.