Dr Notley here. Winnipeg Chiropractor and Athletic Therapist.

Sometimes the cause of morning back stiffness or chronic lower back pain is the bed you sleep in. What is the best type of mattress?

Research has looked at the affect of changing mattress types on the quality of sleep as well as the affect on lower back pain.

Currently there is no definitive answer but this is what I found:

1. Lower back pain is more prominent in those who use cheaper mattresses.
2. Despite similar quality mattresses the amount of spinal twisting or bending in the thoracic spine varies significantly.
3. Foam or innerspring mattress? It doesn’t matter. The quality of sleep is unaffected.
4. Adjustable air beds and custom bedding systems reduce back pain and improve sleep quality.
5. Using a mattress of medium firmness improves pain, disability and sleep quality. But there is some question whether this is true for heavier individuals.

Conclusion

At this point in time it seems that a mattress of medium firmness and of medium or high quality material may be best but there will be some variation in comfort depending on the individual. A customized mattress may be the best option but likely the most expensive.

Dr Notley, Winnipeg Chiropractor and athletic therapist, demonstrates closed chain knee circles to emphasis the rotational mobility of the knee.

The knee has the ability to rotate. A lack of range of motion in rotation can alter the movements around the ankle and hip. This may be a cause of pain in the knee, ankles, hips and even the lower back.

Closed Chain Knee Circles

The reason these are called closed chain is that the chain of joints (toes, foot, ankles, knees, hips, stay in contact with the ground.  You can see in this other knee circles/cars exercise that my foot is off the ground. This is an open chain exercise.

To perform this exercise start with both feet together.  Bend your knees and then separate the knees out wide as far as you circle around the knee straightens out again.

Make sure you keep your feet from coming off the ground. If your foot comes up the rotation is occurring elsewhere.  This knee circles emphasizes knee internal rotation.

To emphasize knee external rotation, which often is not a problem for people, separate your feet and this time flex your knees and bring your knees together as you circle around back  to a straight leg.

You will see in this video that my left knee doesn’t come out to the side as far as the right. I have sprained my left ankle before and have knee pain to the inside of my left knee

Please note that there should be no pain with this movement. If you do experience pain seek out care from a professional. Knee rotation, when the knee is flexed, is a mechanism of injury for the menscii of the knee. Perform this movement slowly. **

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Dr Notley’s practice is an evidence informed, multi-modal treatment method which combines spinal manipulation/mobilization, exercises, acupuncture and other modes of care, along with patient education.

Dr Notley is available, by appointment, through the following link http://bit.ly/Drnotley-Contact

The masseter muscle is located at the angle of your jaw. As you clench your jaw you can feel this muscle contract. it’s primary action is to close the jaw but  can also contribute to retracting (pulling the jaw backwards) the jaw.

Pain can refer to the ear, TMJ, over the eye and into the upper and lower teeth. It can be involved in tension-like headaches, cervicogenic headaches, ear aches or molar pain. Problem with this muscle can also be a cause tinnitis, ringing in the ear.

This muscle may be aggravated due to head posture, prolonged open jaw during dental surgery, habits of clenching the teeth, gum chewing, cracking hard candy.

Often overlooked systemic perpetuating factors are low thyroid function, anemia, vitamin deficiencies, electrolyte disorders, and depression.

To treat the superficial component of the masetter find a tender point using your thumb or ball then open up your jaw.  Feel the tension under your thumb or the ball.

To relax the deep masseter partially open your jaw.  Then attempt to jut your jaw out while using your hands to resist this movement.  This causes the muscles that retract (pull the jaw backwards) to relax.

If you are dealing with back pain some of the easiest tasks in life might prove to be more difficult. Getting down onto the toilet may prove to be a very difficult task.

Getting on and off the toilet when dealing with back pain.

When you have to sit down on the toilet try this out.

1. Keep your back straight
2. Push your hips backwards as you support your upper body with your arms on your thighs. This is the short stop position.
3. Crawl your hands down your thighs to your knees.
4. To get onto the seat you may need to use a handrail or place your hands on the toilet to lower yourself further.

To come back up

1. With your knees out, place your weight firmly on your feet.
2. Lean forward supporting your hands on your knees or using a handrail.
3. Crawl your hands up your thighs as your straighten your self up to standing.

I hope this helps you

Dr Notley

P.S. If you are struggling with pain don’t just expect things to just get better. Seek out a professional who can help you.

The temporalis is the muscle that you feel  over your temples when you clench your teeth and as you chew.

The muscle can be tender to touch and can refer to the upper teeth, over the eyebrow and on the side of the head and sometimes to the temporomandibular joint (TMJ).

It is responsible for closing the jaw (when both contract), moving the jaw from side to side (when one contracts) and a little bit of retraction (pulling the jaw backwards)

It is often affected by excessive gum chewing, jaw clenching, trauma to the muscle and head position.

In my practise I often use  active release technique (ART) or acupuncture to specifically treat this muscle in addition to addressing the causes of this muscle being over worked

To perform your own self treatment of this muscle (self myofascial release) take your thumb or a ball (the smaller the ball the more focused the pressure can be).  Pin the tender point down.  You don’t need to crush the muscle to do this.  Mild to moderate discomfort is fine. Since this muscle fans out from its insertion, once you have pinned the muscle out direct the ball/thumb  in different direction.

To add a stretch to it simply open up your mouth.   If you deviate your jaw to the other side you will add a little more stretch the the muscle.

Dr Notley