Temperature Effects
In summary, passive warming of a muscle before stretching or icing during the stretch can be used to increase the range of motion but will not prevent injury. Patients who include an active warm-up period prior to stretching obtain the greatest range of motion. Contrary to popular belief, warm-up performed without stretching does not increase range of motion. Most of the research in this area has been done on animals using passive warming devices such as heat lamps. Research in humans often uses activity to warm the muscle, but activity affects the muscle in many ways--for example, calcium release and motor unit recruitment patterns--besides simply raising the temperature. This may explain the different results observed in animals and humans.

Passive warm-up and icing.
Several studies examined the effect of temperature on range of motion. When applied before a static stretch, neither heat nor ice significantly affected the range of motion during active knee extension--a test of hamstring range of motion--when compared with stretching alone (38). Though heat alone did not improve range of motion, stretch plus heat was superior to stretch alone... Ice applied during a static stretch was the most effective method for increasing range of motion during a passive static stretch (29), but only when applied during the earlier stages of the stretch (30). Cold application during PNF stretching did not improve range of motion above the normal PNF technique (26). In summary, despite some conflicting results, applying either ice or heat during a static stretch increases the range of motion compared with static stretch alone, but it has no effect during PNF stretches. Because ice and heat both increase range of motion and decrease pain, but have opposite effects on stiffness, the mechanism for the increased range of motion is probably analgesia rather than decreased stiffness.

Active warm-up
Most people believe that the light activity performed during warm-up will increase muscle temperature, decrease muscle stiffness, and increase range of motion. Animal studies consistently show a decrease in stiffness if the muscle or tendon is preheated (39-41). However, the range of temperatures studied is usually outside the normal physiologic range in humans (39-41).

In humans, the effectiveness of active warm-up to decrease stiffness appears to be related to the type of warm-up exercise and the muscle tested. For example, running appears to decrease the stiffness of the calf muscles (42) but not the hamstring muscles (43); running had no effect on range of motion in these studies. Stretching added after warm-up decreases hamstring muscle stiffness (range of motion not reported); however, the effect lasts less than 30 minutes, even if exercise continues after stretching (43). In the only study that measured the effect of cycling, hamstring or quadriceps range of motion did not change, although ankle range of motion increased (stiffness not measured ) (44). In another study, 15 minutes of cycling increased passive hip flexion and extension (stiffness was not measured) (45), but the pelvis was not properly stabilized during range-of-motion measurement.

Of the different types of PNF techniques, the agonist-contract-relax method (the hip flexors, including quadriceps muscles, actively stretch the hamstrings, followed by a maximal quadriceps contraction and passive holding) appears superior to the contract-relax method (muscle contraction followed by passive stretching) (50,54-56), which appears superior to the hold-relax technique (isometric contraction with resistance gradually applied over 9 seconds) (50,54-56,60).

For those who prefer the simplicity of static stretching, one study (61) reported that static stretching (continuous stretching without rest) is superior to cyclic stretching (applying a stretch, relaxing, and reapplying the stretch), whereas two studies (62,63) suggested no difference. All of these studies involved stretching the hamstring muscles, and methodological reasons for the discrepancy were not apparent. More research is needed before definitive conclusions can be made.

• Heat, ice, and warm-up all increase the effectiveness of stretching to increase range of motion, but only warm-up is likely to prevent injury.
• Although one 30-second stretch per muscle group is sufficient to increase range of motion in most healthy people, it is likely that longer periods or more repetitions are required in some people, injuries, and/or muscle groups.
• Individuals should determine a strategy for themselves by simply holding a stretch until no additional benefit is obtained.
• Though PNF stretching is the most effective technique for increasing range of motion, the mechanism is an increase in stretch tolerance, and the muscle actually undergoes an eccentric contraction during the stretch. The increased analgesia may aid in performance but theoretically increases the risk of injury when compared with static stretches.

Across the province, thousands of elementary, high-school and post-secondary students race to the school bus or scurry to their classes with overstuffed backpacks slung over their shoulders. While carrying a backpack to school each morning might seem harmless enough, it can cause painful back and neck problems for students who don't carry them properly.

Scientific studies have revealed a 30 percent increase in back pain in children since 1990 due to at least in part, carrying backpacks. Back pain is pervasive in our society. "Eighty percent of all Canadians will suffer from back pain at some point in their lives. Fifty percent of us will suffer from low back pain this year alone," says Dr. Don Nixdorf, executive director for the British Columbia Chiropractic Association. "Low-back pain is the most common health problem experienced by working Canadians today, and it is a condition which costs our country's economy over $800 million annually in lost wages and productivity. For work-related injuries alone the cost of back claims is $140 million per year."

"Much of this suffering is brought on by bad habits initiated during our younger years - such as carrying overweight backpacks to school. The improper use of backpacks can lead to muscle imbalance that could turn to chronic back and neck injuries."

WHAT CAN YOU DO?

The British Columbia Chiropractic Association suggests the following tips to help prevent the needless pain that backpack misuse could cause students. Now that backpacks have begun to replace briefcases in the work place, you, too, might want to follow this advice.

• Make sure your child's backpack weighs no more than five to ten percent of his or her body weight. If the backpack is heavier, it will cause your child to start bending forward in an attempt to support the weight on his or her back rather than using the straps for support on the shoulders.
• A backpack with individualized compartments will help in positioning the contents most effectively. When packing the backpack, make sure that pointy or bulky objects are packed away from the area that will rest on your child's back. An uneven surface rubbing against your child's back could cause painful blisters.
• It is important that your child wear both shoulder straps. Lugging the backpack around by one shoulder strap can cause a disproportionate shift of weight to one side, leading to neck and muscle spasms as well as low-back pain.
   
• Padded straps are very important. Non-padded straps are uncomfortable, and usually dig into your child's shoulders.
• The shoulder straps should also be adjustable, so the backpack can be fitted to your child's body. Shoulder straps that are too loose can cause the backpack to dangle uncomfortably and cause spinal misalignment and pain.
• If the backpack is still too heavy, talk to your child's teacher. It might be possible to leave the heaviest books at school, and bring home only the lighter handout materials or work books.
• Talk to your child about the proper use of backpacks and help him or her understand why this knowledge is important now and later in life, and that they will be happier and healthier as a result.

CHIROPRACTIC CARE CAN HELP…

If you or your child experience any pain or discomfort in the shoulders, arms, legs or back, call your chiropractic doctor to assess any adverse affects resulting from backpack use. Chiropractic doctors are licensed and trained to diagnose and treat patients of all ages and the type of treatment for children is gentle. In addition, chiropractic doctors can prescribe exercises designed to help children develop strong muscles, and provide instruction in good nutrition, posture and sleeping habits.

Alcohol is, in part, a nutritional source, providing 29 kJ/mL (ie, 7 kcal) of energy, as well as moderate amounts of protein, carbohydrates, and fat. Beers contain small amounts of a variety of the B vitamins, and both red and white wines contain several trace elements, including iron, potassium, copper, and sodium -- although this varies (predominantly for iron) depending on year of harvest, wine preparation method, grape type, etc. Other important components are also found in alcoholic beverages, including flavonols, flavones, flavan-3-ols, flavanones, and anthocyanins.

American and European guidelines on alcohol consumption are given as daily and weekly upper limits. There are no significant health risks at levels of consumption of between 3 and 4 units a day or less for men and between 2 and 3 units a day or less for women. (A "unit" of alcohol is the amount contained in a half pint [284 mL] of beer, a single glass [125 mL] of table wine, a single glass [50 mL] of fortified wine, eg, sherry, or a single measure [25 mL] of spirits; it approximates to 10 mL or 8 g of absolute alcohol.)

There can be no doubt that chronic alcohol abuse is an important risk factor for risk of osteoporosis and fracture. [2-4] The mechanisms remain to be clearly defined, but there is evidence to suggest that in the human model, alcohol in large amounts is directly toxic to osteoblasts, thus reducing bone formation, and may also directly affect bone mineral density (BMD) by impairing liver function and altering both vitamin D and calcium metabolism. Furthermore, the trauma associated with alcohol-related falls is clearly important to fracture risk.

Recent work by Clark and Sowers [5] suggests that women treated for alcohol abuse had a lower femoral neck and lumbar spine BMD when compared with women who did not abuse alcohol. Women in treatment and recovery reported more fractures during childhood and early adolescence than did non-alcohol-dependent women, suggesting that factors other than acute toxification contributed to the greater fracture prevalence.

However, there is evidence for a positive effect of moderate alcohol consumption on bone. Data predominantly for postmenopausal women do indicate a positive correlation between BMD and alcohol consumption. In a study of elderly women by Felson and colleagues, [6] an alcohol intake of more than 210 mL (7 oz) per week was found to be associated with a higher BMD compared with those women consuming less than this amount. In a prospective study by Holbrook and Barrett-Connor, [7] social drinking was associated with higher bone mass, a finding that was consistent across both sexes. In a recent study of 489 elderly women aged 65-77 years by Rapuri and associates, [8] moderate alcohol intake was found to be associated with higher bone mass.

Other possible reasons for the increase seen in bone mass with moderate alcohol consumption include:

1. the stimulation of calcitonin production, which has been shown to increase spine BMD with little effect on femoral sites.
2. the effect of alcohol on endogenous hormone levels -- for example, the influence of alcohol upon inducing adrenal production of androstenedione and its adrenal conversion to estrone. Higher estrogen concentrations have been found in postmenopausal women who consume alcohol.

Although more research is certainly required, there is some good evidence to suggest that moderate alcohol consumption in postmenopausal women is of some benefit to bone health.

References:

Susan New, BA, MSc, PhD, RPHNutr , University Lecturer, School of Biological Sciences, and Lecturer in Nutrition, Center for Nutrition and Food Safety, University of Surrey, Guildford, UK.

From Medscape Ob/Gyn & Women's Health

Q: How Do I Keep Myself Motivated?

A: Most people understand the importance of regular physical activity. We know that by being active everyday we will be healthy and have more energy but why is it then that more than 50% of the population is overweight and getting heavier?

I would like to suggest that motivation is a major component. We may know what to do and even the best way to do it yet the follow through is not happening. The word integrity comes to mind. Just think of the friend who continuously makes plans with you and doesn't follow through. How does this affect your relationship with this person?

Essentially by making plans with yourself and not following through the same scenario is taking place. I would like you to take an opportunity this month to look at where in your life you follow through with your word. How do you feel when this occurs? Next I would like you to observe areas where you could be better. What is the difference?

At Katch Life Health & Wellness we offer Health Coaching. Coaching is an excellent way to keep on track with your goals. Your coach will encourage you to take responsibility while supporting you to make a difference. With a coach you create results in your life NOW . Your coach is a kind, caring individual who challenges you to follow through and keep you motivated. Each plan is designed specifically for you and your goals.

Health & Wellness Coaching Plans Include:

• Detailed History
• SMART Goal Setting
• Game Plan
• Action Step Planning

Health Coaching is ideal for weight loss, emotional eating, self-esteem improvement,exercise technique, injury rehabilitation, motivation and support.