Can’t Help Yourself – Habits and the Brain

There are times in our lives when we want to change the way we do things. We may discover a health issue, and need to change the way we eat, or have had an injury, and need to change the way we exercise, or we might want to give up smoking. Regardless of what it is we are trying to change, there will be habits that we have formed which we need to change, and replace with new habits.

There is a school of thought that it takes, on average, 68 days for form a new habit. But depending on the habit, and the person it can in fact take anything from between 18 and 254 days! That’s a great big difference. But how do habits actually form? And how do we make new ones? Like pretty much everything, it starts in our brain.

A bit about the brain

The brain is made up of a number of different areas, each of which is responsible for certain aspects of our bodies and behavior. Often, there is a crossover where more than one area of the brain is involved. This seems to be the case with habit forming.

The striatum is part of the basal ganglia, and this is where habits are formed. This area is also responsible for the development of emotions, memories and pattern recognition. However, decision making is done in the prefrontal cortex – specifically the infralimbic seems to be responsible for managing ‘automatic’ behavior.

Habits and the Brain

Often we see a habit as one action – for example, cleaning our teeth. However, it is actually a set of specific movements performed in sequence – picking up the toothbrush, putting on the toothpaste, brushing in a habitual pattern, and so on. You get the picture. You do these things on autopilot, without thinking about it. But if you did think about it, you would notice that you do the same thing in the same sequence pretty much every time. Recent studies suggest that what our brain does here is ‘chunking’. Some brain cells ‘bookend’ the habitual actions, so when we first start a doing a new task, the neurons in the striata emit a continuous string of signals, but once it becomes a habit these signals are only fired at the beginning and end of the task – almost like a stop/go directive. This is why it is so hard to break a habit; once the ‘go’ signal has been sent, the sequence plays out. This playing out of the initiated sequence is managed by different brain cells called ‘interneurons’. It seems these interneurons prevent the principle neurons from initiating a new sequence, until the previous one is complete.

Studies in rats suggest that by turning off the infralimbic cortex, the brain moves from ‘automatic’ to a more engaged, actively cognitive mode, and the habitual behavior is dropped, allowing a new habit to form. Interestingly, if the infralimbic cortex is turned off again, the new habit is dropped, but the old one is reactivated. From this we can deduce that the IC is responsible for deciding which habit to express, and that old habits aren’t really ‘broken’, rather they are suppressed by new ones.

When actions become habits

Psychologically, habits form in a loop. There are three aspects to a habit:

  1. The cue or trigger – what it is that makes you undertake the habit. Let’s use brushing your teeth again. The cue might be getting out of the shower, finishing breakfast, putting your pyjamas on.
  2. The behaviour itself. Which is generally performed in the same way and the same order, every time.
  3. The reward. In the case of brushing your teeth it is minty fresh breath. But for addictions, for instance, it is the ‘high’ created by the drug or activity.

How to Rewrite a Habit

As we have said, habits are not really ‘broken’, just overwritten by new ones. So, how do we go about doing that?

They key is in the cue or trigger. It has been identified that changing a habit is often easier when you are on holidays. This makes since our regular routines are disrupted when we are away from home. Beyond that, you need to think about when it is you undertake the habitual behaviour. For instance, if you are a smoker, do you always have a cigarette on your lunch break, or when you have a glass of wine. If that is the case, changing the triggers can help with changing the habitual behaviour. It is also important to overwrite the old behaviour with something new. So for smokers, it might be drinking a glass of water or doing a short exercise – but it needs to be something that provides some sort of ‘reward’.

Exercise as a Habit

Our Chiropractors, Massage Therapists and Podiatrist often prescribe exercises for you to do between appointments, and for lots of patients this presents a challenge. ‘Finding’ time in a busy schedule to do exercises can be difficult. At the start of the process, try and find a time that connects to something you do every day – like cleaning your teeth. This can be the trigger. The reward, of course, is an improvement in your condition or reduction in pain. But if you need further reward, kick in something that you really enjoy – maybe something you like to eat, or a tv show that you love to watch – as a reward. In no time at all, those exercises will become second nature and you will be doing them on autopilot.

If you are having trouble creating a habit, or kicking one, call our Sydney Hills district Clinic on 9639 7337 to have a chat with one of our expert practitioners.


Arthritis-busting Smoothies – packing a whole lot of health in one glass!

Arthritis is a broad term for over 100 separate conditions that affect the musculoskeletal system. The most common forms of arthritis are believed to be autoimmune conditions. What almost all forms of arthritis have in common is that they create pain and stiffness and reduced range of motion in your joints. These symptoms are caused by inflammation.

We talked about inflammation in our Hot Topic blog some months ago, where we talked about how what you eat can positively – or adversely affect – your condition.

Recent studies suggest that inflammation can be reduced significantly by a diet high in proteolytic enzymes. Doesn’t that sound yummy? No? Well, in fact it really is! Proteolytic enzymes can be found in a wide range of fantastic foods. And what’s more – they seem to reduce inflammation more effectively than some of the most powerful anti-inflammatory drugs on the market.

So with summer coming up we thought, what better time than to give you some delicious smoothie recipes that will fill you up and help reduce inflammation. Side note - some might even help reduce the risk of cancer!

What to Eat to Beat Arthritis Inflammation

So, what foods are high in proteolytic enzymes? There are so many that even the fussiest eater will find something to love here:

  • Pineapple (contains bromelain)
  • Ginger (contains zingibain)
  • Papaya (contains papain)
  • Kiwi fruit (actinidin)
  • Bananas (rutin)
  • Figs
  • Blueberries
  • Blackberries
  • Cherries
  • Fish – salmon, snapper, cod
  • Nuts – walnuts, almonds, hazelnuts
  • Good oils – olive, grapeseed and avocado
  • Avocado
  • Onions
  • Green tea
  • Garlic
  • Turmeric
  • Cinnamon
  • Chocolate (70% Cocoa – and YAY!)

And now for the bad news…

Just as there are foods that will help with inflammation, there are foods that will aggravate it. Try and avoid:

  • gluten rich foods – especially white bread and pasta
  • processed foods – including fast food, processed meats
  • trans fats – those pesky fast foods again
  • blackened foods – sorry BBQ fans! The blackened bits on the food contain Advanced Glycation Ends, which are highly inflammatory
  • The Nightshade Family – no, not a Marvel comic. The nightshade family includes potato, eggplant, tomatoes, bell peppers and tobacco.

The good news is, if you can get enough of the good foods in your diet, you should be able to tolerate a small amount of the bad foods. Just how much is enough, and not too much will be a matter of trial and error – and your own level of tolerance.

And Now for the Smoothie Recipes!

Berry and Beet

  • ½ cup peeled and chopped beets
  • 1 cup strawberries (fresh if possible, frozen at a pinch)
  • 1 cup cranberry juice
  • 2 cm piece ginger
  • tablespoon honey
  • pinch of cinnamon
  • ice

Pop it all in a blender and pulse until smooth.

Pineapple Turmeric

This recipe requires you to first make a turmeric paste, which you can keep in the fridge for up to 2 weeks.

1 cup fresh or frozen pineapple

1 cup fresh or frozen papaya

1-1.5 cups cold water

1 tspn grated ginger

1 tspn coconut oil

1 tspn turmeric paste*

Blend away!

  • To make the Turmeric paste: In order for turmeric to be fully absorbed by the body it needs two things – fat (in the form of coconut oil in the smoothie) and black pepper.

Place ¼ cup turmeric powder and ½ cup of water in a pan over low heat, stirring until a paste is formed. Add and ¾ tspn black pepper. Cool and store in a jar in the fridge for up to 2 weeks.

Feel free to add your own spin and mix things up a bit – especially if you choose from the list of high proteolytic enzyme foods above. If you can get one of these delicious drinks in once a day, you will very quickly see an improvement in your pain and inflammation levels.

If you are suffering from any form of Arthritis, massage and chiropractic treatment will also improve your range of motion, reduce swelling and improve your pain. Call our Baulkham Hills Clinic today on 9639 7337 to make an appointment.


BFR – what the heck is it?

The acronym BFR stands for Blood Flow Restriction. Hmm. That doesn’t sound good. Except that it is. In the right circumstances. Over the coming weeks we will be writing about all the ways in which BFR treatment can help you. Because there is just too much to put in one blog!

This week, we will look at Blood Flow Restriction actually is, and who it can help.

What BFR Actually Is

BFR – also known as Occlusion Training or Hypoxi Training – was originally pioneered in Japan in the 1970’s by Yoshiaki Sato. By 2011 the US Military started to experiment in its use on injured soldiers to help skin and tissue grafts heal, and to strengthen limbs in preparation for prosthetics.

In essence, BFR is about profusing the muscles in use with blood. Within the body, arteries take the blood into a muscle, and veins take the blood away from the muscle. Partially restricting the outward flow of blood from the muscle, causes the muscle to swell with a build up of blood, metabolites and lactic acid. The metabolites stimulate muscle growth, the lactic acid increases protein synthesis, and the muscle cells reach a point where they are so full of fluid they can either grow or burst. The result of all this is that the muscle improves in strength, size and functional aerobic capacity in shorter amounts of time with less stress on the body than normal training.

The restriction of blood flow is achieved by specially designed cuffs – something like an old fashioned blood pressure cuff - which are inflated to restrict the veins. These cuffs are placed at the top of the muscle. It is important to get the tightness right. If the cuff is too tight blood flow into the muscle can be compromised, and if it is not tight enough, the blood will not profuse the muscle.

The cuffs are used during training and exercise. Studies have shown that by using BFR you can reduce the weights used in training – by up to as much as 80%. This reduces the stress on your joints. Even uncuffed muscles benefit, as the nervous system senses the increased fatigue in the cuffed muscles, and directs the body to engage related muscles to compensate.

Uses of BFR

The many uses of BFR are still being explored. However, there is a great deal of research evidence to confirm that BFR is ideal for:

  • Prehab and rehab in surgery patients, or those recovering from accidents or injury
  • Performance recovery for athletes after competition
  • Muscle growth and increased strength
  • Improvement of cardiovascular function
  • Increased muscular hypertrophy
  • Improvement of muscular atrophy in disused muscles

Who Can Benefit

BFR can be used by anyone wishing to increase the size and strength of their muscles. It is particularly appealing to weight lifters and body builders, as well as any sports people needing to improve their performance or endurance, or wishing to aid recovery after a game or match.

However, there are also medical uses for BFR. Patients who are bedridden are at risk of muscular atrophy and can benefit from BFR, as can those in a cast or brace for extended periods. It can also be used to improve the strength of muscles in the elderly to improve balance and prevent falls.

But wait, there’s more

Studies have shown that changes to cardio output are lower when using BFR in training, than traditional training methods. Research also suggests that blood clots may break down with the use of BFR.

Important to Note

It is really important to be aware that BFR is about partial restriction of the veins. You must not completely block the flow, or block arterial blood flow into the muscle. It is therefore important that you see a trained professional who know where to place the cuffs, and how tight they need to be to provide the optimum benefit.

SmartTools and BFR

Recently Smart Tools developed and released a state of the art range of BFR Cuffs. Practitioners at Precision Health Spine & Sports Clinic at Baulkham Hills are fully trained in the use of these cuffs. Under their supervision and instruction you can rent this equipment for use at home as part of a structured training programme which the practitioners will work through with you, specific to your needs.

If you think you might benefit from BFR Treatment, or are interested in learning more, contact our Hills District Clinic on 9639 7337 to make an appointment to see one of our qualified BFR practitioners.



Quick treatment is the key

Whiplash is one of the most common injuries dealt with by Chiropractors. It can range from mild to severe, and in some cases can become chronic, causing related psychological issues. In this blog, we will look at what it is and how to treat it.

What is Whiplash?

Whiplash is an injury to the muscles, tendons, soft tissue, bones, discs and nerves of the cervical spine. It is the result of vigorous or violent movement of the head either sideways, or more commonly, front and backwards. Whilst whiplash can be the result of a fall or blow to the head during contact sport, most often it is caused by a rear-end motor vehicle accident.

Recent studies have shown that the sharp forwards/backwards motion causes the lower cervical vertebrae (lower neck) are forced into hyperextension (forwards) while the upper cervical vertebrae are forced into hyperflexion (backwards). This causes an abnormal S shape to form, causing damage to the entire neck area.

Generally, a whiplash injury is acute. However, in around 30% of cases, pain persists and the condition becomes chronic. This is one of the reasons it is imperative to seek treatment for a whiplash injury quickly.


Symptoms of whiplash can range from mild to severe, and may include:

  • pain in the neck, shoulders and even arm and upper back
  • mild swelling and bruising
  • headaches
  • dizziness
  • weakness
  • difficulty concentrating
  • hearing and visual disturbances, including tinitus
  • difficulty swallowing or speaking

Generally, symptoms will start to develop within 6-12 hours of the accident, and may worsen over the following days. Symptoms can last for days, even up to months, depending on the severity of the injury.

In severe cases, you may start to experience numbness or pins and needles in the face, difficulty with balance or walking, fainting and problems controlling your bowel or bladder. If this is the case, seek medical treatment immediately.

Whiplash Associated Disorder

Whiplash Associated Disorder (WAD) refers to symptoms of psychological distress that can sometimes accompany a more severe case of whiplash. Symptoms include:

  • depression
  • anxiety
  • anger & frustration
  • sleep disturbances
  • PTSD

WAD is more likely to occur in cases where the original whiplash injury has not fully resolved and pain is still present months after the injury. These cases are considered to have become chronic.

It is important that as well as seeking treatment for the physical symptoms of whiplash, WAD sufferers seek treatment from a psychologist or counsellor trained in pain and injury related conditions.


Generally, the severity of a Whiplash injury is classified from 0-4 – 0 being no pain, to 4 allowing for potential fracture.

Diagnosis is generally made via examination, and questioning, and then confirmed with either an X-ray or MRI.


Years ago, Whiplash injuries were treated by immobilisation. A soft or hard collar was often prescribed. It has now been proven that excessive immobilisation of the neck can actually lead to muscle atrophy (wasting) and decreased blood flow, which slows healing and reduces eventual mobility. That being said, it is important treat the neck carefully, which is why it is best to seek the advice and treatment of a chiropractor to ensure your injury is receiving appropriate care.

These days your Chiropractor will use a range of treatments, depending on the severity of your injury, and your particular physiology and symptoms.

In the acute phase, your Chiropractor will focus on pain and inflammation reduction. Ultrasound, TENS (Transcutaneous Electrical Nerve Stimulation), gentle stretching, ice and anti-inflammatories will be included.

Once the pain and inflammation has begun to subside, your Chiropractor will treat your injury with gentle manual manipulation of the spine including flexion-distraction; soft tissue therapy with SmartTools; joint stretching and resistance; trigger point therapy, including dry needling; and therapeutic massage. The number of treatments you require will be based on the severity of the injury, and the way in which your body responds to treatment.

Your chiropractor will help you with what exercises you can do, whether your pillow is right for your injury, what pain and anti-inflammatory medications you can use and answer any other questions you may have.

Self Care

In addition to seeking the care of a qualified Chiropractor, there are some things you can do yourself that will help in your recovery:

  • in the hours immediately after the accident, apply ice to the injury. We talked about ice treatment in our blog Blowing Hot & Cold
  • Try not to ‘favour’ your neck, but be gentle in all your head movements
  • Over the counter pain killers and anti-inflammatories will help, discuss this with your health care professional
  • Watch your posture, try not to slump as this puts pressure on your neck
  • Avoid heavy lifting and contact sports until your Chiropractor says it is safe to return to normal activities
  • Make sure your pillow offers you the right support for your head and neck, again your Chiropractor can help with this


Since Whiplash is generally the result of an accident, it is not possible to entirely eliminate the risk. You can, however, reduce the risk by ensuring the headrests in your car have not been removed, and that they are correctly positioned directly behind your head. If you do not have headrests, it is worth seeing if you can have some fitted to protect your head and neck.

If you are concerned you may have a whiplash injury, contact our Baulkham Hills Clinic on 9639 7337 to make an appointment for diagnosis and treatment with our experienced Chiropractor. If you are suffering from any of the more severe symptoms we mentioned, contact your doctor or local hospital immediately.


Hayfever and Acupuncture

Dealing with the symptoms and the cause

Well, the weather today might not reflect it, but it’s Spring! For most people Spring means the start of beautiful weather and looking forward to spending more time outdoors. For many people, however, the start of Spring means the start of misery. Hay fever. Runny nose, itchy watery eyes, sneezing, the list goes on. But there are things you can do about it that will relieve your misery, and maybe even have you outdoors enjoying the warmer weather.

What is Hayfever?

It is estimated that up to 3 million Australians suffer from hayfever. It is most common in the 25-44 year old age bracket. In the simplest terms, hayfever is an exaggerated immune response. This can be a response to all sorts of things – dust, pets, and very commonly, pollen.

When you are allergic, your body responds by flooding your blood stream with histamines. Histamines boost blood flow to the affected area, causing inflammation and signaling to the body’s immune system that help is needed. This is what creates the symptoms we know as hay fever. These symptoms are designed to do one of two things – flush the allergens out of your body (via the mucous membranes) or stop the allergens for getting into your body, by swelling up. Symptoms include:

  • Runny, watery eyes
  • Runny, itchy nose
  • Sneezing
  • Itching and swollen eyes, roof of your mouth and throat
  • Dark circles under the eyes

A tendency to hay fever is usually genetic – you will find a parent or sibling with the same problem. And it often accompanies asthma or eczema.


Western medicine tends to treat the symptoms of hay fever, rather than the cause. Avoiding the outdoors during spring, saline sprays for the nose, and antihistamine tablets will reduce the severity of the symptoms. However, they don’t treat the cause. And the side effects of some antihistamines, like drowsiness, can present problems of their own. In fact, The World Health Organization believes acupuncture to be a more effective way of treating hay fever than antihistamines.

Traditional Chinese Medicine focuses on balancing the body, and so works on not only addressing the symptoms, but resolving the root cause. A combination of Traditional Chinese Herbal Medicine and Acupuncture will help with both.

Since hay fever is essentially an overreaction of the immune system, it makes sense that making sure the immune system is balanced and health is a good place to start. Traditional Chinese Herbal Medicine will help strengthen the immune system by working on the spleen, lungs and kidneys. They will also assist with draining the dampness in the mucous membranes – particularly the nose.

Acupuncture treatment will directly target the site of the inflammation, and assist with strengthening the immune system.

You should feel relief from the symptoms in the first treatment. Over the course of treatment – which, depending upon the severity of the condition may take up to 8-10 sessions, improvement will continue until you should only need occasional ‘maintenance’ appointments.

As an added benefit, you will sleep better, have more vitality and better digestion as the treatment continues.

So if you suffer from debilitating hay fever every spring, call our Hills District Clinic on 9639 7337 to make an appointment with our specialist Acupuncture and Traditional Chinese Medicine practitioner.


Diabetes and Foot Care

Why a Podiatrist is so important

It is currently estimated that around 1.7 million Australians have diabetes. This makes it one of the largest challenges faced by our health system. On a personal level it can be just as challenging. Diabetes can cause all sorts of related complications, which, if not treated properly, can lead to long-term pain and discomfort. One of the areas most at risk of related complications is your feet.

First a Word about Diabetes

Diabetes – both Type 1 and Type 2 - is a condition whereby the body either does not produce sufficient insulin or the cells of the body no longer react to insulin. Insulin is produced by the pancreas, and helps your body use the sugar in the food you eat either for energy, or to be stored for future use. When it is working effectively insulin balances the level of sugar in your blood.

Type 1 Diabetes is an autoimmune disease, and often begins in childhood. Type 2 Diabetes is generally related to lifestyle, occurring most commonly in people who are overweight. Around 95% of all diabetes sufferers are Type 2.

If there is too much sugar in your blood for a prolonged period, organ and tissue damage can occur – including damage to your heart, blood vessels, nerves, kidneys and eyes.

How does Diabetes Affect your Feet

There are two key problems created by Diabetes that affect your feet:

Neuropathy – damage to the nerves. Causes pins and needles, tingling, numbness, pain and a burning sensation. Symptoms can come on very slowly, so that the condition is quite advanced before you notice it. When numbness is present, damage to the skin of the feet – cuts, grazes, blisters – can go unnoticed and infection can set in. Infection may turn to ulceration, which can penetrate to the bone (osteomyelitis) causing a chronic infection, possibly leading to amputation.

Peripheral Arterial Disease – or narrowing of the arteries. Fat and calcium building up in the walls of the arteries (atherosclerosis) reduces blood flow, particularly in the legs and feet. Symptoms include leg pain when walking, known as claudication. Pain can be anything from mild to severe. However, the biggest risk here is the increased risk of infection caused by the restricted blood flow. When blood flow is restricted, healing slows and ulceration can be the result.

Foot Amputation

Complications related to the feet account for the majority of diabetic problems, and most of these relate to ulceration. It is alarming to think that 80% of all foot amputations are caused by ulceration, and up to 80% of amputations could potentially be avoided if the patient had sought timely, structured and appropriate care.


Regular appointments with a Podiatrist are essential if you have diabetes. The combination of reduced sensation and blood flow can create the optimum environment for the development of ulcers. As with many things, prevention is far better than cure, as it is very, very difficult to cure an ulcer, but easy to prevent their development with the right care.

One indicator that an ulcer may be developing is an increase in skin temperature. If you notice a ‘hotspot’ on your foot, hotfoot it to the Podiatrist as quickly as you can.

Caring for your Feet

Daily care of your feet at home is essential:

  • be familiar with your feet – thoroughly wash, dry and check them for changes daily. If you notice anything different, talk to your Podiatrist to make sure it is not cause for concern
  • Keep your feet well moisturised to avoid cracking and peeling
  • Avoid tight or scratchy socks or stockings
  • Take care when cutting your toenails – straight across, not curved into the corners
  • Make sure your shoes are well-fitted and comfortable to avoid blisters, corns and calluses
  • Don’t use DIY corn treatments
  • Treat any cuts, abrasions or blisters immediately with an antiseptic such as betadine and a sterile dressing, and make an appointment to visit the Podiatrist if you do not see improvement within 24 hours, or if there is any sign of infection.
  • Ensure regular visits to a Podiatrist – aim for every 3-6 months

How a Podiatrist Can Help

Visiting a Podiatrist every 3-6 months is essential if you have diabetes. A Podiatrist will:

  • check the blood flow in your feet and lower legs to rule out the development of Peripheral Arterial Disease
  • Check sensation and reflex to rule out Neuropathy
  • Examine your feet for any unusual foot shapes like bunions or hammer toes
  • Treat corns and calluses effectively
  • Trim toenails safely
  • Ensure there are no potential areas where ulceration might be beginning to occur
  • Ensure your shoes fit correctly, and possibly recommend orthotics to offset any inappropriate pressure which may cause ulceration
  • If an ulcer is present, a Podiatrist will treat it with dressing and debridement, and possibly orthotics to reduce pressure on the wound

It is very important if you have diabetes to see a Podiatrist as soon as you notice anything unusual or different in relation to your feet. Since symptoms often develop slowly, once you notice them the problem is often well advanced.

If you have diabetes, or you are experiencing any of the symptoms we have mentioned, call our Hills District Clinic on 9639 7337 to make an appointment to see our specially trained Podiatrist.


Wham, bam see you later M’am

Or why Chiropractic has a bad name



It is easy for some Chiropractors to think that the profession has a bad name because if it’s somewhat strange and, dare we say it, outlandish, beginnings.  But the truth is that many modern Chiropractors are not doing the discipline any good either.  It doesn’t get talked about.  Maybe for fear of triggering the debate, maybe out of misplaced loyalty.  But a practitioner’s loyalty should surely be to his patients, and not having the discussion is only doing them a disservice.  But before we talk about the difficulties faced by today’s practitioners, let’s have a look at the origin of Chiropractic, and why it began as a bit of a black sheep.



Strange Beginnings

The discipline of Chiropractic has it’s origins in America during the second industrial revolution.  Thanks to groundbreaking work by Louis Pasteur and Charles Darwin, medical practitioners were moving away from ‘Heroic Medicine’ – blood letting, purges and sweating designed to ‘shock’ the body back to heal.  But scientific practices within the community had not yet caught up.  Esoteric disciplines like vitalism, herbalism and magnetisim began to gather popularity.   The sale of tinctures and nostrums with no documented or proven effectiveness abounded.  In other words, quacks were everywhere.


It was into this atmosphere that DD Palmer, himself a Magnetic Healer, began to make tentative moves into a type of healing he referred to as “a science, an art and a philosopy”.  In the early days Palmer compared his practices to Osteopathy – founded by Andrew Stills – as an alternative to the unproven drugs being pedaled by unlicenced quacks.  Both Palmer and Stills viewed the body as a ‘machine’.  But in the atmosphere of the day, scientific proof of efficacy was not expected.


Perhaps surprisingly, by the 1930’s Chiropractic was the largest alternative healing profession in the US.



Do you take your Chiropractic Straight or Mixed?

In 1906 DD Palmer’s son BJ took over the School of Chiropractic.  He worked hard at promoting professionalism in the discipline, and overcome resistance to medical technology like X-rays.  However, around this time a divide developed.


In simplistic terms, BJ was what is known as a ‘straight’.  That is, he relied solely on spinal adjustments, according to his father’s teachings.  But a growing group of Chiropractors – known as ‘mixers’ began to combine spinal adjustments with other treatments.  Eventually, the two groups parted ways, forming separate professional associations to govern their particular flavor of chiropractic treatment.  The ‘mixers’ began to incorporate alternative treatments, and look for evidence-based treatment objectives.  Dr Solon Langworthy wrote the first scholarly work on Chiropractic “Modernized Chiropractic”, thereby introducing Chiropractic to the scientific arena.  However, it would be years before the science really caught up.




Chiropractic Comes to Australia

Around this time Chiropractic finally made it to Australia, some 10 years after it began in the US, in the form of Henry Otterholt, a student of DD Palmer.  The Sydney College of Chiropractic was founded in 1959 and in 1990 was the absorbed into Macquarie University, making it the first Chiropractic course in a mainstream university in the world.  Chiropractors study a minimum of 5 years to become registered.



And Now for the Science

Although during the 1980’s Chiropractic had begun to receive mainstream recognition, as recently as 1987 the American Medical Association called Chiropractic ‘an unsafe cult’.  However, a 1975 Conference generated an interest in the discipline, and serious research began.  By the mid 1990’s there was a growing scholarly interest in the relationship of the spine and central nervous system, to overall health.  Today, research continues to support the techniques and modalities taught in Chiropractic degrees and practiced by modern Chiropractors.




Why You Should be Wary

While the concept of ‘mixers’ and straights’ is hugely oversimplified, it still exists today.  As with everything in life, there are no black and white distinctions.  Chiropractors exist on a bell curve with pure straights on one end, and extreme mixers on the other.


These days only about 15% of Chiropractors can be classified as pure ‘straights’.  Many (though not all) can be identified by their unwillingness to incorporate additional therapies into their practice, and by their claims to be able to cure conditions such as asthma with Chiropractic.  A great many of them are anti-vaccination.  They generally do not utilize medical technology such as MRIs and CTs and an appointment with them will involve adjustment only, and usually take only a few minutes.  This type of treatment does not take into account any muscular skeletal issues, and so does not incorporate any soft tissue work on muscles that may have been damaged through activity.  Neither does it allow for the potential that the nerves of the peripheral nervous system can be impinged in any of the joints through which they travel – not just those of the central nervous system in the spinal column.  This concentration on adjustment of the spine means appointments are very brief – often you will spend as little as 5 minutes with the practitioner.  Wham, bam, see you later m’am.


It is not uncommon for patients of these practitioners to never get ‘better’.  The objective is for them to see their practitioner every week or month for the rest of their lives.  These are often the practitioners who generate the media hype about the unsafe nature of Chiropractic treatment.  It is these practitioners who ensure the discipline is still having trouble getting out from under the shadow of its somewhat murky inception.


At the other end of the spectrum we have the extreme mixers – some of whom no longer even attempt adjustments of the spine.  These Chiropractors are more like physiotherapists than anything else in their approach to health care.


And in the middle we have the sweet spot.  Most Chiropractors educated in Australia today would be classified as ‘mixers’, and the greater proportion of them sit somewhere in the middle of the bell curve.  These practitioners have been highly trained – with a minimum of 5 years at university.


Mixers – today more correctly known as Musculoskeletal Chiropractors - will utilize the current medical diagnostic technology available to them to help identify the problem being presented.  Treatment will be drawn from a range of modalities to best suit a patient’s needs, from standard adjustments to soft tissue work, IASTM, dry needling, laser and shockwave therapy and exercise prescriptions.  All treatments are evidence-based and specifically ‘prescribed’ for the individual patient.  Appointments may take anywhere from 20-40 minutes, and care is taken to treat the whole patient, not just the spine.  The focus is correcting the problem so the patient can get on with their daily activities, pain and restriction free.


At the end of the day, what Chiropractic should be about is treating the patient.  If you are looking for a Chiropractor, take a good long look at their website.  Are they focused only on adjustments, or will they use a range of modalities?  How long are the appointments?  What additional services are offered?  If you are still in doubt, call their clinic and have a chat to the staff.  They will soon tell you what the philosophy of the clinic is.  Look at Google reviews, ask your friends for recommendations.  Then weigh up all the evidence and decide for yourself.



If you think you might need Chiropractic treatment, don’t be put off by the small minority of ‘Wham Bam’ practitioners or the sensationalist hype.  A visit to a good Chiropractor might just leave you feeling pain and restriction free.


Growing old gracefully

it's not just a state of mind

In the past we have talked about the benefits of massage in general, as well as the benefits related to sports performance and recovery, pregnancy and mental health. But with a rapidly ageing population in Australia – and around the world – are there benefits in massage for the more mature members of our community?


The answer, of course, is yes there are! Australian Bureau of Statistics figures have tracked a steadily increasing age profile in Australia in the last 100 years. In 1911 one in every 25 people were over 65. By 2016 it was one in six. That’s a whopping 16%! And what’s more – those people over 65 are getting older. That is to say, there is a higher percentage of people 75-84 and over 85 than ever before.



The old prevention is better than cure routine

One of the most important things we can do as we age is retain our health. As we age, it is more difficult to recover from illness, so to avoid getting ill is the best way to ensure we get that letter from the Queen congratulating us on our 100th birthday.


Massage can play a key role in helping us remain fit and healthy as we age. The American Medical Association has stated “it has been verified through scientific exploration that more than 80 percent of all diseases are due to stress and strain that originate in the mind and reflect on the body”. If we consider stress has a cumulative effect on the body, then as we age we are likely to be more and more prone to stress related illnesses. It is also worth noting that illness, in and of itself, can create stress. So as we age, and become more prone to diseases like arthritis, diabetes, stroke, Parkinson’s disease and heart problems, our stress levels can increase.



How Seniors Massage is Different

Many massage clients love nothing more than a good, deep remedial massage, often commenting that it ‘hurt in a good way’. As we age, this is not necessarily the best approach. The older we get, the style of massage we need changes:


  • shorter more frequent sessions often work better – a half hour massage weekly or fortnightly is better than an hour once a month. This is because massage keeps muscles supple and blood moving. A month in between is just too long.
  • Swedish – rather than the pressure of a Remedial or Sports Massage, Swedish style is more appropriate as the body ages. Long sweeping movements to encourage blood flow and lymphatic drainage are best.
  • Hands and Feet – as we age arthritis can make our hands and feet less flexible. If they are not too inflamed massaging hands and feet can keep them moving.


The key is being clear with your therapist about where your aches and pains are, and what level of pressure you would like. Don’t ever be reluctant to speak up. Your massage therapist wants you to leave feeling fabulous – not like you’ve been through the wringer.



Benefits of Massage as we Age

All the benefits of massage that we have talked about in previous blogs apply here. However, there are some aspects that are worth mentioning specifically, as they are particularly pertinent as we age:


  • the stimulation of the lymphatic system offered by massage (even when not specifically a lymphatic drainage) is important as it helps drain the body of toxins. As we become less active, the lymphatic system becomes more sluggish, and the resulting build up of toxins can impact our overall health.
  • Restoration of mobility – conditions like Parkinson’s Disease and Arthritis can reduce our mobility, causing muscles to become stiff and to shorten. Massage will help lengthen and keep these muscles supple.
  • Sleep - many older people have problems sleeping. Regular massage can help you get a better night’s sleep
  • Faster healing – as we age it takes longer and longer for us to heal as the body’s repair systems slow down. The blood-flow and general health benefits of massage mean you will heal faster, reducing the risk of secondary infections and prolonged illness.
  • Many, many studies have confirmed the healing power of touch. This seemingly simple human interaction can have an enormously powerful effect on people who are older, particularly if they have lost their partner and their social circle is limited.
  • Increase production of serotonin and dopamine improves your frame of mind – no more stereotyped Cranky Old Men/Women!
  • Non-invasive and drug free. As we age, the number of pills we take can increase alarmingly. To be able to improve our health or reduce pain without another pill to take can be hugely important.
  • Improved energy – the increased blood flow, improved lymphatic drainage, increased production of serotonin and dopamine, and better sleep all contribute to an elevated level of energy.
  • Reduced risk of falls. It has been well documented that a fall as we age can have extraordinarily negative impact on our overall health and well-being, far beyond the specific damage of the fall. So much so that it is one of the primary concerns of many older Australians. Massage has been proven to help proprioception – that is, our sense of the relative position of our body parts, thereby reducing the risk of falls.


That’s quite a list!


So, if you or someone you know could benefit from a regular massage routine, call our Baulkham Hills Clinic on 9639 7337 to make an appointment.






Custom Made vs Off the Shelf



Lots of our patients ask us about the need for custom made orthotics. Are they really necessary? What about the off the shelf version – aren’t they just as good? The custom made ones are so expensive. We get it. Custom made orthotics can put a bit of a dent in your budget. But when you consider you are walking around on them all day, every day, the cost really is worth it. Let’s have a look at the differences between custom made and off the shelf.


What they are, and what they aren’t

Firstly, not everything you put in a shoe (other than your feet) is an orthotic. Gel insert style products, which you can buy off the shelf in the supermarket or shoe shop for around $30, are not orthotics. These are little more than cushioning, and are really just designed to make your shoes more comfortable. They offer nothing by way of support, and should really only be worn by people who don’t actually need orthotics.


Orthotics aim to provide support and adjustment for feet that have, for many and varied reasons, biomechanical problems. They should provide proper alignment, balance, support and motion-control for your feet, adjusting your gait and the way your foot strikes the ground. This is quite a tall order.



Off the Shelf

Sports shoe stores and clinics often sell off the shelf, or pre-fabricated, orthotics, which can be trimmed to fit a particular shoe. In most cases these orthotics provide little more than support for the arch of your foot, or padding.


For patients with very minor biomechanical problems, or short-term conditions, it may be that off the shelf orthotics are sufficient. However, since they are not constructed based on the wearer’s actual foot, they only provide generic correction that may not be enough for some biomechanical problems. In fact, sometimes, although they may provide short term relief, off the shelf orthotics can often cause longer term problems, especially when not sized and fitted correctly to the shape of the foot and the arch.



Custom Made Orthotics

A full biomechanical assessment is required for custom fit orthotics.   Your podiatrist will examine and evaluate:


  • your feet, looking at things like your foot arch, visible bunions, toe problems and other structural concerns
  • your gait, looking at how you walk, whether your feet roll in or out and watching your leg movement from the hip down through the ankles and feet
  • your shoes, looking for wear patterns that show how you stand and walk


Once the full assessment is complete a cast will be taken of you feet. This cast will be used to design and make orthotics to specifically fit your feet, and address the biomechanical issues causing your problems. Because of this the orthotic for the right and left foot may be different – and sometimes by quite a lot.


It is important to bring your most commonly worn shoes with you for a Biomechanical Assessment, as the shoe you wear most of the time is the one the orthotics should be fitted to. If you already wear orthotics, it is important to bring those too – whether they are custom fit or off the shelf.


There are is enormous range of conditions that can be treated and managed with custom fitted orthotics, including:


  • Flat feet – improving foot and leg position
  • High arches – increasing shock absorption and redistributing pressure
  • Bunions – development of bunions can be slowed
  • Knee, hip and lower back pain – when the feet are not properly aligned knee and hip pain can become a problem
  • Arthritis – joint degeneration can be slowed and pain reduced
  • Plantar Fasciitis – pain can be reduced and a recurrence avoided
  • Pronation (rolling inwards) of the foot whilst standing or walking
  • Supination (rolling outwards) of the foot whilst standing or walking
  • Tendonitis
  • Recurrent stress fractures


It is important to note with orthotics that they may be slightly uncomfortable at first. It is best to wear them in for brief periods – start out with an hour a day and build up over a week or two. This is because the orthotics are designed to realign your foot. For instance, people with very flat feet sometimes comment it feels like there is a pebble in their shoe at first. But you will find that very quickly your foot will adjust and the orthotics will start making a positive impact on any pain or difficulty you have been having.


When your orthotics are ready your Podiatrist will fit them in the shoe and check they are correct and achieving the goals you set out to achieve. On rare occasions, some small adjustments may need to be made. A review of how you are going should be scheduled for a two weeks later to assess how your joints and muscles have adapted to the orthotics.


You should then visit your Podiatrist every 6-12 months to have your orthotics checked. Sometimes you may need new ones, or your existing orthotics may need ‘refurbishing’, depending on the response of your feet and the wear and tear on the orthotics.



If you are experiencing lower back, hip, knee or foot pain, or if you know you have flat feet you might like to make an appointment to see our expert Podiatrist for a Biomechanical Assessment. It could be that some orthotics are just what you need. Call our Hills District Clinic on 9639 7337 to make an appointment.





Travel Tips

how to leave healthy and stay that way

For most people there is not much more exciting than an overseas holiday.  And there is not much that can spoil that holiday faster than getting sick or being in pain.  Let’s have a look at some of the things you can do to stay well and pain-free on your overseas holidays.



Make like a Scout and Be Prepared

Being prepared will not only help avert any health problems when you are travelling, it will also give you peace of mind so you can enjoy your trip.  Here are a few suggestions:

  • make sure you are fit and well, and have had any appropriate shots in plenty of time before you leave. There are specialist travel doctors who can help you understand what shots you need for where you are travelling.
  • While at the travel doctor, pick up a script for broad spectrum antibiotics. If you do get sick you won’t have to waste time looking for a doctor and tackling the language barrier.
  • Take a supply of over the counter medications for tummy bugs, and include something to replace your electrolytes and sugars
  • If you are going somewhere that you don’t trust the water, take some water purification tablets. Sometimes, even the bottled water isn’t what it seems.
  • Make sure your luggage is not too heavy for you to lift easily – especially on the way out, as it will no doubt be full of purchases on the way home. So whatever you have packed, take 30% of it out!
  • Talk to your chiropractor about any exercises you can do while you are travelling to keep you fit and pain-free. If you have neck or back problems this is particularly important as long stretches in planes, trains and automobiles, strange beds and pillows can cause havoc on your spine.
  • Talk to your podiatrist about the right shoes for your trip. Depending on where you are going and what you are doing, your shoe needs might vary.  Comfort might not always be glamorous, but you will never regret opting for the right shoes.


Prevention not Cure

So, you’re all loaded up with the right gear and worded up on exercises.  But really, prevention is best.  There are a few things you can do to avoid problems:

  • Don’t have ice in your drinks. If it is made from local water it may make you sick.
  • Avoid salads, and only eat fruit you have peeled yourself. Again, it’s a water thing.
  • It’s great to eat local, but if you are not used to certain foods, don’t feel you need to try them as they can cause stomach upset. This is particularly the case with spicy foods.
  • Probiotics! These will not only help your stomach cope with unfamiliar foods and routines, but will help get you back to normal quickly should the worst happen.  Metagenics make a probiotic ideal for travel as it doesn’t require refrigeration for up to 60 days.
  • Keep up any exercise regime that your chiropractor has suggested to avoid developing problems.
  • Wash your hands Give your hands with soap and water after handling money and before and after eating. If this is not possible, give your hands a rub with hand sanitizer.
  • Remember to apply sun screen and insect repellent. Nobody needs sunburn or itching bites on a holiday!



Deep Vein Thrombosis

Since an overseas holiday for Australians generally involves a very long-haul flight, an all too common problem is Deep Vein Thrombosis.  At best, this can cause a great deal of discomfort, at worst it can be life threatening.  But there are things you can do to reduce the risk, and signs you should look out for.


A Deep Vein Thrombosis is a blood clot which forms in one of the large veins deep inside your body – generally the leg.  They are the result of blood not circulating freely and pooling in a vein.  These clots can cause pain, swelling and skin discolouration.  However, if the clot begins to move, or a piece breaks off, it can travel to your lung, potentially causing a life threatening pulmonary embolism.  No laughing matter.


Air travel, or even sitting still too long in a car (another hallmark of Australian holidays!) can cause a DVT to develop.  If you are overweight, smoke, take oral contraceptives, are pregnant or have a family history of DVT your risk is increased.  There are, however, things you can do to reduce the likelihood of this painful and potentially life threatening condition:


  1. Drink plenty of fluids on the flight. Yes, I know that will mean more of those awful trips to the toilet, but it’s a small price to pay.
  2. Avoid alcohol and caffeine - sorry, I know I got your hopes up with number 1!
  3. Avoid sleeping tablets – yes, I know it’s almost impossible to get any rest in cattle class without them, but it is best to be safe.
  4. Wear loose clothing that doesn’t restrict movement – jeans are not recommended.
  5. Wear flight socks – especially on flights of 4 hours or more. They may not look glamorous, but they might save your life.  Flight socks should be fitted by a health care professional or pharmacist as it is important they fit properly.
  6. Try and do some stretching and walking around the terminals during stopovers or when waiting for connecting flights.
  7. In flight exercises are a must.


In Flight Exercises

Agreed, there is not much room to do exercises in an economy seat – there is barely enough room for an adult – but there are a few exercises that you can do that will help avoid a DVT.

  1. Lift one knee up and hug it to your chest, keeping your back straight. Hold for 5 seconds.  Alternate sides a few times.
  2. Lift one foot off the floor and draw circles with your toes – clockwise and then anti-clockwise. Alternate sides a few times.
  3. With feet flat on the floor, lift up your heels, pressing the ball of the foot into the floor. Hold, then put your heel down, lifting the toes.  Hold and repeat a few times.
  4. When you make a trip to the toilet, try walking up and down the aisle a couple of times. Don’t try this when there is turbulence as there is a risk of injury.


Finally, keep an eye out for the symptoms of DVT for about a month after a long-haul flight and go straight to the doctor if you experience swelling, pain or skin discolouration.  If you think you may have a DVT and you experience shortness of breath, chest pain, dizziness or fainting or you begin coughing up blood go directly to a hospital.


If you are off on an overseas holiday, firstly – you lucky thing!  Secondly, you can’t start preparing early enough.  Our specialist Chiropractor and Podiatrist can help ensure you are fit as a fiddle so that you finish your journey as strong and health as you started it.  Call our Hills District clinic on 9639 7337 to make an appointment.