Household
chores can be a pain in the sacroiliac. Unless you're careful, routine
activities around the home— washing dishes, vacuuming, even talking
on the phone— can strain your back, including the sacroiliac area
near the tailbone, and result in debilitating discomfort.

But you
can protect your back by knowing the right way to go about such activities,
according to the American Chiropractic Association (ACA).

Consider
lifting. It doesn't matter whether you're picking up your child or a heavy
bucket of water, you need to do it the proper way to avoid injury.

How? Bend
from the knees, not the waist. As you lift, hold the item as close to your
body as possible. If you have to turn to place it, step in the direction
of the turn. That way, you're not twisting your body and straining your
spine.

Back-Saving Tips

The American
Chiropractic Association suggest the following do's and don'ts for chores
and relaxation:

• When
  you wash dishes, open the cabinet beneath the sink, bend one knee and
  put your foot on the shelf under the sink. Lean against the counter so
  some of your weight is supported in front.
• When
  ironing, raise one foot a bit. Place it on a small stool or a book to
  take some strain off your back.
• To vacuum,
  use a "fencer's stance." Put all your weight on one foot, then step forward
  and back with the other foot as you push the vacuum forward and back.
  Use the back foot as a pivot when you turn.
• While
  talking on the phone, don't cradle the phone between your ear and shoulder.
  That can lock up the spinal joints in the neck and upper back, and cause
  pain. Instead, hold the phone with your hand or use the speakerphone.
• While
  watching television or relaxing, don't use the sofa arm as a pillow.
  The angle is much too sharp for your neck.
• Use
  a cold pack if your back begins to hurt. Wrap an ice pack in a towel
  moistened with warm water. The warmth gives way to gradual cold, which
  likely will alleviate the discomfort. (No ice? Try frozen veggies instead.)
• If pain
  persists for more than a day or two or if you experience numbness, tingling
  or weakness in your arms or legs, see a doctor of chiropractic. A doctor
  of chiropractic is an expert in spinal health and can help identify and
  treat your problem.

Back pain is pervasive among American adults, but a new and disturbing
trend is emerging. Young children are suffering from back pain much earlier
than previous generations, and the use of overweight backpacks is a contributing
factor, according to the American Chiropractic Association (ACA). In fact,
according to the U.S. Consumer Product Safety Commission, the use of book
bags or back carriers resulted in over 6,500 injuries in 2000 alone.

Over the past 10 years, the chiropractic profession is noticing a marked
increase in the number of young children who are complaining about back,
neck and shoulder pain. This new back pain trend among youngsters isn't
surprising when you consider the disproportionate amounts of weight they
carry in their backpacks— often slung over just one shoulder. A 2002
study conducted in Italy found that the average child carries a backpack
that would be the equivalent of a 39-pound burden for a 176-pound man,
or a 29-pound load for a 132-pound woman. Of those children carrying heavy
backpacks to school, 60 percent had experienced back pain as a result.

Other studies have shown that slinging a backpack over one shoulder could
exacerbate the curvature of the spine in scoliosis patients.

According to the ACA, preliminary results of studies being conducted show
that the longer a child wears a backpack, the longer it takes for a curvature
or deformity of the spine to correct itself. The question that needs to
be addressed next is, Does it ever return to normal?

The results of these types of studies are especially important as more
and more school districts— many of them in urban areas— remove
lockers from the premises, forcing students to carry their books with them
all day long.

What Can You Do?

• Make sure your child's backpack weighs no more than 5 to 10 percent of
  his or her body weight. A heavier backpack will cause your child to bend
  forward in an attempt to support the weight on his or her back, rather
  than on the shoulders, by the straps.
• The backpack should never hang more than four inches below the waistline.
  A backpack that hangs too low increases the weight on the shoulders,
  causing your child to lean forward when walking.
• A backpack with individualized compartments helps in positioning the contents
  most effectively. Make sure that pointy or bulky objects are packed away
  from the area that will rest on your child's back.
• Bigger is not necessarily better. The more room there is in a backpack,
  the more your child will carry— and the heavier the backpack will
  be.
• Urge your child to wear both shoulder straps. Lugging the backpack around
  by one strap can cause the disproportionate shift of weight to one side,
  leading to neck and muscle spasms, as well as low-back pain.
• Wide, padded straps are very important. Non-padded straps are uncomfortable,
  and can dig into your child's shoulders.
• The shoulder straps should be adjustable so the backpack can be fitted
  to your child's body. 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. Ask
  if your child could leave the heaviest books at school, and bring home
  only lighter hand-out materials or workbooks.

What We Can Do for You...

If you or your child experiences any pain or discomfort resulting from
backpack use, call your doctor of chiropractic. Doctors of chiropractic
are licensed and trained to diagnose and treat patients of all ages and
will use a gentler type of treatment for children. In addition, doctors
of chiropractic can also prescribe exercises designed to help children
develop strong muscles, along with instruction in good nutrition, posture
and sleeping habits.

Although doctors of chiropractic (DCs) care for more than just back pain,
many patients visit DCs looking for relief from this pervasive condition.

Thirty-one million Americans have low back pain at any given time (1).
One half of all working Americans admit to having back symptoms each year
(2). One third of all Americans over age 18 had a back problem in the past
five years severe enough for them to seek professional help (3). And the
cost of this care is estimated to be a staggering $50 Billion yearly— and
that's just for the more easily identified costs! (4).

These are just some of the astounding facts about Americans and their
miserable backs! Is there any wonder why some experts estimate that as many
as 80% of all of us will experience a back problem at some time in our lives?
(5).

Because back problems are this common it's probably going to happen to
you too! Shouldn't you find out what to do about it before it happens rather
than after? Why wait until you're hurting to learn about your treatment options?

When you're hurting you may not give this important decision the time
and attention it needs to make the best choice. Here are the facts about
manipulation as a treatment for back problems:

Manipulation is one of several established forms of treatment used for
back problems. Used primarily by Doctors of Chiropractic (DCs) for the last
century, manipulation has been largely ignored by most others in the health
care community until recently. Now, with today's growing emphasis on treatment
and cost effectiveness, manipulation is receiving much more widespread attention.
In fact, after an extensive study of all currently available care for low
back problems, the Agency for Health Care Policy and Research— a federal
government research organization— recommended that low back pain suffers
choose the most conservative care first. And it recommended spinal manipulation
as the ONLY safe and effective, DRUGLESS form of initial professional treatment
for acute low back problems in adults! (6). Chiropractic manipulation, also
frequently called the chiropractic adjustment, is the form of manipulation
that has been most extensively used by Americans for the last one hundred
years. (7). Satisfied chiropractic patients already know that DCs are uniquely
trained and experienced in diagnosing back problems and are the doctors most
skilled in using manipulation for the treatment of back pain and related
disorders (8). As a public service, the American Chiropractic Association
(ACA) urges you to make an informed choice about your back care. To learn
more about the federal government's recommendations.

References:

1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance
Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994;
331: 69-116.

2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms,
Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

3. Finding from a national study conducted for the American Chiropractic
Association. Risher P. Americans' Perception of Practitioners and Treatments
for Back Problems. Louis Harris and Associates, Inc. New York: August, 1994.

4. This total represents only the more readily identifiable costs for
medical care, workers compensation payments and time lost from work. It does
not include costs associated with lost personal income due to acquired physical
limitation resulting from a back problem and lost employer productivity due
to employee medical absence. In Project Briefs: Back Pain Patient Outcomes
Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health
Care Policy and Research, Rockville, MD, Summer 1994.

5. In Vallfors B, previously cited.

6. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults.
Clinical Practice Guideline No. 14. AHCPR Publication No. 95-0642. Rockville,
MD: Agency for Health Care Policy and Research, Public Health Service, U.S.
Department of Health and Human Services, December, 1994.

7. The RAND Corporation reported from its analysis of spinal manipulation
research literature that 94% of all spinal manipulation is performed by chiropractors,
4% by osteopaths, and the remainder by medical doctors.

8. In Risher P, previously cited.

There is no better time to rejuvenate your health than the start of a new year. So don't let your resolution to eat more nutritiously fall by the wayside. Just a few simple changes in your diet and lifestyle can have a positive impact on your health— and can also prevent you from experiencing a variety of health problems in the future— according to the American Chiropractic Association (ACA).

"In my own practice, I urge my patients to stop smoking, eat a balanced diet, drink plenty of water, exercise regularly and augment their balanced diet with appropriate nutritional supplements," explains Dr. Juanee Surprise.

Dr. Surprise and the ACA offer the following advice to help put your New Year's resolution into practice:

Lifestyle Changes

• Get active! Try to exercise for 20-30 minutes at least 3-4 days a week.
• Eat out more sparingly. Since food preparation methods in restaurants often involve high amounts— and the wrong types— of fat and sugar, give preference to home-cooked food.
• Brown-bagging your lunch is also a good idea because you can control your fat and sugar content while adding nutritious fruits, vegetables and grains.
• Limit your intake of alcohol, and quit smoking. Drinking alcohol excessively and/or smoking can hinder your body's ability to absorb nutrients from your food.

According to Dr. Surprise, "Younger people are starting to suffer from heart disease, not only because of our national diet of hamburgers and fries, but because of an epidemic of inactivity."

Dietary Changes

"We need to eliminate the traditional diet of coffee and doughnuts for breakfast; a hamburger for lunch—or no lunch; candy, cookies and soft drink for a snack; followed by a huge dinner with more protein than a person needs, few or no vegetables, and no water or fruit in the course of the day," explains Dr. Surprise. Keep the following dietary recommendations in mind as well:

• Eat more raw foods. Cooking and canning destroys much of the nutrition in foods that can be eaten raw. With the exception of canned tomatoes— which can help prevent prostate cancer— fresh or frozen fruits and vegetables always have more natural vitamins and minerals than canned vegetables do.
• Select organically grown foods when possible. They have lower amounts of toxic elements than foods that are not grown organically.
• Eat whole foods. Much of the nutrition available to us in fruits and vegetables can be found in its skin, so don't peel it off and throw it away, unless it has been waxed or dyed.
• Stay hydrated! Drink eight to ten 8-ounce glasses of water a day. (Coffee, tea, soft drinks and alcohol are diuretics/dehydrators. Don't substitute them for water.)
• Consume 25-30 grams of fiber per day. Whole-grain breads and cereals, beans, nuts and some fruits and vegetables are good sources of fiber. High-fiber diets can help prevent digestive disorders, heart disease and colon cancer.

Vegetarian Diets

For those who are planning on going veggie in the New Year, research shows that a good vegetarian diet as part of a comprehensive health program can help prevent heart disease, cancer and other diseases. However, only consume moderate amounts of fried foods, hydrogenated fats and commercial meat substitutes. It's possible for a vegetarian to eat even more sugar and fat than a meat-eater by overloading on junk food.

If you are considering a vegetarian diet, keep the following tips in mind:

• Don't rely on fruits and vegetables at the expense of grains and legumes. The repetition of fruits and vegetables can narrow your food choices, thus narrowing the variety of nutrients you consume.
• Tiredness, malaise, and anemia can be signs of deficiencies. Those who have been on a vegetarian diet for some time should have their B12 and iron levels checked at least once a year.
• Consume fortified foods or take supplements to obtain the nutrients you no longer get from animal-based products. The biggest problem with vegetarian diets and others is that you no longer consume important nutrients found in animal protein.

Before eliminating animal products from the diet, it is important to get information about how to do it right. Children, pregnant and breast-feeding women, and people recovering from illness should consult their doctor (e.g. DC, MD, DO).

Supplements

According to the U.S. Food and Drug Administration, dietary supplements are not perfect substitutes for conventional or even fortified foods. Nor can a person sustain good health by just taking vitamin and mineral supplements. But when taken properly, nutritional supplements can play an important role in achieving maximum health. If you are considering nutritional supplements, keep these important tips in mind:

• Don't overlook nutrition. Since supplements are just that— an added source of nutrients— it is important to consume dark green vegetables, oils, nuts and seeds, which are sources of magnesium, fatty acids, and many other vitamins and minerals. Supplements are not an excuse to forget about eating right.
• Since choosing the right nutritional supplements to suit your individual needs can be a complicated endeavor, consult a nutritional practitioner— such as a doctor of chiropractic— to determine what kinds of supplements are best for you.
• Don't try to "self-prescribe." If you have symptoms such as headaches, chronic fatigue or cardiac problems, you need to seek professional advice— not the advice of a supplement store clerk.

The weight gain, the bloating, the nausea... Most new mothers will tell you that the aches and pains of pregnancy are a small price to pay for the beautiful bundle of joy they're rewarded with nine months later.

But as many new mothers can attest, the muscle strains of pregnancy are very real and can be more than just a nuisance. The average weight gain of 25 to 35 pounds, combined with the increased stress placed on the body by the baby, can sometimes result in severe discomfort. In fact, studies have found that about half of all expectant mothers will develop low back pain at some point during their pregnancy. This is especially true during late pregnancy, when the baby's head presses down on a woman's back, legs and buttocks, putting pressure on her sciatic nerve. And for those who already suffer from low back pain, the problem can become even worse.

During pregnancy, a woman's center of gravity almost immediately begins to shift forward to the front of her pelvis, according to Dr. Jerome McAndrews, spokesperson for the American Chiropractic Association (ACA). Although a woman's sacrum— or posterior section of her pelvis— has more depth than a man's to enable her to carry a baby, the displaced weight still increases the stress on her joints. "As the baby grows in size," Dr. McAndrews explains, "the woman's weight is projected even farther forward, and the curvature of her lower back is increased, placing extra stress on her spinal disks in that area. As a result, the spine in the upper back area must compensate— and the normal curvature of her upper spine increases as well."

While these changes sound dramatic, Mother Nature does step in to help accommodate them. During pregnancy, hormones are released that help loosen the ligaments attached to the pelvic bones. But even these natural changes designed to accommodate the growing baby can result in postural imbalances, causing pregnant women to be more prone to awkward trips and falls.

What Can You Do?

The following tips are recommend for pregnant women looking for relief from the discomforts of pregnancy:

• Safe exercise during pregnancy can help strengthen your muscles and prevent discomfort. Try exercising at least three times a week— preceded and followed up by a gentle stretching routine. If you weren't active before your pregnancy, however, now is not the time to start a new fitness routine. Check with your doctor before starting or continuing any exercise regimen during pregnancy.
  Walking, swimming and stationary cycling are relatively safe cardiovascular exercises for pregnant women, because they do not require jerking or bouncing movements. Even jogging, however, can be safe for women who were avid runners before becoming pregnant— if done carefully and under the supervision of a doctor.
  Whatever exercise routine you choose, be sure to do it in an area with secure footing to minimize the likelihood of falls. Also, be certain that your heart rate does not exceed 140 beats per minute during exercise, and that strenuous activity lasts no more than 15 minutes at a time.
  Stop your exercise routine immediately if you notice any unusual symptoms, such as vaginal bleeding, dizziness, nausea, weakness, blurred vision, increased swelling or heart palpitations.
• Wear flat, sensible shoes. Not only can high or chunky heels be uncomfortable, they can also exacerbate postural imbalances and cause you to be less steady on your feet than you already are. This is especially true as you get farther along in your pregnancy.
• When picking up older children— or any other object for that matter— bend from the knees, not the waist. And never turn your head when you lift. Just to be on the safe side, avoid picking up heavy objects altogether, if possible.
• When sleeping, lie on your side with a pillow between your knees to take pressure off your lower back. Many women find that full-length "body pillows" or "pregnancy wedges" are especially helpful during pregnancy. Lying on your left side is ideal. This position allows unobstructed blood flow, and helps your kidneys flush waste from your body.
• If you have a job that requires you to sit at a computer for long hours, be sure your workstation is ergonomically correct. Position the computer monitor so the top of the screen is at or below your eye level, and place your feet on a small footrest to take pressure off your legs and feet. Also, take periodic breaks every 30 minutes by taking a quick walk around the office.
• Eat small meals or snacks every four to five hours— rather than the usual three large meals— to help keep nausea or extreme hunger at bay. Good snacks include crackers or yogurt— bland foods that are high in carbohydrates and protein. Keep saltines in your desk drawer or purse to help stave off waves of "morning sickness" that can, unfortunately, occur at any time throughout the day.
• Folic acid supplements— at least 400 micrograms (mcg) a day— before and during pregnancy have been shown to decrease the risk of neural tube birth defects, such as spina bifida. Some doctors recommend even more for women who are already pregnant, or who previously gave birth to a child with a neural tube defect. However, check with your doctor before taking this or any other vitamin or herbal supplement. Some herbs and supplements that are considered perfectly safe for non-pregnant women can be dangerous or harmful to the baby or expectant mother.
• Get plenty of rest. Don't let the demands of work and family life put you and your baby at risk. Pamper yourself, and ask for help if you need it. Take a nap if you're tired, or lie down and elevate your feet for a few moments when you need a break.

Visit the Chiropractor

Visit your doctor of chiropractic. Before you become pregnant, your doctor of chiropractic can detect any pre-existing imbalances in the pelvis or elsewhere in your body that could make pregnancy discomfort even worse— or leave you with additional neuromusculoskeletal problems after childbirth.

Many pregnant women have found that chiropractic adjustments provide relief from the increased low back pain brought on by pregnancy. Also, scientific studies have found that spinal manipulation carries no increased risk to the pregnant woman or her baby. Chiropractic's non-drug, non-surgical approach to back pain can be especially attractive to pregnant women who are trying to avoid over-the-counter and prescription drugs. Doctors of chiropractic can also offer nutrition, ergonomic and exercise advice that will help you avoid the discomforts of pregnancy.

Chiropractic care can also be helpful after childbirth. In the eight weeks following labor and delivery, the ligaments that loosened during pregnancy begin to tighten up again. Ideally, joint problems brought on during pregnancy from improper lifting or reaching should be treated before the ligaments return to their pre-pregnancy state. In addition, as the upper and lower spine return to normal, muscle tension, headaches, rib discomfort and shoulder problems can result. Your doctor of chiropractic can help.

At least 70 percent of America's 30 million elementary school students use computers, according to a recent New York Times article. As a result of this increased usage, doctors of chiropractic are treating more young patients suffering from the effects of working at computer stations that are either designed for adults or poorly designed for children. Many children are already suffering from repetitive motion injuries (RMI) such as carpal tunnel syndrome and chronic pain in the hands, back, neck and shoulders.

A recently published study conducted by a team of researchers from Cornell University found that 40 percent of the elementary school children they studied used computer workstations that put them at postural risk. The remaining 60 percent scored in a range indicating "some concern."

"Emphasis needs to be placed on teaching children how to properly use computer workstations," stated Dr. Scott Bautch, past president of the American Chiropractic Association's Council on Occupational Health. "Poor work habits and computer workstations that don't fit a child's body during the developing years can have harmful physical effects that can last a lifetime. Parents need to be just as concerned about their children's interaction with their computer workstations as they are with any activities that may affect their children's long-term health," added Dr. Bautch.

What can you do?

To reduce the possibility of your child suffering painful and possibly disabling injuries, the American Chiropractic Association (ACA) and its Council on Occupational Health offer the following tips:

• f children and adults in your home share the same computer workstation, make certain that the workstation can be modified for each child's use.
• Position the computer monitor so the top of the screen is at or below the child's eye level. This can be accomplished by taking the computer off its base or stand, or having the child sit on firm pillows or phone books to reach the desired height.
• Make sure the chair at the workstation fits the child correctly. An ergonomic back cushion, pillow or a rolled-up towel can be placed in the small of the child's back for added back support. There should be two inches between the front edge of the seat and the back of the knees. The chair should have arm supports so that elbows are resting within a 70- to 135-degree angle to the computer keyboard.
• Wrists should be held in a neutral position while typing - not angled up or down. The mousing surface should be close to the keyboard so your child doesn't have to reach or hold the arm away from the body.
• The child's knees should be positioned at an approximate 90- to 120-degree angle. To accomplish this angle, feet can be placed on a foot rest, box, stool or similar object.
• Reduce eyestrain by making sure there is adequate lighting and that there is no glare on the monitor screen. Use an antiglare screen if necessary.
• Limit your child's time at the computer and make sure he or she takes periodic stretch breaks during computing time. Stretches can include: clenching hands into fists and moving them in 10 circles inward and 10 circles outward; placing hands in a praying position and squeezing them together for 10 seconds and then pointing them downward and squeezing them together for 10 seconds; spreading fingers apart and then closing them one by one; standing and wrapping arms around the body and turning all the way to the left and then all the way to the right.
• Your child's muscles need adequate hydration to work properly and avoid injury. Encourage your child to drink four 8-ounce glasses of water a day. Carbonated beverages, juices and other sweet drinks are not a substitute.
• Urge your child's school or PTA officials to provide education on correct computer ergonomics and to install ergonomically correct workstations.

"If your child continues to complain of pain and strain from sitting at a computer, see a doctor of chiropractic," urges Dr. Bautch. "A chiropractor can help alleviate your child's pain and help prevent further injury."

Look around
any crowded city street, and you'll see plenty of footwear— from
stiletto heels to platform shoes— that is more than a little unkind
to our feet. It's no wonder that foot pain is such a common complaint.
But it's not just our feet that are hurting. Improper footwear places strain
on the knees, hips and back. According to Karen Achtermann, DC, your feet
serve three purposes: support, locomotion and shock absorption. So, support
your body by following these guidelines for proper footwear.

Leave the High-Heels Behind

Women,
listen up: The higher the heel on your shoe, the greater the amount of
stress placed on your forefoot. High-heeled shoes can contribute to the
collapse of one or more of the foot's three arches. These shoes also place
undue stress on the ankle, which can lead to ankle instability and sprains.
Plus, when you wear high-heels your calf muscles shorten, warns Achtermann.
Then, if you alternate between high heels and flat shoes, your calf muscles
go through a shorten/lengthen cycle that can lead to pelvic imbalances
and low back pain.

Consider Orthotics

Many chiropractors
recommend orthotics. There are two kinds of orthotics: the simple, commercially-made
insoles that are available at outdoor sports or shoe stores, and custom
orthotics. Custom orthotics are superior since they are tailored to your
individual foot and are designed to correct for your particular imbalances.
These are created by making an impression of each foot called a cast, and
then correcting for specific misalignments. According to Achtermann, custom
orthotics help to prevent dysfunction of the lower body and legs, and decrease
spinal stress.

The growing awareness of safe driving and state safety laws have alerted the general public and parents to the importance of using car seats for their small children whenever and wherever they are driving. Most states require the use of car seats for children under the age of 4 and weighing less than 40 pounds. However, these safety rules aimed at protecting children may cause serious neck and spinal injuries and can even be deadly if the child car seats are used incorrectly.

The American Chiropractic Association (ACA), its Council on Occupational Health and ACA member Dr. Michael Freeman, trauma epidemiologist and clinical assistant professor of public health and preventive medicine at the Oregon Health Sciences University School of Medicine, have developed the following general guidelines and safety tips to ensure proper car seat safety.

• Make sure the child safety seat is appropriate for the age and size of the child. A newborn infant requires a different seat than a 3-year-old toddler.
• Car seats for infants should always be rear facing as the forces and impact of a crash will be spread more evenly along the back and shoulders, providing more protection for the neck.
• Car seats should always be placed in the back seat of the car-ideally in the center. This is especially important in cars equipped with air bags. If an air bag becomes deployed, the force could seriously injure or kill a child or infant placed in the front seat.
• Make sure the car seat is properly secured to the seat of the vehicle and is placed at a 45-degree angle to support the head of the infant or child.
• The lap harness should be fastened low, as close to the hips as possible; the harness should never be fastened around the waist.
• Make certain the shoulder harness is fastened securely and the straps lay flat against the body. Twisted straps can cause additional injury that might prevent the seat from working properly.
• Use a retention clip (if provided by the manufacturer) when securing a child safety seat with the shoulder harness. The retention or shoulder harness clip is an added safety feature and must be fastened close to the armpit of the infant or child.
• Borrowing or purchasing a used car seat can be dangerous; there is the possibility of unknown or undetected damage. Car seats that have been in a serious accident should never be used again.
• Be sure the seat meets federal motor vehicle safety seat standards. Consult the owner's manual or contact the manufacturer for that information. All car seats should have an owner's manual and instruction booklet.
• Be sure the clip between the legs of the child is fastened snugly.

While car accidents can be dangerous for all passengers, small children are especially at risk, according to Dr. Scott Bautch, past president of ACA's Council on Occupational Health. "The weight of the head of a child makes the cervical spine much more vulnerable to injury," Dr. Bautch explained. "The infant has little control in the muscles of the neck, and the head can bounce from side to side and fall forward, which can cause serious spine and neck injuries. Children have more flexible upper bodies and shoulders. Make sure the harness comes up, way up, over the shoulders."

Underscoring the importance of proper car seat use, a recent article in Nation's Health reported the findings of a study conducted in Kentucky by the Centers for Disease Control and Prevention. The study found a 37 percent drop in infant fatalities since the 1982 enactment of the state law mandating the use of child car seats. "To continue this decline, prevention efforts now must focus on the proper use of the seats to maximize their life-saving potential," the researchers said.

The key when traveling with small children is to be aware of and follow these rules and tips to ensure proper car seat safety. And remember everyone: Buckle up!

If you or one of your children have been involved in a serious automobile accident and have experienced neck and back discomfort, you should consider a visit to a chiropractor.

Did you know that drinking too much soda or other carbonated beverages could interfere with calcium absorption - a problem that could eventually lead to osteoporosis? Or that slouching at a desk all day or tapping away at a computer keyboard can lead to painful strains in your wrists, shoulders, elbows and back?

These are just a few of the bad habits that can lead to musculoskeletal problems-conditions that have an enormous impact not only your health, but also on society as a whole. In the United States alone, musculoskeletal conditions cost society an estimated $254 billion every year and one out of every seven Americans reports a musculoskeletal impairment.

Doctors of chiropractic, in particular, have long emphasized the importance of spinal health, posture and other lifestyle factors in the body's ability to function optimally. Poor spinal health, for instance, can cause a negative chain reaction throughout the body. It can cause stress on joints, which, especially if the muscles are weak, can cause wear and permanent damage. The ACA and your local doctor of chiropractic offer the following advice to help improve and maintain your musculoskeletal health.

At the Office

• Make sure your chair fits correctly. There should be 2 inches between the front edge of the seat and the back of your legs. Sit with your feet flat on the floor, with your knees at a 90-degree angle. If you can't sit that way, use an angled or elevated footrest.
• Take periodic stretch breaks. Clench your hands in a fist and move your hands like this: 10 circles in, then 10 circles out. Put your hands in a praying position and squeeze together for 10 seconds and then "pray" with the backs of your hands together, fingers pointed downward for 10 seconds. Spread your fingers apart and then bring them together one by one.
• Hold the telephone with your hand or use the speakerphone. Don't cradle the phone between your ear and shoulder. This can lock up the spinal joints in the neck and upper back, and eventually cause pain.
• Take breaks and alternate tasks that use different muscle groups.
• Arrange your desk so that everything is handy - phone, mouse, reference materials, reports - to minimize awkward stretching and reaching.
• Position your computer monitor so that the middle of your chin is aligned with the middle of your monitor. This will allow for good neck posture.

At Home

• When you wash the dishes, open the cabinet beneath the sink, bend one knee, and put your foot on the shelf under the sink. Lean against the counter so some of your weight is supported in front.
• When resting or watching TV, don't use the sofa arm as a pillow. The angle is much too sharp for the neck.
• Don't bend from the waist when you lift a child. Squat with your back straight. Keep the child close to you and use your legs and arms to lift.

In the Yard

• If you shovel snow, push the snow straight ahead. Don't try to throw it and walk it to the snowbank. Avoid twisting and turning motions. Bend your knees to lift when shoveling. Let your legs and arms do the work, not your back. Take frequent rest breaks to take the strain off your muscles. Try to stand as erect as possible.
• When raking leaves, use a scissors stance: right foot forward and left foot back for a few minutes; then reverse, putting your left foot forward and your right foot back. Bend at the knees, not the waist, as you pick up leaves. Make piles small to decrease the possibility of back strain.
• For mowing, use your weight to push the mower. Whenever possible, use ergonomically correct tools for the job.

Playing Sports

• Warm up slowly before a game. Do calisthenics, flexibility exercises, or light running to increase your heart rate.
• When sweat beads form, your body is at the proper temperature to stretch the tendons and muscles.

While Traveling

• When driving, adjust your car seat so you can sit firmly against the seat back without having to lean forward or stretch. Buckle your seatbelt and shoulder harness, and adjust the headrest so that it supports the center of the back of the head.
• Invest in a wheeled suitcase that has a sturdy handle.
• Don't always carry the weight on one side - take frequent breaks and transfer the weight to the other side.
• Don't try to carry too much. Even wheeled suitcases can cause problems to the neck, shoulders and lower back when pulled from behind.
• When traveling by air, check all bags heavier than 10 percent of your body weight. Overhead lifting of any significant amount of weight should be avoided to reduce the risk of pain in the lower back or neck. While lifting your bags, stand directly in front of the overhead compartment so the spine is not rotated. Do not lift your bags over your head, or turn or twist your head and neck in the process.
• While seated in an airplane, vary your position occasionally to improve circulation and avoid leg cramps. Massage legs and calves. Bring your legs in, and move your knees up and down. Prop your legs up on a book or a bag under your seat.

For Children

• Have a smaller table for them where they can do their homework, rather than force them to use a standard table and chair. If the child's feet don't touch the floor, place a footrest or box under the feet. Position the computer monitor so the top of the screen is at or below the child's eye level.
• Make sure the straps of your child's backpack are padded and worn over both shoulders, not just one. Also, the contents of the backpack should not weigh more than 10 percent of your child's body weight.
• If your child is involved in sports, make sure all equipment, including helmets, pads and shoes, fits your child properly. If your teenage child is involved in soccer, make sure they are taught how to "head" the ball properly. A young child should not use the heading technique at all, according to ACA experts.
• Make sure your child has enough calcium included in his or her diet. ACA recommends 1 percent or skim milk for children over 2 years old, and whole milk for those younger than 2. The calcium in milk is essential for healthy bones and reduces the risk of joint and muscle-related injuries
• Make sure your child avoids sugar-loaded, caffeinated and carbonated drinks. Rather, encourage them to drink plenty of water. Caffeine can dehydrate your youngster, and the high levels of phosphorous in sodas and other carbonated beverages can interfere with calcium absorption - a problem that could lead to osteoporosis down the road.

While the ACA encourages you to follow these tips for better musculoskeletal health, remember that good spinal health is but one component in a healthy lifestyle. Exercising, getting a good night's sleep, drinking plenty of water and eating a nutritious diet contribute not only to health but also to the ability to heal after an injury.

As millions of kids get ready to go back to school, many will pull out
old backpacks or purchase new ones. While the books, homework assignments,
lunches, and other school gear those bags carry may be important for success
in school, some experts point to backpack use as the leading cause of a
growing trend in back pain among youngsters. In fact, a recent study conducted
in Italy found that nearly 60 percent of children carrying heavy backpacks
experienced back pain as a result.

Some states, such as California and New Jersey, have taken legislative
action to reduce the weight of students’ backpacks in their school
districts. However, even for residents of those states, government regulation
may not be enough. Whether you are looking out for your child’s welfare
or you use a backpack yourself, here are some steps recommended by the
American Chiropractic Association to lighten the load.

Tips for purchasing a new pack:

• Be selective. Look for ergonomically designed packs,
  such as the Samsonite Chiropak, that distribute weight evenly along the
  shoulders and spine. Ask your chiropractor for suggestions, and have
  him or her look at the fit of a pack you have purchased.
• Go small. The smaller the pack, the less likely your
  child is to overload it with books and other materials. Look for packs
  that feature special compartments for different types of items— such
  as pencils, calculators, books, or folders.
• Select wide, padded straps. Backpacks that are designed
  with broader straps and ample padding are much more comfortable— and
  healthier.

How to use a backpack wisely:

• Lighten up. Aim for a backpack weight of no more than
  10 percent of your child’s body weight. That means if your child
  weighs 85 pounds, her pack shouldn’t exceed 8.5 pounds. If your
  child is required to carry weight above that 10 percent, talk to your
  child’s teacher about ways to reduce the load.
• Position correctly. A properly adjusted backpack will
  create less stress on the back. Make sure the pack doesn’t hang
  too low (four inches or more below the waist) which can strain the back.
• Two is better than one. Educate your child about the
  importance of wearing both shoulder straps, which will distribute weight
  more evenly.

If you or your child experience tingling or numbness in the hands, or
discomfort in the back or neck after wearing a backpack, discontinue use
and seek the advice of your doctor of chiropractic.