The problem is that with the exception of supplements or fortified foods, Vitamin D is not found in the diet to a significant degree. The primary source our bodies use to get vitamin D is the sun. UVB rays hitting our skin allow it to synthesize and absorb vitamin D. Which leads us to the second problem; it is often difficult to get the appropriate amount of sun to synthesize enough vitamin D. In fact, anywhere north of the 37^th parallel will not provide enough sunlight in the non-summer months to allow our bodies to make enough vitamin D. For my local readers in the San Francisco bay area, we are just north of the 37^th parallel.  What to do? We must supplement. While everybody is different, most people supplementing with 8000IU of vitamin D each day will get their blood levels into at least the lower level of the acceptable range.

I have been doing this for 15 years. The top two reasons people do not seem to want to go to a chiropractor are a fear of being “cracked” and the fear of having to keep going back the rest of their lives – either because some sort of addiction has been unleashed or because they were hit with a huge care plan in which the chiropractor wants to see them three times a week for months.

For me, the first one is easily dismissed. I should emphasize that there is absolutely nothing wrong with the traditional chiropractic adjustments that involve mobilizing the joints in such a way that a “crack” is produced. With my approach, however, I use a computerized instrument that gives a repetitive impulse to gently mobilize the joints. It accomplishes the same thing, but I like the specific control I have with my instrument and the fact that it tends to be a more gentle adjustment. It has the added benefit of not entailing the audible sound that sometimes concerns patients.

The second fear people have requires a bit more explanation on my part. I always endeavor to find out a new patient’s goals and accomplish them as quickly as possible. For some people, the goal is simply to relieve their pain. Other patients may have more active goals such as being able to get back to the gym. In any case, I will come up with a short term care plan to get them to where they want to be.

At the same time, there is a role for wellness care. Like the patient I just mentioned, many patients enjoy and benefit from coming in once a month or so for a “tune-up” to keep the joints moving and healthy. That is optional and always up to the patient.

I’ve been experimenting with making a bone broth soup in my crockpot. When making this broth, I start with 1-2 lbs. of bones. It’s beneficial to add a quarter cup of apple cider vinegar. This helps leach out the beneficial nutrients from the bones. Specifically, I’m interested in getting at the collagen, minerals and the other building blocks for articular cartilage. The collagen is good for the skin as well. I like to add some dried seaweed for added flavor and minerals. Then I let things simmer for a good 10-20 hours.

Whole Foods carries grass fed beef bones. I prefer grass fed meats in general because they have better quality fats as compared to their grain fed counterparts.

I must say, I find it very tasty to drink as is. But I could see that many people would want it to be more of a soup. So, for added nutrients, keep some soup bones in the freezer and throw them into any soup or simmering dish you might be making.

Now that the case was closed, this freed me up to work on her whole body. I ascertained that her work injury in which her right arm had been sharply pulled had not only injured her right shoulder but her neck as well. The cervical injury was causing pinching of the nerves that ran down into her right arm.  I also noticed that her pelvis was misaligned in such a way that it was unlevel when she stood. This had the effect of putting more stress on the whole spine including the cervical area. Although this was completely unrelated to the work injury, it was an additional stress on the already injured area. Interestingly, she mentioned that she had had pelvic pain ever since the birth of her child.

Adjusting the pelvis gave her great relief for that chronic area and helped straightened out her whole spine above it. Adjusting the neck, rib joints in the upper mid back and the right shoulder together reduced the pain significantly and unpinched the nerves that were radiating down her right arm. For the first time in years, she has no pain. The upshot? To get the best results, you have to look at the body as a whole.

When I first started in practice 15 years ago, I used to do spinal screenings at the local GNC store. I would happily check the spines of interested customers and give them a consultation about what I found. Usually people who wanted to be checked had some sort of pain or symptom. But not always. I remember one young guy in his early 20s came in and asked to be checked. He didn’t have any symptoms. He was just curious about his spine.

The reality is that life takes its toll on most of us. As a chiropractor so much of what I do is to compensate for the wear and tear of life. All those childhood falls, hours with the neck craned forward on the computer or school desk and, of course, the more dramatic injuries such as car accidents do affect the spine. The body will always heal as best it can. But it can only heal with some form of scar tissue. Scar tissue by its very nature has less mobility than regular tissue. This is why, as a chiropractor, I’m very focused on finding and releasing fixations. In chiropractic speak, we call these subluxations.  When the joints in the spine stop moving properly they become more susceptible to pain and, over time, degenerative changes. That lack of motion will also affect the nerves going through that area to the vital organs of the body. If I can restore proper motion to those joints, the segments will be healthier and less painful. As a fringe benefit, a spinal joint that is moving properly results in healthier nerve flow through that area.

As I checked this guy’s spine, I expected to find some sort of fixation or muscle spasm indicating less than ideal movement or misalignment. Even though many people don’t have symptoms of neck pain or low back pain, it is very unusual to find a perfect spine. As I examined this guy’s spine, I could find absolutely nothing wrong: his legs were even, normal motion throughout the spine, no muscle spasms, perfect range of motion in the neck and the low back. As he got up I told him that I could find nothing wrong. His spine was perfect. Knowing about the connection between spinal health and nervous system health, I told him that he was probably a pretty healthy guy. He responded by saying that he had never been sick a day in his life. I shook his hand and wished him well.

I hope he is still doing well and has managed to continue to dodge the stresses and strains of life. If he hasn’t, I hope he went to see a chiropractor.

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These are some of the most extreme examples I’ve seen in my practice. And yet, I see this issue crop up to lesser degrees on a daily basis. People come in all the time complaining of shoulder blade pain or upper back pain. Very often the pain is not in the spine or the shoulder joint but rather next to the spine were the ribs form joints with the spine. Most people don’t realize that the rib cage runs between the spine in back and the sternum (chest bone) in front. As we breathe, the rib cage expands and contracts. It also accommodates the motion of our body as it moves. This is another example of the balance that the human body has to strike between support while still allowing for mobility.

In addition to direct traumas to this area, such as auto accidents or falls, pain can also come from a forward head posture. I call this The Posture of the 21^st Century because so much of our lives now entail hours spent hunched over the computer, smart phone, desk or steering wheel. This position puts stress on the back of the spine and the ribs as the head and shoulders rotate forward.

From my point of view, these are very rewarding patients to work on.  When the exact cause of their issues hasn’t been determined and I can put my finger right on the origin of their pain, it is as if a light bulb goes on in their head. “That’s it!” they will so often exclaim.

Gently adjusting the ribs back into place tends to provide great relief. At the same time, it’s important for me to give the patient stretches and exercises they can do at home to address the forward head posture that is predisposing them to have that pain.

Interestingly, I’ve found that even if a patient comes in who does not have direct complaints of rib pain, they seem to feel better and their spines stabilize better if I address any misalignments of the ribs. So for years now, as a matter of course, I address the rib alignment of all my patients.

Proper motion of the pelvis can make a significant difference in the child birthing process. The body, in its innate wisdom, releases a hormone that loosens the ligaments in the mother’s body in preparation for the birth. As the baby comes down the birth canal, the bones of the pelvis shift in order to make more room for the baby’s descent.

And yet things are not perfect. As a chiropractor, my job is to ensure that no joint fixations exist that might complicate the birth. At the very least, keeping the pelvis moving properly may allow for a smoother delivery with less time in labor.

She recently came in for a “tune-up” visit and happily announced that the birth had gone surprisingly easily and her labor time had been very significantly shorter compared to the previous birth.

One concern is that most people do not take enough.  For those with pain, the research indicates that at least 2700-3000 mg/day of EPA + DHA should be taken.  EPA and DHA are the beneficial omega-3 fatty acids found in fish oil.  Check the bottle to see how much that is.  It is usually difficult to take enough capsules to reach this amount.  For this reason, I recommend taking fish oil in liquid form.  If it’s fresh, it won’t taste rancid.

Having done some research into the best brands out there, I recommend the brand Nordic Naturals. I recently read a post by Dr. Centeno, M.D. that addresses some of the issues with using low-quality fish oils. For this reason, I will continue to recommend spending a little more and getting the “good stuff”.

I call the slumped over, forward head posture, “The Posture of the 21^st Century”.  Kids and adults alike are spending so much more time hunched over computers, smart phones and steering wheels that it has begun to make permanent changes in our postures. This is bad for several reasons. As the head and shoulders rock forward, the head is no longer balanced over the shoulders. To compensate, the muscles at the back of the neck have to tighten up to support the head. This tends to cause more muscle tension in that area. This is why people often complain that they hold their tension there. It’s a case of emotional stress piling on top of physical stress.

Headaches are often linked to this issue as well. If you can picture it, as your head goes forward it is also tilting back slightly relative to the neck just below it. This jams that joint and alters the mechanics in that area causing headaches and neck pain.

Also as the head goes forward, it also tends to straighten out the spine in the neck area. This has the unfortunate effect of putting more pressure on the nerves and spinal cord in that area. These delicate nerves control many of the vital functions of the body. Compromising these nerves can have repercussions on one’s health beyond simple mechanical pain.  One study found that elderly people with forward head posture had an over 10 year decreased life expectancy compared to others their age with good posture.

The solution is, not surprisingly, to get adjusted in order to realign and mobilize fixated joints. Then, it is also important to stretch out those muscles that have been shortened over time due to the bad posture. An easy stretch is to go to a doorway, put your forearms on either side of the door jam and lean forward and stretch out your chest muscles. Hold it for about 30 seconds. Do that at least a couple times a day.

Another excellent stretch, one of my favorites, is to stretch the front of your neck by bringing your head straight back. By this I don’t mean extend your head back like you are looking up at the sky, rather, pull your head straight back like you try to give yourself a double chin. That will stretch the deep neck flexors in front that have become shortened. Hold that stretch for 5 seconds then relax. Repeat 10 times. Do a set of 10 a couple of times a day.

Keeping this area in good alignment by seeing a chiropractor and by performing home stretches may mean the difference between being a hunched over crotchety old person and one who is still straight and healthy into old age. Even if we can’t do anything about the upcoming generation, we can do our best to keep our generation going strong.