At some point in time, most of us have had a “Charlie horse” or muscle cramp. In fact, 50% of adults over the age of 50 suffer from night cramps. Doctors of chiropractic are often asked by their patients, “Where do these come from? Why am I having these? What can I do to get rid of them?”

The most common type of muscle cramp is caused by exercise, hence the label “exercise-associated muscle cramps” (EAMC). Though EAMCs are common in both recreational and professional athletes, the actual cause remains unclear. Therefore, treatment is often based on anecdotal studies rather than sound scientific evidence.

With that said, a thorough analysis of previous studies published between 1955 and 2008 concluded that the two most widely discussed theories for the cause of EAMC are 1) dehydration and the resulting electrolyte imbalance/depletion and 2) neuromuscular causes. The authors of the analysis concluded that the actual cause is “…likely due to several factors coalescing to cause EAMC.” In other words, it’s sort of like “a perfect storm”, as several causes interact to result in the cramp, which is why treatment and prevention strategies for EAMC can vary considerably.

The recommended care for acute EAMC is to apply a steady, moderate static stretch to the muscle followed by gathering a proper history to determine if any predisposing conditions exist that can trigger EAMC. Prevention should focus on fluid and electrolyte balance (replacement) and/or neuromuscular training.

Specific physical problems that can increase the rate and/or intensity of muscle cramps include conditions affecting the endocrine system (hormonal imbalance), the metabolic system (loss of fluids and electrolytes), and/or the neurological system (such as nerve injury or damage). Common areas for muscle cramping include the calf, front of the thigh (quadriceps), and back of the thigh (hamstrings).

A thorough history and physical examination may include a nutritional assessment, which can lead to treatment strategies tailored for each unique, individual patient. Additionally, it’s a good idea to review what medications a patient is taking as they may play a role in the development of cramps. For example, diuretics commonly prescribed for high blood pressure and other heart-related conditions may lead to potassium depletion.

Some helpful natural remedies for those with persistent muscle cramping may include a mineral/electrolyte replacement such as calcium, potassium, and/or magnesium. Anti-inflammatory nutritional care such as ginger and turmeric and/or muscle relaxing approaches such as valerian root can also be helpful. Other anti-cramping natural substances include Cassia oil and capsaicin. Riboflavin has been used preventatively with success as well.


There are two types of muscles that help facilitate motion in our hips and lower extremities: tonic and phasic.

Tonic (postural) muscles are always working or contracting to keep us upright. Therefore, these muscles tend to be tight and short. When we sleep, they contract or shorten and are taut upon waking and need to be stretched on a regular basis.  Examples of tonic muscles include the hamstrings and the iliopsoas or hip flexors muscles. Here are two great stretches for these muscles:

Iliopsoas stretch: 1) Stand and take a step forward with the left leg into a front straddled position.  2) Rotate the left side of the pelvis forward so that it becomes square with the right side of the pelvis. 3) Perform a posterior pelvic tilt by flattening the curve in the low back while rocking the pelvis forward to create a strong stretch in the left groin/front of the hip. 4) Lean backwards to the right to further increase the left groin/hip stretch.  Hold for five to ten seconds and repeat this on the opposite side. Practice these stretches multiple times a day.

Hamstrings stretch: 1) Lie on your back and place the left leg on a door jam with the right leg flat on the floor extending through the opening of the doorway.  2) Push the left leg into the door jam and hold for three to five seconds and then scoot closer to the door jam to stretch the hamstring.  Hold for one to two minutes and repeat this on the opposite side, multiple times a day.

Phasic muscles, on the other hand, only work when needed and tend to be weak. These require strengthening, not stretching. Examples of phasic muscles include the abdominal and buttock muscles. Here are two great strengthening exercises for these muscles:

Abdominal strengthening: 1) Lying on the floor, place your hands behind your low back. Bend one knee/leg while keeping the other straight. 2) Lift your breast bone toward the ceiling one to two inches (2.54 to 5.08 cm) and hold for ten seconds. Repeat multiple times until the abdominal muscles are fatigued.

Buttocks strengthening: 1) Squeeze your buttocks together multiple times a day when sitting or standing. 2) Lie on your back with your knees bent and your feet flat on the floor. Raise your buttocks so it lines up with your trunk while pushing your heels into the floor. Hold for ten seconds and repeat five to ten times.

Depending on the nature of your hip pain, your doctor of chiropractic may recommend further exercises that you can perform at home as part of your treatment plan.


With Thanksgiving always comes Black Friday

If you choose to venture out during this time, be safe both financially and physically.
Check out these 9 safety tips to help your shopping experience go a little bit easier!

…. Happy Shopping!

  1. Construct a separation plan for you and your shopping partner(s), especially if you’ve got kiddos with you! Choose a spot to always meet when you’ve lost one another. Instruct your children to reach out to a security office or an employee to have them accompany your child while they walk to your spot you’ve previously agreed upon.
  2. Do not pull out your form of payment at the register until you have been completely rung up. You never know who may be nearby, scoping you out and attempting to steal your credit card numbers and/or see that you have a lot of cash.
  3. Ponder ways to substitute a common form of payment. Like using prepaid cards for transactions to prevent your identity and bank account from being stolen by hackers.
  4. Only buy as much as you and your shopping partner(s) can carry. You can be immediately considered a target by someone searching for overwhelmed shoppers.
  5. Check your bank statements immediately and regularly after your shopping. Save all of your receipts and compare to your statements to make sure you aren’t a victim of fraud.
  6. Carry your keys, or method of safety (such as pepper spray, etc) in your hand and mentally prepare yourself to use it if needed when you are approaching your vehicle.
  7. Before you enter your vehicle when heading back from shopping (or anywhere during this season) be sure to peak under your vehicle, and inside the back and front seats before unlocking and entering. Try to only unlock the specific doors needed if your car will allow it. This prevents anyone from sneaking in on the other side of your vehicle. Also, keep this in mind when pumping gas at gas stations.
  8. Carry your purse or wallet tightly and closely to your body. This will hinder the opportunity for thieves to pickpocket.
  9. Do not leave packages or gifts visible in your vehicle. Hide it in the trunk, or take it home as immediate as possible.



Because the human head weighs between 12-15 pounds (5.44-6.80 kg), the neck and upper back muscles must constantly work to maintain an upright posture. Due to our use of computer and electronic devices, many people have forward head posture (FHP), meaning their head rests forwards on the neck more than it should. In fact, studies show that every inch of FHP places an additional 10 pound (4.53 kg) burden on the muscles in the upper back and neck to keep the head upright. It’s no wonder why a common complaint is, “My head feels so heavy and my neck feels compressed—I constantly have to rest my head on the back of the couch when I sit.” So, what can we do about this?

POSTURE: Reducing FHP is essential. To do this, tuck in your chin (creating a “double chin”) and speak as you do this. You will notice a change in your voice quality—HOLD for ten seconds and then release JUST ENOUGH for the voice to clear and try to KEEP this position throughout the day. It takes about three months to retrain old bad posture habits so be patient!

SLEEP: If your neck is narrower than your head (the case for most of us), your pillow needs to be thicker on the edge to support your cervical spine.

ACTIVITY: You may have to assess which activities (such as sports) are most important to you and either modify how you do it and/or change when and how long you engage in such actions. If your goal is to improve in an activity, gradually increase the frequency, intensity, and duration over time. If you hurt and can’t recover within a “reasonable” time frame (such as 24-48 hours), then you overdid it.

Chiropractic offers MANY therapeutic tools to help those with neck pain, which include spinal and extremity manipulation, soft tissue therapy, physical therapy modalities (like ultrasound), nutritional counseling, and exercise training. Your doctor of chiropractic can give you advice on sleeping posture and prescription pillows, home cervical traction options, and more. The goal is not only to manage your neck pain, but more importantly,  to teach you self-management strategies so YOU can control of this often disabling condition and reduce the need for prolonged care.

Many of us have had problems associated with dizziness from time to time and have not thought much about it. But when dizziness happens frequently, lasts a long time, or is severe, it definitely gets our attention and forces us to get it checked out.

BACKGROUND: To determine how common dizziness is and the personal burden it imposes on the population, a large-scale study examined 2,751 adults (aged 50+ years) using multiple measures for dizziness, hearing, tinnitus (ringing in the ears), and quality of life. An alarming 60% reported some type of vertigo. Interestingly, the researchers observed an association between tinnitus and vertigo. Also, the participants with vertigo reported lower quality of life scores than those without dizziness complaints. This study highlights the significant burden imposed by dizziness/vertigo stating that this is an “important public healthcare issue” that must be studied further.

CAUSES: The most common causes include benign paroxysmal positional vertigo (BPPV), acute vestibular neuronitis or labyrinthitis, Meniere’s disease, migraine headaches, and anxiety disorders. Less commonly, reduced blood flow to the brain/head (“vertebrobasilar ischemia”) and retrocochlear tumors can cause dizziness. The risk also increases with age.

TREATMENT OPTIONS: Most vertigo sufferers do not require extensive testing and can be treated in the clinic.  Benign paroxysmal positional vertigo and labyrinthitis are most often successfully managed by doctors of chiropractic with specific exercise to reposition the displaced “canaliths” or small stone-like material in the inner ear.

Treatment with a low-salt diet and diuretics (herbal options include: dandelion, ginger, parsley, hawthorn, and juniper) can also be helpful in resistant cases with fewer side effects than prescription vestibular suppressing medications. Consuming potassium-rich foods such as bananas, avocados, raisins, beans, squash, mushrooms, potatoes, yogurt, or fish is often wise when taking a diuretic. Chiropractors often provide nutritional counseling and can help guide you in this area as well.