Tag Archives: Dr. Alim Kara

NW Calgary Chiropractor

10 steps to decrease your risk of getting sick during the COVID-19 crisis

10 steps to decrease your risk of getting sick during the COVID-19 crisis


It seems simple enough but there are actually important reasons, considerations and steps to follow when staying safe during the COVID-19 pandemic.  For instance, did you know that hand washing has an equally important second step that must be followed?  That the reason the common cold is so “common” is the same reason that COVID-19 spreads?  That masks only protect you if you use them correctly?  That one of the greatest vectors of infection follows you everywhere (hint: it’s your phone)? 


These are just a few of the topics we will go over in the following post – but just for the record, the only real way of protecting yourself from contracting COVID-19 is complete social isolation (which is very unrealistic and impractical).  Keep in mind that all of these suggestions are no different for any infectious illness. 


Apologies for the length of this post but I have found some things need to be blatantly explained as WE CANNOT ASSUME some of the intricacies or reasons behind this stuff.  


The below suggestions are ordered starting from the most significant steps of things you can do to stay safe and decrease your risk of contracting COVID-19:



  • Hand Washing is king:


      1. This is considered the single most important infection prevention and control practice to break the chain of transmission of infectious disease (but this is because we touch our face so much – foreshadowing to the next suggestion).
      2. Soap (of any kind) and water is the gold standard of hand washing and must be done for a minimum of 20 seconds.
      3. Hand sanitizer is also acceptable but must have a minimum strength of 60% ethanol or isopropyl alcohol (but hand washing with soap is the superior and recommended method).
      4. This should be done when you enter a new environment (ie. someones house, a business) and again when you leave an environment (including before you leave your own house).  Here is a helpful link with more information on how to wash your hands correctly.  


  • DO NOT touch your face:


      1. Hand washing is technically irrelevant if you touch your face.  Your hands don’t make you sick – touching your face with contaminated hands is what makes you sick.  This is likely how you contract the majority of all colds/flu you have ever had: hand-to-mouth transmission.
      2. It is estimated the average human being touches their face up to 23-times an hour.  Therefore it is unrealistic to assume you will stop or even know you are doing so just make sure your hands are as clean as possible and try your best not to do it.
      3. This applies even more if you are wearing a mask (as the mask is likely moist and soiled from your own breath making it a great environment for virus and bacteria to transmit to you if you touch the mask).




      1. The main reasons why the common cold and flu are so prevalent is that as a social we have gotten used to still going out/working if we are sick.  
      2. These common illnesses spread in the EXACT same way as COVID-19 – except COVID-19 is unique in that is far more dangerous (even fatal) and virulent (spreads even easier and faster via the same means as the common cold/flu).
      3. This apply even to a minor sore throat or running nose.  STAY HOME FOR ANY AND ALL ILLNESS SIGNS OR SYMPTOMS.
      4. If people generally practiced this simple strategy alone it would significantly reduce how much everyone gets sick forever for all infectious illnesses that exist, period.
      5. Don’t be selfish and don’t be a hero.  It is not worth potentially furthering and prolonging the COVID-19 crisis.  Most illness will NOT be COVID-19 but should be treated as if they might be.  Symptoms can be very mild in the majority of infected people and these people usually never know they have it because they do not get tested because they are not that sick.
      6. It is much more responsible and helpful if you just isolate when sick, instead of everyone isolating to prevent from getting sick.


  • Social distancing (2-meters separation):


      1. Yes, this still applies as another significant reason viruses spread is by respiratory droplets – so keeping your distance helps a lot.  
      2. Standing or talking closely to someone can allow those droplets to get on you or your belongings – when you then touch those belongings and then touch your face or direct contact from those droplets get on your face/hands you run the risk of getting sick.
      3. Stay 2 meters or more away from everyone who lives outside of your household.
      4. Droplets are invisible and you cannot feel them – so it is best to assume they are just there if you are too close.


  • Masks don’t prevent you from getting sick:


      1. Masks do not protect you from getting sick from others – if anything they prevent others from getting sick from you.  
      2. The purpose of masks is only to contain your own droplets from your own breathing and speech.  
      3. Touching your mask once it is on is just like touching your face – viruses are really tiny and masks are porous in comparison.
      4. Once a mask is on, DO NOT touch it.  If adjustments need to be made, make them by only touching the straps/ties – NEVER touch the actual mask once it is on.
      5. Removing the mask should be done when you are home or in a sterile environment by only touching the straps/ties of the mask.  Immediately discard single use masks as they are not helpful after one completed use.  Cloth masks must be washed with soap and water after every use. 
      6. Wearing a mask incorrectly can confer a false sense of security if you do not use it properly.
      7. NEVER pull your mask down temporarily for any reason.  Pulling it down then putting it back up is actually no different than just straight up touching your face – in fact it might be worse as your mask is likely wet from you own breath and makes your hands wet, which makes it easier for viruses and bacteria to stick onto your wet hands (and then you touch your face or mask with these wet hands).  If you have to take your mask off, it is recommended you donn a new one on.
      8. It is recommended (not mandatory) that you use/wear a mask in situations where you will be interacting with people other than those in your own household (ie. grocery shopping, going to the bank, seeing your chiropractor).  Here is a helpful link with more information about masking.




      1. The dirtiest thing you probably own is your cell phone.  You are likely constantly touching it each day and not cleaning it.
      2. Using your non-cleaned cell phone defeats the purpose of washing your hands.  Think about it: you are touching your cell phone all day so whatever is touching your hands is on your phone so if you wash your hands and then immediately touch your phone then your hands are dirty again.  When was the last time you cleaned your phone?  Have you done it ever?  Studies show the majority of people have never properly cleaned their phone even once.
      3. If your phone is dirty and you use your phone for real phone calls, you are putting a dirty phone directly onto your face.  Consider the speaker phone option if possible.
      4. Make sure you search and educate for yourself how to properly clean and disinfect your phone.  I suggest you just google “how to clean my phone” and include the make and model of your specific phone.  DO NOT spray or immerse or wipe your phone with any liquid until you know it is safe to do so. 
      5. Do not blame me if you ruin your phone – it is your responsibility to understand how to do this without ruining your phone.  There is a plethora of information easily available online about  how to do this safely clean your phone.
      6. Same can be said about commonly touched items that leave the house with you (ie. keys, wallet/purse, car handle/steering wheel, etc) so wipe them down as well or ensure your hands are cleaned before you touch something new.


  • Modify/limit your social interactions:


      1. You might feel safe to start seeing family or friends again but remember the threat of COVID-19 has not passed us – we are just opening businesses and trying to rebuild the economy.  Do not let your guard down or think we are past this.
      2. Avoid any physical contact.  As hard as it may be to avoid hugging, kissing, touching loved ones, it should be avoided until we are out of the pandemic stage of this crisis. 
      3. Maintain social distancing when seeing friends or family (2 meters apart).
      4. If going to someone’s house/business, make sure you wash or sterilize your hands upon entry.  Do the same when you leave.
      5. If someone is coming to your house/business, make sure you clean all surfaces you may use with that guest over.
      6. Reconsider how you interact with the eldery.  The eldery are at a significantly higher risk than the rest of the population.  Is it really worth exposing them to a possibly fatal illness during this exact moment?  This same suggestion applies to smokers as COVID-19 affects them more significantly than the other populations of people.  Again it is very hard to say do not see these people but waiting a little bit longer before we resume in-person interactions is probably a good idea in the short-term.


  • Protect yourself first:


      1. You do not know what other people are doing or what their practices are, so it is best to assume they are not following proper practices and hygiene so it is your job to protect yourself by understanding proper procedures and etiquette to keep yourself safe.
      2. Politely educate your family and friends on how to stay safe as their behaviours may directly affect you – especially if you see them doing something that could be done in a more hygienic or considerate fashion.  
      3. It is important to keep in mind this is new to all of us so do not judge anyone for not knowing or misunderstanding; have tolerance and patience for others as we all navigate this unfamiliar situation together.  
      4. It is advised you abstain from educating strangers as this may result in unwanted and unnecessary conflict and confrontation.


  • Gloves are not as helpful as you think:


      1. Consider gloves to be the same as your hands – whatever your hands would touch, your gloves touch.  This means your gloves will be as “dirty” as your hands are so be careful what you touch when wearing gloves.
      2. DO NOT touch any of your personal items when using gloves as they confer a false sense of security that your hands are protected (which they are but contaminated gloves touching personal items just contaminate those items so later when your gloves are off and you touch those items with your hands you have defeated the purpose of wearing the gloves in the first place).
      3. Once you place a pair of gloves on (if you choose to use them) do not remove them until you are completely finished your purpose of wearing them and dispose of them immediately.  
      4. You still need to wash/sanitize your hands after using gloves.
      5. Washing/sanitizing your hands often is more helpful and protective than wearing gloves.




    1. You cannot really control whether you get sick or not.  All you can do is be mindful and try your best to avoid situations or circumstances in which you can decrease your risk.
    2. Do not live in fear.  It is hard to say that but life has to go on at some point, whether we agree with it or not.  All you can do is control your own situation and put yourself in the best spot to decrease your own risk.
    3. Do not worry about what other people are doing – it will drive you mad.  As mentioned above, protect yourself and try to avoid situations where you may have an increased risk or use some of the strategies mentioned above to lower your risk of infection.


Additionally, a healthy balanced diet and good cardiovascular health are exceptionally helpful as well as new studies are showing those with good cardiovascular health (people who exercise regularly) are less likely to become infected and those infected show less illness and recover significantly faster.  I suppose I should have made this a list of 12 steps but we all know 10 is far catchier.  


This is new and difficult for EVERYBODY, there is no “right” way and there is a lot to figure out when it comes to the “new normal.”


Hope you learned something new and that these tips help you in maintaining your health and those you care for.


Be safe, be patient, be tolerant and be kind,

Dr. Alim Kara BSc, DC


If you have any signs or symptoms of illness and believe you may have COVID-19 please use the Alberta Health Services Self Assessment Tool

***Disclaimer: These are 10 suggestions for decreasing your risk of infection only and will not completely prevent you from getting sick.

Pillow talk: How to choose the best pillow

Now that Dr. Kangarloo has educated you on the most optimal sleeping positions, I thought it would be great to follow up with some advice on how to choose the best pillow.


Picking a pillow can be a daunting task and that is because we are all made/shaped differently. It always surprises me why there is such a huge selection of pillows available but so little about how to choose the right one. Most people tend to choose which feels the most comfortable or what seems to be something that sounds fancy but that is the wrong approach.


When narrowing down your choices, think about your main sleeping position. It is recommended that your pillow support the natural curvature/alignment of your spine to offer the best comfort and support (too thick will flex your neck up/forward and too thin will extend your neck/tilt back). You want the goldilocks setting, jjjjust right!


These generalizations can be made:

Face down: Thin pillow, soft fill

Face up (or all positions): Medium pillow, mid to firm fill

Side Sleeper: Thick pillow, firm fill


Natural fill: Usually feather and/or down. These pillows need to be reshaped after use but offer great comfort and a luxurious feel. Hotels typically use natural fill pillows for their plushness and versatility. Tend to be more expensive than most pillows due to their sourcing and cost of materials. Another con is that due to the natural materials these pillows wear out the fastest as the natural material can break down over time. These however, are my choice as the most comfortable and versatile pillow. Also best for pillow fights; feathers everywhere! Good for all sleep types, depending on the amount of fill.


Synthetic: These pillows attempt to create a natural fill feel for far more value. They can range from a fluffy teddy bear stuffing type of fill to a more gel-like feel. The firmer synthetic pillows tend to be more of the gel type material so they are plush but do not need to be readjusted/fluffed as much as a natural fill pillow. They do have a more artificial feel than natural, which I find hard to explain (they almost push back more than they surround, if that makes sense). Good for all sleep types, depending on the amount of fill. Easily the most cost effective, available and popular of all pillow types.


Memory foam: This material does not need to be adjusted at all. It is designed to rebound back on its own after use. These pillows are not plush and offer more of a firm support. Probably the best pillow if you sleep a certain way all the time and you can find the right fit. Typically I do not suggest the pre-contoured ones as these pillows are contoured the same for everyone; so how do you know the contoured the pillow company decided is the one that fits your neck.  Accordingly, choose a gentle contour if this is your preferred material.  I do not recommend these pillows at all for children, as the contoured pillow design is more shaped for the adult neck. Usually best for side and back sleepers. Ideally a good idea but not practical in my opinion. Can also be expensive and gimmicky.


Water: Water pillows offer support/firmness of memory foam and the versatility of a natural/synthetic fill. The reason is because water is not only soft but moveable; based on the position you are in, the water will move into the areas that allow your head to rest while moving into and bolstering the areas your head is not. It also offers the most customization of all the pillows as you choose how much water to put in based on your comfort and main sleeping style. These pillows get heavy due to the high amount of water you add and a lot of people worry about swishy sounds of water or leaks but those concerns are minimal/rare. Do not use these for pillow fights as they will definitely give you a concussion. Good for all sleep types as you are in control with the amount of fill.


Other: This includes beads, seeds/organic material (ie. buckwheat) and other. Typically these tend to fall more into a synthetic (cost effective and plush) or memory foam (firm/supportive) type category. These pillows are more gimmicky and tend to be featured on TV infomercials and at trade shows. From my experience, less people tend to find success with pillows like this. Usually best for side and back sleepers.


Personally, I have had the most success with a natural fill pillow as the comfort and luxury they provide is greater than the other pillow types. I also sleep in all of the sleeping positions so I go with a medium fill as it is the most versatile for all sleepers. I found my ideal pillow by sleeping on it at a hotel one day and liking it so much that I followed up with the hotel so I could track it down. I have found good pillows to be incredibly hard to find so if you find one make sure you get it!


However, I do recommend water pillows often, as people who tell me that they can never find a comfortable pillow tend to do very well with a water pillow. Ideally, water pillows offer the best in terms of customization, as they are the only pillow I am aware of that you can change/modify based on your specific size and shape. We also sell these at CCST (and they make an excellent Xmas gift, nudge nudge).


From a full disclosure standpoint, I have never tried a water pillow myself, as I like the pillow I currently have and thus it is not worth messing with that. I have tried synthetic, memory foam, bead and buckwheat pillows and personally did not like them (synthetic is not bad and I can comfortably sleep on one, but I prefer the plush feel of a natural fill).


Pillows are definitely something you should invest in (all bedding as far as I am concerned) as you use it more than practically any other product! Treat yourself and understand you get what you pay for; a cheap pillow will likely have cheaper results.  In terms of cost, I have found that a good pillow will range between $60-120. The main drawback is it is very hard to find something that is worth investing in without wasting your money, but when you find a winner, oh boy the sleep will be glorious!


Hopefully this gives you some tips on how to make a better decision.  Good pillow talk!


Written by Dr. Alim Kara BSc, DC

What is Cupping?

Cupping is probably the most topical and viral treatment option in medicine right now, period! Thanks to those characteristic circular bruises Olympic legend Michael Phelps has been sporting it seems as if every media outlet is covering stories surrounding this treatment option.


The technique of cupping can be dated as far back as 3000 BC. Rooted in Traditional Chinese Medicine (TCM), glass cups are used to create suction on the skin. There are several different ways in which cupping can be applied, such as dry, wet and fire cupping. Cupping is said to increase blood flow, and stimulate qi (which TCM describes as life force) and draw “toxins” out of the body.


There is little doubt that cupping increases blood flow as you can literally see it in action. The jury is still out on the qi and toxins thing but let me say that applying any sort of suction to the skin for greater than 2-minutes will very likely result in a bruise; I believe the technical term of “hickey” can be used?


I have always had a problem with the whole debate on what are “toxins” as I have never seen or read anything, scientific or otherwise, which describes what a toxin is. Like I said, any suction greater than 2-minutes will cause capillaries in your skin to break and thus release blood causing a bruise, not a release of toxins. Whether this act (of creating a bruise) actually creates a healing effect is scientifically unknown.


However, I personally use the use of suction cups in my clinic with great success. I use silicone cups in my office (applied much easier) and I choose to not leave the cup on any one spot for greater than 1-minute. Instead, I choose to place a lubricant on the skin and move the suction cup up, down and across the skin to solicit the effect of increased blood flow and to also mechanically lift the tissue via the act of suction.


By moving the cup you allow the tissues to be pulled and tensioned in a fashion similar to a massage. The scientific evidence on the benefit of massage is clearly proven to be effective for pain relief and healing; thus a very clear correlation can be made between cupping and pain relief/healing when you are moving/gliding the cup over an area of tissue.


It actually feels quite nice, like a deep massage and very rarely causes enough of a sustained suction to leave a bruise. What’s more is that gliding suction cups across an area of tissue falls in line with treating fascia or kinetic chains when applied correctly. When applied in a manner where the cups are moved and only on the skin for under 2-minutes the risk of side effects (like bruising) are very rare.


Ultimately, I think cupping is getting a bad rap for not being scientifically proven to work, but keep in mind, this is along the context of proving that qi and toxins are involved in the process. This supernatural idea of qi/life force is the main downfall for the overall acceptance of cupping in western medicine, along with poor quality research and study design.


It is important to consider though that if the most highly decorated and arguably the best and most dominant athlete of all time feels like this technique works, there is probably something to it. Cupping has been used all over the world for millennia so although the evidence might not be clear on its effect, there is a proven staying power of this treatment modality that must be respected and confer some degree of credibility.


In my humble opinion, cupping is best to be considered and grouped as a soft-tissue/massage technique that allows for the mechanical stimulation of the tissues that are being treated. My personal recommendation is to move the cups around rather than allow for bruising to occur (as bruising is a marker of tissue damage/injury). Anecdotally, I have found this to be a very successful treatment option, especially when it is coupled with other soft-tissue therapy techniques.


Written by Dr. Alim Kara BSc, DC

Pokemon Induced Neck Pain (PINP)

The Pokemon catch phrase is “Gotta catch em all” but I don’t believe that includes neck pain! Pokemon Go is a fun game designed to get you outdoors and moving but there are some important factors you must consider to ensure your long-term health and safety.


The main injury associated with excessive cell phone use is neck pain. Most of us have a sore neck from time-to-time due activities that involve things like prolonged computer use, studying and sitting with our head in a flexed forward position. The problem with Pokemon (and all other cell phone activities that involve you looking down at your screen for long periods of time) is the amount of pressure this posture creates on our necks.


A 2014 study showed that when your head is flexed forward 45 degrees (a common posture for people looking down at their phones) that this exerts 50 pounds of pressure on your neck! This increases to 60 pounds with 60 degrees of neck flexion!


Our design as humans can tolerate this stress and pressure but when you consider the cumulative effect of this trauma over months and years it will result in neck pain. One to two hours a day of looking down at your phone would equal 1250-hours/year, which shocking equates to 300,000 pounds of neck pressure over a four-year period.


Considering that it is our children that commonly play Pokemon Go and they already sit a lot, use the computer for school and their usual cell phone habits (outside of any games they play) already exceeds one to two hours a day, adding Pokemon Go to your routine can cause some significant strain to your neck!


Here are some suggestions to still play but mitigate your risks for neck pain while playing Pokemon Go:

  1. Know your Poke Stops:
    • Plan ahead by knowing where you have to go, don’t constantly look at your phone until you arrive at your stop.
  2. Look up more:
    • Looking down isn’t bad, but looking down for long stretches of time can be. Make sure you look up more, rotate your head from side to side just to give your neck muscles and joint a little stretch.
  3. Be smart about the time you spend on your phone:
    • The best way to not strain your neck, is to not strain your neck. Activities that involve prolonged sitting, computer or cell phone use will all stress/strain your neck.  Consider how much time you spend doing each and plan accordingly. So basically try to be mindful and make modifications in you find you are spending a lot of time doing these activities.
  4. See a practitioner for hands-on therapy and preventative advice:
    • Reducing the strain that is caused in your neck by getting hands-on therapy, coupled with exercise/stretch advice will help significantly.  Check out Dr. Kangarloo’s past blog post on neck pain exercises for some things you can start today.


Moral of the story: Be smart, don’t PINP your neck!


Written by Dr. Alim Kara BSc, DC

Do I need an X-Ray?

Do I need an x-ray??? Nine times out of ten the answer is NO!!!


This is easily one of the most common questions I have encountered in my practice. Over time, we have been lead to believe that an x-ray is an important and vital tool when it comes to the diagnosis of injuries. What we have learned is that this is not necessarily the case for the majority of injuries.


X-Rays primary goal is to assess your bones and do not/rarely show any soft-tissue findings. They also tend to show signs of joint degeneration, which can be completely normal considering age and in most cases asymptomatic. Research shows that the majority of people >40-years old show multiple signs of degeneration in joints of their body but lead healthy, pain-free lives.


What this means is that just because your x-ray might show some degeneration/arthritic changes that it is rare that this is a significant finding that will affect your pain and/or overall health.


Generally, these are the people who might (depending on a carefully history and physical examination) need an x-ray:

Trauma (ie. fall, hit, bump)

Not getting better after being monitored/treated

Injury/pain getting worse over time

Acute (recent onset) swelling/redness of known or unknown origin

Visual/physical deformity


As you can now tell, most people do not fall into those above categories. Clinical practice guidelines and evidence-based medicine suggest clinicians show restraint and caution when sending their patients for an x-ray as they are grossly over-prescribed and unnecessary in vast majority of cases.  The Ottawa Ankle and Knee rules are great examples of how the research is influencing clinicians to make better decisions on when to prescribe x-rays to their patients.


In my personal experience, even when people fall into the above mentioned categories it is still rare that the x-rays show any significant findings that change the treatment plan. In most cases they are used to rule out certain things (rather than rule them in).


My advice, be wary of practitioners who are quick to x-ray (especially if you do not fall into one of the above mentioned categories); the radiation dose from the x-ray, although safe and minimal, is still unnecessary and as detailed above, rarely contributes to the plan of management. Be even more careful if words like “degeneration” or “arthritis” are being used to intimidate/scare you, especially when it is coupled with the request of needing multiple treatments to fix.


A good practitioner will carefully assess (with a through history and examination) and educate you on whether you actually need to get an x-ray or not. In addition to this, they will responsibly go over the x-ray findings with you to ensure you can make the most informed and educated decisions regarding your care to ensure a true patient-centered doctor/patient relationship.


Written by Dr. Alim Kara BSc, DC