Tag Archives: Posture

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

Pokemon Induced Neck Pain (PINP)

July 28, 2016

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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:

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.
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.
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.
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

Neck Pain Solutions

February 19, 2016

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Exercise Health & Wellness Injuries No Comments

Regularly we have patients coming to the clinic complaining of neck pain. Most commonly these patients are reporting discomfort after sitting for long hours at their desk or pain worsening throughout the day. I am not saying all neck pain is the same but a generalized tight and stiff neck is commonly caused by bad sitting habits and poor neck posture.

This poor head and neck posture increases the stress on your muscles, ligaments and joints, causing the postural deconditioning model- which Dr. Kara talked about here. This deconditioning can lead to neck pain, headaches and jaw pain.

So what can you do to stop the de-conditioning?

Try these two simple exercises which only take a couple minutes. I always say to do these exercises once an hour every hour. Sneak them in before you head to lunch, at every red light, once you have sent off an email or after you have liked a picture from our instagram. Yes once an hour every hour seems like a lot but that is only ~12 times in your day and should only take you 24 minutes. Ultimately you would benefit doing these exercises 3 times a day but 12 would be even better!

The Chin Tuck: A very “attractive” exercise, creating the double chin effect.

This exercise helps decrease forward head posture by strengthening your neck muscles. You can do this exercise standing, sitting or even laying down on a mat on the floor.

When doing this exercise seated or standing:

Start with your shoulders rolled back and gently pulled down.
Look straight ahead, and move your chin straight back. (Make sure you chin is not flexed forward or tilted backwards)
Hold for 5 seconds and release for 1 second.
Repeat 10 times

You are all done and that only took 1 minute! I perform these at red lights, while pushing my head into the headrest for some resistance. Notice after performing the exercise in the car that you may need to adjust your mirror as you will be sitting taller. If you plan on doing this laying on the floor, place a small towel behind your head so you have something to push your head back into.

Wall Angels:

This exercise helps open your shoulders back and strengthen your shoulder blades. This exercise can be performed standing against a wall or laying on the floor.

Stand with your back against the wall.
Place your feet a few inches from the wall and have a slight bend in your knees. Your head, spine and glutes should be flush against the wall.
Bring your arms up in a “Goal Post” position on the wall, your elbows bent with your upper arms parallel to the floor, and back of the hands touching the wall.
Hold this position for 2 seconds
Slowly straighten your elbows while sliding your hands up the wall to form a letter “Y”. Pay attention not to shrug your shoulders to your ears.
Hold for 2 seconds
Repeat 10 times

Again that only took 1 minute. Good work

You are on your way to better neck health and posture. If you need any help with these exercises just ask me.

Written by Dr. Shereen Kangarloo BSc, DC

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Posture: The structure of health

February 4, 2016

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Health & Wellness No Comments

Let me start off by telling you a little story about the birds and the bees…actually on second thought, lets just skip to birth! As infants, we are born as wee little C-shaped babies; think fetal position. This shape/position is the first posture we assume in life and we call it the ‘primary curve’ which forms a full-spine kyphosis. As we develop and start lifting our cute little baby heads, a ‘secondary curve’ forms in our neck (cervical spine); this time in the shape of a lordosis. Finally when we begin getting ourselves into trouble by moving around the house (via crawling and walking) a second ‘secondary (lordosis) curve’ develops in our low back (lumbar spine).

So let’s recap: now we have a lordotic curve in our neck and low back, while we have a kypotic curve in our mid back (thoracic spine) and we can walk! Having these curves in our spine gives us proper body posture to support all of our internal organs as well as angulate all of our muscles in the correct positions to give us the ability to walk. This process can be summed up as: Postural Development/Conditioning.

Now posture is an important thing as without it, we get injured. Think of the human musculoskeletal system (muscles and bones) as the greatest architectural creation to ever exist. Every curve, dent and hole in a bone (206 bones in the human body equates to a lot of different curves, dents and holes) has a specific purpose of existing due to our evolution and adaptation over millions of years. Every muscle, ligament and tendon is attached to one or more of these bones (in very specific locations) and has multiple blood and nerve supplies. It is very complicated! When you start to now consider that the process of movement originates in the brain (as hormonal and electrical impulses) and travels down the spinal cord, out the nerves of the spine and to the muscle, things become almost incomprehensible! All in all, it is the human posture that allows us to stand-up straight and walk.

The body can be thought of as a house, building or bridge. Something specifically and meticulously designed to stand the test of time and to protect what is inside. There is not one house, building or bridge that doesn’t eventually need to be upgraded or repaired (ie: replace the roof, add an energy efficient furnace, fill in a pothole etc.) because we use them so much. With use comes damage, it is inevitable! Now imagine if you could physically feel that damage…well, you can, that’s what your body goes through! Your posture is the house, building or bridge for your body (don’t you love it when an analogy comes together). Your posture protects what is important inside of you and it is your posture that takes the brunt of the wear and tears of the environment to your body.

The point? Posture is extremely important! The human body is designed to be most functional and work at its best when a correct posture/position is maintained (good form = good function). So what is a ‘good posture?’ This is where things get a little more complicated because posture is a dynamic concept, meaning it is always changing as we do different things. However, a general idea remains that if you promote and consciously have an intent to maintain the ideal posture (ie. the prototypical human form), which promotes and supports the natural curvature of the spine, you can use your bones and muscles in the ideal form/position they were created/designed to operate in; thus minimizing the risk of injury.

In closing, a wise man once said “chickity-check yo self, before you wreck yo self” which couldn’t be more true! That man, Confucius? Ghandi? No my friends, it was my man, Ice Cube. YEAH YEAH!

Written by Dr. Alim Kara BSc, DC

Postural Deconditioning: Adaptation from repetitive strain injuries

February 4, 2016

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Health & Wellness Injuries 2 Comments

Ooooh, sounds fancy and complicated but in reality, it isn’t! So what is Postural Deconditioning and how does Repetitive Strain factor in? I left off my last entry by introducing the thought: imagine that you used your body and its bones and muscles with a poor posture. What would happen?

Now in this scenario, these muscles and joints are in mechanically poor positions and thus they cannot work as efficiently or effectively as they are designed to do. This creates a STRAIN, which essentially is STRESS to the muscle, joint and bone. Now this is not a huge deal, it is obviously possible to do, we are resilient creatures. However, this is done at the cost of increased energy and stress to the body. Over months and years, these muscles, joints and bones slightly change to ADAPT to the consistent STRESS it is being subjected to (because we are so resilient remember) and we develop REPETITIVE STRAIN injuries.

One day, years later, your body has changed: you’re not sitting straight, you’re hunched, you’re always experiencing constant chronic low-level pain and discomfort; essentially, you are POSTUALLY DECONDITIONED! At this point, the muscles are more shortened and denser in composition, the joints are wearing out and thinned from constant pressure held in the same poor position and you now find yourself in a higher risk category for developing pain (low back pain, neck pain, etc.).

The entire mechanics and design of your body has changed! Your risk of injury is far greater than someone who has a great posture. Now the keyword here is RISK of injury. Think of it like: your chances of getting into a car accident with a low pressure tire (meaning the alignment would be off kilter) are higher than a car driving with equally inflated tires.

Why you are told to lift something by bending your knees and sticking your butt out? So you can assume an optimal lifting posture for the purpose of reducing your chances of getting injured. Apply this principle of doing ANYTHING to someone who is POSTURALLY DECONDITIONED. The chances of “picking up a pencil and throwing out your back” are a lot higher than someone who has a great posture. Let’s get one thing straight, it’s NEVER the pencil’s fault. This is why low back and neck pain are so common, because we REPETITIVELY STRAIN our bodies to the point where our body ADAPTS over time and eventually fails us (even while doing the most mundane of tasks, like picking up a pencil) and then we become injured.

Written by Dr. Alim Kara BSc, DC