If you experience generalized pain in a particular muscle and have been to a massage therapist, physical therapist or chiropractor you may have heard the provider use the term “scar tissue.”  So what exactly is scar tissue?

The general understanding of scarring is a permanent mark on you skin after some kind of injury.  It could be large and raised, or small and flat, depending on the nature of the injury and how the body healed it.  What the body does when it detects an injury is, among a lot of other things, sends in thousands of cells called fibroblasts to the injury site.  These special cells make collagen, a special type of protein molecule that functions as structural tissue.  It is found in skin, bones, fascia (covering of muscle) and cartilage.  The collagen is like a webbing that closes the injury site, stabilizing it so that it cannot progress.  It forms a hard shield so that germs cannot enter.

But what happens if you sustain a muscle injury without breaking the skin?  For example, if you’ve ever been on the wrong side of a rear end car collision and experienced whiplash, you know how painful it can be:  stiff, swollen-feeling neck, pain with head and neck movement; nearly impossible to back out of your driveway without twisting your body to look behind you.  But, from the outside you cannot tell you were injured because there was no superficial injury– it was all “internal.”

In these types of cases, scar tissue develops as well, but in a manner that is suitable for inside the body.  The fibroblasts lay down collagen fibers along the small injury sites on the muscle.  For a minor sprain strain injury, you can’t even see the injury because it is microscopic, but it is definitely there.  For more severe sprains strains like those occurring from a sports injury, it is more obvious, and may require surgery as it is too big for the body’s scar tissue healing capability to handle alone.

Sometimes after an injury, too much scar tissue is laid down, which then forms into small “knots” and pebble-feeling bumps over the muscle.  The areas tend to develop “trigger points” which are very focused points that are very sore to the touch.  The excess scar tissue eventually interferes with proper muscle contraction, and results in a chronic type of pain.   This condition can come as a result of a whiplash accident, or overuse type condition such as tendonitis.

So what does one do for chronic muscle pain due to scar tissue?  One of things offered at our center is Instrument Assisted Soft Tissue Mobilization.  This is a form of massage done with an edged tool that breaks apart or softens the scar tissue.  As a result, there is more range of motion and less pain.  I use it in conjunction with the LiteCure laser, which energizes weak cells and speeds up healing.

If you are experiencing muscle pain that doesn’t seem to want to go away despite regular massage, acupuncture, and stretches, IASTM and laser may be the solution.  Call the office at (415) 627-9077 to find out.

There are not many things more miserable than a full blown, seasonal allergy attack.  As we transition from Spring to Summer here in the San Francisco Bay Area, pollen and other airborne irritants, combined with windy conditions spell itchy, swollen eyes, runny noses, and general malaise for millions of people.

An allergic reaction occurs when the body’s immune system mistakes foreign particles as microbial threats.   In response, it releases a massive amount of histamine, a biochemical that dilates blood vessels and  makes them more permeable, which causes swelling and puffiness around the mucous membranes.  The Bay Area, especially the East Bay and Marin has the distinction of being home to many species of vegetation that are especially allergenic, especially tree blossoms and sunflowers.   It can make what should be a festive Summer a dreaded time of the year.

Here are some tips to minimize allergies:

1.  Wear sunglasses and a large brimmed hat when going outside during peak allergy times (10 am to 3 pm).  This will block a significant amount of pollen from reaching your eyes and nose.

2.  Remember to change clothes frequently.  Pollen gets stuck on your clothes, which is how it makes it into your home.  Before you sit on your couch or in your bed, change clothes if they were previously exposed to pollen.

3.  Wash your hair and face frequently; avoid hair spray and hair gel.  Pollen sticks to hair due to static electricity; hair products prevent them from being brushed out.  Wash your hair thoroughly before you go to bed.  You don’t want to sleep through the night with pollen on your pillow and sheets.

4.  Wash your eyes with a saline solution.  If your allergic reaction is severe, use anti-histamine eye drops.

5.  For itchy and runny noses, use over the counter medications like Zyrtec and saline sprays.

6.  Try using air filters around the home, and humidifiers to minimize pollen and dander concentrations.

7.  If necessary, stay indoors especially during high pollen alerts.  Keep windows shut, use air conditioner, and make sure you have a clean filter.

With careful planning and vigilance, you can make it through allergy season.

Dr. Dan

San Francisco chiropractor

Let’s face it, most of us sit in front of a computer at least a couple of times a day.  The desktop and laptop computer have become a fixture in everyday life.  It is now more popular than watching television, especially with on-demand, unlimited videos of every conceivable topic on YouTube.

The problem is that the human body is not optimally designed to sit in a static position for extended periods, not to mention crane over a desk looking at a bright screen.  Here are the adverse things that happen if you sit too frequently:

1.  Your back muscles weaken.  Sitting down inactivates the postural muscles along the spine.   Not only do they lose strength, they lose responsiveness.  This refers to the automatic, synchronized neural firing of several layers of muscles that move the spine.  Loss of responsiveness leads to “pulled” muscles and makes one more prone to injuries.

2.  Your bad cholesterol goes up, and insulin effectiveness (its ability to shuttle sugar into the muscles) drops dramatically.  This can lead to heart disease and diabetes.

3.  Blood stagnates in the legs, making the heart work more.  Veins require muscle twitching of the gastrocnemeus (calf) muscles to pump blood back to the heart, and of course if you are sitting, your legs don’t move much.

4.  Hydrostatic pressure in your discs increases.  Discs require small movements so that they can draw in fluids to keep them full and healthy.  Sitting compresses them over time, which can lead to degeneration.

5.  Your head gravitates forward and places strain on the tops of and between the shoulders, as they are connected by the upper trapezius, levator scapulae and splenius capitis muscles.  This can lead to shoulder pain and dysfunction.

6.  Your computer screen’s brightness can overstimulate the eyes and brain, contributing to headaches and loss of concentration.

So, make sure you stand up, at least every 2o minutes if you are engaged in sitting in front of your computer.   If you are using it to surf, read the news or play games, then try to find another way to spend your time that is not so harmful to your body.  Get out doors, read a book, go for a hike or a bike ride instead.

To reduce the posture-damaging effects of prolonged sitting, do the Wall Angels exercise:

1.  Find an empty wall in your office.

2.  Stand against it, heels touching the  baseboard; buttocks, upper shoulders, and back of head contacting the wall.

3.  Raise your arms, bend elbows 90 degrees, keep wrist straight, open hands flat.  The backs of both arms, wrists and hands should be contacting the wall.

4.  Raise and lower your arms as high and as low as you can go without breaking contact with the wall (similar to making snow angels in the snow).  Do about 50 every 20 minutes.  One rep (arms up and down) should take about 2 seconds, so you’re exercising for only a minute and a half or so, every 20 minutes.

What this does is activate the back muscles, which regain tone and pull the head and shoulders back to center.  Sitting at a desk causes the anterior (front part) muscles of the chest and neck to overpower the back muscles, which lead to the familiar hunchback and forward leaning head posture.  Doing the wall angels will counteract this and will prevent your posture from deteriorating.

If it’s been too long sitting and your posture is really out, consider getting chiropractic adjustments.  Chiropractic can help vertebral segments regain proper motion, which will facilitate your posture correction efforts.  Just call the office at (415) 627-9077. 

We are now called The Body Doctors, and are located near Union Square in downtown San Francisco.  We feature chiropractic, massage therapy, laser pain relief treatments, and wellness care.

While massage therapy has always been referred to as a form of bodywork, the same can be said for chiropractic.   Both disciplines respect the human body as a whole unit, rather than a sum of individual parts, which affects the treatment approach.  This is why massage and chiropractic are often classified as “wholistic” or “holistic” healing arts.

Let me give you an example.  If someone suffers from headaches or back pain, the convention is to take aspirin or Tylenol.  What these medications do is inhibit the action of an enzyme called COX-2, which is indirectly involved in the biochemicals responsible for the sensation of pain.  This is the basic allopathic model of healthcare, in which all MDs are trained.

A chiropractor is more likely to go several layers deeper in determining why the patient is experiencing headaches.  Again, this goes along with the holistic, or “entire organism” approach.  The chiropractor may ask the patient if she has ever experienced any physical trauma in the past, such as a car accident or sports injury.  He may also ask her about her diet, lifestyle habits, and type of work she does.

Many types of tension headaches are caused by nerve irritation from misaligned vertebrae in the neck from previous trauma, or weak and unbalanced neck muscles from inactivity.  The nerves get pressed, and cause muscles around the neck and head to contract.  They can also contract the blood vessels that supply blood to the scalp.  If this is the case, then no amount of aspirin will cure the headaches.   A more sensible approach to  would be to restore proper alignment and movement to the neck vertebrae.    Chiropractic adjustments along with massage, stretches and corrective exercises can accomplish this.

Massage therapy is more than a luxury.  It can improve health in several ways:

1) increase circulation to the muscles and skin.  Oxygenated blood is needed for proper cellular function.

2) reduce stress by its calming effect.  This can lower heart rate and blood pressure.

3) improve joint range of motion in the neck and extremities by breaking apart old scar tissue.  This can help protect against arthritis.

Massage and chiropractic together is a powerful, non-drug combination to achieve better health.   When done regularly, it can help you feel better and improve your quality of life.

We take chiropractic and massage appointments Mondays through Fridays at our new Sutter Street office.  For more info, call us at (415) 627-9077.

Dan Perez, DC

San Francisco Chiropractor in Union Square

In April, we will be relocating to 447 Sutter Street, a block north of Union Square and across the more famous San Francisco landmark building, 450 Sutter, which offers ample parking.    Chiropractic, Massage Therapy, and Endermologie will remain our core sevices.

The office decor will be a relaxing blue and features a more spacious, comfortable and quiet treatment room.

I also recently opened an office closer to home in the East Bay (San Ramon) and will split my week between the two locations.   Both offices are designed to make your office visit as pleasant as possible– ample parking, little to no waiting, minimal paperwork, simple payment options, advanced equipment, and of course, personalized service tailored around your needs.  Supportive services including orthotics prescriptions, nutritional therapy, and weight loss are available as well.

There will be a special discount on all of our services in April to celebrate our new location, so mark your calendars! 

Till next time,

Dr. Perez

These are exciting times at our clinic!

If you haven’t been in recently; now’s a good time to give us a call.

First and foremost, we are going beyond chiropractic and are transforming into a full-service Wellness Center.   After 16 years of practice, I’ve come to the realization that achieving true, lasting health (which includes being pain-free, mobile and flexible) is more than getting your spine adjusted and improving your posture.   While this is a good component of a wellness regimen, for some, it is not enough due to pre-existing chronic, systemic problems.

For example, someone who exhibits any form of gastrointestinal deficiency (gas, fullness, reflux) may not be getting adequate nutrient absorption and may therefore not heal properly from, let’s say, a lumbar disc bulge.

Or, someone who has built up toxins in their body over the years from ingesting them through the lungs, skin, and poor food choices may have a difficult time losing weight or fighting chronic fatigue.

In cases like these, nutritional intervention and lifestyle modification are needed to transform the body into a healthier state.  And that, dear patients, is now an integral part of our services.

We will now offer nutritional management of chronic, degenerative diseases such as metabolic syndrome (insulin insensitivity, obesity/excessive weight gain); chronic fatigue syndrome and fibromyalgia; cardiovascular disease, gastrointestinal disorders such as Chron’s Disease and IBS; and musculoskeletal conditions such as rheumatoid arthritis, acute sprain/strains, and bone and joint weakness.   The system we use is Metagenics line of medical foods and nutraceuticals.   Metagenics is the only supplement company that is Triple-GMP (Good Manufacturing Processes) Certified for quality and is only available through health care providers.

Secondly, exercise rehabilitation methods are now emphasized equally to and in some cases, in place of, chiropractic adjustments.  Somatic therapy is specially designed movements that help “break” abnormal, neurologically controlled muscle patterns in the body.  I find that many cases of chronic back pain and stiffness are not just a matter of misaligned vertebrae.  Old injuries and repetitive movements/habits over years can literally program your muscles contract unevenly, resulting in pain and stiffness.  Like a broken record, the brain commands the muscles to maintain this abnormal contraction.  Somatic therapy “de-programs” this and re-sets the muscles to their original state.

Lastly, we will be offering weight loss, body contouring, cellulite reduction, and non-surgical face lifts to improve the outer appearance of the body.  We already have the cellulite reduction services at our location, which is quite popular; the other services will be in place shortly.

In the next few weeks, we will be launching a new website and FaceBook Fan Page, where we will update clients and the public on the latest developments.  An Open House is planned this Summer or early Fall– stay tuned!

Till next time,

Dr. Dan

Vitamin D is a critical micronutrient that in many ways acts more like a hormone than a vitamin.  It is estimated that 30-50% of the population is low in Vitamin D, which can lead to a myriad of health conditions, including:

• bone thinning
• muscle pain and weakness
• cardiovascular disease
• diabetes
• breast and prostate cancer
• depressed immune system response
• asthma; wheezing
• high blood pressure
• metabolic syndrome
• fibromyalgia (widespread muscle tenderness)
• schizophrenia/ seasonal affective disorder/cognitive disorders

Studies show that low levels of Vitamin D are associated with increased mortality (death) across the  board, meaning, all diseases considered.

Your body can make Vitamin D with the help of ultraviolet (UVB) rays from sunshine, but you have to expose your skin to the sun, daily for it to suffice.  This is a problem for those who go from house to car to office; then back, every day.  People who live above 37 degrees N. latitude (that includes San Francisco) during the winter months are at higher risk of developing low Vitamin D levels — one of the reasons why colds and flu are more prevalent during these months.

The liver, kidneys and immune cells play a role in the manufacturing of the biologically active form of Vitamin D, referred to as calcitriol, or 1, 25 Dihydroxy Vitamin D.  So if there are any problems with these organs, it can lead to Vitamin D insufficiency.

Vitamin D occurs naturally in cold water, oily fish such as salmon (avoid farm raised), mackerel and sardines (canned is ok), tuna and eel.  Light-exposed mushrooms are the only vegan sources of Vitamin D.

Factors that can lead to Vitamin D deficiency include:

• elderly persons
• sunscreen users
• diseases of the kidneys, liver, intestines
• drugs and additives that interfere with fat metabolism (Olestra, bile sequestrant meds)
• statin (cholesterol-lowering) drugs
• long term use of anti-convulsive drugs
• frequent antibiotic use

As you can see, Vitamin D is critical to overall health.  You should have your Vitamin D levels checked periodically to make sure your levels are in the normal range (30-60 ng/mL).  There are numerous studies that show its beneficial effects in protecting against cancer, auto immune diseases, multiple sclerosis, metabolic diseases and depression.

Supplementation can help guarantee that your Vitamin D levels are where they need to be, and are probably required during the winter months for most people who live above the 37th latitude.  You should make sure the brand you choose has the proper potency, is stable enough to withstand delivery, and contains no contaminants.

We carry the Metagenics brand of nutraceuticals that meet all these criteria.  If you are experiencing symptoms associated with low Vitamin D levels, especially the feeling of weak muscles, tender bones, fatigue, and easily get sick make sure to get a blood test to measure your levels of active and inactive Vitamin D.

Have to share this article (abridged) with you all, written by Dr. Joseph Mercola, a medical doctor and popular natural health advocate:

Prescription drugs are responsible for an estimated 700,000 ER visits a year* due to adverse drug reactions. And adverse drug reactions from drugs that are properly prescribed and properly administered cause about 106,000 deaths per year, making prescription drugs the fourth-leading cause of death in the U.S.

The truth is prescription drugs kill more than twice as many Americans as HIV/AIDS or suicide. Fewer die from accidents or diabetes than adverse drug reactions.

In 2006, the pharmaceutical industry spent an estimated $16 BILLION on physician advertising. At the time, that amounted to $10,000 for every doctor in the US…out of Harvard’s 8,900 professors and lecturers, 1,600 admit that they or a family member have ties to drug companies that could bias their teaching or research. In 2008 alone the pharmaceutical industry contributed more than $11.5 million to Harvard for “research and continuing education classes.”

And here’s a powerful statement from Dr. Mercola that I totally concur with, and that more people need to realize considering the large number of deaths each year from prescription drugs:

The pharmaceutical industry is not really about promoting health, but making money off disease. And when one market begins to dwindle, they simply create a new one, by inventing yet another disease. Usually by “upgrading” a common symptom into disease status…

*Yahoo News October 17, 2006

This kind of advice is needed to remind us of the importance of taking proactive steps in ensuring a healthy future.  We all get caught up on the demands of life (job, kids, bills, etc) that we let things slip.  So, remember to eat right, get enough rest, release emotional stress, exercise regularly (consistency is better than amount per workout), and do your best to avoid toxins in your diet and environment.  It will pay off in huge dividends.

Heart disease is the number one killer of Americans each year.  This helpful article recently came out.  Please familiarize yourself with these symptoms, whether you have risk factors for heart disease or not.

How to Tell if Someone Is Having a Heart Attack

Don’t let that happen to you. Here, 10 heart symptoms you’re likely to ignore — and shouldn’t.

1. Indigestion or nausea

One of the most oft-overlooked signs of a heart attack is nausea and stomach pain. Pay attention when anything seems out of the ordinary, particularly if it comes on suddenly and you haven’t been exposed to stomach flu and haven’t eaten anything out of the ordinary.

2. Jaw, ear, neck, or shoulder pain

A telltale sign: The pain comes and goes, rather than persisting unrelieved, as a pulled muscle would. This can make the pain both easy to overlook and difficult to pinpoint. You may notice pain in your neck one day, none the next day, then after that it might have moved to your ear and jaw. If you notice pain that seems to move or radiate upwards and out, this is important to bring to your doctor’s attention.

3. Sexual dysfunction

Having trouble achieving or keeping erections is common in men with coronary artery disease, but they may not make the connection. Just as arteries around the heart can narrow and harden, so can those that supply the penis — and because those arteries are smaller, they may show damage sooner. One survey of European men being treated for cardiovascular disease found that two out of three had suffered from erectile dysfunction before they were ever diagnosed with heart trouble.

4. Exhaustion or fatigue

A sense of crushing fatigue that lasts for several days is another sign of heart trouble that’s all too often overlooked or explained away. Women, in particular, often look back after a heart attack and mention this symptom. More than 70 percent of women in last year’s NIH study, for example, reported extreme fatigue in the weeks or months prior to their heart attack.

The key here is that the fatigue is unusually strong — not the kind of tiredness you can power through but the kind that lays you flat out in bed. If you’re normally a fairly energetic person and suddenly feel sidelined by fatigue, a call to your doctor is in order.

5. Breathlessness and dizziness

When your heart isn’t getting enough blood, it also isn’t getting enough oxygen. And when there’s not enough oxygen circulating in your blood, the result is feeling unable to draw a deep, satisfying breath — the same feeling you get when you’re at high elevation. Additional symptoms can be light-headedness and dizziness. But sadly, people don’t attribute this symptom to heart disease, because they associate breathing with the lungs, not the heart.

In last year’s NIH study, more than 40 percent of women heart attack victims remembered experiencing this symptom. A common description of the feeling: “I couldn’t catch my breath while walking up the driveway.”

6. Leg swelling or pain

When the heart muscle isn’t functioning properly, waste products aren’t carried away from tissues by the blood, and the result can be edema, or swelling caused by fluid retention. Edema usually starts in the feet, ankles, and legs because they’re furthest from the heart, where circulation is poorer. In addition, when tissues don’t get enough blood, it can lead to a painful condition called ischemia. Bring swelling and pain to the attention of your doctor.

7. Sleeplessness, insomnia, and anxiety

This is an odd one doctors can’t yet explain. Those who’ve had heart attacks often remember experiencing a sudden, unexplained inability to fall asleep or stay asleep during the month or weeks before their heart attack. (Note: If you already experience insomnia regularly, this symptom can be hard to distinguish.)

8. Flu-like symptoms

Clammy, sweaty skin, along with feeling light-headed, fatigued, and weak, leads some people to believe they’re coming down with the flu when, in fact, they’re having a heart attack. Even the feeling of heaviness or pressure in the chest — typical of some people’s experience in a heart attack — may be confused with having a chest cold or the flu.

If you experience severe flu-like symptoms that don’t quite add up to the flu (no high temperature, for example), call your doctor or advice nurse to talk it over. Watch out also for persistent wheezing or chronic coughing that doesn’t resolve itself; that can be a sign of heart disease, experts say. Patients sometimes attribute these symptoms to a cold or flu, asthma, or lung disease when what’s happening is that poor circulation is causing fluid to accumulate in the lungs.

9. Rapid-fire pulse or heart rate

One little-known symptom that sometimes predates a heart attack is known as ventricular tachycardia, more commonly described as rapid and irregular pulse and heart rate. During these episodes, which come on suddenly, you feel as if your heart is beating very fast and hard, like you just ran up a hill — except you didn’t.

Some patients confuse these episodes with panic attacks. Rapid pulse and heartbeat that aren’t brought on by exertion always signal an issue to bring to your doctor’s attention.

10. You just don’t feel like yourself

Heart attacks in older adults (especially those in their 80s and beyond, or in those who have dementia or multiple health conditions), can mimic many other conditions. But an overall theme heard from those whose loved ones suffered heart attacks is that in the days leading up to and after a cardiac event, they “just didn’t seem like themselves.”

A good rule of thumb, experts say, is to watch for clusters of symptoms that come on all at once and aren’t typical of your normal experience. For example, a normally alert, energetic person suddenly begins to have muddled thinking, memory loss, deep fatigue, and a sense of being “out of it.” The underlying cause could be something as simple as a urinary tract infection, but it could also be a heart attack. If your body is doing unusual things and you just don’t feel “right,” don’t wait. See a doctor and ask for a thorough work-up.

And if you have any risk factors for cardiac disease, such as high blood pressure, high cholesterol, smoking, or family history of heart disease, make sure the doctor knows about those issues, too.

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Related articles

• What’s the Difference Between Heartburn and Heart Attack? (everydayhealth.com)
• Does Chest Pain Always Mean Heart Attack? (everydayhealth.com)
• Symptoms of a Heart Attack (everydayhealth.com)

October 2010 started a new phase in San Francisco Chiropractic.

I relocated my main practice a block and a half away to 369 Pine Street (at Montgomery), and opened a smaller satellite office on 447 Sutter Street (at Powell), two blocks from Union Square.  The idea was to geographically split the practice and serve a bigger section of San Francisco.  We’ll see mostly Financial District workers and residents at the Pine St. location; and tourists, retail and hospitality workers at our Sutter St. office.

Image via Wikipedia

I am also emphasizing wellness care in my practice.  People forget, and often chiropractors forget, that chiropractic was originally developed as a way to stay healthy.  Sure, it can be effective for reducing musculoskeletal pain, but the more powerful benefit of chiropractic is keeping the spine flexible and properly aligned throughout life, whether you have pain or not, so that it does not shift out of place and encumber the central nervous system within.  Pressure to the spinal cord and nerves from misaligned vertebrae can disrupt optimal nerve function, leading to a host of problems besides pain.

It’s always a good time to do something good for your future health; no need to wait for the new year or some other milestone.  Exercising, eating healthy foods, reducing/properly managing stress, and keeping your spine fit by getting regular chiropractic adjustments is a sure way to an enjoyable life well into the future, free from disabilities.

Related articles

Chiropractic Care…A Growing Part of the Health Team (prnewswire.com)