b'CODING Update ComplianceLEGAL NUTRITIONUpdateANJC NewsANJC Leadership ANJC News! NUTRITION LEGAL EASEANJC Scholarships REHAB UpdateThe 35-Minute Posture Fix in 5 MinutesBy Dr. Donald C. DeFabioCHIRO Assist Forward head postureis superior to cervical spine treatment alone. In addition to CMT (FHP) is the most commonhome exercises need to be performed. postural imbalance in the LEGAL Q&A sagittal plane and whenBelow are seven exercises for FHP specifically arranged for the patient working from home or in virtual meetings. Each exercise Executive Directors Update combined with loss ofis performed in 3 sets of 5 repetitions, which on average will take motion it contributes to 2020 ANJC AWARDS 5 minutes per exercise. The prescription is to perform one exercise neck pain in adults. The increasing amount ofevery hour throughout the workday. Essentially, a 3-5-minute time on computers, smartexercise break every hour, and by the end of the work day the phones, laptops and even video games insidiously weakens posturepatient has performed 35 minutes of exercise. Simple, effective creating an increase in the thoracic kyphosis, rounded shouldersand applicable. Legislative Update and FHP. By definition, FHP is an increase of the craniovertebralHere are the exercises:angle (CVA) over 49.9 degrees.INSURANCE Update INSURANCE Update The CVA is measured as the angle formed between the horizontal1.Seated Bruggers Phasic with elastic resistance2.Seated Cervical Retractions (Chin Tucks) w/o resistanceTECHNIQUE Update 3.Seated Cervical Retraction with isometric load usingline through the tip of the spinous process of C7 and the line fromthe tip of C7 to the tragus. As the CVA increases, the mechanicalelastic resistanceload on the soft tissues in the cervicothoracic region increases, and over time creates degenerative changes in the joints and interver- 4.Seated or Standing Wall Angels with elastic resistance tebral discs. FHP has also been linked to decreased respiratory(emphasize scapular retraction and depression)function, coordination, balance, reposition sense and vestibular5.Standing Shoulder Flexion to 90 degrees in scaptiondysfunction. MedicareQ&AMedicare Update Assessment of FHP is accurately and easily performed with6.Cheerleaders with elastic resistanceOUR HEALTH 7. Seated or Standing Chest Stretches. photographic analysis. However, the cervical lordosis can only The exercises can be done in any order, and remember to be measured via a lateral cervical radiograph. Although the slowly recover when using elastic resistance and to hold the CVA may be reduced, the cervical lordosis may be increased, normal or decreased. Mechanically, it is common for the upperendpoints for a 2-second count. The chest stretches are held for cervical and upper thoracic vertebrae to be hypomobile and 30-60 seconds, 3-5 repetitions. Remember to maintain sagittal the mid-cervical vertebrae to be hypermobile.plane alignment at all times while exercising.The chiropractic rehabilitative approach to FHP is straightforwardTo repattern faulty movement patterns and to create strength and extremely effective. First, CMT is needed to the hypomobileand endurance, exercises need to be performed properly with vertebral segments to restore spinal compliance. Second, theadequate load and volume. Prescribing a 35-minute daily workout shortened, tight muscles need to be lengthened. Commonly thiswill most likely not get done. However, prescribing a 5-minute includes the suboccipital, upper trapezius, levator scapulae, SCMhourly posture break to reduce neck pain, headaches, and progres-and pectoralis groups. Once the patient has the understandingsive postural distortion is an effective and simple option. and motor repatterning to approximate strong sagittal plane alignment, strengthening of the local stabilizers can begin.REFERENCES:Cho J, Lee E, Lee S, Upper thoracic spine mobilization and mobility exercise versus upper Often the deep cervical flexors, mid and lower trapezius andcervical spine mobilization and stabilization exercise in individuals with forward head serratus anterior are weakened and require strengthening.posture: a randomized clinical trial, BMC Musculoskelet Disord. 2017; 18: 525.Daffin L, Stuelcken M, Sayers M Internal and external sagittal craniovertebral alignment: However, in addition to the deep cervical flexors, strengtheningA comparison between radiological and photogrammetric approaches in asymptomatic of the cervical extensors has also been demonstrated effective inparticipants, Musculoskel Sci Pract 2019 Oct;43:12-17.treating chronic neck pain. Once the local stabilizers are strongKim DH, Kim CJ, Son SM, Neck Pain in Adults with Forward Head Posture:the global or prime movers can be strengthened. It is essentialEffects of Craniovertebral Angle and Cervical Range of Motion Osong Public Health Res to perform all of these exercises in sagittal plane alignment,Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG, The Relationship otherwise they will only reinforce the imbalanced movementBetween Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis. patterns present. Curr Rev Musculoskelet Med. 2019 Dec;12(4):562-577. Working from home, virtual meetings, virtual school, and dailyDonald DeFabio, DC, DACBSP, DACRB, DABCO, is in private laptop and smartphone use have increased FHP and decon- practice in Berkeley Heights where he hosts relevant rehab study ditioning of many patients and their families. As mentioned above,groups for doctors looking to workshop together. For questions or FHP patients need CMT to obtain optimal results, and studiesadditional information, he may be reached at DeFabioChiropractic@have shown that thoracic spine manipulation and mobilizationgmail.comwww.njchiropractors.com I 13'