Who Cares for the Caregivers?

H istorically, in almost every society on Earth, the role of the woman as carcgivcr. matriarch, and the true strength behind any family is well understood. Throughout the ages, we have seen many instances where females single-handedly work, raise children, and ensure that the domestic chores arc done. Even in modern times when men started to pick up more of the slack, we still sec how mothers and wives typically do a majority of the heavy lifting when it comes to caring for the family. Women traditionally have had the unyielding responsibil­ity to take care of their children and spouses, and they often sacrifice heaven and earth to do so. With all of the effort they put forth for others, they often neglect themselves. It is very common for a mother to bring her children or spouse in to the office for care because she does not want them suffering with any amount of pain. However, when it comes to taking care of herself, she is last on her long to-do list. I have witnessed many moms in pain, nibbing their necks or backs, while I take care of their children and family mem­bers. When I ask a woman if she will let me help her next. I have often heard the reply. "Oh. I am not important. My kids come first." Many women will sacrifice their health for the sake of their families and friends. It is a trait that helps define women as natural caregivers. Now. I certainly do not mean to leave out all of the fathers who assume a majority of the responsibilities for their kids and family. Since their lives arc full of so much physical activity, we need to pay attention to them as well. For most chiropractic offices, however, many of the patients tend to be women, and many have suffered with some amount of pain for months to years. So are there any special ways to treat these patients? We need to take a closer look at their daily lives to get some insight into the patterns we tend to sec. When I first begin treating an individual who I know is the primary carcgivcr and stay-at-home parent, especially of young children, there arc some visual and verbal indicators I look for that help me understand how to treat them. It is a time in a patient's life that does not last forever, but it seems that way to parents. 1 ."My feet grew one whole size during my pregnancy," and. "My shoes don't fit me anymore." Pregnant women have increasing stress on the soft tissues of their feet during that nine-month period that will collapse and flatten their arches. The progressively heavier baby causes medial, lateral, and transverse arch stress, which can create plantar fasciitis. neuromas, mctatarsalgia. bunions (toes one and five), and foot Hare. Furthermore, carrying the children as they grow from be­ing infants to toddlers adds more stress on the feet, thereby exacerbating the whole ovcrpronation issue. It is imperative that you check your patient's feet and arches and provide necessary orthotic support. Otherwise, the problems of the foot will spread the stress to the knees, hips, and all the way up. potentially, to the neck and jaw. 2."My shoulders always seem to ache after holding and carrying the kids." Our patients tend to refer to the word "shoulder" when they are really describing pain in the trapezius and levator scapulae regions. It is important to realize that the actual shoulder girdle instability and stress is responsible for tra­pezius strain. These areas are problematic when parents hold their children in their arms, wear a sling or baby carrier, or even when they wear a backpack or purse incorrectly. Shoulder stability is a big problem when we lift, carry, and hold our children. Remember, you need to analyze the glenohumeral, acromioclavicular. stcrnoclavicular. scapulo-thoracic. and upper rib joints (front and back) when situations like this occur. When one or more of the shoulder joints are out of alignment, it can lead to pain in the neck, upper back, mid back, and down the upper arm. If you don"t adjust and stabilize the shoulder joints, then pain in the neck, upper/mid back, and arms will not improve appreciably. I often use clastic sports tape to support the shoulders after I have aligned them, which helps stabilize the joints faster. Shoulder stretching and strengthening exercises can be utilized here, as well as clastic bands, such as the Thcra-Ciscr™. or any type of rehab you like. 3."When I feed the baby. I notice pain in my neck and back." I know this one seems obvious to you. but think for a mo­ment and look at the biomechanics and joints that this this activity stresses. The person is usually in a forward leaning position while looking down at the child. This motion w ill activate the neck, upper back/mid back, and lower back muscles. At times, those feeding a baby will even cock their heads to one side when looking at the child. These repetitive and chronic positions of the head and upper spine create stress for the muscles, joints, and soft tissue. It is very common to \m\ c multiple areas of spinal, shoulder, rib. and even lower back misalignments. It stands to reason that there can be pain anywhere along the spine. 4."I know having a child (or young kids) is stressful, but I get headaches and neck pain more often than I used to." Both parents always feel the stress of being pregnant and having a child, but especially and obviously the mother. Since we all deal with stress differently, we can sec physical symptoms manifest in various ways. At any time during the pregnancy, and even past the delivery date, jaw clenching and grinding may develop. The contraction of the jaw and head muscles not only creates pain and misalignment, but it affects the upper cervical region as well. The muscles of mastication in the anterior neck and throat, the massctcr. the temporalis. and the muscles inside the mouth that aid in jaw movement all become hypcrtonic and sore. Please remember to evaluate the TMJ and cervical regions of your carcgivcr patients and treat them accord­ingly. Relieving stress in the muscles and gently realigning the TMJs will alleviate their pain and stabilize the spine and jaws. To round things out. let's list a few of the other daily ac­tivities carcgivcrs engage in: a) Carrying/lifting b) Domestic chores c) Yard work d) Driving c) Standing 0 Pushing strollers These physical activities cause a tremendous amount of stress that involves the upper and lower extremities, as well as the axial spine. Because so many body parts come in to play, you will obviously go to each of the affected regions, examine, and treat accordingly. To conclude. I want to remind you to make sure to pay attention to the axial kinematic chain that begins from the ground up. The feet arc the conductors of a body-wide sym­phony. If the pedal foundation is compromised, more stress is created from the feet/ankles, knees, hips, lower back, and the rest of the spine up to the neck. We always want to ad­dress point-specific pain for our patients without losing sight of the big picture. Chiropractors are adept at supporting the bodv from toes to nose. Dr. Kevin Wong is an expert on foot analysis, walking and standing postures and orthotics. Teaching patients and chiropractors is a passion for him, and he travels the country speaking about spinal and extremity adjust­ing. Dr. Wong practices full-time in Urinda, California. Contact Dr. Wong at 925-254-4040 or drkevinwong'cigmail.com.