Chronic poor posture, commuting, sitting at a desk all day, being stuck in fixed posture for prolonged periods, and stress all play havoc on the body. Weekend warriors, sports enthusiast, home improvements, gardening can overwhelm the sedentary body.

     As we get older, there is tightening of tendons and ligaments, muscle shortening, and inflammatory changes in the body. Before too long the shortened, tightened muscles are pulling incorrectly on the joints that they are set up to move. Strains, sprains, repetitive strain injuries become more prevalent. Sitting in the car all day, commuting to work in traffic, sitting on the train, working at the computer, talking on the phone, lifting, reaching, etc. all of a sudden can cause neck, upper and lower back problems.

     One way to help with the problem is to stretch every morning. After getting up from bed, a gentle stretching routine should be done after a warm shower, and some time has passed to get the blood flowing. Stretching isn't just for the occasional sporting event or when all of a sudden the back or neck feels a little tight. A daily gentle stretch is better then trying to break through a tightened muscle episode.

     If you have a chronic neck, upper back, lower back problem you should have a medical evaluation to make sure there are no problems that need to be immediately addressed, especially if there is numbness, tingling, loss of strength, balance, change in bowel or bladder function, pain on a daily basis, etc..

     Many of the stretches learned in our days of attending gym classes no longer apply to the aging body and many been revised for better results and less chance of injury. Stretching should be done slowly, calmly, and progressively. Don't try to be a yogic guru over night. All stretches should be started with the body slightly warmed up. The posture is begun by taking the slack out of the muscle then gradually going into the stretch by gently exhaling. Once the new stretch has taken place try to go further by exhaling again. Once a full stretch has been met try to hold for approximately 1second for each year of age, then gently release the stretch.

Three great, gentle morning stretches are as follows:

•  Lie on your back on the floor and place your calves on a couch, ottoman, or chair so that the knees are at a 90 degree angle, arms gently to your side, lie for 3-5 minutes. This stretch is good for the low back.

•  Lie on back, cross ankles and gently bring knees towards chest, with gentle traction by pulling knees with hands.

•  Lie on back with 1 leg bent at the knee and the other straight, pull the straight leg towards body, stretching the hamstring muscle. Repeat with the other leg.

     Proper stretching posture, ergonomics, exercise, and keeping active help keep the body in good shape. A through evaluation, tailored exercises/stretching, postural consultation may be warranted. Osteopathic manipulation, acupuncture, physical therapy, massage body shaping programs all help to release chronic patterns that aren't relieved with simple stretches.

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     Temporomandibular joint dysfunction (TMJ) is a very common diagnosis but still a much overlooked condition. 50% of the population have it to some degree, it is 3 times more common in females than males, commonly ages 30-50. TMJ is both preventable and treatable. TMJ can be caused postural strains, stress, dental malocclusion, teeth grinding, trauma, poorly fitting dental appliances, gum chewing, etc. TMJ   symptoms are often misdiagnosed, and untreated. TMJ can cause jaw pain, clicking in the jaw, ear fluid retention, tooth pain, earache, neck pain, headaches, tinnitus (ringing in the ear), dizziness, fatigue and irritability.

      Many times TMJ can be caused by or create simple facial asymmetry (uneven facial features). Look in the mirror and see if the jaw is slightly forward or backwards, higher or lower, more or less pronounced on one side,. You can compare prior photos to see if there have been any changes over time.

     When treating TMJ it is important to get a thorough dental exam, followed by a comprehensive postural, neuromusculokeletal evaluation.   The temporomandibular joint is a complex joint that allows us to eat and talk, but is complex in its motion. There is a fibrocartilaginous disk between the mandible (where the lower teeth are) and maxilla (where the upper teeth are). The TMJ is similar to other joints in the body such as the knee in that it is a synovial joint, which has a disk. The mandible articulates (joined through a movable joint) into the sphenoid bone which is part of the cranium (skull) and the maxilla is part of the cranium. The TMJ is balanced by several very strong/tiny muscles, and ligaments. Cervical (neck), first rib, shoulder, craniofacial (skull and face) anatomy is involved in the overall TMJ function. Tendons, muscles, bony articulations, ligaments must be tested   for strain and biomechanical imbalances.

      Proper stretching of the cervical(neck)/facial muscles, stress management, proper eating techniques (ex: avoid always chewing on one side of the mouth), postural retraining, ergonomics at home and work all play a major role. Jaw rest, avoidance of certain foods ( bagels, large sandwiches, chewy meat and foods, gum), proper sleep ergonomics, moist heat, anti-inflammatories, muscle relaxants have been shown to have some effect in symptoms. People who grind their teeth at night do better with stress management techniques and may benefit from the uses of a dental night guard. TMJ is very responsive to a combination of osteopathic musculoskeletal treatment and acupuncture. TMJ may be part of an overall musculoskeletal problem that responds well to the treatment for an overall sense of wellbeing and freedom from pain. As with any condition it is important to get a thorough evaluation for diagnosis, and to look for the precipitating cause, and work to eliminate or treat the cause.

David A. Gentile, D.O. practices Osteopathic musculoskeletal medicine, medical acupuncture, nutrition and weight loss with culinary techniques in Shoreham, Long Island and Manhattan New York. He can be reached with questions at Doc@Drdavesfood.com .