It’s Winter; Be Careful to Prevent Falls

Slips and falls in the rain and snow are a major cause of painful traumas, especially in older people this time of year. The worse type of injury is the vertebral fracture. This occurs when a hard fall onto the back or buttock causes one or more of the bones of the spine to fracture and collapse. The fracture is extremely painful because unlike other fractures, it’s position deep in the body prevents it from being immobilized to allow healing and even everyday activities such as sitting up to eat a meal causes movement of the fractured bone.

If you experience a fall and have severe pain that doesn’t improve within one to two weeks and have severe back pain with any position or activity except lying down, more than likely, you have a spinal fracture. It is very important to have a physician evaluate you and order a diagnostic x-ray so that you can receive appropriate treatment in a timely manner.

The treatment for a spinal fracture depends on the severity of pain and on how much the pain limits your everyday activities. Younger adults may have a fracture, but because of good muscle tone and strength surrounding the spine, they might not have such severe pain that prevents their usual activites such as work, dressing, bathing, eating, etc. Older adults however, tend to have less muscle mass and support of the spine so that even sitting at the dinner table to eat a meal is a chore because of severe pain. In less painful fractures, wearing a tight, elastic, low back support belt can be very helpful, along with taking anti-inflammatory medications such as Advil or Aleve. These fractures may take up to six months to a year to heal naturally.

For older adults who have severe pain that prevents them from participating in their usual activities of daily living, we recommend a curative procedure called a Percutaneous Balloon Kyphoplasty. The procedure fixes the fracture by injecting cement into the bone through a thin, hollow needle. The cement is the same that is used in knee and hip replacement surgeries. It hardens immediately and the severe pain is gone immediately as well. The procedure is safe, done in the office under conscious sedation and takes one to two hours. There are no physical restrictions after the procedure and since the fracture is then fixed, there is no need for any strong pain medications.

I recommend that the procedure be done as soon as the fracture is identified if there is severe pain. If the fracture is allowed to heal on its own, it will likely heal with a deformity of the bone that causes the spine to bend forward, called kyphosis. Kyphosis can lead to long term health problems including respiratory diseases and chronic back pain. An MRI of the spine is usually ordered by the doctor to ensure that the fracture is still new enough to be fixed. Usually the MRI will show inflammation of the bone due to the fracture even six months after the fall has occurred. Once the bone heals, usually six months to a year after the fall, nothing can be done to reverse the deformity.

The best option of course is to avoid falls and injuries. “An ounce of prevention is worth a pound of cure,” as our friend, Benjamin Franklin, says. Wear shoes with good treading and if you need a cane or a walker, use it! Do as much safe exercise as you can to keep your back and spine strong and healthy.


What About that Pain or Sound in Your Jaw?

For years we called it TMJ (temporomandibular joint) but now we refer to it as TMD or temporomandibular joint dysfunction which is certainly more descriptive of why treatment is necessary.

There is much confusion in the field of TMD, many times leading to incredibly expensive and unnecessary, sometimes invasive dental treatments. In previous articles I have reviewed many of these protocols from the use of electromyography, to pharmaceuticals, to full mouth reconstruction or even surgery.

In this article I want to share what you can do to help your TMD and what to avoid in order to prevent damage to this very complex joint. First, we can take a look at what makes up the TMJ. It is composed of the glenoid fossa of the temporal bone, the condylar head of the mandible, an articular disc and articular capsule. The purpose of the disc is to prevent bone to bone contact and, when functioning correctly, the disc and capsule provide a smooth, well lubricated, rotation and translation of the joint. 

The elastic ligaments associated with the capsule are responsible for keeping the disc in place. Excessive stretching, like opening too wide to yawn, taking a big bite of a sandwich, or singing can stretch or even tear these structures. The disc then is allowed to become displaced, many times not returning back when the condyle reseats itself in the fossa. When the patient then opens their mouth, the condyle has to bounce over the back of the displaced disc, resulting in a popping sound, sometimes accompanied by pain and limited opening or a feeling that one’s bite is misaligned.

This pain is due to inflammation of the stretched or torn ligaments. When the disc continues to be displaced, or if clenching wears a hole in the disc, the condyle and fossa begin to touch, resulting in a sandy or gravely sound as the joint moves. At this point, arthritis and degeneration can develop.

What can you do to help? 

  • Like any other joint, over use can be abuse, such as chewing gum.
  • Regularly patients show me their pop by moving the jaw laterally. Never do anything on purpose to cause a pop! Lateral jaw movement is not what the jaw was designed to do.
  • Learn to hide your yawns like you are in the front row of an important class.
  • Eat smaller bites and avoid big sandwiches.
  • Avoid hard, tough or crunchy foods, such as nuts, ice or beef jerky.
  • Never check to see if the popping is still there. If the joint is quiet, it is getting better.
  • Stress is a major factor causing us to keep our teeth together (clenching or grinding). Teeth are only supposed to meet when swallowing, as little as one minute per hour. Learning to control the stress in your life will help. My next article will address this subject.
  • Learn to follow an anti inflammatory diet. Google it.
  • If you are prescribed drugs, check out the side effects. You may possibly get professional help to correct what causes the need for that drug. Many of my patients are experiencing a greatly improved life by doing this.
  • Schedule a free consultation with my office. I treat TMD differently than most dentists. If needed, I make a custom appliance, in office, fit specifically to your bite, not made by an outside lab.

Don’t let the dysfunction and pain get out of control before you seek help. Occasionally I find something quite simple that is causing the problem.



Healing Pinched Nerves and Neck Pain

If you are suffering with neck pain from a pinched nerve or herniated disc, you know how debilitating it is and how the pain slowly leaks the vitality from your life. At Align Healing Center we specialize in treating pain naturally. It is our mission to help relieve pain without the use of drugs, invasive procedures and without inducing more pain! If you or someone you care about suffers from pinched nerves or disc related pain, it is worthwhile to explore the natural therapies that are available today.

What is cervical disc herniation?

The bones (vertebrae) that form the spine in your back are cushioned by round, flat discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. If they become damaged, they may bulge abnormally or break open (rupture), in what is called a herniated or slipped disc. Herniated discs can occur in any part of the spine, but they are most common in the neck (cervical) and lower back (lumbar) spine.

A herniated disc usually is caused by wear and tear of the disc. As we age, our discs lose some of the fluid that helps them maintain flexibility. A herniated disc also may result from injuries to the spine, which may cause tiny tears or cracks in the outer layer of the disc. The jellylike material (nucleus) inside the disc may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.

What are the symptoms of a herniated disc in the neck?

Herniated discs in the neck (cervical spine) can cause pain, numbness, or weakness in the neck, shoulders, chest, arms, and hands. In some cases a very large herniated disc in the neck may cause weakness or unusual tingling affecting other parts of the body, including the legs.

Arm pain from a cervical herniated disc is one of the more common cervical spine conditions. The arm pain from a cervical herniated disc results because the herniated disc material “pinches” or presses on a nerve in the neck, causing pain to radiate along the nerve pathway down the arm. Along with the arm pain, numbness and tingling can be present down the arm and into the fingertips. Muscle weakness may also be present due to a cervical herniated disc.

How can I heal my pain without drugs or surgery?

  1. Non-Surgical Spinal Decompression Therapy

Non-surgical spinal decompression is a state of the art treatment that has been helping thousands of patients with chronic neck or low back pain, sciatica, and herniated, bulging or degenerated discs. This is an entirely different treatment from traditional chiropractic adjustments. Many of the patients who are candidates for this procedure have already tried chiropractic, physical therapy, injections, and/or were told they would need surgery.

This breakthrough treatment works by gently separating the vertebra which decompresses the disc, thus causing the bulging material to be drawn back into the disc. Non-surgical spinal decompression is very effective, has a high success rate, and can be utilized for both cervical and lumbar disc injuries.

  1. Class IV Laser Therapy

Laser treatments at Align Healing Center are done with the K-laser 1200 Class IV Laser.  Class IV Laser therapy gets to the root of the injury and treats it at the cellular level, providing energy to the cells so they can heal.This laser does not cut or burn but is gently absorbed by the tissue. During each painless treatment, laser energy increases circulation, drawing water, oxygen and nutrients to the damaged area. This creates an optimal healing environment that reduces inflammation, swelling, muscle spasms, stiffness and pain. As the injured area returns to normal, function is restored and pain is relieved.

There is hope!

We have found that a combination of Class IV laser therapy and spinal decompression offers outstanding results in healing stubborn neck pain due to a pinched nerve, bulging discs or spinal degeneration. This unique combination of non-invasive therapy offers a chance for realizing a permanent cure for neck or back pain. This eliminates the long-term care commitment forced upon patients by other symptomatic low-back pain treatments, such as drugs, injections or surgery. With proper care and rehabilitation of your spine you can be back to your healthy self quickly!

For more information about Dr. Niele Maimone, DC or to set up a complimentary consult call 925.362.8283 or visit



The Power of Strength Training

As an endurance coach and athlete, I was skeptical about the value of lifting heavy as it pertains to endurance performance. After all, what good is toting around six plus pounds in upper body mass over the course of the 140.6 miles of an Ironman triathlon? I mean, I worked my butt off to drop those (and any other) extra pounds to improve my power to weight ratio, right? This is just one of the many misnomers I have found that exist in the perceptions that many endurance athletes have about strength training. Specifically, what I call, “lifting heavy.” Granted, this is a relative term, but the reality is, many endurance athletes don’t do enough strength training. Period.

Triathletes, in particular, are often characterized by their lean, slight frames with little to no extra physical “baggage” along with a Type A personality—both of which are counter-intuitive to the culture of the large, “bunchy muscled Lifters” who are often much more laid back. Let me explain.

Triathletes and most endurance athletes (with the exception of ultra-runners who are a different breed altogether) opt for the latest technology that can tell them how many watts, how many strokes or strides are being delivered at what heart rate and level of exertion, right down to vertical oscillation, and contact time everytime their foot hits the ground, while their “heavy lifting counter-parts (especially in CrossFit) opt for a back to basics “box” containing copious amounts of very heavy weights, tires, steel rigs, and little else. Diets and nutritional strategies could not be more polar opposite: One group opting for animal proteins, fats, and plants. While the other live and die by the nemesis of the muscle builders and Crossfitters; grains and sugars wrapped up in a million different favors, energy gels, drinks, and chewables. The two are deft by comparison.

Yet, there exists a physiologically synergistic (though often mentally volatile) relationship between these two disciplines that too often is not explored, exploited, or capitalized on nearly enough by either camp. True, on the surface it appears a clash of the cultures. However, when explored at a deeper level, the benefits for “Lifters” and CrossFitters to train like endurance athletes, and visa versa, are undeniable. The value in accessing and exploiting both the anaerobic and aerobic systems is hugely beneficial for those looking to become better, well rounded athletes, if/when prescribed properly. Additionally, since when is building balanced, functional strength not an asset to any athlete? I have had extraordinary success with my athletes by including strength training of all types as part of their endurance programming, regularly during the race season and using it as a primary exercise medium during the off season.

The natural relationship between the development of slow twitch muscle fiber, also known as Slow Oxidative (SO) and aerobic fitness is where the endurance athletes make their living. Conversely, development of fast twitch muscle fibers:  type IIa, also known as Fast Oxidative-Glycolytic (FOG) and type IIb, Fast-Glycolytic (FG) is the bread and butter of the “Lifters” who rely upon developing this group for maximum strength gains that can be used at the high intensity required by CrossFit and many heavy lifting programs. It is important to note that muscles are made up of all these fibers and distribution of these fibers is dependent on training, genetics, and the function of the muscle it serves. Without getting into what could a be a painfully tedious biology diatribe, suffice it to say that since muscles contain all of the above mentioned fibers, in order to achieve optimal athletic performance it is imperative for endurance athletes to develop both the FOG and FG muscle fibers in addition to SO fibers to help maximize the potential to access all sources of energy within the muscles. On the other hand, more “Lifters” would be well served to develop the SO (resists fatigue) muscle fibers to help build the capacity of sustainable energy release for longer periods of time to help offset the rapid rate of fatigue that occurs in the FG fibers (easily fatigued) and to a lesser extent the FOG (some fatigue resistance) group.

Oh, and let’s not forget the undeniable value of developing more aerobic capacity which is a health benefit for anyone! Bottom line, strength helps to build speed, prevent injuries, and helps create a well-balanced musculature and skeletal system.

If you’re looking for personal training, body composition change, strength training specifically for triathletes & endurance athletes, metabolic efficiency training, or triathlon/endurance coaching contact me at