Dr. Michelle Clark, D.C.

I first met Jason 3 years ago when I joined Runner’s Edge of the Rockies. He was a long time runner, but was training for his first full marathon. Needless to say, he smoked his first full! As a result of that first race, his dreams of becoming an Olympian for marathon were beginning to become realized. His mileage increased and so did the need for soft tissue therapy. Read what he has to say about Active Release Technique and what it has done for him on his journey to the Olympics.

Dr. Clark

I am proud to present a new alternative treatment to the practice. Mike Allen, a board certified acupuncturist with a diplomat in Chinese Medicine, has joined our team! His enthusiasm for the outdoors is what brought him to Denver in February 2010. Because of his love for being active, he focuses on treating sports related injuries among many, many other ailments. In his spare time he is a supervising clinician at the Acupuncture school here in Denver. We are so fortunate to have him on staff!

He is offering some summer specials to existing patients of the practice. He is giving 20% off of his initial consult and treatment!

Aside from that, he writes a great BLOG. Check it out if you want to know more info about Mike and his Acupuncture happenings.

Schedule with us today….
Dr. Clark

Here’s an interesting article that was published in USA Today. My favorite tip in this article is about resuming normal activity as soon as possible. I always preach to my patients that being sedentary is worst thing you can do even if you are in pain. I don’t expect you to run a marathon if you are hurting, but you still need to keep moving!

This is yet another reminder that conservative care for the first six weeks is better than jumping on the injection/surgical bandwagon. Please reference an earlier blog called “The Natural History of Uncomplicated Low Back pain”

I am here to help!
Dr. Clark

Watch as Coach David Manthey from Runner’s Edge of the Rockies shows some great stretching tips!

Coach David Stretches his Stuff

Here is an interesting article that was published in this months ACA News. It uncovers the science behind the “gluten-free” diet.

Designing an Anti-Inflammatory Diet
Help your patients prevent chronic disease by reducing inflammation risk factors.

By James Gerber, MS, DC

The pathological process of inflammation has been understood for decades, but only recently health conditions not previously associated with inflammation, such as heart disease, cancer and degenerative brain disease, have been linked with this process. As a result, there has been an expansion of interest in discovering how anti-inflammatory interventions might help in the prevention or management of many diseases.

Natural approaches to achieving anti-inflammatory effects through the diet typically include: 1) an attempt to shift dietary fatty acid intake to reduce pro-inflammatory products of fatty acid metabolism, 2) an increased intake of plant-based foods that are naturally high in antioxidants and other anti-inflammatory phytonutrients and 3) a search for potentially allergenic foods, which, when eliminated, may lower systemic immune responses that promote inflammation. Let’s consider each of these strategies, the evidence supporting their rationale and the steps needed to implement them.

The Complexity of Fatty Acids
Fatty acids, specifically certain members of the omega-6 and omega-3 polyunsaturated families, are precursors of eicosanoids such as prostaglandins that have many influences on local tissues, including the mediation of inflammatory mechanisms. One of the omega-6 family, arachidonic acid, can be converted to a variety of powerful promoters of inflammation, while conversion of gamma-linolenic acid (GLA, another omega-6 fatty acid) and eicosapentaenoic acid (EPA, a long-chain omega-3 fatty acid) does not help promote inflammation to any considerable degree.

Since these precursors compete with each other for conversion to their respective eicosanoid products, a relative anti-inflammatory balance would be achieved by minimizing arachidonic acid and/or maximizing GLA and EPA in the diet. This is the rationale for modifying fatty acid intake in the anti-inflammatory diet, as well as for the use of anti-inflammatory fatty acids, such as fish oils, as supplements.

Popular anti-inflammatory diets often oversimplify the relative contribution of different omega-6 and omega-3 fatty acids to the inflammatory response. Since arachidonic acid can be produced in the body from other omega-6 precursors, a broad recommendation is typically made to limit omega-6 intake from all sources, even though some omega-6 precursors, such as GLA, are anti-inflammatory. Similarly, since EPA can be produced from other omega-3 precursors, a broad recommendation to increase intake in general from all omega-3 sources is common, even though short-chain omega-3s are converted to EPA to a limited degree only.

Clinical studies have shown the most promise for increasing food and supplemental sources of EPA and other long-chain omega-3s, beginning at about 500 mg/day for heart disease prevention and up to 3,000 mg/day for clinical anti-inflammatory effects. Reducing dietary sources of arachidonic acid by minimizing animal fats and flesh has some support, as well. GLA has shown promise as a supplement in amounts beginning at about 1,000 mg/day, but it is not present in edible foods. Flaxseed and its oil are rich in short-chain omega-3 and have some healthful properties, but flaxseed oil was ineffective in the only clinical trial to date that investigated effects on a chronic inflammatory disease.

Clearly, the best evidence for designing the fatty acid contribution of an anti-inflammatory diet is to increase EPA intake from marine sources such as oily fish (salmon, sardines, herring, trout, black cod) and oysters, aiming for consuming these foods several times a week, and to reduce dietary sources of arachidonic acid (meat, high-fat milk and cheese products, eggs) as much as possible. This was demonstrated well in a randomized controlled trial in rheumatoid arthritis patients that found benefits from either a diet low in arachidonic acid or supplementation with fish oils—but an even larger clinical effect when both strategies were combined.

Switching to Plants
Plant-based foods are the richest dietary sources of substances known to affect the biology of inflammation, such as antioxidants and phenolics, which include the flavonoid family. The Mediterranean diet, with its emphasis on unprocessed plant-based foods and phenolic-rich olive oil, as well as recommending seafood as a preferred source of animal protein and fat, has emerged as a healthful anti-inflammatory diet. (To view Mediterranean Diet Food Pyramid, go to www.mediterraneandiet.com/tag/new-mediterranean-pyramid/.)

This diet has not only been found helpful for the prevention of heart disease through anti-inflammatory and other mechanisms, but has even helped reduce symptoms and disease activity in patients with rheumatoid arthritis. The Mediterranean diet and probably other, similar plant-based diets are certainly legitimate models for an anti-inflammatory diet.

Reducing Allergic Response
The role of food allergy in inflammatory disease has primarily focused on disorders of joints, such as rheumatoid arthritis; of the intestine, such as Crohn’s disease; and of the skin, as in atopic dermatitis. While benefits from food allergy identification and avoidance have been frequently demonstrated in individual cases and some clinical trials, controversy persists due to lack of double-blind challenges to confirm true sensitivities in most research. Of course, most dietary interventions cannot easily be concealed from subjects in a clinical trial, so placebo effects could explain the positive results on symptoms reported in these studies. Nonetheless, at least one rheumatoid arthritis trial has demonstrated persistent benefits of a low-allergen diet for up to one year.

A Combined Approach
Clinical benefits of anti-inflammatory diets may be due to a combination of the above mechanisms. Researchers in Sweden and other countries have shown that a “vegan diet free of gluten” has positive effects on symptoms and clinical signs of inflammatory diseases in trials lasting as long as one year. Such a diet would be void of arachidonic acid; free of potentially allergenic wheat, dairy and egg products; and high in plant-based antioxidants and other potentially anti-inflammatory phytonutrients. Similarly, the Mediterranean diet will typically have a more favorable omega-3/omega-6 fatty acid balance and might significantly limit potential allergens from animal-based foods. Clearly, there is more than one way to design an anti-inflammatory diet or to explain the benefits of such an approach.

Dr. Gerber is associate professor of clinical sciences at Western States Chiropractic College (WSCC) and is the lead instructor for WSCC nutrition courses. He has authored conservative care pathway protocols for treating dyslipidemia and obesity, as well as for using specialized supplements for treating joint disorders and musculoskeletal trauma. Dr. Gerber can be reached at jgerber@wschiro.edu.

Sources
1. Adam O, Beringer C, Kless T, et al. Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatol Int 2003 Jan;23(1):27-36.
2. Gamlin L, Brostoff J. Food sensitivity and rheumatoid arthritis. Env Toxicol Pharmacol 1997;4:43-49.
3. Harris WS, Mozaffarian D, Rimm E, et al. Omega-6 fatty acids and risk for cardiovascular disease: a science advisory from the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention. Circulation 2009 Feb 17;119(6):902-7.
4. Hafström I, Ringertz B, Spångberg A, et al. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford) 2001 Oct;40(10):1175-9.
5. Kapoor R, Huang YS. Gamma linolenic acid: an antiinflammatory omega-6 fatty acid. Curr Pharm Biotechnol 2006 Dec;7(6):531-4.
6. Pischon T, Hankinson SE, Hotamisligil GS, Rifai N, Willett WC, Rimm EB. Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation 2003 Jul 15;108(2):155-60.
7. Skoldstam L, Hagfors L, Johansson G. An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis. Ann Rheum Dis 2003;62:208-14.

Dr. Clark has entered the world of social media marketing. Follow Active Release Technique Denver on Facebook and you will be privy to internet specials and discounts. This month Dr. Clark wants to remind you that if you have a flex spending account that you will lose at the end of the year, you should consider buying a package that NEVER expires. That way you won’t lose your flex dollars.

We are here to help!

On Sunday, October 25th, 2009 in Austin, Texas, the twenty women of the 70.3 Triathlon Team of Team WILD: Women Inspiring Life with Diabetes, participated in the Longhorn 70.3. Fifteen of the women have Type 1 diabetes, one woman has Type 2 diabetes and five of the women are Type 3, supporters of women with diabetes.

Seven of the team members live and work in the Denver/Boulder metro area! In addition, the Head coach, Yoli Casas, and the Sports Nutritionist and Diabetes Educator, Marcey Robinson, live here in Colorado!

Team WILD is the first team in the world to use virtual team training, coaching, medical support, and camaraderie to prepare teams of women with diabetes. They train for specific events ranging from 5k’s to Iron distance Events.

There are 23.6 million children and adults in the United States, or 7.8% of the population, who have diabetes. Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches, and other foods into energy needed for daily life.

This was Team WILD’s inaugural endurance event and the first time an organized team of women with diabetes has ever participated in a triathlon.

For more information or to schedule and interview, please contact Mari Ruddy, Team Founder at mruddy@teamwild.org.

I had the pleasure of meeting 3 women affiliated with this organization. Their stories are amazing, their lives are touching, and their ambition is definitely inspiring….

Dr. Clark

As an ART practitioner, I am surrounded by athletes doing amazing things day in and day out.  This woman is no exception.  I am inspired by Becca’s motivation and courage to do something so selfless for her dear friend Kori.  Please read Kori’s story below and donate to her cause if this touches you in any way.  Dr. Clark

Once again I have a goal and a cause….a cause not like the one in previous years, because it is a lone cause.  I have come to many of you on a few occasions asking for you to support me with my Team in Training events through the Leukemia and Lymphoma Society.  This organization is very important to me, but as important as it is, the cause I am fighting for now holds another dear place in my HEART.  My college roommate and amazing friend, Kori Bigge, is waiting for a new HEART.  A link to a video relaying her story is below. Please take the time to watch it as I want you to know of her amazing fight and courage.  In order to show my support for her,  I have decided to do tackle my ultimate and most feared feat.  I am going to compete in my first Ironman!  You know where all of you come in to play, as my goal is to raise $5,000 to help her with her medical bills and complete this task of swimming 2.4 miles, biking 112 miles and running 26.2 miles in Tempe, AZ, on November 22nd!  I know neither will be easy.  The training up to this point has left me exhausted, but know it is little compared what Kori has gone through and what still lies ahead.  Please consider donating to Kori.  All the information on how to donate is below.  Every penny you donate will go to her to help with the multitude of medical bills.  I am paying for all of my expenses out of pocket.  This is the least I can do for her!

Thank you for your consideration!!!!!
Becca Stevens

Donations:

A check may be made out to SNB (Stockton National Bank) c/o Kori Bigge Medical Fund.  Please either send checks to Ironman For Kori c/o Mary Stevens at 19381 US 75, Benedict, KS 66714, or hand deliver to myself or a family member.

Kori’s Story

Please click on the link to watch the video or read the stroy below:

http://connect2utah.com/content/video/?cid=39233

Right now at this hour, there are nearly three thousand people across the country waiting for a heart transplant. 35 of them are here in Utah. The stories are many, but for one family, the road to getting on the list came with a great sacrifice, including losing a child.

For Kori and Doug Biggie, their life together started as many couples do. They got married, live in Kansas and then had their first child. But it was during Kori’s second pregnancy in April of last year that forever changed the Biggie’s life.

During a checkup, doctors discovered their unborn baby had an enlarged heart. 28 weeks into the pregnancy, Dena was born by C-Section. The tiny baby spent most of her short life in the hospital, where family gathered to say goodbye as she passed away.

The morning of Dena’s funeral on September 10th, Kori suffered a massive heart attack. Kori was rushed into emergency surgery. She had a stroke that has left her blind. Under the advice of doctors, Kori was eventually transferred to the University of Hospital, where surgeons inserted a heart pump. “I finally woke up and really became conscious of everything in October. I found out that I had a heart attack and was in Salt Lake and not in Kansas anymore,” said Kori during an interview with 2News.

The small cord from the heart pump comes out of her rib cage on her right side and plugs into a small battery pack. The pump actually keeps her failing heart beating. But there is a serious problem, the pump is not meant to last forever.
So Kori is now among the thousands across the nation on a heart transplant waiting list. Since her life is not in immediate danger, those on the list who are ill, move to the top of the transplant list.

Despite all their challenges, the Biggie’s are not giving up hope. “It happened and there is no sense in dwelling on the bad stuff because that is just going to bring you down and everybody else around you down, so try to dwell on the good things and the funny things.”

Kori’s husband Doug has been making frequent trips to Utah to be with Kori as she waits for a new heart. “Her attitude about this whole thing is unbelievable. I don’t know how many people could be through what she’s been through, losing her eye sight, losing a child, having her heart damage and have such a good outlook on life as she does.”

Kori has been staying at the House of Hope during her stay here in Utah. Her health right now has improved so much that she’s been allowed to go home to see her family in Kansas.

Last year, about 33 people here in Utah received heart transplants. Currently about 69% of licensed drivers are on the Donor Registry. Kori and Doug hope stories like this help that number of donors go up.

Right now at this hour, there are nearly three thousand people across the country waiting for a heart transplant. 35 of them are here in Utah. The stories are many, but for one family, the road to getting on the list came with a great sacrifice, including losing a child.

Here is an update to Kori’s Story:  She has been home for quite some time enjoying her family and living as normal a life as possible. She is now waiting to have medication approved in order for her to get her antibodies down.  Although this medication has been used for multiple organ transplants, it has never been used for heart transplants.  As soon as it is approved, Kori will head back to Salt Lake City, where she will go to the top of the transplant list.  I hope the day I cross the finish line, she has her dream…A NEW HEART!

Watch Coach David Manthey talk about the importance of marathon training in a group setting.  I am currently training for my second half marathon with Coach Manthey and Runner’s Edge of the Rockies.  Come out and support me (Dr. Clark), Coach David, the hundreds of Runner’s Edge members at the Denver Marathon on October 18th at Civic Center Park!!!

Active Release Techniques make me hurt so good

My hamstrings and quadriceps are bruised and slightly tender to the touch. In some spots the bruising is a dark red, but in others it is blue, green and brown. Was I kicked by a horse? Trampled by a wild boar? Attacked by a band of ruffians? No, no, and no. The truth is that I paid someone to inflict these injuries upon me.

But let me start at the beginning. In early 2004, I injured my Achilles tendon doing a track workout two days after a fast half marathon. With the Olympic trials on the line, I was willing to do just about anything to coax it to heal. I ran in the water, stretched my hamstrings, iced my injured tendon, wore a special boot, got fitted for orthotics, and even bought an ultrasound/electro stimulation machine. I also spent hundreds of dollars on massage, chiropractic visits, physical therapy, and acupuncture. Despite my efforts, an MRI revealed that my Achilles had microscopic tears that put it at risk of rupturing, and so I decided to skip the trials.

For the next year, the injury persisted. It abated for a while, but by the spring of 2005 it was flaring up so badly that at moments I was literally frozen in pain. One night I was recounting my Achilles woes to a friend, and she recommended that I see Dan Selstad, a Del Mar, Calif., sports therapist specializing in Active Release Techniques (ART). I’d never heard of ART before, but I figured I would give it a try.

When I arrived at Dan’s office, I was pessimistic, to say the least. After spending thousands of dollars trying to heal my Achilles, I did not think that anyone or anything could help me. But after one session with Dan’s magic hands, my injury had noticeably improved. It turned out that it wasn’t my Achilles that was causing the flare-ups, but my Achilles bursa and my flexor hallucis longus (big toe muscle). Dan treated those, and I was able to run without any pain.

So what exactly is ART? “ART is a type of myofascial release that uses active motion to help break down scar tissue in overused or injured muscles,” Dan says. “It’s different than massage because you’re using active motion to help break down scar tissue. You’re not gliding over the skin like massage does; you’re holding a fixed point while the muscle is actually moving underneath your contact.” Dan uses ART to treat such athletic greats as eight-time Ironman champion Paula Newby-Fraser and 2006 Ironman champion and 2000 Olympic silver medalist Michellie Jones.

“I see Dan once a week and sometimes twice a week,” Jones says. “There’s no way I could get away with not seeing him that much. That’s how important ART is. I’ve gone in with torn calves or a hip or hamstring issue, and Dan stays on top of stuff for me. It’s part of my training program to see him at least once a week.”

Yet as effective as ART is, it also really hurts. Once I was getting ART on my IT bands, and I told Dan it wasn’t that bad: just a seven on a scale of one to 10. “Oh, I’m just buttering the bread,” Dan said, as he dug his hands into my legs, making me scream.

Most ART therapists seem to have an incredibly positive disposition — almost as if they like inflicting pain. Dan is always friendly and upbeat, and so is Lynn Schankliess, the physical therapist I see in the San Francisco Bay area. Lynn is equally sunny but significantly more retro. By retro, I mean Middle Ages. Although she does regular ART, she has also mastered a technique called “Graston,” which involves using various metal instruments that must have debuted in torture chambers of medieval Europe.

Lynn’s favorite is about the size of a butter knife, but she also has one that is long and thin, allowing her to grip it with both hands. She rubs the instrument back and forth to break up adhesions in my muscles. She does it for about 10 seconds on each spot, and the pain is so intense that I feel like screaming/biting/kicking and pummeling her all at once. It’s no surprise that, when Lynn worked at the University of California, Berkeley, one of the offensive linemen called her “Spawn of Satan” (or the more affectionate “Spawn”).

Lynn also uses an Eastern technique called Gua Sha, which uses a small, guitar pick-shaped instrument that’s made of bone, polycarbonate, or horn to help release toxins. It has a different feel than Graston, a lighter sweeping motion, but like Graston, it allows Lynn to get to the tissue she can’t get to with her hands.

Lynn has helped me get over an Achilles injury (in the other leg), a calf injury, and a recalcitrant hamstring injury. Her savagery breaks up the scar tissue and helps my muscles to flow, allowing me to do what I love: run.

I have another appointment scheduled with Lynn for this Wednesday 11:00 a. m. I have no illusions about what it will be like: 60 minutes of discomfort and pain. But I also know that it works, and despite the unsightly bruises, I’ll definitely be back again.

Tamara Rice Lave, Ph. D., represented the U. S. in the marathon at the 2003 IAAF World Track and Field Championships in Paris.