Blog – Classic (1 column)

Driving with Back Pain

Whether you have a trip coming up or you drive for your job, driving with low back pain can really suck. After about twenty on the road, you notice your back start to cramp up and the pain sets and and worsens with each mile. But there are things you can do to help make the journey a little better! So if you’re headed out of Portland for a small adventure or delivering someone’s lunch, check out the checklist for a more comfortable drive.

Road Trip and Driving Tips for Low Back Pain

Now it’s worth mentioning that there are lots of kinds of low back pain and what feels great for some types may not for others. But these tips will cover the most common causes and types of low back pain.

1 – Use your car mirrors like a back brace

Back braces can offer relief of low back pain in part by keeping your posture upright. You can use your car mirrors to do the same thing while you drive. When you get in the car, sit up tall and find a good, comfortable posture. Then adjust your mirrors to this position. When you’re driving down the road and you can’t see well out of the mirrors – it’s because your posture has changed. So don’t adjust the mirrors – sit back up!

2 – Don’t reach too far for the car’s steering wheel

When you have to reach too far for the wheel, you slump. This can increase the pressure in the low back and compound the effects of all the bumps and potholes you go over on the drive. So in a nice and tall seated position, bring the wheel close enough to where you have a little bend in your elbows. But obviously – – don’t bring it too close in case you’re in an accident

3 – Use a bolster for extra support

Not all cars have adjustable lumbar support bars; and even the ones that do don’t seem to fit most backs. So use a bolster and put it in the middle of your low back where it curves in. This will keep your back supported through the trip. You can buy a bolster from the store or make your own by wrapping up a smaller bath towel nice and tight and taping both ends

4 – Gas up your car every quarter to half tank

It will take you a little longer to get where you’re going, but your back will thank you. Frequent mini breaks where you can change position and walk around will make you more comfortable later on compared to just driving straight through. Now some of you have hybrids or electric cars – – you could probably drive pretty far on half a “tank”. So if that’s the case, just stop off somewhere every 45 minutes or so. Maybe grab some road snacks; take a picture in front of a cool sign; just enjoy the journey!

And that’s that! 4 quick tips to making sure low back pain doesn’t stop you from taking road trips all around this gorgeous state. Until next time, take care!


Easy Home Posture Test

Hey guys, Dr. Lell here – your family Chiropractor serving patients from Sellwood to Oregon City. And today I’m telling you how to quickly check your posture. This is a great thing to do because if you can catch yourself developing bad posture, it is easier to fix than if you waited. Chronic turtle posture is a hard thing to fix – better to catch it early.

What Does Good Posture Look Like?

oregon city chiropractor explains what good posture looks like


First, what do we look for in good posture? We check posture from the side and from the front. From the front view, you want to make sure everything on either side is level. The head shouldn’t be slant or turn, the shoulders, hips, knees, and ankles should be the same height from the floor.

When assessing posture from the side, we use a plumb line to see if the following points line up. In good posture, the middle of the ear will be in line with the shoulder, hip, knee, and ankle.

Now there are countless of gadgets and gizmos that assess posture and many chiropractors, PT’s, and athletic trainers will consider posture when evaluating you because of the many harmful effects of bad posture. If you’re wondering what those are, read this.

The Test

Oregon City Chiropractor explains a simple home posture test


This is a quick down and dirty screen for posture. Stand against a wall. Put your feet out about 6 inches from the wall – toes forward. Your butt, shoulder blades, and head should be touching the wall. Now here’s the test – there should be no more than about 2 inches space between the wall and the back of your neck and between the wall and the small of your back.

This ensures that the curves of your spine aren’t curing too much or too little. If the position is painful, all the points can’t touch the wall, or there’s too much space between the back of your neck and the small of your back and the wall, then it’s time to work on your posture. Check out my favorite posture exercises to get started or make an appointment if you think you need additional help.

As always, drop me a line on Facebook if you have any questions or if you’d like to request a specific topic.

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3 Surprising Effects of Bad Posture

Hey guys. Your family Chiropractor, Dr. Lell, here. Oregon City schools are back in and with that comes the school supplies, books, and assignments all overstuffed into that back-pack. If the backpack is too low or too heavy, it’s common to accommodate with bad posture (hyperkyphotic posture, to be clinically specific). The same bad posture that you’ll use when you’re hunched over your computer or looking down at your cell phone for the majority of your day. That’s how bad posture sets in. There’s not one random event or injury; bad posture is like bad teeth. It’s the end result of accumulated small neglects. It’s something you effortlessly slip into; one day realizing that you’re the person with bad posture.

If you think you’re developing bad posture, read this to find out.

But why does it matter anyway? Is there any consequence of bad posture beyond looking like someone with bad posture? Yes! Yes there is! As a Chiropractor, I’m always paying attention to a patient’s posture because beyond aesthetic, bad posture can cause difficulty breathing, shoulder injuries, and can shorten your life! How? Let’s find out!


Posture and Breath

Try this. Sit up nice and tall and take a deep breath. In and out. Now hunch over and repeat. Feel the difference?

The middle part of your spine, the thoracic spine, is attached to your rib cage. Know what’s in your rib cage? Your heart and lungs. When the thoracic spine is straight, the chest cavity is nice and open. The lungs can completely fill with air and the ribs can accommodate the expansion by moving up and down a little bit. But if you decrease the height of your thoracic spine (by hunching over) you make your chest cavity smaller. You can’t fill up your lungs enough. And your rib joints get crunched and can’t move as much to accommodate that expansion. Poor breathing can be linked to poor performance, anxiety, increased pain, and a dysfunctional core.

Posture and Shoulders

Okay time for another one. Sit up nice and tall. Now move your arms allllll the way up and reach for the ceiling. Okay arms down. Now hunch over and try again. See the difference? You shoulder, the glenohumeral joint, relies on many things to move the way it should. It especially relies on the the mobility of your thoracic spine and the stability of your shoulder blade (which in turn can depend on the mobility of the thoracic spine). So if your upper back doesn’t move the way it should (because it’s stiff and hunched forward), your shoulders won’t move properly either. This can set a person up for things like upper cross syndrome, thoracic outlet syndrome (numbness, tingling, weakness in arms and hands) and can make it easier for people to injure their rotator cuff, especially athletes.

Posture and Life Span

It might be surprising, but the bigger the hump in your back, the shorter your life. Many prospective observational studies have measured the degree of thoracic kyphosis in senior citizens in tracked their life spans over the next 15-35 years. What many of those researched found is that those with a stooped posture ended up dying a lot sooner than those without. They figure it has to do with the decreased heart and lung efficiency which increases the overall frailty of aged people.

So there you have it! The three surprising consequences of poor posture. If you have bad posture that you’d like to improve or if you’d like to maintain the good posture that you have, check out my favorite posture exercises.

As always, drop me a line on facebook if you have any questions or if you’d like to request a specific topic. And for more great information delivered right to you, sign up for my mailing list! A special thank you gift will be on its way when you do.


  • Crawford. 1993. The influence of Thoracic Posture and and Movement on Range of Arm Elevation. Physiotherapy Theory and Practice. 9;3.
  • Culham, E. 1994. Thoracic Kyphosis, Rib Mobility, and Lung Volumes in Normal Women and Women with Osteoporosis. Spine. 19;11.

An Important Question You’re NOT Asking your Doctor

Hey guys, Dr. Lell here – your family Chiropractor serving patients from Sellwood to Oregon City. I’m not going to talk to you about a specific condition or health tip today, but I am going to give you a pretty powerful piece of advice. Ready for it? -Ask “why” more often. This is good advice for every day life but I am going to frame it around your next doctor’s appointment.

Your doctor – whether they’re your specialist MD, dentist, or chiropractor – is not beyond reproach. They’re not too good to answer the question, “why?” If they act like they are or doesn’t take the time – then fire them and find a new doctor.

Why you should ask “why”

I’ll admit, sometimes the explanations are really dull. Sometimes the answer won’t be very satisfying. But it’s important to engage your doctor this way because medical professionals aren’t perfect. The day of the 1950’s white coat of armor are gone. You as a patient have a world of information at your fingertips and it’s your job to take an active role in your health by researching, learning, and questioning.

Yes, there’s a lot of garbage out there. But that’s why you have the doctor – to listen to your inquiries and help you sort out the good from the bad. Access to information and the power of why changes the doctor-patient dynamic from one of authority (do as I say because I’m the doctor) to more of a partnership which is – in my opinion – better.

You wouldn’t think twice about asking your plumber or mechanic “Why?”

A lot of people think, “Well he’s the doctor, certainly he knows more than I do so why bother questioning him?” Well yes, we probably know more than you about whatever it is you’re coming to see us for. But you know what? Your plumber probably knows more about pipes than you. Your mechanic probably knows more about engines than you. But it’s not odd to ask your plumber or mechanic “why?” and then ask more questions after that, is it? So why feel weird about asking your doctor the same thing? Yeah the explanation may be counterintuitive or hard to grasp, but the attempt should be made to help you understand.

Asking your doctor “why” is good for your health and your wallet.

Outside of being more informed and empowered, asking your doc “why” does two other things. It can prevent unnecessary procedures, tests, and medications and it shows that you’re not just being put through the numbers and getting the same treatment and approach like every other person today. Because I can have 5 different people, all with neck pain, and those 5 people will likely have 5 different treatment plans. Because neck pain isn’t just neck pain; every body is different and everyone deserves personalized tailored care. Asking why and getting a reasonable response shows that critical thinking was used when designing your treatment.

So the next time you’re told to “take this pill”, “get this procedure done”, or “come back x many times a week for x many weeks” – you should follow-up with “why?” What will this show? What will will this accomplish? How will this change my prognosis? You shouldn’t feel badly about asking and your doctor shouldn’t look annoyed to answer because in healthcare today, you and your doctor need to work together, side by side, to help you reach your health goals.

That’s it for today, guys! As always, drop me a question or request on Facebook. And hey! Sign up for my newsletter. If you’re wondering why you should, it’s because you’ll get some great information delivered to your inbox and a special gift as soon as you sign up. Have a good day!


Yours in Health,

Dr. Lell

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Do Corticosteroid Shots work for Shoulder Tendonitis?

Hey guys! Dr. Lell here, your family Chiropractor helping patients from Sellwood to Oregon City and I’m back to talk about corticosteroid shots for shoulder / rotator cuff tendonitis.

Are you or someone you know considering a steroid shot for rotator cuff tendonitis? Chances are, someone at one point has asked, “will this work?” and the results from a recent meta-analysis (a higher quality study) of 11 studies gives a pretty surprising answer.

What is a corticosteroid shot?

Corticosteroid shots have been used since the 1950’s for many acute and chronic conditions. It’s a very common procedure and often a first choice in the management of musculoskeletal conditions by general practitioners and orthopedists. But how do these “magic” shots work?

I won’t get too technical here. But when a part of your body is injured, it sends up a flag for help. The help comes in things like white blood cells, stem cells, macrophages, etc. All the stuff that your body needs to clean up the mess and heal injured tissues. A lot of extra fluid comes in too causing swelling, warmth, and pain. This process is called inflammation; the body’s natural response to injury and infection.

Usually, the body does its things and the inflammation goes away leaving behind repaired and healthy tissues. Sometimes the inflammation can go haywire. This is where the shot comes in. The corticosteroid is delivered to local tissues to stop current and prevent more inflammation thereby decreasing the associated pain, swelling, and warmth.

But do you see the kicker? The inflammation was healing the injury. So when you put an abrupt stop to inflammation, you’re leaving injured tissues in a vulnerable state by prolonging the healing time. This can make re-injury more likely.

Do corticosteroid Shots Work?

Success with corticosteroid shots is across the board. For bursitis and arthritis, I have patients that swear by them. But I’m seeing a lot of patients get them for rotator cuff injuries with little to no benefit. Now to be fair, that’s a biased view. Because if the shot did work, I wouldn’t be seeing them for the same shoulder pain. So of course I only see people that didn’t get much help. That’s why the title of this study caught my eye: Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendonosis by Mohamadi written this year.

Results of the Study

The analysis looked at a total of 726 patients with rotator cuff tendonitis. Some patients got a single shot, some got multiple, and some got a fake shot. Then they checked in on their pain levels at 4, 8, and 12 weeks. They found that the people who got the shot had pain levels only a little better than people who got the fake shot at 4 and 8 weeks. Only 1 in 5 had much less pain. At three months, the pain levels of everyone was the same. They found that multiple injections made no difference.

In other words, the injection made their shoulders feel slightly better for 2 months, but the effect was gone by month 3. After three months, there was no difference in people who did and didn’t get the shot.

Why Don’t Cortisone Shots work for Shoulder Tendonosis?

The cortisone shot prevents and decreases inflammation. But in tendonitis, the underlying issue isn’t the presence of inflammation, it’s the damaged tissues. Preventing the natural healing process with a cortisone shot can make the tendons chronically degenerative and sore. This makes them prone to more injury.

What are the alternatives?

Chiropractic works with the body’s natural healing process. Not in spite of it. This approach uses treatments like electrical stimulation, adjustments, and functional rehab which can speed up the body’s inflammatory process healing tissues quicker. It helps with pain levels too.

If you are considering steroid injections for your shoulder, or did not get much relief from them, make an appointment with our online scheduler and start getting better.

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References and Interesting Reading

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How to Prevent Headaches from your Computer

Hey guys, Dr. Lell here – your family chiropractor here in Portland. Frequently, a patient will ask a great question that I think a lot of people might wonder and I turn it into a blog. This time, I even tried my hand at a question and answer video! Excuse the quality; I’ll get the technical parts figured out eventually.

What are Computer Headaches?

There are many different kinds of headaches that you may be experiencing throughout your day: tension, ocular, or migraine just to name a few. But the headaches this blog is about is the kind of headache that sets in after a few hours of you sitting at your desk hunched over your computer. These are muscle tension headaches. They typically begin with a stiff neck and upper back, the neck stiffness becomes soreness, and a tight achy grip travels up your head sometimes settling behind the eyes.

Why do I get Headaches from Hunching over my Computer?

It comes down to bad ergonomics. Poor placement of things in your work station can cause you to hunch over and put a hump in your upper back. Often, your neck will either be too low (looking down at your monitor) or kinked back (so that you can see your monitor when you’re hunched too far). This position is okay for a while, but after an hour and a half or so, the muscles you’re misusing will get tight and angry and you could start hanging on the ligaments in your upper back. This combination of angry muscles and stretchy ligaments will often create the stiffness in your upper  back and neck that may eventually lead to a headache.

This tight and bunched up position (it’s called the t-rex position for obvious reasons) puts a lot of tension on your upper traps, levator scapulae, suboccipital muscles, and pecs while lengthening and weakening your postural support muscles in the upper thoracic spine.

2 Simple Tricks on Preventing Computer Headaches

There are two simple things you can do that will automatically fix all of your working posture issues without you having to constantly think about it.

1 – Align the top of your monitor with your eyes

This forces you to keep your neck upright and in a neutral position; you won’t have to tilt your head down or up for hours to see you screen and it will help to prevent you from hunching your upper back as well.

2 – Put your keyboard just under your hands

Sit upright in your chair and let your arms hang at your side. Bend your elbows to 90 degrees or so. Wherever your hands are is where your keyboard should be. Most people have their keyboard too far away from them so they have to reach over. This causes your to slump and to internally rotate and protract your shoulders with can cause tightness in the pecs and upper traps. By having your keyboard in the right position, you’re forced back in your seat more and your upper body will adopt a more neutral position with the neck.

There you have it! It’s as simple as monitor height and keyboard placement!

Over time, this unchecked posture can lead to something called upper cross syndrome which is characterized by slumped shoulders, a hunched upper back, and forward head carriage. Typically, the most common symptoms of upper cross syndrome are very tight muscles and frequent headaches but it can lead to other conditions such as cervical disc herniations, shoulder injuries, and thoracic outlet syndrome.

If are experiencing troubles like headache and tight muscles from your hours spent hunched over your computer, make an appointment online and start feeling better again. As always, drop me a line or topic request on Facebook!

Yours in health,

Dr. Lell

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