Dr. Olexa Chewpa

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Dr. Olexa Chewpa Doctor of Chiropractic based in Ottawa Ontario

Cortisol, known by most as a stress hormone 😬, is a steroid hormone secreted by the adrenal glands (adrenal meaning: on ...
03/02/2025

Cortisol, known by most as a stress hormone 😬, is a steroid hormone secreted by the adrenal glands (adrenal meaning: on top of your kidney) that helps to regulate our stress response and metabolic activity by suppressing inflammation, controlling blood sugar levels, regulating blood pressure, and utilizing fats and carbohydrates appropriately for metabolism.

Exercise is a potent stimulus for cortisol secretion. We actually want to encourage cortisol release at the appropriate times of day so that it isn’t chronically being released later due to build up of daily stress with no release valve. Studies show that exercise in the morning (around 7:00AM) produce the greatest cortisol spike and lasted 55 minutes longer than exercise done at the end of the day (7:00PM).

Some important points to consider:
👉 Although preference is important, exercise done in the morning when cortisol is at its all time high will improve sleep quality, blood sugar control, blood pressure regulation, and certain aspects of metabolism.
👉 Cortisol levels are highest in the hour after waking and gradually decrease throughout the day
👉 Morning exercise can boost wakefulness and cortisol secretion early in the day and increase growth hormone and melatonin production at night
👉 Some individuals may still prefer to exercise in the evening because their body is more primed for high intensity exercise
👉 It is usually a good idea to avoid intense exercise in the 3-6 hour window before bed as it can elevate core body temperatures, suppress melatonin, and disrupt sleep.

Cortisol levels will rise and fall with exercise regardless of timing, but if we time it to align with our natural circadian rhythm, we can increase the spike of cortisol when it’s supposed to be there and lower it throughout the day as we draw nearer to bed time.🥱 💤

Spinal manipulation can have many beneficial outcomes such as improved mobility, blood flow, and muscle function. Muscle...
15/06/2024

Spinal manipulation can have many beneficial outcomes such as improved mobility, blood flow, and muscle function. Muscle function was shown to be significantly affected through changes in motor control and recruitment patterns. These changes were able to be measured by researches through the use of trans cranial magnetic stimulation input-output curves. In a study by Haavik H. et al., (2016), muscles were measured in the upper and lower limb, specifically the abductor pollicus brevis and tibialis anterior muscles. Spinal manipulation resulted in significant increases in motor evoked potentials in both groups of muscles. This means that spinal manipulation leads to changes in cortical excitability, potentially being capable of restoring the proper level of muscle tone to a recovering muscle group.
This suggests that adjustments or spinal manipulation can be a beneficial treatment option for individuals with muscle dysfunctions, weakness or those in need of sport specific rehabilitation.



Source:
Haavik H, Niazi IK, Jochumsen M, Sherwin D, Flavel S, Türker KS. Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles. Brain Sci. 2016 Dec 23;7(1):2. doi: 10.3390/brainsci7010002. PMID: 28025542; PMCID: PMC5297291.

Emerging research highlights the profound impact of eccentric exercise on neuromuscular control and muscle morphology. E...
26/05/2024

Emerging research highlights the profound impact of eccentric exercise on neuromuscular control and muscle morphology. Eccentric means that we are controlling the lengthening of a muscle as opposed to shortening it as in concentric movements. This type of exercise not only enhances muscle structure but also improves peripheral and central neural activity. This is partly due to how eccentric contractions utilize greater excitability in the motor cortex compared to concentric and isometric muscle contractions. Addressing neuromuscular deficits through eccentric exercise could be key to reducing injury rates, as strength alone may not suffice.

Here are the main benefits that eccentric exercise gives us that could benefit injury prevention and rehabilitation:

➡️ Improvement in the recruitment and/or firing rate of alpha motor neurons
➡️ Improved fiber typing
➡️ Increased muscle cross-sectional area
➡️ Increased working range of motion
➡️ Improved pennation angle



Lepley LK, Lepley AS, Onate JA, Grooms DR. Eccentric Exercise to Enhance Neuromuscular Control. Sports Health. 2017;9(4):333-340.

Sports injuries like ACL tears alter proprioceptive inputs to the brain and can cause dysfunction in visuospatial and se...
11/05/2024

Sports injuries like ACL tears alter proprioceptive inputs to the brain and can cause dysfunction in visuospatial and sensory awareness during complex movements.

Sports activities demand a heightened situational awareness encompassing a wide attentional scope to manage surroundings, sift through irrelevant stimuli, and execute intricate motor tasks. Heightened arousal or anxiety in athletes can diminish this focus, narrowing their attention and affecting muscle coordination, ultimately impairing performance. After an ACL tear, the central nervous system may compensate by relying more on alternative sensory inputs, such as visual feedback and spatial awareness. Individuals with deficiency show increased brain activity in regions related to visual processing, motor planning, and sensory processing, suggesting neuroplastic changes following injury. This altered neuromuscular control could lead to chronic adaptations, highlighting the importance of appropriate rehabilitation strategies. Interventions that modify visual feedback, such as blindfolds or virtual reality, may enhance proprioceptive inputs, potentially reducing the reliance on visual-spatial strategies. The high speeds and forces in athletics necessitate sophisticated pre-planned motor control for optimal performance and ACL protection, as reflexive or reactive strategies alone may be inadequate. Despite being a unilateral injury, an ACL tear affects both lower extremities, indicating a broad sensorimotor dysfunction. Rehabilitation post-ACL injury should incorporate sensory challenges to reduce visual dependency and promote neuroplasticity.

Sources:
Chaput M , Onate JA , Simon JE , et al. Visual cognition associated with knee proprioception, time to stability, and sensory integration neural activity after ACL reconstruction. J Orthop Res. 2022; 40: 95-104. https://doi.org/10.1002/jor.25014

Piskin, D., Benjaminse, A., Dimitrakis, P., & Gokeler, A. (2022). Neurocognitive and Neurophysiological Functions Related to ACL Injury: A Framework for Neurocognitive Approaches in Rehabilitation and Return-to-Sports Tests. Sports health, 14(4), 549–555. https://doi.org/10.1177/19417381211029265

Research has been exploring gut-brain communication and how exercises influences it. 🏃‍♂️ The gut is home to a diverse c...
09/05/2024

Research has been exploring gut-brain communication and how exercises influences it. 🏃‍♂️
The gut is home to a diverse community of bacteria that play a crucial role in our health, including endocrine and brain health via what is commonly referred to as the gut-brain axis.🦠🔁🧠 When the balance of these bacteria is off, it can lead to alteration of inflammatory pathways and enzymatic activity due to the bacteria’s central role in these processes. The gut microbiome also produces molecules that affect cognition. For example, it makes short-chain fatty acids (SCFAs) that nourish cells in the gut and brain, help with cholesterol, and regulate appetite. Probiotics and aerobic exercise have been found to help maintain a healthy balance of gut bacteria, especially within the Firmicutes phylum.

The communication between the gut and the brain is a bidirectional pathway that is mediated through the autonomic nervous system (ANS) efferent and afferent signals via the vagus nerve; neuroendocrine signaling through the hypothalamic–pituitary–adrenal axis (HPA axis), and serotonin (5-HT) regulation. Exercise has a potent effect on the autonomic nervous system and the activity of these pathways that ultimately modulate communication and function of the gut and the brain.

🧠💪

Dalton, A., Mermier, C., & Zuhl, M. (2019). Exercise influence on the microbiome-gut-brain axis. Gut microbes, 10(5), 555–568. https://doi.org/10.1080/19490976.2018.1562268

Manual therapy interventions, such as spinal manipulation (adjustments) and myofascial trigger point therapy, show promi...
25/04/2024

Manual therapy interventions, such as spinal manipulation (adjustments) and myofascial trigger point therapy, show promise in altering Heart Rate Variability (HRV)🫀and reducing sympathetic tone, with potential implications for pain management. HRV is a tool used to assess the balance between the sympathetic and parasympathetic nervous systems. Some studies suggest acute changes in HRV following manual therapy, indicating a temporary restoration of autonomic nervous system balance in individuals with neck and low back pain. Altering vagal tone have been proposed as the likely mechanism for such changes. These findings underscore manual therapy’s potential to modulate autonomic function and alleviate pain symptoms.

Exercise goes further than just helping to keep lean muscle mass. This review looked at 71 studies with over 5,600 parti...
23/04/2024

Exercise goes further than just helping to keep lean muscle mass. This review looked at 71 studies with over 5,600 participants in order to determine which type of exercise helps people with memory problems like mild cognitive impairment (MCI) or dementia. They found that all types of exercise helped, but lifting weights 🏋️‍♀️ (resistance) was the best for slowing down memory loss, especially in people with dementia. For those with mild memory problems 😶‍🌫️, doing different exercises together (multimodal)🤸🏻seemed to be the best for protecting memory and thinking skills. Most sports are great examples of multimodal exercise 🤼🧗‍♂️. The bottom line is that exercise is paramount for both brain and body health when done in the right dose and format.

It doesn’t require the perfect program or trainer to start doing this stuff, although they can certainly help to elevate the experience. Start with being able to lift your own body weight in a controlled way or even sub body weight using resistance bands.

🚴‍♂️

Source:
Huang, X., Zhao, X., Li, B., Cai, Y., Zhang, S., Wan, Q., & Yu, F. (2022). Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: A systematic review and network meta-analysis. Journal of sport and health science, 11(2), 212–223. https://doi.org/10.1016/j.jshs.2021.05.003

There is a set of small muscles located at the base of our skull that help to orient us and keep us aligned with the hor...
18/04/2024

There is a set of small muscles located at the base of our skull that help to orient us and keep us aligned with the horizon. They work alongside the vestibular system to feed information to the brain regarding the positioning of our head and eyes in relation to our trunk, gravity, and each other. They are referred to as the suboccipital muscles or deep neck muscles broadly. They act as postural stabilizers or shunt stabilizers of the head. Most of the surrounding muscles are much stronger than they are, but they have a unique feature that makes up for their lack of raw strength. They have higher densities of muscle spindles per gram than any other muscle in the neck. This means that their movements and stressors have an outsized amplification into the coordination and sensory centres of the brain.
The upper cervical spine also has the majority of the joint receptors found in the neck. The joint capsules of C1-C3 are responsible for around 50% of the necks proprioception. This works similar to the muscles in that the story they tell the brain about their movement is amplified, except now it’s the joint angle and load as apposed to muscle tension.
If there is an asymmetry in the inputs of sensory information entering the nervous system for any reason (including deep cervical muscle or joint capsule injury), things like dizziness, changes in posture, feelings of unsteadiness, nausea, and visual disturbances can result.
These are all structures that are well within our grasp to manipulate and force adaptation through changing the flow of sensory input coming from the joints themselves or through the muscles that aid in their movement.

Want to keep balance, posture, and coordination optimized? Book an assessment with me to see how we can improve performance, boost wellness or just move through life better!

Source:
Sung Y. H. (2022). Suboccipital Muscles, Forward Head Posture, and Cervicogenic Dizziness. Medicina (Kaunas, Lithuania), 58(12), 1791. https://doi.org/10.3390/medicina58121791

How many headaches originate from the neck? It turns out, quite a few. This kind of headache is said to be cervicogenic....
12/04/2024

How many headaches originate from the neck? It turns out, quite a few. This kind of headache is said to be cervicogenic.

How exactly does pain travel from the neck to the head to produce a headache? Some theories jump straight to the muscles as being the culprit. Citing the presence of trigger points (TrPs) in the muscles. Trigger points are essentially tight knots within a muscle that can be tender to the touch and send pain to other locations of the body (like the head). A more complete understanding is needed when asking the question: Why are the muscles acting up in the first place? Muscles will become dysfunctional from things like poor posture because certain muscles are being stretched all the time while others are shortened. This can be the cause (or be caused by) poor movement patterns and problems in joint mechanics. Pain can also be referred from the components of the joint itself. Whether it is the joint or the muscles or (more often than not) both, there is a barrage of pain generating signals (nociceptive fibres) coming into the Central Nervous System. The injured or dysfunctional muscles or spinal structures can increase the amount of pain referred to the base of the skull, the top of the head, the temporal area, and even all the way forward to the eyes and face. Some studies cite that close to 15-20% of all chronic headaches stem from the neck, which is a substantial piece of the pie considering the many causes of headaches.

Treatments that have been shown to be beneficial for headaches include adjustments (SMT), soft tissue therapy, therapeutic exercise, acupuncture as well as modalities like red light therapy. These avenues of treatment can be used in concert with one another to boost the efficacy of any individual modality.

Morningstar, Mark W et al, discuss how posture is regulated in the brain and the body. It’s an important place to invest...
25/02/2024

Morningstar, Mark W et al, discuss how posture is regulated in the brain and the body. It’s an important place to investigate considering its correlation with health and health span.

The static upright posture we’ve all been told to adhere too is regulated by the nervous system through a set of postural reflexes. A reflex, by definition is not under our conscious control, although it may be influenced by our state of mind.

What are these postural reflexes?
They can be grouped into the following categories:
1. Visual righting reflexes
2. Labyrinthine righting reflexes
3. Neck righting reflexes
4. Body on head righting reflexes
5. Body on body righting reflexes

Depending on the nature of the environment, one or more of the postural systems outlined above will work to maintain a desired position at any given time. The eyes (and oculomotor system), vestibular system, and joints of the body work together to create redundancy so that our positioning is always appropriate for what’s in front of us.

If a joint is restricted or injured, then the joint receptors will fail to send accurate information to the brain about the joint angle and positioning relative to the rest of the body. Since the brain is getting faulty information, its response back to the body will also be incorrect, predisposing us to bad posture.

Various types of treatment can positively influence the accuracy of these reflexes. The treatment will depend on which of the systems are involved. Some of these treatments include: chiropractic adjustments, joint mobilization, therapeutic exercises, vibration, eye exercises and vestibular maneuvers.

A literature review on the effects of Spinal Manipulation Therapy on various stages and causes of low back pain was unde...
19/02/2024

A literature review on the effects of Spinal Manipulation Therapy on various stages and causes of low back pain was undertaken to update best practices in 2008. The majority of studies the paper analyzed were moderate to high level RCTs and systematic reviews along with fewer case studies and cohort studies. These studies compared Spinal Manipulation Therapy to other modalities such as exercise, diathermy, electric stimulation. It also showed whether or not pairing these other modalities was beneficial.

Here are the main conclusions of the analysis:

1. There is just as much or more evidence for the effectiveness of Spinal Manipulation in improving function and reducing symptoms in chronic low back pain cases as there are in acute and subacute cases

2. Use of exercise in conjunction with manipulation is likely to speed and improve outcomes as well as minimize recurrence of symptoms

3. There still needs to be more high quality research on the efficacy of SMT for radicular symptoms, but there is growing evidence that this too can be managed effectively through Chiropractic Care. 

4. Certain cases with high severity of symptoms may benefit from co-management of symptoms with other pain mediating modalities.

In other words:

There is good evidence pointing towards the benefits of Spinal Manipulation (adjustments) for most chronic, acute and subacute musculoskeletal conditions of the low back. Pairing passive treatment with exercise is an important component of care that helps speed recovery and limits the recurrence of symptoms in the future. Spinal manipulation with exercise outperforms basically every other modality and this should come as no surprise. Joints need adequate movement and stability from surrounding muscles to both heal and remain healed moving forward. Chiropractors are highly trained in patient assessment in part due to the need to differentiate between musculoskeletal conditions and other more severe conditions that require a referral.

After checking how the spine moves I like to see how the extremities are affecting the movement of the spine and vice ve...
06/02/2024

After checking how the spine moves I like to see how the extremities are affecting the movement of the spine and vice versa. If there is dysfunction of axial joints (meaning the spine and pelvis), then there is often downstream dysfunction of the joints above and below. More often than not, dysfunction of the spine will need to be addressed before a secondary downstream area can be healed. It seems cliche to say that “everything is connected”, but it’s a cliche for a reason. More and more often my patients will straight up tell me that they think such and such joint is being affected by this other problem or restriction elsewhere in their body. They’re usually at least partially correct, solely from their intuition. Sometimes we need to zoom in to see pathology, but until we contemplate how different systems of the body are interacting with one another, we won’t have the entire picture. This is definitely easier said than done, but it’s an ideal worth pursuing in my humble opinion. Thanks for reading 🤘

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