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Link to our article published by the Town Crier on "Lighten the Load,"

Heavy backpacks cause back problems among teens; experts offer solutions.


Excerpts provided below by


December 15, 2004


Chiropractic for PMS

Automobile Accident injuries


Workers' Compensation

Current Updates:

Legal Update from the Law Office of Silvano Miracchi on Car Seats

What to do after a slip and fall accident 

Personal Injury Reminder

Liposuction and your health...   From "The Health and Nutrition Letter" of Tufts University



Chiropractic for PMS



No one is completely certain what causes premenstrual syndrome (PMS), but there is no denying the pain and distress millions of women suffer 7-10 days before menstruation every month. Different doctors have different recommendations for treating PMS, and there's one perspective you might be hearing more about soon -- Chiropractic.

A study involving 84 subjects (54 with diagnosed PMS and 30 without) evaluated the potential for chiropractic to help relieve PMS symptoms. Complete chiropractic examinations revealed that the PMS group was more likely to show signs of spinal problems (i.e., spinal tenderness, muscle weakness, neck disability,  etc.) than the non-PMS group. The study authors suggest that chiropractic care to correct these spinal problems may be an effective way to reduce some of the symptoms of PMS.

If you're still searching for relief from the pain and frustration of premenstrual syndrome, make an appointment with your local chiropractor. A complete spinal examination could be an important step toward finding a solution.

Walsh MJ, Polus BI. The frequency of positive common clinical findings in a sample of premenstrual syndrome sufferers. Journal of Manipulative and Physiological Therapeutics, May 1999: Vol. 22, No. 4, pp216-220. 



Automobile Accident injuries




When you are involved in a motor vehicle accident it is very important that you report any collision and/or injuries to your insurance carrier immediately.  Pain or other symptoms of an automobile accident injury are not always apparent at the time of the accident. Some injuries are hidden by other factors of the accident and can be missed by emergency room technician. Some of the signs and symptoms present themselves after the initial effects of the accident have worn off. It is important not to settle the claim with the insurance carrier until you have had a thorough examination by a trained specialist in diagnosing and treating soft tissue injuries. Should you need legal representation with regards to your automobile accident, Dr. Frozenfar has the experience necessary to assist your attorney in any way needed. 



Workers' Compensation



If you have been injured on the job, your right to file a Workers' Compensation claim is protected under California Law. Your first step is to report the injury to your supervisor immediately. Even if you do not feel injured at the time, pain or irritation may develop later that will require proper care. Your supervisor in turn must report it to the Workers' Compensation insurance carrier. You are then responsible to deal directly with the carrier's adjuster ( the one who handles your case) for pre-approval of any care, until you are released from care. Initially you will be sent to a general physician. If the physician that you see does not refer you out to see  a Chiropractor, then you must speak with your adjuster and make it known that you want to see a Chiropractor. Remember that it is your right to request to see a Chiropractor.

Studies have shown that in many cases, Chiropractic Manipulation can get injured workers back on the job faster than other types of care. Workers' Compensation insurance carriers acknowledge and pay for Chiropractic services. As with all care under Workers' Compensation there is no out-of pocket expense for you.

California's Workers' Compensation regulations allow 24 Chiropractic visits. The sooner that you are evaluated by a Chiropractor trained in diagnosing work related injuries, the sooner you can start your treatment and be on the road to improvement or complete recovery of  your injury.



Current Updates:



Legal Update from the Law Office of Silvano Miracchi on Car Seats


A new study released by the government found that nearly 73% of child car seats are used wrong, needlessly to say, are risking the lives of children.

The study looked at how car seats that children weighing 80 pounds or less, where being placed in cars.

  • over 10% of children were not restrained at all. The rest were restrained in a child car seat, booster seat or seat belt.

  • 72.6% of child car seats were misused. The common serious problems were loose straps around the child and loose straps attaching the safety seat to the car's seat. Other problems included damaged car seats and using seats previously owned by others. 

According to the government, infants should ride in a rear-facing child safety seat until they're at least one years old and weighing at least 20 pounds. Toddlers between 20 and 40 pounds should ride in a forward-facing child safety seat until he or she is a least 8 years old, unless taller than 4'9".

This new study is a reminder to parents and other who drive young children, make sure your child car seat or other restraint system is used right.



What to do after a slip and fall accident 


Do you know what to do if you are in a slip and fall accident? Taking the right steps will help you receive the maximum compensation for your injuries and losses. 

Key steps to take after a slip and fall accident:

  • report the accident right away to the owner or manager where it occurred.

  • get the names, addresses and phone numbers of all witnesses.

  • write down what happened.

  • save any physical evidence.

  • take photos of the accident scene if possible. Also take photos of any visible injuries, like cuts and bruises.

  • do not sign anything or make a statement before consulting your lawyer. When a slip and fall accident occurs in a store, theater, restaurant or other business, employees often try to get a damage statement from the victim to use against him/her later. The law does not require you to give a statement. 

How strong your case is usually depends on what the property owner knew and did. For example, suppose you slip on a wet floor in a market. If the floor was wet for a while and employees knew but did nothing, you likely have a good case. But if the floor became wet right before the accident, your chances of getting compensated are lower. 

Slip and fall accidents can cause serious injuries resulting in large medical bills and lost of wages. If you are in a slip and fall accident, your lawyer can evaluate the facts and tell you if your claim is strong as well as how much compensation you may recover.


Personal Injury Reminder


Many accident victims do not make a claim because they think they were partly at fault and therefore won't be able to recover any money. It's important to remember that in almost every state, you can still recover money even if you were partly at fault for the accident. Your award will just be reduced by the amount of your fault.


Liposuction and your health...   From "The Health and Nutrition Letter" of Tufts University


Liposuction may improve appearance, but not your health. When body fat is lost through traditional means, diet and exercise, numerous health benefits result. You reduce the risk for heart disease, stroke, and diabetes. When your body fat is lost through liposuction, the surgical removal of fat tissues, the same benefits do not appear to be conferred. 

That's the finding of scientists at the Washington University School of Medicine, who studied the effects of liposuction surgery on 15 obese women. They checked blood markers for health both before and after the surgery, during which about 20 pounds of abdominal fat were removed from each women. 

Twelve weeks after the surgery, no improvements were seen in cholesterol levels or blood pressure. Blood markers called cytokines and C-reactive protein (related to heart disease risk) and insulin sensitivity (related to diabetes risk) were not positively affected, either. 

The reason, believes lead researcher Samuel Klein, M.D., is that liposuction removes fat only from one area. Unlike weight loss through eating less food and getting more exercise, it does not decrease the size of the fat cells that remain throughout the body, nor does it remove fat from muscle and liver tissue. That's important because large fat cells and fat in tissue such as those in  the muscles and liver may release harmful substances that contribute to, high blood pressure, high blood cholesterol and so on. If there are no changes in those cells, there's relatively little chance for those health risks to improve. 

That's not to say that surgical procedures such as liposuction don't have their place. For those who are extremely over weight and may have difficulty starting an exercise program, Dr. Klein comments that ''removing fat by liposuction can improve the ability to walk and be more active. It can also make obese people fell better about themselves, which may be motivational for diet and lifestyle changes."



Lightening the Load


Reprint supplied by Los Altos Town Crier

December 15, 2004


Lightening the Load

Heavy backpacks cause back problems among teens; experts offer solutions

By Bruce Barton, Town Crier Staff Writer

Chiropractor Rachel Frozenfar adjusts 16-year-old Shachar Ben-David's back. Ben-David suffers from back and neck pain as a result of bad posture and carrying an overloaded backpack.

Los Altos chiropractor Dr. Rachel Frozenfar is well aware of the problems caused by heavy backpacks. She said approximately 85 percent of her adolescent patients have back problems directly related to carrying them.

Despite increasing awareness of the problem and introduction of legislation, Frozenfar doesn't see the problem lessening. "I see it getting worse," she said, noting the load was much lighter when she was a student. "We had lockers, and we didn't have to carry so many books," Frozenfar said. "Kids are so inundated with homework and projects, they need their reference books."

The problem is especially acute among middle- and high-school students, she said. "Teens tend to slouch - when they have heavy backpacks, their postures get worse - especially if they wear them very low on their backs."

Frozenfar recommends carrying no more than 10 percent to 12 percent of one's body weight - 12 pounds of textbooks for a 100-pound student. But she observed that many students are carrying twice that load.

As a result, students are putting undue pressure on their shoulders and upper and lower backs, risking injury and scoliosis, or curvature of the spine, at a time when their fragile bodies are still developing. The weight has students slumped forward to avoid falling backward.

Frozenfar is a participating doctor in the Backpack Safety America program, which involves more than 1,000 professionals and educators helping school-age children use their backpacks safely and properly.

"Students, parents and educators should understand the risks in the use of backpacks," Frozenfar said. "We're committed to the health and safety of these children, so we help raise awareness through our work with schools."

She pointed to a U.S. Consumer Product Safety Commission study that showed a 330 percent rise in emergency room visits since 1996 due to backpacks. Back strain was the most common injury, but students also were injured by tripping over and getting hit by backpacks.

In an attempt to respond to the problem, the state Legislature in 2002 passed AB 2532, requiring the state Board of Education to adopt maximum weight standards for elementary and secondary school textbooks by July of this year. This past May, the board established those maximum weights as 3 pounds per textbook for grades K-4, 4 pounds for grades 5-8 and 5 pounds for grades 9-12.

Frozenfar said she recently met with Patricia Boettcher, assistant superintendent in the Los Altos School District, about the possibility of putting some, if not all, textbook material on CD-ROM so that students would not have to carry the material around with them.

"We are aware of the concerns and have tried to make accommodations when appropriate," Boettcher said. "Many students choose to use the backpacks on rollers, which makes it easier to transport the books from home to school."

Frozenfar agrees that rolling backpacks offer a good alternative, but the trick is getting more children to use them. She said some see them as "not hip."

"The ideal solution is one book at home and another at school, but that is too expensive to do in every subject," said Marge Gratiot, Los Altos School District superintendent. "At some schools the local PTAs have helped with purchasing classroom sets. We do also provide parents with information about how to purchase an additional book themselves or a CD-ROM should they choose to do so."

"Recently, publishers have made CD-ROMs or interactive versions of the text available," Boettcher said. "In some instances, we have shared this information with parents to pursue if they choose. We've also explored the possibility of having some books placed on the school server for access in the library or computer lab. Additionally, I think teachers often try to assign worksheets, workbooks or projects for homework rather than assignments from the hardbound texts."

"I think one solution is for the textbook companies to publish lighter versions of their books," Gratiot said, such as paperbacks. "Some teachers in self-contained classrooms might vary their homework assignments so every book doesn't have to go home every evening, but that certainly shouldn't be their priority if it is detrimental to their instructional program."

Meanwhile, Frozenfar suggests students wear ergonomically sensitive backpacks. She supports a brand called AirPacks, whose products, according to the Massachusetts-based company, use a combination of air-filled straps and a lumbar cushion to redistribute weight to the stronger, load-bearing muscles in the hips and lower back - where medical experts say weight should be carried.

"By shifting weight to the lower extremities, the AirPacks System creates a fulcrum that promotes an upright standing position," the company says. "Encouraging the body to stand posturally correct, the AirPacks System actually improves the overall biomechanics of the spine, reducing the stress on the body by 80 percent and lightening the effective load by 50 percent. So the wearer actually feels better."

For more information, logon to, contact Backpack Safety America at (800) 672-4277 or For more information about AirPacks, logon to



According to Journal of the American Chiropractic Association(JACA)-WHIPLASH DEBILITATING, YET OFTEN IGNORED.
Experts offer advice on prevention and treatment of whiplash.
Whiplash affects more than 3 million people each year, yet research into this condition is severely under funded and little is done to prevent it-according to the February 2000 issue of the JACA. Although the United States spends as much as $23 billion each year to treat whiplash, many lawyers, legislators and medical doctors deny it's existence, says Dr. Arthur Croft. a chiropractor and whiplash researcher.
This is beginning to change as whiplash enters a new phase of research and understanding, Dr. Croft and other whiplash researchers point out in the February JACA.
"We have always known that chiropractors are effective with whiplash, but there were lots of theories as to why," explains Dr. Dan Murphy, a chiropractor who teaches on the subject of whiplash throughout the world. "Now, it appears that by the very nature of what we do, chiropractors are most effectively treating the tissues injured during the accident."
Two studies- one in the Journal INJURY and another in the JOURNAL OF ORTHOPEDIC MEDICINE. The studies specifically look at people who failed under medical management and were referred to chiropractors for treatment of chronic whiplash pain. "In both studies," Dr. Murphy says."the results were phenomenal, and one of the conclusions is that chiropractic is the only proven effective treatment for chronic whiplash.
In addition, research soon to be published in the JOURNAL OF MUSCULOSKELETAL PAIN shows that there are risk factors for acute whiplash injury and that chronic whiplash pain can occur even after the most minor accidents. "We are finding that risk factors for acute injury, such as having the head rotated, being out of position in the vehicle, lack of preparation for the crash, and being struck from the rear, are present not only for initial injury, but also chronic injury," explains Dr. Michael Freeman, a chiropractor and PHD clinical assistant professor of epidemiology at Oregon Health Sciences University School of Medicine."If you are injured, whether the vehicle sustains no damage or is totaled, there is a one-in-three chance you will have chronic pain. It doesn't matter how much,or, how little damage there is to the vehicle."
Technological improvements are also being perfected in an effort to prevent whiplash. Dr Croft reports in the JACA article that seat and head restraint improvement have already been made in a few models of Saab and Volvo. Sophisticated forward and rear looking systems are also being developed to gauge the distance between cars. A computer chip on board will contain a preprogrammed set of instructions to allow calculation of impending crash conditions. One of those will gauge speed and if you are gaining on the car in front of you at what the computer is programmed to consider a dangerous rate, it will sound an alarm.
These new developments are extremely important considering the largest single contributor to chronic neck pain and overall spine pain is motor vehicle crashes, the JACA article states. Of the 6 million injuries per year due to motor vehicle crashes, about three million are whiplash-type injuries. Of those, 500,000 to 900,000 will develop chronic pain.
So, how many crashes can actually be avoided? Perhaps only ten percent, according to Dr. Croft. "But what we've found in our whiplash studies is that the people that have the worst outcomes are the ones who were caught absolutely unaware."
In the JACA article, Dr. Croft shares seven ways to minimize pain and suffering before, during and after a whiplash accident.
Before you buy your next car, compare vehicle structural design, vehicle size and weight, and restraint systems, belts, airbags, head restraints and crash avoidance features. Consider mass and crashworthiness. "Smaller cars put you at greater risk," adds Dr. Croft. Also, check Insurance Institute for Highway Safety ratings for safest seats, head restraints, etc.
Eighty percent of cars have the head restraint adjusted in the low position, yet research showed that having no head restraint is safer than having one in the low position. In addition, because head restraints are designed to fit the average man, it can be difficult for taller or shorter people to get a good fit. Some add on head restraints are available, but check first for safety approval and ease of installation.
Crashes happen at lightning fast speeds, but if you have time to prepare:
* Put your head and neck all the way back so that your in contact with the seat back and the properly adjusted head.
* Straight arm the steering wheel and get a good grip.
* Put you foot on the brake as hard as you can ( assuming that you are stopped, of course.)
* Look straight ahead, not in the rear view mirror. Don't have your head turned at all.
* Put your neck back slightly so your eyes are looking level up at about the top of the windshield.
* Scrunch your shoulders up towards your ears and then brace.
Do what the doctor orders. Exercises, ice, nutrition, soft collars for the first few days, adjusted work stations, deep tissue work in the early stages.
 The treatments and the ancillary products we recommend are fairly inexpensive and none of them is dangerous or painful. It's worthwhile to prevent these injuries from becoming chronic."
Positions to avoid, how to sleep, conditions at work, these are everyday factors that can hasten healing. For example, patients have problems when their heads are turned for long periods of time, such as when talking to someone to one side, looking out an airplane window, or working at the computer with the copy on the  side.