Dr. Jessica Lee – Hong Kong Chiropractor

Information and Thoughts about Chiropractic, Health, and the Human Body.

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Can Ankle Sprains Lead to Back Pain??


As a chiropractor, ankle sprains are one of the most common complaints that my patients have. Often these are due to sports injuries, but I have seen many that were due to walking on uneven surfaces or just missing a curb. Immediately after the sprain, there is usually swelling and pain that can affect your daily activities. After 4-6 weeks, the soft tissues will have mostly healed, but I have seen many cases that have lasted for months or even years where the original ankle sprain has led to problems in the pelvis or lower back due to compensation. Most people don’t realize that even minor ankle sprains can lead to long-term consequences.

First of all, the ligaments that are damaged during the sprain lose their elasticity and functionality due to build up of scar tissue. This is why after jogging or long walks especially on uneven ground you may notice increased ankle pain or stiffness. The ankle ligaments also become overstretched from the sprain when the ankle is suddenly turned past its normal range of motion. Once these ligaments are overstretched they will not return to their original shape and this results in decreased stability in the joint. Both of these problems lead to increased chances that you will sprain your ankle again. These issues also change the way the ankle moves and may lead to problems in the parts of the body above this joint including the knees and the spine.


The sprained ligaments also lose the ability to effectively communicate with the brain leading to decreased coordination of the ankle. This leads to poor balance, and again, you are more likely to twist your ankle repeatedly. This makes walking on uneven surfaces or playing sports more dangerous because our brain is having trouble telling our body how to make small adjustments to avoid injury. Decreased coordination also changes the way you walk leading to torsion or strain in the lower back.

If an ankle sprain is not properly treated it may lead to chronic stiffness. This means that the ankle may have trouble moving in certain directions such as the toes moving upwards and turning the foot outwards. This loss of ankle motion will cause changes in how the body moves during walking. Since the heel is not contacting the ground properly, the muscles of the pelvis and leg regions will not work efficiently and lose strength, leading to an alteration of normal gait that in turn can lead to problems such as lower back pain.


Even minor ankle sprains can have a big effect on your body. With proper treatment, improvements can be made quickly even with chronic cases. If you have an old ankle sprain then you may need chiropractic therapy to help you achieve full range of motion and complete your rehabilitation. An examination of the structures that have been affected since that time may be necessary including the hips and lower back. Some chiropractors will perform special techniques on the ankle to help promote healing and increase the ankle’s range of motion. Chiropractic treatment can help to prevent chronic and recurrent problems. If you have ankle, knee, hip, or back pain, your chiropractor will perform a careful case history and examination to determine the actual cause of the problem and remedy it accordingly.


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Is the Weather Giving You Pain?


Ever since I broke my finger in the 8th grade, I have had the ability to sense when it is going to rain or become quite cold.  However, as I got older, I realized that large amounts of people have this ability and that it is not unique.  It is very common for people to blame weather for increased pain in their joints.  We all know someone who say things like “my knees are hurting more than usual today, it must mean that tomorrow is going to rain”.  It is a phenomenon that is most often associated with cities that experience extremely cold weather, but it happens to many people in Hong Kong too possibly due to the humidity and precipitation.  Even in a city like San Diego where the temperature is always mild and never gets too hot or too cold, people report a great sensitivity to weather changes.


So what is it that brings on increased joint pain with weather changes?  Currently, there is no full agreement among scientists that weather causes pain, and the exact mechanism is not known, but there are several plausible theories.  Although people blame the cold, wind, rain or snow, research suggests that barometric pressure is what affects people the most.


Barometric pressure is the weight of the atmosphere that surrounds us.  Imagine the tissues surrounding the joints to be like a balloon.  Barometric pressure normally pushes against the body from the outside and keeps the tissues from ballooning out or expanding.  Usually before bad weather starts, the barometric pressure of the environment decreases.  Because there is less air pressure pushing against the body, this allows the tissues surrounding the joints to expand and this leads to more pressure on the joints.  If the joints have arthritis already, this increased pressure may lead to more pain.  When people have chronic pain, often the nerves are already more sensitive due to injury, inflammation, adhesions, and scarring.  In these people, even very minor changes in barometric pressure can lead to pain. 


Cold weather can affect joint fluid thickness so that there is less lubrication in the joints that leads to more pain.  When the temperature is cold outside, the tissues of the body contract and this pulls on the nerve endings that can lead to increased sensitivity or pain.  So when the barometric pressure drops when it is cold, again there will be less air pressure pushing against the tissues and this inflamed tissue will expand leading to more pain.


There are many methods to alleviate weather related joint pain.  One of the most effective strategies is to keep active.  Exercise helps to lubricate the joints to prevent pain.  Try some low impact aerobic moves that are easy on the joints such as walking, Yoga, or Tai Chi, which enhances the range of motion.  Stretch in the mornings and evenings to stay flexible and decrease tension.  Swimming in a heated pool can help alleviate back and joint pain.  You can also try applying a heating pad onto your painful joints to let the muscles relax and sooth the joint pain. 


As a chiropractor, I have seen first hand how this regular therapy can help these patients.  Many of my patients complain of increased joint pain with poor weather.  After undergoing a treatment plan where the movement of their joints improves significantly, their weather related pain dissipates.  Now these patients no longer have joint pain with damp or cold weather.   


Is Crossing the Legs Good or Bad for Your Spine?


“Sit properly! Cross your legs! Be more ladylike!” Many of us ladies were scolded by our mothers growing up to sit with our legs crossed at the knee.  Nowadays, most men and women usually cross their legs due to comfort and habit rather than for manners.  Often when we cross our legs now, one of our friends will exclaim “don’t cross your legs, that’s bad for you!”  Ever wonder why?  Well, this position can lead to an unbalanced pelvis or even contribute to pelvis, lower back, and hip discomfort.

The pelvis needs to be balanced for the spine to be balanced.  The pelvis consists of 3 bones: the two hip bones and the triangular sacrum in between.  If the hips are level and the hips and sacrum are aligned, the legs will be able to sit evenly into their sockets and the spine can be straight.

How can crossing the legs lead to pelvic imbalance?

The bones of the body are held together by tendons and muscles, which run from one bone to the next.   These keep the bones in the right place so that every joint can move properly.  Each muscle has a specific length and when they are all in their ideal range of length, everything is held in perfect alignment.   However, if you habitually adopt a slightly different position, slowly over a long time the muscles adapt and become permanently longer or shorter leading to the chance that your joints will move out of place.

Constantly crossing your legs eventually makes the outer thigh muscle longer and the inner thigh muscle shorter.  When the posterior hip muscles shorten, it can lead to tightness and discomfort in the lower back and hips.  Over time, this additional pressure on the hip muscles and the sciatic nerve can throw off your sacroiliac joint and pelvis leading to sciatica and back pain.

Sometimes your pelvis may be already out of alignment for other reasons such as accidents, falls, poor posture, etc.  In this case, the body may try to alleviate the discomfort by crossing the legs.  Crossing one of the legs will lessen the discomfort by taking the pelvis out of a neutral position to adapt to the imbalanced pelvis; however, this will just create more problems over time if the original issue is not corrected.

When is there a problem with crossing legs?

 Crossing the legs is acceptable if you cross both sides approximately for the same amount of time and switch regularly as this is just a position switch that can relieve your body when sitting for long periods of time

It becomes a concern if:

  1. You notice that you feel more comfortable with one leg crossed over the other
  2. You always cross only one side over the other
  3. You find that crossing one way has more hip range than the other side.
  4. You notice that when you walk it seems like you have two different length legs
  5. You get regular low back or pelvis pain
  6. Feel like one leg is becoming weaker or heavy
  7. If your lower back, hips, or pelvis feel uncomfortable when you sit properly


If you experience these problems you need to seek a qualified professional to assess your pelvis and spine, and to check the nerves.  Chiropractors are highly experienced in balancing the spine and nervous system.

How should you sit?

Find a supportive chair with good low back support that allows you to sit with feet flat on the floor, knees and hips close to 90 degrees.  Your weight should be placed evenly across both bones of the bum and make sure there is a natural arch in the lumbar spine.  The most important point is to remember to take breaks often from sitting at least one time every hour and get moving!

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Help! My Child’s Feet are Flat!

Recently, a mother brought her 3-year-old child to my office very concerned that he has flat feet.  Another practitioner told her that he requires orthotics immediately.  This is a common concern of many parents out there so let’s get our facts straight.


It is normal for babies and infants to have the appearance of flat feet due to a fat pad that is in the arch region and also because the arch hasn’t fully developed yet.  The longitudinal arch of the foot begins to develop around the age of 2.  Children’s bones and joints are quite flexible so at a young age, their feet tend to flatten when they stand.  It takes time for the muscles, tendons, ligaments, and bones to grow strong to form an arch.  Having the child go barefoot more often on varying terrain can help with arch development.  By the age of six or seven, the feet become less flexible and the arches become fully developed.    

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Are Backpacks Harming Your Child?


When was the last time you weighed your child’s backpack? If the backpack is 15% or more of your child’s body weight, they have an increased chance of experiencing neck and back pain due to backpack induced poor posture.  If your child feels a need to lean forward while carrying the backpack, it is a sign that the bag is too heavy.  Many Hong Kong parents are very concerned about how heavy backpacks are affecting their child’s health; here are some tips!

Backpack Shopping Tips:

  1. Is the bag made of lightweight material?
  2. Does the bag have a padded back?
  3. Are there individualized compartments to separate items?
  4. Are there two padded, wide, adjustable shoulder straps?
  5. Is there a waist belt to redistribute the weight of the backpack?
  6. If your child often needs to carry a heavy backpack, have you considered a rolling backpack?

(All of these answers should be “yes”)

Backpack Habits:

  1. Is your child using both shoulder straps?
  2. Is your child’s posture straight with the backpack or are they leaning forward while walking?
  3. Are the heaviest objects packed in first so they are lower and closer to the body?
  4. Is your child only carrying what is needed and leaving unnecessary items at home or at school?
  5. Does your child clean out their backpack at least once a week?
  6. Is the backpack within 10-15% of your child’s body weight?
  7. Does your child lift the backpack using their leg muscles rather than their back?
  8. Are the straps adjusted so that the backpack fits snugly to your child’s body?
  9. Is the bottom of the backpack approximately 2 inches above the waist, and the top of the backpack just below the base of the skull?

(All of these answers should be “yes”)


Tips for Parents:

  • Observe if your child has difficulty putting on and taking off their backpack.
  • If the backpack is too heavy for your child, remove some items from the bag and have your child hug them in front of their body
  • Communicate with your child regularly regarding any neck pain, back pain, or numbness and tingling in their arms and legs
  • If your child or teenager reports neck or back pain, take them to a chiropractor immediately
  • Choose the smallest and lightest backpack that will suit your child’s needs
  • If your child experiences discomfort carrying their backpack, reduce the weight right away

Chiropractors are health professionals that can provide further advice regarding proper postures in young people to improve their spinal health and avoid future injury.  If your child has pain from backpack use, or you notice them developing a hunchback or forward head posture, it is time to consult your family chiropractor.  The sooner these issues are dealt with, the less problems they will lead to in the future.  Kids need a healthy spine for a healthy life!

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Is your neck too straight?

forward head postureLook into a mirror when you are standing sideways and draw an imaginary line from your ear hole to the shoulder.  If your head is forward of the line then you have forward head posture.  Forward head posture means a loss of the curve of the neck, which is needed to function properly.  The vertebral column has 4 spinal curvatures that are important for balance, flexibility, shock absorption, and force distribution.  If these spinal curvatures deviate too much from normal limits, it can lead to issues such as pain, muscle tightness, and can even affect your spinal nerves.

It is not unusual that so many people suffer from forward head posture.  With the advances in technology, there is frequent usimage-400x275e of devices such as computers and smart phones that have made us very vulnerable to postural problems.  Our bodies were not designed to spend hours hunched in front of a computer, looking down at a phone to text, playing portable video games, or watching shows on tablet devices.  Consider how many years you have been doing this.  The youth of today have been doing this for basically their entire lives and now many more are suffering from postural health issues.  Due to this technological lifestyle, postural problems have become an epidemic.

When the head sits properly on top of the spine the weight of the head is evenly balanced.  When your head is forward of your body’s centre of gravity, this causes the structures of your neck to undergo unnecessary strain.  For every inch of forward head posture, the weight of your head increases by an additional 10 pounds.  If this faulty position perpetuates, the bones in your neck will move out of alignment and will not function as they should.  Furthermore, retaining a particular position for even 3 hours can result in scar tissue being laid down in and around the joints, which will ultimately reduce the neck’s range of motion and nerve function.  A mound of soft tissue at the base of the neck may develop due to the compressive loads upon the upper thoracic vertebrae known as a “Dowager’s Hump”.  The added pressure on the spinal cord, nerves, and discs can cause neurological issues such as headaches, disc herniation, and pinched nerves leading to numbness or tingling in your hands or feet as well as fatigue and a weakened immune system.  Over time, poor neck posture can also lead to long-term complications such as osteoarthritis.  In fact, forward head posture may actually promote accelerated aging of the spinal joints resulting in early degeneration.  There are even more far reaching effects of anterior head carriage.  Posture also affects bodily functions from breathing to hormonal production such as mood, blood pressure, pulse, and lung capacity.

Correcting anterior head carriage cannot be accomplished overnight.  It takes time for the body to revert to a correct position.  The first step is to see a chiropractor to obtain a diagnosis and receive treatment to relieve your neck from joint and muscular problems.  Once the neck structures are functioning well, corrective exercises will be prescribed to restore and maintain proper posture.  Also, many lifestyle changes need to be made, for example, the set up of your office workstation and the amount of time spent using devices.  It is also important to maintain an active lifestyle to prevent early degeneration and posture associated injury.  Forward head posture has serious impacts on your health. It will only become worse with time if not corrected.

Suggested Exercises for Improving Posture

lateral flexionLateral Neck BendsMove your ear towards your shoulder on the same side.  Use your hand to pull your head farther until you feel a stretch.  Hold for 20 seconds and repeat on the other side.  Perform 10 times each side.


shoulder rollsShoulder RollsRoll your shoulders backwards in a circle.  Perform for 2 minutes.


chin tucksChin TucksMove your head straight backwards to make a double chin.  Hold this position for 10 seconds.  Perform 20 times.

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How Can “W-Sitting” in Kids Be Bad?

Many times when I spend time with my nephew, we play with toys on the floor. Sometimes he will adopt the “W-sitting” posture and I will then gasp with horror and suggest he sit another way.  My family may think that I’m just crazy, but here’s the rationale…

What is W-sitting?

W-sitting is when a child sits with their bottom on the floor, knees bent, legs rotated outwards, and one leg to either side of their pelvis.  So basically their sitting position forms the letter “W”.

Why do kids sit this way?

The W-sitting position feels more stable than other sitting positions as it widens the child’s base of support. This way, the core musculature does not need to work as hard to keep the child in an upright position. Children who preferably sit this way usually have lower muscle tone, hypermobile joints, and difficulty with balance. These kids may have more hip ligament laxity that allows them to have a greater than normal range of motion but less joint stability.

Why is this such a bad posture?

If the child is using W-sitting briefly to transition from one position to another or transitions in and out of this position then it is not usually a problem. However, if your child uses the W-sitting position all the time for prolonged periods, this can lead to a significant amount of pressure being placed on their hips, knees, and ankles.  Over time, this amount of pressure on the joints can lead to problems such as sway back postures, walking and standing with the feet turned inwards, weak trunk and lower back musculature, tight hamstring and lower back muscles, and possibly in some cases when there is a predisposition it may lead to hip dislocation.

There is another developmental issue at hand with W-sitting as children who prefer to use this position regularly will not need to shift their weight and rotate their trunk while playing. Weight shifting and trunk rotation are important in the development of balance, crossing the midline with the hands, and using both hands together.  All of these skills are necessary for the development of fine motor skills.

How can you reduce W-sitting with your child?

Suggest to your child to sit cross-legged or with the legs to one side rather than W-sit. (However, make sure if your child prefers to sit with the legs to one side that it is not always to the same side). If this is difficult, have the child sit at a small table with an appropriately sized chair when performing their activities. Another suggestion is to have the child sit on the floor with their legs straight in front with a tray on their lap as a work surface. An exercise program from a chiropractor to develop core strength and increase muscle tone may be helpful as well.

How can a chiropractor help?

A chiropractor can help by assessing the child’s back, hips, knees, ankles, and feet to make sure that all the joints and muscles are functioning properly.  An exercise program to strengthen the weak muscles and stretch the tight muscles may also be prescribed to correct imbalances. If you are concerned about your child’s spine and joint health it may be beneficial to check with a chiropractor.

Feel free to call us at (852) 3698 0298 for any concerns.