July 2019 Newsletter


Happy Summer! I hope that you are all enjoying the sunshine and are getting a chance to spend quality time with family and friends. I love the relaxed feeling of summer and hearing about all of your travels and adventures. Looking forward to seeing you in the office soon for a summer tune up!

Love, Dr. Tablak

What is Adrenal Fatigue?

Juliet Tablak, D.C.

We have an epidemic of stress in our society. Life seems to be getting busier and people are working longer hours and sometimes more than one job to meet the rising cost of living in the Bay Area. We all have cell phones and computers and are easily available during non-working hours. Often times we feel we need to answer work emails/texts even on weekends leaving very little time to rest. On top of work demands there are family and social demands, taking kids to school, sports, dance, camp, etc, making sure we spend quality time with our partner and friends and then somehow finding enough time for self care in all of that!

As our stress levels increase we activate our sympathetic nervous system also known as the “fight or flight” phase. This part of our nervous system is useful if we are in eminent danger. It helps us think clearer, move faster, and slows down digestion so we don't have to stop to eat or go to the bathroom. Living in this alarm state has become a new normal for a lot of people. When we spend chronic amounts of time in our sympathetic nervous system we tire out our adrenal glands or suprarenal glands. These glands sit just above our kidneys and are responsible for producing stress hormones such as adrenaline and cortisol. In small amounts at the right time these hormones are important but having a large amount of these hormones circulating on a regular basis can cause our adrenal glands to become tired and create dysfunction of the adrenal glands and our endocrine system.

Signs of adrenal fatigue include feeling excessively tired, trouble falling asleep or waking up in the morning, salt and sugar cravings, weight gain, and needing stimulants like caffeine to get through the day. Having one or more of these symptoms does not necessarily mean you have adrenal fatigue although it can be a sign that your adrenal glands are tired and need some support.

We do some specific tests in our office to check for adrenal fatigue, we use an at home saliva test and a postural blood pressure test called Ragland’s test. Cortisol should be higher in the morning when you wake up and taper down throughout the day. The saliva test looks at cortisol levels four times throughout the day to get an idea of your cortisol patterns. Ragland’s test is a blood pressure test where we take your blood pressure lying down and then standing up. The difference between the numbers lying down and standing determine the amount of adrenal fatigue you may have and if it is present at all.

We use herbs and whole food supplements to help regulate and support adrenal function. Herbal supplements such as Ashwaganda, Rehmannia and licorice root have been found to help balance the function of the endocrine system and in particular the adrenal glands. Using one or a combination of these herbs along with supplements that contain whole foods specifically designed to support the adrenal glands can help improve symptoms of adrenal fatigue. Looking at diet and lifestyle modifications is also important. If you are experiencing any of these symptoms on a regular basis or have any questions about adrenal fatigue please let us know!

Ligament Sprains, Muscle Strains, and Overuse Injuries….. Oh My!

Juliet Tablak, D.C.

So you have an injury… what do you do? Do you Ice, rest, compress, wear a brace, get back to activities??

How do you know what the right course of action is after an injury? Here are some common injuries and some tips for how to manage them if they happen. A strain usually effects a muscle and is a tiny tear, over stretch or multiple micro tears in your muscle , a sprain is a ligament injury and is a tear or an overstretch injury to your ligament, an overuse injury can effect the muscle, tendon or ligament and is typically caused by repetitive use.

If you have a muscle sprain right after it happens you may want to ice it and rest it for the day. You may continue to ice for the next few days to one week. The day after a muscle strain happens you want to begin to move gently, this is also a good time to come in for an adjustment. It may feel counter intuitive to move because it hurts, but if you immobilize the muscle for too long it will become stiff and may atrophy making rehabilitation more difficult and a longer process. Say you strain the muscles of your low back, doing some belly breathing and a cat/cow like exercise the next day will help with circulation, help to decrease inflammation and keep your spine and the surrounding structures mobile.

If you have a ligament sprain immediately following the onset of the sprain you may notice swelling and possible bruising along with pain. Ice, rest ,compression, and elevation are a good place to start and getting any imaging you may need to rule out a fracture. You may be given a hard brace to wear, I recommend taking the brace off during the day when you are not weight bearing and beginning to move the affected body part gently, this is also a good time to get adjusted. The sooner you can put correct motion into a joint the quicker it will heal. The adjustment will help decrease swelling, increase circulation to the area and break up any muscle adhesions that may be forming. Wearing a hard brace for too long will cause decreased range of motion, muscle atrophy and decreased proprioception ( a fancy word for our brains perception of where our body or a certain body part is in space). When proprioception is decreased there is a higher risk of repeating the same injury. When rehabilitating a sprain you want to load the body part to tolerance slowly over time. Meaning if you have a sprained ankle you want to start to do light weight bearing to no more than a level three on the pain scale which is moderate discomfort. As we load the ligaments appropriately they become stronger and therefore quicker to heal. Challenging proprioception is important too, ie working on balance in the case of a sprained ankle, creating some instability so the brain has the opportunity to get that body part back on line.

If you have an overuse injury likely you have been feeling pain or discomfort for a while and it is not getting better. There may be some inflammation but usually no bruising. Typically resting from the activity you are doing, icing, myofascial work and getting adjusted will help decrease the pain and inflammation. With an overuse injury it is also important to get your biomechanics evaluated, meaning looking at how you are using your body, what muscles are firing and not firing, how the joints are moving and overall symmetry. This is important in order to prevent the overuse injury from returning or getting worse.

Having an injury evaluated is important, it will help you with guidelines of what to do and not do, and give you a blueprint for rehabilitation. Proper care and rehabilitation is the key to preventing the same injury from happening more than once!

Chinese medicine approach to injuries:

Kim Silsby, L.Ac.

Hope everyone is having an enjoyable and injury free summer so far! If any injuries occur, consider seeing your Chinese medicine provider soon after to give your body a healing boost. Whether it’s from goofing off on vacation or over-doing it in a routine workout, injuries can ruin your day and can set you back for weeks. 

The typical response to acute injury is RICE (Rest, Ice, Compress, Elevate) which is perfect for the first 24 hours, but after that the Chinese medicine approach improves healing without the use of ice and compression.Cold contracts the tissues and blood vessels, causing blood and fluids to stagnate and congeal, which slows down healing and ultimately can lead to residual pain and arthritis in the affected area. Compression in the form of an Ace elastic bandage wrapped snugly around an injury further stagnates blood and fluid. We use internal and topical herbal combinations in the form of teas, liniments, plasters, and herbal oils. If you have gotten a sprain, strain, tear, or fracture, consider seeing your Chinese medicine provider along with your chiropractor and medical doctor.

Historically, martial arts injuries were treated with acupuncture and herbal medicine, as it quickly and effectively addresses trauma to any part of the body. Trauma obstructs the flow of qi and blood, and without proper treatment, an injury can become chronic, recurrent, or debilitating. Acupuncture and herbs augment healing and relieve pain without drugs, surgery, or side effects. Together they reduce pain and swelling in an acute injury in a matter of minutes, reducing healing time dramatically.

With severe injuries, it’s ideal to get an x-ray or MRI to accurately diagnose fracture, ligament, or tendon injury. If surgery is required, Chinese medicine is helpful in facilitating recovery. The number of treatments necessary depends on the health of the person and the severity of the injury.The most important point is to get treatment soon after the injury occurs and throughout the healing process to insure a full recovery. 

Our bodies are amazingly designed to self-correct, and we need to support that process as naturally as possible. Don’t forget to eat healthy whole foods with a rainbow of colors and avoid excess sugar. Consider veggie broths as well as bone broths in your healing nutrition plan, as well as many kinds of berries, leafy greens, lean proteins, seeds, and nuts. And last but not least, hydrate well and get ample rest to fully recover from injuries. Enjoy the rest of your summer and stay healthy! If you have any questions feel free to contact me at kimasilsby@gmail.com or call the office to schedule: 408-891-8222.

Dr. Tablak’s favorite summer treat:

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The freeze from Pressed Juicery is delicious and healthy too! It is vegan, gluten-free, and has only whole food ingredients. Dr. Tablak’s favorite is the strawberry flavor with strawberries and the cacao drizzle. Click the button to check out the Freeze!

Juliet Tablak