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September 28, 2019 Clinical0

Some interesting research has just come out from the Netherlands.

They did a 1 year follow up with patients that presented with severe lower back pain with nerve impingement often known as ” Sciatica “.

What the researchers found that was after a 1 year follow up there was no correlation between the ongoing presence of a disc herniation and the persons pain level.

The implication here for us humble clinicians is that the physical presence of a disc herniation 1 year after incident is not really a good way of determining in itself whether that disc herniation is actually causing the patients pain and discomfort.

More and more research is now coming in that pours cold water on the notion that we can rely on imaging findings alone to make recommendations and predictions about the best treatment and chances of impairment.

Pain and disfunction are really complex things with many variable coming into play and it’s clear that us practitioners for too long have been giving too much weight to the structural and imaging side of the coin. But let’s through any babies out with the bathwater just yet. MRI imaging has been a great tool in the mix of understanding and helping our patients problems. It’s just not the be all and end all.

You can read the full study here if you are interested


Just a reminder that Niseko Chiropractic is still open over the shoulder season for evening and weekend appointments.


To book online please go to


July 19, 2019 Uncategorized0

Strider cup 2019 in Niseko

With the Niseko classic cycling race now well behind us Niseko was treated to the true sporting highlight of our 2019 summer. The Niseko strider cup or perhaps as it’s coming to be known the Strider international.

Whilst training our 4 year old consisted of mainly toilet training, teaching him not to get his tongue stuck in the electric window and wearing pants in public places it’s clear that some parents are well ahead of the curve, busy sculpting the minds and bodies of their finely honed racing toddlers.

Some of these kids are quick. Real quick and it looks like the training throughout the winter with special Strider snow tires made a difference in those crucial few seconds that separates winners and losers.

Others are just getting started in their competitive careers choosing to do the circuit in reverse but either way a great day was by all and it was an honor to be part of a true community event like this to just get out there and have some old fashioned fun.

Nothing brings the world closer like hurling kids on bikes without brakes down a ski slope in matching active wear. Niseko delivered again with a great injury free day on the slopes for all with plenty of Japanese food tents and some added dancing and entertainment for the kids.

In the end of there can only be one winner and the 5-6 year old category proved just how good some of these kids are, whizzing by the traffic cones with millimeters to spare as they judged each corners entry and exit like a formula one driver.

Even you have not experienced a Strider cup add it to your 2020 events dairy. You will not be disappointed.

If anybody would like to book an appointment this week during evening hours you can do so on the link below


June 17, 2019 Clinical0

There has been a been a lot of talk about the risks of sitting lately. Some commentators have coined the term ” Sitting is the new smoking ” and certainly the research does support the large health risk of sitting too much correlates with poorer health outcomes (1).

But the plot thickens when we start to look further.

How much of the health risk is due to the sitting itself and how much is just because people that sit more tend to exercise less ? What about to standing workstations ? Do they actually help reduce our risk or are they just a fad ? Once again we need to turn to the research to cut the wheat from the chaff.

The dangers of sitting too much

In 1953 Morris (2)  published a paper in the prestigious medical journal ” The lancet “.

Morris noted that bus drivers in the 1950’s had far more heart disease than bus conductors. This was interesting. They both worked identical hours and shared almost identical work environments and backgrounds. The main difference seem to be that one group was sitting and one group was standing. Was sitting causing their heart disease ?

Fast forward to 2016 and several papers did some large meta analysis and it seems yes that too much sitting was associated with a range of problems from Heart disease, to type 2 diabetics and obesity (3).

But the interesting question still remained. Is it the sitting itself that causes the problem or is it the lack of physical activity associated with the sitting that causes that leads to poor health ?

Maybe both ?

Well the research at this point is divided with some experts claiming that doing exercises does not offset the dangers of sitting whilst others claiming daily exercise can mitigate a lot of the the dangers of sitting.

Dr. Alter and colleagues conducted a meta-analysis ( where they study other studies ) of 47 studies that tracked groups of people who reported data on how often they spent sitting and on how much exercise they took.

They found that people who were the most sedentary were more likely to be diagnosed with type 2 diabetes, cardiovascular disease and various cancers, including breast, colon and ovarian cancers. The most sedentary people were also 24% more likely to die during the studies than participants who spent the least amount of time sitting.

Although this association was much stronger among people who spent little time exercising, the study also found that too much sitting time was associated with poor health outcomes, regardless of physical activity (4)

Alter was of the opinion that exercise alone does not reduce the health risks of sitting. He believes we actually need to sit less.

In 2016 a much larger study was published by Owen et al (5) in the reputable journal The Lancet that found that moderate activity ( about 60 to 75 minutes a day ) does seem to offset the health risk of sitting in regards to death rates. They did find however that if you watched more than 3 hours of TV a day then even moderate to heavy exercise did not offset the health risks of the sitting.

So they researchers are still a little divided about whether sitting itself is the issue or if is sitting is a co-founding variable associated with the real culprit, lack of enough activity.

I think it’s safe to say that we should all be aiming to try to get an hours walking in more days than not and also minimizing or at least having breaks with the amount of sitting we need to do over the day. A short walk to the water fountain to bitch about a c0-worker may be healthy.

What about standing workstations

It seems like an obvious solution. If sitting is causing the problem then why not just stand ? The sitting/ standing workstation became an overnight sensation in the corporate world with some pretty hefty price tags too.

The interesting thing here is the jury is still out on weather standing workstations make much of a difference. Surprisingly little research has been done to date on whether a standing workstation is really a viable alternative to combat the risks of sitting.

A Harvard study found that when you sit you burn about 80 calories an hour and when you use a standing workstation you use about 88. Over a 3 hour period this relates to about the same energy difference from eating a carrot ( 6). The authors concluded you would be far better off doing a short walk in your lunch break.

And just to make things even more spicy…….

Maybe standing still all day at a workstation is not that good for your either ! One study find that finding that occupations involving predominantly standing were associated with an approximately 2-fold risk of heart disease compared with occupations involving predominantly sitting (7). With all the media attention on the dangers of sitting some authors noted a gap in the research knowledge on looking at the risks of standing.

Again it seems like gentle daily exercise may be worth impliementing first before you worry about rushing out to purchase a standing workstation.

In conclusion it’s probably safe to say that an doing a job where you sit all day is a risk to your health and this becomes far more serious when you are not doing enough exercises.

So get out there and move more !



  2. Morris JN, Heady JA, Raffl e PA, Roberts CG, Parks JW. Coronary heart
    disease and physical activity of work. Lancet 1953; 265: 1053–57.
  3. Ekelund, U., Steene-Johannessen, J., Brown, W. J., Fagerland, M. W., Owen, N., Powell, K. E., … Lee, I.-M. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet, 388(10051), 1302–1310.doi:10.1016/s0140-6736(16)30370-1


June 17, 2019 Clinical0

With the DIY revolution now in full swing many people are now getting familiar with power tools previously left in the hands of licensed professions. Whilst doing some jobs yourself can save you a lot of money and also be very rewarding there are some risks.

A recent study (1) examined the use of power tool injuries causing hospital admissions from 2005 to 2015 and examined what the risk factors are in injuries leading from accidents around power tools.

So what are they ?

Firstly having a penis seems to be a massive problem. Males accounted for 96% of power tool injuries compared to only 4% for females.

So if you do happen to have penis be aware that you are are far more likely to have a power tool injury. The idea that just being male allows you to use power tools safely is unfortunately a dangerous myth.


“The wise rest at least as hard as they work.”
― Mokokoma Mokhonoana


Something interesting happened on the 28th of May 2019.

The World Health Organisation (WHO) officially recognized and classified workplace burnout as a Occupational phenomena but they did stop short of classifying it as full disease (2).

For those interested ” Burnout ” is now officially defined as by the WHO as

Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

  • feelings of energy depletion or exhaustion;
  • increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and
  • reduced professional efficacy

If you are suffering from 3 of the above criteria it’s possible you may actually be suffering from burnout.

It’s important to note that burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.” (1) This is important to note as there is a lot of overlap between burnout and other conditions such as depression so i think the WHO got this right in seeking to limit the definition of burnout to just the workplace.

This is still a significant step forward as clearer terminology leads to better studies and hence better solutions to this perplexing problem. It’s likely as this important topic gets more attention we can better manage burnout and its implications.

Let’s talk more about Burnout

Having experienced a burnout last year I now have more than academic interest in the topic.

The movies like to depict a sudden snap where all of sudden you are wearing your pajamas to work and making goodbye speeches standing on your desk.  The reality is far more boring. And depressing.

You find yourself tired all the time, growing increasingly disconnected from you work and meaning that you attributed to it. Your coping mechanics such as a quick holiday or a few cheeky bevies on the weekend that used to see you through no-longer seem to be effective and in some cases just make the problem worse.

In his classic “The E-Myth Revisited: Why Most Small Businesses Don’t Work and What to Do About ItMichael Gerber talks about another peak in business failure rates around 5 years. It’s not because the the business was unsound, it was financially viable and had found a niche to service and generate income. It had survived the dreaded start up phase. But it failed for another reason. The owner simply burned out from exhaustion.


June 4, 2019 walks0

Sunday the 2nd of June saw the Niseko Walking groups 2nd adventure and the early summer hokkaido weather did not disappoint supplying us with ample bluebird weather and maybe even a touch too much sun.

The walk took about 2 hours and linked 2 trails Kompirayama Walking Trail and the Nishiyama Crater Walking Trail that can be attempted individually if you have small children and think it may be little to much for them to do both.

It’s hard to put into the words the experience of walking the volcanic craters and ruins created by the eruption of Mount Usa.

The Eruption of Mount Usu

The 2000 eruption of Usu volcano was the first in 22 years and followed several days of rumblings which thankfully gave the community ample time to evacuate.

A first new vent opened in the West-Nishiyama area on 31 March 2000, followed by activity in the Kompira area on 1 April. Eruptive activity lasted for more than a year and gradually declined until September 2001.

A large area of Usu volcano deformed during the eruption by uplift of up to 60 m vertical displacement and involving a volume of ca. 40 million m3. That figure makes sense when you walk past the ruins of housing block. My first thought was ” Well it doesn’t look too bad ” until you realise what you are looking at the 2nd story. The first story being all but completely buried by mud. The town takes this threat very seriously with a wall that’s built to funnel any future flows away from populated areas.


May 28, 2019 Uncategorized0


Change in Summer trading hours for Niseko Chiropractic

Brent will be assisting a friend with some house maintenance work over the next few quieter summer months.

As a result Niseko Chiropractic will be now be extending opening hours over both Saturday and Sundays and into the evenings on all week and closing availability over Monday to Friday over the 9am to 3pm time slots.

Apologies to anybody that this temporary change puts out but most of our clients seem to prefer the weekend and evening slots anyway so hoping this temporary change does not cause any inconvenience.

You can see and book Niseko Chiropractic online in real time on the link below


May 28, 2019 Clinical0

The Rise of Chronic disease and what to do about it

Do you have any Nastie Oudours in your life ?

I don’t mean to ask a blunt personal question but this is important. We as a species have a little of bit of a problem here.

For the the time in human history we are getting sicker than previous generations.

Life expectancy in the US is now falling with life expectancy now down to 78.6 and falling each year its measured from 2016 ( 1). And even here in Japan, a country that is used to pride itself on how its population seemed to live forever is seeing a decline in its longevity with the average male now living 83.98 years (3) but this is no longer the worlds leading figures (2).

This is even more perplexing when you consider just how amazing some of the recent medical advances in the last few decades have been. We have seen the rise of HIV managed very well with antiretroviral drugs, artificial hearts, Hep C can be cured in some cases. Keyhole surgery and increased sophistication of some anti cancer drugs.

Yet even these can’t quite manage to keep us living any longer.


So what does this have to do with Nasty odours ?

Well the reason we are getting sicker is the change from people dying from Acute diseases such as infections, Workplace accidents, Tuberculosis etc to people dying from Chronic disease such as Diabetes, Obesity and Cancers.

The ” sweet spot ” between decreasing Acute and increasing Chronic Disease.


Australia has some of the worlds leading researchers into this problem such as Professor Gary Egger and what they are have brought up is the concept of ” Anthropogens“.

Most of of our theories about why we get sick are based on middle ages discovery and 19th century concept of Germ Theory ( 4). This basically states that a pathogen like a virus or bacteria gets into our systems and makes us sick.The founders of lifestyle medicine propose a new term ” Anthropogens ” which can be defined as ” man made environments that can be detrimental to human health ” (5)

That’s right.Humans themselves are making our environment around us unhealthy.

How are we doing this ?

If you add together all things we are doing as a species to make ourselves chronically ill you come up with the acronym Nasty Malodours.

See the graph below


This is really important work.

What modern researchers are finding is that things like relationship problems and poor sleep can be just as bad for your health as viruses and bacteria. In fact the components of Chronic diseases are now winning the battle for making our lives shorter and less enjoyable.


So what can we do ?

It’s worth having a think about your own situation and the Nasty odours in your life.

What factors have chosen to that you think may be contributing to own chronic disease risk ? Take the time once a month to give yourself and honest self audit of your situation.

  • Is your weight an issue ? That’s a very important area and one that affects many aspects of your life
  • Are you getting enough sleep  ?
  • Are you living work or working to live, does your life give you a sense of purpose ?
  • Do you spend too much time on your mobile phone ?
  • Are you eating poorly ?
  • Are you getting enough sunlight ? This can be challenge for those of us working in Niseko over the winter months.


If you take the time to address the Nasty odours in your life you stand a much better chance of not just living longer but living better for longer as well.






May 20, 2019 Clinical0


To stretch or not to stretch ?

Dotted all over the slopes of Niseko during peak season are ski schools packed with eager students going through a stretch routine before they eagerly start their lessons and start carving up Niseko, arguably the worlds most consistent powder snow.

The motivation is good and at first glance, it kind of makes sense. After all we care about our students and hopefully the stretches will help them avoid a ski injury and help them enjoy their time in Niseko and their snowboarding or skiing lesson.

But there is a small problem. It probably doesn’t work.


May 12, 2019 walks0

First Niseko walk of the season a great success

The niseko Walkers tackled the snow covered peak of Iwaonupuri on the 4th of April 2019. It was our first walk for the season and also our first event as a walking group.

We meet at the carpark and after a brief meet and great began the slow careful climb. The Snowcover was a lot more than anticipated with a only a few steps briefly revealing their hiding place from the long winter before ducking under the snow back again.


May 7, 2019 Clinical0

A great article was recently published in the British Medical Journal about how practitioners and patients should view osteoarthritis.

Certainly when I went through colleague we were taught that osteoarthritis is degeneration of the cartilage, it was irreversible and leads to pain and dysfunction. In short many medical, physiotherapy and chiropractic schools taught us that osteoarthritis was disease of cartilage.

But there a few problems with model. Firstly more and more studies are coming out that show that the correlation between the decree of tissue damage shown in your joint cartilage correlates very poorly ( if at all sometimes ! ) with the amount of pain and dysfunction a patient has.


May 6, 2019 walks0

Get fit and meet new people in Niseko

When I first to moved to Niseko last summer I was very eager to explore some of the amazing hiking peaks and even valleys that surround Niseko in all directions.

It was very surprising that no formal walking group had yet been set up in Niseko. In light of this I thought until somebody more qualified comes along ( and the bar is low ! ) I would give it a crack and get something going.

Sure it’s not pretty or well organised but a bunch of us are coming together to walk most days around Niseko town and we have some upcoming hiking trips planned already.

Just a few Km’s pumped out over a week can make a big difference to your overall health. You can see more on the health benefits of increasing your daily walking on this post here

Walking also a great way to meet new people and be active in this great community that we are lucky to call home.

How to join the Niseko Walking club

It’s pretty informal with no obligations to turn up or not and no leaders as such. Just a group of people trying to get fitter and healthier in Niseko.

Hoping over time to grow into more formal hiking group and tackle some of the amazing alpine peaks which are all in easy reach of Niseko.

We have started a facebook page here and encourage you to join the mailing list below for updates and future trips.

The Niseko walking group is currently meeting most mornings at the Southern carpark at the over the  yellow Niseko bridge at 6:30 am for about a 5 to 7 km walk which takes about an hour.

Hope to see you on the footpath or the mountain.

If you would get in contact with us you can email at



May 1, 2019 Clinical0

What is Sacroiliac pain and why is it overlooked ?

Lower back pain is one of the most reasons a patient may present to a Niseko Chiropractor, physiotherapist or Osteopath for treatment. About 20-30% of the population will experience some episodes of lower back pain that just doesn’t go away so you are in good company (1).

What gets more interesting is what causes the pain. A most common folk diagnosis is to complain of ” Sciatica ” where the pain originates in the lower back and then refers into the hip and leg. But from a practitioners point of view sciatica has a more specific meaning. We would refer to sciatica when there a some pressure or irritation of the sciatic nerve, most commonly a disc herniation or protrusion. This commonly radiates right down the very back on the leg and can also often be associated with numbness and parenthesis and often severe pain.


May 1, 2019 Clinical0

Manual manipulative therapy may reduce fear avoidance in Chronic lower back pain.

Some very interesting research was just published in the ” Journal of Pain “. The authors looked at the effect of fear avoidance patterns in patients suffering chronic lower back pain.

If you do happen to suffer chronic lower back pain you understand that it’s not just the pain that gets you down but also the fact that you can become fearful to do movements that used to cause you no problems at all .In short you can can become scared to move.


April 25, 2019 Clinical0


There is a really easy way to increase your health dramatically that does not cost any money, does not require any sit ups or resisting chocolate. Do I have your attention now ?

Its sleep. It’s likely you are not getting enough both in quantity and quality.

Niseko Chiropractic recently made some simple changes by cutting out caffeine after 2pm, reducing alcohol in the evenings and tying to be in bed by 9pm and I feel a whole better for it. The results were obvious within a week or 2.

So why does sleep matter ?


April 19, 2019 Uncategorized0

New research shows positive benefit for yoga in the ageing population

Yoga has been practised for centuries as a way to maximise our function and increase our health but western research is finally beginning to catch up with ancient art.

A recent met-analysis published in the  International Journal of Behavioral Nutrition and Physical Activity Showed great benefits across 22 randomised controlled studies looking into the possible health benefits of yoga. This paper is significant as it was the first review that looked at yoga as a practise in health populations rather than just for significant conditions.

What was really interesting is that yoga was shown to be of significant benefit not just to compared to doing nothing ( well dah ! ) but also to other exercise forms and meditative exercises such as gentle walking or aerobics etc.

Benefits were found not just for things like balance but also mild depression and increasing lower limb strength and guarding against falls and also things like sleep quality (often a problem in older individuals) and other mental health variables.

So you are considering doing yoga this summer in Niseko into your senior years now would be a great time to consider it. Marika from Niseko Ashtanga yoga would be a place for getting started in your yoga game in Niseko. Powder yoga with Kanami also runs at the Aya hotel over the winter season.

You can see her timetable on her facebook page below


You can see the full study published below







April 18, 2019 Uncategorized0

Niseko Chiropractic is very excited to learn that Qantas will launch new direct seasonal flights between Sydney and Sapporo next season. This will make getting to Niseko from Australia that much easier for families that wish to experience some of the worlds best powder.

No excuses not to ski Niseko

To coincide with the peak ski season, Qantas will fly three times per week to Sapporo’s New Chitose Airport between 16 December 2019 and 28 March 2020. The flights will be operated with Qantas’ upgraded Airbus A330 aircraft, offering more than 10,000 seats on the route over this period.

This is great news and will be a significant boost to the Niseko economy.

Hope to see you here later this year. If you do need an english speaking Chiropractor for Chiropractic or sports massage here in Niseko I hope you can keep Niseko Chiropractic in your mind.


April 15, 2019 Uncategorized0

An important meta-analysis was just published in the British Medical association sports jornal. The authors addressed the important question of when one should start rehab after surgery.

Just how early should one start rehab exercises after repair of tear ?

Like all themes on Niseko Chiropractics blog. It depends.

Age is going to play after as well as wear the tear is located. Because much of the meniscus has a poor supply it may take a little longer before it’s safer to move. Generally speaking the deeper the tear within the meniscus  the longer you may wish to wait to allow more healing.

All meniscus tears are not created equal. Here is a run down of the type of tears that can occur and be corrected surgically.


The longitudinal tears on the outside in a young athlete are going to be able to be rehabed fairly quickly whilst a deep bucket handle tear in an older inactive person is going to need longer.

The take home message from the study that looked at 17 other studies is that the traditional approach of a conservative window may not be backed by evidence of risk and some studies showed more favourable results by getting moving early with some studies prescribing weighted range of motion exercises within 3 days of your surgery.

The implications from the study is that getting moving earlier than previously thought may be the better approach although at some point there is going to be a risk/ benefit playoff and that is going to vary based on a your own personal circumstances.

Ff you are going to have surgery make sure you discuss and understand what type of tear you have and how it will be repaired. Ideally get this in writing from the surgeon. Then ask them for their guidance with your unique situation.

Lastly find a good rehab provider that is going to be able to assist you in getting active as soon as possible.

You can find a link to the full article below

If you would like to make a year round appointment with an English speaking chiropractor in Niseko you can book online on the link below





April 13, 2019 Clinical0


One of the more exciting things to come along in the last few years is the new discipline of lifestyle medicine. This approach seeks to make changes in our lifestyle as ways to treat illnesses and improve health.

A recent study has found that just 20 minutes a day in nature can have a good effect of reducing cortisol and improving our well being. Yes there is benefits to more but the effect size is less. So based on this if you are a busy person try to aim for 20 minutes a day doing something in the outdoors that finds you peace.

You can read more on the link below



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Please do not hesitate to contact Niseko Chiropractic if you have any questions.We apologize in advance if there is some delay in our response during peak periods. You can contact Niseko Chiropractic at


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