Dr Joseph Ierano Killer Fashion Interview

Dr Joseph Ierano Killer Fashion Interview

Is the pursuit of the latest fashion trends causing you physical harm?

A new survey by chiropractors in NSW has revealed that some people are risking serious physical injuries because they are slaves to fashion.

Among the main culprits are;
high heels
heavy handbags
fat wallets in men's back pockets
skinny jeans
bras that are too tight
body shaping underwear
thongs on feet

The President of the Chiropractors' Association of Australia (NSW), Dr Joseph Ierano says it's apparent that many people are prepared to tolerate a high level of discomfort, in their effort to keep up with the latest trends.

The survey found that on average chiropractors in NSW can see 10 to 15 patients per week with problems caused by fashionable clothing and accessories.

By far the most deadly fashion accessory was high heels. Over 65 per cent of chiropractors listed them as their number one concern, leading to lower back pain, knee problems, unpleasant bunions and in some cases foot and ankle sprains.

That's quite apart from the number of physical injuries caused by women tripping over, slipping or falling because of the inherent instability associated with extremely high heels.

'High heels throw the centre of gravity forward, causing you to lean backwards to keep from falling face first. This overcompensation often leads to low back pain, while instability through the ankle can put additional strain on the knees and hips," Dr Ierano said.

Oversized heavy handbags and manbags worn on one shoulder were another concern, with 48 per cent of chiropractors saying they can lead to back, shoulder and neck complaints.

'Ideally handbags or any type of bag should not be more than 10 per cent of your weight when packed," Dr Ierano said.

The Chiropractors' Association of Australia (NSW) released the top five fashion hazards from the survey and a set of guidelines -
Hazard 1: High Heels

Wear flat shoes to and from work, only wear high heels to functions and meetings
Don't stand for extended periods in stilettos
If you must wear heels use ones with a wide heel and stretch your calves regularly
Always wear shoes with arch support and make sure they are wider than your feet

Hazard 2: Handbags or Man Bags
Regularly clean out your handbag to remove the temptation of over stuffing
Alternate shoulders
Try a smaller bag and look for one with broad straps
Check to see the weight of a handbag when it's empty prior to making your purchase
Where ever fashionably possible, use a backpack rather than a handbag

Hazard 3: Wallets
Don't sit on your wallet. Find somewhere else for it – front pocket, side drawer or give it to your wife
Reduce the number of cards carried inside the wallet

Hazard 4: Tight Bras
Have your bra professionally fitted to avoid thoracic pain due to the bra being too tight
Make sure straps are wide
Underwire should be avoided when possible

Hazard 5: Tight Jeans
Squeezing into skin-tight jeans can cause nerve compression, poor posture and misalignment of the spine. Look for a style that allows you to perform daily tasks such as bending and sitting at ease.

Interview with Dr Joseph Ierano

Question: What types of injuries are chiropractors seeing result from -fashion'?

Dr Joseph Ierano: The most obvious culprit is high heeled shoes. I don't discourage women from wearing high heels but I think the issue is wearing them too long, too often and way too high. We need to be reasonable in regards to the amount of time we spend in heels and the height that they have, reason being is because they put abnormal stress on the spine. Humans have been doing strange things to the foot for centuries but when you lift the heel up and push the centre of gravity forward as a chiropractor I see my patients with back pain as a result. Also, heels are not very accommodating on the foot functions as they crush little toes and create tension throughout the body including the brain.


Question: Are these types of serious physical injuries increasing?

Dr Joseph Ierano: I don't have the statistics to confirm that but I think we've always seen it, I've been in practice for 16 years and I've always seen it and we're continually putting out the same message. When I talk to women they do say that high heels are getting ridiculously high and the injuries are getting worse however we've always had culprits in regards to fashion throughout the ages such as corsets in the Victorian ages. I'm not saying things are getting worse but it's not getting much better especially with the introduction of skinny jeans worn below the waist which restrict the normal motion of the pelvis.

Body jewellery and body piercing can also interfere with body functions.


Question: Can you talk about the injuries caused from body shaping underwear?

Dr Joseph Ierano: Body shaping underwear aims to gather in flappy bits and tuck in the tummy but this is not good for breathing and it gathers in cellulite which only causes the body to be unwell. I'd suggest looking at ways to tone up, lose weight and most importantly accepting what we look like which is a huge part of the whole issue. We've got to accept what we look like as beauty is only skin-deep.


Question: How do wearing thongs on our feet cause injuries?

Dr Joseph Lerano: Let's not pick on thongs too much but I think some people can wear thongs however others need extra supportive shoes for their arches and proper footwear especially when walking or running. Thongs aren't always the best all the time as adequate footwear similar to high heels.


Question: High heels are even more dangerous, what types of shoes should we be wearing?
Dr Joseph Ierano: Our podiatry friends would have a lot more to say than a chiropractor as we don't specialise in feet but we still want to see people in the right footwear. A lot of people like to have an open-toed shoe and I assess where feet are problematic. If you don't have problem feet you can wear whatever shoes you want, within reason however if you have arches that are dropping or foot functions that affect the spine or neck then you do need to find adequate footwear such as a shoe with good cushioning, good support in the sole and most importantly enough room for the toes especially the pinky toes!


Question: What types of pains result when bra are too tight?

Dr Joseph Ierano: This is an age old problem and a lot of bra manufactures are now focusing on this and I'm glad they are. You will get tightness in the middle back, between the shoulder blades if your bra is too tight or if it's worn too often as you do need time without the bra, as well. Also the underwire should not be digging into the chest. If you've got stress between the shoulder blades resulting from a tight bra you can even develop chest pains or symptoms of a heart attack. There are a small number of cases where patients complain of chest pains that are so profound and when we look at the spine we realise the pain is being referred from the back to the front of the chest which implements a lot of restrictions in the shoulder blade area that travels up to the neck which also develops headaches and problems in other areas.


Question: Tight jeans, tight underwear and tight bras causes issues; should all tight clothing be avoided?

Dr Joseph Ierano: No, I wouldn't generalise and say tight clothing should be avoided. When tightening a piece of machinery you tighten it, but you don't over tighten it nor do you leave it too loose, there is always that middle ground. You can wear tight jeans if they're elasticised and allow movement or a tight fitting top that is quiet stretchy. If a product is body hugging but doesn't restrict and allows movement then that's okay, the issue is with materials that don't give.


Question: What rules should we follow in regards to keeping injuries low regarding handbags?

Dr Joseph Ierano: Handbags are too heavy and one sided. I recommend swapping the shoulders regularly or wearing the bag across the chest and shoulders. Handbags these days are too heavy however the body can stand the weight if the bag is swapped around from left to right which is what I teach my patients to do. Manbags are great and I believe more men should have bags because they often have so much junk in their pockets and then they sit on it which puts their pelvis all out of wack.


Question: What are the typical issues chiropractor deal with on a daily basis?

Dr Joseph Ierano: Most of the issues are centred around the neuromuscular skeletal system which is mainly around the spine. Chiropractors have been studying the spine, spinal manipulations and spinal adjusting techniques longer than any other profession. We look around the spine at what maybe causing headaches, neck pain or even chest pain. You typically wouldn't go to chiropractors to treat Insomnia however once I've sorted out a patient back, spine or neck problem they get to sleep and they sleep better as they're not interrupted.


Question: Can you talk about exactly what a patient should expect when visiting a chiropractor?

Dr Joseph Ierano: A patient should expect a full and thorough consultation consisting of history, forms, a chat and an examination to assess what the particular needs are. The examination could range from five to fifty minutes depending on what needs to be done. We may need to organise an X-Ray, MRI or another scan and most chiropractors are licensed to take X-Rays. From the treatment phase, once things are all steam ahead, we usually conduct a form of manual assessment such as ranges of movement, the way your body is moving and if it is correct or abnormal and we do techniques where we gently put the joints back in their place using gentle tapping of the hands or instruments that produce a slight impulse or vibrations. Some chiropractors are extended to soft-tissue techniques to help muscles adapt to the new position as well as extending to other areas such as prescribing vitamins.

Chiropractic is the diagnoses and treatment of muscular skeletal problems mainly around the spine.


Interview by Brooke Hunter