Back Clinic Chiropractic Spine Care Team. The spine is designed with three natural curves; the neck curvature or cervical spine, the upper back curvature or thoracic spine, and the lower back curvature or lumbar spine, all of which come together to form a slight shape when viewed from the side. The spine is an essential structure as it helps support the upright posture of humans, it provides the body with the flexibility to move and it plays the crucial role of protecting the spinal cord. Spinal health is important in order to ensure the body is functioning to its fullest capacity. Dr. Alex Jimenez strongly indicates across his collection of articles on spine care, how to properly support a healthy spine. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
El Paso, TX. Chiropractor Dr. Alex Jimenez takes a look at driving and how it effects the spine.
Daily, nearly 90% of journeys and 92% of miles traveled are made in autos or ground transportation (buses, trucks). On average, guys drive 44 miles as well as girls drive 34 miles each day. For many Americans, driving a motorized road vehicle is their job: truck drivers, bus drivers, ambulance and fire trucks, police, taxis etc.
Modern car and truck layouts have come a long way in their own design over the past 20 years, with better fuel efficiency, better features, better styling and better relaxation. But is there any signs that the look of contemporary bus, car or truck seats and driving might play a part in causing a few of the back injuries that plague�Americans each year?
Exactly Why Is Driving Different To Ordinary Sitting?
In case your own car is not moving, then sitting in a driving seat probably isn’t substantially different to sitting in a chair that is cushioned, but as soon as the vehicle begins moving things change. Additionally, when driving the feet are actively being used, the right foot on the gas (accelerator) pedal, the left on the brake, and in a stick-shift also on the clutch. When the feet are active they can’t be utilized to support and stabilize the reduced body when they’re put on the floor during regular sitting in a chair, as usually occurs. There is evidence the blend of those variables, coupled with the look of the car seat itself, can increase the possibility of back problems for many people.
Is Driving Linked With Back Problems?
Lab studies have examined the effects of whole-body vibration when a person is sitting in a car seat. The lumbar spine has a natural resonant frequency of 4-5 Hz , and results show that this natural frequency can be excited by lab simulated vehicle driving, and this may result in high spinal loadings in the lower back, and also this in turn could result in greater postural distress and an increased hazard of low back pain and injury.
Quite a few research studies have investigated potential associations between back and driving problems, and usually these studies have found significant consequences.
Drivers in the USA and in Sweden found that in each country 50% of those questioned reported low back pain.�
Investigation of the potential reasons for this revealed that long term vibration exposure from driving was among the greatest risk factors for neck, back and low back problems.
Gender generally seems to play an important part in the possibility of developing driving-related back problems. A survey of over 7000 Parisians found that even though severity and the prevalence of low back pain was higher in women, driving was just connected with back problems in guys. The need for driving as a risk factor improved with driving time, and was especially important for guys who drove 4 hours or more each day.
A survey of over 1400 urban transportation system motorists showed that issues using the capacity to accurately adjust the seat that was driving have significant effects on the prevalence of low back problems.
Nevertheless, it appears that driving need not consistently raise the chance of back problems.
Is There An Ideal Car Seat Layout?
Based on a comprehensive evaluation of advice from peer-reviewed scientific journals and texts, automotive engineering reports, and also the National Library of Medicine a string of requirements for the best car seat layout have been developed. Ideally, the optimal car seat should have:
1. Adjustable seat back incline (100 degrees from horizontal is ideal)
2. Changeable seat bottom depth (from seat back to front edge)
3. Adjustable seat height
4. Flexible seat bottom incline
5. Seat bottom cushion with solid (dense) foam
6. Adjustable lumbar support (horizontally and vertically adjustable)
7. Depth pulsating lumbar support to lessen static load
8. Flexible bilateral arm rests
9. Flexible seat back incline (100-degrees from horizontal is optimal
10. Flexible head restraint with pad that is lordosis
11. Frequencies between 1- 20 Hz to dampen
12. Linear front-back seat traveling to allow otherwise sized drivers to reach the pedals
13. Seat back damped to reduce bouncing of the torso in rear end impacts
Driving Safety
What To Check For In A Great Car Seat Layout When You Buy The Next Car
It is likely that most automobiles available on the market today won’t have the features listed above that are desirable in the optimal car seat all, but some will have more than others pick wisely. Pay close focus on the subsequent 5 guidelines which should help you to protect your back when you drive.
1) Car Seat Comfort
You’ve fixed this to suit your body and when you sit in the car seat does it feel comfortable. Otherwise, you will be most likely caused by then the car seat rear discomfort issues should you drive for any length of time. Rebound up and down in the seat to find out the way that it adapts vibration. Take the automobile on a test drive.
2) Car Seat Adjustments
Can you correct each of the features of the car seat you want to adjust? At a minimum you need to have the ability to adapt:
Seat space to accommodate different leg lengths
Seat height to accommodate different leg lengths
Backrest angle to sit down in either an upright or more reclined posture
You Should�Look For Other Adjustments That Are Useful:
Seat tilt to angle the front of the seat down or up so that this does not press against the back of your knees
Look for a car seat that supplies you with great low back support that can be corrected for depth (frequently the seat has an inflatable cushion) and is height adjustable
Headrest for neck support
Arms rests which are broad, cushioned and comfortable, and preferably height flexible
3) Shift Your Position
Remember to go your position from time to time. Wait until driving conditions are right to enable you to wriggle in the seat to relieve postural fatigue.
4) Take Breaks
Driving is exhausting work and to prevent driver fatigue and minimize postural discomfort it is good move around and take to pretty frequent rest breaks that enable you to stand up.
You can select a number of car seat accessories that will enhance seat comfort for you personally, from fleece covers to soften the seat to bead backrests to provide for some type of back massage while you drive. Select anything you find adds to your driving comfort.
5) Seat Accessories
You’re able to pick a number of car seat accessories which will improve seat comfort for you personally, from fleece covers to soften the seat to bead backrests to provide for some sort of back massage while you drive. Choose anything you locate adds to your driving comfort.
Once you’ve developed symptoms of back pain, you may need to visit a physical therapist. A physical therapist will then work together with the patient to help restore their original mobility and help heal their body as a whole. Moreover, the therapist can also recommend a series of methods and techniques to help the individual minimize their pain and symptoms in the future.
Physical therapy includes both passive and active treatment options. Passive treatments are helpful for helping people relax while also helping the body heal. These are referred to as passive treatments because the patient does not need to actively participate in them to experience the benefits. Most physical therapy treatment plans may begin with passive treatment while the body begins to heal, however, the goal is to ultimately get the patient to participate in active treatments. Therapeutic exercises can help strengthen the body in order to help prevent future episodes of back pain.
Passive Treatments
A physical therapist may offer the following passive treatments including:
Deep Tissue Massage: This treatment method targets chronic muscle tension and/or spasms that build up as a result of daily life stress. Muscle tension or spasms can also be caused due to strains or sprains from sports injuries or trauma from an accident. A physical therapist can apply direct pressure and friction to the affected region in order to release the tension in the soft tissues, such as ligaments, tendons and muscles.
Hot and Cold Therapies: A physical therapist can alternate between using hot and cold treatment methods for a variety of symptoms. Through the use of heat therapy, for instance, the therapist can achieve an increased blood flow, bringing more oxygen and nutrients to the affected regions of the body. Good blood circulation is essential to remove waste products which may have manifested due to muscle spasms in addition to helping the patient heal. Through the use of cold therapy, for example, also referred to as cryotherapy, blood flow is decreased or slowed down to help reduce pain and inflammation from muscle spasms. Applying a cold pack to the affected region or an ice massage are common ways of applying cold therapy. Another option to cryotherapy is a spray called fluoromethane, which functions by cooling the tissues. After the application of ice to the affected area of the body, a physical therapist may help stretch the affected muscles to improve healing.
Transcutaneous nerve stimulation or TENS: A TENS machine helps stimulate the muscles through the use of electrical currents which help reduce muscle spasms by boosting the body’s production of endorphins, or the body’s natural pain killers. The TENS equipment a physical therapist utilizes can be considerably large, but smaller TENS units are available for use at home. Utilizing transcutaneous nerve stimulation can be beneficial.
Ultrasound: This form of treatment helps reduce muscle spasms, cramping, swelling, stiffness and pain by also increasing blood circulation. This is achieved by sending sound waves deep into the muscles and other tissues of the body, creating mild heat which functions to enhance blood flow.
Active Treatments
Active physical therapy treatments a therapist can perform includes guiding the patient through a series of stretches and exercises which can help improve the body’s overall strength, mobility, flexibility and stability. Each person’s physical therapy program should be specialized according to their specific needs and their type of injury or condition. Taking into consideration the individual’s specific quality of life, health and well-being, particularly for someone who has back pain symptoms, the physical therapist should develop a physical activity program which will best benefit the patient.
If needed, you may additionally need to learn how to correct your posture and incorporate ergonomic principles into your daily activities. This is all part of the “self-care” or “self-treatment” aspect of physical therapy: through physical therapy, you learn good habits and principles that enable you to take better care of your body. Your physical therapist may also suggest a personalized exercise program for you. This can help reduce the likelihood of your back pain recurring and can also improve your overall health and wellness.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: What is Chiropractic?
Chiropractic care is an well-known, alternative treatment option utilized to prevent, diagnose and treat a variety of injuries and conditions associated with the spine, primarily subluxations or spinal misalignments. Chiropractic focuses on restoring and maintaining the overall health and wellness of the musculoskeletal and nervous systems. Through the use of spinal adjustments and manual manipulations, a chiropractor, or doctor of chiropractic, can carefully re-align the spine, improving a patient�s strength, mobility and flexibility.
Neel Anand, MD demystifies common myths about back pain. Dr. Anand is the Director of Orthopedic Spine Surgery at the Cedars-Sinai Institute for Spinal Disorders in Los Angeles.
Your mother wasn�t entirely incorrect; hunching your back can definitely be bad for your spine. Nevertheless, the reverse is true also. Sitting up straight for too long without a rest may also add stress to the structures of the spine. Be sure to stand up, stretch, and take a quick walk several times a day to help you from developing complications which can lead to injury.
Conversely, a mattress that is too soft could lack the support necessary to allow appropriate movements. Studies reveal that the medium-firm mattress offers an ideal level of support to help prevent additional injury.
Exercise Behind Back Pain
A survey by the North American Spine Society revealed this as the number one misconception. Of course, in the event that you aren�t energetic all week and you participate in a strenuous activity soon after, you could readily experience injury. It’s possible for you to help prevent back pain by preparing your body for especially more intense work outs and the shock of everyday motions before engaging in physical activity with stretches and warm-up exercises to greatly help wake up muscle tissue. (Take a cue from professional sportsmen who factor stretching and warm ups within their daily routine.) By strengthening your core and torso, you strengthen your back. That means exercises focused on strengthening back muscles and your stomach together with cardio to improve your total fitness.
Other Causes for Back Pain
Getting older doesn�t mean life needs to be debilitating. While there are aches and pains which occur naturally with age, remaining physically fit through exercise helps keep our bodies strong, flexible and limber, making them extremely beneficial to your overall health and wellness. There are so many exercise options to try including Tai Chi, Pilates, yoga and other treatment options that range from acupuncture to complex treatment alternatives, surgical and nonsurgical, to physical therapy. The bottom line is, back pain is not something you should have to live with.
Back pain sufferers often claim that an improper twist caused their injury. However, that occasion was probably the end result of a great many other variables. Overdoing a workout, while lifting heavy things, using poor techniques, bad posture and particularly weight gain can all place strain on the spine and lead to seemingly �out of nowhere � spasms. Occasionally the issue is more serious, as with joint and disc disorders and injuries.
There are few things as relaxing as sinking into a warm tub, but after injuring your back, doing so could really make your situation worse by increasing inflammation. Healthcare specialists recommend applying ice to the affected region for 20 minutes at a time for the initial two or three days in order to be able to decrease pain and inflammation. Individuals who suffer with chronic back pain and who do not experience inflammation can find relief with a warm bathtub. Play it safe and check with your healthcare professional for the best treatment option.
Most people will experience some form of back pain in their life, but the majority will find relief through simple lifestyle changes such as exercise, over-the-counter anti-inflammatory medicines, physical therapy, or even simply by waiting it out. In fact, spine surgery is only recommended to a small percentage of patients after all other methods of treatment have proven futile. These patients frequently suffer from joint issues that cause persistent pain or degenerative back issues. Whether you comprehend the source of your back pain or not, a fear of movement shouldn’t ever prevent you from living.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Weight Loss Eases Back Pain
Back pain and symptoms of sciatica can affect a majority of the population throughout their lifetime. Research studies have demonstrated that people who are overweight or obese experience more back complications than people with a healthy weight. A proper nutrition along with regular physical fitness can help with weight loss as well as help maintain a healthy weight to eliminate symptoms of back pain and sciatica. Chiropractic care is also another natural form of treatment which treats back pain and sciatica utilizing manual spinal adjustments and manipulations.
Modern chiropractic started in the late 1800s when Daniel David Palmer, a self-educated teacher and healer, performed the very first spinal manipulation on a patient. Chiropractic is the third largest area of medicine today. The word chiropractic comes from Greek words meaning “treatment by hand”, which is exactly what chiropractors do�they use their hands to manipulate the body and promote healing and wellness.
The chiropractic philosophy is dependant on the following belief statements:
All bodily functions are connected as well as the healing process requires the entire body.
A healthy nervous system, especially the spine, is the important thing to your healthier body. The spinal cord carries advice throughout the body and is accountable for many bodily functions including voluntary movements (such as walking) and involuntary functions (like respiration). When the systems of the body have been in equilibrium, it is called homeostasis. Disorders of the bones, muscles, and nerves increase the risk of disorder along with other health problems and can disrupt homeostasis.
When body systems are in harmony, the human anatomy gets the extraordinary ability to keep well-being and treat itself.
Chiropractors
They use traditional diagnostic testing strategies (like x-rays, MRI, and laboratory work) along with specific chiropractic techniques that involve hands-on manipulation of the articulations (joints) of the body. Nutrition and healthful lifestyle counseling is also offered by chiropractors. Chiropractors elect to not prescribe drugs, plus they do not perform operation; however, many chiropractors work with medical doctors and certainly will refer a patient when needed.
Chiropractors believe among the chief reasons for pain and disease is the misalignment of the vertebrae in the spinal column (this is known as a chiropractic subluxation). Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors are able to alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis.
Some chiropractors dedicate their practices exclusively to finding and removing subluxations. But in addition to using manual adaptations, most chiropractors offer other treatment modalities such as the following:
Physiotherapy
Herbal therapy
Heat/cold therapy
Ultrasound
Electric muscle stimulation
Acupuncture
Manipulation under anesthesia
Traction
Massage
Exercise programs and teaching
Lifestyle and nutrition counselling
Physical rehabilitation
Additionally, many chiropractors have considerable postgraduate training and become board certified in some specific regions of interest such as for instance:
Neurology
Orthopaedics
Sports medicine
Physical rehabilitation
Nourishment
Diagnostic radiology
In Overview
Chiropractic has come a long way since its beginnings. Due to its success in treating back and neck problems and as a consequence of changing approaches and recent research, chiropractic has become more accepted and is currently considered by many to be a piece of mainstream Western medicine. Actually, many hospitals finally have chiropractors on staff. Chiropractors will also be recognized by the court system as expert witnesses inside their field.
The understanding the spine is somehow involved in health and wellness, in addition to the practice of utilizing manual manipulation as a way to obtain healing, dates back to the time of the ancient Greek philosophers. In fact, Hippocrates once said, “Get understanding of the back, for this is the requisite for several ailments.”
The First�Chiropractic Adjustment
Modern chiropractic, however, indicates its beginnings in the late 1800s, �when a Canadian living in the US, Daniel David Palmer, a self educated teacher and healer, performed the very first spinal manipulation on a patient.
That patient was Harvey Lillard, a janitor who worked in Palmer’s building. Lillard was almost totally deaf and mentioned to Palmer that he lost his hearing many years before when he was bending over and felt a “pop” in his upper back.
Palmer, who had been a practitioner of magnet therapy (a common therapy of the time) was fairly learned in physiology and incredibly interested in how a spine interacts with all the remainder of the entire body’s systems.
He found a difficulty with one of his vertebra and examined Lillard’s back. Palmer manipulated Lillard’s vertebra and an amazing event occurred�Lillard’s hearing was restored. Today, this process is referred to as a chiropractic adjustment.
Palmer soon found that alterations could alleviate patients’ pain as well as other symptoms. These problems with vertebrae are called chiropractic subluxations.
He started to use these “hand treatments” to treat many different ailments, including sciatica, migraine headaches, stomach complaints, epilepsy, and heart trouble. In 1898, he started the Palmer School & Infirmary in Davenport, Iowa, and began teaching his chiropractic techniques.
Initial Resistance In The Medical Community
The medical community failed to immediately embrace techniques and Palmer’s chiropractic theories. The called him a “quack” and refused to recognize his achievements. At one point, Palmer spent time in jail because of his violation and was indicted for practicing medicine with no license.
Research has shown that Palmer was not the fish monger that was unlearned that some in the health care profession claim. An investigation of this library, which he quoted in his letters, showed that he was up to date in his knowledge at the turn of the 20th century. Obviously, his theories, in the light of 21st century knowledge, seem uneducated.
Chiropractic Today
Today, chiropractors are licensed in most European countries, Canadian provinces, all the US states, Australia and New Zealand. There tend to be more than 50,000 practicing chiropractors in the US alone . Despite its North American roots, there are more chiropractic educational programs beyond North America.
The concept that light energy from a laser can reduce inflammation and pain, hasten healing in damaged tissues, relax muscles, and stimulate nerve regeneration appears far fetched. Science, however, tells us these effects do happen.
“Power and wavelength ascertain the capability of the laser to penetrate into the body. Once you are in the infrared spectrum and above 800 nanometers in wavelength, laser energy penetrates like X-rays, but to attain depth you need substantial electricity or energy,� Dr. Bruce Coren told Spine Universe.
Two Categories Utilized in Physical Therapeutics
You can find just two groups of lasers being used in physical therapy; group 3 and 4. �Category 3 lasers are much less than 500 milliwatts, mw, in power while class 4 lasers are greater than 500 mw,� Dr. Coren said. Class 3 lasers are occasionally known as cold lasers, while the treatment may be called LLLT for low-level laser therapy. In contrast, class 4 laser treatment might be called HPLT for high power laser therapy.
�The majority of neuro-musculoskeletal conditions respond better to a higher power and a greater dosage, which will be a function of power output and time,� Dr. Coren commented. The best results are going to be obtained with a laser that’s 30 watts of power or more. A 10-minute treatment using a 30-watt laser will generate 18,000 joules, which gives a critical pain relieving, anti inflammatory and healing effect.�
Although 5 or more sessions may be required to solve the problem, patients usually begin to feel better after 1 or 2 treatments. � The more extensive the injury and the more chronic, the more treatments are usually needed,� he included.
Properties of High Power Laser Treatment
Pain Relief: Laser decreases nerve sensitivity by decreasing bradykinin; a pain generating compound. It normalizes ion channels, gatekeepers that are mobile, and releases endorphins, body�s natural pain reliever, and enkephalins, that is related to endorphins, that generate an analgesic effect. Additionally, it has a pain-blocking effect on specific nerve fibers. This increased energy accelerates the repair processes of the cell. Laser additionally causes a widening of the arteries and veins around the damage which really helps to remove damaged cellular debris and increase nutrients and oxygen. White blood cell activity is improved leading to a more fast repair process.
Gifted Tissue Repair and Cell Growth:�Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and growth. As a result of exposure to laser light, the cells of nerves, ligaments, tendons and muscles are repaired quicker.
Improved Vascular Action:�Laser light raises the formation of new capillaries in damaged tissue, which closes wounds quickly, and speeds up the healing process.
Cause and Acupuncture Points:�Laser is very effective in extinguishing painful trigger points. It’s likewise a highly effective method of stimulating acupuncture points with no distress related to needling.
Reduced Fibrous Tissue Formation:�Laser therapy reduces the formation of scar tissue following tissue damage from burns, cuts, scratches, repetitive motion injuries or surgery.
Faster Wound Healing: Collagen is the essential protein necessary to repair injuries or to replace old tissue. Because of this, the laser is effective on burns and open wounds. Laser raises the number of stem cells, which enhances healing.
Conditions Treated Where Laser Therapy is Administered
High power lasers are typically present in physical therapy clinics and chiropractic offices. Neck, back or joint pain generally responds immediately to laser therapy.
�Lasers are also rather powerful for inflammatory conditions, including peripheral neuropathy, tendonitis, bursitis, and capsulitis. Sprains, strains, and repetitive motion injuries all have an inflammatory component and may be successfully treated with laser,� he remarked. �There is no specific state that reacts more quickly to laser. Nonetheless, some patients will respond faster than others for precisely the same condition as individual healing rates can change.�
Laser therapy can be used as a stand-alone treatment, or with rehabilitative exercise therapy. �Rehabilitative exercises and laser therapy complement each other nicely,� explained Dr. Coren.
Precautions of Laser Therapy
There are a few precautions with laser treatment. Eye protection is required for both therapist and the patient, and laser must not be performed over malignancies, pacemakers, spinal stimulators or within the midsection of pregnant women.
Further Recommendations
High power laser treatment is just one of the quickest, most powerful modalities therapists now need to treat inflammation and pain. �Sadly, laser just isn’t covered by insurance, and high-power lasers could be difficult since they are high-priced to locate. Most importantly, results are reached by the quantity of energy produced, 18,000-30,000 joules per treatment being the sweet spot,� Dr. Coren reasoned.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 . �
By Dr. Alex Jimenez
Additional Topics: Chiropractic and Sciatica
Sciatica is identified as a group of symptoms rather than a single injury or condition. Low back pain is common among a variety of individuals, but when symptoms of numbness and tingling sensations are accompanied with pain and discomfort, there may be unnecessary pressure being placed against the sciatic nerve. Sciatic nerve pain or sciatica can occur due to a variety of factors and chiropractic treatment can help relieve the symptoms. Chiropractic care is a safe and effective treatment option available for restoring the health of the spine and reducing sciatica symptoms.
Exercise can help with back pain�you’ve probably heard that before. And Pilates tops the list of “helpful for your back” exercises.
This shows 4 Pilates moves to prevent pain. Of course, talk to your doctor before beginning an exercise plan.
Warm-up Your Spine with this Exercise
Cat/Cow
The cat/cow stretch lengthens and strengthens the muscles along your spine.
Start on hands (shoulder-distance apart) and knees (hip-distance apart).
Inhale and look up as you slightly arch your spine. Then exhale, engage your abdominal muscles, and draw your belly button toward your spine as you gaze at your navel. Repeat 5 to 10 times every day.
Chest Lift
Not Your Average Sit-up
The chest lift is similar to a basic crunch. The difference? This move deeply targets your abs.
Lie on your back with knees bent and feet flat (hip-distance apart). Bring hands behind head with fingertips touching. Elbows are wide open.
Inhale, and then as you exhale, pull belly button toward the spine and lift the shoulders off the ground (leading with chest). Really use your abs to lift�not your neck. Inhale again as you release toward the ground. Repeat 6 to 8 times daily.
Pelvic Curl
A Pose to Help Ease Low Back Pain
Doing this exercise regularly teaches you how to engage your abs to help support and lengthen the low back.
Start by lying on your back with knees bent and feet flat (hip-distance apart).
Arms are straight along the sides of your body and palms are touching the ground. Inhale deeply and engage your abs as you lift your hips off the floor�vertebra by vertebra.
Exhale and roll back down very slowly, engaging core muscles. Link breath with movement. Repeat 3 to 5 times daily.
Child�s Pose
An Easy, Restorative Stretch
This move really stretches tight, sore low back muscles.
From hands and knees, bring hips toward heels, and stretch arms in front of you so palms are touching the ground.
Press forehead gently to the floor and do some deep belly breathing. Bring hands toward the legs to slowly sit up. Repeat 3 times daily.
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