It’s been great, my turf toe has been getting a lot better. Actually, I didn’t see a doctor for about 4 months and it just kept getting worse. But when I started seeing Dr. Jimenez, it just, little by little it’s been starting to get better. It feels a lot better when I practice and stuff like that. So, it’s getting better. – Vincent Garcia
There’s always a particular risk for athletes when it comes to sports-related injuries, or sports injuries, particularly when participating in physical activities. Moreover, contact sports, such as soccer, baseball, football and basketball, tend to have higher injury rates than any other sport.
Twice as many men suffer sports-related injuries in contrast with females as a consequence of the types of sports that they most commonly engage in. Whether you’re a seasoned and experienced athlete or you simply play as a weekend warrior, there’s always a chance of experiencing a sports injury. Below, we will discuss several of the most common types of sports injuries, or sports-related injuries.
Common Sports Injuries
Sprains and strains are the most common sports injuries. Sprains are medically defined as injuries to the ligaments, or the strong bands which connect bones to the joints. Overly stretching these ligaments beyond their natural range can ultimately damage or even tear them.
Strains are medically referred to as injuries to the muscle fibers or tendons, which connect muscles to bones. Strains are known as “pulled muscles” for a reason, overly stretching or overuse of a muscle can cause tears in the muscle fibers or tendons.
�Think of ligaments and muscle-tendon units like springs,� explained Dr. William Roberts, MD, sports medicine physician at the University of Minnesota and spokesman for the American College of Sports Medicine. �The tissue lengthens with stress and returns to its normal length, unless it is pulled too far out of its normal range.� Additionally, sports injuries can result in a variety of other health issues.
Patellofemoral Syndrome
Accidents in sports which can harm an athlete generally are inclined to be knee injuries. Patellofemoral syndrome could be caused by a slide or fall onto the knees. This type of sports injury involves swelling, inflammation and an imbalance of the knee at its groove. Strengthening exercises and stretching can help provide flexibility and mobility to the muscles. Apart from strengthening exercises and stretches, a doctor of chiropractic, or chiropractor, may utilize therapeutic techniques for this specific injury.
Concussion
A blow to the head could lead to a concussion. Concussions are a serious type of sports injury and these should never be disregarded. Symptoms indicating a possible head injury may include nausea, vomiting, confusion, headache, and slurred speech. Any athlete who incurs a concussion must seek immediate medical attention. Chiropractic care can help with several of the symptoms, such as headaches, related to a concussion.
ACL Tear
The anterior cruciate ligament, or the ACL, is a fundamental ligament found in the knee. An ACL tear can be caused due to a sudden change in directions or coming to a sudden stop when playing sports or during exercise and physical activities. There’s typically swelling, inflammation and uncertainty in movement working with an ACL tear. Chiropractic care can assist with the recovery process of an ACL tear, particularly through physical therapeutics and rehabilitation programs.
Hip Flexor Strain
The hip flexor muscles are all located in the upper front area of the thigh. Sprinting, running slopes and sudden movements could lead to a hip flexor strain. There can be pain and discomfort together with swelling and inflammation in the region surrounding the thigh. Stretching and range of motion exercises employing a doctor of chiropractic, or chiropractor, can help aid with recovery. A chiropractor will work closely with a patient to determine the best treatment approach for their sports injuries.
Shin Splints
With shin splints, there’s usually pain and other painful symptoms in the lower leg, particularly along the tibia. Shin splints are the most common type of sports injuries among runners or running athletes. Ice and cold therapy can help reduce swelling and inflammation on the site. Moreover, runners or running athletes can prevent suffering shin splints by purchasing a good pair of shoes with proper arch support. The right equipment can always promote a safe participation in sports and physical activities.
Sciatica
Sciatica is back pain which radiates down the back of the leg and into the foot. This collection of symptoms is often seen in cyclists and athletes who perform a lot of backwards turning and swinging sports like tennis and golf. Sciatica, or sciatic nerve pain, may be caused by a pinched or compressed nerve, frequently due to a bulging or herniated disc. Chiropractic care is a well-known, alternative treatment option which can help alleviate sciatica, or sciatic nerve pain, symptoms.
Shoulder Injury
Shoulder injuries in sports commonly range from dislocations and misalignments to strains and sprains of the shoulder tendons and ligaments. Because the shoulder is frequently referred to as a weak joint, it is often vulnerable to suffering harm from sports injuries during exercise and physical activities, aside from the athlete’s specific sport. Ice and cold therapy as well as chiropractic care and rehabilitation can help ease the symptoms associated with shoulder injuries.
Tennis or Golf Elbow
This issue is known as an overuse sports injury. Repetitive actions inflame the forearm and wrist. Ice and cold therapy as well as rest normally helps with the symptoms, but stretching and strengthening exercises recommended by a chiropractor can also help.
Groin Pull
Additionally known as a groin strain, the groin muscles can get strained with quick side-to-side movements when engaging in exercises and physical activities. Stretching and strengthening exercises can help with the recovery process in this case as well.
Hamstring Strain
The hamstring muscles can be found in the back of the thigh. When athletes fail to stretch or exercise accordingly before engaging in their specific sports, it can cause this muscle to be pulled. If the symptoms of this condition continue over a couple of weeks, a chiropractor, or doctor of chiropractic, can help provide the necessary treatment through the use of other treatment approaches, such as ultrasound, among others, to help encourage the natural healing of the muscle and improve symptoms.
Dr. Alex Jimenez’s Insight
Although many common sports injuries are often beyond our control, athletes can engage in stretches and exercises before participating in their specific physical activities to help prevent a sports injury. Every workout should start with a gentle warm-up to prevent most of these sports injuries. It’s important for athletes to be mindful of the amount of pressure they exert on their bodies in order for them to avoid suffering sports injuries.
If you’ve suffered a sports injury, make sure to seek immediate medical attention from a qualified and experienced healthcare professional. Many skilled sports medicine doctors are dedicated to sports medicine and also focus on providing rehabilitation determined by the performance requirements of athletes. Healthcare professionals will design a treatment plan targeted to your sports injuries.
Get back in the game with the guidance of qualified and experienced healthcare professionals in sports injuries. Contact us and make sure to schedule a consultation.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain is one of the most prevalent causes for disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Knock knee is a condition that many children acquire when they are toddlers. Often, within a few years they grow out of it and their legs straighten naturally with no lasting effects.
Occasionally, though, a child�s legs don�t straighten and this is a cause for concern. There are many problems that can stem from knock knees, some of which will follow the child into adulthood and for the rest of his or her life. While there are several recognized treatments for knock knee, including surgery, chiropractic care has an excellent track record in managing and remedying this disorder.
What Is Knock Knee?
Knock knee, or genu valgum, is a condition that causes a person�s knees to bow in toward each other. In other words, when they stand with their knees touching and feet flat, parallel to each other, facing forward, their ankles do not touch. There may be a few inches between them or a foot, depending on its severity.
Most children go through a stage at around 3 or 4 years where they are knock kneed but by around age 8 or 10 they grow out of it and their legs straighten. Many parents become concerned when they first see their child becoming knock kneed. This is why it is vital that they understand a child�s normal growth patterns. It helps them worry less about something completely normal as well as know when to seek help if the condition does not right itself.
Aside from normal physiological child development, the atypical version of knock knees can be caused by several factors including:
Bone deformities
Knee malalignment
Genetics
Infection
Weak knee infrastructure
Injury
Rickets Disease
Scurvy
Blount�s Disease
What Health Problems Can Be Caused By Knock Knee?
Knock knee can cause pain and inflammation in the knees, ankles, and feet, as well as the hip and back. The pain can make mobility difficult. This is exacerbated if the patient is overweight because the added pressure on the joints as they are set at an unnatural position that does not adequately support the body can result in injuries to the bone, ligaments, and tendons.
A difference in leg length, a common issue with knock knee, can also cause the body to become misaligned, leading to back and hip pain. Over the long term and in severe cases, knock knee can lead to arthritis in adults and children.
How Is Knock Knee Treated?
Treatment for knock knee depends on the cause and age of the child. If the child is young and it has been determined that the knock knee is just a normal part of their growth pattern, very little action is taken although some experts advise laying a good foundation for the child by teaching them the importance of a healthy diet, regular exercise, and good posture.
Cases that are caused by some underlying factor, or that extend beyond the age that the child�s legs are expected to straighten, may require bracing. If there is an underlying cause such as infection or injury, that will need to be addressed in order to correct or manage the problem. In severe (and rare) cases, surgery may be necessary.
Is Chiropractic Care An Effective Treatment For Knock Knee?
Chiropractic care is an exceptional treatment for children of all ages who have knock knee. For younger patients who are experiencing it as a normal stage of development, it will help to keep their spine aligned and encourage good, healthy posture. In children who have an underlying cause, it can help to relieve any pain while increasing mobility as well as bringing the spine into proper alignment.
Many of the factors that cause knock knee can be addressed through chiropractic treatment and it has the added benefit of providing a whole-body wellness approach that teaches proper diet, exercise, and lifestyle changes. This noninvasive, gently, natural treatment can give children their best chance at being free from this condition.
Injury Medical Clinic:�Chiropractic Care Knee Injury
I actually feel pretty good right away, just because I know what I need and he knows how to take care of my particular injury. So, I’m usually good to go, next day, after I get re-aligned. Without a shadow of a doubt. I like the way he treats his patients, I like the way he treats me and he gets it done for me. I would recommend Dr. Jimenez to anyone. He is incredible. He is awesome. And I think he can pretty much pinpoint a lot of the issues that you may have. – Carlos Hermosillo
The vast majority of people are capable of dealing with a little bit of pain. Some people may often experience the occasional aggravation from overdoing their workout at the gym or perhaps some people have experienced that sudden twinge out of hitting their shins on the mattress, however, most of the time, these symptoms can be easily dismissed through the use of an over-the-counter anti-inflammatory drug and/or medication and they can go about their everyday life again as usual. But when pain is much more widespread throughout the whole body and it starts to be accompanied with fatigue, changes in mood and sleep patterns, these people may be dealing with a more serious health issue: fibromyalgia.
What is Fibromyalgia?
Fibromyalgia is a medical term utilized to describe a group of symptoms, rather than a single condition. Ordinarily, someone who is experiencing debilitating fatigue, tender areas around their the body, changes in mood or muscular pain, it may be characterized as common symptoms associated with this particular illness. Even though many healthcare professionals are still not sure about what causes fibromyalgia, most believe the pain is due to an overactive sympathetic nervous system, the part of the human body which activates the fight or flight response. A great deal of individuals experience symptoms after a physically or emotionally traumatic event. Other individuals begin having pain after spells of chronic depression or anxiety although others have symptoms that grow gradually over time. Fibromyalgia has been demonstrated to impact more women than men and in the event that they’ve got a relative with the disease, they are more likely to develop it also.
How is Fibromyalgia Treated?
Because fibromyalgia is not considered to be a single illness but rather a collection of symptoms and since it’s cause is unknown, there is currently no known cure for fibromyalgia. Instead, healthcare professionals generally focus on improving as well as managing the symptoms, typically by prescribing pain drugs and/or medications. Frequently, in case the sympathetic nervous system does respond to drugs/medications, the pain will subside. Healthcare professionals usually prescribe a combination of pain drugs and/or medications, antidepressants or anti-seizure medication to achieve this sort of regulation and alleviate symptoms. However, this treatment approach only temporarily relieves the symptoms associated with fibromyalgia instead of treating the health issue at its source. Chiropractic care is a safe and effective, alternative treatment option which focuses on the diagnosis, treatment and prevention of a variety of injuries and conditions associated with the musculoskeletal and nervous system.
Dr. Alex Jimenez’s Insight
Many patients with fibromyalgia seek chiropractic care to help ease neck pain, back pain and leg cramps which are often common symptoms associated with this syndrome. Research studies have also demonstrated that spinal adjustments and manual manipulations can help relieve chronic pain. One research study evaluated the effectiveness of chiropractic care on relieving symptoms related to fibromyalgia. The outcome measures demonstrated a decrease in pain and fatigue as well as an increase in the quality of sleep of the patients. A chiropractor who specializes in patients with fibromyalgia can carefully correct the alignment of the spine, alleviating the chronic pain associated with fibromyalgia.
Chiropractic Care for Fibromyalgia
Although fibromyalgia cannot be cured, one of the most well-known ways of managing and improving your symptoms is with chiropractic care. Chiropractic care can help relieve fibromyalgia pain by�carefully correct any spinal misalignments, or subluxations, through the use of spinal adjustments and manual manipulations. A variety of research studies have also demonstrated that other treatment techniques, such as aerobic exercise together with postural strengthening activities, which not only alleviate widespread pain, but also increase energy levels, improve sleep and elevate mood. Through an appropriate treatment plan, a chiropractor can help balance your own body’s capability to control nerve impulses, thus relieving your fibromyalgia symptoms. Normally, chiropractic care can include the following treatment techniques, besides spinal adjustments and manual manipulations.
Cardiovascular Exercise
One of the best methods to alleviate widespread pain would be by means of low-impact movement. This may include exercises and physical activities, such as walking on a treadmill, water aerobics or other exercises aimed towards improving blood flow, reducing strain and increasing cardiovascular fitness. A doctor of chiropractic, or chiropractic, can prescribe an exercise and physical activities program designed to your abilities, in order to help relieve fibromyalgia pain and symptoms.
Muscle Strengthening and Range of Motion
If you are in pain, the human body’s natural tendency is to protect the area, or limit its motion from fear of causing aggravation. This limited mobility can weaken substantial muscle structures and functions which further limit your range of motion and lift your stress� levels. This vicious cycle can only be improved by working to strengthen weakened muscles and reunite range of motion to the area you have been guarding. But how can you do this if you are in pain? A chiropractor will combine special exercises and physical activities together with other treatment approaches in order to help promote a faster recovery as well as decrease the symptoms of pain. A chiropractor will also closely assess the patient to make sure they are performing the right treatments.
Pain Relieving Modalities
A doctor of chiropractic, or chiropractor, comprises a large number of tools aimed toward relieving pain without the need for drugs and/or medications. These may consist�of ice, heat, trigger point therapy, stretching, massage, electrical stimulation, or other therapeutic tools that can help limit your pain and retrain your body. With concentrated exercise together with a cardiovascular exercise program, it is very likely to retrain your body without triggering widespread pain. Whether you have a disease which cannot be cured, such as fibromyalgia, it is very likely to get relief in the worst indications throughout alternative treatment options. Contact a healthcare professional to schedule your evaluation and find out how we can get you on the road to recovery. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain is one of the most prevalent causes for disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Damaris Foreman experienced migraine headaches for approximately 23 years. After visiting many healthcare professionals due to her migraine pain without seeing a great deal of progress, she was finally advised to find migraine pain treatment with Dr. Alex Jimenez, a chiropractor located in the city of El Paso, TX. Damaris significantly benefitted from chiropractic care and she experienced a massive sense of relief after her first spinal adjustment and manual manipulation. Damaris Foreman was able to confront a great deal of her questions and concerns and she was efficiently taught how to deal with her migraine pain. Damaris clarifies how Dr. Alex Jimenez’s migraine treatment is one of the best treatments she’s received and she highly recommends chiropractic care as the best non-surgical choice for enhancing and healing her migraine headaches.
Chiropractic Migraine Treatment & Relief
A migraine is commonly referred to as a primary headache disorder characterized by recurrent headaches as well as identified by moderate to severe in intensity. Ordinarily, the migraine headaches affect one half of the brain, are pulsating in personality, and might last from two to 72 hours. Associated symptoms may include nausea, vomiting, and sensitivity to light, noise, or odor. The pain could be aggravated by bodily activity. One third of people who suffer with migraines experience migraine with aura: normally a brief number of visual disturbance suggests that the headache will soon happen. It can also occur with minimal if any aggravation pain following it.
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As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.
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Costochondritis, also called Tietze syndrome, is often misdiagnosed due to the varied symptoms. It involves the ribs and, depending on the area affected, the pain, discomfort, and other symptoms can mislead doctors to underdiagnose or misdiagnose.
Patients may experience pain in the side, back, and chest which means it can mimic several different conditions, including heart attack, gastrointestinal problems, and lung disease. This can lead to anxiety and increased stress. It is also a chronic problem for some people, causing pain that can range from moderate to intense.
What Is Costochondritis?
The body is constructed so that the ribs protect the lungs. The first seven pairs connect to the sternum in the front and at two areas in the back along the spine while the lower five pairs are connected in the front by cartilage and in the back along the spine.
Ribs are meant to protect the organs, including the lungs and they are on hinges so that the lungs have room to expand during respiration. Costochondritis occurs when one of those hinges doesn�t work or the cartilage becomes inflamed. The condition is accompanied by pain and sometimes swelling in the affected area.
Symptoms Of Costochondritis
While swelling may occur in some cases with costochondritis, the primary symptom is pain in the chest area. This pain may become worse when coughing or taking a deep breath and is typically characterized as sharp or aching, although some patients do describe pressure or tightness in the chest area. It often occurs on the left side of the sternum and typically affects several ribs instead of just one. The area is also usually sensitive to touch and pressing on it will increase the pain.
Because the pain occurs in the chest area, many people believe that they are having a heart attack. It is important to note that anyone who experiences chest pain or tightness should seek emergency medical attention immediately in order to rule out heart attack or other life threatening conditions.
How Is Costochondritis Diagnosed?
Usually when a patient seeks treatment for costochondritis, there is no clear cause. However, there are some conditions and activities that have been linked to it and could be the cause or aid in creating the condition. Typical causes of costochondritis include:
Physical strain such as severe coughing, strenuous exercise, and heavy lifting. People with bronchitis and pneumonia sometimes get costochondritis because of the intense coughing. It is also common among body builders, caused when they strain to lift extremely heavy weights.
Injury such as getting hit in the chest.
Joint infection such as bacteria, viruses, and fungi that cause illnesses like aspergillosis, syphilis, and tuberculosis can infect and inflamer the rib joints.
Arthritis such as ankylosing spondylitis, rheumatoid arthritis, and osteoarthritis have all been linked to costochondritis.
Tumors including cancerous as well as noncancerous can cause costochondritis. When cancer moves through the body from the lung, thyroid, or breast it can cause inflammation in the rib joints.
People over 40 years old and women are the high-risk categories for costochondritis. Young adults and teenagers are more prone to the connected condition, Tietze syndrome, which is equally frequent in both women and men.
Chiropractic For Costochondritis
There is no standard treatment for costochondritis other than managing symptoms. However, chiropractic has proven to be exceptional for managing pain. Chiropractic treatment for the condition involves a gentle approach with anterior thoracic chiropractic adjustments along with treatment for the soft tissue around the affected area and extending along the nerve path.
The chiropractor may also recommend alternating heat and cold directly on the painful areas. Light massage may also work and the chiropractor will show them how to do this at home for continuing self-care. With regular chiropractic treatments and diligent self-care at home, patients can lessen the occurrences of costochondritis and greatly reduce or eliminate the pain.
Injury Medical Clinic: New Patient Chiropractic Care Intake Forms
“Clinical decision rules, spinal pain classification and prediction of treatment outcome: A discussion of recent reports in the rehabilitation literature”
Abstract
Clinical decision rules are an increasingly common presence in the biomedical literature and represent one strategy of enhancing clinical-decision making to improve the efficiency and effectiveness of healthcare delivery. In the context of rehabilitation research, clinical decision rules have been predominantly aimed at classifying patients by predicting their treatment response to specific therapies. Traditionally, recommendations for developing clinical decision rules propose a multistep process (derivation, validation, impact analysis) using the defined methodology. Research efforts aimed at developing a diagnosis-based clinical decision rule have departed from this convention. Recent publications in this line of research have used the modified terminology diagnosis-based clinical decision guide. Modifications to terminology and methodology surrounding clinical decision rules can make it more difficult for clinicians to recognize the level of evidence associated with a decision rule and understand how this evidence should be implemented to inform patient care. We provide a brief overview of clinical decision rule development in the context of the rehabilitation literature and two specific papers recently published in Chiropractic and Manual Therapies.
Clinical Prediction Rules
Healthcare has undergone an important paradigm shift toward evidence-based practice. An approach thought to enhance clinical decision-making by integrating the best available evidence with clinical expertise and patients’ preferences.
Ultimately, the goal of evidence-based practice is to improve healthcare delivery. However, the translation of scientific evidence into practice has proven a challenging endeavor.
Clinical decision rules (CDRs), also known as clinical prediction rules, are increasingly common in the rehabilitation literature.
These are tools designed to inform clinical decision-making by identifying potential predictors of diagnostic test outcome, prognosis, or therapeutic response.
In the rehabilitation literature, CDRs are most commonly used to predict a patient’s response to treatment. They have been proposed to identify clinically relevant subgroups of patients presenting with otherwise heterogeneous disorders such as non-specific neck or low back pain, which is the perspective on which we intend to focus.
Clinical Prediction Rules
The ability to classify or subgroup patients with heterogeneous disorders such as spinal pain has been highlighted as a research priority and, consequently, the focus of much research effort. The appeal of such classification approaches is their potential for improved treatment efficiency and effectiveness by matching patients with optimal therapies. In the past, patient classification has relied on implicit approaches founded in tradition or unsystematic observations. The use of CDRs to inform classification is one attempt at a more evidence-driven approach, less dependent on unfounded theory.
CDRs are developed in a multistep process involving studies of derivation, validation, and analysis of impact, with each having a defined purpose and methodological criteria. As with all forms of evidence used to make decisions about patients, attention to appropriate study methodology is critical to assessing the potential benefits of implementation.
Benefits Of Clinical Prediction Rules
It can accommodate more factors than the human brain can take into account
CDR/CPR model will always give the same result (mathematical equation)
Ultimately, the usefulness of a CDR lies not with its accuracy but with its ability to improve clinical outcomes and enhance the efficiency of care.[15] Even when a CDR demonstrates broad validation, this does not ensure that it will change clinical decision-making or that the changes it produces will result in better care.
The changes it produces will result in better care. McGinn et al.[2] identified three explanations for the failure of a CDR at this stage. First, if clinician judgment is as accurate as a CDR-informed decision, there is no benefit to its use. Second, the application of a CDR may involve cumbersome calculations or procedures which discourage clinicians from utilizing the CDR. Third, using the CDR may not be feasible in all environments or circumstances. In addition, we would include the reality that experimental studies may involve patients that are not entirely representative of those seen in routine care and that this may limit the actual value of a CDR. Therefore, to fully understand the utility of a CDR and its ability to improve healthcare delivery, it is necessary to undertake a pragmatic examination of its feasibility and impact when applied in an environment reflecting real-world practice. This can be undertaken with different study designs such as randomized trials, cluster-randomized trials, or other approaches such as examining the impact of a CDR before and after its implementation.
Prevalence of classification methods for patients with lumbar impairments using the McKenzie syndromes, pain pattern, manipulation, and stabilization clinical prediction rules.
Aims were (1) to determine the proportion of patients with lumbar impairments who could be classified at intake by McKenzie syndromes (McK) and pain pattern classification (PPCs) using Mechanical Diagnosis and Therapy (MDT) assessment methods, manipulation, and stabilization clinical prediction rules (CPRs) and (2) for each Man CPR or Stab CPR category, determine classification prevalence rates using McK and PPC.
CPRs are sophisticated probabilistic and prognostic models where a group of identified patient characteristics and clinical signs and symptoms are statistically associated with meaningful prediction of patient outcomes.
Two separate CPRs were developed by researchers for identifying patients who would respond favorably to manipulation.33,34 Flynn et al. developed the original manipulation CPR using five criteria, i.e., no symptoms below the knee, recent onset of symptoms (<16 days), low fear-avoidance belief questionnaire36 score for work (<19), hypomobility of the lumbar spine, and hip internal rotation ROM (>35 for at least one hip).33
Flynn’s CPR was subsequently modified by Fritz et al. to two criteria, that included no symptoms below the knee and recent onset of symptoms (<16 days), as a pragmatic alternative to reduce clinician burden for identifying patients in primary care most likely to respond to thrust manipulation.34 positively
“Potentia.l Pitfalls Of Clinical Prediction Rules”
What Are Clinical Prediction Rules?
A clinical prediction rule (CPR) is a combination of clinical findings that have statistically demonstrated meaningful predictability in determining a selected condition or prognosis of a patient who has been provided with a specific treatment 1,2. CPRs are created using multi-variate statistical methods, are designed to examine the predictive ability of selected groupings of clinical variables3,4, and are intended to help clinicians make quick decisions that may normally be subject to underlying biases5. The rules are algorithmic in nature and involve condensed information that identifies the smallest number of statistically diagnostic indicators to the targeted condition6.
Clinical prediction rules are generally developed using a 3-step method14. First, CPRs have derived us prospectively-
ing multivariate statistical methods to examine the predictive ability of selected groupings of clinical variables3. The second step involves validating the CPR in a randomized controlled trial to reduce the risk that the predictive factors developed during the derivation phase were selected by chance14. The third step involves conducting an impact analysis to determine how the CPR improves care, reduces costs, and accurately defines the targeted objective14.
Although there is little debate that carefully constructed CPRs can improve clinical practice, to my knowledge, there are no guidelines that specify methodological requirements for CPRs for infusion into all clinical practice environments. Guidelines are created to improve the rigor of study design and reporting. The following editorial outlines potential methodological pitfalls in CPRs that may significantly weaken the transferability of the algorithm. Within the field of rehabilitation, most CPRs have been prescriptive; thus, my comments here are reflective of prescriptive CPRs.
Methodological Pitfalls
CPRs are designed to specify a homogenous set of characteristics from a heterogeneous population of prospectively selected consecutive patients5,15. Typically, the resulting applicable population is a small subset of a larger sample and may only represent a small percentage of the clinician’s actual daily caseload. The setting and location of the larger sample should be generalizable15,16, and subsequent validity studies require assessment of the CPR in different patient groups, in different environments, and with a typical patient group seen by most clinicians16. Because many CPRs are developed based on a very distinct group that may or may not reflect a typical population of patients, the spectrum transportability17 of many current CPR algorithms may be limited.
Clinical prediction rules use outcome measures to determine the effectiveness of the intervention. Outcome measures must have a single operational definition5 and require enough responsiveness to capture appropriate change in the condition14 truly; in addition, these measures should have a well-constructed cut-off score16,18 and be collected by a blinded administrator15. The selection of an appropriate anchor score for measurement of actual change is currently debated19-20. Most outcome measures use a patient recall-based questionnaire such as a global rating of change score (GRoC), which is appropriate when used in the short term but suffers from recall bias when used in long-term analyses19-21.
A potential drawback for CPRs is the failure to maintain the quality of the tests and measures used as predictors in the algorithm. Therefore, the perspective test and measures should be independent of one another during modeling16; each should be performed in a meaningful, acceptable manner4; clinicians or data administrators should be blinded to the patient’s outcomes measures and condition22.
Sources
Potential Pitfalls Of Clinical Prediction Rules; The Journal of Manual & Manipulative Therapy Volume 16 Number Two [69]
Jeffrey J Hebert and Julie M Fritz; Clinical decision rules, spinal pain classification and prediction of treatment outcome: A discussion of recent reports in the rehabilitation literature
The reason I chose Dr. Jimenez is that he’s very thorough. From the get-go, he diagnoses the problem, diagnoses what he needs to do. I’ve had a couple shoulder injuries, I’ve had some wrist and elbow injuries, back injuries, and Dr. Jimenez has been the only one, like I said, he’s very thorough, he’s got great manners, and he’s nursed me back to health immediately. – Louie Martinez
Similar to athletes who suffer sports injuries, employees can also experience work injuries; simply the circumstances are different. And as with athletes with sports injuries, many employees with work injuries can benefit from chiropractic care. If you’ve suffered a work-related accident which resulted in injury and you require treatment for your specific health issues, a worker’s compensation claim can help pay for the expenses of rehabilitation. However, it’s important to understand the various types of work injuries as well as how a worker’s compensation claim should be filed before receiving treatment. Below, we will discuss how a healthcare professional can help you with your work injury.
Strategies for Payment of Work Injury Treatment
To begin with, the appropriate treatment option, such as chiropractic care, needs to be organized by your treating healthcare professional and the patient’s insurance company should offer approval. If you do not get approval for work injury treatment, do not be alarmed, there are a lot of steps you may take to get the treatment accepted. These essential basic guidelines will be described below, including:
Ask the doctor’s office to file a Form WC-205 requesting acceptance
File a Form WC-PMT for treatment approval
Ask for a hearing in front of a judge to get acceptance
Obtain an worker’s compensation lawyer for faster approval
Common Work Injuries
Serious workplace accidents are much too prevalent and there are a variety of common work injuries which can occur across all occupational sectors. People working in different sorts of jobs face a different range of dangers. By way of instance, an office worker would not have the same risk of suffering burns as a chef in a restaurant would.
What we do understand, however, is that about 144 employees were killed at work between 2015 and 2016 and approximately 621,000 estimated non fatal injuries to workers were reported, equating to an astonishing 4.5 million estimated working days being lost.
The workplace can be a very hazardous place and not only is it the employer’s responsibility to guarantee a safe working environment; every worker also has a responsibility to take care of themselves when they’re on the job. But to be forewarned is to be forearmed, as the saying goes. Here are several of the most common work injuries, where we will also discuss various safe and effective ways to prevent future workplace accidents.
Slips, Trips and Falls
Focusing on the most important dangers within your workplace, particularly the ones with the capability to cause harm, can help prevent work injuries. In many cases, simple measures can readily control risks, for example, ensuring spillages are cleaned up immediately so people don’t slip or making sure cabinet drawers are kept closed to make sure people do not trip and fall. For most, these are easy, economical and effective measures to ensure your most precious asset, that your work force is protected.
Muscle Strains
Strained muscles are just another frequent work-related injury, as anyone who frequently lifts hefty things at work will likely know already. Neck and back strains, specifically, are all too often sustained while working. These injuries can be prevented easily, some basic training on proper lifting techniques can make a tremendous difference. The use of specialized equipment as well as safety tools and gear can also help prevent muscle strains.
Being Hit By Falling Objects
Falling or flying objects in the workplace can expose workers to relatively minor injuries, like cuts or abrasions, as well as more severe injuries such as concussions or blindness. Wearing safety gear and equipment in workplace areas where objects can fall or fly out can help prevent these types of injuries. Moreover, ensuring that your own equipment is secured and wont’ fall or fly away can help prevent these type of work injuries in the first place.
Repetitive Strain Injury
Repetitive strain injury, or RSI, is a health issue that’s become increasingly common in the workplace.�RSI may be caused by many different tasks, including strong or repetitive activity, or by poor posture. The condition mostly affects parts of the upper body, such as the�hands, writs, forearm, elbow, neck and shoulders. The cumulative effect of RSI can be severe in some cases, so it is logical to take the necessary precautions and avoid overexertion.
Crashes and Collisions
Accidents leading to crash or impact injuries are rather frequent in workplace settings as well. Whether they involve cars, lorries or smaller vehicles like forklift trucks, they could have serious consequences. It’s therefore up to companies to make sure that seatbelts and other safety precautions are in position and in use where appropriate, to prevent these types of workplace injuries.
Cuts and Lacerations
All kinds of office implements may end up leaving a painful cut. From power generators to paper trimmers, it is easy to get hurt on the job. The most common causes of those lacerations consist of poor training, inadequate security procedures and neglecting to wear the appropriate protection. Employers may help prevent such accidents by providing adequate safety equipment and putting the right procedures, such as training.
Inhaling Toxic Fumes
The air in several workplaces contains toxic substances in the kind of dusts, fumes, mists, gases and vapours. While most of us do not work with toxic chemicals, those of us who do, without the proper safety measures, may be at risk of impairment to breathing, skin or eye reactions as well as possibly more severe injuries. Employers must provide employees with the correct workwear, such as fitted face masks and goggles, to avoid dangerous exposure.
Exposure to Loud Noise
Loud noise on the job can lead to hearing damage that is permanent and disabling. This can be hearing loss that is gradual due to exposure to noise over time, but also damage caused by sudden, extremely loud noises. Industrial deafness may also result in significant compensation payouts farther across the line, and its often considered to be very much in companies’ interest to disregard this health issue. Safety measures like ear protection can help to prevent it.
Walking Into Objects
It is probably safe to say we’ve all done this at any point. Maybe you’re chatting absent-mindedly or perhaps you’re feeling a little under the weather, when you suddenly end up on the sharp end of a doorway, wall, table or cabinet. Obviously, these accidents can cause damage. Fortunately, such mishaps can be avoided by approving employees to be vigilant and transferring unnecessary hazards out of the way so people can’t walk into them.
Fights at Work
Simmering workplace stress can bubble under for weeks or perhaps years before spilling over into physical confrontation, or rather one workmate can take another’s opinion on last weekend’s game the incorrect way. Fights in the workplace can, unsurprisingly, lead to some serious work injuries. Effective procedures for dealing with employee grievances can reduce the probability of them being irritable and causing fights at work.
Oftentimes, accidents aren’t only brought on by a small mistake or a simple mishap from a busy employee. Many workplace accidents are tied to employer or employee negligence. Even though there’s no shortage of ways people can injure themselves in the office, we do know there are various procedures employers can set up to prevent workers from coming to some avoidable harm. Training, signage and accessibility to the essential safety equipment can all be a major assistance, with regular risk assessments becoming a necessity within the office, as well as in other workplace settings, to help avoid unnecessary mishaps and work injuries.
Dr. Alex Jimenez’s Insight
While the workplace is meant to be a safe and professional environment often supplied with protective gear and equipment, work injuries can sometimes occur. A variety of workplace injuries can lead to trauma, damage or injury and can even aggravate a previously existing condition, although some occur more frequently than others. Common work injuries can include, slips, trips and falls, muscle strains, being hit by falling objects, and repetitive strain injury, among others. However, the most important thing for employees to be aware of at any time an accident occurs is that if they are injured on the workplace, they should report the injury immediately to a supervisor.
Chiropractic Care and Workplace Injuries
Individuals who have been injured at work may often have an underlying condition to begin with. Once they’ve suffered a work injury, however, returning to work is a necessity for the individual’s household. A healthcare professional, such as a chiropractor, will produce a treatment plan that is specifically targeted to your own situation. Goals are put up, and your chiropractor can permit you to achieve those aims. This healthcare professional is your trainer in returning to work. Treatment may consist of spinal adjustments and manual manipulations, physical therapeutics, stretching, particular exercises, hot and cold therapy, ultrasound, aquatic therapy and joint mobilization. Chiropractic care is an alternative treatment option which focuses on the treatment of a variety of injuries and conditions associated with the musculoskeletal and nervous system.
When you have been hurt in the workplace, contact a healthcare professional immediately. Chiropractors are skilled and dedicated to your personal restoration. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain is one of the most prevalent causes for disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
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