Sports Injury Treatment: PUSH-as-Rx ��: 915-203-8122 | Dr. Alex Jimenez � Chiropractor: 915-850-0900 PUSH-as-Rx ���is leading the field with laser focus supporting our youth sport programs.� The�PUSH-as-Rx ���System is a sport specific athletic program designed by a strength-agility coach and physiology doctor with a combined 40 years of experience working with extreme athletes. At its core, the program is the multidisciplinary study of reactive agility, body mechanics and extreme motion dynamics. Through continuous and detailed assessments of the athletes in motion and while under direct supervised stress loads, a clear quantitative picture of body dynamics emerges. Exposure to the biomechanical vulnerabilities are presented to our team. �Immediately,�we adjust our methods for our athletes in order to optimize performance.� This highly adaptive system with continual�dynamic adjustments has helped many of our athletes come back faster, stronger, and ready post injury while safely minimizing recovery times. Results demonstrate clear improved agility, speed, decreased reaction time with greatly improved postural-torque mechanics.��PUSH-as-Rx ���offers specialized extreme performance enhancements to our athletes no matter the age.
Sports Injury Treatment
Vincent Garcia, an athlete training in mixed martial arts, or MMA, suffered a knee injury and developed turf toe, but that hasn’t stopped him from participating in his regular training regimen. In order to return to as well as improve his original physical performance, Vincent Garcia found treatment with Dr. Alex Jimenez, doctor of chiropractic. Now recovering from his sports injuries, Vincent Garcia looks forward to regaining his strength, flexibility and mobility to return to sport.
Dr. Alex Jimenez D.C. – Treats Vince Garcia MMA Fighter for Sports Injuries, including knee pain and turf toe. Dr. Jimenez D.C can be reached at (915) 850-0900 or visit our website at www.DrAlexJimenez.com
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Why Chiropractic Works:�PUSH-as-Rx ��: 915-203-8122 | Dr. Alex Jimenez � Chiropractor: 915-850-0900
PUSH-as-Rx �� & Chiropractor Dr. Alex Jimenez are leading the field with laser focus supporting our youth sport programs.� The�PUSH-as-Rx ���System is a sport specific athletic program designed by a strength-agility coach and physiology doctor with a combined 40 years of experience working with extreme athletes. At its core, the program is the multidisciplinary study of reactive agility, body mechanics and extreme motion dynamics. Through continuous and detailed assessments of the athletes in motion and while under direct supervised stress loads, a clear quantitative picture of body dynamics emerges. Exposure to the biomechanical vulnerabilities are presented to our team. �Immediately,�we adjust our methods for our athletes in order to optimize performance.� This highly adaptive system with continual�dynamic adjustments has helped many of our athletes come back faster, stronger, and ready post injury while safely minimizing recovery times. Results demonstrate clear improved agility, speed, decreased reaction time with greatly improved postural-torque mechanics.��PUSH-as-Rx ���offers specialized extreme performance enhancements to our athletes no matter the age.
Why Chiropractic Works
We Welcome You ??. Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional & Integrative Nutrition, Agility & Mobility Fitness Training and Cross-Fit Rehabilitation Systems for all ages. As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high performance exercises and advanced agility treatment options. We have teamed up with the cities premier doctors, therapist and trainers in order to provide high level competitive athletes the options to push themselves to their highest abilities within our facilities. We’ve been blessed to use our methods with thousand of El Pasoan’s over the last 3 decades allowing us to restore our patients health and fitness while implementing researched non-surgical methods and functional wellness programs. Our programs are natural and use the body’s ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, un-wanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living. With a bit of work, we can achieve optimal health together, no matter the age or disability. Join us in improving your health for you and your family. Its all about: LIVING, LOVING & MATTERING! �And this is why chiropractic works!�?
A migraine is commonly identified by a moderate to severe throbbing pain or a pulsing sensation, usually on one side of the head, often accompanied by nausea, vomiting and extreme sensitivity to light and sound. Migraine headache pain can last for hours to even days and the symptoms can become so severe they may be disabling. Many doctors can treat varying intensities of head pain, however, the use of drugs and/or medications may only temporarily relieve the painful symptoms. Evidence-based research studies like the one described below, have determined that chiropractic spinal manipulative therapy may effectively improve migraine headaches. The purpose of the article is to educate patients on migraine headache chiropractic treatment.
A Twelve Month Clinical Trial of Chiropractic Spinal Manipulative Therapy for Migraine
Abstract
Objective: To assess the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatment of migraine.
Design: A prospective clinical trial of twelve months duration. The trial consisted of 3 stages: two month pre- treatment, two month treatment, and two months post treatment. Comparison of outcomes to the initial baseline factors was made and also 6 months after the cessation of the study.
Setting: Chiropractic Research Centre of Macquarie University
Participants: Thirty two volunteers, between the ages of 20 to 65 were recruited through media advertising. The diagnosis of migraine was based on a self reported detailed questionnaire, with minimum of one migraine per month.
Interventions: Two months of chiropractic SMT at vertebral fixations determined by the practitioner, through orthopedic and chiropractic testing.
Main Outcome Measures: Participants completed diaries during the entire trial noting the frequency, intensity (visual analogue score), duration, disability, associated symptoms and use of medication for each migraine episode.
Results: The initial 32 participants showed statistically significant (p < 0.05) improvement in migraine frequency, VAS, disability, and medication use, when compared to initial baseline levels. A further assessment of outcomes after a six month follow up (based on 24 participants), continued to show statistically significant improvement in migraine frequency (p < 0.005), VAS (p < 0.01), disability (p < 0.05), and medication use (p < 0.01), when compared to initial baseline levels. In addition, information was collected regarding any changes in neck pain following chiropractic SMT. The results indicated that 14 participants (58%) reported no increase in neck pain as a consequence of the two months of SMT. Five participants (21%) reported a slight increase, three participants (13%) reported mild pain, and two participants (8%) reported moderate pain.
Conclusion: The results of this study support the hypothesis that Chiropractic SMT is an effective treatment for migraine, in some people. However, a larger controlled study is required.
The cervical spine as a cause of headache has been well described in the literature (1,2). The Headache Classification Committee of the International Headaches Society, has defined cervicogenic headache, in addition to the other types of headaches, including migraine and tension type headache (3).
However, the role of spinal conditions (especially the cervical spine) and their associated treatment for migraine does not have a well established causal relationship or clear aetiological pathway (4-7). In addition, migraine often has uncertain or overlapping diagnostic criteria thus making the role of the cervical spine as an aetiological factor even more uncertain (8,9).
Migraines are a common and debilitating conditions yet because of this uncertain aetiology, the most appropriate long term treatment has not been established (9,10). Most aetiological models relate to vascular causes of migraine, where episodes seem to be initiated by a decreased blood flow to the cerebrum followed by extracranial vasodilatation during the headache phase (11,12). However, other aetiological models seem connected with vascular changes related to neurological causes and associated serotonergic disturbances (10). Therefore, previous treatments have focused on pharmacological modification of blood flow or serotonin antagonist block (11).
This paper will evaluate the efficacy of chiropractic spinal manipulative treatment during a prospective clinical trial of twelve months duration.
Chiropractic Treatment
Chiropractic SMT is defined as a passive manual manoeuvre during which the three joint complex is carried beyond the normal physiological range of movement without exceeding the boundaries of anatomical integrity (4). SMT requires a dynamic force in a specific direction, usually with a short amplitude to correct a problem of reduced vertebral motion or positional fault. Treatment usually consists of short amplitude, high velocity spinal manipulative thrusts (diversified technique), on areas of vertebral fixation determined by a clinical history and physical examinations.
The most commonly used factors to locate vertebral fixation (denoted vertebral subluxation complex by�chiropractors) are a clinical history relating to mechanical pain patterns and medical details to excluded possible non- mechanical causes (4). These findings would then be confirmed by a thorough physical examination, by assessing which tests/signs (orthopaedic and chiropractic) were able to reproduce the presenting symptom (7).
Studies in effectiveness and cost-effectiveness of treatment for back pain have found significant benefit for chiropractic spinal manipulative therapy (SMT). These studies have been detailed in a previous publication by this author on chiropractic in the workers compensation system (13). In addition, numerous studies have identified improvement in neck pain and headache following chiropractic SMT (4,7,14-17).
This paper will test an hypothesis that spinal conditions appear to contribute to the aetiology and morbidity of migraine.
Methodology
The study was twelve month prospective clinical trial which involved 32 subjects who received a two month course of chiropractic SMT. Treatment consisted of short amplitude, high velocity spinal manipulative thrusts (chiropractic adjustive technique), on areas of vertebral subluxation determined by the physical examination.
Participants were recruited via the radio and newspapers in the Sydney region. Applicants completed a previously reported questionnaires, and were selected according to responses in the following symptoms. The participants needed to a minimum of 5 of the following IHS indicators: reaction to pain requiring cessation of activities, the need to seek a quiet dark area, unilateral pain located parieto- temporal, pain described as pulsating/throbbing, associated symptoms of nausea &/or vomiting, photophobia &/or phonophobia, migraine aggravated by head or neck movements, and a family history of migraine (3).
Inclusion was also based on participants experiencing at least one migraine a month. Exclusion was based on non- migraine indicators of a daily migraine or the initiating factor being trauma. Participants were also excluded from the study if there were contra-indications to SMT, such as meningitis or cerebral aneurysm. In addition, participants with temporal arteritis, benign intracranial hypertension or space occupying lesions were also excluded due to safety aspects.
Participants completed diaries during the initial six month trial noting the frequency, VAS, duration, disability, associated symptoms and use of medication for each migraine episode. Participants were instructed how to complete the diary which contained a table and an�instruction sheet. Participants had to note the date of the migraine, an intensity score based on a visual analogue scale, the hours the migraine lasted and the time before they could return to normal activities. In addition, participants noted associated symptoms using a letter abbreviation and they noted the type and strength of medication for each migraine episode.
Patient's blinding was achieved by participants being informed that they may be randomly assigned to a control group which would receive a placebo (non effective) treatment. Concurrently, the practitioners were "blinded" to previous treatment results, assignment of control procedures and other outcome measures.
The first aspect of the trial was conducted over six months, and consisted of 3 stages: two months pre-treatment, two months treatment, and two months post treatment. Participants were contacted by the author a further six months after the initial trial and asked to complete another questionnaire regarding their current migraine episodes for comparison to baseline data. The follow up questionnaire sought information on the same outcome measures, as detailed in the diaries described above.
Comparison was made to initial baseline outcome measurements of migraine preceding commencement of SMT, data at the end of the two months post SMT, and to the six month follow up data. Statistical analysis involved comparing the changes of the different outcome measurements of frequency, VAS, duration, disability, and medication use throughout the trial. Statistical tests employed were a paired t test to test for significant difference between each group and a one way analysis of variance (ANOVA) to test for changes for all groups.
Dr. Alex Jimenez's Insight
"How can chiropractic spinal manipulative therapy help manage my migraine headache pain?"�Although researchers today don't know the definitive cause behind these complex headaches, many healthcare professionals believe migraines are often the result of an underlying issue along the cervical spine, or neck. If you suffer from migraine headache pain, chiropractic treatment can help correct spinal misalignments, or subluxations, in the cervical spine to improve the severity of the headache and decrease their frequency. It's not necessary to rely on drugs and/or medications to relieve the painful symptoms, however, these may be used if properly directed by a healthcare professional. Rather than focusing on the head pain alone, a doctor of chiropractic will target the source of the issue and help improve your overall health and wellness.
Results
Thirty two participants, between the ages of 23 to 60, joined the study with there being 14 males and 18 females. Table 1 gives the comparative descriptive statistics for the group. The length of time the person had migraines ranged between 5 to 36 years for the group, with the average being 18.1 years. The duration of a typical migraine episode ranged between 0.75 to 108 hours for the group, with the average being 23.3 hours. The disability (length of time before the person could return to normal activities) of a typical migraine ranged between 0 to 108 hours for the group, with the average being 25.0 hours.
The percentage response for each of the diagnostic criteria of the IHS guidelines is detailed in table 2 (Table 2). The highest responses were for photophobia (91%), nausea (88%), reaction to pain requiring the person to seek a quiet dark area (84%), phonophobia (72%), throbbing pain characteristic (69%), parieto-temporal pain location (69%), inability to continue normal activities (66%), and family history (63%).
The IHS diagnostic criteria with the lowest responses were aura (31%), migraines aggravated by head or neck movement (53%), and vomiting (56%). A moderate number (44%) of people did not indicate aura as a feature, however, they described either homonymous visual changes or parasthesias. Therefore, the number of people experiencing migraine with aura (MA) for this group was twenty four (75%) of a total group of thirty two.
The group showed statistically significant improvement (p < 0.05) in migraine frequency, VAS, duration and disability, when compared to initial baseline levels. The frequency rates reduced by 46% for the group, severity reduced by 12%, duration reduced by 20%, disability reduced by 14% only one participant (3.1 %) reported that their migraine episodes were worse after the two months of SMT, but this was not sustained at the two month post treatment follow up period. Table 3 demonstrates variate scores in each of the six diary categories for the three phases of the trial.
From the initial thirty two participants who entered the study, four participants failed to complete the entire trial, one due to alteration in work situation, one due to a fractured ankle, one due to soreness after SMT, and one ACO�following a perceived worsening of their migraine due to chiropractic SMT. In addition, four people failed to return their six month follow up data, and were excluded from the assessment. Therefore the assessment of changes in migraine at the twelve month period was based on 24 participants. Table 4 gives the comparative statistics for this group at the end of the 12 month period.
The average response at twelve months (n=24) showed statistically significant improvement in migraine frequency (p < 0.005), VAS (p < 0.01), duration (p < 0.05), and medication use (p < 0.01), when compared to initial baseline levels (Figure ????). The greatest area for improvement was with the frequency of episodes (60% reduction), and the associated severity of each migraine (14% reduction). In addition, the duration of the migraine (20% reduction) and the use of medication, reduced significantly following the SMT intervention (36% reduction). Table 3 shows mean variate scores for the three phases of the trial and statistical significance by analysis of variance (ANOVA).
Another additional result related to associated neck pain. Fourteen participants (58%) reported no increase in neck pain as a consequence of the two months of SMT. Five participants (21%) reported slight pain, three participants (13%) reported mild pain, and two participants (8%) reported moderate pain.
Discussion
The majority of participants were chronic migraine sufferers, on average they had experienced migraines for 18.1 years. However, the results have demonstrated a significant (p< 0.005) reduction in their migraine episodes and their associated disability. The mean number of migraines per month reduced from 7.6 to 2.6 episodes.
A twelve month study gives the results substantial significance because a criticism of early studies were that the length of the trial was too short to allow for the cyclical nature of migraines (18). However, the study was limited in the sample size and the fact that the trial was a pragmatic study which did not consider what aspects of chiropractic SNIT had contributed to the improvement in the migraines.
In addition, the study was limited due to the lack of a control group. However, it could be argued that participants acted as their own form of control, due to the�baseline two months data collection, especially given the fact that this group were chronic migraine sufferers.
A further limitation of this study, as with other studies of migraine or headaches was that there is substantial overlap in diagnosis and classification of migraines. The questionnaire used in this study proved to have good reliability, however, there is strong suggestion that many headache sufferers may have more than one type of headache (6-9). An advantage with the design of this study is that regardless of the exact "diagnosis" of the migraine, self reported improvement of outcome measures allow assessment of the validity of the therapy in question (4).
This study appears to confirm that there are a number of precipitating or aggravating factors involved in migraine episodes and therefore a single treatment regime may prove ineffective in the long term (4,5,9,15).
Practitioners need to be aware of the various treatment strategies and their relative advantages or limitations.
Importantly, many of the associated symptoms suffered by participants on the trial were reported to be decreased following the SMT. The associated symptoms which decreased following the trial included nausea (41% of participants felt reduction), photophobia (31 % felt reduction), vomiting (25% felt reduction), and phonophobia (25% felt reduction). Commonly reported side effects which often increase following pharmaceutical trials include nausea, vomiting, fatigue, chest pain, paraesthesia, somnolence, syncope, vertigo and less commonly atrial fibrillation. In addition, recent evidence has identified sumatriptan to be a potential cause of birth defects and myocardial infarction (19,20).
Whilst not a factor noted by the IHS, stress as either an aggravating or precipitating factor was cited by 73% of participants. In addition, 66% of people reported neck pain at the time of the migraine, with a further 31 % of people reporting upper back pain (some people noted both simultaneously).
Interestingly, five people at the end of the 12 months followup had no migraines and had decreased need for medication by 100% following chiropractic SMT. No patients reported that their migraines had increased as a result of the SMT trial.
Conclusion
The results of this study support the hypothesis that Chiropractic SMT is an effective treatment for migraine, in some people. However, due to the multifactorial nature of migraine, and the finding that episodes usually reduce following any intervention, further larger controlled study is required.
A prospective randomised controlled trial utilising detuned EPT (interferential), a sham manipulation group and an SMT group is nearing conclusion. It is anticipated this trial will provide further information of the efficacy of Chiropractic SMT in the treatment of migraine with aura.
In conclusion,�because migraine headache pain can be significantly debilitating, it's essential for patients who suffer from this complex type of head pain to understand the effectiveness of chiropractic spinal manipulative therapy. According to the results of the research study above, migraine headache chiropractic treatment can be effectively used to as migraine treatment. Regardless of the results of the twelve month clinical trial, further research studies are still required. Information referenced from the National Center for Biotechnology Information (NCBI). 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: Neck Pain
Neck pain is a common complaint which can result due to a variety of injuries and/or conditions. According to statistics, automobile accident injuries and whiplash injuries are some of the most prevalent causes for neck pain among the general population. During an auto accident, the sudden impact from the incident can cause the head and neck to jolt abruptly back-and-forth in any direction, damaging the complex structures surrounding the cervical spine. Trauma to the tendons and ligaments, as well as that of other tissues in the neck, can cause neck pain and radiating symptoms throughout the human body.
1. Bogduk N. Cervical causes of headache and dizziness. In: Greive GP (ed) Modern manual therapy of the vertebral column. 2nd ed 1994. Churchill Livingstone, Edinburgh. p3l7-31.
2. Jull GA. Cervical Headache: a review. In: Greive GP (ed) Modem manual therapy of the vertebral column. 2nd ed 1994. Churchill Livingstone, Edinburgh. p 333-34,6
3. Headache Classification Committee of the International Headache, Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalgia 1988, 9. Suppl. 7: 1-93.
4. Tuchin PJ. The efficacy of chiropractic spinal manipulative therapy (SMT) in the treatment of migraine - a pilot study. Aust Chiro & Osteo 1997; 6: 41-7.
5. Milne E. The mechanism and treatment of migraine and other disorders of cervical and postural dysfunction. Cephaigia 1989; 9, Suppi 10: 381-2.
6. Kidd R, Nelson C. Musculoskeletal dysfunction of the neck in migraine and tension headache. Headache 1993; 33: 566-9.
7. Tuchin PJ, Bonello R. Classic migraine or not classic migraine, that is the question. Aust Chiro & Osteo 1996; 5: 66-74.
8. Marcus DA. Migraine and tension type headaches: the questionable validity of current classification systems. 1992; Pain 8: 28-36.
9. Rasmussen BK, Jensen R, Schroll M, Olsen J. Interactions between migraine and tension type headaches in the general population. Arch Neurol 1992; 49: 914-8.
10. Lance JW. A concept of migraine and the search for the ideal headache drug. Headache 1990; 1: 17-23.
11. Dalassio D. The pathology of migraine. Clin J Pain 1990 6: 235-9.
12. Moskowitz MA. Basic mechanisms in vascular headache. Neurol Clin 1990; 16: 157-68
13. Tuchin PJ, Bonello R. Preliminary Findings of Analysis of Chiropractic Utilisation and Cost in the Workers Compensation System of New South Wales. J Manipulative Physiol Ther 1995; lg: 503-11.
14. Tuchin PJ, Scwafer T, Brookes M. A Case Study of Chronic Headaches. Aust Chiro & Osteo 1996; 5: 47-53.
15. Parker GB, Tupling H, Pryor DS. A Controlled Trial of Cervical Manipulation for Migraine. Aust NZ J Med 1978; 8: 585-93.
16. Young K, Dharmi M. The efficacy of cervical manipulation as opposed to pharmacological therapeutics in the treatment of migraine patients. Transactions of the Consortium for Chiropractic Research. 1987.
17. Vernon H, Steiman I, Hagino C. Cervicogenic dysfunction in muscle contraction headache and migraine: a descriptive study. J Manipulative Physiol Ther 1992; 15: 418-29
18. Parker GB, Tupling H, Pryor DS. Why does migraine improve during a clinical trial? Further results from a trial of cervical manipulation for migraine. Aust NZ J Med 1980; 10: 192-8.
19. Ottervanger JP, Stricker BH. Cardiovascular adverse reactions to sumatriptan: cause for concern? CNS Drugs 1995; 3: 90-8.
20. Simmons VE, Blakeborough P. The safety profile of sumatriptan. Rev Contemp Pharmacother 1994; 5: 319-28.
These assessment and treatment recommendations represent a synthesis of information derived from personal clinical experience and from the numerous sources which are cited, or are based on the work of researchers, clinicians and therapists who are named (Basmajian 1974, Cailliet 1962, Dvorak & Dvorak 1984, Fryette 1954, Greenman 1989, 1996, Janda 1983, Lewit 1992, 1999, Mennell 1964, Rolf 1977, Williams 1965).
Clinical Application of Neuromuscular Techniques: Infraspinatus
Assessment of Shortness in the Infraspinatus
Infraspinatus shortness test (a) The patient is asked to reach upwards, backwards and across to touch the upper border of the opposite scapula, so producing external rotation of the humeral head. If this effort is painful infraspinatus shortness should be suspected.
Infraspinatus shortness test (b) (see Fig. 4.37 below) Visual evidence of shortness is obtained by having the patient supine, upper arm at right angles to the trunk, elbow flexed so that lower arm is parallel with the trunk, pointing caudad with the palm downwards. This brings the arm into internal rotation and places infraspinatus at stretch. The practitioner ensures that the shoulder remains in contact with the table during this assessment by means of light compression.
Figure 4.37 Assessment and self-treatment position for infraspinatus. If the upper arm cannot rest parallel to the floor, possible shortness of infraspinatus is indicated.�If infraspinatus is short, the lower arm will not be capable of resting parallel with the floor, obliging it to point somewhat towards the ceiling.
Assessment for Infraspinatus Weakness
The patient is seated. The practitioner stands behind. The patient�s arms are flexed at the elbows and held to the side, and the practitioner provides isometric resistance to external rotation of the lower arms (externally rotating them and also the humerus at the shoulder). If this effort is painful, an indication of probable infraspinatus shortening exists.
The relative strength is also judged. If weak, the method discussed by Norris (1999) should be used to increase strength (isotonic eccentric contraction performed slowly).
NOTE: In this as in other tests for weakness there may be a better degree of cooperation if the practitioner applies the force, and the patient is asked to resist as much as possible. Force should always be built slowly and not suddenly.
MET Treatment of Infraspinatus
Figure 4.38 MET treatment of infraspinatus. Note that the practitioner�s left hand maintains a downward pressure to stabilise the shoulder to the table during this procedure.
The patient is supine, upper arm at right angles to the trunk, elbow flexed so that lower arm is parallel with the trunk, pointing caudad with the palm downwards. This brings the arm into internal rotation and places infraspinatus at stretch.
The practitioner ensures that the posterior shoulder remains in contact with the table by means of light compression. The patient slowly and gently lifts the dorsum of the wrist towards the ceiling, against resistance from the practitioner, for 7�10 seconds.
After this isometric contraction, on relaxation, the forearm is taken towards the floor (combined patient and practitioner action), so increasing internal rotation at the shoulder and stretching infraspinatus (mainly at its shoulder attachment).
Care needs to be taken to prevent the shoulder from rising from the table as rotation is introduced, so giving a false appearance of stretch in the muscle. In order to initiate stretch of infraspinatus at the scapular attachment, the patient is seated with the arm (flexed at the elbow) fully internally rotated and taken into full adduction across the chest. The practitioner holds the upper arm and applies sustained traction from the shoulder in order to prevent subacromial impingement.
The patient is asked to use a light (20% of strength) effort to attempt to externally rotate and abduct the arm, against resistance offered by the practitioner, for 7�10 seconds.
After this isometric contraction, and with the traction from the shoulder maintained, the arm is taken into increased internal rotation and adduction (patient and practitioner acting together) where the stretch is held for at least 20 seconds.
Dr. Alex Jimenez offers an additional assessment and treatment of the hip flexors as a part of a referenced clinical application of neuromuscular techniques by Leon Chaitow and Judith Walker DeLany. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
Chiropractic Relieves: How can a body part you have probably never heard of hurt so BAD? This is a common question we hear from individuals suffering from sacroiliac joint pain.
The sacroiliac�joint is formed by the sacrum and the ilium where they meet on either side of the lower back, with the purpose of connecting the spine to the pelvis. This small joint is one of the most durable parts of the human body, and it is responsible for a big job.
The unassuming little sacroiliac joint withstands the pressure of the upper body’s weight pushing down on it, as well as pressure from the pelvis. It’s basically the cushion between the torso and the legs. As such, it handles force from pretty much every angle.
While immensely strong and durable, this joint is not indestructible. Sacroiliac joint pain usually crops up as lower back pain, or pain in the legs or buttocks.
Weakness in these areas may also be present. The typical culprits in causing the sacroiliac joint to exhibit pain are traumatic injuries to the lower back, but more frequently develops over a longer period of time.
Sacroiliac joint pain is often misdiagnosed as soft tissue issues instead of the joint itself. Doctors may rule out other medical conditions before settling on a diagnosis that includes a sacroiliac joint problem.
If you have suffered an injury, a degenerative disease, or otherwise damaged the sacroiliac joint, there are treatments available to help manage pain, promote healing, and lessen the chances of recurrence. Here are a four helpful guidelines to assist in effectively handling sacroiliac joint pain.
Chiropractic Relieves:
First, rest and ice the area. Avoid exaggerated movements of your lower back in order to relieve some of the body’s pressure on the sacroiliac joint. Also apply ice wrapped in a towel periodically to soothe the area and minimize the pain.
A second way to handle sacroiliac pain is with therapeutic massage. Tightness around the joint is a common cause of discomfort and pain. Professional massage serves to loosen and relax the lower back, buttocks, and leg areas, offering relief from pain.
Third, consider chiropractic and seeing a chiropractor. Chiropractic relieves pain, treatment known as adjustments, not only provides great options for pain relief but also helps promote the healing process of this joint.
A chiropractor is specifically trained to guide you through several phases of care. They don�t focus just on pain relief but are primarily interested in helping you fix the problem.
They�re also very well trained in rehabilitation of the spine. This approach will help loosen the muscles surrounding the joint as well as strengthen them. This will decrease the risk of pain returning down the road.
Finally, in very rare cases, doctors will choose to apply an injection to the area to alleviate pain and inflamed tissue. Obviously, the injection won�t fix the problem but may give the patient relief temporarily. Surgery is rarely a viable option.
If you show symptoms of sacroiliac pain, it’s important to see a Doctor of Chiropractic so he or she can perform tests to correctly diagnose your condition. It could very well be another type of lower back problem. Remember chiropractic relieves, so quit suffering and give us a call!
An ankle can be injured as glamorously as falling off a $400 platform stiletto heel, stepping off a Parisian curb, or as mundanely as tripping over a toy truck, or falling over a rock on your way to the mailbox. No matter the cause, ankle injuries are painful and problematic, and cause recurring problems if left untreated.
The poor ankle sure has it rough. It supports a person’s entire body weight, twists and turns many times a day, and maintains proper balance. This heavy responsibility takes its toll. Emergency rooms treat approximately one million patients ever year for ankle injuries.
Ankles are technically “the joint where the foot joins the leg.”� In reality, there are more moving parts involved than that simplified definition allows. Multiple bones and two separate joints actually converge in the ankle area, which increases the chance of an ankle injury.
Ankle Injuries:
Sprains:
When you roll your ankle outward, the movement damages the ligaments on the outside of the ankle. This is a common sports injury and, unfortunately, once you have sprained your ankle it’s more likely to recur. Up to half of the people who suffer from a sprained ankle will sprain it again.
Strains:
There are two tendons in the ankle that are commonly strained, usually over stretching from overuse or trauma.
Fractures:
This injury happens when one or more of the three bones in the ankle is injured. While less common than a sprain or strain, a fractured ankle may also involve damaged ligaments and require surgery.
Many instances of ankle injuries are avoidable. Be sure to wear proper shoes when exercising or participating in sports, avoid uneven walking surfaces, and keep stairways and floors in your home clear of clutter
And, ladies, avoid the really high heels. We know, we know, they are just so cute! 🙂
Even with ankle-protecting precautions, you still may end up on your rump in the grass nursing your swollen ankle. What should you do if you injure your ankle? There are several forms of treatment for an ankle injury depending on its severity.
Rest and ice: For mild injuries, stay off your ankle and use ice packs to reduce the swelling. Rest allows the injured area to heal faster.
Visit a doctor: If you experience severe pain, swelling, and are unable to put weight on your ankle, see a doctor, as some ankle injuries grow worse without treatment. Injuries may require a brace, cast, or even surgery.
See a chiropractor: Patients frequently see strongly positive results in ankle injuries from a series of chiropractic treatments. Chiropractors understand the way the ankle is built, and use chiropractic adjustments to reduce pain and inflammation and promote faster healing.
Exercise rehab: Once you are healed, it’s vital to build up the ankle’s strength to avoid re-injury. Your chiropractor can lay out an exercise routine that you can employ into your regular workouts that will improve your balance and increase mobility. Performing these moves helps dramatically decrease dealing with this again down the road.
Ankle injuries are common and, whether or not you maintain an active lifestyle, you may end up suffering from one. By visiting a chiropractor on the front end, you can better plan a course of treatment that will heal your ankle quickly, reduce the pain effectively, and minimize the chance of a recurrence.
Whole Food: We always eat our vegetables, drink our kale smoothies, and tear through a bag of fruit on a daily basis, right? Uh, sure, whatever.
The truth is most Americans are busy and make dubious dietary choices. Meat heavy, overly processed, and vegetable skimpy most like describes our meals. Some of us try to counterbalance our imperfect eating choices by taking vitamin supplements to help fuel our bodies with the proper nutrients.
Roughly half the U.S. population takes some form of vitamin supplements. We understand vitamins and minerals help protect our muscles, bones, and joints, keeps our skin and hair healthy, and boosts our immune system.
Choosing a supplement regimen seems like a healthy trend, because of our perception they are good for us. How accurate is that, really?
The answer depends on the type of supplements you choose, as they vary widely from one brand to the next, and labels don’t necessarily give insight as to their quality. A good standard of practice is to choose whole food vitamins over synthetic whenever possible.
Why Is That? Here Are a Few Points To Remember About Whole Food vs. Synthetic Vitamins
Like processed foods, synthetic vitamins are not naturally occurring. Whole food vitamins operate on the principle that natural is easier for the body to absorb and use, so it ends up offering greater benefits. A synthetic multivitamin may show everything you think you need on the label, but if your body isn’t absorbing it, then taking it does little good.
Another point is that natural supplements tend to be easier to absorb. Vitamins and minerals are absorbed by the body in complex ways, often taking one type of mineral for the other to be digested. Whole food vitamins are real foods in their entirety, supplying the body’s need for the vitamins we understand as well as the secondary ingredients that make up the food. Conversely, synthetic vitamins isolate each separate vitamin, so the overall result is less effective.
Finally, taking isolated nutrients can actually cause deficiencies. As shocking as this may sound to those of us who religiously pop extra vitamin C before we board a packed plane, it’s true.
When an isolated vitamin or mineral enters the body, it still demands other nutrients to be present in order to be digested and utilized. This requirement can pull those nutrients out of the body’s reserves, which, over time, can cause a deficiency of completely different vitamins. Whole food vitamins, on the other hand, don’t cause this, because everything they need to be used by the body is included, since it is a natural food.
If you use supplements to ensure you meet your dietary requirements, take a long look at the labels, and do your own research on the type of vitamins in your medicine cabinet. If they are synthetic, think about making a change to whole food vitamins for greater health benefits.
And remember that real food is best. No supplement, no matter how high quality or natural, beats eating a healthy variety of high quality organic foods. If your current diet is lacking in healthy, fresh foods, set a goal to add a few to your meals over the next few weeks.
Your body is the only one you will ever have, so it’s vital to take care of it. Empower yourself to stay strong and healthy longer by committing to eating healthy and exercising. If you decide to take supplements, choose the whole food options, and keep in mind they are no substitute for nutrient rich eating.
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