Case Report: The Assessment of Traumatic Cervical Spine Injury and Utilization of Advanced Imaging in a Chiropractic Office.
Abstract: the objective is to explore the standard of care regarding the assessment of cervical spine injuries in a setting of a chiropractic office. Diagnostic studies include physical examination, range of motion studies, orthopedic testing and cervical spine. MRI.
Introduction: On January 30, 2017 a 49 year old female presented in my office to a second opinion examination at the request of her attorney. She had been involved in a rear-end collision on 12/12/2015. (2) She was transported to a local hospital and arrived with complaints of headaches, disorientation, right-sided neck pain and right arm pain. At the hospital emergency department CAT scan was taken of her brain, which proved to be negative. She received prescriptions of muscle relaxers and pain relievers and instructed to visit her primary care physician if her symptoms persisted.
Contents
Initial Examination
She consulted a local Chiropractor on December 15, 2015. The initial examination included the following from my review of the doctor�s notes: Presenting complaints were right-sided neck pain that radiates to the right arm. The doctor�s records show a positive cervical compression test and a positive maximum cervical compression test. Both produced pain bilaterally worse on the right. Facet provocation tests were positive for facet disease. Right side radicular pain pattern includes the trapezius and deltoid. No x-ray studies were included in the doctor�s orders. The patient received 23 chiropractic treatments from 12/15/2015 through 4/5/2016 for a diagnosis of cervical sprain/strain. The treatments consisted of spinal manipulation and a variety of soft tissue therapies.
Around January 15, 2017 I received a phone call from a local attorney regarding this patient and asking if I would do a second opinion examination on her due to persistent neck pain and right upper extremity pain. The patient presented on January 30, 2017 for my evaluation. My clinical findings are as follows:
Vitals: Age 49, weight 170 lbs. height 5� 8�, B.P 126/82, pulse 64, Resp. 16/min.
Appearance: in pain
Orthopedic/Range of motion: All cervical compression tests produced pain with radiation bilaterally worse on the right. Range of motion studies revealed: 40 degrees of left rotation and 32 degrees of right rotation with radiating pain produced by both motions.
Palpation: cervical spine palpation produced centralized spine pain that radiates to the right shoulder with numbness in the right arm and hand.
The patient informed me during the examination that her pain made it difficult to sleep through the night. If she was on her right side her right arm and hand would go numb immediately. A big part of this patient�s life was riding and caring for her horse and she could not do either because it resulted in severe neck and arm pain.
My recommendation to her and her attorney was to obtain a cervical spine MRI with a 1.5 Tesla machine due to the high quality images it can produce. MRI is a highly sensitive tool to evaluation of neurologic tissue including the spinal cord and nerve roots. (1) I bypassed the x-ray at this time due to the clinical presentation and 12% of spinal cord with injuries having no radiographic abnormality. (3)
Imaging
Figure 1: T2 Sagittal Cervical Spine MRI
Fig 2: T2 Axial Cervical Spine with Scout line through C3/4.
Radiology Report: The report and the images demonstrated a right paracentral disc extrusion measuring 9 mm and extending 8 mm cranial/caudal causing abutment of the spinal cord. (Fig 1)(2) Additionally the diameter of the central canal was reduced to 8.1mm and projected into the right lateral recess resulting in severe stenosis of the right neural canal. (Fig 2) Additional findings not pictured: C4/5 demonstrated a 2.5 mm bulging disc with facet hypertrophy with moderate stenosis of the left neural canal and severe stenosis of the right neural canal. C5/6 demonstrated a 1.5 mm posterior subluxation narrowing the central canal to 9.1 mm with unconvertebral joint hypertrophy resulting in moderate right and severe left neural canal stenosis. C6/7 revealed a broad based disc herniation worse on the left measuring 3.6 mm resulting in severe neural canal stenosis bilaterally complicated by unconvertebral joint hypertrophy. The MRI findings correlate with the patient�s clinical presentation. (4)
Discussion: When the patient returned to a consultation on the MRI findings my recommendation was to consult a neurosurgeon. (3) Her attorney asked me if the treating doctor acted incompetently. My only response was that I would have ordered the MRI immediately before treating the patient with manual manipulation. The case is likely to go to trial and there is a good chance that I will be called in as an expert witness. It is almost a guarantee that the defense attorney will ask me if I would have treated the patient for such a long period of time without an MRI or whether the treating doctor could have made the problem worse. The failure to accurately determine a diagnosis may result in malpractice action or a board hearing or both for this treating doctor and I would have ordered the MRI immediately considering the radicular findings and symptoms. After any myelopathic or significant radiculopathic symptoms a referral of advanced imaging needs to be performed in order to conclude and accurate diagnosis, prognosis and treatment plan prior to rendering care. Diagnostic appropriateness in the case of traumatic injury or with any etiology with neurologic symptoms or findings necessitates following triage protocols. In this case, an immediate 2-3mm MRI of the cervical spine is clinically indicated and proved integral to the safe care of this patient.
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 .
References:
Haris, A.M., Vasu, C., Kanthila, M., Ravichandra, G., Acharya, K. D., & Hussain, M. M. 2016. Assessment of MRI as a modality for evaluation of soft tissue injuries of the spine as compared to intraoperative assessment. Journal of Clinical and Diagnostic Research, 10(3), TC01-TC05
Schneider RC, Cherry G, Pantek H. The syndrome of acute central cervical spinal cord injury, with special reference to the mechanisms involved in hyperextension injuries of cervical spine. J Neurosurg 1954; 11: 546�577.
Tewari MK, Gifti DS, Singh P, Khosla VK, Mathuriya SN, Gupta SK et al. Diagnosis and prognostication of adult spinal cord injury without radiographic abnormality using magnetic resonance imaging: analysis of 40 patients. Surg Neurol 2005; 63: 204�209.
Miyanji F, Furian J, Aarabi B, Arnold PM, Fehlings MG. Acute cervical traumatic spinal cord injury: MR imaging Findings correlated with neurologic outcome-prospective study with 100 consecutive patients. Radiology 2007; 243: 820�827.
Additional Topics: Recovering from Auto Injuries
After being involved in an automobile accident, many victims frequently report neck or back pain due to damage, injury or aggravated conditions resulting from the incident. There’s a variety of treatments available to treat some of the most common auto injuries, including alternative treatment options. Conservative care, for instance, is a treatment approach which doesn’t involve surgical interventions. Chiropractic care is a safe and effective treatment options which focuses on naturally restoring the original dignity of the spine after an individual suffered an automobile accident injury.
Title: Conservative care and axial distraction therapy for the management of cervical and lumbar disc herniations and ligament laxity post motor vehicle collision.
Dr. Alex Jimenez, doctor of chiropractic, focuses on the diagnosis, treatment and prevention of a variety of injuries and conditions associated with the musculoskeletal and nervous systems, utilizing several chiropractic methods and techniques. The following procedures may be similar to his own but can differ according to the specific issue and complications by which the individual is diagnosed.
Abstract: This middle-aged female was injured in a vehicle collision causing her to sustain disc and additional ligament injuries in the cervical and lumbar spine. Diagnostic studies included physical examination, orthopedic and neurological testing, lumbar MRI, multiple cervical MRI�s, CRMA with motion cervical radiographs and EMG studies. Typically, conservative care is initiated prior to interventional procedures, and this case study seeks to explore the usage of passive therapy for mechanical spine pain and noted anatomic disc lesions after failure of interventional procedures. She reported both short term and long term success regarding pain reduction along with improvement in her activities of daily living after initiating conservative care, and continued to report further reductions in pain with periodic pain management using conservative care.
Introduction: The 49-year-old married female (Spanish speaking patient) reported that on March 4th, 2014 she was the seat-belted driver of a truck that was struck by a much larger fuel truck changing lines, hitting her vehicle at the front passenger side (far side, side impact). The force of the impact caused her truck to be lifted up and the right wheel popped off. Her head hit the window after impact and the spinal pain and complaints started approximately 24 hours later. Two days after the crash she went to the emergency department. Occupant pictures were taken describing an out of position occupant injury. She did not report any additional significant trauma after the collision.
Contents
Initial Diagnosis and Treatment for Disc Herniations
Prior to her evaluation at our clinic, she utilized multiple providers for diagnosis and treatment over the course of 11 months. She went to the emergency department, utilized 3 pain management medical doctors, neuropsychologist and a cognitive rehabilitation therapist. Imaging included radiographs and MRI of the right shoulder revealing rotator cuff tear; radiographs of the lumbar and thoracic spine, and left hand; CT of the head and cervical spine were performed; MRI cervical (3) and lumbar spine. Medications prescribed included Fentanyl, Percocet, Naprosyn, Cyclobenzaprine, Norco, Hydrocodone-acetaminophen, Soma, and Carisoprodol. Physical therapy was provided for spinal injuries and she did not respond to treatment. The neurosurgeon recommended epidural steroid injections and facet blocks. Cervical nerve blocks and cervical trigger point injections, cervical and lumbar epidural steroid injections (ESI), lateral epicondyle steroid injections were performed, none of which were palliative. Post-concussion disorder and PTSD with major depressive disorder were diagnosed.
On February 12th, 2015, she presented to our office with neck pain (average 6/10 VAS) that affected her vision, with paresthesia�s in both upper extremities radiating to the hands with numbness. She had low back pain (average 6/10 VAS), and she additionally reported paresthesia at the plantar surface of feet bilaterally. She had left elbow pain, right shoulder pain, knee pain, headaches and �anxiety� along with anterior sternal pain.
Her injuries were causing significant problems with her activities of daily living. Summarily she had increased pain with lifting, increased pain and restricted movement with bending, walking and carrying. She had been unable to perform any significant physical activity from the time of the crash in March 2014 until March 2015. Her right hand was always hurting and her forearms. She was not able to clean windows or do laundry, difficulty using stairs, problems with mopping, ironing and cleaning. She had to limit her walking and jogging primarily due to neck pain and right arm pain. She was not able to sit for long periods of time and sleeping was disrupted due to numbness in her hands. She was only able to walk on a treadmill for 10 minutes before having to stop due to pain, prior to the crash she would exercise for an hour.
Prior History: No significant prior musculoskeletal or contributory medical history was reported.
Research Study Conclusions
Clinical Findings (2/12/15): She had a height of 5�2�, measured weight of 127 lbs.
Visual analysis of the cervical spine revealed pain in multiple ranges of motion including flexion, extension, bilateral rotation and bilateral side bending. On extension pain was noted in the upper back, on rotation pain was noted in the posterior neck, and on lateral flexion pain was noted contralaterally.
Visual analysis of the lumbar spine revealed pain in the low back on all active ranges of motion, including flexion, extension and side bending, pain primarily at L5/S1.
Dual inclinometer testing was ordered based on visual active range of motion limitations with pain.
Sensory testing was performed of the extremities, C5-T1 and L4-S1. No neurological deficits other than right sided C5 hypoesthesia.
Foraminal compression test produced pain in the cervical spine. Foraminal distraction test caused an increase in pain in the neck. Jackson�s test on the right produced pain bilaterally in the neck. Straight leg raise bilaterally produced low back pain, double Straight leg raise produce pain at L5/S1 at 30 degrees.
Muscle testing of the upper extremities was tested at a 5/5 with the exception of deltoid bilaterally tested at a 4/5. The patient�s deep tendon reflexes of the upper and lower extremities were tested including Triceps, Biceps, Brachioradialis, Patella, Achilles: all were tested at 2+ bilaterally, equal and reactive. No evidence of clonus of the feet and Hoffman�s test was unremarkable.
C3-C5 right sided segmental dysfunction was noted on palpation. T5-T12 spinous process tenderness on palpation. Low back pain on palpation, particularly L5/S1.
Imaging Results
MRI Studies:
I reviewed the cervical MRI images taken May 2014 with the following conclusions (images attached):
Dramatic reversal of the normal cervical curvature, apex C5/6.
C5/6 herniation, indentation of the spinal cord anteriorly. High signal posterior on STIR.
Due to the angular kyphosis of the cervical spine and axial slices performed, C6/7 slices did not render a pure diagnostic image for disc disruption.
Fig. 1 (A) T2 Axial C5/6, 2 months post injury Fig. 1 (B) Sag T2 C5/6
I reviewed cervical MRI images taken September 17th, 2014 approximately 6-months post injury, and rendered the following conclusions:
Reversal of the normal cervical lordosis.
C5/C6 herniation (extrusion type) with indentation of spinal cord, appropriate CSF noted posteriorly.
I reviewed the cervical MRI dated October 24th, 2015 (images attached):
C4/5 herniation, extrusion type, left oriented into the lateral recess and neural canal causing moderate neural canal stenosis
Fig. 2 (A) 3D Axial C4/5, 19 months post injury Fig. 2 (B) Sag T2 C4/5
IMPRESSIONS: C4/5 herniation noted on 10/24/15 was not noted on prior images. The patient reported no additional injury or symptoms between MRI studies, so it is postulated that initial slices revealed a false negative; or due to the severity of abnormal cervical biomechanics, it is possible that the C4/5 disc herniated between the pre/post MRI�s with no significant increase in symptomatology. There was improvement at C5/6 related to disc abnormality and cord involvement (see below).
Fig. 3 (A) 3D Axial C5/6, 19 months post injuryFig. 3 (B) Sag T2 C5/6, 19 months post injury
The cervical flexion/extension images were digitized February 2016 and interpreted by myself and Robert Peyster MD, CAQ Neuroradiology, revealing a loss of Angular Motion Segment Integrity at intersegment C6/C7 measured at 19.7 degrees (maximum allowed 11 degrees), indicating a 25% whole person impairment according to the AMA Evaluation of Permanent Impairment Guidelines 5th edition1. CRMA provided from Spine Metrics, independent analysis.
Evidence of significant ligament injury causing functional subfailure was measured at C3/4 at 10.4 degrees and at C4/5 measuring 10.9 degrees regarding angular motion. Abnormal paradoxical translation motion measured at C6/7 and C7/T1.
Functional Testing:
EMG of the upper extremity revealed bilateral C6 radiculopathy, December 16th, 2015.
Range of Motion Cervical Dual Inclinometry:
Initial Max 4 months later % Improvement
Cervical Extension 44 42 -5%
Flexion 40 62 55%
Cervical Left 25 41 64%
Lateral flexion Right 12 26 117%
Cervical Left 46 59 28%
Rotation Right 43 73 70%
Conservative treatment rendered: A neurosurgical referral was made for assessment and surgical options. Conservative care was initiated despite failure of other medical procedures since there is �further evidence that chiropractic is an effective treatment for chronic whiplash symptoms�2-3. The patient was placed on an initial care plan of 2-3x/week for 5 months, with a gap in passive care for 1 month.
23 chiropractic visits. Instrument adjusting cervical spine was utilized with Arthrostim. Non-rotatory HVLA (high velocity low amplitude) spinal adjustments were performed thoracic and lumbar spine, applied A-P. No HVLA spinal adjustments to the cervical spine.
Prior to being placed at maximum medical improvement she had persistent low back symptoms, continued tingling in the fingertips and occasional neck pain at a 4/10, with her upper extremity paresthesia�s improved 50%. She continued with pain management chiropractic care after MMI, approximately 1 visit every 3-4 weeks with axial distraction to the cervical and lumbar spine, chiropractic adjustments as needed (PRN). 2 years/9 months post collision, and 1 year/9 months after initiating conservative care at our clinic, she reports only slight (1-2/10 VAS) spinal complaints with her primary concern being a torn rotator cuff injury from the crash that still requires surgical intervention. After initiating care at our clinic, no other interventional procedures were performed, although medication usage persisted. Due to improvement in symptoms and functional status, spinal surgery was not considered. She still utilizes Aleve PRN, 1-2 tablets. No significant active spinal rehabilitation was utilized. The patient was given at home active care consisting only of cervical and lumbar stretches, walking, and ice to affected areas.
Conclusion:While chiropractic care is safe even in the presence of herniations and radicular symptoms, �the likelihood of injury due to manipulation may be elevated in pathologically weakened tissues�4. Due to cord involvement, the provider decided to utilize low force procedures although HVLA spinal adjustments to the cervical spine could be considered safe due to lack of cord compression. HVLA spinal adjustments A-P were utilized in the lumbar and thoracic spine not only for short term pain relief but also as part of managing the chronic low back pain secondary to ligament/disc damage. While previously theorized to be only episodic, low back pain can be a lifelong condition requiring patients to seek ongoing care5. This care can be active, passive, pharmaceutical, interventional, or conservative in nature, but ongoing pain management therapy is often required for permanent ligament conditions. There is clear benefit to the patient population to be able to avoid surgical intervention due to risks, costs, ongoing prescription medication usage and adjacent level degeneration in the future6. Avoiding opioid usage is also a high priority in today�s environment.
Long term conservative care utilizing instrument spinal adjusting and targeted axial distraction therapy significantly reduced subjective reporting of pain, increased activities of daily living, and allowed the patient to avoid further spinal injections or surgical intervention. Considering that various interventional procedures failed prior to conservative care, it is important that providers work in an interdisciplinary environment such that the safest, and in this case the most effective, therapies are utilized first to reduce risk to the patient and maximize benefit and reduce costs.
In this case study, the patient utilized multiple pain management physicians, cervical nerve blocks and epidural steroid injections, and was not directed to conservative care for 11 months post injury. Utilizing chiropractic as conservative care would have enabled this patient to regain function and decrease pain while reducing costs and risks that are associated with medications and interventional procedures.
Competing Interest: There are no competing interests in the writing of this case report.
De-Identification: All of the patient�s data has been removed from this case.
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 .
Cocchiarella L., Anderson G. Guides to the Evaluation of Permanent Impairment, 5th Edition, Chicago IL, 2001 AMA Press.
Khan S, Cook J, Gargan M, Bannister G. A symptomatic classification of whiplash injury and the implications for treatment. Journal of Orthopaedic Medicine 1999; 21(1):22-25.
Whedon J, Mackenzie T, Phillips R, Lurie J. Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-99 years. Spine, 2015; 40:264�270.
Hestbaek L, Munck A, Hartvigsen L, Jarbol DE, Sondergaard J, Kongsted A: Low back pain in primary care: a description of 1250 patients with low back pain in Danish general and chiropractic practices. Int J Family Med, 2014.
Faldini C., Leonetti D., Nanni M. et al: Cervical disc herniation and cervical spondylosis surgically treated by Cloward procedure: a 10-year-minimum follow-up study. Journal of Orthopaedics and Traumatology, June 2010.Volume 11, Issue 2,pp 99-103.
Additional Topics: Recovering from Auto Injuries
After being involved in an automobile accident, many victims frequently report neck or back pain due to damage, injury or aggravated conditions resulting from the incident. There’s a variety of treatments available to treat some of the most common auto injuries, including alternative treatment options. Conservative care, for instance, is a treatment approach which doesn’t involve surgical interventions. Chiropractic care is a safe and effective treatment options which focuses on naturally restoring the original dignity of the spine after an individual suffered an automobile accident injury.
It’s no surprise — overweight children who don’t properly learn self-regulating habits likely become obese adults. What is surprising is that one of the most common ways to help — restricting children’s diets — actually compounds the problem.
That’s the thrust of a new study by University of Illinois researchers who point to a disturbing pattern: Parents shame by withholding food due to weight gain, then children cope with the negative emotions by overeating.
Further exasperating the trend, overweight children are often rewarded with food by parents, and as they grow older, the children reward themselves with food.
Researchers who studied the pattern added a genetic component as well to better understand obesity. They reported that a child’s genetics, relating to cognition and emotion, likely play a key role. They found that when biological conditions were just right, a nudge by the social aspect sets kids on a path to obesity.
Kelly Bost, co-author of the study (published in Pediatric Obesity), and professor of child development at the University of Illinois, said: “When parents offer food to children whenever they are upset, children may learn to cope with their negative emotions by overeating, and they start to develop this relationship with food early in life; eating — especially comfort food — brings a temporary soothing. People intuitively understand that.”
The findings support the team’s hypothesis that a correlation exists between all factors: parenting approaches, combined with a child’s genetic make-up and restrictive feeding, and the child’s weight and the child’s propensity to be obese.
Bost said that children can effectively learn control for themselves: “Some of the things parents do, they may not think are related to how children are developing their eating habits. The ways parents respond or get stressed when children get upset are related in an indirect way. The way we respond to that emotion can help children to develop skills for themselves, to self-regulate, so that everyday challenges don’t become overwhelming things that they have to manage with respect to food.”
Bost and her team used data from the “Strong Kids” program, outreach developed by The Oregon Resiliency Project, an organization that is based on “research, training, and outreach effort aimed at social and emotional learning, mental health promotion, and social-emotional assessment intervention” of children, according to the organization’s website.
The team examined information about parents’ feeding styles, and how they typically reacted to their children’s (ages 2.5 to 3 years) negative emotions. The researchers examined these factors in combination with genetic data.
For the genetic factor, they looked at the COMT gene, a gene known for regulating cognition and emotion. This gene is the gatekeeper for dopamine, which controls the brain’s reward and pleasure centers.
Bost and her team studied minute variances in the gene pool to determine which children might be more susceptible to negative emotions or stress. They based their genetic research on the breakdown of amino acids in proteins that could lead to personality differences. One of them is the change produced by genetics in the form of a single part of our DNA: the nucleotide polymorphisms (SNPs). There are many types of SNPs; some affect the composition of protein and, depending on the change, affect the amount of dopamine in the brain, as presented by Psychology Today. Dopamine controls the brain’s reward and pleasure centers.
One type of SNP can change an amino acid from valine (Val) to methionine (Met). While largely academic, these two types of proteins influence emotion. Bost explained it best in the study: “We all carry two copies of genetic information — one from Mom, and one from Dad. In a person with Val/Val, the COMT system works three to four times faster than those with other combinations do, and therefore accumulates less dopamine in the front of the brain. Children who have at least one copy of Val tend to be more resilient emotionally. Those who are Met carriers have the propensity to be more reactive to negative emotion or stress.”
This genetic component was combined with the researchers’ studies. “We know that how parents respond to their children’s negative emotions influences the development of children’s response patterns over time,” Bost said in the study. “There is a whole body of literature linking emotion dysregulation to emotional overeating, dysregulation of metabolism, and risk for obesity, even starting at early ages. We wanted to begin to integrate information from these various fields to get a more holistic view of gene-environment interactions at this critical time in life for developing self-regulation.”
They began their research with a group of 126 children who were studied for the social aspect. For the genetic component, saliva samples were taken. Parents filled out questionnaires, rating how they typically respond to their common situations, including emotional outbursts.
Bost and colleagues found that parents most likely to use restrictive feeding were those who reported more frequent use of unresponsive stress-regulating strategies with their children — punishing or dismissive —and had children who were higher weight status and tested positive for the Met amino acid. But the same was not necessarily true for children who were Val carriers.
Bost and her team determined that breaking the cycle did not begin with blaming parents but instead by encouraging them to develop positive reinforcement and other techniques that could help their kids respond better and also help develop positive eating habits that likely would carry into adulthood.
While there exist myriad programs that focus on providing good nutrition or how to plan less stressful mealtimes, Bost explains that parents should also learn emotion regulation strategies in response to children who display emotional breakdowns and are eating to soothe — especially if the parents are restricting foods.
She added, “Sometimes the way parents respond is based on their own stress, belief systems, or the way they were raised. Educating parents from a developmental perspective can help them to respond to their children’s emotions in ways that will help their children learn to self-regulate their emotions and their food intake . . . responsive parenting involves an understanding of what stress-reducing approaches are most effective for a particular child.”
A new diet plan that dictates that you eat only one food for several weeks to lose weight fast is drawing warnings from many experts who say it is dangerous and only successful in the short term.
The Mono Diet (sometimes called the Banana Island or Monotrophic Diet) was popularized by a YouTube star nicknamed “Freelee the Banana Girl” (real name: Leanne Ratcliffe) who claimed it helped her lose weight, the New York Post reports.
Ratcliffe claimed to have lost 40 pounds eating close to 30 bananas a day.
A new version, the Sweet Potato Diet, promises the spud can help you lose 12 pounds in just two weeks. The hashtag #monomeal on Instagram, which highlights pictures of people’s meals containing a single food, has more than 38,000 posts, and the diet was one of the most searched in 2016, according to Google.
Frances Largeman-Roth, a registered dietitian and author of “Eating in Color,” tells the Post you can lose weight by eating only one food, but it’s likely to result from eating less.
“Yes, this diet can produce weight loss,” she says “But, the weight loss is a result of caloric restriction — not because any particular food is magically producing weight loss. It’s an incredibly restrictive and unbalanced diet and I do not recommend that anyone follow it.”
Experts warn such diets can also cause symptoms like dizziness and lead to some serious health problems, including dangerous metabolic changes and muscle loss.
Leg length discrepancy is a condition in which the legs are not of equal length. This might give an appearance that one leg is shorter compared to the other. The reasons for leg length discrepancy can be many, including defects that are congenital or may be acquired, which might include certain medical conditions, fractures, infections or injuries impacting the bone.
Leg length discrepancy might be a result of accurate discrepancy, which can be caused by real distinctions in the leg lengths. In other instances, the causes of leg length discrepancy might be due to circumstances that result in change in the angle of the hip or pelvic bone. In such cases, as the hip gets tilted to the other side and one side gets raised, the leg on that side seems to be shorter.
However, it is important to understand the foundation and causes of leg length discrepancy to handle the condition properly. It is also crucial to understand the impact of leg length discrepancy on an individual health and overall performance just as the the reasons are important. Mental and physical health can be affected by leg length discrepancy health insurance and will also be connected to spinal issues like scoliosis.
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Can Limb Length Discrepancy Trigger Scoliosis?
Leg length discrepancy, due to uneven leg lengths, can impact the normal gait of the person. The main perform that is noticeable is the way a person walks or performs human anatomy actions. These can get afflicted or be difficult because of leg size discrepancy. Changes in normal movements can more lead to certain issues of the muscles like soreness, discomfort, weak imbalances or muscles on either side of the physique. Leg duration discrepancy can impact the hip, knees and ankle, can cause pain and dysfunction.
The muscles on both sides of the physique and those related to the hip can get pulled due to tilting of the hip-bone. This can be one the major effects of leg duration discrepancy, where the muscles get pulled to one side, creating changes in the curvature of the backbone. In to side ways pulling of the spinal curvature, which is termed as scoliosis, such adjustments can eventually result. There is much concern whether leg length discrepancy can cause scoliosis and it is important to understand correct therapy to be planned by this and a void further complications.
Limb Length Discrepancy and Scoliosis
Many studies have already been conducted, which revolve round the chance of leg duration discrepancy being an underlying cause of scoliosis. In the same time, leg length discrepancy can also result in pulling of the muscles that are back to one facet, which can contribute to some extent to or worsen existing scoliosis.
It might result in scoliosis, which might be useful in the beginning as the curvature gets tilted to one aspect. In scoliosis that is functional there might be slight tilting or pulling of the muscles to one side, without adjustments or damage to the structure of the spine. However, if functional scoliosis, which is caused or aggravated by leg-length discrepancy isn’t treated in time, it might worsen, causing changes in the structure of the curvature. This may result in structural scoliosis, which may not be disturbing and only more painful but also difficult to manage.
Some studies have revealed that scoliosis in certain persons is the result of mechanism, to make up for the leg length discrepancy. Simply stated, in leg length discrepancy, the legs are of unequal lengths, so to match the lengths the individual pulls the aspect down along with the hip starts to tilt. This, when continued for a longer period of time, can result in pulling to one aspect, making changes in the curvature. Scoliosis is one such change in spinal curvature, at which spine gets curved to one side, comprising alternative activities.
Symptoms of Scoliosis from Limb Length Discrepancy
A person that has developed scoliosis due to leg size discrepancy, usually presents with tilting of the hip. Along with the signs of leg length discrepancy, the individual may possibly also encounter pain in the muscles that are again, imbalances of muscle power and function of the muscles that are again. Bending, twisting movements might be difficult and it could also be painful to maintain or raise objects.
The appearance of the shoulders may possibly be different on account of scoliosis and one-shoulder can happen elevated in relation to the other. This could cause problems in neck, arm and shoulder movements and also hurt. It could sometimes result into serious degrees of scoliosis, if the status is left unattended.
Treatment of Scoliosis from Limb Length Discrepancy
It is importance to comprehend if leg-length discrepancy can trigger scoliosis. The treatment options might have to be planned appropriately if scoliosis has been resulted in by complications of leg-length discrepancy.
In some cases, leg size discrepancy can contribute to or worsen existing scoliosis, therefore, correcting leg duration discrepancy with heel raise have to be in the offing cautiously. It’s important to thoroughly examine any circumstance with leg-length discrepancy, as they can cause scoliosis in some instances. Prescribing a heel raise to appropriate leg length discrepancy can boost the chances of worsening the scoliosis due to tilting if scoliosis is obvious.
Hence, it really is essential to to examine the bio mechanics of the hi-P, evaluate the modifications in the spinal curvature in scoliosis as well as the tilting due to leg duration discrepancy. Depending on the the reasons, some cases of leg length discrepancy might require procedure for surgical correction of leg lengths. When the symptoms, scoliosis and causes like complications of leg length discrepancy, are correctly evaluated a multi disciplinary treatment approach may be planned.
Limb Length Discrepancy Explained (Video)
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: Scoliosis Pain and Chiropractic
According to recent research studies, chiropractic care and exercise can substantially help correct scoliosis. Scoliosis is a well-known type of spinal misalignment, or subluxation, characterized by the abnormal, lateral curvature of the spine. While there are two different types of scoliosis, chiropractic treatment techniques, including spinal adjustments and manual manipulations, are safe and effective alternative treatment measures which have been demonstrated to help correct the curve of the spine, restoring the original function of the spine.
Here’s a scenario that’s probably easy for you to imagine: You’ve just endured a grueling flight to a far-off travel destination. After your arrival at the airport, you spot your luggage on the baggage carrousel. But as grab it, you feel that scary twinge in your back that feels like a pulled muscle or worse.
If this sounds like something you’ve experienced, you have plenty of company. Thousands of Americans suffer low back injuries when traveling each year. And, the truth is, the end of a long journey is the most dangerous moment for a traveler’s back, according to orthopedic specialists.
“When you rush to get your luggage and throw it on the cart to be the first to get customs and out, that’s when you can your hurt your back,” says Dr. Garth Russell, founding member of the Columbia Orthopedic Group in Missouri.
Travel can be a prescription for back pain and injury, experts agree. The long periods of forced immobility in airplanes, lifting the luggage packed with heavy documents or vacation gear, the fatigue, and the time pressure — not to mention the less-than-firm hotel beds — can add up to back spasms and sciatic nerve pain.
Since back pain is the most frequent cause of lost work days after the common cold, according to the American Academy of Orthopaedic Surgeons, it’s crucial take prudent precaution to protect your back when traveling.
“Summer vacation can spell disaster for your aching back if you don’t pay attention to how you move and how you prepare yourself for the journey,” says Dr. Richard Berger, a noted orthopedics surgeon and assistant professor of orthopedics at Rush University in Chicago. “People will be traveling in planes, trains and cars for hours and back pain can ruin even the best laid vacation plans.”
But Berger tells Newsmax Health a handful of back-saving tips can be the difference between a great vacation and a panful experience away from home. Here are his best suggestions:
Lift luggage in stages. “Move slowly and deliberately,” he says. “It’s the sudden jerking movements going full throttle that injure most patients.”
Never twist while lifting. This common error is the most frequent way people injure their back, says Berger, who explains that it takes much less force to cause injury when twisting than when lifting straight up and down.
Ask for help if you have back trouble. “Don’t hesitate to ask another passenger or flight attendant for help,” he says. “Explain your condition and most folks will be happy to assist.”
Ship bags instead. Mail your essentials to the designated destination and avoid luggage entirely. “With airline fees for checked luggage skyrocketing, this may also turn out to be an economical solution, too,” he says
Pack light. Moving a few light bags instead of one very heavy one, will likely avoid back injuries. “This is especially true if you are on an extended vacation with multiple stops so you have to transfer your bags in and out of your vehicles or into overhead bins and compartments,” he notes.
Plan for medication. If you are running low on your pain medication, get new prescriptions from your doctor and fill them so that you have enough. It may seem obvious but do not check medication with your luggage. “You may need them in flight or you may get delayed so that you may need more meds that you originally expected,” he says. Also: Bring backup over-the-counter medications such as Tylenol, Motrin or Aleve.
Ice, ice, baby. If you do suffer a back injury a pack of ice may be your first line of defense. Your flight attendant can fill a bag for you. Place it on your back for 20 minutes, then off for 20 minutes. Products like Icy Hot or Bengay Pain relief medicated patches may also provide relief.
Heat wraps work. There are disposable, portable hot packs that heat up after you open them and you can apply them as needed. Ask your pharmacist to suggest a few brands and check with your airline to make sure they allowed.
Muscle relaxants. These not only treat but may avoid back issues during a long flight. Ask your doctor if they are right for you.
Get the right seat. An aisle seat makes it easier to get in and out of your seat. Moreover, an aisle seat offers you the freedom to get up and move around more frequently.
Get up and move. This is crucial because sitting for an extend period of time stiffens the back muscles, putting stress on the spine and can cause pain. Get up to stretch often. Stretch the hamstrings muscles especially which will reduce stiffness and tension. If you are taking a road trip, stop for a stretch break every couple of hours.
Use a lumbar pillow. If you don’t own your own lumbar support, use a pillow, blanket or rolled up jacket to support the national curve of your back when traveling. Speaking of pillows, if you are staying in a hotel, your may sleep better if you bring your own pillow.
Early onset scoliosis (EOS) is an abnormal sideways curvature of the spine found in children under the age of 10 years.
More than 100,000 kids are diagnosed with scoliosis each year in the USA and most have adolescent idiopathic scoliosis, or AIS. AIS is one of the most common types of scoliosis and it can affect kids between the ages of 10 to 18. EOS is significantly rarer and often more complex in character.
Contents
Types of Early Onset Scoliosis
Doctors have recognized several types of EOS. Most types of EOS have an obvious trigger and are associated with individual health issues. On the other hand, a general number of EOS cases are idiopathic, meaning they have no recognized cause and are identified based on the age at diagnosis.
Below are kinds of EOS:
Congenital scoliosis occurs when the bones of the spine do not form properly in the mother�s womb.
Neuromuscular scoliosis is caused by brain, spinal cord, or muscular system disorders (such as muscular dystrophy). These disorders prevent the back muscles from holding the spine straight.
Syndromicscoliosis develops as part of an underlying syndrome or disorder that affects numerous parts of the body (such as Prader-Willi
Syndrome; a rare disease affecting development).
Infantile idiopathic scoliosis is diagnosed in children ages birth to 3 years. It has no known cause.
Juvenile idiopathic scoliosis is diagnosed in children ages 4 to 10. It has no known cause.
Early Onset Scoliosis Symptoms
EOS can be difficult to identify, as some children don’t have a serious spinal curve and might not have pain that stops them from their typical exercise. The primary factor to keep in mind, however, is symmetry, as it could reveal an issue when all other indications point to a regular spine.
Below are the most frequent indicators of EOS:
The body appears to lean to one side
Shoulders look uneven, with one shoulder blade sticking out more
Waistline is uneven
Hip height appears off balance
Ribs protrude on one side more
Early Onset Scoliosis Diagnosis
Your child’s pediatrician, pediatric orthopedist, or spinal specialist can identify EOS utilizing a number of methods.
Physical exams including the Adam’s forward bend test, will expose a prominence, hump or deviation of the backbone, or spine, indicating an irregular curvature. But, it’ imaging scans, namely x-rays, that doctors count on most to validate EOS.
The doctor will simply take standing x-rays of your child’s spine to properly see the entire nature of the scoliosis. Typically, one x-ray is taken from back to front (called a posterior-anterior x-ray) and the second is from the side (called lateral x-ray).�Other x-rays may possibly contain bending from aspect-to-facet.
Your doctor may possibly also request a magnetic resonance imaging (MRI) test in order to rule out underlying involvement of the spinal-cord along with other buildings or CT scan to show 3 D views of the bone constructions.
Because x-rays are used throughout the monitoring process throughout therapy, and to identify scoliosis, individuals have raised concerns over radiation. With this consideration in mind, doctors limit the number of x-rays that a child may use direct shields to safeguard breast and thyroid tissue and wants, lower dose x-rays, as well as light-based scans of the physique form.
Early Onset Scoliosis Treatment
There are four general approaches for managing EOS:
Observation
Spinal bracing
Body casting
Spine surgery
Observation
Your physician may suggest an observation period prior to any active treatment is warranted, as some times the scoliosis even correct itself as your child grows especially with very little curves in really young kids and will stabilize. This generally indicates attending normal follow up appointments together with your doctor throughout the year to determine any adjustments in your child’s curve.
Spinal Bracing
Spinal bracing is a typical nonsurgical treatment for EOS. Your physician works with an orthotist to craft a custom spinal brace for your child. The objective of the brace is not necessarily to correct the scoliosis but to avoid the curve from progressing.
Body Casting
Body casting may be advised for kids between SIX MONTHS months and 6 years of age who have curves likely to to succeed. Body casts are custom made and placed while your child is asleep under general anesthesia. Casts can be in spot for up to 12 months, so that your child will require a sequence of casts throughout therapy. A cast may possibly be employed for more severe curves or in cases in which a brace fails to prevent the curve from getting worse. Often the forged is used to delay the need for spine surgery that is ideally performed after much of your child’s growth is complete. A brace is often used for the same purpose.
Spine Surgery
If your child has a severe curve of 50-levels or higher, spine surgery is considered but usually delayed before the curvature is significantly greater and the child is bigger and h-AS finished more development.
There are various surgical methods for EOS, including expanding rod surgery, VEPTR® (vertical expandable prosthetic titanium rib), vertebral physique tethering, growth guided gadgets, and spinal fusion.
Recovery Potential for Early Onset Scoliosis
It could be scary for each of you when your youngster is identified with early onset scoliosis. The remedies obtainable today are highly-successful at managing or even correcting the curve. Your encouragement and support along with the determination of your pediatric spine specialist will help your child respond well to treatment, and lead a pleased and full life.
Identifying Scoliosis in Children (Video)
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: Scoliosis Pain and Chiropractic
According to recent research studies, chiropractic care and exercise can substantially help correct scoliosis. Scoliosis is a well-known type of spinal misalignment, or subluxation, characterized by the abnormal, lateral curvature of the spine. While there are two different types of scoliosis, chiropractic treatment techniques, including spinal adjustments and manual manipulations, are safe and effective alternative treatment measures which have been demonstrated to help correct the curve of the spine, restoring the original function of the spine.
The importance of Magnetic Resonance Imaging to evaluate the integrity of the lumbar posterior ligament complex post trauma.
Abstract: Posterior ligamentous complex(PLC), consisting of the supraspinous ligament, interspinous ligament, ligamentum flavum, and the facet joint capsules is thought to contribute significantly to the stability of the lumbar spine. There has been much debate on whether Magnetic Resonance Imaging(MRI) is specific and sensitive in diagnosing pathology to the PLC. The objective is to determine the necessity of MRI imaging for evaluating the integrity of the lumbar posterior ligament complex post trauma.
Key Words: Magnetic Resonance Imaging(MRI), interspinous ligament, posterior ligament complex, low back pain, ligament laxity, electromyography, impairment rating
A 41-year-old male, presented to my office for an examination with complaints of low back pain with numbness, tingling and weakness into the left lower extremity after he was the restraint driver in a motor vehicle collision approximately three and a half months� post trauma.�He�rated the pain as a�3/10 on a visual analog scale with 10/10 being the worst and the pain and noted the pain as being�present most of the time.� He stated that he was on pain killers daily and this helped manage his daily activities. Without pain killers his pain levels are rated 8/10 being present most of the time. The pain killers stated by the patient are Oxycodone and Naproxen. He�reported that the pain would be aggravated by activities which required excessive standing, repetitive bending, and lifting. He further noted that in the morning the pain was increased and his left leg would be numb and weak for about the first hour.
The patient stated that his care to date had been managed by a pain management clinic and that he had minimal improvement with treatment which has included physical therapy and massage therapy. He reported the pain clinic next recommended steroid injections which he refused. He states there has been was no imaging ordered and that an Electromyography(EMG) had been performed. He was told the test was negative for pathology.
Prior History: No significant medical history was reported. Clinical Findings:�The patient is 6�0� and weighs 210 lbs.
Physical Exam Findings:
Cervical Spine:
Cervical spine range of motion is full and unrestricted. Maximum cervical compression is negative. Motor and other regional sensory exam are unremarkable at this time.
Thoracic Spine:
Palpation of the thoracic spine region reveals taught and tender fibers in the area of the bilateral upper and mid thoracic musculature. Thoracic spine range of motion is restricted in flexion, extension, bilateral lateral flexion, and bilateral rotation. Regional motor and sensory exam are unremarkable at this time.
Lumbar Spine:
Palpation of the lumbosacral spine region reveals taught and tender fibers in the area of the lumbar paraspinal musculature. Lumbar spine range of motion is limited in flexion, extension, bilateral lateral flexion and bilateral rotation. Extension restriction is due to pain and spasm. Straight leg raise causes pain at approximately 50 degrees when testing either side in the left low back. There is no radicular symptomatology down the leg. Kemp�s maneuver recreates pain in the L4 region on the left. No radicular symptoms are noted. The patient is able to heel and toe walk. Regional motor and sensory exam is unremarkable at this time other than L4, L5 and S1 dermatomes having decreased sensation with light touch.
Muscle testing of the upper and lower extremities was tested at a 5/5 with the exception of the left quadricep tested at a 4/5.� The patient�s deep tendon reflexes of the upper and lower extremities were tested including triceps, biceps, brachioradialis, patella, and Achilles and all were tested at 2+ bilaterally except the left patellar reflex was 1+.
RANGES OF MOTION EVALUATION
All range of motions are based on the�American Medical Association�s Guides to the Evaluation of Permanent Impairment, 5th�Edition1�and performed by a dual inclinometer for the lumbar spine.
�� Range of Motion������Normal�������� Examination�������� % Deficit
Flexion
60
48
20
Extension
25
12
52
Left Lateral Flexion
25
16
36
Right Lateral Flexion
25
18
28
An MRI was ordered to rule out gross pathology.
Imaging:
�
A lumbar MRI reveals;
1)��� Mild disc bulges at T11-T12, T12-L1, L1-L2 and L5-S1
2)��� Low disc signals indicative of disc desiccation at T11-T12, T12-L1, L1-L2, L2-L3, L3-L4 and L4-L5
3)��� Retrolisthesis of 2mm at L3-L4
4)��� Mild ligamentous hypertrophy at L1-L2, L2-L3, L3-L4, L4-L5 and L5-S1
5)��� L4-L5 has a Grade 1-2 tear of the interspinous ligament with mild inflammation
6)��� L5-S1 has a Grade 1 interspinous ligament tear with mild inflammation
After reviewing the MRI I ordered lumbar x-rays to rule out ligament laxity.
X-RAY STUDIES
Lumbar x-rays reveal the following:
1)��� Left lateral tilt
2)��� Retrolisthesis at L1 of 3mm
3)��� Retrolisthesis at L2 of 3mm
4)��� Combined excessive translation of 4mm of L1 during flexion-extension
5)��� Combined excessive translation of 4mm of L2 during flexion-extension
6)��� Excessive translation of L3 in extension posteriorly of 2.5mm
7)��� Decreased disc space at L5-S1
Chiropractic care was initiated. The patient was placed on an initial care plan of 2-3x/week for 3 months and then a recommended break in care for one month so the patient could be evaluated for permanency while he was not care dependent.
At maximum medical improvement, he had continued low back pain rated 4/10, continued numbness and tingling into his left leg and left quadricep weakness rated 4/5. He does not need pain killers for pain management anymore. He continues chiropractic care every two weeks to manage his symptoms.
Conclusion:
In this specific case, pathology to the posterior ligament complex diagnosed on MRI lead to the x-ray finding of excessive translation at L1-L2 and L2-L3. The patient was given a permanent impairment rating of 22% based on my interpretation of the American Medical Association�s Guides to the Evaluation of Permanent Impairment, 5th�Edition1. The interspinous ligament tears at the L4-L5 and L5-S1 level would not have been diagnosed without the MRI.
There has been much debate on whether MRI imaging has a role in evaluating lumbar PLC. MRI is a powerful diagnostic tool that can provide important clinical information regarding the condition of the PLC. Useful sequences for spinal MRI in trauma include sagittal and axial T1-weighted images, T2-weighted FSE, fat-saturated T2-weighted FSE, and STIR sequences to highlight bone edema.2�Ligamentous injuries are best identified on T2-weighted images with fat saturation because the ligaments are thin and bonded on either side by fat, which can appear as hyperintense on both T1 and T2 images.3�T1-weighted images are inadequate in isolation for identifying ligamentous injuries.4�
The diagnostic accuracy for MRI was reported for both supraspinous ligament and interspinous ligament injury with a sensitivity of 89.4% and 98.5%, respectively, and a specificity of 92.3% and 87.2% in 35 patients.5
For patients with persistent symptoms after trauma an MRI may be indicated to evaluate posterior ligamentous complex integrity.
Competing Interests:� There are no competing interests in the writing of this case report.
De-Identification: All of the patient�s data has been removed from this case.
References:
1. Cocchiarella L., Anderson G. Guides to the Evaluation of Permanent Impairment, 5th Edition, Chicago IL, 2001 AMA Press.
2. Cohen, W.A., Giauque, A.P., Hallam, D.K., Linnau, K.F. and Mann, F.A., 2003. Evidence-based approach to use of MR imaging in acute spinal trauma.�European journal of radiology,�48(1), pp.49-60.
3. Terk, M.R., Hume-Neal, M., Fraipont, M., Ahmadi, J. and Colletti, P.M., 1997. Injury of the posterior ligament complex in patients with acute spinal trauma: evaluation by MR imaging.�AJR. American journal of roentgenology,�168(6), pp.1481-1486.
4. Saifuddin, A., Green, R. and White, J., 2003. Magnetic resonance imaging of the cervical ligaments in the absence of trauma.�Spine,�28(15), pp.1686-1691.
5. Haba H, Taneichi H, Kotani Y, et al. Diagnostic accuracy of magnetic resonance imaging for detecting posterior ligamentous complex injury associated with thoracic and lumbar fractures.�J Neurosurg. 2003; 99(1 Suppl):20-26.
Whether your friend has hurt your feelings or you’re upset over a lovers tiff, swearing could help to ease your pain, according to new research published in the European Journal of Social Psychology.
Carried out by Dr Michael Philipp, a lecturer at Massey University’s School of Psychology, New Zealand, along with Laura Lombardo from the University of Queensland, Australia, the work looks at the effect of swearing on “short-term social distress,” which could be anything from an argument with your partner to being excluded from a social situation.
Although previous studies have looked at common methods for relieving both physical and social pain, fir example with paracetamol, none have so far looked at whether swearing aloud could also help relieve social distress in the same way that it has previously been shown to ease physical distress.
To test this idea, the study looked at Pain Overlap Theory, which suggests that physical and social/emotional pain share the same underlying processing system, and anything affecting physical pain will also have similar effects on social pain.
For the research 70 participants were split into two groups, and tested for feelings of social pain and sensitivity to physical pain.
During the study participants had to write either about an inclusive social situation, or a distressing one, to induce the corresponding emotions. They were then were randomly assigned to either swear aloud or say a non-swear word aloud.
The results showed that those participants who were socially distressed experienced less social pain and less sensitivity to physical pain than those who didn’t swear.
“Previous research suggests that social stressors, like rejection and ostracism, not only feel painful but also increase people’s sensitivity to physical pain,” explained Dr Phillip. He also added that swearing can help ease both social and physical pain by reducing its intensity, by distracting the person in pain.
However, Dr Phillip also pointed out that swearing may not have the same effect if used on an everyday basis or in a situation which is only mildly irritating or stressful, when the use of profanity may lose its impact.
He also added that swearing is not a quick answer for those experiencing serious emotional pain and stress such as grief or abuse, when clinical care may be needed.
Previous research on swearing has also found that cursing aloud can make you stronger. In a small-scale study published early last month, a team of researchers found that participants who completed a test of anaerobic power — a short, intense period on an exercise bike — and isometric handgrip test — produced more power and had a stronger grip if they swore while completing the exercises.
UTEP claimed two superlative Conference USA track and field honors as Emmanuel Korir and Tobi Amusan were named C-USA Male and Female Track Athletes of the Year, announced by the league office on Friday afternoon.
�Both athletes are very special and talented. He [Korir] was the best candidate for our league and would most likely do very well other top conferences as well,� head coach Mika Laaksonen stated. �A lot of work goes into these things and Tobi worked incredibly hard over these past two years and she absolutely deserves this award, they both do.�
Korir ran a world best 1:14.97 in the 600m earlier this year at the New Mexico Cherry & Silver meet, which was his first race on an indoor 200m banked track. The freshman followed that up by capturing the NCAA title in the 800m (1:47.48) at the same track in Albuquerque, N.M., with a time of 1:47.48. The freshman is one of three athletes in the world to run an outdoor sub-45 400m and a sub-1:44 in the 800m.
The Kenyan native won the NCAA outdoor title in the 800m (1:45.03) and is the first Miner to win both titles in the same year.
Amusan was the leading scorer for the Miners with 25 points at the C-USA Indoor Championships and notched a meet record in the 60m hurdles with a time of 8.01. The sophomore helped her team win its third consecutive conference title. Amusan qualified to the NCAA Indoor Championships in the 60m hurdles where she notched a sixth-place showing.
The outdoor season started with a bang, as she set a school record (12.63) in the 100m hurdles at the UTEP Springtime meet. She followed that with a first-place finish at the 2017 Clyde Little Field Texas Relays in the 100m hurdles, setting a meet record time of 12.72. The Nigerian native scored 24.5 points at the C-USA Outdoor Championships leading the women�s team to its first ever outdoor conference title.
Both athletes were named semifinalists for college track and field�s high individual honor, The Bowerman Award. The women�s three finalists will be announced on Wednesday, June 21 and the men�s finalists will be announced Thursday, June 22.
For more information on UTEP track and field, follow the Miners on Twitter (@UTEPTrack) and on Instagram (uteptrack).
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