Athletes who perform daily rigorous training and/or participate in regular competitions can often be at a higher risk of suffering an injury or developing an injury. Because most sports or physical activities require the repetitive and constant use of the lower extremities, experiencing a complication which affects the lower back, buttocks, thighs and even the feet of the athlete can ultimately alter their performance.
Medial tibial stress syndrome, commonly referred to as shin splints, is not considered to be a medically serious condition, however, it can challenge an athlete�s performance. Approximately 5 percent of all sports injuries are diagnosed as medial tibial stress syndrome, or MTSS for short.
Shin splints, or MTSS, occurs most frequently in specific groups of the athletic population, accounting for 13-20 percent of injuries in runners and up to 35 percent in military service members. Medial tibial stress syndrome is characterized as pain along the posterior-medial border of the lower half of the tibia, which is active during exercise and generally inactive during rest. Athletes describe feeling discomfort along the lower front half of the leg or shin. Palpation along the medial tibia can usually recreate the pain.
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Causes of Medial Tibial Stress Syndrome
There are two main speculated causes for medial tibial stress syndrome. The first is that contracting leg muscles place a repeated strain upon the medial portion of the tibia, producing inflammation of the periosteal outer layer of bone, commonly known as periostitis. While the pain of a shin splint is felt along the anterior leg, the muscles located around this region are the posterior calf muscles. The tibialis posterior, flexor digitorum longus, and the soleus all emerge from the posterior-medial section of the proximal half of the tibia. As a result, the traction force from these muscles on the tibia probably aren�t the cause of the pain generally experienced on the distal portion of the leg.
Another theory of this tension is that the deep crural fascia, or the DCF, the tough, connective tissue which surrounds the deep posterior muscles of the leg, may pull excessively on the tibia, causing trauma to the bone. Researchers at the University of Honolulu evaluated a single leg from 5 male and 11 female adult cadavers. Through the study, they confirmed that in these specimens, the muscles of the posterior section of muscles was introduced above the portion of the leg that is usually painful in medial tibial stress syndrome and the deep crural fascia did indeed attach on the entire length of the medial tibia.
Doctors at the Swedish Medical Centre in Seattle, Washington believed that, given the anatomy, the tension from the posterior calf muscles could produce a similar strain on the tibia at the insertion of the DCF, causing injury.
In a laboratory study conducted using three fresh cadaver specimens, researchers concluded that strain at the insertion site of the DCF along the medial tibia advanced linearly as tension increased in the posterior leg muscles. The study confirmed that an injury caused by tension at the medial tibia was possible. However, studies of bone periosteum on individuals with MTSS have yet to find inflammatory indicators to confirm the periostitis theory.
The second theory believed to cause medial tibial stress syndrome is that repetitive or excessive loading may cause a bone-stress reaction in the tibia. When the tibia is unable to properly bear the load being applied against it, it will bend during weight bearing. The overload results in micro damage within the bone, not just along the outer layer. If the repetitive loading exceeds the bone�s ability to repair, localized osteopenia can occur. Because of this, some researchers consider a tibial stress fracture to be the result of a continuum of bone stress reactions that include MTSS.
Utilizing magnetic resonance imaging, or MRI, on the affected leg can often display bone marrow edema, periosteal lifting, and areas of increased bony resorption in athletes with medial tibial stress syndrome. This supports the bone-stress reaction theory. An MRI of an athlete with a diagnosis of MTSS can also help rule out other causes of lower leg pain, such as a tibial stress fracture, deep posterior compartment syndrome, and popliteal artery entrapment syndrome.
Risk factors for MTSS
While the cause, set of causes or manner of causation of MTSS is still only a hypothesis, the risk factors for athletes developing it are well-known. As determined by the navicular drop test, or NDT, a large navicular drop considerably corresponds with a diagnosis of medial tibial stress syndrome. The NDT measures the difference in height position of the navicular bone, from a neutral subtalar joint position in supported non-weight bearing, to full weight bearing. The NDT explains the degree of arch collapse during weight bearing. Results of more than 10 mm is considered excessive and can be a considerable risk factor for the development of MTSS.
Research studies have proposed that athletes with MTSS are most frequently female, have a higher BMI, less running experience, and a previous history of MTSS. Running kinematics for females can be different from that of males and has often been demonstrated to leave individuals vulnerable to suffer anterior cruciate ligament tears and patellofemoral pain syndrome. This same biomechanical pattern may also incline females to develop medial tibial stress syndrome. Hormonal considerations and low bone density are believed to be contributing factors, increasing the risk of MTSS in the female athlete as well.
A higher BMI in an athlete demonstrates that they have more muscle mass rather than being overweight. The end result, however, is the same in that the legs bear a considerably heavy load. It�s been hypothesized that in these cases, the bone growth accelerated by the tibial bowing may not advance quickly enough and injury to the bone may occur. Therefore, those with a higher BMI may need to continue their training programs gradually in order to allow the body to adapt accordingly.
Athletes with less running experience are more likely to make training errors, which may be a common cause for medial tibial stress syndrome. These include but are not limited to: increasing distance too quickly, changing terrain, overtraining, poor equipment or footwear, etc. Inexperience may also lead the athlete to return to activity before the recommended time, accounting for the higher prevalence of MTSS in those who had previously experienced MTSS. A complete recovery from MTSS can take from six months up to ten months, and if the original injury does not properly heal or the athlete returns to training too soon, chances are, their pain and symptoms may return promptly.
Biomechanical Analysis
The NDT is used as a measurable indication of foot pronation. Pronation is described as a tri-planar movement consisting of eversion at the hindfoot, abduction of the forefoot and dorsiflexion of the ankle. Pronation is a normal movement of the body and it is absolutely essential in walking and running. When the foot impacts the ground at the initial contact phase of running, the foot begins to pronate and the joints of the foot acquire a loose-packed position. This flexibility helps the foot absorb ground reaction forces.
During the loading response phase, the foot further pronates, reaching peak pronation by approximately 40 percent during stance phase. In mid stance, the foot moves out of pronation and back to a neutral position. During terminal stance, the foot supinates, moving the joints into a fastened position, creating a rigid lever arm from which to generate the forces for toe off.
Starting with the loading response phase and throughout the rest of the single leg stance phase of running, the hip is stabilized and supported as it is extended, abducted and externally rotated by the concentric contraction of the hip muscles of the stance leg, including the gluteals, piriformis, obturator internus, superior gemellus and inferior gemellus. Weakness or fatigue in any of these muscles can develop an internal rotation of the femur, adduction of the knee, internal rotation of the tibia, and over-pronation. Overpronation therefore, can be a result of muscle weakness or fatigue. If this is the case, the athlete may have a completely normal NDT and yet, when the hip muscles don�t function as needed, these can overpronate.
In a runner who has considerable overpronation, the foot may continue to pronate into mid stance, resulting in a delayed supination response, causing for there to be less power generation at toe off. The athlete can make the effort to apply two biomechanical fixes here that could contribute to the development of MTSS. First of all, the tibialis posterior will strain to prevent the overpronation. This can add tension to the DCF and strain the medial tibia. Second, the gastroc-soleus complex will contract more forcefully at toe off to improve the generation of power. However, it�s hypothesized that the increased force within these muscle groups can add further tension to the medial tibia through the DCF and possibly irritate the periosteum.
Evaluating Injury in Athletes
Once understood that overpronation is one of the leading risk factors for medial tibial stress syndrome, the athlete should begin their evaluation slowly and gradually progress through the procedure. Foremost, the NDT must be performed, making sure if the difference is more than 10mm. Then, it�s essential to analyze the athlete�s running gait on a treadmill, preferably when the muscles are fatigued, such as at the end of a training run. Even with a normal NDT, there may be evidence of overpronation in running.
Next, the athlete�s knee should be evaluated accordingly. The specialist performing the evaluation should note whether the knee is adducted, whether the hip is leveled or if either hip is more than 5 degrees from level. These can be clear indications that there is probably weakness at the hip. Traditional muscle testing may not reveal the weakness; therefore, functional muscle testing may be required.
Additionally, it should be observed whether the athlete can perform a one-legged squat with arms in and arms overhead. The specialist must also note if the hip drops, the knee adducts and the foot pronates. Furthermore, the strength of the hip abductors should be tested in side lying, with the hip in a neutral, extended, and flexed position, making sure the knee is straight. All three positions with the hip rotated in a neutral position and at end ranges of external and internal rotation should also be tested. Hip extensions in prone with the knee straight and bent, in all three positions of hip rotation: external, neutral and internal can also be analyzed and observed to determine the presence of medial tibial stress syndrome, or MTSS. The position where a healthcare professional finds weakness after the evaluation is where the athlete should begin strengthening activities.
Treating the Kinetic Chain
In the presence of hip weakness, the athlete should begin the strengthening process by performing isometric exercises in the position of weakness. For example, if there is weakness during hip abduction with extension, then the athlete should begin isolated isometrics in this position. Until the muscles consistently activate isometrically in this position for 3 to 5 sets of 10 to 20 seconds should the individual progress to adding movement. Once the athlete achieves this level, begin concentric contractions, in that same position, against gravity. Some instances are unilateral bridging and side lying abduction. Eccentric contractions should follow, and then sport specific drills.
In the case that other biomechanical compensations occur, these must also be addressed accordingly. If the tibialis posterior is also displaying weakness, the athlete should begin strengthening exercises in that area. If the calf muscles are tight, a stretching program must be initiated. Utilizing any modalities possible might be helpful towards the rehabilitation process. Last but not least, if the ligaments in the foot are over stretches, the athlete should consider stabilizing footwear. Using a supported shoe for a temporary period of time during rehabilitation can be helpful to notify the athlete to embrace new movement patterns.
MTSS and Sciatica
Medial tibial stress syndrome, otherwise known as shin splints, ultimately is a painful condition that can greatly restrict an athlete�s ability to walk or run. As mentioned above, several evaluations can be performed by a healthcare professional to determine the presence of MTSS in an athlete, however, other conditions aside from shin splints may be causing the individuals leg pain and hip weakness. That is why it�s important to also visit additional specialists to ensure the athlete has received the correct diagnosis for their injuries or conditions.
Sciatica is best referred to as a set of symptoms that originate from the lower back and is caused by an irritation of the sciatic nerve. The sciatic nerve is the single, largest nerve in the human body, communicating with many different areas of the upper and lower leg. Because leg pain can occur without the presence of low back pain, an athlete�s medial tibial stress syndrome could really be sciatica originating from the back. Most commonly, MTSS can be characterized by pain that is generally worse when walking or running while sciatica is generally worse when sitting with an improper posture.
Regardless of the symptoms, it�s essential for an athlete to seek proper diagnosis to determine the cause of their pain and discomfort. Chiropractic care is a popular form of alternative treatment which focuses on musculoskeletal injuries and conditions as well as nervous system disorders. A chiropractor can help diagnose an athlete�s MTSS as well as overrule the presence of sciatica as a cause of the symptoms. In addition, chiropractic care can help restore and improve an athlete�s performance. By utilizing careful spinal adjustments and manual manipulations, a chiropractor can help strengthen the structures of the body and increase the individual�s mobility and flexibility. After suffering an injury, an athlete should receive the proper care and treatment they need and require to return to their specific sport activity as soon as possible.
Chiropractic and Athletic Performance
In conclusion, the best way to prevent pain from MTSS is to decrease the athlete�s risk factors. An athlete should have a basic running gait analysis and proper shoe fitting as well as include hip strengthening in functional positions as part of the strengthening program. Furthermore, one must ensure the athletes fully rehabilitate before returning to play because the chances of recurrence of medial tibial stress syndrome can be high.
Chiropractic care is an effective form of alternative treatment which is commonly preferred by many athletes as it can help with the recovery of an injury and/or condition without the need for medications or surgery. Most athletes are specially trained to prevent injuries, however, the constant and repetitive overworking of the structures of the body can gradually begin to degenerate, leading to issues like shin splints which may potentially manifest symptoms of sciatica if left untreated for an extended period of time.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Low Back Pain After Auto Injury
After being involved in an automobile accident, the sheer force of the impact can cause damage or injury to the body, primarily to the structures surrounding the spine. An auto collision can ultimately affect the bones, muscles, tendons, ligaments and other tissues surrounding the spine, commonly the lumbar region of the spine, causing symptoms such as low back pain. Sciatica is a common set of symptoms after an automobile accident, which may require immediate medical attention to determine its source and follow through with treatment.
Sometime after Kyle Gibson starts for the Twins in their home opener Monday afternoon, the durable young right-hander will connect with perhaps the most important member of his support team this year: his Chiropractor.
Gibson is still just 28, smack in the prime of his career, but there were times during the second half last season when his lower back started to bark at him. In early August in Toronto, for instance, he was shelled for eight earned runs in just 4 2/3 innings.
�I had a problem in Toronto,� Gibson said.
�There were a couple starts where I didn�t sit down in between innings,� Gibson said, �because if I sat down, my hips just got tight.�
Meanwhile, fellow Twins pitcher Trevor May, 26, was dealing with lower back issues of his own. In May�s case, the additional pounding of making multiple relief appearances without much recovery time had caused issues with the hip and lower-back area of his left (landing) leg, as well.
May�s physical woes left him unavailable for days at a time while the Twins chased their first postseason berth since 2010. Massage and electronic stimulation could only do so much to keep May on the mound.
A few sporadic sessions with a chiropractor didn�t provide immediate results, so May discontinued them.
Upon returning to Seattle this offseason, the yoga devotee decided to up the ante and visit a chiropractor weekly for hour-long sessions. This time, he began to see the benefits.
�A couple weeks before spring training, I felt it coming on a little bit again,� May said. �I was like, what is going on? I got it adjusted and my chiropractor said, �Man, you are way, way out of whack.� He explained to me where my pain was and why the hip was pressing against where it was and if we get that moved back, just lengthened out, it�s going to be really sore for a few weeks, but then it�s just going to go back to normal.�
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OVERCOMING FEARS
In 2014, his first full season in the majors, Gibson saw a chiropractor a few times at the recommendation of Twins closer Glen Perkins.
Gibson missed a start in late July after getting shelled at home for six earned runs against the Tampa Bay Rays.
�One of Perk�s guys came in and adjusted me,� recalled Gibson, who threw seven shutout innings at Kansas City his next time out.
That never led to a regular appointment, partly because of Gibson�s relative youth but also because of a long-held fear of what a chiropractor might do to a young athlete�s spine.
�My view of them was, �OK, I want you to lay on a table and I�m going to pop your back and you can come back in a week,� � Gibson said. �Once you start doing it, you�ve got to keep doing it the rest of your life. That was my view.�
A conversation with May early in spring training this year left him more open to chiropractic manipulation.
Hoping to build on the gains of a breakthrough 2015 but still bothered by soreness in his lower back, Gibson asked May for feedback on his chiropractor. May, who by then was going once at week to Darin Stokke at Lifestyles Chiropractic, had nothing but good things to say about the sessions.
Dr. Stokke
�We found that baseball players get skeletally out of line,� May said. �They do one motion one way much harder (than most people), and my hips were really, really out of line. Seeing a chiropractor consistently has helped me make sure I�m getting readjusted and staying in line as much as possible.�
While initially there was some concern that the bullpen simply did not agree with May�s back, his chiropractic sessions convinced him (and the Twins) that he could manage the additional workload with proper preparation.
What derailed him in September 2015, as it turns out, was a problem with the set joint, where the left hip and lower back meet.
�It was all muscular,� May said. �It was just because one hip was closer to the spine than the other side. The other side was normal. (The left side) was just pressing so much and you get so much inflammation. It was just a perfect storm. It was just a little extra torque being in the �pen. That�s why it was bothering me. Now I�m on top of it.�
As May explained it to Gibson, realignment of the spine would allow the overtaxed areas of a pitcher�s core to meet the challenge of persistent pounding.
�Letting those muscles unflare and then heal and rebuild them back to where they�re supposed to be, that�s what we�re doing,� May said.
After doing some �normal treatment stuff� as a warmup, Stokke would check May�s alignment much the way a tire installer might need to check an automobile before sending it back out into traffic.
�He checks where you legs are,� May said. �If he sees you�re out of line, he puts you back in line, and the next day I try to do some exercises and heavy strength stuff, just to build those muscles back up. I�m seeing soreness go and I feel more in line and healthier.�
BELIEF SYSTEM
Despite taking the loss in his season debut in Baltimore, Gibson reports much the same results from his twice-weekly chiropractic sessions this spring.
�Toward the beginning of spring training my back started getting sore again,� Gibson said. �Going twice a week helped get things moving in the right direction.�
Now that he feels his lower-back problems are under control, Gibson plans to scale back to a single visit per homestand. That way he won�t have to find somebody to visit on the road, while also limiting those realignment sessions to perhaps two per month.
�It has made a big difference in my hips and just everything,� said Gibson, who set career highs for starts (32) and innings (194 2/3) last season. �My skeletal system was basically allowing my muscular system to stay tight and not function properly. That caused some nerve irritation.�
While May features the classic �drop and drive� delivery, Gibson is from the �tall and fall� school that should, in theory, produce less strain on a pitcher�s hips and back. That didn�t prove to be the case over Gibson�s first few seasons in the majors, so he finally realized adjustments were needed.
�Some of my problem was just that I had some tight hips pulling my pelvis out of line and causing some irritation in the nerve,� Gibson said. �There were certain things I realized I could pitch through. You find ways to get around certain sorenesses and aches and pains.�
If the Twins can get 200 innings out of Gibson and 65 to 75 relief appearances out of May, they won�t just have a better chance to end a postseason drought that has reached five years and counting. They could have additional members of their pitching staff lining up for realignment sessions.
Kyle Gibson, last season his lower back started to bark at him. The durable young right-hander connected with the most important member of his support team, his Chiropractor. While Trevor May, was dealing with lower back issues of his own. In May�s case, the additional pounding of making multiple relief appearances without much recovery time had caused issues with his�hip and lower-back area of his left (landing) leg, as well.
Complications affecting the lumbar region of the spine can affect a wide amount of the population at least once throughout their lifetime. Low back pain is one of the most frequently reported symptoms, together with various other symptoms, causing pain and discomfort. Although low back pain can include several other symptoms, a collection of specific symptoms could signal the presence of another disorder: sciatica.
Affecting millions among the American population, sciatica can be characterized within a range of minor irritation to a severe, disabling complication. Despite how frequently its diagnosed and treated, there�s an assortment of information about the condition that many individuals do not yet understand and its often a topic of confusion among the general population.
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What is Sciatica?
First of all, sciatica can best be described as a group of symptoms from an injury or an underlying medical condition rather than a singular disorder. The term is used to specify symptoms of pain, tingling and numbness sensations, or weakness that often originates on the lower back and radiates through the sciatic nerve found in either leg.
Also, when it comes to sciatica, the common injuries or underlying conditions causing the symptoms differ greatly based on age. Adults under the age of 60 frequently develop sciatica as a result of a lower back, or lumbar, herniated disc, degenerative disc disease, and isthmic spondylolisthesis. Adults over the age of 60 frequently develop sciatica as a result of degenerative changes, such as lumbar spinal stenosis and degenerative spondylolisthesis. Occasionally, pregnancy, or injuries such as muscle strains and bone fractures, which may create scar tissue, can also begin to develop sciatica symptoms.
In addition, the initial location of the nerve compression can affect the overall symptoms of sciatica as well as create new ones. Five nerve roots found on the low back region connect to form the large sciatic nerve. Symptoms can generally be defined by which of these five nerve roots becomes compressed or irritated. For example, numbness on the feet is common when the nerve root near the L5 vertebra in the lumbar region is pinched. Then, it�s also possible to experience multiple symptoms. Various nerve roots can become compressed at the same time, causing a combination of symptoms, such as pain or a tingling sensation on the outside area of the foot while simultaneously causing stiffness on the leg.
Treatment for Sciatica
When seeking treatment, an individual�s source of their sciatica symptoms can help determine the appropriate care plan in order to relieve pain and discomfort. A chiropractor for example, will diagnose an individual for any injuries or underlying conditions that could be causing their sciatica symptoms as well as determine the location of the nerve impingement to recommend a proper set of stretches and exercises. The specific exercises can vary depending on the location of the nerve damage or injury. Certain symptoms of sciatica may require immediate medical attention. It is rare for sciatica symptoms to require immediate surgery but if an individual experiences worsening neurological symptoms that begin to affect both legs, if there is bladder or bowel incontinence, or if symptoms occur directly after trauma from an accident, its essential for the individual to seek immediate medical attention.
Chiropractic and Sciatica
Sciatica is also known as lumbar radiculopathy or may often be referred to as pinched or compressed nerve pain. Many individuals may find these terms confusing when they are used interchangeably but these refer to the same diagnosis. Furthermore, sciatica is a frequent term used to describe a variety of symptoms on the legs, however, leg pain may not always be due to sciatica. A piriformis muscle complication or a sacroiliac joint issue can also cause pain and discomfort that travels down the leg similar to sciatica.
A majority of individuals whom experience sciatica can achieve relief from their symptoms within 6 to 12 weeks without relying on surgery. In fact, studies have shown that the long-term results of surgery and non-surgical treatments are similar. Faster pain relief may occur through surgery but, after a year, both surgical and non-surgical approaches produce identical outcomes. Throughout an individual�s treatment for sciatica, the application of ice and/or heat therapy, gentle stretching, and low-impact exercises, such as walking, can help ease sciatic nerve pain during the process of rehabilitation.
The symptoms of sciatica can manifest due to a broad variety of factors, including trauma from an injury or an aggravated condition. It’s essential to be able to identify these signs in order to seek the proper care and treatment for the specific complication. Chiropractic care is a common form of treatment utilized to help reduce and improve the symptoms of sciatica.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Low Back Pain After Auto Injury
After being involved in an automobile accident, the sheer force of the impact can cause damage or injury to the body, primarily to the structures surrounding the spine. An auto collision can ultimately affect the bones, muscles, tendons, ligaments and other tissues surrounding the spine, commonly the lumbar region of the spine, causing symptoms such as low back pain. Sciatica is a common set of symptoms after an automobile accident, which may require immediate medical attention to determine its source and follow through with treatment.
The spine is a complex structure that consists of bone, muscle, tendons, ligaments, nerves and other tissues. Spine fitness is essential towards maintaining the body�s optimal performance as it functions to support an upright posture, provides flexibility to allow the body to bend and twist freely, and protect the spinal cord. While a healthy back can easily be taken for granted, a�back injury�or other type of complication may result in long-lasting consequences that could alter an individual�s aspect of daily life.
Unfortunately,�back injuries�are among the most common types of complications suffered after an automobile accident. Each day, thousands of individuals are involved in head-on, side-impact, and rear-end auto collisions, often leading to spinal injuries even during minor car crashes. Depending on the force of the impact, a single or multiple areas of the back may be affected. Automobile injuries can range from mild sprains and bruises to fractured vertebrae and spinal cord damage.
If you�ve had a car accident, it�s essential to take note of any symptoms of�back pain, as there are a variety of spine complications which could result after experiencing an auto collision.
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Central Sensitization & Auto Injuries
Recovering From Auto Injuries
Disc Herniation
One type of spine injury among individuals who have suffered from an auto accident is a�herniated disc, or a slipped/ruptured disc. Discs are small, sponge-like structures found within the spinal column which function as cushions to separate and protect the vertebrae from the others while providing the spine with smooth flexibility. The force from an auto accident impact can damage a disc, causing it to break or deform, affecting its ability to cushion the bones of the spine.
Furthermore, a damaged disc can also place unnecessary pressure directly on the nerves surrounding it, leading to symptoms of pain, numbness and weakness on the region of the body where the affected nerve travels to.
Disc injuries to the�lower back�frequently lead to a group of symptoms commonly referred to as sciatica, which is characterized by radiating pain, numbness and tingling sensations in the leg and/or buttock on either side, or occasionally, in both sides, depending on the type of injury. The symptoms associated with sciatica can be impairing and may worsen over time if left untreated.
Auto Injury Back Pain
Spinal Cord Distress
Spinal cord injuries occur from the impact of an automobile accident. It sends a direct blow to the spine, that damages the delicate bundle of nerves within it. The spinal cord is the most important structure between the body and the brain. It is a vital link between the brain and the body, functioning to carry essential information back-and-forth from the brain to the central nervous system, facilitating motor control and sensory function. Spinal cord injuries impair the brain�s ability to communicate effectively with the rest of the body, resulting in paralysis and/or lack of sensation in all or part of the body. The more severe an injury to the spinal cord is, the more of the body will be affected.
Compression Fracture aka Bone Break
Car accidents can also cause compression fractures. Compression fractures or cracks in the bones of the spine may cause the vertebrae to collapse and deform. This can permanently alter the shape and structure of the spine.
Symptoms of a compression fracture include pain and postural changes as well as breathing difficulties. Due to the fact that compression fractures are common among older adults, many individuals mistake the symptoms for�signs of aging�or arthritis. An estimated two-thirds of compression fractures go undiagnosed.
While cars are built to withstand the great force of a collision, the human body is not. The complex structures of the body, especially the spine, are vulnerable even in low speed collisions, resulting in injuries or conditions more often than not. An individual who�s been injured in an accident should seek immediate medical attention in order to diagnose any possible injuries or conditions as early as possible to begin treatment.�Chiropractic care�can effectively treat a variety of spinal complications, including auto injuries. Through the use of spinal adjustments and manual manipulations, a chiropractor can gradually help restore the individual�s natural mobility and flexibility, as well as progressively strengthen the structures surrounding the spine to relieve the symptoms and restore the individual�s lifestyle.
After being involved in an automobile accident, injuries inflicted to the spine can be a common complication for many individuals. From herniated discs to compression fractions, the force of an auto collision can place great amounts of stress on the complex structures of the spine, often leading to damage, injuries and even aggravate an existing condition.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
The Clinic & Crossfit:
A Clients Story
Jacqulyn Quevas is up on her feet a lot as a hair stylist and she was�searching for�and overall become healthier and once she found Push-as-Rx ��, her amazing journey began. The motivation and enthusiasm of the trainers at Push as Rx has greatly influenced Jacqulyn.
The clinic and PUSH-as-Rx �� system is leading the field with laser focus supporting our youth sport programs.� The PUSH-as-Rx �� System is a sport specific athletic�program�of reactive agility, body mechanics and extreme motion dynamics. Through detailed and continued assessments of the athletes in motion and under stress loads offer a clear scientific picture of body dynamics. This system also has helped many athletes come back from injury faster, stronger, and ready to safely return to their sport without losing a beat after recovery. Results demonstrate clear improved agility, speed, decreased reaction time and advantageous postural-torque mechanics.� PUSH-as-Rx �� offers specialized extreme performance enhancements to our athletes no matter the age.
If you�ve had a car accident, it�s essential to take note of any symptoms of�back pain, as there are a variety of spine complications which could result after experiencing an auto collision.
Low back pain is a common symptom reported among the majority of the population. Generally caused by direct trauma from an injury or as a result of an aggravated condition, low back pain can greatly restrict an individual’s daily activities, affecting their overall physical as well as mental performance. Although there’s a variety of factors which can lead to back pain along the lumbar area of the spine, an incorrect sitting posture over an extended period of time has been known to be one of the leading causes for this well-known symptom.
Sitting is one of the most difficult positions for the body to maintain. Improper sitting postures�for prolonged periods of time while hunched over in a chair can build excessive pressure on the spine and affect the blood circulation in the legs. For an individual that spends their workdays sitting down, the long term result of an improper posture can greatly alter the individual�s overall health.
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Proper Posture While Sitting
Sitting for extended periods of time while hunching over a desk can cause discomfort, numbness and spine misalignment over time if the improper sitting posture is not corrected. Holding the body upright can also further increase pressure and tension in muscles, ligaments, joints, and other tissues surrounding the spine. A sedentary lifestyle where the individual doesn�t take frequent breaks throughout their workday to stand and stretch can gradually lead to cardiovascular disease due to the decreased blood flow, tightened hip flexors, shortened hamstrings, pinched nerves and many other physical injuries and/or conditions in the long run.
How Chiropractic Differs from Traditional Care
Aches and pains on the body, particularly around the spine, herniated discs, nerve complications and painful joints are direct results of working while in improper sitting postures for prolonged hours of the day. When you’re in a seated position, a lot of pressure is being placed directly on the spine and its surrounding structures. Our bodies were designed to stand upright and maintaining a seated position can be physically stressful.
“The weight is distributed while in a standing position,” explained Kelly McGonigal, Ph.D., a health psychologist at Stanford University and a leading expert in neck and back pain, �That’s not the case with sitting. McGonigal added, “When you sit, you distort the natural curve of the spine, which means your back muscles have to do something to hold your back in shape because you’re no longer using the natural curves of the spine to lift yourself up against gravity.”
Approximately 80 percent of individuals in the United States alone may experience some form of chronic pain in their lifetime. Ultimately, working on a sitting position for extended periods of time per day is putting a tremendous mental and physical stress on our bodies.
Correcting Posture
Maintaining good posture when sitting helps preserve the three natural curves of a healthy spine; the cervical curvature, the thoracic curvature, and the lumbar curvature. The normal curvatures of the spine should form a slight S-shape. An excessive curve in the spine could suggest a possible underlying condition and may present symptoms of pain and discomfort, among other uncomfortable symptoms.
The key to maintaining a proper posture is to avoid slouching by sitting up straight as well as sitting all the way back in your chair. Additionally, the chair should be tucked in close to the desk. Placing a pillow or cushion directly behind your lower back area, or the lumbar spine, can help sustain good posture by providing enough support and allowing the spine to naturally curve inward. Furthermore, it�s also recommended to stand and stretch about every 20 minutes to give your body a break from long held positions, release pressure that is being built up on the spine and restore the body�s regular circulation by pushing the blood out of your legs. Doing this consistently throughout your day can prevent the muscles, ligaments and other tissues of the body from getting strained. Simple stretches at your desk, such as twisting, turning the head from side-to-side and chin tucks upward towards the ceiling can also help. These movements will ultimately help to relieve an individual�s chronic pain as well as restore an individual�s health progressively over time and improve their overall well-being.
Sitting is one of the most difficult positions for the body to maintain. Sitting for prolonged periods of time while hunched over in a chair can build excessive pressure on the spine and affect the blood circulation in the legs. For an individual that spends their workdays sitting down, the long term result of an improper posture can greatly alter the individual�s overall health.
While for many individuals sitting behind a desk for a prolonged period of time each day is an inevitable and often necessary part of their lifestyle, practicing a proper posture as well as seeking the proper care once the symptoms of low back pain manifest can change the effect of the issue. Chiropractic care as well as physical therapy and other forms of treatment, are available to the public to help reduce their painful symptoms and restore their original functionality. The spine is one of the body’s most important structures and it’s essential to maintain its health to achieve overall wellness.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Chiropractic care is a natural treatment utilized to provide regular health maintenance to the spine, intervertebral discs, nerves and other tissues surrounding these structures, without the use of drugs or surgery. It focuses on the proper alignment of the joints in the body, particularly the spine, to reduce spinal nerve stress, promoting overall wellness.
Chiropractic is a well-known, alternative treatment option used to treat a variety of injuries and conditions, most commonly to improve symptoms of neck and back pain. From athletes to the general population, chiropractic treatment has been regarded as a safe and effective form of care, most recently, it�s even been utilized for women throughout pregnancy.
While it�s not commonly considered, chiropractic care can offer tremendous benefits for patients during their pregnancy and there have been no known contraindications to chiropractic treatment throughout this stage of a woman�s life.
Contents
Is Chiropractic Care Safe During Pregnancy?
All doctors of chiropractic, or chiropractors, are trained to work with women who are pregnant. Investing in the fertility and overall health and wellness of women throughout their pregnancy or those whom are trying to conceive is a routine care for a majority of chiropractors.
Many chiropractors take a specific interest in prenatal and postnatal care and they may pursue additional training to specialize in the treatment of pregnant women. The following represents designations of chiropractors who�ve taken advanced steps in working with infertility and pregnancy health and wellness.
DACCP � Diplomate with ICPA reflecting highest level of advanced training
CACCP � Certified with the ICPA reflecting advanced training
Member of ICPA reflecting special interest
Webster Certified � trained to work specifically with pelvic balance in pregnancy
Chiropractors which have acquired professional training to work with pregnant women commonly utilize special chiropractic tables that adjust to a woman�s pregnant body. They are also trained to utilize treatment methods and techniques which avoid the use of unnecessary pressure on the abdomen. In addition, a doctor of chiropractic will provide the patient with the most appropriate set of stretches and exercises that are safe to perform during pregnancy.
The Importance of Chiropractic During Pregnancy
Throughout the pregnancy process, a woman�s body will undergo a variety of physiological and endocrinological changes in preparation for creating the best environment for the development of the baby. Furthermore, the body will have to adjust to its new body mechanics, especially the normal structure and function of the spine. Several pregnancy body changes include: a protruding abdomen; increased back curve; pelvic alterations; and postural adaptations.
These new adjustments can challenge the structure and function of the body, to the point that a misalignment of the spine of other joints as well as the irritation and inflammation of the tissues can occur. Ultimately, restoring the original alignment of the spine and the balance of the pelvis in relation to the rest of the body is one of the main reasons why chiropractic care is essential throughout a woman�s pregnancy.
A misalignment of the spine or pelvis, also known as a subluxation, can reduce the amount of room available for the proper development of the baby. This restriction is medically referred to as an intrauterine constraint. Also, the misalignment of these specific structures can make it difficult for the baby to get into the best possible position for delivery, affecting the mother�s ability to have a natural, non-invasive birth. Breech and posterior positions can interfere with the ease of labor, leading to the use of other medical interventions, such as c-sections.
Maintaining the spine�s natural alignment helps the entire body function effectively. Because the nervous system is the master communication system between the brain and the rest of the body, including the reproductive system, ensuring the connection between these is not interfered by a subluxation is fundamental to guarantee the well-being of the individual.
Benefits of Chiropractic Treatment Throughout Pregnancy
Chiropractic during pregnancy can provide a substantial amount of benefits for pregnant women. These benefits include: maintaining overall health and wellness throughout pregnancy; helps control symptoms of nausea; reduces labor and delivery time, relieved neck, back and joint pain; and it can help prevent a potential cesarean delivery.
Talking to a Health Care Provider
As the amount of women who seek to take advantage of the benefits chiropractic care can offer throughout their pregnancy increases, more healthcare providers have begun to seek the services of doctors of chiropractic who specialize in the treatment of pregnant women. When considering chiropractic to maintain overall health and wellness during pregnancy, or when searching for an alternative treatment option for an injury or condition while pregnant, make sure to discuss these options with your healthcare provider. Chiropractic care should not be utilized as a sole source of treatment and maintenance during pregnancy, however, chiropractic can be used in collaboration with other medical services to ensure the patient receives the best care throughout their pregnancy.
Kinesio Taping Can Benefit Pregnancy
Aside from chiropractic care, there are other treatment methods and techniques which can also benefit women throughout their pregnancy. Many individuals use kinesio tape, also known as elastic therapeutic tape, an elastic cotton strip with an acrylic adhesive that comes in a variety of colors. Kinesio tape is generally utilized in athletes to treat a variety of injuries or conditions, however, applying the elastic therapeutic tape on pregnant women can help relieve many pregnancy discomforts, providing other great benefits.
The elastic therapeutic tape, or kinesio tape, functions by treating as well as helping to recover from and prevent injuries. With its acrylic adhesive, it serves to lift the skin and promote better blood circulation. Used universally today by the growing population, kinesio tape has even been utilized by the elderly to treat normal home injuries. Apart from treating injuries, elastic therapeutic tape can help stabilize and correct posture.
When it�s applied properly by a professional, the natural elasticity of the tape will gently lift the skin to help relieve pressure from pain receptors. Once it�s applied, the individual�s circulation will improve, working immediately and continuing to provide relief 24/7 for approximately 3 to 5 days per application. In addition, kinesio taping helps ease the body�s natural healing process, allowing for the individual�s original range of motion to improve by also providing stability and support to the surrounding muscles, joints and other tissues, as well as reducing pain and discomfort, swelling and controlling inflammation as a result of the improved blood flow.
A variety of benefits kinesio tape can offer include: prevention of injury; treatment and rehabilitation; promotes blood circulation; posture correction; optimized performance; near immediate treatment; stays on up to 3 to 5 days throughout treatment; able to shower and sleep with it for continuous relief; no heavy bracing; and it offers no restrictions due to its elasticity.
How Kinesio Tape Helps Pregnant Women
During pregnancy, the use of elastic therapeutic tape can be a safe and effective treatment option for pregnancy discomfort as well as for other types of injuries and conditions. Low back pain and pelvic pain can be common issues that affect pregnant women.
Kinesio tape is a drug-free alternative, similar to chiropractic care, that can offer pregnant women additional relief from the well-known symptoms which develop during pregnancy, including back pain, swollen feet, sciatica, and carpal tunnel, among others. Because of this, elastic therapeutic taping can be one of the most ideal options for expecting mothers who seek natural relief from the common symptoms associated with pregnancy.
Kinesio tape can also function similarly to a support belt or belly band, with the proper placement of the colorful tape to either the back or abdomen. The most frequent postural pain and discomfort pregnant women experience can be relieved using the kinesio tape in this manner as it will help distribute the weight of the additional pounds. It can also greatly reduce fatigue as well. In comparison to purchasing support belts and belly bands, elastic therapeutic tape can be considerably more economic in the long run. For most pregnant women, symptoms of pain and discomfort while pregnant can make sleeping difficult. Nonetheless, because these tapes can be worn while sleeping, they can provide continuous relief and a much needed rest.
Many healthcare professionals are trained to apply elastic therapeutic tape, however, one can learn to apply them themselves. Using kinesio tape can be challenging and difficult to apply at first. It�s important to allow a primary care physician, chiropractor or other healthcare specialist to demonstrate the proper way to apply kinesio tape before attempting to apply it yourself. Some elastic therapeutic tape may need to be altered before being applied to achieve a specific function. Always make sure the skin is dry and clean before applying the tape to ensure it lasts longer. To remove the tape, use baby oil on the strips to gently loosen the adhesions.
Technique #1: Belly Belt
This first technique functions by lifting the lower belly to help relieve painful symptoms as a result of the increased amount of pressure being placed onto the pelvic flooring. Begin by attaching one strip of tape firmly at the middle of the lower belly. Then, follow by pulling both sides of the tape upward to lift the belly, attaching the ends securely. If you need to apply more strips, repeat the process using a second strip and check how it feels for you.
Technique #2: Front Sling
This technique is excellent for providing frontal support for pregnant women. Using two strips of kinesio tape, attach the ends firmly at the bottom, pulling each strip upwards and securing them under the breasts. Women with smaller and/or shorter torsos can cut the elastic therapeutic tapes in half and follow the same application process.
Technique #3: Baby Belt
This technique can be significantly helpful for pregnant women whose bellies are protruding outwards quite a bit. Using two strips of kinesio tape, you are going to form an �X� at your belly button, beginning from the bottom, just above the hip bones. While pulling the tape across the belly, make sure to pull firmly in order for the tape to hold your belly in place securely.
Technique #4: Maximum Support
This fourth technique is for pregnant women who experience full belly pain. If you have lower back pain as well as belly pain, you can combine this technique with the following technique (see next technique). Using 4 strips of elastic therapeutic tape, beginning at one hip, apply the tape and pull it diagonally across your belly button up to the opposite ribcage. With a second strip, follow the same procedure as before on the opposite side. Next, take a strip of kinesio tape and apply it from the bottom, up on each side of the navel. Make sure to firmly attach the elastic therapeutic tape at the bottom and then pull upwards to anchor it at the top above the diaphragm.
Technique #5: Lower Back & Belly Support
If you need both lower belly and back support, this one is good for you. You will need two strips.. Using one strip you will have someone attach one end to one side of your lower back and firmly stretch it across, anchoring on the other side. With your second strip, you will stretch only the middle by pulling at both ends, attaching the middle part of the tape first to your lower abdomen. Then, you will firmly pull each side upward to secure. It should feel as if you are �lifting� up your belly. The discomfort should go away immediately.
Technique #6: Frontal Belly Support
The next technique is perfect for pregnant women who�ve only experienced discomfort in the front and lower abdominal regions. Utilizing two strips of elastic therapeutic tape, with the first strip, begin by applying it at the pubic line then pull upward, attaching the end of the tape right under the diaphragm. With the second strip, begin by applying it at one end of the lower belly, above the pubic line, and stretch it across. With smaller women, it might be necessary to cut the strips in half and follow the same procedure.
Technique #7: Diaphragm Support
This final technique is considered fundamental for when the baby gets so big that they begin to push into the diaphragm and can make normal breathing difficult. For this procedure, only one strip of elastic therapeutic tape is necessary. Smaller pregnant women may have to cut the strip in half and follow the same procedure. Foremost, you will need to firmly attach and hold the strip at one end while pulling it across to the other side, focusing on pulling it downward. The point is to bring the top of the belly down to ease the diaphragm.
It�s important to consult your healthcare provider or chiropractor before attempting any of the following kinesio tape techniques by yourself to discuss whether kinesiology taping is appropriate for you. Furthermore, be sure to notify your healthcare practitioner if you have sensitive skin to ensure you do not react negatively from the tape adhesive. Once the kinesio tape is applied, a healthcare professional can provide careful instructions on how you can preserve the usefulness of the tape while showering, bathing and dressing.
The above information is by no means a replacement to a consultation with a licensed healthcare provider. Consultation with a chiropractor or other healthcare provider is recommended for any individual suffering from symptoms due to an injury or condition. If you are not experienced with using elastic therapeutic tape, allow a medical doctor, chiropractor, physical therapist or other experienced healthcare provider to demonstrate how to properly apply the tape for use at home.
Massage for Pregnant Women
Just as chiropractic treatment and various techniques using elastic therapeutic tape can benefit women throughout their pregnancy, massage can also be a helpful alternative to provide further relief to pregnant women. The goal of every pregnancy massage is to provide unique and special needs to expecting mothers.
Certified pregnancy massage therapists are qualified and experienced to perform the specially designed massage techniques on women to help relieve the most common pregnancy symptoms, making sure to protect both mother and child during the massage.
Pregnancy massage can differ greatly from others and it is often unique in its application. During the massage, the pregnant women is carefully supported using cushions and pillows to provide the expectant mother with superior comfort. This type of massage is above all very gentle and deep tissue techniques are never utilized as a safety precaution. In addition, many areas of the body are avoided to protect both mother and child, providing extra attention only to specific areas of the body which are particularly affected by pregnancy, such as the back and/or the feet. Regardless of these safety precautions, pregnancy massage is generally not advised during the first trimester.
The gentle pregnancy massage can tremendously help both physical and emotional pain and discomfort in pregnant women and the psychological benefit of itself can be greatly therapeutic. In addition to stress and anxiety reduction, a pregnancy massage can help reduce common symptoms associated with pregnancy, such as swollen ankles and lower back pain.
In conclusion, a woman�s overall health and wellness is fundamental throughout their pregnancy and alleviating painful symptoms along with those common discomforts associated with the stages of pregnancy can help provide comfort to expecting mothers. From chiropractic care and the application and use of elastic therapeutic tape to pregnancy massages, there are a variety of safe, efficient and beneficial alternative treatments and techniques that can help pregnant women throughout their pregnancy without the need of drugs. The above mentioned treatment options are natural alternative which have been considered by many women. If you are in need of relief or simply wish to enjoy the benefits of these procedures, make sure to discuss them with your healthcare provider before following through with these treatments.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Your body is designed to work well and take care of itself, as long as you take care of it. In part, this means eating a balanced diet, exercising regularly, and getting the right amount of sleep. But sometimes you do need outside help to keep your body working at peak efficiency. Chiropractic care serves as an excellent example. Your chiropractic visits�do more than crack your back. Your treatment sessions can help improve your overall body structure and health.
1. Better Posture
If you work in an office or over a machine during the day, you likely develop a slump in your workplace. Your back starts to curve, your shoulders droop forward, and soon you start feeling a bit of an ache to your torso at the end of every day. If you let it go for long, you soon discover you don�t stand or sit as tall as you used to. You can almost feel your body deteriorate around you, from your spine out to your arms and legs.
Chiropractic care helps head this off at the pass. You stretch your body out and stretch and straighten your�back. The small curves that start to set in on you unfurl, and you soon feel your whole body relaxing as a result. The treatment soon has you standing taller, working more comfortably and moving into your evening feeling stronger than ever.
2. Better Body Movement
As you stand straighter and move through your day with your back set more correctly, you begin to see the benefits extend into other areas. One is your overall range of motion. A straighter, better aligned back gives your arms and legs a better base from which to move. You can move more comfortably and freely through your day and your whole body responds, adjusting to your centered, realigned core.�Your body is meant to be flexible;�designed to bounce back and recover quickly and freely from exertion.
Stiffness in the center stifles this natural state throughout the body and chiropractic care brings you back to where you should remain. Instead of movements beginning out of place, you can move your arms and legs with a fuller range of motion. Your body no longer fights itself for you to move. Everything flows in concert, and you feel better with every step and arm swing.
Football & Chiropractic
3. Greater Strength
Beyond flexibility, you also generate strength from your core. Personal trainers and fitness gurus explain this theory from their perspective of toning stomach and back muscles- and they are correct. However,�strength runs deeper than even the muscle groups, extending to your skeletal structure underneath it all. Your spinal column and hips underlie and support the movements you make at a basic, foundational level. When your spine is misaligned, the system of bones and muscles cannot create and work in the harmony with which they were designed to act.
A chiropractic alignment returns the natural order and base of your strength. It allows your vertebrae to work together, each bone supporting and adding to the strength of the next. The result? A body working as one powerful unit, creating and building strength from the center, rather than relying on a less complete support system. You work less to do more, and have more power to use when you need to use it.
�A Healthier You
4. More Effective Nervous System
The body needs a straight, free spine for more than just physical support. Your spine protects the spinal cord, the center (with your brain) from which all communication through your nervous system emanates. If the bones contract or move out of place, that communication system works less efficiently. You cannot react as quickly or respond as well to the world around you.
A chiropractic realignment helps return your body to peak functional capacity. The nerves no longer get pinched off or otherwise interrupted in the process of moving impulses and stimuli though the body. Your senses sharpen and work better, resulting in an improved reaction time. Your internal safety systems and mechanisms work better, and your whole body functions more smoothly. You start to heal yourself more quickly, from physical aches and pains to infections because your signaling mechanisms and pathways are more clear. You can respond to issues inside your body more quickly, and fight off issues more readily.
Whole Body Wellness
5. Pain Relief
In the midst of all of this, some of the symptoms that may initially drive you to a chiropractor can start to diminish. Pain does not come directly when you are not aligned properly. The body has a remarkable tolerance to small changes, and at times,�big changes. This generally works to your advantage, but it has the downside of masking smaller problems and concerns until they become bigger ones. Your body starts to cover up alignment issues with shifts in posture and resilience. By the time you feel the discomfort, you have likely shifted dramatically out of place.
Because of this, expecting immediate relief from chiropractic treatment may be setting yourself up for disappointment. You sometimes do feel instantaneous improvement, but the more likely scenario is to feel your physical symptoms gradually improve. With the help from your body, time heals. Maintaining your body to help�it do its job more effectively goes a long way toward making your life more comfortable.
Your body can do amazing things for you if you let it. Unfortunately, the stress and the wear and tear we put it through over time can diminish its effectiveness in handling everyday experiences and events. When you take the time and effort to maintain your physical condition, you free your body up to do the things it was meant to do: support, protect, and take care of itself. We are remarkable beings, designed to achieve incredible things both mentally and physically.�Chiropractic care�helps you maintain your body, as a support system and a base for everything else that you do.
Sometimes you need outside help to keep your body working at peak efficiency. Chiropractic care serves as an excellent example. Chiropractic �does more than crack your back and treatment can help improve your overall body structure and health.
Proven�research is now indicating that receiving Chiropractic adjustments to the pelvis can�increase vertical jump height. �This new research further solidifies the stance of many professional and collegiate teams with providing Chiropractic care for their athletes. In addition to injury prevention this research proves that chiropractic care results in an increase in sports performance.
[Purpose] This study aimed to investigate the effect of pelvic adjustment on vertical jump height (VJH) in female university students with functional leg length inequality (FLLI). [Subjects] Thirty female university students with FLLI were divided into a pelvic adjustment group (n = 15) and a stretching (control) group (n = 15). [Methods] VJH was measured using an OptoGait. [Results] After the intervention, jump height improved significantly compared with the pre-intervention height only in the pelvic adjustment group, while FLLI showed statistically significant improvement in both groups. [Conclusion] Pelvic adjustment as per the Gonstead method can be applied as a method of reducing FLLI and increasing VJH.
Key words:�Pelvic adjustment, Functional leg length inequality, Vertical jump height
INTRODUCTION
The pelvis, a structure located between the hip joint and the lumbosacral spine and attached to several muscles, regulates the movement of the hip joint and lumbosacral spine. The position of the pelvis is the most critical factor determining the sagittal alignment and posture of the human body). Only when the pelvis is in the neutral position can be in the right posture, move the upper and lower body in the dynamic posture, and improve daily movements and ambulatory ability).
Functional leg length inequality (FLLI) worsens due to pelvic tilt in the medial plane and pelvic rotation in the sagittal plane). Therefore, FLLI might be improved by pelvic adjustment. High-velocity and low-amplitude (HVLA) adjustment has been widely utilized as a general chiropractic adjustment method). Many studies have indicated that leg length inequality (LLI) causes posture alteration), limiting exercise and causing tension of the muscles and other soft tissues5). LLI is accompanied by several clinical symptoms6)�such as lumbar pain)�and hip pain). Correcting leg length inequality reportedly reduces pain, increases mobility, and improves posture).
Vertical jumping is practiced to enhance the muscular strength and endurance of the leg and serves as a barometer of muscular strength). There have been studies in which plyometric training was undertaken to improve leg muscle strength), dynamic stretching was applied after jogging for 5 minutes to improve vertical jump height (VJH), or HVLA manipulation was performed for talocrural joint dysfunction). However, there has been no study in which FLLI was corrected and VJH was measured as a barometer for leg muscle strength. Many studies have assessed the effect of pelvic adjustment on FLLI), posture), pressure on the foot, and balance). However, no study has investigated the changes in FLLI and VJH resulting from just a single adjustment. Therefore, this study aimed to assess the immediate effects of a single pelvic adjustment on FLLI and VJH in female university students with FLLI.
SUBJECTS AND METHODS
A total of 30 female university students with an FLLI of more than 10?mm between the left and right legs were selected and randomly assigned to one of two groups: the pelvic adjustment group (adjustment group, n = 15) and control group (stretching group, n = 15). The exclusion criteria were as follows: anatomical LLI; degenerative osteoarthritis; muscle, bone, or nervous system problems; ankle joint, knee joint, hip joint, or lumbar pain; limited range of motion due to burn or postsurgical scarring; and regular leg exercise. This study was approved by Korea Nazarene University�s Institutional Review Board, and the safety of all subjects was protected during all parts of the experiment. All subjects understood the purpose of this study and provided written informed consent prior to participation in accordance with the ethical standards of the Declaration of Helsinki.
The age, height, and weight of the subjects in the adjustment group were 23.5�4.7?years, 163.0�5?cm, and 54.1�5?kg, while those in the stretching group were 22.2�6.3?years, 162.7�6?cm, and 53.1�6?kg, respectively. Gender was analyzed using the ?2�test, while age, height, and weight were analyzed using the independent t-test. As these analyses detected no statistically significant differences (p>0.05), the two groups were deemed identical.
The pelvic adjustment performed in the adjustment group consisted of an HVLA technique administered in the prone posture in accordance with Gonstead�s theory. Subjects were instructed to lie prone, their pelvic height was checked, and the posterior-inferior innominate bone was given an anterior-superior impact while the anterior-superior pelvis was given a posterior-inferior impact. When making these impacts, the therapist put one of his hands on top of the other, placed them on the posterior-superior iliac spine or the ischial spine, and then gave the impact using his own weight, gravity, and acceleration). This adjustment was performed 3�5 times by one skilled physical therapist with more than 10?years of clinical experience. The control group stretched the backbone erector, rectus abdominis, iliac muscle, psoas major, quadriceps muscle, leg adductor, and quadratus lumborum adjacent to the pelvis in order to resolve muscular imbalance that could further the pelvic imbalance. In the process, the therapist assisted the subjects in performing additional height training for each muscle and maintaining each posture at the maximum height for 10�15 seconds. The subjects then resumed the initial posture, rested for 5 seconds, and repeated the stretching one more time. Stretching was done three times per posture for a total of 15 minutes).
For leg length measurement, subjects lay straight on a bed, and the tape measure method (TMM) was used to measure the leg from the anterior superior iliac spine (ASIS) to the medial malleolus. Beattie et al. reported that LLI as measured by the TMM did not show a significant difference from radiological findings. We were therefore confident in the reliability of using the TMM for measuring leg length). The measurement started from the ASIS so that pelvic bone-related problems such as pelvic tilt and pelvic asymmetry could be included.
We used an OptoGait (Microgate Srl, Bolzano, Italy), a system for optical detection, to analyze ambulation and measure VJH. On its signal-sending bar, there are 96 LEDs that communicate via an infrared frequency. The signal-receiving bar has an identical number of LEDs. We installed the signal-sending and signal-receiving bars of the OptoGait one meter apart on a flat surface. When a subject performs a vertical jump between the bars, the bars calculate the time at which the subject touches the floor or stays in the air and communicates this information by sending and receiving 1,000 signals per second, generating accurate data. Based on this basic data, the OptoGait software calculates the precise VJH.
Leg length and VJH were measured before and after the intervention. The measured data were analyzed using the statistics program SPSS 12.0 KO (SPSS, Chicago, IL, USA), and the collected data are presented as averages and standard deviations. The significance of pre- and post-intervention differences was tested using the paired t-test, and the significance of between-group differences was tested using the independent t-test. The p-value ? was set at 0.05.
RESULTS
In the pre- and post-intervention comparison, VJH improved significantly only in the adjustment group, while FLLI improved significantly in both the adjustment group and the stretching group (p<0.05) (Table 1). When comparing the pre-intervention data, post-intervention data, and changes between the pre- and post-intervention data, VJH showed statistical significance only for the changes between the pre-and post-intervention data, while FLLI showed statistical significance for post-intervention data and changes between the pre- and post-intervention data (p<0.05) (Table 2).
Table 1.
Comparison of the Pre- and post-intervention data for VJH and FLLI in each group (mean�SD) (Unit: VJH-cm, FLLI-mm)
Table 2.
Comparison of VJH and FLLI between the adjustment group and stretching group (mean�SD) (Unit: VJH-cm, FLLI-mm)
DISCUSSION
The pelvis supports the abdomen, connects the spine and legs, and is involved in transferring weight from the spine to the legs when a person stands up, maintaining a straight posture and enabling smooth arm movements). Due to their erect ambulation, human beings are exposed to gravity and can thus be subject to a malalignment of the pelvis and legs affecting posture, ambulatory pattern, and balance. LLI is easily observed clinically and causes functional disturbance of normal biomechanics).
Winter and Pinto reported that pelvic obliquity is caused by LLI), and Mccaw and Bates explained the relation between biomechanics and spinal deformity due to LLI). Defrin et al. reported that when a shoe insert was used in 22 chronic back pain patients with LLI of 10?mm and less, pain intensity and muscular weakening were reduced), which appears to be due to reduced pain and muscular weakening attributed to decreased pelvic tilt resulting from LLI adjustment. On the basis of previous studies on pelvic adjustment, Alcantara et al. reported that following adjustments using fast and slow speed amplitudes in patients with sacroiliac joint obliquity, pain was reduced, and patients could resume daily life and work). Park et al. reported that balance in 20 elderly men was improved through pelvic adjustment according to the Gonstead method). In this study, FLLI was reduced after pelvic adjustment, a finding similar to a previous study in which pelvic adjustment helped reduce FLLI and the pressure difference between soles).
In this study, stretching was not associated with increased VJH, while pelvic adjustment was. In a previous study by Ryan et al. in which subjects jogged for 5 minutes in order to improve VJH, a barometer for leg strength, and then performed dynamic stretching, VJH was increased as compared with a control group that only jogged for 5 minutes). In the present study, it is suspected that VJH did not increase because only static stretching was applied. Hedlund et al. reported that VJH showed a statistically significant increase following 3 weeks of chiropractic HVLA manipulation in 22 female handball players with talocrural joint dysfunction, which is similar to the findings of the present study).
Pelvic adjustment balances the left and right pelvic height and left and right anterior and posterior rotation of the hip bones, which, in turn, leads to FLLI improvement. It also balances the left and right muscle lengths of the rectus femoris and sartorius, which are involved in the hip bone�s anterior rotation, and the hamstring and gluteus maximus, which are involved in posterior rotation. This seems to explain the improvement in vertical jump ability. We recommend that pelvic adjustment be applied for decreasing FLLI and increasing VJH, a barometer for leg muscle strength, in the future.
Research now indicates that receiving Chiropractic Adjustments to the pelvis can�increase vertical jump height. �This research solidifies many professional and collegiate teams that�provide chiropractic care for their athletes. In addition to injury prevention this research proves that chiropractic care results in greater athletic performance.
Tony Robbins, the #1 personal growth and business leader, talks about his experience with�Network Chiropractic and Donny Epstein.
Network Spinal Analysis� could be described in this way, arising as it did when in 1982, New York Chiropractor, Dr Donald Epstein began �networking� various chiropractic techniques. Through meticulous observation and by comparing the findings and results of one method with another, he began to see the efficacy of marrying certain techniques in a manner which enables the practitioner, through the use of light touch, to release large amounts of spinal tension from a patient. Although this might not sound very dramatic, it is a fact that the absolutely remarkable �life-changing� ways in which patients respond to this method of care has become a hallmark of NSA. This unique approach to health is a synthesis of long standing chiropractic methods, quantum mechanics, neuroanatomy and neurophysiology while also acknowledging changing perspectives in health care. In Dr Epstein�s case, these changes involve an expanded interpretation of the concept of �wellness�.
What is Network Chiropractic?
Here is an interview with Dr. Epstein from the Positive Health Online website:
Dr Epstein: �Network Spinal Analysis� sits within a new paradigm which I have been developing internationally and that�s called the Wellness Paradigm. Wellness is not about whether a person has disease. It�s about their internal experience of their body, the ability to make constructive healthy choices, and their ability to enjoy life and be well. Wellness is that state of concern in which you are relatively invincible, nothing can ruin your day, you feel alive, vital and confident and experience a high state of well-being. When you experience wellness, your circumstances of the moment do not easily upset your internal state.�
Findings from Network Care have been documented in major university studies which examine the social science and bio-medical indicators of wellness by looking at a variety of different things people do to increase their health levels. A person who meditates daily, has buns of steel from exercise and the most expensive urine on the planet from supplements, and who has stopped doing the destructive things, will double their perceived wellness factor. However, if that person then adds Network Care, their wellness factor � their ability to make healthy life choices and stick to them � trebles!
Dr Epstein: �What we are looking at here is an experience of life beyond the usual form. A more subtle engagement with the parts of the brain that allow a person to express their higher level of humanity and function occurs so that a greater capacity to express more connections of compassion and love arises. I call these �higher end social changes�, because there are spiritual connotations involved. The individual is different in the way they relate to others and their environment. They can be instrumental in helping create a more compassionately productive community.
�To understand the �mechanics� of NSA, we must first remind ourselves that the spine is composed of bones sitting on top of each other with discs or pads in-between. These bones or vertebrae have holes like donuts in them. These holes create a spinal-canal for the spinal cord which extends from the base of the brain to the tail-bone. The central nervous system comprises the brain and the spinal cord, and is supported by an intricate system of tissues called the meninges that are filled with fluid which nourishes and protects the nervous system, all of which sits within the spinal canal, protected by the bony vertebrae. Connective tissue attaches this system to the top and bottom of the spine and this tissue is subject to stresses, tension and distortion.
�We perceive our world through the nervous system. It is also through the nervous system that we coordinate the function of every cell, organ and tissue in the body. Every region of the body and every emotion is expressed through the nervous system. Also, it�s the part of us with which we reason and which adapts us to stress and it�s the vehicle we use to create our conscious reality. So, when an event occurs that our brain decides is not safe for us to fully experience at that particular time, the energy and information of the event is translated into vibration and tension, which is then stored in the body. This tension begins to distort the spinal system: Spinal bones (the vertebrae) lose their normal alignment, and muscles and ligaments strain and pull. Nerves can become compressed or stretched and irritated which results in abnormal function. As the nervous system is put under pressure, the spine is no longer able to right itself without outside help. Our body then �closes off� the offending energy and tension, but over time, muscular tightness, spinal distortion, reduced breathing into the area occurs and consequently reduced movement results. Until it is safe to experience that energy again, and digest the information from the trauma, we cannot really feel whole or well.
�This is a very real thing � anyone who is at the crossroads of life, physically, emotionally or spiritually, or anyone who cannot get further than they were before, needs Network Care to help their brain to move from stress physiology which results in a person�s structure being fixed in defense posture. In fact, most of us remain in defense mode throughout our lives and this can retard the higher, more evolved area of the brain from developing its unique properties and evolving new strategies for experiencing and responding to life. There are many people whose vertebrae, ligaments and tissues are locked into stress patterns, creating so much tension, that their focus in life is just getting through another day! Network care allows the brain to move from the stress physiology into safety.�
So How Does The Practitioner Go About Relieving This Stress?
Dr Epstein: �I found that by using gentle and specific touches in a consistent sequence, where the spinal cord attaches to the spine, a patient�s own body learns to release complex patterns of tension and areas of disablement. Once this has been achieved, a further unwinding of deeper tensions from the spine occurs. These �touches� consist of gentle finger or hand contacts applied at �spinal gateways�� or �access points� along the neck and lower spine. They are applied in such a way as to engage the higher part of the brain, the frontal lobes of the cerebral cortex. This is the most recently developed region of our brain and is the area through which we observe ourselves and make choices regarding our behavior. This is the area through which we can reach a higher level of humanity, one which embraces spirituality and evolution.�
During Network Spinal Analysis� Care, two �healing waves� develop. One is a breathing wave which releases tension throughout the spine and body and relaxes a person. The other is called somatopsychic (or body-mind) wave, which is associated with undulation or movement of the spine.
Dr Epstein: �The mathematics of this wave are unique because it appears that this type of wave has not been reported anywhere else, so it has to be a signature in Network care. The theory being purported now suggests that as the individual progresses through levels of care, that wave, that signal along the spine is organizing high levels of complexity. That means there�s more letters in the language � more words available and ultimately more information becomes accessible. There is an evolutionary aspect to this in that there is an increase in the ability of the system to self-organize so it can have more appropriate views about the environment and become more energy efficient. Thus an outcome is produced, that is significantly beneficial to the species and that was not there before.
�What we are looking for in Network is for the system itself to reorganize and develop strategies for experiencing and releasing tension on its own. In the first level of care, which may last a few weeks, the person develops a strategy to connect the brain to the body more effectively and to develop a capacity for self-correction of the tension patterns. The care program encourages the development of spontaneous stretching movements and breath movements which help release tension in the spine. In the second level of care, we are looking for the brain to be aware of the person�s tension, and actually temporarily amplify that tension and redirect it so that the tension actually becomes the fuel for further healing and transformation. Tension is what holds a person anchored in a position of non-safety. Lack of safety is the basis for all physiological stress and the way we accumulate this stress is directly associated with the way we experience our world.
�I would like to see Network Spinal Analysis� practitioners in places like cancer clinics and working with people who have had recent heart attacks; serious trauma patients and those who have had emotional traumas as children. I see Network Care not as competing with the existing medical paradigm, but instead offering a totally different approach that says no matter what you do about the disease, allow that person to be upgraded from say a 64k computer to a Pentium. Allow them to develop new strategies that they never had before and that person will make healthier choices. They will become more at peace and ease with their life and they will have a greater capacity to heal, which often means the disease going away. And if the disease doesn�t go away, at least that person�s life is going to be richer than it was before. Network Care is an approach to wellness that embraces everyone. Babies, children, seniors. All can develop these strategies which allow a higher level of function.
�A man who came to a talk I was giving, told me he had metastatic prostate cancer. He had had surgery and radiation treatments and the cancer had gone away but now it was back and spreading and he was very worried. I asked him what he was afraid of and if he was afraid of dying. He said, �No, I�m afraid of the way I have to die if I go for further chemotherapy and radiation.� It is upsetting that the treatment has to take away a person�s dignity which in my opinion can never heal. But I asked him what he would have to do differently if he was going to die. He said that he would have to get his affairs in order so I asked him what he meant by that. �Well,� he said, �I haven�t spoken to my son in 20 years and I never forgave my wife for dying�. And he went through a variety of things. I asked him why he would have to do these things. He said so that he could die in peace and I said, �Sir, this is a mistake, it�s so you can live in peace�. For some people, the only way they can make the changes which will enable them to live in peace is at the very end of their life.
�And the point of this is � there are people who have cancer who never know it and who live full and perfectly wonderful lives. I know of one Network doctor I met at a seminar recently who told people that she is more alive, more compassionate and responsive with more feelings of gratitude than ever before. Six months previously, she had a breast removed, and for six weeks before that she had received chemotherapy. The other people who had had chemotherapy and surgery at the same time were not receiving Network Care. Her internal state of wellness was so high irrespective of her circumstance, that she could be well and produce the physiology that would allow for a person to heal.
�When someone comes to me for care, I do not have to know what it was that caused that person�s problem. What I do know, is how to intervene, to help their system to observe itself and to make a change. I have clinically dedicated myself to furthering the knowledge of the biological links which will help us express a greater range of our humanity. I believe that by optimizing an individual�s biology, Network Spinal Analysis� will facilitate positive transformation on a global scale, changing the world, a spine at a time�.
In 1982, New York Chiropractor, Dr Donald Epstein began �networking� various chiropractic techniques. Through observation, comparing the findings and results of one method with another, he began to see the efficacy of marrying certain techniques in a manner which enables the practitioner, to release large amounts of spinal tension from a patient. �Dr. Jimenez is proud to be a practitioner that combines not only the “Network Techniques” discussed above as well as the established “Advanced Diversified Procedures.“
are impairments in detecting, modulating, interpreting, or responding to sensory stimuli. One study estimates that 5 percent of elementary aged children met the criteria for SPD. These conditions are closely related to other neurodevelopmental disorders and often overlap with autism and ADHD. Recent studies have shown the benefits of chiropractic in enhancing the functionality of individuals with SPD and Autism.
In 2011, we have more children and young adults affected by neurodevelopmental disorders than ever before in history. There are many factors involved in this such as birth and/or early childhood trauma, environmental toxins, food allergens, the avoidance of breast feeding and heavy vaccination. These are all areas that show promise as causative factors in the formation of neurodevelopmental disorders.
Birth trauma can come in the form of a forceps or vacuum extraction delivery. Even normal vaginal or cesarean birth processes can be particularly traumatic. The most vulnerable area of the infant�s body is the upper cervical spine. This also happens to be the area where the brain stem ties into the top of the spinal cord. Birth trauma can significantly damage this region andcreate a neurological insult that is referred to as subluxation.
Subluxation alters neurological processing
Subluxation is a term used to describe mechanical compression and irritation to spinal joints and nerves. Subluxation scrambles the neurological feedback loop by causing altered rhythms of neurological flow. Subluxation insults the neurology of the infant and affects normal development and maturation. This can often create an environment conducive to the formation of neurodevelopmental disorders such as autism, ADHD andSPD.
Many chiropractors specialize in the location, diagnosis and correction of subluxation patterns in infants and young children. These chiropractors often have unique training with digital technology that uses thermographic and surface electromyography to calibrate the function of the nervous system and identify areas of neurological insult. They are also gifted with palpation, posture and body motion observations to locate specific biomechanical and neurological imbalances in the young child.
Spinal Decompression Therapy
Two recent studies published in the 2011 edition of the Journal of Pediatric, Maternal & Family Health showed the benefits of chiropractic on SPD and Autism. In both cases the children were diagnosed with upper cervical subluxation patterns that were thought to have occurred from early childhood traumas. The children also showed signs of neurological imbalance and subluxation in other regions of the spine. Results of their care were startling and would naturally be considered major breakthroughs in the medical model.
The children�s care consisted of specific chiropractic adjustments for a period of weeks to remove subluxation and balance the neurology. They also followed an anti-inflammatory nutritional program that involved a gluten-free, casein-free diet and nutritional supplements such as probiotics and digestive enzymes.Most natural health practitioners would agree that the majority of children with neurodevelopmental disorders have neurological and digestive damage. The digestive issues typically involve leaky gut syndrome, gut dysbiosis, Candida infections and chronic food allergens. These problems typically present together and can be remedied with an anti-inflammatory diet and nutritional supplements.
There are 10 other case studies of children with similar neurodevelopmental issues who have seen significant improvements through chiropractic care. This is evidence of the role that subluxation plays in affecting normal sensory system maturation and development.
Hopefully these recent studies will shine a light on the impact of subluxation correction on healthy neurological balance. This can range from immune system disorders, chronic disease and neurodevelopmental problems. More research dollars should be spent on inexpensive, low risk, non-invasive modalities such as chiropractic care for childhood health problems and normal brain and immune system maturation processes.
Sensory Processing Disorders (SPD) are impairments in detecting, modulating, interpreting, or responding to sensory stimuli. One study estimates that 5 percent of elementary aged children met the criteria for SPD.
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A total of 30 female university students with an FLLI of more than 10?mm between the left and right legs were selected and randomly assigned to one of two groups: the pelvic adjustment group (adjustment group, n = 15) and control group (stretching group, n = 15). The exclusion criteria were as follows: anatomical LLI; degenerative osteoarthritis; muscle, bone, or nervous system problems; ankle joint, knee joint, hip joint, or lumbar pain; limited range of motion due to burn or postsurgical scarring; and regular leg exercise. This study was approved by Korea Nazarene University�s Institutional Review Board, and the safety of all subjects was protected during all parts of the experiment. All subjects understood the purpose of this study and provided written informed consent prior to participation in accordance with the ethical standards of the Declaration of Helsinki.
