Skateboarding is a popular activity among children, teenagers, and young adults. It is recreational, competitive, fun, and exciting but, like any sport, carries a risk of injury. There are around 70,000 skateboarding injuries requiring a visit to the emergency room every year. The most common injuries involve the shins, ankles, forearms, wrists, elbows, face, and skull, with many left untreated that worsen as they heal improperly, leading to further damages and complications. Chiropractic can treat the injuries, rehabilitate the muscles and joints, and strengthen the body to get the skater back on their board.
Skateboarding Injuries
Skateboarding injuries can range from scrapes, cuts, and bruises to sprains, strains, broken bones, and concussions.
Shin injuries often happen during flip/twist tricks where the board or axle hits the shin causing bruising and swelling.
Shoulder, wrist, and hand injuries are common when skaters lose their balance and fall with outstretched arms.
Ankle injuries include rolls/sprains, as well as dislocations and fractures.
Dislocations usually happen to the shoulders, wrists, and fingers.
Facial injuries include teeth knocked out, broken nose, or jaw are typically caused by fast forward hard falls.
Severe injuries include concussions and head injuries.
Injury causes
Skateboarding injuries typically occur from:
Skating on irregular surfaces locks up wheels and affects balance, causing falls.
Losing balance or losing control of the board and falling hard/slamming into the pavement.
Inexperience, slow reaction times, and less coordination lead to falls and slams.
Skating into another skater, a person walking or cycling, a car, or a road hazard.
Trying an advanced trick/maneuver too soon and beyond their skill level.
Help prevent further injuries and long-term effects.
Chiropractic Skateboarding Injury Treatment
References
Forsman, L, and A Eriksson. “Skateboarding injuries of today.” British journal of sports medicine vol. 35,5 (2001): 325-8. doi:10.1136/bjsm.35.5.325
Hunter, Jamie. “The epidemiology of injury in skateboarding.” Medicine and sport science vol. 58 (2012): 142-57. doi:10.1159/000338722
Partiali, Benjamin, et al. “Injuries to the Head and Face From Skateboarding: A 10-Year Analysis From National Electronic Injury Surveillance System Hospitals.” Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons vol. 78,9 (2020): 1590-1594. doi:10.1016/j.joms.2020.04.039
Shuman, Kristin M, and Michael C Meyers. “Skateboarding injuries: An updated review.” The Physician and sportsmedicine vol. 43,3 (2015): 317-23. doi:10.1080/00913847.2015.1050953
Internal injuries occur under the skin and muscle tissues. Internal organ damage occurs when an organ’s structure becomes altered or begins to malfunction and can be brought on by trauma or disease. Sympathetic nerves send and receive messages, including pain signals, from the brain through the spinal cord. Chiropractors understand the spine and internal organ connection. For example, the splanchnic nerves connect to the stomach, originating between thoracic vertebra six and ten.
Internal Organ Damage
Blunt Trauma
Blunt trauma/Non-penetrating trauma happens when a forceful impact strikes the body.
A car accident, hard fall, or getting hit by a dull object qualifies as blunt trauma.
Blunt trauma can rupture the blood vessels and organs.
Organs most likely to experience damage include the spleen and liver.
Penetrating Trauma
Penetrating trauma happens when an object enters the body.
The object can bruise, slice, and pierce organs.
Internal bleeding can occur if blood vessels are torn or cut.
Compartment syndrome occurs when swelling restricts blood circulation to and from the organ to the circulatory and nervous systems, causing pain and further damage to the organ tissues.
If circulation is not restored, the organs may fail.
Severe swelling of the organs can cause heart and lung problems, as the swollen organs leave no room for the lungs to expand or for the heart to pump blood.
Emergency Treatment and Rehabilitation
Blunt force injuries that produce significant organ impact, bleeding, and penetrating injuries may require surgery to repair or remove damaged organs. Doctors may keep the injured individual under observation for minor internal bleeding to see if surgery is needed. Minor internal bleeding often heals on its own without surgery. Injury Medical Chiropractic and Functional Medicine Clinic offer rehabilitation after surgery as a thorough way to expedite healing and recovery.
Chiropractic manages pain without medications that can interfere with the ability to perform simple tasks.
The body’s functions and biochemical responses from the trauma and surgery are addressed.
Inflammation and swelling are alleviated, and prevention is done through adjustments, massage, diet, and health coaching.
Severe Back Pain Chiropractic
References
Iheozor-Ejiofor, Zipporah, et al. “Negative pressure wound therapy for open traumatic wounds.” The Cochrane database of systematic reviews vol. 7,7 CD012522. 3 Jul. 2018, doi:10.1002/14651858.CD012522.pub2
McCausland C, Sajjad H. Anatomy, Back, Splanchnic Nerve. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK549856/
Newman RK, Dayal N, Dominique E. Abdominal Compartment Syndrome. [Updated 2022 Apr 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK430932/
Risselada, Marije. “Perforating Cervical, Thoracic, and Abdominal Wounds.” The Veterinary clinics of North America. Small animal practice vol. 47,6 (2017): 1135-1148. doi:10.1016/j.cvsm.2017.06.002
Shaheen, Aisha W et al. “Abdominal compartment syndrome in trauma patients: New insights for predicting outcomes.” Journal of emergencies, trauma, and shock vol. 9,2 (2016): 53-7. doi:10.4103/0974-2700.179452
Sikka, Rishi. “Unsuspected internal organ traumatic injuries.” Emergency medicine clinics of North America vol. 22,4 (2004): 1067-80. doi:10.1016/j.emc.2004.05.006
Wrestling is a sport that requires speed, strength, and endurance that involves intense physical contact, pushing and pulling the muscles, tendons, ligaments, and joints to their limits. Wrestlers’ are constantly contorting their bodies. Pushing the body to its limits increases the risk of developing wrestling injuries that include:
The most common injuries usually occur from forceful contact or twisting forces. And if a wrestler has been injured, there is an increase for re-injury. Wrestling tournaments typically take place over days, often with back-to-back matches, which significantly fatigues the body and increases injury risk. The most common wrestling injuries include:
Muscle strains of the lower extremities and/or the back.
Chronic problems can result from hours in the forward stance posture and repetitive motions.
Dislocations and sprains of the elbow or shoulder from take-downs.
Cauliflower ear – is a condition that can cause ear deformity and develops from friction or blunt trauma to the ears.
Skin infections occur from constant contact, sweating, bleeding, and rolling on the mats. Infections include herpes gladitorium, impetigo, folliculitis, abscesses, and tinea/ringworm.
Concussions are usually caused by hard falls/slams or violent collisions with the other wrestler.
Injuries can cause wrestlers to alter/change their technique, exacerbating the existing damage and potentially creating new injuries.
Chiropractic Rehabilitation and Strengthening
There can be a variety of pain generators/causes when it comes to wrestling injuries. Joints and muscles can get overstretched, muscles can spasm, and nerves can become compressed and/or irritated. For example, a neck muscle spasm could be caused by nerve irritation from a shifted vertebrae. To determine the specific cause or causes of the injury/pain, a detailed chiropractic examination will be performed that includes:
Range of motion testing
Ligament tests
Muscle palpation
Gait testing
Injuries often relate to the proper weight, neuromuscular control, core strength, proper technique, hygiene, and hydration management. Successful treatment depends on identifying the root cause of the wrestling injury. Chiropractic restores proper alignment through massage, specific manual adjustments, decompression, and traction therapies. Adjustments can include the back, neck, shoulder, hips, elbows, knees, and feet. Once correct body alignment is achieved, rehabilitative exercises and stretches are implemented to correct and strengthen muscle function. We work with a network of regional medical doctors specializing in referral situations and strive to return the athlete to their sport as soon as possible.
Wrestling Match
References
Boden, Barry P, and Christopher G Jarvis. “Spinal injuries in sports.” Neurologic clinics vol. 26,1 (2008): 63-78; viii. doi:10.1016/j.ncl.2007.12.005
T-bone accidents/collisions, also known as side-impact or broadside collisions where the front end of one car slams into the side of another, can result in severe injuries and tend to have a more devastating effect on the body. Side impact collisions account for 24% of driver or passenger deaths; even at 30 mph, side-impacts regularly cause injuries to the occupants of the struck car. Modern vehicles have many safety features, including safety belt features, airbags, and collision avoidance systems that protect drivers and passengers from front and rear collisions; however, when it comes to side-impact, occupants tend to remain unprotected.
T-Bone Side Collision Causes
T-bone accidents usually happen at intersections. Usual Causes of T-bone accidents involve someone failing to yield the right of way. The most common causes include:
A driver makes a risky left turn at an intersection, believing the other car/s will stop.
A driver decides to run a red light crashing into a vehicle making a left turn.
A driver runs through a stop sign, slams into a vehicle, or gets slammed.
Back injuries can damage the spinal cord causing herniated discs, sciatica, and chronic pain that can radiate to the rest of the body.
Treatment and Recovery
Individuals have different recovery times and depend on the severity of the injury and on any pre-existing conditions. Brain injuries and spinal issues can take months to recover fully. Fractures placed in a hard or soft cast to heal for weeks or months can lead to muscle atrophy. Chiropractic therapeutic massage and decompression strengthens muscle weakness, resets and realigns the spinal column, improves range of motion/movement, strengthens grip, and relieves pain.
Neurosurgeon Explains DRX9000
References
Gierczycka, Donata, and Duane Cronin. “Importance of impact boundary conditions and pre-crash arm position for the prediction of thoracic response to pendulum, side sled, and near side vehicle impacts.” Computer methods in biomechanics and biomedical engineering vol. 24,14 (2021): 1531-1544. doi:10.1080/10255842.2021.1900132
Hu, JunMei, et al. “Chronic widespread pain after motor vehicle collision typically occurs through immediate development and nonrecovery: results of an emergency department-based cohort study.” Pain vol. 157,2 (2016): 438-444. doi:10.1097/j.pain.0000000000000388
Lidbe, Abhay, et al. “Do NHTSA vehicle safety ratings affect side impact crash outcomes?.” Journal of safety research vol. 73 (2020): 1-7. doi:10.1016/j.jsr.2020.02.001
Mikhail, J N. “Side impact motor vehicular crashes: patterns of injury.” International journal of trauma nursing vol. 1,3 (1995): 64-9. doi:10.1016/s1075-4210(05)80041-0
Shaw, Greg et al. “Side impact PMHS thoracic response with a large-volume airbag.” Traffic injury prevention vol. 15,1 (2014): 40-7. doi:10.1080/15389588.2013.792109
The body needs protein which is essential in building muscle, repairing tissue, producing enzymes and hormones and is a source of energy. Whey is a complete protein source that provides all the essential amino acids, vitamins, minerals, and other nutrients that increase anabolism, also known as muscle growth. It is used for various reasons. Some individuals want to build muscle mass and gain strength, while others want to lose weight and achieve improved results from working out. Even individuals who don’t exercise can benefit from the supplement as it supports immune function, helps reduce blood pressure, and improves insulin response.
Whey Protein
Whey protein is made from the liquid produced during the cheese-making process.
Milk comprises two forms of protein: casein (80%) and whey (20%).
It contains less than 0.5 g of fat and only 5 mg of cholesterol per serving.
Pure whey does not contain any gluten.
It is referred to as the most nutritious protein available.
It’s easy to digest.
Incorporating whey into a healthy diet can help lower the risk of diabetes.
Types
There are three primary types of whey protein in supplements.
Hydrolysate is a form that has already gone through partial hydrolysis, a process so the body can absorb protein.
It is considered pre-digested, so it gets absorbed quicker.
Concentration is the most popular and least expensive option that retains the most nutrients. However, some individuals can tolerate isolate and hydrolysate a lot better and are ideal for those trying to cut down on carbs and fats.
Benefits
Increased Strength and Muscle
Helps to increase protein consumption.
Most brands contain 80 to 90 percent without added carbs or fats.
Helps to build muscle and increase strength after physical activity/exercise recovery.
Can Help Burn Fat
A study found a group of adults that supplemented their diet with whey protein experienced a decrease in body fat and weight.
Combining whey protein and resistance training, participants found their weight and fat loss were even higher.
Can Help Stabilize Blood Sugar
Consuming whey protein with a high glycemic index before a meal can help stimulate insulin production while preventing spikes in blood sugar levels.
The protein naturally reduces blood sugar levels after meals when consumed before the meal.
Improves Heart Health
It can help reduce blood pressure and arterial stiffness.
It has been linked to improving individual lipid profiles.
Promotes heart health by building muscle and helping with weight loss.
Increased Immunity
It can help encourage glutathione synthesis, which increases immune system function.
It is also rich in vitamins and minerals that promote immune function.
It helps the body recover from oxidative stress and inflammation.
Improves Energy Levels
It helps to increase glycogen, a source of energy during exercise or other physical activities.
It also increases leptin which helps balance the body’s energy levels.
Whey is easily digested, which can be quickly converted to energy.
Factors to Consider When Choosing
Flavor
The flavor is crucial because nobody wants to drink a daily protein shake they cannot enjoy.
Options like chocolate and vanilla are usually safe.
If experimenting, get a small container to start.
Mixability
Not all supplements mix properly or thoroughly.
Find a brand that dissolves quickly and has little clumping.
Container Size
Most protein supplements are available in 1 lb, 2 lb, 5 lb, or 10 lb containers.
Larger sizes are more cost-effective.
One 5 lb package is cheaper than buying five 1 lb containers.
Everything You Need To Know
References
Ebaid, Hossam et al. “Whey protein enhances normal inflammatory responses during cutaneous wound healing in diabetic rats.” Lipids in health and disease vol. 10 235. 14 Dec. 2011, doi:10.1186/1476-511X-10-235
Hashemilar, Mazyar, et al. “Effect of Whey Protein Supplementation on Inflammatory and Antioxidant Markers, and Clinical Prognosis in Acute Ischemic Stroke (TNS Trial): A Randomized, Double-Blind, Controlled, Clinical Trial.” Advanced pharmaceutical bulletin vol. 10,1 (2020): 135-140. doi:10.15171/apb.2020.018
Kim, Jooyoung, et al. “Effect of timing of whey protein supplement on muscle damage markers after eccentric exercise.” Journal of exercise rehabilitation vol. 13,4 436-440. 29 Aug. 2017, doi:10.12965/jer.1735034.517
Marshall K. Therapeutic applications of whey protein. Alternative Medicine Review. 2004;9(2):136-156.
Pradhan, Geetali, et al. “Ghrelin: much more than a hunger hormone.” Current opinion in clinical nutrition and metabolic care vol. 16,6 (2013): 619-24. doi:10.1097/MCO.0b013e328365b9be
Volek, Jeff S et al. “Whey protein supplementation during resistance training augments lean body mass.” Journal of the American College of Nutrition vol. 32,2 (2013): 122-35. doi:10.1080/07315724.2013.793580
Children, teens, and adults participate in organized and recreational sports activities for fun, exercise, and social benefits. Individuals and parents are used to scrapes, bumps, bruises, sprains, and strains. However, internal abdominal injuries from the body colliding with another player or object are less common but dangerous. Abdominal injuries make up less than 4 percent of sports injuries but can be severe when they occur. These injuries are common in sports like wrestling, gymnastics, soccer, basketball, football, skiing, snowboarding, BMX freestyle, motocross, skateboarding, ice/field hockey, and lacrosse. Early symptoms are not always obvious or apparent and can be mild or seem to go in a different direction away from the abdominal region, which is why it is essential to know what to look for.
Internal Abdominal Injuries Athletes
There are about 3oo 000 abdominal sports-related injuries. Kids and young athletes risk injuring their abdominal organs because their abdominal wall is thinner and still in development. However, internal abdominal injuries to the stomach, small and large intestine, spleen, liver, and kidneys can and do happen in adults.
Injury Types
Sports-related internal abdominal injuries are considered rare, but studies suggest they are increasing. The most common sites include:
Liver
This causes pain in the upper right side of the abdomen.
The right lobe is the one that gets injured more often because it is bigger and presses against the ribcage.
A torn liver can cause severe bleeding.
Shock can develop from the bleeding, causing heart palpitations, rapid breathing, shortness of breath, and a pale, grey, and/or sweaty appearance.
The liver and spleen are the most commonly injured organs in sports. They are filled with blood and can get bruised, or ruptured, and can cause severe bleeding when torn or cut. Bleeding in the abdomen can irritate the diaphragm, which can cause pain in the shoulder. Sometimes shoulder pain is the only symptom making it difficult to diagnose and because bleeding can take time to develop, the symptoms might not present for several hours.
Spleen
This causes pain in the upper left side of the abdomen.
The spleen filters around 10% of the body’s blood supply every minute.
A torn spleen can cause rapid and life-threatening internal bleeding.
Kidneys
The kidneys can be injured by a blow/hit to the back or flank that causes bruising or laceration.
This injury can cause flank/side pain, blood in the urine, nausea, and/or vomiting.
Abdominals
A single organ or multiple organs can be injured.
This can be the pancreas, diaphragm, stomach, gallbladder, bladder, or intestines.
Bruising discoloration or bruising, particularly around the belly and flanks.
This can cause abdominal pain with movement that does not get better that could be accompanied by fever, nausea, or vomiting.
Running into an object, another player, or falling hard can cause bruising, laceration, or create a tear/opening of a bowel wall. Symptoms can be delayed days to weeks after the injury when inflammation or infection develops.
Recognizing Internal Injuries
Signs and symptoms to look for include:
Abdominal pain
Bruising around the abdominal area.
Tenderness over the injured area.
Rigid abdomen.
Left-arm and shoulder pain.
Right-sided abdominal pain and right shoulder pain.
Blood in the urine.
Cold, sweaty skin.
Nausea and vomiting.
Rapid heartbeat.
Low blood pressure.
Loss of consciousness.
Treatment
Chiropractic focuses on whole-body health and can help with abdominal injuries. The nervous and digestive systems are interconnected, meaning that damage could lead to viscerosomatic reflexeseven if not directly injured. If internal damage or bleeding has occurred, individuals will be referred to a specialist, surgeon, or another emergency medical professional. If internal damage is ruled out, a chiropractic treatment plan that includes adjustments, massage therapy, manual and mechanical decompression, exercises, stretches, and health coaching will help with tissue injuries and problems that are causing gastrointestinal distress.
Spinal Non-Surgical Decompression
References
Arumugam, Suresh, et al. “Frequency, causes and pattern of abdominal trauma: A 4-year descriptive analysis.” Journal of emergencies, trauma, and shock vol. 8,4 (2015): 193-8. doi:10.4103/0974-2700.166590
Barrett, Cassie, and Danny Smith. “Recognition and management of abdominal injuries at athletic events.” International journal of sports physical therapy vol. 7,4 (2012): 448-51.
Kucera, K. L., Currie, D. W., Wasserman, E. B., Kerr, Z. Y., Thomas, L. C., Paul, S., & Comstock, R. D. (2019). Incidence of Sport-Related Internal Organ Injuries Due to Direct-Contact Mechanisms Among High School and Collegiate Athletes Across 3 National Surveillance Systems. Journal of athletic training, 54(2), 152–164. doi.org/10.4085/1062-6050-271-17
Slentz, Cris A et al. “Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT.” American journal of physiology. Endocrinology and metabolism vol. 301,5 (2011): E1033-9. doi:10.1152/ajpendo.00291.2011
Referred pain is the interpretation of feeling pain in a different location than the actual cause. For example, a pinched nerve in the spine/back causes pain not to show up not where it is pinching but further down in the buttock, leg, calf, or foot. Similarly, a pinched nerve in the neck could translate to shoulder or elbow pain. Referred pain is often caused by the muscles overcompensating weaker ones, like feeling pain outside the knee, with the actual injury stemming from hip joint dysfunction caused by weakened lateral hip muscles. The athletic referred pain could have been brought on by an acute sports injury, an overuse injury from the repetitive motion/s.
Athletic Referred Pain
Somatic referred pain originates from the muscles, skin, and other soft tissues and is not to be confused with visceral pain, which refers to the internal organs/viscera. However, the pain presents in regions supplied by the same nerve roots. Damaged or injured body structures can cause referred pain. This includes the muscles, nerves, ligaments, and bones.
Common Sites
Individuals can experience referred pain almost anywhere. Athletic referred pain commonly occurs in these areas:
The neck and shoulder where pain can be felt in the elbow, arm, and hand or cause headaches.
The back where pain can be felt in the hips, buttocks, and thighs.
The hip/s area, where pain can be felt in and around the low back and abdominal regions.
The groin, where pain can be felt in and around the abdominal region.
Problems with the vertebral discs, nerve root compression, muscle spasms, osteoarthritic changes, spinal fracture, or tumor/s can affect the body’s ability to transport sensory information, which can cause strange sensations and weakness of muscle tissues, and sometimes problems with coordination and movement. Part of an accurate diagnosis is knowing the patterns of referred pain in all the muscles and internal organs.
Pain Activation
Many nerve endings come together and share the same nerve cell group in the spinal cord. When signals travel through the spinal cord to the brain, some signals follow the same path as the pain signals from a different body part. Pain awareness is felt in a deeper center of the brain known as the thalamus, but the sensory cortex determines the perception of where the pain is coming from and the location of the pain. The intensity and sensation of the athletic referred somatic pain vary for different structures and depend on the inflammation level. For example:
Nerve pain tends to be sharp or shooting.
Muscle pain tends to be a deep dull aching or a burning sensation.
However, muscles can give a sensation of tingling where referred pain is presenting, but tingling is more commonly associated with a nerve injury.
Diagnosing referred pain injuries can be complex as there are various areas where the pain can show up. The source of damage needs to be identified; otherwise, achieving lasting pain relief will not last. A biomechanical analysis can help to find movement/motion patterns that may be causing pain and help identify the source.
Treatment
Athletic performance and spinal health are interconnected. Chiropractic treatment involves whole-body wellness that involves the spine and nervous system. Routine chiropractic care relieves neck, shoulder, arm, back, leg, and foot conditions/injuries and helps prevent disorders of joints and muscles. It calms the mind, provides pain relief, and educates individuals on being more aware of the body. Chiropractic adjustments improve blood flow and nerve function to increase agility, reaction times, balance, strength, and expedited healing of the body.
DRX9000 Decompression
References
Kapitza, Camilla, et al. “Application and utility of a clinical framework for spinally referred neck-arm pain: A cross-sectional and longitudinal study protocol.” PloS one vol. 15,12 e0244137. 28 Dec. 2020, doi:10.1371/journal.pone.0244137
Murray, Greg M. “Guest Editorial: referred pain.” Journal of applied oral science: Revista FOB vol. 17,6 (2009): i. doi:10.1590/s1678-77572009000600001
Weller, Jason L et al. “Myofascial Pain.” Seminars in neurology vol. 38,6 (2018): 640-643. doi:10.1055/s-0038-1673674
Wilke, Jan, et al. “What Is Evidence-Based About Myofascial Chains: A Systematic Review.” Archives of physical medicine and rehabilitation vol. 97,3 (2016): 454-61. doi:10.1016/j.apmr.2015.07.023
Forearm pain refers to soreness, aches, or discomfort between the wrist and the elbow. An injury or inflammation can affect any tissues, including muscles, bones, blood vessels, tendons, and the skin. The causes usually include overuse injuries, pinched nerves, accidents causing trauma, lifting or heaving heavy objects, sports injuries, and fractures. If left untreated, issues like chronic muscle pain and decreased and disrupted blood/nerve circulation can develop, leading to numbness and weakness. Chiropractic treatment can release tension, massage, reset, and stretch the muscles to expedite healing.
Anatomy
The forearm comprises the radius and ulna, which extend the forearm’s length and cross at the wrist.
The Radius
This bone starts at the elbow and connects to the wrist on the thumb side.
Ulna
This bone begins at the elbow and connects to the wrist on the side of the little finger.
Muscles
Several muscles operate to rotate the forearm up/supination and down/pronation and flex and extend the fingers.
Causes
Forearm pain can happen to anyone and is usually related to traumatic or repetitive use injury. In other cases, pain may be associated with a benign growth, like a cyst or possibly a malignant tumor. Common causes include:
Pulled and/or strained muscles
Muscle ruptures or small tears
A direct blow, fall, or any extreme twisting, bending or jamming action.
Tendonitis from tennis or golfers elbow.
Tennis elbow is caused by inflammation or tiny tears in the forearm muscles and tendons outside the elbow.
Golfers’ elbow is on the inside of the elbow.
Carpal Tunnel Syndrome is a repetitive stress disorder that affects the nerves and tendons of the wrist and forearm.
Musculoskeletal Causes
The musculoskeletal causes involve issues in how the forearm components operate together.
Repetitive actions like lifting, gripping, and typing can compress nerves and blood vessels throughout the forearm.
Forearm problems like dislocations or sprains can also lead to chronic inflammation and pain.
Traumatic Causes
Traumatic causes include those that result in injury to components of the forearm.
Anything that causes a direct injury to the forearm, including an automobile crash or accident, fall, or a direct hit, can fracture bones in the forearm.
A sprain can twist or stretch a ligament or tendon.
Activities that cause bending, twisting, quick sudden movement or direct impact can result in sprained multiple ligaments in the forearm.
Chiropractic Treatment
Healing forearm pain depends on the type of injury, location, and cause of the pain. Chiropractic addresses arm pain, tingling, and numbness in ways often overlooked by general physicians.
A chiropractor will perform a physical examination to determine if there are any underlying causes.
They may apply an ice pack to help control inflammation before the massage.
The chiropractor will perform gentle adjustments to the wrist, arm, and shoulder.
They may recommend a forearm brace to help retrain positioning and movement.
They will recommend exercises and stretches to strengthen and maintain the adjustments.
Carpal Tunnel Pain Treatment
References
Ellenbecker, Todd S et al. “Current concepts in examination and treatment of elbow tendon injury.” Sports health vol. 5,2 (2013): 186-94. doi:10.1177/1941738112464761
Shamsoddini, Alireza, and Mohammad Taghi Hollisaz. “Effects of taping on pain, grip strength and wrist extension force in patients with tennis elbow.” Trauma monthly vol. 18,2 (2013): 71-4. doi:10.5812/traumamon.12450
Suito, Motomu, et al. “Intertendinous epidermoid cyst of the forearm.” Case reports in plastic surgery & hand surgery vol. 6,1 25-28. 28 Jan. 2019, doi:10.1080/23320885.2018.1564314
Bicycling at any level is excellent healthwise, but the specific physical repetitive motions and postures can wear on a cyclist’s body, causing strains and injury to the:
Muscles
Ligaments
Tendons
Nerves
Spine
Injuries can be caused by falls, overused muscles, joints, posture, and/or balance problems, whether riding a bicycle for fun, health, or sport. Chiropractic decompression can treat cycling-related injuries and help prevent common injuries by helping cyclists with conditioning and exercises. Chiropractic adjustments, combined with health coaching and nutrition planning, can maximize the body’s overall athletic ability and increase/improve:
Many cyclists suffer from back pain overuse injuries that are caused by:
Incorrect saddle/seat height or an uneven seat/saddle
Not bending the knee at the end of a pedal stroke forces the cyclist to rock the pelvis side to side to generate enough power, placing added stress on the low back muscles.
Handlebars that are too far forward can cause over-stretching of the spine.
Constantly tilting the head can cause neck and shoulder pain.
Staying in the same position for an extended period strains the spine.
Repetitive hip flexion causes the muscles to become tight and perform less efficiently, straining the rest of the body to make up for the lost support.
Hamstrings that become tight can shorten in length, causing the body to pull on the pelvis and the spine.
Lack of core strength allows more stress to penetrate the glutes, back, and hips.
Riding on bumpy or rough terrain increases body jarring and spinal compression.
Chiropractic Decompression
Chiropractic decompression for cyclists can rehabilitate the body from injuries, alleviate pain, improve blood and nerve circulation and maintain the body’s flexibility. Advanced decompression techniques personalized to the individual realign and release the body from obstructions and toxins in the neural pathways. Nutritional and supplementation recommendations are incorporated to enhance the body’s natural healing abilities, and exercise/stretches to sustain the adjustments.
Spinal Decompress
References
Schultz, Samantha J, and Susan J Gordon. “Recreational cyclists: The relationship between low back pain and training characteristics.” International journal of exercise science vol. 3,3 79-85. 15 Jul. 2010
Silberman, Marc R. “Bicycling injuries.” Current sports medicine reports vol. 12,5 (2013): 337-45. doi:10.1249/JSR.0b013e3182a4bab7
Streisfeld, Gabriel M et al. “Relationship Between Body Positioning, Muscle Activity, and Spinal Kinematics in Cyclists With and Without Low Back Pain: A Systematic Review.” Sports health vol. 9,1 (2017): 75-79. doi:10.1177/1941738116676260
Thompson, M J, and F P Rivara. “Bicycle-related injuries.” American family physician vol. 63,10 (2001): 2007-14.
Many complex spinal surgeries take place in a hospital environment. The individual spends a night or two in the hospital, so medical staff can monitor them if any complications arise. However, outpatient surgeries have increased with new developments in minimally invasive procedures, pain management, and home rehabilitation. The improvements compared to traditional spinal surgical procedures are significant. These advancements have made it possible to perform more complex surgeries outside of a hospital. Outpatient surgeries have:
Accelerated recovery times
Decreased complications
Decreased infections
Healthier overall outcomes
Outpatient Surgery Candidates
Determining if outpatient surgery can be performed effectively depends on the injury/s and/or conditions that the individual is going through. An individual who is debilitated or has underlying medical conditions that increase their risk for complications or do not have support at home to assist with recovery and rehabilitation is recommended to have the surgery done in a hospital. To be considered for outpatient spine surgery, a surgeon looks at:
Standalone ambulatory surgery centers offer same-day surgical procedures for individuals that meet specific criteria. Medical staff assess the patient’s condition and determine recovery at home. If issues arise, the individual can be transferred to a hospital. Some facilities are single-specialty facilities, focusing on one medical specialty, and others are multi-specialty, meaning they offer a range of medical services from:
Orthopedic
Podiatry
Pain management services
Procedures
Anterior Cervical Discectomy and Fusion – ACDF
ACDF is a two-part surgery. First, the surgeon removes part of an intervertebral disc with bulged and compressed nerves from the spinal cord. Because there is less cushion, the vertebrae above and below are fused to prevent and eliminate painful movement. The discectomy:
Provides more accessible access to the vertebrae
Reduces healing time
Causes less pain
ACDF outpatient procedure treats several neck conditions that include:
Cervical spinal stenosis
Cervical radiculopathy
Neck-related degenerative disc disease
Herniated disc
Cervical spinal fracture
Individuals recover in the surgical center for one to several hours following the surgery before returning home. Traditional ACDF procedure takes three weeks to three months to recover.
Lumbar Discectomy
A lumbar discectomy is a minimally invasiveprocedure that repairs a lower back herniated disc compressing the surrounding nerves. This procedure provides compression relief and allows the nerve to heal. A traditional lumbar discectomy takes four to six weeks to recover.
Lumbar Laminectomy
This minimally invasive procedure removes thickened ligaments and lamina from the lower back. This opens the spinal canal space, relieving pressure and bringing pain relief. The surgery commonly treats lower-back spinal stenosis. A traditional laminectomy takes four to six weeks to recover.
Lumbar Spinal Fusion
Outpatient lumbar spinal fusion permanently connects two or more vertebrae in the lower back. The surgery helps stabilize the spine from severe arthritis or herniated disc removal. Spinal fusion has been found to be effective for correcting certain spinal deformities. The surgery involves a short recovery time at the outpatient center, after which the individual can return home the same day. A traditional or open spinal fusion requires a two-to-three-day hospital stay. After four to six weeks and with a doctor’s clearance, individuals can return to light activities, with full recovery requiring six months.
Chiropractic Spinal Decompression
References
International Journal of Spine Surgery. (April 16, 2021) “The expanding frontier of outpatient spine surgery.” pubmed.ncbi.nlm.nih.gov/33900984/
Injury Medical Spinal Decompression: Spinal decompression therapy/treatment can be surgical or non-surgical, with differences in the procedure, recovery time, and results. Individuals who experience compression-related problems can have severe and prolonged spinal conditions that can lead to various health issues. Individuals experiencing persistent or chronic neck, back, or leg pain should know the differences between surgical and non-surgical spinal decompression. Spinal decompression aims to relieve pressure on the discs and reduce stress on the nervesto eliminate the pain associated with compression on the spine,restoring optimal circulation and improving spinal function.
Surgical Procedure
It is invasive, must be performed by a surgeon, and can have a recovery time of up to 6 weeks.
Surgery is usually suggested as a last resort after alternative therapies have not succeeded or when the compression is so severe that surgery is the only option.
Surgical spinal decompression is directed towards removal to reduce pressure instead of adjusting or stretching the discs.
In cases of severe nerve compression, surgery can be an effective option.
Risks include infection, damage to the spinal cord, and blood clots.
Types of Spinal Decompression Surgery
Types of surgeries; spinal fusion could be necessary to stabilize the spine. Common types of back surgery:
Discectomy
This procedure removes a portion of the disc to relieve pressure on nerves.
Laminotomy
The procedureremoves a small portion of the bone or a section of the bony arch to increase the size of the spinal canal and relieve pressure.
Laminectomy
The procedureremoves theentire bony arch or lamina to increase the size of the spinal canal and relieve pressure.
Foraminotomy
This procedure removes bone and other tissue to widen the openings for the nerve roots to pass through.
The procedure removes a vertebral body along with discs.
Injury Medical Spinal Decompression
Surgery for a damaged/injured spine is not always necessary. Treatment regimes vary depending on each individual’s medical condition. Non-surgical motorized spinal decompression is a non-invasive back treatment that uses a mechanized decompression table to slowly and gently stretch the spine. The therapy gradually relieves the pressure on the compressed nerve root/s resulting in reduced or complete alleviation of pain.
Oxygen, water, and nutrients circulate abundantly, promoting healing as the discs re-hydrate, and are re-nourished, improving and enhancing spine function. Individuals can enjoy increased levels of mobility, strength in the spine and muscles, and more flexibility.
Descompresión Espinal Con La DRX9000
References
American Spinal Decompression Association: “Spinal Decompression Therapy.”
Daniel, D.M. Chiropractic and Osteopathy, 2007.
Macario, Alex, and Joseph V Pergolizzi. “Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.” Pain practice: the official journal of World Institute of Pain vol. 6,3 (2006): 171-8. doi:10.1111/j.1533-2500.2006.00082.x
Golfing Back Injuries: Golf is an enjoyable game that can be played at all ages. It involves the foundation of the body’s range of motion, the spine. Because of the repetitive nature of a golfer’s unique swing, the repetitive rotating/twisting of the spine slowly degrades the integrity of the spinal discs causing them to bulge, herniate, or rupture. The slightest shift causing misalignment can leave the spine vulnerable to further injury. Non-surgical motorized decompression combined with chiropractic musculoskeletal adjustments can restore and maintain optimal health.
Golfing Back Injuries
Golfing involves muscle memory. Going through the walk, bending to tee the ball, recoiling for the swing, swinging and following through, walking to the hole, and bending down to retrieve the ball are all repetitive motions that can lead to:
Soreness
Inflammation
Back, hip, leg, and foot pain.
Strains
Other injuries to the muscles and discs.
The bending and twisting are the least tolerated motions by the spine. More than half of injuries sustained involve the back and/or neck. Having the spine correctly aligned is vital to retaining accuracy, power, and injury prevention. Common injuries include:
Sacroiliac Joint/SI Joint Dysfunction
The sacroiliac joint is located between the spine and the hip. Symptoms of sacroiliac joint pain include:
Low back pain.
Hip pain
Pain in the buttocks.
Pain radiating down the legs.
Groin pain
Pelvis pain
Burning sensation in the pelvis.
Numbness and weakness in the pelvis and legs.
SI Joint Pain Causes
The sacroiliac joint requires supported stability when transferring a load from the torso to the legs, specifically during the swing.
If there is compression, misalignment, or weakness, the motion will begin to wear away this stability and leave the sacroiliac joint open to further injury.
Sacroiliac joint injuries often occur from minor multi-incidents and not one major trauma.
With time the SI joint becomes misaligned, exposing the cartilage between joints, causing inflammation known as Sacroiliitis.
Facet Joint Syndrome
The facet joints are located between two vertebrae, allowing the ability to bend and twist.
Healthy facet joints have cartilage all around them, allowing the vertebrae to move smoothly in all directions.
Facet joint syndrome causes pain between the vertebrae.
Facet Joint Syndrome Causes
The leading cause of facet joint syndrome is excessive and repetitive swing movement.
Misalignment can expose and irritate the joints, causing pain, swelling, and inflammation.
Multi-micro-traumas and not one major trauma are often the cause of injury/s.
Muscle spasms are common.
Symptoms
Highly reduced range of motion
Muscle pain
Numbness
Weakness
Cervical Facet Syndrome affects the neck, shoulders, arms, and hands.
Lumbar Facet Syndrome affects the buttocks, legs, and feet.
The treatment is computer-controlled to provide gentle and painless decompression.
The therapist enters the program cycle.
The decompression table goes through brief moments of pulling and relaxing.
The spine’s bones are stretched slowly and methodically.
As the vertebrae are separated, a vacuum is formed, pulling the gel-cushion center of the disc back inside, removing the pressure on the spinal nerves and alleviating pain and disability.
The vacuum also draws oxygen and nutrients into the injured and degenerated discs to optimize healing.
DRX 9000
Long Term Success
References
Cole, Michael H, and Paul N Grimshaw. “The Biomechanics of the Modern Golf Swing: Implications for Lower Back Injuries.” Sports medicine (Auckland, N.Z.) vol. 46,3 (2016): 339-51. doi:10.1007/s40279-015-0429-1
Dydyk, Alexander M., et al. “Sacroiliac Joint Injury.” StatPearls, StatPearls Publishing, 4 August 2021.
Hosea, T M, and C J Gatt Jr. “Back pain in golf.” Clinics in sports medicine vol. 15,1 (1996): 37-53.
Lindsay, David M, and Anthony A Vandervoort. “Golf-related low back pain: a review of causative factors and prevention strategies.” Asian journal of sports medicine vol. 5,4 (2014): e24289. doi:10.5812/asjsm.24289
Smith, Jo Armour, et al. “Risk Factors Associated With Low Back Pain in Golfers: A Systematic Review and Meta-analysis.” Sports health vol. 10,6 (2018): 538-546. doi:10.1177/1941738118795425
Individuals drive to jobs, to school, run errands, take road trips, spending a lot of time on the road. Accidents and crashes happen more frequently with all kinds of injuries. The National Highway Traffic Safety Commission has found that 37% of car accidents and crashes involve leg injuries and damage. Chiropractic physical rehabilitation and functional medicine can help heal injuries getting the individual back to everyday life.
Bruising and cuts are typical from the impact and the body getting slammed around. Lacerations can be noticed right away, but bruising comes from blood pooling underneath the skin and can take time to present, possibly 24 to 48 hours. Most bruises and cuts heal independently from home first aid care. A standard recovery used to take care of bruising is R.I.C.E or rest, ice, compression, and elevation. This helps the healing process; however, if the injury/s are more severe, chiropractic can help with therapeutic massage to relieve pain and strengthen the injured muscles, tendons, and ligaments.
ACL Injuries
The femur or thigh bone has several bands of tissue connecting it to the patella or kneecap and tibia or shin bone. One of the bands is the anterior cruciate ligament or ACL. Injuries to this band of tissue are common in sports. Car accidents and crashes are another common cause, specifically tearing the ligament. Individuals experiencing a tear may notice some or all of the following symptoms:
A cracking or popping sound when the accident or crash took place.
Swelling in and around the knee.
Severe pain in and around the knee.
Unstable and unsteady when walking or standing.
Reduced range of motion that makes walking or moving difficult.
A chiropractor can help treat the injury and help correct any muscular imbalances.
Meniscus Tears
Tears to the meniscus are also common in car accidents and crashes. The meniscusis a part of the knee. Two wedge-shaped pieces of cartilage provide a cushion where the femur and tibia meet to absorb shock. The wedges are called menisci.
When the meniscus tears, individuals might feel or hear a pop and could feel the leg suddenly give out.
Swelling in the knee.
Some pain but still be able to walk.
The knee will be stiff for the next few days.
More difficulty bearing weight or walking.
The RICE method is a recommended method of self-care. Many meniscus tears do not require surgery to improve knee function. Mild to moderate meniscus tears can be successfully treated with chiropractic techniques like soft tissue work, corrective stretches, and exercises. Surgery could eventually be necessary for severe cases to repair the meniscus to prevent long-term complications.
Chiropractic care can help the body heal and recover from a bone fracture. A patient’s bone density is evaluated and tested with an individualized treatment plan to help regain and maintain optimal bone strength. The treatments strengthen the muscles, reduce stiffness, improve nutrition, and relieve pain. Manipulation adjustments, rehabilitation, relaxation techniques, and dietary health coaching help individuals heal faster and strengthen their bones. The objective is to help regain increased mobility and range of motion.
Sciatica
Car accidents and crashes are one instance where the spine can be damaged enough to bring on sciatic pain where no back problems were present before. The impact from a car accident can cause the discs to be knocked out of place, damaged, and/or rupture around the surrounding tissue. Any of these results can pinch the sciatic nerve, leading to pain and other sciatica symptoms. Chiropractic can realign the spine and relieve pressure from the nerve/s.
DOC Spinal Decompression Table
References
Atkinson, T, and P Atkinson. “Knee injuries in motor vehicle collisions: a study of the National Accident Sampling System database for the years 1979-1995.” Accident; analysis and prevention vol. 32,6 (2000): 779-86. doi:10.1016/s0001-4575(99)00131-1
Foulk, David M, and Brian H Mullis. “Hip dislocation: evaluation and management.” The Journal of the American Academy of Orthopaedic Surgeons vol. 18,4 (2010): 199-209. doi:10.5435/00124635-201004000-00003
Wilson, L S Jr et al. “Foot and ankle injuries in motor vehicle accidents.” Foot & ankle international vol. 22,8 (2001): 649-52. doi:10.1177/107110070102200806
Whenever stepping out onto a playing field or gym, there is a risk of suffering sports back injuries. Back pulls, strain and sprain injuries are the most common. Low back pain is one of the most prevalent complaints at all levels of competition. 90% of these acute back injuries will heal on their own, usually in about three months. However, sometimes these injuries can be more severe and require professional medical care. Treatment options for different groups of athletes include nonsurgical motorized spinal decompression.
Sports Back Injuries
Injury mechanisms vary from sport to sport, but there are recommendations regarding spinal decompression treatment for these injuries and return to play. Chiropractic healthcare specialists understand the sport-specific injury patterns and treatment guidelines for athletes following a back injury. Spinal decompression treatments are beneficial and result in higher rates of return to play depending on the specific sport of the injured athlete. A chiropractor will create a personalized spinal decompression treatment plan for the sport-specific context to meet the athlete’s short and long-term needs.
An estimated 10–15% of athletes will experience low back pain.
All types of sports place increased stress on the lumbar spine through physically demanding and repetitive movements/motions.
The repetitive shifting, bending, twisting, jumping, flexion, extension, and spinal axial loadingmotions contribute to low back pain even though the athletes are in top shape with increased strength and flexibility.
Injury patterns demonstrate the increased stresses that athletes place on the lumbar spine.
Common Spine Sports Injuries
Cervical Neck Injuries
Stingers are a type of neck injury.
A stinger is also known as a burner is an injury that happens when the head or neck gets hit to one side, causing the shoulder to be pulled in the opposite direction.
These injuries manifest as numbness or tingling in the shoulder from stretching or compressing the cervical nerve roots.
Lumbar Lower Back Sprains and Strains
When trying to lift too much weight or using an improper lifting technique when working out with weights.
Fast running, quick stopping, and shifting can cause the low back and hip muscles to get overly pulled/stretched.
Staying low to the ground and springing/jumping up can cause abnormal stretching or tearing of the muscle fibers.
Fractures and Injuries to the Supporting Spinal Structures
In sports that involve repetitive extension movements, spinal stress fractures are relatively common.
Excessive and repeated strain to the spinal column area leads to low back pain and injury.
Nonsurgical Spinal Decompression
Nonsurgical spinal decompression is motorized traction that is used to relieve compression pressure, restore spinal disc height, and relieve back pain.
Spinal decompression works to gently stretch the spine changing the force and position of the spine.
The gel-like cushions between the vertebrae are pulled to open up the spacing taking pressure off nerves and other structures.
This allows bulging or herniated discs to return to their normal position and promotes optimal circulation of blood, water, oxygen, and nutrient-rich fluids into the discs to heal, as well as, injured or diseased spinal nerve roots.
DRX 9000 Decompression
References
Ball, Jacob R et al. “Lumbar Spine Injuries in Sports: Review of the Literature and Current Treatment Recommendations.” Sports medicine – open vol. 5,1 26. 24 Jun. 2019, doi:10.1186/s40798-019-0199-7
Jonasson, Pall et al. “Prevalence of joint-related pain in the extremities and spine in five groups of top athletes.” Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA vol. 19,9 (2011): 1540-6. doi:10.1007/s00167-011-1539-4
Lawrence, James P et al. “Back pain in athletes.” The Journal of the American Academy of Orthopaedic Surgeons vol. 14,13 (2006): 726-35. doi:10.5435/00124635-200612000-00004
Petering, Ryan C, and Charles Webb. “Treatment options for low back pain in athletes.” Sports health vol. 3,6 (2011): 550-5. doi:10.1177/1941738111416446
Sanchez, Anthony R 2nd et al. “Field-side and prehospital management of the spine-injured athlete.” Current sports medicine reports vol. 4,1 (2005): 50-5. doi:10.1097/01.csmr.0000306072.44520.22
Any vehicle crash, collision, or accident can cause various injuries, with back pain issues as a primary injury or a side effect from other injuries. Usually, injury symptoms begin right after the collision, but in other cases, individuals may not start experiencing symptoms until hours, days, or even weeks later. This is from the adrenaline that rushes throughout the body during the collision/fight or flight response delaying the injury symptoms. There are reports of individuals who walk away from an accident unscathed but require urgent medical treatment a short while later. Chiropractic care can provide manual and spinal motorized decompression benefits.
Decompression Benefits
Head Injuries
Head injuries occur when drivers and/or passengers hit their heads on the steering wheel, windows, dashboard, metal frame, and sometimes each other.
A head injury is considered a severe condition that can cause concussions, skull fractures, comas, hearing loss, cognitive and memory issues, and vision problems.
A significant head injury can cause extensive and costly medical treatment with the possibility of long-term medical care.
Neck Injuries
Neck injuries are common in vehicle collisions.
The most common is whiplash, with the head and neck-snapping from indirect blunt force, like being rear-ended.
Whiplash can cause significant damage to the ligaments and muscles, like swelling and neck pain, and temporary paralysis of the vocal cords.
Injury patterns of whiplash can differ depending on the speed, force, and overall health of the individual involved.
Back Injuries
Back injuries can range in severity from sprains to significant damage involving the nerves and/or the spinal cord.
If the damage is severe, it can lead to loss of sensation in the body, loss of limb control, or permanent paralysis.
Disc herniation/s can lead to disability, muscle weakness, tingling and numbness in the limbs, and radiating body pain.
Chest and Torso Injuries
Vehicle collision forces can result in severe chest injuries that include broken ribs.
Broken ribs might not sound dangerous by themselves; they can puncture the lungs leading to other injuries and internal bleeding.
The legs, feet, arms, and hands are frequently injured, broken, and sometimes dislocated.
Motorcyclists are also at a higher risk for significant injury that includes:
Multiple fractures, internal injury, head injuries, and severe ligament damage.
Pedestrians struck by a vehicle have an increased risk for a combination of all injuries at once.
Non-Surgical Decompression Benefits
Chiropractors are trained to identify and treat injuries from vehicle collisions.
Non-surgical spinal decompression gently stretches the spine using a motorized traction device to help reposition the spine and remove the pressure.
As the pressure is taken off, the spinal discs regain their natural height, relieving the pressure on the nerves and other spinal structures.
Optimal healing is promoted by an improved circulation of nutrients, water, and oxygen to the injury site.
Decompression helps to strengthen the muscles in the affected area.
It provides positive spinal structural changes.
Improves nervous system function.
Non-surgical decompression is a tool for correcting injuries and relieving pain, allowing optimal health for the individual.
DOC Decompression Table
References
Apfel, Christian C et al. “Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study.” BMC musculoskeletal disorders vol. 11 155. 8 Jul. 2010, doi:10.1186/1471-2474-11-155
Koçak, Fatmanur Aybala et al. “Comparison of the short-term effects of the conventional motorized traction with non-surgical spinal decompression performed with a DRX9000 device on pain, functionality, depression, and quality of life in patients with low back pain associated with lumbar disc herniation: A single-blind randomized controlled trial.” Turkish Journal of physical medicine and rehabilitation vol. 64,1 17-27. 16 Feb. 2017, doi:10.5606/tftrd.2017.154
Macario, Alex, and Joseph V Pergolizzi. “Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.” Pain practice: the Official Journal of World Institute of Pain vol. 6,3 (2006): 171-8. doi:10.1111/j.1533-2500.2006.00082.x
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