Resolving Frozen Shoulder

Frozen Shoulder, or adhesive capsulitis, is a very stubborn, debilitating, and restrictive condition that can affect all the activities of daily living. It may present its ugly head shortly following that first tennis practice of the season that exhausted you to the point of “becoming one” with your recliner for three hours before bed. Or, maybe you decided to save a few bucks and wash and wax your cars over the weekend and found it nearly impossible to get a fork of linguine up to your mouth on Monday evening.  The common symptoms of this condition include: severe pain, progressive stiffness and loss of motion in the shoulder joint. The shoulder’s range-of-motion is often so limited that many patients have difficulties in raising their arm above the head, moving the arm across the body, and especially behind the back. What is most disturbing about this condition is that the loss of movement that can last from months to years.

Fortunately, we can show our patients ways to control the pain and regain full range of motion and full function in a lot less time. Often, the actual cause of this condition is unknown. The medical community is still debating over possible causes. However, Frozen Shoulder usually occurs in three distinct phases: 

Freezing Stage 

This stage is characterized by pain in and around the shoulder and progressive loss of range of motion. 

Frozen Stage 

 Pain is actually reduced in this stage. The range of motion of your shoulder seems to be stuck, not decreasing or increasing. 

Thawing Stage 

This stage is characterized by a slow increase in range of-motion of the shoulder. It is also a stage of increased weakness due to the disuse atrophy of the shoulder. 

Examination and Diagnosis

 The diagnosis of Frozen Shoulder is usually made after an examination. X-rays or an MRI are usually not prescribed, unless the doctor needs to rule out other conditions such as osteoarthritis or significant tear(s). Patients with Frozen Shoulder have a very limited range-of-motion in both active and passive ranges of motion. Active range-of-motion is when you move yourself; passive range of motion is when someone moves your arm for you. In addition to the decreased active range-of-motion in the shoulder joint itself, it is common to find significant trigger points in several of the rotator cuff muscles. This is especially true of a muscle called the subscapularis,as pointed out by Janet Travell, author of “Myofascial Pain and Dysfunction”. Trigger points in the subscapularis muscle refer pain to the back of the shoulder (deltoid muscle), shoulder blade (scapulae), and even the wrist. 

Treating Frozen Shoulder

 There is no doubt that Frozen Shoulder is one of the tougher conditions to treat. The good news is that 80 – 90% of patients suffering from Frozen Shoulder will eventually experience a complete recovery. The bad news, recovery that is based on conventional therapy (muscle relaxants, corticosteroid injections) can take a very long time (twelve to forty-two weeks). 

Exercise

Fortunately there are alternatives to these traditional therapies, which with the right therapy and exercises can reduce treatment time to between 4 to 10 weeks in most cases. I have consistently seen positive results in over 80% of Frozen Shoulder cases that we treated with a combination of specifically designed soft-tissue protocols along with rehabilitative exercise routines.At our office, we often use a treatment protocol that involves:

• Using Cold Laser (LLLT) to the involved shoulder prior to treatment in order to increase blood circulation, reducing swelling and to make the tissue more malleable.

• Administering appropriate hands-on soft-tissue and joint adjusting protocols directly to the shoulder and surrounding areas. (Active Release Technique, Graston, Fascial Distortion Model, and Chiropractic Manipulation to the shoulder and possibly other joint areas).

• Acupuncture (using pin-point laser and Piezo electric stimulation) for not only trigger points directly on the muscle, but also for sites away from the shoulder along meridians that affect shoulder function.

• A gentle shoulder exercise routine that mobilizes both the joint and the soft-tissues involved in this condition, following-up with more advanced exercise routines that address range-of-motion, strength, and flexibility as the patient improves.

 So, remember to stay active by incorporating toning as well as stretching exercises to compliment your cardio routine. Your body will thank you with fewer ailments!If you would like more information about treating this or other conditions, or would like to schedule an appointment, just give us a call at the clinic.

Disclaimer

This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Any attempt to diagnose and treat an illness using the information in this site should come under the direction of a trained medical practitioner.We accept no responsibility for any adverse effects or consequences resulting from the use of any of the suggestions or procedures in this site or related internet links. By using the information in this web site you are confirming that you understand this statement and that you accept all risk and responsibility.

All matters regarding your health should be supervised by your health care provider. All information provided in this site is for the purpose of education, not treatment.

The Treatment of Chronic Pain

Many of my previous articles have primarily centered about the treatment of acute and repetitive strain injuries, primarily brought on by work or recreational activities. With a large segment of our population reaching “maturity”, quite a number of the individuals that I see also deal with chronic pain. The pain is usually initially described with the generic default term “arthritis”, but there are many other causes and contributing factors, which make it imperative to assess the patient, and not just the pain. The American public has been emotionally and physically traumatized due to announcements by the FDA concerning the devastating long term health effects discovered in a number of prescription pain medications, including of the COX-2 inhibitors (i.e. Aleve and Naprosyn) - some of the most popular pain drugs on the market. Many are now wondering what their future holds, where they can go, and what they can do to ease their chronic pain.

Chronic pain is in fact it is a distinct neurological condition, most often involving the brain and it is often poorly understood, poorly treated, and often stigmatized. It is like a broken alarm; it's permanently stuck in the “on” position. Chronic pain can make employment or recreational activities difficult or impossible. At the same time, one of the worst effects of chronic pain is isolation – which in turn can increase the pain itself. The complexity of chronic pain includes a multidimensional input.

First, the biological component. Within this area, unresolved acute strain-sprain injuries and, often, years of over-use and repetitive strains have caused a breakdown in one or more tissues in the body (bone, muscle, fascial, etc.), so physically, something is not working, or broken. Initially, the acute pains are mainly felt due to the signals by the nervous system’s nerve endings, making you respond accordingly to put a stop to the stimulus. The action typically involves taking a few days off from the painful activity(ies), using some ice or heat and downing some meds to numb the pain. However, the longer that the unwanted signals remain or persist, the more “sensitized” the nervous system becomes; the pain remains even after the stimulus is long gone. One’s pain threshold is lowered to where activities or stimuli, that normally would not have hurt, now do. This manifestation can then be aggravated by the aberrant or abnormal mechanical behavior of individual joints. For example, if an injury occurs to one’s ankle (a very flexible joint), the knee, (a hinge joint, that is limited in its motion), will then be called upon to ante up more than its designed mobility and thus be compromised for easier and, or, compounded injuries. This has chronic implications, as we are able to compensate for weaknesses, up to a point; eventually, something within the tissues is going to fail, and when tissues fail, injuries occur. There is the need to address the specific injured tissues.

Secondly, there is the metabolic and endocrine component. This involves the correct or adequate processing of nutrients (and hydration!) as well as the functional behavior of hormonal activity and adequate sleep. Some individuals are very sensitive to acidity within their body and can become more inflamed; the body desires to be at a slightly alkaline pH. Foods that include dairy, refined carbohydrates (processed) and meats all tend to make one more acidic, or lowered pH, whereas, vegetables and most fruits lead the body to respond oppositely. Thankfully, most of us can balance that plate of manicotti with a nice mixed green salad! Also, thyroid imbalances can masquerade as pain and parathyroid imbalance can influence muscle activity via calcium shortages. When this physiological breaking down occurs, even one’s immune system may be affected. Fibromyalgia is a condition where “allodynia”, which is defined as a painful response to a non- painful stimulus (i.e. touch), or “hyperalgesia”, which is a heightened degree of pain to a normally painful stimulus, constantly plague the individual, sometimes even to a debilitating degree. Pain is their focus, at least to some degree on a daily basis, initially at trigger points and the referred pattern areas ( i.e. the quadratus lumborum, a deep muscle between the last rib and the pelvis has trigger points that can refer pain sensations down the buttock and posterior thigh); the chronic cascading of this is where stress now increases one’s misery and sleep is interrupted, headaches are frequent, mood swings and phobias are apparent and even irritable bowel syndrome or gastric reflux become unwanted physiological guests. Herein lies the term “psychosomatic” in which the brain (psyco) affects the body (somatic) as the chronic picture unfolds. While this term has often meant that “it’s all in your head” (meaning that the symptoms were not real), it is actually true, reflecting the Central Nervous System’s involvement , but, it could get you a verbal, if not worse, beating if you even inadvertently make the casual inference to someone!  

Lastly, there is the psyco-emotional component. This area dove-tails with the above, as it refers to the individual’s internal emotional response to certain experiences (work, child raising, parental care giving, personal, family crises, or being told that your pain is just in your head!), as well as a triggering by our thoughts (grandmothers of European and Asian descent seem most prone to these unsubstantiated and often unnecessary worries, in my non-scientific experience and observation). We can worry about things that do not have a snowball’s chance of materializing and become quite adept at it, only to bring us to our symptom expressive demise! Hopefully, you begin to see how integrated these components are and that the longer that they persist, the broader, or more multidimensional one’s issues become.

So many have been emotionally and physically traumatized due to the influences of these factors and this makes it unsurprising when we observe the habitual abuse of strong meds, alcohol and illegal drugs! So, what’s the solution? One will probably be able to get a litany of suggestions over the internet, but, I will offer my own based on my personal research and clinical experience.

1. Balance your diet to become more alkaline. You can Google “alkaline diet” and see the food selection. Also, you can purchase pH test strips at your local health store or pharmacy, or, even online to monitor your daily balancing (7-7.5 is optimal); also, limit total calories and HYDRATE well!
2. Beginner yoga to stretch, strengthen the core muscles and deep breathe, engaging your diaphragm (lie on your back, put your fingers over your tummy and breathe; you should see your fingers rise, and not your chest). Activity (walking, eliptical machine, water aerobics) will help to divert your brain away from your symptoms, as well as promote the release of endorphins, your “happy hormones”.
3. Get a good night’s sleep (avoiding sugar, caffeine and electronic devices that may not allow you to relax, i.e. the news, action movies, business calls). Behavior modification is paramount and exercising to tissue tolerance is always advised. Also, try to smile as much as possible. If nothing else, you will be a joy to those around you and they, in turn, to you.
4. Chiropractic adjustments for joint mobility and stiffness.
5. Acupuncture (including needleless laser and Piezo-electric), which generally reduces stress, benefits sleep, lifts and stabilizes moods, and improves energy. All of these effects might be helpful to someone who is pursuing a multi-pronged approach to managing chronic pain. Therefore, we encourage everyone who wants to try acupuncture for pain to do so. I generally recommend that patients get 8-10 treatments as close together as possible in order to initially decide if acupuncture would be helpful for them. After the initial 10 visits, it's a good idea to have a conversation about what a maintenance schedule might look like. By that time, most patients have a good idea of what acupuncture can do for them. Interestingly, the fascial tissue below the skin, which contains an abundant nerve supply, is unavoidably involved and the meridians involved are often within fascial separations. This is why addressing soft tissue restrictions works so well in combination with acupuncture. An important fact to remember is that the more chronic your pain, your pain threshold decreases, meaning that it will take less and less to trigger a flare-up. 

So, if you are the victim of chronic pain, please call for an appointment, and, if someone even innocently says that it may be in your head, just smile and say “Thank you for noticing!”

Have a blessed month!

Disclaimer

This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Any attempt to diagnose and treat an illness using the information in this site should come under the direction of a trained medical practitioner.We accept no responsibility for any adverse effects or consequences resulting from the use of any of the suggestions or procedures in this site or related internet links. By using the information in this web site you are confirming that you understand this statement and that you accept all risk and responsibility.

All matters regarding your health should be supervised by your health care provider. All information provided in this site is for the purpose of education, not treatment.

Acupuncture Treatment On Exercise Performance and Post Exercise Recovery

Allow me to begin this newsletter with a story that I recently read.

“A wise woman who was traveling in the mountains found a precious stone in a stream. The next day she met another traveler who was hungry, and the wise woman opened her bag to share her food. The hungry traveler saw the precious stone and asked the woman to give it to him. She did so without hesitation. The traveler left, rejoicing in his good fortune. He knew the stone was worth enough to give him security for a lifetime. But, a few days later, he came back to return the stone to the wise woman. ‘I’ve been thinking’, he said, ‘I know how valuable the stone is, but I give it back in the hope that you can give me something even more precious. Give me what you have within you that enabled you to give me the stone.”

“The Wise Woman’s Stone”-----Author Unknown

“That is just a nice story,” you might be thinking. Perhaps so, but the underlying message is truly one to reflect upon in our daily lives. And, so it is with my passion to see our patients get well and learn what tried and true, as well as new procedures or exercises they can do to be active, satisfied “stakeholders” in their well-being, which is my ultimate purpose in sending these newsletters each month, to share the knowledge that I have gained through my constant research. It is my hope that each of you will glean some benefit to your good health endeavors.

The following article offers light on the utilization of acupuncture for more than just pain control. In previous articles, I have shared that acupuncture (remember that this is a “system” that can be carried out via pin-point laser or piezo electric stimulation, and, not just through needling) is effective for: decreasing the nerve signals that cause pain, stimulating the release of your own endorphins (happy hormones) and other opioids, as well as to modulate (regulate) muscle and connective tissue (fascia) activity.

Effect of acute acupuncture treatment on exercise performance and post exercise recovery: a systematic review.
By Dr. Jennie Gillis
  
As previous studies have suggested that acupuncture may improve exercise performance and post-exercise recovery, Urroz et al. from the University of Western Sydney (Australia), reviewed data collected in four separate and published studies. They found that acute acupuncture applied during exercise exerted beneficial effects on power and blood pressure, heart rate, oxygen consumption, and blood lactate, as well as the body's ability to recover post-exercise.  The study authors submit that: "There is preliminary support for the use of acupuncture as a means to enhance exercise performance and post-exercise recovery."

While these results are promising and exciting, randomized control trials with thorough and standardized reporting of research methods (e.g., acupuncture and exercise interventions) and results should be the next step to determine more adequately the effect of acupuncture on exercise performance and post-exercise recovery.

Urroz P, Colagiuri B, Smith CA, Cheema BS. Effect of acute acupuncture treatment on exercise performance and post exercise recovery: a systematic review. J Altern Complement Med. 2013 Jan;19(1):9-16.


While I have consistently witnessed positive results with post exercise or event recovery, the ability to positively influence performance prior to/during the activity is exciting! As data is gathered, it will be interesting to see the results of these studies. I find that the functional rehabilitation method that I utilize has provided excellent outcomes when patients follow instructions, in fewer visits, and are excited to refer their friends and family for care. So, another month, another calendar leaf in the basket; it is now officially Spring! So, thank you for the privilege of allowing me to be a part of your health care team and I look forward to continuing to assist you, your loved ones and friends  with the musculo-skeletal needs as you carry on with the outdoor  hobby and sports activities you enjoy. As one who is committed to the practice of Manual Medicine via Chiropractic and complimentary procedures, I adhere to the antithesis of the negative computer axiom, “garbage in-garbage out” with “quality in-quality out” with regard to my research and care in the encounters that I have with each of your prevailing needs. We look forward seeing you! Have a blessed month! Enjoy the snow tomorrow!
(April Fools!)

Disclaimer

This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Any attempt to diagnose and treat an illness using the information in this site should come under the direction of a trained medical practitioner.We accept no responsibility for any adverse effects or consequences resulting from the use of any of the suggestions or procedures in this site or related internet links. By using the information in this web site you are confirming that you understand this statement and that you accept all risk and responsibility.

All matters regarding your health should be supervised by your health care provider. All information provided in this site is for the purpose of education, not treatment.

Fascial Distortion Part 2

Continuing from last month’s article on fascial distortions, I hope to convey the broad spectrum of potential problematic areas that everyone, at some point, experiences, at least to some degree. The critical point to remember is that fascial tissue is extremely “nerve rich”, meaning that it makes one very aware when something with the musculoskeletal system, along with its connective tissue,  has been injured or gone awry;remember the “good vibrations” that are transmitted for our benefit!

So, remember from last time that:

1.     Banded fascia includes Triggerbands which are anatomical injuries to banded (parallel fibers reinforced by perpendicular cross-bands)fibers which resemble a Ziploc® bag in that the fibers/bands separate and, if become chronic, can become filled with scar tissue. This category of fascia also includes Continuum Distortions, which occur when the transition zones between tendons, ligaments, other fascial tissue, and the bones lose their ability to respond correctly to external forces. A majority of Continuum Distortions are found in acute injuries, but some may be found along with chronic injuries. Ankle sprains, cervical strains, sore shoulders, and sacroiliac pain are a few examples of these exquisitely tender disruptions of the ligament/bone junction. The impressive part about the transition zone is that there is an inherent quality that makes it more flexible than bone, yet more sturdy than ligament, and, depending on the forces being experienced, the zone is in a constant, demand-oriented flux, depending on the need imposed upon the joint. So, say a fall onto one’s wrist (one direction force) occurs. This situation would signal the bones in that area to send more osseous (boney) elements to the transition zone to make it stronger.However, if one’s experience is a car accident that involves a rear ending that ends with impacts from the front or side (multi-directional forces), the areas impacted (think neck or back), the transition zone sends those osseous elements back toward the bones, to allow for more give to minimize tears. The problem is that when the transition zone becomes stuck in one of those configurations,injuries are escalated because of the inability to adapt to the demands.

2.    Coiled Fascia, which includes Cylinder Distortions (superficial,tangled coils of circular fascia that act like a tourniquet around muscles and other tissues) when they become restricted. One will typically experience tingling and numbness with this distortion following a pulling, twisting injury. Think of a Slinky® toy that has been pulled or pushed with a twist and how it will lose its shape. Now, envision your arm or leg having experienced that type of injury.

3.    Folding Fascia, along with the associated Folding Distortion, is found in joint areas and is injured via traction or compression (pull/push)injuries, i.e. a dog on a leash yanking the shoulder or landing on the wrist with a fall. The involved tissue in these examples will become distorted like a road map that does not re-fold into the original shape and allowing for greater distortion with subsequent like injuries.

4.    Smooth Fascia is another vulnerable fascia type. There are two types of distortions in this fascial category. Herniated Trigger Points occur in the soft areas between the neck and shoulder, the buttock cheeks, the abdomen and the flank between the top of the pelvis and last rib. This fascial injury occurs when the tissue tears and the underlying tissue protrudes through and becomes pinched in the breached area. Tectonic Distortions present themselves in joint areas and are most noticeable with stiffness, “like feeling a quart low on oil”. So, decreased range of motion and pain are the obvious complaints as a result of a loss in the natural “glide” in the joint.

While it is likely apparent which fascial injuries you are most prone to, the obvious question should be, “how do I avoid them?”  Inevitably, the two major influences are acute injuries and repetitive strains.  So, avoid collisions, falls and pulls as well as doing the same motions over and over like running, spinning or swinging a golf club or racquet. As that is about as unlikely as my dad, Lou, turning away from a Jersey Shore sausage and pepper sandwich (if he were still living), let’s get real! We obviously cannot live in a “bubble”, so, prevention with adequate strength and flexibility exercises (beginner yoga is my favorite) and addressing these injuries fairly quickly are paramount. How are these injury types addressed? Evaluation of the tissues in question is followed up with manual procedures and possibly some electro or laser therapy, including acupuncture points. Some areas may have been overworked in your exercise routine and the weaker, or inhibited muscles may need to be concentrated on.  Each situation may call for specific or a combination of procedures. So, pay close attention to your body’s signals and contact us if you have any concerns!

 

      

 

 

Disclaimer

This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Any attempt to diagnose and treat an illness using the information in this site should come under the direction of a trained medical practitioner.We accept no responsibility for any adverse effects or consequences resulting from the use of any of the suggestions or procedures in this site or related internet links. By using the information in this web site you are confirming that you understand this statement and that you accept all risk and responsibility.

All matters regarding your health should be supervised by your health care provider. All information provided in this site is for the purpose of education, not treatment.

Good, Good, Good Vibrations

You have inevitably heard it before, that person “puts out bad vibes”, or, “that music has good vibes”. We often refer to these colloquial expressions when describing what we “feel” when we are exposed to certain stimuli. The body acts as a complex machine, consisting of many separate, interconnected, individually vibrating mechanisms that allow us to experience pleasant or less than gratifying emotional or physical sensations. Think about that tax bill you just received, or that very first car and the rumble of that engine that was pitch perfect, or your daughter’s first ballet performance, possibly, the Nutcracker, which even though may not have been without some flaw, was something that warmed the cockles of your heart! Of course, let’s not forget about that first encounter with your spouse that gave you the “deer in the headlights” look on your face, that if someone had just informed you of a million dollar lottery win, it would not have fazed you anymore than the beauty (handsomeness) that was beheld in your immediate visual field! So, conversely, if the components of our body have their tolerances exceeded to the point of emotional or physical pain, some sort of sickness will be experienced; think headache and motion sickness).

This leads me into the subject of one of our least talked about tissues in our bodies, the connective tissue, which includes tendons, ligaments, and in particular, the fascial tissue.

Aside from connecting, our fascia surrounds, separates, compartmentalizes, protects, insulates and buffers bones, nerves, muscles, and other tissues. In fact, each individual muscle fiber is sheathed with fascia! Fascia is made up of parallel fibers that transmit tension forces, or, vibrations to nerves. An analogy of this is our own clothing, which has a similar capability. If something or someone should tug on our pant cuff but not directly touch any part of our body, we would still have a fair appreciation of both the location and nature of the stimulus. This is because the tension on the pant cuff is transmitted up the pant leg to the waist where the stimulus is integrated into the nervous system.

In this way, fascial fibers function much as stringed musical instruments do. For example, a guitar or piano works on the principle of vibration. Each string has a specific diameter and tension, and when stimulated, it vibrates at a precise frequency and causes a specific note to play. Just as our ears hear music, our nervous system is interpreting fascial tension input. But, when the piano is “out of tune”, the expected frequency of the notes is usually undesirably changed. This is also the case with a distorted fascial band in which the off-key vibratory frequency is transmitted through the nervous system to the brain where it is deciphered as burning, tightness, pulling, or pain.

There are four different types of fascia and six different distortions that can affect our well being.

I will address these over a couple of articles. What is interesting is that while we all have each type of fascia, we each have differing amounts of them. For instance, a healthy football player will probably have more of one type, than say, a ballet dancer, who will generally be endowed with another.

1. Banded.

As one of the most common types of fascial tissue, trigger bands are anatomical injuries to banded (parallel fibers reinforced by perpendicular cross-bands) fascial tissues in which the fibers have become distorted (i.e., twisted, separated, torn, or wrinkled). The associated verbal description by patients is: burning or pulling pain along a linear course, say, along the neck, down the shoulder, into the arm and resembles a Ziploc® bag in that the fibers/bands separate and, if become chronic, can become filled with scar tissue. The goal of treatment in this distorted tissue is to zip up the separation(s) and to iron out the wrinkles by hand or instrument. In a number of circumstances, the other facial distortion types must first have this tissue “cleaned up” first in order to see the optimal results with other fascial, muscular and spinal alterations.

So, bear in mind, that when injuries occur, whether noticeable or not (think of the proverbial frog boiling in water), you may not notice pain yet, but as the off-key vibrations build up and are transmitted to the tipping point of your threshold, your attention will eventually demand a response. The only question is, are you paying attention to those good vibrations?

Disclaimer

This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider. Please consult your health care provider with any questions or concerns you may have regarding your condition. Any attempt to diagnose and treat an illness using the information in this site should come under the direction of a trained medical practitioner. We accept no responsibility for any adverse effects or consequences resulting from the use of any of the suggestions or procedures in this site or related internet links. By using the information in this web site you are confirming that you understand this statement and that you accept all risk and responsibility.

All matters regarding your health should be supervised by your health care provider. All information provided in this site is for the purpose of education, not treatment.

Happy New Year!

I apologize for the lateness of this second rendition of the January newsletter; yes the first one somehow got lost in cyberspace, the new“my dog ate my homework” excuse! Enjoy!

So, here we are again… awakened to the New Year, possibly like Bill Murray in his Ground Hog Day movie! Has much changed for you from this time last year, or is it “déjà vu all over again?” Some of us began noticing that our toes started to shrink somewhere around the Thanksgiving weekend, only to see them disappear by 01January! For our family, ok, me, the innocent slice or two of Pecorino Romano cheese, assorted olives and Soprasotta salami for antipasto continued with the meatballs and Italian sausage, the Christmas Eve seafood, (I forgot the office and church gatherings with the Southern, Mexican and Chinese “low cal” appetizers and dinners), the Christmas tenderloin and the incredible dinner at Da Corrado’s Italian Ristorantein Greensboro, GA on New Year’s Eve. Then, just when there seemed to be a digestive respite, the Southern fare New Year’s Day dinner with some dear friends! At that point, a food coma nearly overwhelmed us; however, the wonderful home cooked meal prepared by our daughter and son-in-law this past weekend was just a prelude to the delicious dinner that they sprung for after church. I have finally given up! Yes, in Italian (and Chinese families, it’s all about the food). I am now ready for a diet of mung bean thread noodles and quinoa!  Perhaps a fast is in order!! Maybe this wouldn’t have been so bad if the weather had been more cooperative the past six weeks; exercising would have been easier, or at least more inviting. I have observed, in more than just clinical settings, that it is much easier to excuse calorie intake over burning them! I now stand at 10 pounds over my desired weight (confession time); something I have not loathed since college wrestling days before weigh-in!

But, alas! This is, as I alluded to, the New Year and time for those inevitable resolutions to be written in stone… again. This year, although,has an opportunity to be new and improved, in that a commitment can be made and discipline enforced.  So, first, is to get back to the discipline of cheating only on the weekends (except for special events).  Then, being committed to exercise in a way that challenges the body. It has to not only be a mindset,but a passion to be healthier. Proper diet is paramount, as is a balanced exercise r o u t i n e.

What part do exercises play in your treatment procedures? I believe that effective, focused exercises play an important role in healing and regeneration of damaged tissues. Every patient receives appropriate exercises as the body can handle. Our exercises are based on four basic principles:strength, flexibility, balance and cardiovascular function.

Flexibility

• Good flexibility enables muscles and joints to move through their full range of motion. Poor flexibility leads to a higher chance of injury to muscles, tendons, ligaments and connective tissue, or fascia.
• Flexibility is joint-specific; a person may have excellent range of motion at one joint, yet be restricted in another. It is also plane specific, along fascial planes, which may encompass the wrist, elbow, shoulder and neck for instance in an overuse syndrome.
• Stretching exercises help to realign new tissue that is being laid down in the direction of the muscle and facial fibers. Without appropriate stretches, new scar tissue may form in weak random patterns, resulting in new restrictions and problems.

Strength

• Resistance training is essential in the rehabilitation of any injury.
• Tissue goes through a remodeling phase which can take from six months to a year.
• When new tissue is laid down to repair an area, it is very thin and weak.
• During the remodeling phase, this tissue will increase to over ten times it original diameter if the appropriate resistance training exercise are applied against it.
• Without resistance training the probability of re-injury remains high.

Balance and Proprioception

• Proprioception describes the body’s ability to react appropriately (through balance and touch) to external forces. Kneeling or standing lunges or exercise ball maneuvers employ this concept.
• Effective proprioception exercises are designed to restore the kinesthetic awareness of the patient. These exercises form the basis for the agility, strength, and endurance required for complete rehabilitation.

Cardiovascular

• Cardiovascular or aerobic exercises are essential for restoring good circulation and for increasing oxygen delivery to soft-tissues. Lack of oxygen and poor circulation is a primary accelerator of injuries.

So, what will be your plan for the New Year? Will you hear the alarm clock go off each morning and see the same undesired reflection in the fogged up bathroom mirror? Or, will you inch toward a healthier, more fit body. I am here to help and guide you, but ultimately, we each have to be responsible for our physical, mental and spiritual growth and improvement. I just remembered…I forgot to make the biscotti this year!

May your 2014 be blessed indeed!

Disclaimer

This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider. Please consult your health care provider with any questions or concerns you may have regarding your condition. Any attempt to diagnose and treat an illness using the information in this site should come under the direction of a trained medical practitioner. We accept no responsibility for any adverse effects or consequences resulting from the use of any of the suggestions or procedures in this site or related internet links.By using the information in this web site you are confirming that you understand this statement and that you accept all risk and responsibility.

All matters regarding your health should be supervised by your health care provider. All information provided in this site is for the purpose of education, not treatment.

SO, YOU THINK YOUR MUSCLES HURT?

 

Here we are again…Thanksgiving, which ushers in not only the wonderful Christmas holidays, but, the perennial, favorite activity of…dragging the Christmas tree out of the attic! There is a commercial running nowadays with the wife saying that her husband seems to speak a different language when he struggles with domestic responsibilities of the like. Anyway, with the frustration of the huge, now duct taped, box of tree pieces needing to be shoved through the disappearing staircase hole that undoubtedly shrinks more with each passing year, there always seems to be a bit of tweaking to one or more unfortunate body parts. The usual verbal response by most is that a muscle just “pulled”.

But, before you are too quick to blame the seemingly obvious culprit, consider another possibility, the fascial tissue. This connective tissue, which covers the muscles, has a high sensory feedback (lets you know that you just messed up!). The thoracodorsal fascia (TLF) that covers the posterior aspect of the torso is a major player in virtually every trunk motion; an injury to this tissue can cause unlimited potential movement disorders. In fact, pain found in other areas can be resultant from problems in the TLF.  Fibers from this tissue attach to the lats (broad climbing muscle that connects the back to the shoulder), the internal obliques (along the flanks above the hips)and even the diaphragm, which can make for better reasoning why a shoulder can hurt with a problem originating in the lower back, or why it is difficult to breathe well with back pain.

So, what are the signs of TLF dysfunction?

1.     Tightness or spasticity in the back between the bottom of the shoulder blades and the lower back even after localized therapy.

2.     Chronic lower back pain (not diagnostically confirmed in itself)

3.     Repetitive or chronic sacroiliac locking.

4.     Nagging shoulder and hip pain that does not improve with localized treatments to painful area.

5.     Inability to expand the ribcage with diaphragm breathing.

6.     Decreased thoracic (mid spine) motion.

7.     Altered gait pattern with poor arm and leg swing.

8.     Base of the skull type headaches or plantar fascial pain due to the fascial attachments referenced in Thomas Meyers’ Anatomy Trains.

9.     Spasms or weakness of the quadratus lumborum muscle(below the obliques, attaching the pelvis to the last rib).

Now, what can be done?

In previous articles, I have addressed the successful protocols that we utilize to treat adhesions and fascial dysfunction, but, I will briefly address them here for clarity purposes.

1.     Evaluate for muscle motor inhibition (locate what is not working).

2.     Find any restrictions due to adhesion build-up.

3.     Break down adhesions via therapies such as cold laser,Active Release or Graston protocols.

4.     Activate (wake up) muscles that are inhibited via electrotherapy techniques.

5.     Adjust the spine (or other involved joints) that are dysfunctional.

 

It has been a pleasure and an honor to be able to care for you and your family and friends over the past year that have entrusted me with the challenges of pain management, as well as functional improvement. Daily, I seek the wisdom and insight to meet those challenges in order to be the best in my field. May you each be able to enjoy a healthy, warm and enriched Christmas season that is blessed beyond your dreams! Also, be careful shoving that Christmas tree back up in the attic!

Disclaimer

This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider. Please consult your health care provider with any questions or concerns you may have regarding your condition. Any attempt to diagnose and treat an illness using the information in this site should come under the direction of a trained medical practitioner. We accept no responsibility for any adverse effects or consequences resulting from the use of any of the suggestions or procedures in this site or related internet links. By using the information in this web site you are confirming that you understand this statement and that you accept all risk and responsibility.

All matters regarding your health should be supervised by your health care provider. All information provided in this site is for the purpose of education, not treatment.