SMARTPHONES… CAN DUMB DOWN OUR POSTURE!

Dr. Kenneth Hansraj, an orthopedic surgeon in Poughkeepsie, NY, was cited in a recent article in Good Housekeeping regarding our obsessive and epidemic problem with neck posture and cell phone usage. A computer model analysis showed how compromised posture with usage may take a toll on one’s health.The average head weighs approximately 10-12 pounds, so in the neutral position, that weight would translate into the same as downward force on the neck components, namely the vertebrae, discs, nerves and other soft tissues.At just a 15 degree forward head tilt, the impact is elevated to 27 pounds. With a 30 degree tilt, the downward force is now at 40 pounds. With a 45 degree, the force increases to 49 pounds and with a 60 degree head tilt, the force tops out at 60 pounds. If you have difficulty in figuring out the degrees, if you tilt your head forward so that your neck is at a right angle with your back, that’s 90 degrees. Then, come up half way to get to 45, and you can get a feel for the rest of the positions.

So, what can you do?

1. Carry your device at chest height, with the head up, chest open and shoulder blades back. Imagine a helium balloon attached by a string to your chest and lifting you to a straighter posture. Use your eyes for movement rather than your head.
2. Take a break every 5 minutes and look up, down and rotate right and left. Remember, your neck is part of a living entity that likes motion.
3. Try to avoid being CDO (that’s OCD in alphabetical order) about having to be on your device constantly.

Headaches, neck pain, numbness and tingling sensations in the arms and hands and jaw pain can really be annoying, distracting and severely affect your productivity. By simply being more cognizant of your posture in this age of technology, you can make your life much more enjoyable! 

Image courtesy of stockimages at FreeDigitalPhotos.net

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.

Plantar Fasciitis: Da Agony of Da Feet!

Why do so many people suffer from it and so few actually get better with traditional therapy? Sadly, it is not well-understood, scientifically or biomechanically.

Most individuals do not know the latest research and are not even aware of the basic program for plantar fasciitis treatment, much less advanced care options for severe and/or atypical cases.

What is plantar fasciitis and why does it develop? Plantar fasciitis is a very common kind of tendinitis, but instead of a tendon, it's the plantar fascia of the foot that's inflamed. The plantar fascia (aka the plantar aponeurosis) is a sheet of connective tissue that stretches from the heel to toes, spanning the arch of the foot. It is basically an inflammation and thickening of the plantar fascia caused by chronic irritation of the arch of the foot due to excessive strain. 

Muscle knots, technically known as myofascial trigger points (MTPs), are a factor in almost all cases. A trigger point is a section of super-contracted and irritated muscle tissue, and it can cause symptoms ranging from mild stiffness to extreme pain. They not only cause pain and problems directly, but also develop in response to other biomechanical problems, particularly with lower crossed syndrome (LCS). LCS is a consequence of poor postural alignment and dynamic postural equilibrium dysfunction of the kinetic chain.1 (See previous articles on my website).  

Laser Therapy

Lasers significantly reduce pain and inflammation, but also stimulate the formation of new collagen matrix in damaged tissues.2 Properly applied laser therapy with optimal dosage is one of the best modalities available for effective treatment. The protocol is two visits per week for a total of 10 laser sessions. This protocol is often used along with Manual Therapy.

Manual Therapy

Trigger points and myofascial adhesions are primary culprits in unresolved plantar fasciitis. Some of these muscles are far-removed from the symptomatic area. So why work them? To remove kinetic chain biomechanical compensation patterns, performing hands-on fascial and muscle therapy to the following areas with soft tissue techniques (Fascial Distortion Model, or FDM and Active Release Technique, or ART) have shown to be very effective in my experience. If affected, these areas will be tender and painful.  Body language, verbal description of the pain and mechanism of injury all are pertinent in proper diagnosis and care.  It usually takes six to 10 sessions for most cases to resolve; come chronic cases could be longer, but, I personally have not seen more than one or two cases go beyond 10. Primary muscles include anything that attaches to the lower back, all the way down to the foot. 

Home Care

Home applications, using tennis balls, lacrosse balls, baseballs, golf balls and biofoam rollers are helpful in expediting treatment time. Primary areas include the plantar surface of the foot, calf and buttock regions.

Joint Fixation

The following areas may be addressed for possible subluxation/fixation (any and all areas may be involved): L1 and L2, L5 and S1, sacrum torque, rotated ilium, anterior femur head, tibiofemoral complex, fibular head, calcaneus, talus, navicular, cuboid and cuneiforms; basically, anything from the lower back to the foot. 

Lifestyle

One's activities of daily living (ADL) must be mentioned here, including proper shoes, exercise, work habits, ergonomics, etc. Despite the best care program, maximum results will not occur if patients continue to irritate the condition. They will need to make genuine effort and certain sacrifices to recover. 

Plantar fasciitis can certainly interrupt your lifestyle and can throw off your body mechanics, leading to ankle, knee, hip or back issues. This will not help you to stay active, thus leading to cardiovascular de-conditioning as well as loss of general flexibility.

If you, or someone you know has been suffering with this condition, please call my office to schedule an appointment.

References

1. Clark MA. Integrated Core Stabilization Training. NASM, Thousand Oaks, Calif., 2001.
2. Blahnick JA, Rindge DW. Laser Therapy. Healing Light Seminars, Melbourne, Fla., 2003.
3. Gunn CC. The Gunn Approach to the Treatment of Chronic Pain. Churchill Livingstone, 1996.

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.

Image courtesy of satit_srihin at FreeDigitalPhotos.net

“IT’S DÉJÀ VU ALL OVER AGAIN!”

So, here we are post holiday season once more with mirrors our enemies and failing eyesight, “a friend closer than a brother.” Echoes of the 1960’s television advertisement for Alka Seltzer, “I can’t believe I ate the whole thing!” are a reminder that with each extra plate of lasagna, sausage, meatballs, shrimp and the rest of the seafood and even those extra brownies and biscotti, there was an informed choice to abstain. Albeit, with those choices, that unwanted guest named “Ten” has returned. Not the “Ten” that was famous back in the 80’s with the first name Bo, but that increased circumferential mass (that hides our toes when standing and looking downward). Further, it has us holding our breath to button our pants, as well as had some of us nearly in tears because the only clothing that fit as we shopped at those ubiquitous temples of merchandise was the one item on the hanger that, at first glance, looked like it was made by Saul the tentmaker!

Well, by now, (New Year’s night), you have probably just finished your collards, peas, bar-b-que and pecan pie and possibly are, with a national throng, watching one of the final college football games of the season, inevitably hyperventilating. Not to discourage, but, rather to encourage you, I just capped off my low calorie day with a vegetable based protein shake with flax seed, lecithin, a banana, fresh ginger and a little cayenne pepper. OK, you won’t be the first this season to be grossed out by my culinary prowess. My lovely young ladies at our office were not impressed with my Christmas clams oreganata and low country boil!

When it comes to protein shakes as meal replacements, patients often ask which kind is best and why even consider using. The most common and popular choices include soy, whey and plant (or vegan). Protein is essential to rebuilding cells and tissues, keeping fluids in balance, protecting enzyme functions, supporting nerve and muscle contraction as well as supporting the health of skin, hair and nails. Meat, fish, dairy and beans are the usual food sources; protein shakes can be just as nutritious, simpler to prepare and satisfying enough to keep you from ingesting more calories. Some research is pointing to the need for cutting back on volume rather than simply avoiding certain foods. 

• Whey protein is theorized to help not only build muscle and enhance body composition but also to speed the recovery of broken down and stressed muscles (as occurs from exercise). As with most supplements, there are certain side effects from whey protein. Some of these side effects include gas, bloating, cramps, tiredness, fatigue, headaches and irritability. 
•  Soy protein is derived from the soybean that has been de-hulled and de-fatted. Some claims state that soy protein consumption helps lower bad cholesterol, prevent heart disease and even fight off some cancers. However, more recent studies have indicated that many of these health claims are not only false but that there are serious concerns with concentrated soy protein consumption. These concerns have to do with the phytoestrogens found in soy proteins, especially the concentrated soy proteins. Phytoestrogens mimic estrogen. The concern with this is that many people today are becoming estrogen dominant and this can be potentially hazardous to their health. High levels of estrogen have been associated with increased risk of certain cancers in both men and women. Men and children in particular, should use caution with soy protein. The only soy that I consume is occasional tofu.
• Plant based or Vegan protein powder is easily digested and very few people are allergic to it; unlike whey. The concern is that individually, plant protein may not give you as much “bang for the buck”. I am most impressed with blended plant based products that have pea, sprouted whole grain brown rice, hemp and chia, with a protein amount of 18-25g per serving.  

How much protein do you need?

Adults in the U.S. are encouraged to get 10% to 35% of their day's calories from protein foods. That's about 46 grams of protein for women, and 56 grams of protein for men. (Pregnant or lactating women may need about 10g more, but always check with your attending doctor to be sure).

It's not hard to get this amount if you eat two to three servings of protein-rich foods a day, according to the CDC.

• A small 3-ounce piece of meat has about 21 grams of protein. A typical 8-ounce piece of meat could have over 50 grams of protein.
• One 8-ounce container of yogurt has about 11 grams of protein.
• One cup of milk has 8 grams of protein.
• One cup of dry beans has about 16 grams of protein.

Foods are a great source, but, again, the control of total calorie intake is the purpose of this article.

The things to look for when purchasing protein powder

1. Cold Processed and RAW, No heat processing
2. Only ORGANIC so it’s free of pesticides and heavy metals
3. Easy to Digest and Sprouted, No isolated whey that hurts digestion
4. High Bio-Availability (sprouted) so you can digest ALL amino acids
5. Sweetened naturally, No artificial sweeteners
6. With Probiotics to increase absorption
7. Low Carb, No fructose or other processed sugars

A sample meal replacement or post workout shake:

1 Scoop protein powder

1/3 cup coconut or filtered water

1 tbsp chia or flax meal

½ cup berries or banana

** I also sprinkle in some cayenne pepper and shave some fresh ginger root for anti-inflammatory benefit and I try to do shakes for breakfast and dinner and have real food (with limited carbs for lunch).

Believe me, there is nothing more attractive right now than desiring to give in to a plate or two of eggplant parmesan and mussels marinara, but, more importantly, I want to start off the year on a healthy note as well as in pants that I can breathe in; in a month, I’ll resume cheating on the weekends! Hopefully, by next January, I can forget about the great Yogi Berra’s quote at the title of this epistle!

May one year from now, you be able to reflect back, having experienced a year where your health and faith were cultivated, planted, watered, reaped and shared with abundance! Happy 2015!

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.

Image courtesy of imagerymajestic at FreeDigitalPhotos.net

Holiday Encouragement

 I’m not sure who said it first about “The older you get, the faster time goes by,” but while most children would certainly disagree, (I remember it taking forever to get from Christmas to February…my birth month!), most over 40 would certainly attest to the years having jet propulsion! Anyway, the days between Thanksgiving and New Years Day are enigmatic in how our weight monitoring and cardio conditioning seemingly go south overnight. Hence, the resolutions are the banner that every one flies for about two-three weeks while frustration abounds because there are people that you could not get together with during the holidays that now require another upper end calorie meal and another day where exercise takes a back seat. Ugh! Now it’s almost beach season and there is no end in sight to eliminate the prevailing guilt and stress and unwanted weight. Stress….that ugly six letter word that hits us morning, noon and night. That’s six-six six…I read about that number in a world-wide best seller; not good! Aside from attributing to forehead wrinkles and gastrointestinal gas, it has an awful effect on our adrenal glands, which are responsible blood pressure regulation, glucose mobilization and reducing inflammation through the secretion of its hormone cortisol (coritiSONE is often injected as an anti-inflammatory). Cortisol is typically released when our body experiences a stress that would make us respond in “fight or flight” situations, i.e. when you get mad or scared. However, worry (related to fear) seems to pervade that small area between our ears much more often than we were designed to handle. Chronic increased levels of cortisol will impede one’s overall state of health. Unchecked, it can: 

•  Tear down muscle.
•  Increase fat storage (especially around the belly).
•  Increase pain.
•  Increase blood pressure.

 So, what is one to do, given that so much of the holiday schedule is unavoidably time compressive, making for a more sedentary and diet poor lifestyle with excessive starch, salt, sugar, and fat … all those things that are inextricably appealing to our palates? 

• Time management; be intentional about your day.
•  Graze rather than gorge AND hydrate well!
• At least take walks and stretch; “a little dab’l do ya!”
• Deep breathe, using your diaphragm (try not to breathe shallow with chest).

 Yes, it will be impossible to follow good habits over the next four to six weeks, but it won’t hurt you to attempt. Who knows, you may surprise yourself! Wouldn’t it be wonderful to get through the holidays without anxiety?! Once again, we would like to wish you each a Merry Christmas and Happy New Year! May God bless you during the weeks ahead as well as into the coming year. Thank you for the honor of allowing me the opportunity to provide for your physical medicine needs during the past year!

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.

DO YOU HAVE ACHILLES TENDON PAIN?

Image courtesy of satit_srihin at FreeDigitalPhotos.net

In Greek mythology, Achilles was a Greek hero in the Trojan War and the central character of Homer’s Iliad. It has been passed down and presumed that he died following a fatal small wound to his one vulnerable area, the tendon above his heel (Achilles tendon). Thus, this spot in our anatomy has traditionally come to represent a person’s point of weakness. While the Achilles tendon is the strongest and largest tendon in the body, it is extremely vulnerable to injury due to the limited blood supply as well as the combined forces that are imposed on it. So, does your Achilles tendon: 

• Feel tender or swollen?
• Experience pain when you rise up on your toes?
• Experience pain with any action that limits your ankle range of motion or stretches your Achilles tendon?

 Injuries to this area are quite common.

• The weekend warrior who ramps up their activity without adequate preparation (the computer terminal slave that decides a large tree needs cutting down, cutting up and dragging off).
• Women who have worn high heel shoes all day during the week and go to sandals or barefoot on the weekend.
• Individuals who have an “over-pronation” of the foot see a cascading effect on stressing the calf muscles.
• Walkers or runners who increase mileage or inclines without adequate, correct stretching and preparation.
• Some individuals just have developed tight muscles along the kinetic chain into the Achilles tendon.
• Repetitive injuries, which can cause friction and subsequent inflammation, thereby squeezing the surrounding tissue, promote an environment for scarring along the soft tissues, including in and around the Achilles. The resulting inflexibility can then lead to tissue failure and further injury.

 Conventional treatments include NSAIDS (non-steroidal anti-inflammatory meds) and steroid injections, which, when repeated, may cause weakening of your tendons. Conservative therapy, utilizing soft tissue mobilization techniques, electrotherapies and cold laser have proven to be very successful in not only pain management, but in breaking up adhesions in and around the heel, foot, calf and thigh that may have precipitated the architectural changes in the lower extremity. The plantar fascia on the underside of the feet may possibly be tender or downright painful. Even when looking at the calf, which is obviously close to the Achilles, there are layers of muscle that can be suspect, thus, there is a need to not just look up and down, but inwardly as well. Following treatment with the conservative measures listed above, possibly along with pelvic, knee and foot adjustments, I will typically advise stretching exercises like:

• Standing, facing a wall with the uninvolved leg bent at the knee and the involved leg straight, gently stretching the heel toward the floor. Do not bounce, but hold the stretch to your tissue tolerance for 5 seconds.
• While lying on your back, uninvolved leg is straight out on floor, or, bent at the knee to comfort. Then raise the involved leg toward the ceiling with a belt around the sole of the foot, toward the toes. Gently pull back on the belt for 5 seconds.
• While standing on the bottom step of a stairway, let your heel(s) gently stretch downward for 5 seconds.
• Yoga position called “Downward Dog” can be accomplished while face down on the floor on your hands and knees. Push your body up into an inverted “V”, keeping legs and torso straight, pulling your Abs toward your spine and gently stretching tour heels toward the floor. Hold for 5 seconds.

 These can all be repeated several times a day, again, to tissue tolerance. These stretches should be discontinued if pain increases!  So, if your Achilles is taking you out of your game (even if it’s just walking), give us a call to help you get a leg up on your pain! 

OUR PRAYER IS FOR YOU TO HAVE A MOST BLESSED THANKSGIVING, ENJOYING THE GIFT OF YOUR FAMILY, FRIENDS AND FREEDOM! 

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.

Frequency Specific Microcurrent

Image courtesy of dream designs at FreeDigitalPhotos.net

I am always researching for different alternatives to treat musculoskeletal pain and have been around long enough to know that one type of treatment for a specific problem may not produce the same positive response across the board for everyone. Even within the realm of electrotherapy, different frequencies have to be utilized to address individual issues. Are you looking for pain management, muscle inhibition (not working) modulation or stimulation of acupuncture points to achieve some regulatory effect to an area? Each of these responds best to specific parameters due, in part, to the goals and the type of nerves being targeted.Frequency Specific Microcurrent is an exciting, relatively new way of treating nerve and muscle pain and many other conditions using specific frequencies and micro amperage current.

There are hundreds of practitioners in the US, Australia, Ireland, and Canada using FSM to create miraculous changes in patients to reduce pain and improve health. Most of the time FSM produces immediate and dramatic changes in tissue that makes it an indispensable tool in treating pain and many other health concerns.

Because of its anatomical pervasiveness, (covering not only muscle tissue, but even every muscle fiber), the fascia is involved in every aspect of physiology. Hence, the fascia constitutes a medium by which superficial injuries or contractions or constrictions might influence internal organs, and by which organ pathologies might be expressed in the periphery. Recent research has indicated that fibrosis (adhesions) created by a superficial injury can extend into the viscera to create so-called “fibrocontractive” diseases. These concepts provide a possible fascial basis for the so-called somatovisceral and visceralsomatic reflexes (think gut-muscle relationship). Consider the Chinese acupuncture meridians. A headache may be addressed by applying stimulus to areas in the hand or wrist. This is possible via the “channels” that are formed by the fascial boundaries around the soft tissues in the body. Of course, the human body does not always pay attention to “norms” and tweaking of procedures is necessary at times. So, the following is designed to answer some of the question you might have about FSM.

What is Microcurrent? Microcurrent is a physical therapy modality that has been in use for over 16 years. Microcurrent is measured in millionths of an amp. By comparison, a TENS unit and most other electrotherapies produce milliamps, 1000 times greater. Your own cells make current in micro amps. 

How does it work? Your body seems to use the Microcurrent energy to increase its own energy production. Microcurrent increases the production of ATP, your own chemical energy, by up to 500%. It also increases protein synthesis and waste product removal.

Why can't I feel it? The current is so low it doesn't stimulate sensory nerves.

Why does the doctor change frequencies on the machine? It has been observed that specific frequencies seem to target specific conditions in the tissues. In many cases the tissues will suddenly soften and become less painful when the correct combination of frequencies is chosen. This softening and the pain relief that comes with it seems to be long lasting and in some cases permanent.

How do the frequencies work? The frequencies appear to work on the principle of biologic resonance. For example, a singer can shatter a glass when the note resonates with the crystal structure of the glass. Microcurrent frequencies seem to be able to resonate with biologic tissue and change the structure of the tissue when the frequency is correct. Once the tissue is changed and stable it seems to be able to stay in the new configuration.

What are the benefits of FSM therapy? Microcurrent treatment is painless, increases speed of recovery, often promotes healing in conditions that have not responded to other treatment, and is cost effective. The effects are long lasting and the healing of tissue is more complete.

What are the side effects? Microcurrent changes muscle tissue, softens scar tissue, and increases circulation with the effect of removing long stored waste products and increasing cellular metabolism so quickly that there is often a detoxification reaction after treatment. Some people have a similar reaction after a massage but the reaction after Microcurrent is stronger because so much is accomplished in such a short period of time. The side effects can include nausea, fatigue, drowsiness, a temporary increase in pain, and a flu-like feeling. The side effects usually start during or about 90 minutes after treatment, and may last from 4 to 24 hours. There have been no lasting adverse reactions reported. FSM has a history of being very safe.

What can I do about the side effects? You should drink at least two quarts of water in the two hours following treatment. If you feel the side effects return, drink more water and it should pass in about 20 minutes. Note that with all soft tissue treatment, even massage therapy should be augmented with copious amounts of water!

Do the benefits last? Every patient responds individually but the changes to the tissues seem to be long lasting. About 60 to 80% of the changes created in one treatment last until the next treatment, about four to seven days. Your muscles are used to responding the way they are and may return to the old configuration if not treated again, although some patients have had permanent changes in one treatment. Repetitive strains, including poor posture, can hamper favorable results.

If you have any other question or concerns be sure to ask me. Otherwise, relax, drink your water and enjoy the relief you can receive from Frequency Specific Microcurrent!

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.

Knee Pain and the Kinetic Chain

“The knee tries to do what the ankle wants it to do, but does what the hip allows it to”. I am not sure of the origin of this phrase, but it remains a powerful truth in my mind! While there can be many sources for knee pain, altered biomechanics can certainly be a primary culprit in a cascading effect on any part of the musculoskeletal system, including the knee. The following is a non-exhaustive list of some of the manifestations of the dreaded knee pain.

• ACL injury
• Torn meniscus
• Knee bursitis
• Patellar tendinitis

• Loose body within knee
• Iliotibial band syndrome
• Dislocated kneecap

• Osteoarthritis
• Rheumatoid arthritis
• Gout
• Pseudogout
• Septic arthritis.
• Chondromalacia patellae (patellofemoral pain syndrome)

Some of the above are the result of trauma, some from infection or poor diet considerations and others are from repetitive strain/stress/overuse. So, a “one size fits all” approach with say, an anti-inflammatory medication, exercises or “working through” the pain may not prove to be palliative.

A look at one’s history of the complaint, their activities (or lack of!), diet and family background are critical in finding the cause; examination and additional tests such as blood work, x-rays and MRI can provide further information that will enable the doctor to properly and expediently manage the case.
As a practitioner of manual medicine, via chiropractic care, the spine is not the only joint or tissue area that I address. According to a 2006 National Health Interview Survey, approximately 30 percent of adults reported experiencing some form of joint pain during the previous 30 days, and knee pain was a leading complaint.

When infection or other presentation (that needs a more critical care approach) is ruled out, my job is to sort out which structure(s) are the pain generators. It is important to consider the body’s kinetic chains that can fall victim to a sequence of events involving tissues along a line of tension that are necessary to complete a task (such as throwing a ball, completing a golf or tennis stroke, or simply walking). Think of the muscles and other tissues at the back of your foot and ankle. They don’t just stop there; they continue northward up the calf to the thigh and buttock and back. This is why just treating the area of pain may prove frustrating and, in a number of situations, futile. For example, if one is suffering with pain on the medial, or inside of the knee, it may be as a result of a direct trauma, or, possibly due to a deep buttock muscle group known as the external hip rotators being overly tightened and not allowing the femur (thigh bone) rotate properly, causing stress on the knee area. Also, hyper-pronation of the foot can lead to internal rotation or twisting of the lower leg bone named the tibia, and lead to significant stress on the medial meniscus of the knee joint. The iliotibial band on the lateral side of the knee may also be affected. The point is that there are connected “chains” that are only as strong as there weakest link. The problem sometimes is that our bodies are excellent at compensating for movement deficiencies (to a point) and convince us to ignore it until it becomes unbearable or activity preventing.
So, what do you do for your knee? As I have often stated in previous articles, there first is a need to take responsibility for the things you have control over and:

1. Assess the pain and recount what the possible mechanism of injury is to rule out need for meds or other crisis care (think gout, infection or torn ligaments).
2. Have a chiropractic examination to determine restrictions around the knee as well as along the kinetic chains involved, including up to the pelvis and spine. The surrounding fascia should be examined as well. Also, determine if there are any weak or inhibited muscles involved.
3. Fix the restrictions to diminish or resolve the pain, increase the range of motion and then engage (via electric stimulation or exercise if possible) any weak muscles to strengthen.

Now, as you get back to your regular activities, go slowly and “test the waters” so that you can perform the movements that you desire dialed back several notches (think slow moving Tai Chi versus all out Tai Kwan Do). As we reach that “onset of maturity” phase of our lives, it makes good sense to warm up with very slow golf or tennis swings or even sweeping and vacuuming motions to prepare your body for the impending increased demands even before any injury.  So, slow down before going all out, stretch and hydrate well and remember your kinetic chain…..it’s only as strong as your weakest link!

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.