My aching shoulder!

Shoulder pain is one of the most common non-spinal injury I see in my office.  What I hear a lot of as your Chiropractor in the Woodbridge, Dale City VA area is the patient can’t raise their arm like before.  Most times it is noticed when they go to comb your hair or put on a jacket.  Adhesive capsulitis is usually the cause but biceps tendonitis can’t be overlooked.  Especially in athletic patients.

 

Biceps Tendinitis

Biceps tendinitis is an inflammation or irritation of the upper biceps tendon. Also called the long head of the biceps tendon, this strong, cord-like structure connects the biceps muscle to the bones in the shoulder.

Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis. They can often be relieved with rest and medication. In severe cases, surgery may be needed to repair the tendon.

 

Anatomy

Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).

 

Biceps tendons

The biceps tendons attach the biceps muscle to the shoulder bone.

Glenoid. The head of your upper arm bone fits into the rounded socket in your shoulder blade. This socket is called the glenoid. The glenoid is lined with soft cartilage called the labrum. This tissue helps the head of the upper arm fit into the shoulder socket.

Rotator cuff. A combination of muscles and tendons keeps your arm centered in your shoulder socket. These tissues are called the rotator cuff. They cover the head of your upper arm bone and attach it to your shoulder blade.

Biceps tendons. The biceps muscle is in the front of your upper arm. It has two tendons that attach it to bones in the shoulder. The long head attaches to the top of the shoulder socket (glenoid).

The short head of the biceps tendon attaches to a bump on the shoulder blade called the coracoid process.

 

Description

Biceps tendinitis is inflammation of the long head of the biceps tendon. In its early stages, the tendon becomes red and swollen. As tendinitis develops, the tendon sheath (covering) can thicken. The tendon itself often thickens or grows larger.

The tendon in these late stages is often dark red in color due to the inflammation. Occasionally, the damage to the tendon can result in a tendon tear, and then deformity of the arm (a “Popeye” bulge in the upper arm).

Biceps tendinitis usually occurs along with other shoulder problems. In most cases, there is also damage to the rotator cuff tendon. Other problems that often accompany biceps tendinitis include:

 

Arthritis of the shoulder joint

Tears in the glenoid labrum

Chronic shoulder instability (dislocation)

Shoulder impingement

Other diseases that cause inflammation of the shoulder joint lining

 

Cause

In most cases, damage to the biceps tendon is due to a lifetime of normal activities. As we age, our tendons slowly weaken with everyday wear and tear. This degeneration can be worsened by overuse — repeating the same shoulder motions again and again.

Many jobs and routine chores can cause overuse damage. Sports activities — particularly those that require repetitive overhead motion, such as swimming, tennis, and baseball — can also put people at risk for biceps tendinitis.

Repetitive overhead motion may play a part in other shoulder problems that occur with biceps tendinitis. Rotator cuff tears, osteoarthritis, and chronic shoulder instability are often caused by overuse.

 

Symptoms

Pain or tenderness in the front of the shoulder, which worsens with overhead lifting or activity

Pain or achiness that moves down the upper arm bone

An occasional snapping sound or sensation in the shoulder

 

Nonsurgical Treatment

Biceps tendinitis is typically first treated with simple methods.

Rest. The first step toward recovery is to avoid activities that cause pain.

Ice. Apply cold packs for 20 minutes at a time, several times a day, to keep swelling down. Do not apply ice directly to the skin.

Nonsteroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling.

Steroid injections. Steroids such as cortisone are very effective anti-inflammatory medicines. Injecting steroids into the tendon can relieve pain. Your doctor will use these cautiously. In rare circumstances, steroid injections can further weaken the already injured tendon, causing it to tear.

Chiropractic/Physical therapy. Specific stretching and strengthening exercises can help restore range of motion and strengthen your shoulder.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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The pain in my neck is giving me a headache!

As your chiropractor in the Woodbridge, Dale City VA area headaches are a very common problem that I see.  Most times the headaches are associated with some type of neck pain.  This is the type of headache that responds very well to chiropractic care.

Neck pain and headaches are linked more often than you would think.  Most people think they have a headache and it is local to the head.  Further investigation could find the cause being your neck.  There are two major types of headaches:  Migraines (which we all seem to know about) and cervicogenic.   Most people assume a really bad headache is just a migraine.  This isn’t always the case and more often than not the headache is coming from the upper neck region.  This is the reason migraine medication doesn’t work on these headaches.

Getting the headaches properly diagnosed will help people properly treat them.  I see tons of patients who come in with “migraines.”  They explain the entire headache.  It starts in the back of my neck then shoots into my head.  By this point they are taking their medication but it never seems to work.  Then they sit in a dark room and try and ride out the “migraine.”

Visiting Doroski Chiropractic Neurology in Woodbridge VA is a great place to start to get the headaches properly diagnosed.  If that isn’t possible check out a local chiropractor who can help you properly diagnose the headache.   The headache could be what is called a cervicogenic headache.  Sound scary but it is treatable and generally chiropractic care is the place to begin.

By definition a cervicogenic headache is any headache which is caused by the neck. The term ‘cervicogenic’ simply refers the cervical area, which is a part of your spine located right near the base of the skull. The pain of cervicogenic headache is usually unilateral; it originates in the neck and then spreads to the oculofrontal-temporal areas of the head. The headache initially presents as intermittent episodes and then progresses to an almost continuous pain. Pain may be triggered or exacerbated by neck movement or a particular neck position; it can also be triggered by applying pressure over the ipsilateral upper part of the back of the neck or the ipsilateral occipital region.   If this sounds like your headache visiting a Doroski Chiropractic Neurology in Woodbridge Virginia may help.

There are some simple things you can do at home to help prevent the headaches if you can’t get to a chiropractor.

Relaxation

Heat or cool the head and neck

Mobilizing

Postural exercise

Improve your computer work station ergonomics (see our tips on this in other blogs at doroskichiropractic.com)

Of course if the headaches are severe enough and none of your home therapies are working do not hesitate to contact your Doctor.  Headaches could be a symptom of a more serious problem and your Doctor will be able to do further testing or imaging to rule out more serious conditions.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Kids and Sports!

With all the sports off the table right now it doesn’t mean they won’t return.  So, in this time of limbo it is still good for kids to stay in shape for the return of their beloved sports!  Us old people are dealing with injuries we experienced as kids, so take some of that wisdom and apply it to them.  Here are some pretty solid tips from your Woodbridge, Dale City VA chiropractor to help you help them.

The majority, if not all, sports are good, provided that the child prepares appropriately,” says Timothy Ray, DC, a member of the American Chiropractic Association’s Council on Sports Injuries and Physical Fitness. “Without proper preparation, playing any sport can turn into a bad experience. There are structural and physical developmental issues that need to be taken into consideration before children undertake certain sports.”

Highly competitive sports such as football, gymnastics and wrestling follow rigorous training schedules that can be potentially dangerous to an adolescent or teenager. The best advice for parents who have young athletes in the family is to help them prepare their bodies and to learn to protect themselves from sports related injuries before they happen.

“Proper warm up, stretching and strength-training exercises are essential for kids involved in sports, but many kids learn improper stretching or weight-lifting techniques, making them more susceptible to injury,” says Steve Horwitz, DC, an ACA member from Silver Spring, Md., and former member of the U.S. Summer Olympic medical team. “Parents need to work with their kids and make sure they receive the proper sports training.”

“Young athletes should begin with a slow jog as a general warm-up, followed by a sport-specific warm-up. They should then stretch all the major muscle groups,” says Dr. Horwitz. “Kids need to be instructed in appropriate exercises for each sport to prevent injuries.”

Proper nutrition and hydration are also extremely vital. “While an ordinary person may need to drink eight to 10 8-ounce glasses of water each day, athletes need to drink even more than that for proper absorption. Breakfast should be the most important meal of the day. Also, eating a healthy meal two to four hours before a practice or a game and another within one to two hours after a game or practice allows for proper replenishment and refuels the body,” adds Dr. Horwitz.

Young athletes today often think they are invincible. The following tips can help ensure your child does not miss a step when it comes to proper fitness, stretching, training and rest that the body needs to engage in sporting activities.

Encourage your child to:

Wear the proper equipment. Certain contact sports, such as football and hockey, can be dangerous if the equipment is not properly fitted. Make sure all equipment, including helmets, pads and shoes fit your child or adolescent. Talk to your child’s coach or trainer if the equipment is damaged.

Eat healthy meals. Make sure your young athlete is eating a well-balanced diet and does not skip meals. Avoid high-fat foods, such as candy bars and fast food. At home, provide fruit rather than cookies, and vegetables rather than potato chips.

Maintain a healthy weight. Certain sports, such as gymnastics, wrestling and figure skating, may require your young athlete to follow strict dietary rules. Be sure your child does not feel pressured into being too thin and that he/she understands that proper nutrition and caloric intake is needed for optimal performance and endurance.

Drink water. Hydration is a key element to optimal fitness. Teenage athletes should drink at least eight 8-ounce glasses of water a day. Younger athletes should drink five to eight 8-ounce glasses of water.

Drink milk. Make sure your child has enough calcium included in his/her diet. For children over 2 years of age, ACA recommends 1 percent or skim milk rather than whole milk. Milk is essential for healthy bones and reduces the risk of joint and muscle related injuries.

Avoid sugar-loaded, caffeinated and carbonated drinks. Sports drinks are a good source of replenishment for those kids engaged in long duration sports, such as track and field.

Follow a warm-up routine. Be sure your child or his/her coach includes a warm-up and stretching session before every practice, game or meet. A slow jog, jumping rope and/or lifting small weights reduces the risk of torn or ripped muscles. Flexibility is key when pushing to score that extra goal or make that critical play.

Take vitamins daily. A multi-vitamin and Vitamin C are good choices for the young athlete. Vitamin B and amino acids may help reduce the pain from contact sports. Thiamine can help promote healing. Also consider Vitamin A to strengthen scar tissue.

Avoid trendy supplements. Kids under the age of 18 should avoid the use of performance-enhancing supplements, such as creatine. Instead, they should ask their coach or trainer to include weekly weight training and body-conditioning sessions in their workout.

Get plenty of rest. Eight hours of sleep is ideal for the young athlete. Lack of sleep and rest can decrease performance. Sluggishness, irritability and loss of interest could indicate that your child is fatigued.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Bored… Go rake some leaves!

Yep we have reached this level of quarantine boredom… leaf raking.  We all know this would never take place but here we are.   Your Woodbridge, Dale City VA chiropractors has a few tips to help you do it safely!

Just as playing football or golf can injure your body, the twisting, turning, bending, and reaching of mowing and raking can also cause injury if your body is not prepared. Like an athlete, if you leap into something without warming up or knowing how to do it, the chances of injury are greater.

What Can You Do?

The American Chiropractic Association (ACA) offers the following tips to help prevent the needless pain yard work may cause.

Do stretching exercises, without bouncing, for a total of 10 to 15 minutes spread over the course of your work. Do knee-to-chest pulls, trunk rotations, and side bends with hands above your head and fingers locked. Take a short walk to stimulate circulation. When finished with the yard work, repeat the stretching exercises.

Stand as straight as possible, and keep your head up as you rake or mow.

When it’s still warm outside, avoid the heat. If you’re a morning person, get the work done before 10 a.m. Otherwise, do your chores after 6 p.m.

Wear supportive shoes. Good foot and arch support can stop some of the strain from affecting your back.

When raking, use a “scissors” stance: right foot forward and left foot back for a few minutes, then reverse, putting your left foot forward and right foot back.

Bend at the knees, not the waist, as you pick up piles of leaves or grass from the grass catcher. Make the piles small to decrease the possibility of back strain.

When mowing, use your whole bodyweight to push the mower, rather than just your arms and back.

If your mower has a pull cord, don’t twist at the waist or yank the cord. Instead, bend at the knees and pull in one smooth motion.

Drink lots of water, wear a hat, shoes and protective glasses. And, to avoid blisters, try wearing gloves. If your equipment is loud, wear hearing protection. If you have asthma or allergies, wear a mask.

Try ergonomic tools, too. They’re engineered to protect you when used properly.

If you do feel soreness or stiffness in your back, use ice to soothe the discomfort. If there’s no improvement in two or three days, see your local doctor of chiropractic.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Carpal Tunnel Injury

This blog is for all of you who have turned their kitchen table into a workstation for the time being.  Or the ones rolled into a couch with a laptop.  Either way be careful of those wrist angles and long periods of use.  Your Woodbridge, Dale City VA Chiropractor has some information on the most common wrist injury.

CTS typically occurs in adults, with women 3 times more likely to develop it than men. The dominant hand is usually affected first, and the pain is typically severe. CTS is especially common in assembly-line workers in manufacturing, sewing, finishing, cleaning, meatpacking, and similar industries. Contrary to the conventional wisdom, according to recent research, people who perform data entry at a computer (up to 7 hours a day) are not at increased risk of developing CTS.

What Is CTS?

CTS is a problem of the median nerve, which runs from the forearm into the hand. CTS occurs when the median nerve gets compressed in the carpal tunnel—a narrow tunnel at the wrist—made up of bones and soft tissues, such as nerves, tendons, ligaments, and blood vessels. The compression may result in pain, weakness, and/or numbness in the hand and wrist, which radiates up into the forearm. CTS is the most common of the “entrapment neuropathies”—compression or trauma of the body’s nerves in the hands or feet.

What Are the Symptoms?

Burning, tingling, itching, and/or numbness in the palm of the hand and thumb, index, and middle fingers are most common. Some people with CTS say that their fingers feel useless and swollen, even though little or no swelling is apparent. Since many people sleep with flexed wrists, the symptoms often first appear while sleeping. As symptoms worsen, they may feel tingling during the day. In addition, weakened grip strength may make it difficult to form a fist or grasp small objects. Some people develop wasting of the muscles at the base of the thumb. Some are unable to distinguish hot from cold by touch.

Why Does CTS Develop?

Some people have smaller carpal tunnels than others, which makes the median nerve compression more likely. In others, CTS can develop because of an injury to the wrist that causes swelling, over-activity of the pituitary gland, hypothyroidism, diabetes, inflammatory arthritis, mechanical problems in the wrist joint, poor work ergonomics, repeated use of vibrating hand tools, and fluid retention during pregnancy or menopause.

How Is It Diagnosed?

CTS should be diagnosed and treated early. A standard physical examination of the hands, arms, shoulders, and neck can help determine if your symptoms are related to daily activities or to an underlying disorder.

Your doctor of chiropractic can use other specific tests to try to produce the symptoms of carpal tunnel syndrome.  The most common are:

Pressure-provocative test. A cuff placed at the front of the carpal tunnel is inflated, followed by direct pressure on the median nerve.

Carpal compression test. Moderate pressure is applied with both thumbs directly on the carpal tunnel and underlying median nerve at the transverse carpal ligament. The test is relatively new.

Laboratory tests and x-rays can reveal diabetes, arthritis, fractures, and other common causes of wrist and hand pain. Sometimes electrodiagnostic tests, such as nerveconduction velocity testing, are used to help confirm the diagnosis. With these tests, small electrodes, placed on your skin, measure the speed at which electrical impulses travel across your wrist. CTS will slow the speed of the impulses and will point your doctor of chiropractic to this diagnosis.

What Is the CTS Treatment?

Initial therapy includes:

Resting the affected hand and wrist

Avoiding activities that may worsen symptoms

Immobilizing the wrist in a splint to avoid further damage from twisting or bending

Applying cool packs to help reduce swelling from inflammations

Some medications can help with pain control and inflammation. Studies have shown that vitamin B6 supplements may relieve CTS symptoms.

Chiropractic joint manipulation and mobilization of the wrist and hand, stretching and strengthening exercises, soft-tissue mobilization techniques, and even yoga can be helpful. Scientists are also investigating other therapies, such as acupuncture, that may help prevent and treat this disorder.

Occasionally, patients whose symptoms fail to respond to conservative care may require surgery. The surgeon releases the ligament covering the carpal tunnel. The majority of patients recover completely after treatment, and the recurrence rate is low. Proper posture and movement as instructed by your doctor of chiropractic can help prevent CTS recurrences.

How Can CTS Be Prevented?

The American Chiropractic Association recommends the following tips:

Perform on-the-job conditioning, such as stretching and light exercises.

Take frequent rest breaks.

Wear splints to help keep the wrists straight.

Use fingerless gloves to help keep the hands warm and flexible.

Use correct posture and wrist position.

To minimize workplace injuries, jobs can be rotated among workers. Employers can also develop programs in ergonomics—the process of adapting workplace conditions and job demands to workers’ physical capabilities.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Don’t stop exercising!!!!

Now that all the gyms in town are closed you need to find home ways to work out.  One of the easiest ways to stay fit during this time is running.  Having a good running shoe can make the difference between an enjoyable experience and a horrible experience.  Your Woodbridge, Dale City VA chiropractor has some pretty solid information to help you decide which pair is good for you.

How to Select Athletic Shoes

Too many people choose fashion over function when purchasing athletic shoes, not realizing that poor-fitting shoes can lead to pain throughout the body. Because footwear plays such an important role in the function of bones and joints—especially for runners and other athletes—choosing the right shoe can help prevent pain in your back, hips, knees, and feet.

Unfortunately, there is no such thing as the very best athletic shoe—every pair of feet is different, every shoe has different features, and overall comfort is a very personal decision. For this reason, it is recommended that you first determine your foot type: normal, flat, or high-arched.

The Normal Foot

Normal feet have a normal-sized arch and will leave a wet footprint that has a flare, but shows the forefoot and heel connected by a broad band. A normal foot lands on the outside of the heel and rolls slightly inward to absorb shock.

Best shoes: Stability shoes with a slightly curved shape.

The Flat Foot

This type of foot has a low arch and leaves a print that looks like the whole sole of the foot. It usually indicates an over-pronated foot—one that strikes on the outside of the heel and rolls excessively inward (pronates). Over time, this can cause overuse injuries.

Best shoes: Motion-control shoes or high-stability shoes with firm midsoles. These shoes should be fairly resistant to twisting or bending. Stay away from highly cushioned, highly curved shoes, which lack stability features.

The High-Arched Foot

The high-arched foot leaves a print showing a very narrow band—or no band at all—between the forefoot and the heel. A curved, highly arched foot is generally supinated or under-pronated. Because the foot doesn’t pronate enough, usually it’s not an effective shock absorber.

Best shoes: Cushioned shoes with plenty of flexibility to encourage foot motion. Stay away from motion-control or stability shoes, which reduce foot mobility.

When determining your foot type, consult with your doctor of chiropractic. He or she can help determine your specific foot type, assess your gait, and then suggest the best shoe match.

Shoe Purchasing Tips

Consider the following tips before you purchase your next pair of athletic shoes:

 

  • Match the shoe to the activity. Select a shoe specific for the sport in which you will participate. Running shoes are primarily made to absorb shock as the heel strikes the ground. In contrast, tennis shoes provide more side-to-side stability. Walking shoes allow the foot to roll and push off naturally during walking, and they usually have a fairly rigid arch, a well-cushioned sole, and a stiff heel support for stability.
  • If possible, shop at a specialty store. It’s best to shop at a store that specializes in athletic shoes. Employees at these stores are often trained to recommend a shoe that best matches your foot type (shown above) and stride pattern.
  • Shop late in the day. If possible, shop for shoes at the end of the day or after a workout when your feet are generally at their largest. Wear the type of socks you usually wear during exercise, and if you use orthotic devices for postural support, make sure you wear them when trying on shoes.
  • Have your feet measured every time. It’s important to have the length and width of both feet measured every time you shop for shoes, since foot size often changes with age and most people have 1 foot that is larger than the other. Also, many podiatrists suggest that you measure your foot while standing in a weight bearing position because the foot elongates and flattens when you stand, affecting the measurement and the fit of the shoe.
  • Make sure the shoe fits correctly. Choose shoes for their fit, not by the size you’ve worn in the past. The shoe should fit with an index finger’s width between the end of the shoe and the longest toe. The toe box should have adequate room and not feel tight. The heel of your foot should fit snugly against the back of the shoe without sliding up or down as you walk or run. If possible, keep the shoe on for 10 minutes to make sure it remains comfortable.

How Long Do Shoes Last?

Once you have purchased a pair of athletic shoes, don’t run them into the ground. While estimates vary as to when the best time to replace old shoes is, most experts agree that between 300 and 500 miles is optimal. In fact, most shoes should be replaced even before they begin to show signs of moderate wear. Once shoes show wear, especially in the cushioning layer called the midsole, they also begin to lose their shock absorption. Failure to replace worn shoes is a common cause of injuries like shin splints, heel spurs, and plantar fasciitis.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Do I need a back brace?

Should I be using a back brace?  As your Woodbridge, Dale City VA chiropractor I hear this from a lot of patients once they recover from an injury.  There is no one size fits all answer.  It is really based on the type of injury and the types of activities.

So let me give you some background on back braces and do they really help.

The truth is that wearing an elastic or other support around your waist to help your back may be both good and bad.  And whether wearing such a back belt will prevent back problems is controversial.  A new study that found workers who routinely wear these support belts while working at Wal-Mart, were just as likely to injure their backs as those who did not.(1)  However, some previous studies have shown back belts to prevent injuries, such as the UCLA study conducted with Home Depot workers, which found a 1/3 decrease in back injuries due to wearing back belts.(2)

Let’s look at the scientific evidence about whether back belts might help to support the back, whether there are any risks associated with wearing them, and whether such belts should be recommended or not.

How might back belts help to support the back?  They do not hold the back in, as many presume. Back belts function primarily to hold the stomach in, thus increasing intra-abdominal pressure.  This has led some to refer to these belts as abdominal belts rather than as back belts.  But how does increasing intra-abdominal pressure support the spine?  We will briefly review the intra-abdominal balloon theory and a more modern theory.

Intra-Abdominal Balloon Mechanism

It was originally proposed by Bartelink in 1957 that increased intra-abdominal pressure would decrease the compressive load on the spine through the intra-abdominal balloon mechanism.(3)  To begin with, you must think of the abdominal cavity and the abdominal organs as a squishy liquid.  Then realize that the abdominal cavity becomes a closed chamber when we bear down and hold our breath, which we instinctively do when we lift heavy things.  This chamber is closed on the bottom by the anal sphincter and on the top by the diaphragm.  When bearing down, the abdominal contents tend to push outwards.  But if we contract our deep abdominal muscles—the obliques and the transverse abdominus muscles—or we wear a thick belt, the abdominal contents are forced upwards rather than outwards.(4 p.109)  This theoretically provides a decompressive effect on the lumbar spine.  Since the crura of the diaphragm is attached to the first 3 lumbar vertebrae, when the diaphragm is pushed upwards, it exerts a traction force on the lower lumbar spine (L4 and L5).  It was also theorized that since this balloon mechanism makes the spine more rigid, it would decrease the amount of work required of the erector muscles to prevent us from falling forwards.   Kapanji estimated that this abdominal support mechanism acts to reduce compression forces on the L5/S1 disc by 30% and reduces the force required by the erector spinae muscles by 55%. (4, p.198).

But more recent scientific evidence fails to support some of these theoretical assumptions.  Such recent studies reveal that an increase in intra-abdominal pressure actually results in an increase (rather than a decrease) in compressive force on the lower spine.(5,6) And there is no decrease in the amount of work required of the lower back muscles.(7)  However, by stiffening the trunk, increased intra-abdominal pressure may prevent the tissues in the spine from strain or failure from buckling.  Such intra-abdominal pressure may also act to reduce anterior-posterior shear loads.(8)  In other words, support for the spine is provided, without reducing compression to any appreciable degree.

Belts may also help to protect the spine by limiting the range of motion that occurs when bending or twisting, though this effect is less than expected.(9,10)  However, since when the spine bends more, it is more vulnerable to injury, if these belts reduce extreme bending at all, they may be beneficial.

Are there any risks associated with wearing a back belt?

The main risk associated with wearing a back belt is that during the period of wearing it, the supportive spinal muscles—the deep abdominal and back muscles—that normally support your spine will become weaker.  These muscles are less active while your spine is being artificially supported by the belt.  Muscles need to be consistently exercised in order to stay strong.  If these muscles become weaker, when you stop wearing the belt, you may be more likely to hurt your back.  And at least one study seems to suggest this.  In this study, there was an increase in the number and severity of back injuries following a period of belt wearing.(11)

Another risk associated with wearing a back belt is that it causes an increase in both blood pressure and heart rate.(12)  This may pose a problem for those individuals with existing cardiovascular disease or risk factors, such as hypertension.

A third risk associated with wearing a back belt is that workers may be inclined to lift heavier objects while wearing them.  These belts may be giving workers a false sense of security.  This could result in an increased risk of injury.

REFERENCES:

Wassell JT, Gardner LI, Landsittel DP, Johnston JJ, Johnston JM.   A prospective study of back belts for prevention of back pain and injury.  JAMA.  2000; 284(21): 2727-32.

McIntyre DR; Bolte KM; Pope MH. Study provides new evidence of back belts’ effectiveness. Occup Health Saf.  1996; 65(12): 39-41.

Bartelink DL, “The Role of Abdominal Pressure in Relieving Pressure on the Lumbar Intervertebral Discs,” J Bone Joint Surg, (Br) 1957, 39B: 718-725.

Kapanji, IA. The Physiology of the Joints, Vol. III.

McGill SM, Norman RW.  Reassessment of the role of intra-abdominal pressure in spinal compression.    Ergonomics. 1987; 30: 1565-1588.

Nachemson AL, Anderson GBJ, Schultz AB. Valsalva maneuver biomechanics. Effects on lumbar spine trunk loads  of elevated intrabdominal pressures. Spine. 1986; 11: 476-479.

McGill S, Norman RW, Sharatt MT. The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics. 1990; 33:147-160.

McGill S. Abdominal belts in industry: A position paper on their assets, liabilities and use. Am Ind. Hyg. Assoc. J. 1993; 54(12): 752-754.

Lantz SA, Schultz AB. Lumbar spine orthosis wearing I. Restriction of gross body motion. Spine. 1986; 11: 834-837.

McGill SM, Sequin JP, Bennett G. Passive stiffness of the lumbar torso in flexion, extension, lateral bend and axial twist: The effect of belt wearing and breath holding. Spine. 1994; 19(19): 2190-2196.

Reddell CR, Congleton JJ, Huchinson RD, Mongomery JF. An evaluation of a weightlifting belt and back injury prevention training class for airline baggage handlers. Appl. Ergonomics. 1992; 23: 319-329.

Hunter GR, McGuirk J, Mitrano N, et al. The effects of a weight training belt on blood pressure during exercise. J Appl Sport Sci Res. 1989; 3: 13-18.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Maplink

What is Sciatica?

Sciatica is one of those terms I hear from patients all the time as your Woodbridge, Dale City VA Chiropractor.  It is fairly generic for any pain into the leg.  Dr Google has helped with that overuse of the term.  To help you better understand sciatica and what it is here is some information.  Unfortunately, I am only helping Dr Google but these are the facts.

Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.

Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.

Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.

What are the symptoms of sciatica?

The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.

Some patients also report:

  • A pins-and-needles sensation, most often in the toes or foot
  • Numbness or muscle weakness in the affected leg or foot

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.

How is sciatica diagnosed?

Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.

In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.

What are my treatment options?

For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.

Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.

 

An Ounce of Prevention Is Worth a Pound of Cure

While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.

 

  • Maintain a healthy diet and weight
  • Exercise regularly
  • Maintain proper posture
  • Avoid prolonged inactivity or bed rest
  • If you smoke, seek help to quit
  • Use good body mechanics when lifting

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Scoliosis information

I see tons of patients with scoliosis as your Woodbridge, Dale City VA Chiropractor.  Even though it is a common finding there is still a lot of questions about it.  One thing is almost everyone has a slight scoliosis because your heart is in the way.  But for those of you with a different type here is some information.

What is scoliosis?

Because we walk on 2 feet, the human nervous system constantly works through reflexes and postural control to keep our spine in a straight line from side to side. Occasionally, a lateral (sideways) curvature develops. If the curvature is larger than 10 degrees, it is called scoliosis. Curves less than 10 degrees are often just postural changes. Scoliosis can also be accompanied by lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back). In most cases, the vertebrae are also rotated.

In more than 80% of cases, the cause of scoliotic curvatures is unknown; we call this condition idiopathic scoliosis. In other cases, trauma, neurological disease, tumors, and the like are responsible. Functional scoliosis is often caused by some postural problem, muscle spasm, or leg-length inequality, which can often be addressed. Structural scoliosis does not reduce with postural maneuvers. Either type can be idiopathic or have an underlying cause.

What are the symptoms of scoliosis?

Scoliosis can significantly affect the quality of life by limiting activity, causing pain, reducing lung function, or affecting heart function. Diminished self-esteem and other psychological problems are also seen. Because scoliosis occurs most commonly during adolescence, teens with extreme spinal deviations from the norm are often teased by their peers.

Fortunately, 4 out of 5 people with scoliosis have curves of less than 20 degrees, which are usually not detectable to the untrained eye. These small curves are typically no cause for great concern, provided there are no signs of further progression. In growing children and adolescents, however, mild curvatures can worsen quite rapidly—by 10 degrees or more—in a few months. Therefore, frequent checkups are often necessary for this age group.

How is scoliosis evaluated?

Evaluation begins with a thorough history and physical examination, including postural analysis. If a scoliotic curvature is discovered, a more in-depth evaluation is needed. This might include a search for birth defects, trauma, and other factors that can cause structural curves.

Patients with substantial spinal curvatures very often require an x-ray evaluation of the spine. The procedure helps determine the location and magnitude of the scoliosis, along with an underlying cause not evident on physical examination, other associated curvatures, and the health of other organ systems that might be affected by the scoliosis. In addition, x-rays of the wrist are often performed. These films help determine the skeletal age of the person, to see if it matches an accepted standard, which helps the doctor determine the likelihood of progression. Depending on the scoliosis severity, x-rays may need to be repeated as often as every 3 to 4 months to as little as once every few years.

Other tests, including evaluation by a Scoliometer™, might also be ordered by the doctor. This device measures the size, by angle, of the rib hump associated with the scoliosis. It is non-invasive, painless, and requires no special procedures. A Scoliometer™ is best used as a guide concerning progression in a person with a known scoliosis—not as a screening device.

Is scoliosis always progressive?

Generally, it is not. In fact, the vast majority of scolioses remains mild, is not progressive, and requires little treatment, if any.

In one group of patients, however, scoliosis is often more progressive. This group is made up of young girls who have scolioses of 25 degrees or larger, but who have not yet had their first menstrual period. Girls generally grow quite quickly during the 12 months before their first period and if they have scolioses, the curvatures tend to progress rapidly. In girls who have already had their first periods, the rate of growth is slower, so their curves tend to progress more slowly.

What is the treatment for scoliosis?

There are generally three treatment options for scoliosis—careful observation, bracing, and surgery. Careful observation is the most common “treatment,” as most mild scoliosis do not progress and cause few, if any, physical problems. Bracing is generally reserved for children who have not reached skeletal maturity (the time when the skeleton stops growing), and who have curves between 25 and 45 degrees. Surgery is generally used in the few cases where the curves are greater than 45 degrees and progressive, and/or when the scoliosis may affect the function of the heart, lungs, or other vital organs.

Spinal manipulation, therapeutic exercise, and electrical muscle stimulation have also been advocated in the treatment of scoliosis. None of these therapies alone has been shown to consistently reduce scoliosis or to make the curvatures worse. For patients with back pain along with the scoliosis, manipulation and exercise may be of help.

Most people with scoliosis lead normal, happy, and productive lives. Physical activity including exercise is generally well-tolerated and should be encouraged in most cases.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Ankle Injuries!

I have been seeing a few of those horrible looking boots in my office.  The one you get to stabilize and ankle injury.  My biggest concern is the boot being thicker than your shoe and the boot screwing up your low back.  Of course, those are on people who are being treated for an ankle injury.  For those of you who are going it alone, much like your Woodbridge, Dale City VA Chiropractor would, here is some things that may help you.

Ankle Rehabilitation Program1

As described in Human Locomotion, the following is a sample ankle sprain rehabilitation plan.

Phase 1. The patient is unable to bear weight.

  1. A) Compressive wrap with U-shaped felt balance around fibula. Change every 4 hours.
  2. B) Patient actively abducts/adducts toes for 5 seconds, repeat 10 times.
  3. C) Write out alphabet with toes, 5 times per day.
  4. D) Stationary bike, 15 minutes per day.
  5. E) Ankle rock board performed while seated (off weight-bearing), 30 circles, performed clockwise and counterclockwise 2 times per day. Perform on uninjured ankle while standing for 3 minutes. The standing rock board performed on the uninjured ankle has been shown to increase proprioception in the contralateral limb.
  6. F) Mild Grade 3 and 4 mobilization of the joints of the foot and ankle.

Phase 2. Patient can walk with minimal discomfort, and the sprained ankle has 90 percent full range of motion.

  1. A) Mobilize all stiff joints in the lower extremity and pelvis.
  2. B) Thera-Band exercises in all planes, 3 sets of 25 in each direction.
  3. C) Double-leg and then single-leg heel raises on the involved side, 3 sets of 10 reps, performed 2 times per day.
  4. D) Standing closed-eye balance, 30 seconds, 5 times per day.
  5. E) Standing single-leg ankle rock board, performed for 1 minute, 5 times per day.
  6. F) Closed kinetic chain exercises. (The sprained ankle is positioned securely on the ground while the patient pulls a resistance band forward and to the side. The patient then rotates 180° and the exercise is repeated by extending and abducting the uninvolved limb.)

Phase 3. Patient can hop on involved ankle without pain.

  1. A) Run at 80 percent full speed, avoid forefront touch down.
  2. B) Minitrampoline: 3 sets of 30 jumps forward, backward, and side to side. Begin on both legs, progress to single limb.
  3. C) Plyometrics performed on a 50cm and a 25cm box, positioned one meter apart. Jump from one box to the ground and then to the other box, landing as softly as possible. Perform 3 sets of 5 repetitions.

Resource:

Michaud, T. 2011. Human Locomotion: The Conservative Management of Gait-Related Disorders. Newton Biomechanics.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link