Shoulder and Elbow Injuries in Baseball Players

8 Sep

Overuse injuries in baseball—particularly in the shoulder and elbow—are a significant problem at both amateur and professional levels. Studies have shown that shoulder pain is one of the most common complaints among amateur baseball players, with a prevalence ranging from 13.4% to 20.6% of players. Elbow injuries are also very common and affect from about a fifth to a quarter of all players, with youth players at greater risk. While all position players can develop upper-extremity injuries, these injuries tend to occur more frequently and severely in the dominant arm of pitchers.

Despite advancements in medical management and increased knowledge about preventive care, the rates of shoulder and elbow injuries in baseball players are on the rise. The consequences of these injuries can be significant, leading to time lost from the sport, reduced performance, the need for surgical interventions, and giving up the sport entirely.

Researchers have identified several potential risk factors for shoulder and elbow injuries in baseball players including increased mechanical load (measured by pitch count or training hours), higher pitching velocity, and decreased shoulder range of motion (ROM), particularly in flexion, internal rotation, and horizontal adduction. While the perceived stress of throwing curve balls is thought to increase the risk for arm injury, it’s not currently demonstrated in the data that this is the case. There’s limited evidence that weakness of the shoulder abductors and external rotators can contribute to shoulder pain, as can scapular dysfunction. Despite the clinical emphasis on the role of lower limb and trunk function in injury prevention and rehabilitation, there isn’t much research to support this strategy.

A study that included 60 active young adult baseball players may have uncovered a strategy for preventing upper extremity injuries. In the study, researchers assigned half the players to a stretching group and the other half to a stretching plus manual therapy group with the goal of addressing range of motion deficits between their dominant and non-dominant sides. After a single treatment session, both groups demonstrated improved range of motion (internal rotation, total arc of motion, and horizontal adduction), but the stretching plus manual therapy group experienced greater improvement. Because the loss of motion is a known risk factor for arm-related injuries, the authors reported that this combined approach should be used to prevent future injury.

Chiropractors utilize manual therapies more than any other healthcare profession with goal of breaking up scar tissue and adhesions, promoting circulation to the region to facilitate healing and strengthening of muscles and tendons, and restore normal motion to affected joints.

Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

The Jaw Pain and Neck Pain Connection

7 Sep

Temporomandibular disorders (TMDs) are a common condition characterized by pain and discomfort while chewing. Traditionally, when patients complain of jaw pain, the focus has been on structures like the temporomandibular joint or the masseter muscles. However, there’s a growing body of research suggesting the intimate relationship between the jaw and the neck may be a contributing factor or even the underling cause of a patient’s TMD.

In one study, which included 40 women between 19 and 49 years of age, half of whom had chronic TMD, researchers observed that participants with jaw pain and discomfort were more likely to have neck pain and stiffness that limited their daily activities. Additionally, among the TMD patients, the more jaw muscle tenderness they exhibited, the higher their scores for both TMD- and neck-related disability. The research team observed a similar relationship between tenderness in the upper trapezius (the muscles in the shoulder and neck regions) as well as the temporalis muscles that function to close the jaw, located on the side of the head above the ear extending to the temporomandibular joint. The authors concluded that a significant correlation between neck disability and jaw disability exists and that healthcare providers should consider the neck and its related structures during the evaluation and management of patients with TMD.

These findings are echoed in a July 2022 study that found TMD patients with restricted cervical range of motion experience more severe TMD-related pain and disability than TMD patients with normal cervical range of motion. Another study published the same month found that patients with chronic (lasting longer than three months) TMD were two times more likely to have neck pain than individuals with acute (less than three months) TMD. A study published later that year linked neck pain with increased sensitivity of the masticatory muscles in TMD patients, leading the author to conclude, “In TMD treatment, we should pay attention to and actively relieve neck pain.”

In a study published in October 2021, researchers found that patients with concurrent neck pain and TMD experienced improvements in jaw function following care targeting the cervical spine. A systematic review conducted in 2023 confirmed these findings. The authors cited five studies that supported the application of manual therapies to restore normal movement to the cervical joints can improve pain, pain sensitivity, and function in the jaw. Interestingly, a systematic review published in March 2024 concluded that cervical rehabilitation interventions—such as manual therapies combined with neck-specific exercises—are effective for reducing pain intensity associated with myogenic temporomandibular disorders, which is TMD specifically linked to pain originating in the jaw muscles.

The good news is that doctors of chiropractic are well-versed in managing patients with neck pain as well as TMD using manual therapies and specific exercises to address trigger points in the jaw and neck muscles, as well as to restore normal motion to the temporomandibular joint and cervical spine.

Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Aquatic Exercise for Low Back Pain

7 Sep

Deconditioned and tight muscles are often observed in patients with chronic low back pain and must be addressed for the patient to achieve a satisfactory outcome. Research on physical activity to manage chronic low back pain typically involves land-based exercises— like brisk walks or cycling, for example—but what about aquatic exercises? Do water-based exercises have a place in chronic back pain management?

In January 2024, researchers conducted a systematic review and meta-analysis that included data concerning 524 chronic low back pain patients from 15 studies who participated in either water- or land-based exercise intervention, or they had been assigned to a waiting list to serve as a non-active control group. Their analysis revealed that participants in both exercise groups experienced significant improvements in pain intensity when compared with the non-active patients. Those in the water- and land-based groups also reported similar improvements with respect to low back pain-related disability and flexibility that were not evident in the control group. Ultimately, the authors concluded that aquatic exercise is as effective as land-based options for managing chronic low back pain.

For those who find land-based exercises challenging—especially if weight-bearing exercises are too stressful on the joints—aquatic exercise may be a viable option. However, water-based exercise is not just a synonym for swimming laps. There are several forms of water-based exercise available, such as water aerobics, aqua jogging, water walking, aqua Zumba, water yoga, water polo, aqua cycling, pool volleyball, resistance band training, and water tai chi. These various workouts take advantage of buoyancy so there’s less impact on joints, the natural resistance of water for strength training, and the cool-down effect of water on the skin. For individuals who get more enjoyment from group workouts, these exercises are an excellent choice!

In addition to helping manage chronic low back pain, meeting physical fitness guidelines of 150 minutes of moderate- or 75 minutes of vigorous-intensity exercise each week may also reduce the risk for developing chronic low back pain in the first place. Furthermore, patients who recover from chronic low back pain and stay physically active are also less likely to experience a recurring episode. So if traditional exercise like jogging or cycling doesn’t appeal to you and you’d rather spend time in the pool, consider an aquatic exercise routine!

Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Chiropractic Treatment for Lumbar Disk Herniation

10 Dec

The annulus of the intervertebral disk is comprised of tough, dense, and strong cartilaginous fibers that protect the nucleus within, which facilitates the movement of the spine. If the structure of the annulus is compromised, the nucleus can leak into or beyond the annulus, a condition that may be classified as a disk herniation, protrusion, extrusion, or sequestration. In the event a disk herniation in the lumbar spine places pressure on a lumbar nerve root, an individual may feel pain down into the leg, which is called lumbosacral radiculopathy or sciatica. Absence a red flag—infection, fracture, cancer, and cauda equina syndrome (loss of bowel and/or bladder control)—that may necessitate immediate emergency and/or surgical intervention, what treatment approach may best serve a patient with a newly diagnosed lumbar disk herniation?

In 2022, researchers conducted a retrospective cohort study that looked at outcomes of more than 11,000 patients under age 49 with a newly diagnosed lumbar disk herniation, half of whom received initial treatment from a doctor of chiropractic. While the authors of the study note that additional studies are needed, their analysis revealed that lumbar disk herniation patients whose first choice of treatment is chiropractic care are significantly (up to two-times) less likely to undergo lumbar diskectomy in the following two years than disk patients who initially seek out a different healthcare provider.

It should be noted that treatment guidelines generally advise conservative treatment approaches, which include chiropractic care, before consulting with a surgeon. However, another study published in 2022 found that, among a group of 144 patients who underwent back surgery, 60 (41.7%) did not receive any conservative treatment in the six months before their procedure. A 2021 study that looked at questionnaires completed by 3,724 adults revealed that the majority of respondents believe that surgery is always needed for a disk herniation, which is inaccurate.

For the management of a lumbar disk herniation, doctors of chiropractic will typically employ a multimodal approach that includes spinal manipulative therapy, mobilization therapy, soft tissue therapy, and exercise training. Chiropractors may also offer additional services such as traction or non-surgical decompression that can benefit such patients. If the patient does not experience improvement in their pain and disability or their condition worsens, they may be referred to an allied healthcare provider to explore other treatment options.

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Royal Jelly and Stronger Bones

31 Oct

Royal jelly is a milk–like secretion of honeybees that is used to feed the larvae in the honeycomb to facilitate development into drones (males), worker bees (infertile females), and queens (fertile females).  The National Institutes of Health notes that royal jelly consists of water, proteins, amino acids, fatty acids, simple carbohydrates, vitamins, and minerals and the active ingredient that stimulates and modulates larval development is believed to be a series of major royal jelly proteins (MRJP). The substance is harvested from the individual queen bee cells from beehives and is made into topical creams as well as dietary supplements. 

Many people believe royal jelly offers several health-enhancing benefits from slowing the aging process to enhancing the immune system to improving conditions such as diabetes, high cholesterol, asthma, fatigue, hay fever, kidney disease, pancreatitis, PMS, and more. Such claims are not sufficiently substantiated in the literature for firm recommendations to be made. However, as more research is conducted, royal jelly may begin to be recommended in a healthcare setting for one or more conditions. One area that looks promising is the effect royal jelly may have on bone health. 

Osteoporosis is characterized by the depletion of bone mineral mass combined with bone micro-architecture deterioration that results in greater bone fragility leading to increased fracture risk. It’s reported that just a 10% reduction in vertebral bone density can double the risk for fracture. It’s estimated that 10 million adults in the United States have osteoporosis and another 44 million are at serious risk for the condition, thus the importance of identifying strategies to preserve bone mass as people age. 

In a 2021 study, researchers studied the effects of royal jelly protein supplementation on female rats at risk for osteoporosis. After eight weeks, the equivalent of roughly five years of human life, the rats given a royal jelly protein supplement had greater lumbar spine, tibia, and femur bone mineral density and strength than subjects not given the supplement. The authors of the study note that further research is needed to understand the physiological mechanisms behind bone loss suppression associated with royal jelly protein intake. 

If future research supports the benefits of royal jelly protein for preserving bone mass in humans, we may find it being added to lifestyle recommendations for aging adults at risk for osteoporosis such as maintaining a healthy vitamin D status, taking a calcium supplement, eating a healthy diet pattern (like the Mediterranean diet), and engaging in regular weight-bearing exercise.  

Pain Relief Chiropractic

4909 Louise Dr 

Mechanicsburg, PA 17055 

(717) 697-1888

Member of Chiro-Trust.org 

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Cervical Spinal Stenosis and Whiplash Injury

25 Oct

Cervical spinal stenosis (CSS) is a condition characterized by the narrowing of the spaces within the spine through which the spinal cord and the nerves pass. The condition becomes more common with age, affecting 6.8% of adults over age 50 and 9% of those over age 70. While it’s not unusual for a CSS patient to be asymptomatic, a sudden injury to neck tissues can compress, constrict, or injure the spinal cord (or associated nerves) and result in symptoms such as pain, numbness, and/or tingling along the course of that nerve that can affect physical function over time. 

It’s estimated that more than two million Americans sustain a whiplash injury each year, with automobile collisions being the primary cause. In a June 2023 study, researchers used a previously validated three-dimensional model of the human head-neck complex to assess the risk for spinal cord injury with CSS of varying sizes (from 14 mm to 6 mm—a lower number is worse) with rear-impact acceleration of both 1.8 m/s and 2.6 m/s. At the C5-6 level of the cervical spine, which sits toward the bottom of the neck, the stress on the spinal cord was enough to cause injury at both accelerations with a stenosis of 6 mm. However, for the less severe 8 mm stenosis, only 2.6 m/s acceleration applied sufficient forces to injure the spinal cord.  In general, the authors surmised that the narrower the opening for the nerve/spinal cord to pass through, the less force needed to reach the threshold for spinal cord injury. 

Aside from genetics, the risk factors for CSS include cumulative trauma, osteoporosis, cigarette smoking, and degenerative joint disease/osteoarthritis—all of which can affect the ability of the tissues of the neck to absorb the forces stemming from the sudden acceleration and deceleration during a rear-end collision, leading to a potentially more severe injury, which may require a more comprehensive treatment approach to reduce the risk for ongoing, chronic symptoms. The good news is that doctors of chiropractic offer an excellent conservative treatment option for managing both cervical spinal stenosis and whiplash injuries.

While it may not be possible to fully prevent CSS, there are measures one can take to reduce their risk for developing the condition. This includes eating a healthy diet, getting regular weight-bearing exercise, getting good sleep, not smoking, avoiding excessive alcohol intake, and avoiding the risk factors for metabolic syndrome including obesity, hypertension, diabetes, and dyslipidemia. A 2018 study found a link between worse spinal posture and spinal stenosis, so maintaining good posture and getting regular chiropractic care to keep the spine aligned may also lower the risk for CSS!

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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